National Hospital Organization Osaka National Hospital.
The Cardiovascular Research Institute.
Circ J. 2019 Jun 25;83(7):1538-1545. doi: 10.1253/circj.CJ-19-0094. Epub 2019 Jun 5.
Despite the well-established benefits in patients with nonvalvular atrial fibrillation (NVAF), anticoagulants have been underused in elderly patients. The All Nippon AF In the Elderly (ANAFIE) Registry is a multicenter, prospective, observational study with 2-year follow-up of Japanese patients aged ≥75 years with a definitive diagnosis of NVAF, aiming to collect detailed information on clinical status and therapeutic challenges in this patient population.
Patients were enrolled from October 2016 to January 2018. A total of 32,726 patients (57.2% male) were included. The average age, CHADSscore, and creatinine clearance were 81.5±4.8 years (26.2% of patients were aged ≥85 years), 2.9±1.2, and 48.4±21.8 mL/min, respectively. Paroxysmal AF was the most common clinical AF type (42.0%), and most patients (97.2%) had comorbidities. Most patients (91.9%) were receiving anticoagulant therapy; of these, 27.8% and 72.2% were treated with warfarin and direct oral anticoagulants, respectively. The average number of concomitant drugs used was 6.6±3.2, including anticoagulants.
The ANAFIE Registry is the largest prospective registry study of elderly Japanese patients with NVAF to date. Baseline data indicate that patients in this age group are treated in a manner similar to their younger counterparts.
尽管在非瓣膜性心房颤动(NVAF)患者中已证实抗凝治疗具有益处,但老年患者中抗凝药物的使用率仍较低。全日本老年 AF 研究(ANAFIE)登记研究是一项多中心、前瞻性、观察性研究,对 2 年随访的年龄≥75 岁、确诊 NVAF 的日本患者进行研究,旨在收集该患者人群临床状况和治疗挑战的详细信息。
患者于 2016 年 10 月至 2018 年 1 月入选。共纳入 32726 例患者(57.2%为男性)。平均年龄、CHADS₂评分和肌酐清除率分别为 81.5±4.8 岁(26.2%的患者年龄≥85 岁)、2.9±1.2 和 48.4±21.8 mL/min。阵发 AF 是最常见的临床 AF 类型(42.0%),大多数患者(97.2%)合并有合并症。大多数患者(91.9%)接受抗凝治疗;其中 27.8%和 72.2%分别接受华法林和直接口服抗凝剂治疗。平均同时使用药物数为 6.6±3.2,包括抗凝药物。
ANAFIE 登记研究是迄今为止规模最大的前瞻性登记研究,纳入了日本老年 NVAF 患者。基线数据表明,该年龄组患者的治疗方式与年轻患者相似。