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Goto, Shinya;
Angchaisuksiri, Pantep;
Bassand, Jean‐Pierre;
Camm, A. John;
Dominguez, Helena;
Illingworth, Laura;
Gibbs, Harry;
Goldhaber, Samuel Z.;
Goto, Shinichi;
Jing, Zhi‐Cheng;
Haas, Sylvia;
Kayani, Gloria;
Koretsune, Yukihiro;
Lim, Toon Wei;
Oh, Seil;
Sawhney, Jitendra P. S.;
Turpie, Alexander G. G.;
van Eickels, Martin;
Verheugt, Freek W. A.;
Kakkar, Ajay K.;
Fitzmaurice, David A.;
Hacke, Werner;
Mantovani, Lorenzo G.;
Misselwitz, Frank;
[...]
Management and 1‐Year Outcomes of Patients With Newly Diagnosed Atrial Fibrillation and Chronic Kidney Disease: Results From the Prospective GARFIELD‐AF Registry
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- Medientyp: E-Artikel
- Titel: Management and 1‐Year Outcomes of Patients With Newly Diagnosed Atrial Fibrillation and Chronic Kidney Disease: Results From the Prospective GARFIELD‐AF Registry
- Beteiligte: Goto, Shinya; Angchaisuksiri, Pantep; Bassand, Jean‐Pierre; Camm, A. John; Dominguez, Helena; Illingworth, Laura; Gibbs, Harry; Goldhaber, Samuel Z.; Goto, Shinichi; Jing, Zhi‐Cheng; Haas, Sylvia; Kayani, Gloria; Koretsune, Yukihiro; Lim, Toon Wei; Oh, Seil; Sawhney, Jitendra P. S.; Turpie, Alexander G. G.; van Eickels, Martin; Verheugt, Freek W. A.; Kakkar, Ajay K.; Fitzmaurice, David A.; Hacke, Werner; Mantovani, Lorenzo G.; Misselwitz, Frank; [...]
- Erschienen: Ovid Technologies (Wolters Kluwer Health), 2019
- Erschienen in: Journal of the American Heart Association
- Umfang:
- Sprache: Englisch
- DOI: 10.1161/jaha.118.010510
- ISSN: 2047-9980
- Schlagwörter: Cardiology and Cardiovascular Medicine
- Zusammenfassung: <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> Using data from the <jats:styled-content style="fixed-case">GARFIELD</jats:styled-content> ‐ <jats:styled-content style="fixed-case">AF</jats:styled-content> (Global Anticoagulant Registry in the <jats:styled-content style="fixed-case">FIELD</jats:styled-content> –Atrial Fibrillation), we evaluated the impact of chronic kidney disease ( <jats:styled-content style="fixed-case">CKD</jats:styled-content> ) stage on clinical outcomes in patients with newly diagnosed atrial fibrillation ( <jats:styled-content style="fixed-case">AF</jats:styled-content> ). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">GARFIELD</jats:styled-content> ‐ <jats:styled-content style="fixed-case">AF</jats:styled-content> is a prospective registry of patients from 35 countries, including patients from Asia (China, India, Japan, Singapore, South Korea, and Thailand). Consecutive patients enrolled (2013–2016) were classified with no, mild, or moderate‐to‐severe <jats:styled-content style="fixed-case">CKD</jats:styled-content> , based on the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative guidelines. Data on <jats:styled-content style="fixed-case">CKD</jats:styled-content> status and outcomes were available for 33 024 of 34 854 patients (including 9491 patients from Asia); 10.9% (n=3613) had moderate‐to‐severe <jats:styled-content style="fixed-case">CKD</jats:styled-content> , 16.9% (n=5595) mild <jats:styled-content style="fixed-case">CKD</jats:styled-content> , and 72.1% (n=23 816) no <jats:styled-content style="fixed-case">CKD</jats:styled-content> . The use of oral anticoagulants was influenced by stroke risk (ie, post hoc assessment of <jats:styled-content style="fixed-case">CHA</jats:styled-content> <jats:sub>2</jats:sub> <jats:styled-content style="fixed-case">DS</jats:styled-content> <jats:sub>2</jats:sub> ‐ <jats:styled-content style="fixed-case">VAS</jats:styled-content> c score), but not by <jats:styled-content style="fixed-case">CKD</jats:styled-content> stage. The quality of anticoagulant control with vitamin K antagonists did not differ with <jats:styled-content style="fixed-case">CKD</jats:styled-content> stage. After adjusting for baseline characteristics and antithrombotic use, both mild and moderate‐to‐severe <jats:styled-content style="fixed-case">CKD</jats:styled-content> were independent risk factors for all‐cause mortality. Moderate‐to‐severe <jats:styled-content style="fixed-case">CKD</jats:styled-content> was independently associated with a higher risk of stroke/systemic embolism, major bleeding, new‐onset acute coronary syndrome, and new or worsening heart failure. The impact of moderate‐to‐severe <jats:styled-content style="fixed-case">CKD</jats:styled-content> on mortality was significantly greater in patients from Asia than the rest of the world ( <jats:italic>P</jats:italic> =0.001). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> In <jats:styled-content style="fixed-case">GARFIELD</jats:styled-content> ‐ <jats:styled-content style="fixed-case">AF</jats:styled-content> , moderate‐to‐severe <jats:styled-content style="fixed-case">CKD</jats:styled-content> was independently associated with stroke/systemic embolism, major bleeding, and mortality. The effect of moderate‐to‐severe <jats:styled-content style="fixed-case">CKD</jats:styled-content> on mortality was even greater in patients from Asia than the rest of the world. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Clinical Trial Registration</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">URL</jats:styled-content> : <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">http://www.clinicaltrials.gov</jats:ext-link> . Unique identifier: <jats:styled-content style="fixed-case">NCT</jats:styled-content> 01090362. </jats:p> </jats:sec>
