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首页> 外文期刊>Circulation journal >Regional Differences in Frequency of Warfarin Therapy and Thromboembolism in Japanese Patients With Non-Valvular Atrial Fibrillation　– Analysis of the J-RHYTHM Registry –
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Regional Differences in Frequency of Warfarin Therapy and Thromboembolism in Japanese Patients With Non-Valvular Atrial Fibrillation　– Analysis of the J-RHYTHM Registry –

机译：日本非瓣膜性心房颤动患者华法林治疗和血栓栓塞发生频率的地区差异– J-RHYTHM注册表分析–

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Background: The proportion of patients with atrial fibrillation (AF) treated with anticoagulation varies from country to country. In Japan, little is known about regional differences in frequency of warfarin use or prognosis among patients with non-valvular AF (NVAF). Methods?and?Results: In J-RHYTHM Registry, the number of patients recruited from each of 10 geographic regions of Japan was based on region population density. A total of 7,406 NVAF patients were followed up prospectively for 2 years. At baseline, significant differences in various clinical characteristics including age, sex, type of AF, comorbidity, and CHADS2score, were detected among the regions. The highest mean CHADS2score was recorded in Shikoku. Frequency of warfarin use differed between the regions (P<0.001), with lower frequencies observed in Hokkaido and Shikoku. Baseline prothrombin time international normalized ratio differed slightly but significantly between the regions (P<0.05). On univariate analysis, frequency of thromboembolic events differed among the regions (P<0.001), with the highest rate seen in Shikoku. An inverse correlation was detected between frequency of thromboembolic and of major hemorrhagic events (P=0.062). On multivariate analysis, region emerged as an independent risk for thromboembolism. Conclusions: Thromboembolic risk, frequency of warfarin use, and intensity and quality of warfarin treatment differed significantly between geographic regions of Japan. Region was found to be an independent predictor of thromboembolic events. ( Circ J 2016; 80: 1548–1555)
机译：背景：接受抗凝治疗的房颤患者的比例因国家而异。在日本，对非瓣膜性AF（NVAF）患者使用华法林的频率或预后的区域差异知之甚少。方法和结果：在J-RHYTHM注册中心中，从日本10个地理区域中的每个地区招募的患者人数均基于区域人口密度。总共对7,406名NVAF患者进行了为期2年的随访。基线时，在各地区之间发现了各种临床特征的显着差异，包括年龄，性别，房颤类型，合并症和CHADS 2 得分。在Shikoku中记录了最高CHADS 2 平均值。华法令的使用频率在两个地区之间存在差异（P <0.001），在北海道和四国的使用频率较低。基线凝血酶原时间国际标准化比率在各地区之间略有差异，但差异显着（P <0.05）。在单变量分析中，各地区血栓栓塞事件的发生频率不同（P <0.001），在四国中发生率最高。血栓栓塞发生频率与主要出血事件之间呈负相关（P = 0.062）。在多变量分析中，区域表现为血栓栓塞的独立风险。结论：日本不同地区血栓栓塞风险，华法林使用频率以及华法林治疗强度和质量存在显着差异。发现该区域是血栓栓塞事件的独立预测因子。 （Circ J 2016; 80：1548-1555）

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