title: Incidence of ischemic stroke in Japanese patients with atrial fibrillation not receiving anticoagulation therapy--pooled analysis of the Shinken Database, J-RHYTHM Registry, and Fushimi AF Registry.
abstract: BACKGROUND
  The incidence rate of ischemic stroke in Japanese non-valvular atrial fibrillation (NVAF) patients without anticoagulation therapy remains unclear.
  
  
  RESULTS
  We performed a pooled analysis of 3,588 patients from the Shinken Database (n=1,099), J-RHYTHM Registry (n=1,002), and Fushimi AF Registry (n=1,487) to determine the incidence rate of ischemic stroke in Japanese NVAF patients without anticoagulation therapy. Average patient age was 68.1 years. During the follow-up period (total, 5,188 person-years; average, 1.4 years), 69 patients suffered from ischemic stroke (13.3 per 1,000 person-years; 95% confidence intervals [CI]: 10.5-16.8). The incidence rates of ischemic stroke were 5.4, 9.3, and 24.7 per 1,000 person-years and 5.3, 5.5, and 18.4 per 1,000 person-years in patients with low (0), intermediate (1), and high (≥ 2) CHADS2 and CHA2DS2-VASc scores, respectively. History of ischemic stroke or transient ischemic attack (hazard ratio [HR], 3.25; 95% CI: 1.86-5.67), age ≥ 75 years (HR, 2.31; 95% CI: 1.18-4.52), and hypertension (HR, 1.69; 95% CI: 1.01-2.86) were independent risk factors for ischemic stroke.
  
  
  CONCLUSIONS
  A low incidence rate of ischemic stroke was observed in Japanese NVAF patients except for those with CHADS2 score ≥ 2. In this pooled analysis, history of ischemic stroke or transient ischemic attack, advanced age, and hypertension were identified as independent risk factors for ischemic stroke.
authors.affiliation: Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan. sinsuz-tky@umin.ac.jp
authors.forename: Shinya
authors.initials: S
authors.lastname: Suzuki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamashita
authors.forename: Ken
authors.initials: K
authors.lastname: Okumura
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Atarashi
authors.forename: Masaharu
authors.initials: M
authors.lastname: Akao
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ogawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000453:epidemiology; D002545:Brain Ischemia / Q000139:chemically induced / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012042:Registries; D020521:Stroke / Q000139:chemically induced / Q000453:epidemiology
chemical_list: D000925:Anticoagulants