Author + information
- Yutaka Hatori,
- Hiroyuki Sakai,
- Tomoyuki Kunishima,
- Keiichi Chin,
- Nobuo Hatori and
- Naoki Sato
Anticoagulant therapy for atrial fibrillation (Af) has been dramatically changed in the era of therapy with direct oral anticoagulants (DOACs). The real-world status of patients with Af treated with warfarin or DOACs or without anti-coagulants is not clarified. Furthermore, the beneficial three-year effect and safety of DOACs have not been well compared to that of warfarin in real-world patients with Af.
The ASSAF-K (a study of the safety and efficacy of anticoagulant therapy in the treatment of Af in Kanagawa: UMIN 000011830), a prospective, multi-centre, observational study, was started from 2013 and finished the enrollment at the end of March in 2015. The follow-up was completely finished by the end of March in 2018. The primary endpoints were to clarify epidemiologic characteristics, status of treatment with antic-coagulants, three-year outcomes, and adverse events, including cerebrovascular disease, bleeding, and death.
Total number of enrolled patients was 4014 (hospital: 2500 cases, clinics: 1514 cases) in 105 institutes (26 hospitals and 79 clinics). The number of the final data set excluded duplicated and missing data was 3839. Mean age was 72.7±10.1 years, proportion of men was 65.4%. CHADS2-Vasc score and HAS-BLEAD were 3.00±1.59, 2.23±1.06, respectively. Three year-event-free-rate of primary composite endpoint in the DOACs, warfarin, and without anti-coagulants were 91.5%, 87.3%, and 86.6%, respectively. The event of composite endpoint was estimated by the Kaplan-Meier method, which revealed that event rate in the DOACs was significantly lower than that in warfarin (P=0.002). Interestingly, three-year outcome with warfarin was not different from that without anti-coagulants. Severe adverse events were significantly (P=0.016) lower in DOACs than those in warfarin.
The prospective, multi-centre registry have demonstrated the important data regarding real-world patient characteristics and three-year outcome in Af patients treated with DOACs or warfarin or without anti-coagulants, suggesting that treatment with DOACs for real-world Af patients was safe and beneficial in hospitals and clinics
Posters Hall_Hall A
Saturday, March 28, 2020, 10:00 a.m.-10:45 a.m.
Session Title: ACC International Conferences Best Posters
Abstract Category: 06. Arrhythmias and Clinical EP: Other
Presentation Number: 1136-412
- 2020 American College of Cardiology Foundation