-
Beschreibung:
<jats:sec xml:lang="en">
<jats:title>Background</jats:title>
<jats:p xml:lang="en">
Using data from the
<jats:styled-content style="fixed-case">GARFIELD</jats:styled-content>
‐
<jats:styled-content style="fixed-case">AF</jats:styled-content>
(Global Anticoagulant Registry in the
<jats:styled-content style="fixed-case">FIELD</jats:styled-content>
–Atrial Fibrillation), we evaluated the impact of chronic kidney disease (
<jats:styled-content style="fixed-case">CKD</jats:styled-content>
) stage on clinical outcomes in patients with newly diagnosed atrial fibrillation (
<jats:styled-content style="fixed-case">AF</jats:styled-content>
).
</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Methods and Results</jats:title>
<jats:p xml:lang="en">
<jats:styled-content style="fixed-case">GARFIELD</jats:styled-content>
‐
<jats:styled-content style="fixed-case">AF</jats:styled-content>
is a prospective registry of patients from 35 countries, including patients from Asia (China, India, Japan, Singapore, South Korea, and Thailand). Consecutive patients enrolled (2013–2016) were classified with no, mild, or moderate‐to‐severe
<jats:styled-content style="fixed-case">CKD</jats:styled-content>
, based on the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative guidelines. Data on
<jats:styled-content style="fixed-case">CKD</jats:styled-content>
status and outcomes were available for 33 024 of 34 854 patients (including 9491 patients from Asia); 10.9% (n=3613) had moderate‐to‐severe
<jats:styled-content style="fixed-case">CKD</jats:styled-content>
, 16.9% (n=5595) mild
<jats:styled-content style="fixed-case">CKD</jats:styled-content>
, and 72.1% (n=23 816) no
<jats:styled-content style="fixed-case">CKD</jats:styled-content>
. The use of oral anticoagulants was influenced by stroke risk (ie, post hoc assessment of
<jats:styled-content style="fixed-case">CHA</jats:styled-content>
<jats:sub>2</jats:sub>
<jats:styled-content style="fixed-case">DS</jats:styled-content>
<jats:sub>2</jats:sub>
‐
<jats:styled-content style="fixed-case">VAS</jats:styled-content>
c score), but not by
<jats:styled-content style="fixed-case">CKD</jats:styled-content>
stage. The quality of anticoagulant control with vitamin K antagonists did not differ with
<jats:styled-content style="fixed-case">CKD</jats:styled-content>
stage. After adjusting for baseline characteristics and antithrombotic use, both mild and moderate‐to‐severe
<jats:styled-content style="fixed-case">CKD</jats:styled-content>
were independent risk factors for all‐cause mortality. Moderate‐to‐severe
<jats:styled-content style="fixed-case">CKD</jats:styled-content>
was independently associated with a higher risk of stroke/systemic embolism, major bleeding, new‐onset acute coronary syndrome, and new or worsening heart failure. The impact of moderate‐to‐severe
<jats:styled-content style="fixed-case">CKD</jats:styled-content>
on mortality was significantly greater in patients from Asia than the rest of the world (
<jats:italic>P</jats:italic>
=0.001).
</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Conclusions</jats:title>
<jats:p xml:lang="en">
In
<jats:styled-content style="fixed-case">GARFIELD</jats:styled-content>
‐
<jats:styled-content style="fixed-case">AF</jats:styled-content>
, moderate‐to‐severe
<jats:styled-content style="fixed-case">CKD</jats:styled-content>
was independently associated with stroke/systemic embolism, major bleeding, and mortality. The effect of moderate‐to‐severe
<jats:styled-content style="fixed-case">CKD</jats:styled-content>
on mortality was even greater in patients from Asia than the rest of the world.
</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Clinical Trial Registration</jats:title>
<jats:p xml:lang="en">
<jats:styled-content style="fixed-case">URL</jats:styled-content>
:
<jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">http://www.clinicaltrials.gov</jats:ext-link>
. Unique identifier:
<jats:styled-content style="fixed-case">NCT</jats:styled-content>
01090362.
</jats:p>
</jats:sec> - Anmerkungen:
- Zugangsstatus: Freier Zugang