title: Predictors for Stroke and Death in Non-Anticoagulated Asian Patients with Atrial Fibrillation: The Fushimi AF Registry.
abstract: BACKGROUND
  Atrial fibrillation (AF) increases the risk of stroke and death. Data on the predictors for stroke and death in 'real-world' AF patients are limited, especially from large prospective Asian cohorts.
  
  
  METHODS
  The Fushimi AF Registry is a community-based prospective survey designed to enroll all AF patients who visited the participating medical institutions in Fushimi-ku, Kyoto, Japan. Follow-up data were available for 3,304 patients (median follow-up period 741 days). We explored the predictors for 'death, stroke, and systemic embolism (SE)' during follow-up in 1,541 patients not receiving oral anticoagulants (OAC) at baseline.
  
  
  RESULTS
  The mean age was 73.1 ± 12.5 years, and 673 (44%) patients were female. The mean CHADS2 and CHA2DS2-VASc scores were 1.76 and 3.08, respectively. Cumulative events were as follows: stroke/SE in 61 (4%) and death in 230 (15%), respectively. On multivariate analysis, advanced age (hazard ratio (HR): 1.68, 95% confidence interval (CI): 1.24-2.29), underweight (body mass index <18.5 kg/m2) (HR: 1.71, 95% CI: 1.25-2.32), previous stroke/SE/transient ischemic attack (HR: 1.70, 95% CI: 1.25-2.30), heart failure (HR: 1.59, 95% CI: 1.17-2.15), chronic kidney disease (HR: 1.53, 95% CI: 1.16-2.02), and anemia (HR: 2.41, 95% CI: 1.78-3.28) were independent predictors for death/stroke/SE. Cumulative numbers of these 6 risk predictors could stratify the incidence of death/stroke/SE in patients without OAC, as well as those with OAC in our registry.
  
  
  CONCLUSIONS
  Advanced age, underweight, previous stroke/SE/transient ischemic attack, heart failure, chronic kidney disease, and anemia were independently associated with the risk of death/stroke/SE in non-anticoagulated Japanese AF patients.
authors.affiliation: Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hamatani
authors.affiliation: Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
authors.forename: Yugo
authors.initials: Y
authors.lastname: Yamashita
authors.affiliation: Department of Arrhythmia, Ijinkai Takeda General Hospital, Kyoto, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Esato
authors.affiliation: Department of Arrhythmia, Ijinkai Takeda General Hospital, Kyoto, Japan.
authors.forename: Yeong-Hwa
authors.initials: YH
authors.lastname: Chun
authors.affiliation: Tsuji Clinic, Kyoto, Japan.
authors.forename: Hikari
authors.initials: H
authors.lastname: Tsuji
authors.affiliation: Division of Translational Research, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Wada
authors.affiliation: Division of Translational Research, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Hasegawa
authors.affiliation: Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Abe
authors.affiliation: University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom.|Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
authors.affiliation: Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Akao
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D044466:Asian People; D001281:Atrial Fibrillation / Q000150:complications* / Q000401:mortality*; D003643:Death; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000209:etiology; D007564:Japan; D008297:Male; D011446:Prospective Studies; D012042:Registries; D051436:Renal Insufficiency, Chronic / Q000209:etiology; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology*
chemical_list: D000925:Anticoagulants