title: Regional Differences in Frequency of Warfarin Therapy and Thromboembolism in Japanese Patients With Non-Valvular Atrial Fibrillation　- Analysis of the J-RHYTHM Registry.
abstract: 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).
  
  
  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).
authors.affiliation: Second Department of Internal Medicine, Toyama University Hospital.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inoue
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Atarashi
authors.forename: Eitaro
authors.initials: E
authors.lastname: Kodani
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
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sakurai
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kawamura
authors.forename: Isao
authors.initials: I
authors.lastname: Kubota
authors.forename: Kazuo
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ogawa
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Aizawa
authors.forename: Masaomi
authors.initials: M
authors.lastname: Chinushi
authors.forename: Itsuo
authors.initials: I
authors.lastname: Kodama
authors.forename: Eiichi
authors.initials: E
authors.lastname: Watanabe
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Koretsune
authors.forename: Yuji
authors.initials: Y
authors.lastname: Okuyama
authors.forename: Akihiko
authors.initials: A
authors.lastname: Shimizu
authors.forename: Osamu
authors.initials: O
authors.lastname: Igawa
authors.forename: Shigenobu
authors.initials: S
authors.lastname: Bando
authors.forename: Masahiko
authors.initials: M
authors.lastname: Fukatani
authors.forename: Tetsunori
authors.initials: T
authors.lastname: Saikawa
authors.forename: Akiko
authors.initials: A
authors.lastname: Chishaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D013923:Thromboembolism / Q000188:drug therapy* / Q000209:etiology; D014859:Warfarin / Q000008:administration & dosage*
chemical_list: D014859:Warfarin