title: Beneficial Effect of Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Nonvalvular Atrial Fibrillation　- Results of the J-RHYTHM Registry 2.
abstract: BACKGROUND
  The J-RHYTHM Registry 2 was a multicenter, prospective observational study that extended the follow-up period of the J-RHYTHM Registry in order to investigate long-term outcomes and effects of non-vitamin K antagonist oral anticoagulants (NOACs) in Japanese patients with atrial fibrillation (AF).
  
  
  RESULTS
  Among 6,616 patients with nonvalvular AF (NVAF) (men 71.0%, 69.7±9.9 years, CHADS2score 1.7±1.2), event rates were compared among patients receiving warfarin (n=3,964), NOACs (n=923), and no anticoagulation therapy (No-OAC, n=753) at the end of follow-up, except for 976 patients lacking anticoagulant data. During the 5-year follow-up period, thromboembolism occurred in 196 (4.9%), 19 (2.1%), and 45 (6.0%) patients, respectively; major hemorrhage in 233 (5.9%), 22 (2.4%), and 36 (4.8%); all-cause death in 230 (5.8%), 13 (1.4%), and 105 (13.9%), (P<0.001 for each). After adjusting for the components of the CHA2DS2-VASc score and antiplatelet drug use, the odds ratio (OR) in the Warfarin group was significantly lower for all-cause death compared with that in the No-OAC group (OR 0.30, 95% confidence interval [CI] 0.23-0.39, P<0.001), whereas ORs in the NOACs group were significantly lower for all events (OR 0.42, 95% CI 0.24-0.74, P=0.003 for thromboembolism; OR 0.53, 95% CI 0.31-0.93, P=0.027 for major hemorrhage; and OR 0.10, 95% CI 0.06-0.18, P<0.001 for all-cause death, respectively).
  
  
  CONCLUSIONS
  NOACs could be beneficial for reducing event rates of all types in Japanese NVAF patients.
authors.affiliation: Department of Internal Medicine and Cardiology, Nippon Medical School, Tama-Nagayama Hospital.
authors.forename: Eitaro
authors.initials: E
authors.lastname: Kodani
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Atarashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inoue
authors.forename: Ken
authors.initials: K
authors.lastname: Okumura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamashita
authors.forename: Hideki
authors.initials: H
authors.lastname: Origasa
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D044466:Asian People; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012042:Registries; D013923:Thromboembolism / Q000139:chemically induced / Q000453:epidemiology; D014812:Vitamin K; D014859:Warfarin / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014812:Vitamin K; D014859:Warfarin