title: Clinical characteristics and outcomes of dialysis patients with atrial fibrillation: the Fushimi AF Registry.
abstract: Atrial fibrillation (AF) is common in dialysis patients. However, clinical characteristics and outcomes of dialysis patients with AF are poorly understood. The Fushimi AF Registry is a community-based prospective survey of AF patients in Japan. Follow-up data were available for 3713 patients with a median follow-up of 2.8 years. We compared clinical characteristics and outcomes between the dialysis group (n = 92; 2.5 %) and others. The dialysis group had more various co-morbidities, with a mean CHADS2score of 2.5, and the rate of warfarin prescription was 38 %. The annual incidence rates of stroke or systemic embolism (SE), major bleeding, and all-cause death in the dialysis group were 4.0, 5.1, and 20.9 per 100 person-years, respectively. There was no significant difference in the incidence rate of stroke/SE between the dialysis group and the non-dialysis group [hazard ratio (HR) 1.74 (95 % confidence interval (CI) 0.74-3.42)]. The incidence rates of major bleeding, all-cause death, and the composite of stroke/SE and all-cause death in the dialysis group were higher than those in the non-dialysis group [major bleeding: HR 3.09 (95 % CI 1.46-5.72), all-cause death: HR 3.51 (95 % CI 2.48-4.81), the composite of stroke/SE and all-cause death: HR 2.99 (95 % CI 2.15-4.05)]. Among dialysis patients, warfarin did not affect major clinical events including stroke/SE, bleeding or all-cause death. Among AF patients, those receiving dialysis showed higher incidence of major bleeding and all-cause death compared with non-dialysis patients, but the risk of stroke/SE was not particularly high.
  
  
  BACKGROUND
  URL: http://www.umin.ac.jp/ctr/index.htm .
authors.affiliation: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Yugo
authors.initials: Y
authors.lastname: Yamashita
authors.affiliation: Department of Cardiology, National Hospital Organization Kyoto Medical Center, 1-1, Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takagi
authors.affiliation: Division of Heart Failure, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hamatani
authors.affiliation: Department of Cardiology, National Hospital Organization Kyoto Medical Center, 1-1, Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan.
authors.forename: Moritake
authors.initials: M
authors.lastname: Iguchi
authors.affiliation: Department of Cardiology, National Hospital Organization Kyoto Medical Center, 1-1, Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan.
authors.forename: Nobutoyo
authors.initials: N
authors.lastname: Masunaga
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: Itoh Hemodialysis Clinic, Kyoto, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Itoh
authors.affiliation: Cardiovascular Division, Toujinkai Hospital, Kyoto, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Nishimura
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, 1-1, Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ogawa
authors.affiliation: Department of Cardiology, National Hospital Organization Kyoto Medical Center, 1-1, Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Abe
authors.affiliation: Department of Cardiology, National Hospital Organization Kyoto Medical Center, 1-1, Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan. akao@kuhp.kyoto-u.ac.jp.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Akao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D002423:Cause of Death; D015897:Comorbidity; D004617:Embolism / Q000453:epidemiology; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012042:Registries; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants
keywords: Atrial fibrillation; Bleeding; Dialysis; Oral anticoagulant; Stroke