Abstract 12909: Differences in Clinical Characteristics and Outcomes between Patients with Paroxysmal and Sustained Type of Atrial Fibrillation: From the Fushimi Af Registry
Background: Atrial fibrillation (AF) increases the risks of stroke, and is increasing significantly as the population ages (reportedly 0.6% of total population in Japan). Previous studies demonstrated that patients with paroxysmal AF have a risk of stroke similar to that in patients with sustained (persistent or permanent) AF.
Methods: The Fushimi AF Registry, a community-based prospective survey, was designed to enroll all of the AF patients in Fushimi-ku, Kyoto, Japan. Fushimi-ku is densely populated with a total population of 283,000, and is assumed to represent a typical urban community in Japan. At present, we have enrolled 3,661 patients (1.3% of total population) from March 2011 to April 2013. One-year follow-up was completed in 2,548 patients as of April 2013. We compared the baseline clinical characteristics and one-year outcome between paroxysmal AF (PAF; n=1,197, 47.0%) and sustained AF (SAF; n=1,351, 53.0%).
Results: Patients with PAF were younger (PAF vs. SAF: 72.4±11.7 vs. 74.8±9.9 years of age), and were more symptomatic (the proportion of patients with any AF-related symptoms: 66.4% vs. 36.1%; p≤0.001). They were less likely to have a history of stroke (15.5% vs. 22.0%; p≤0.001), heart failure (17.3% vs. 35.3%; p≤0.001), chronic kidney disease (32.5% vs. 37.0%; p=0.018). The CHADS2 score was smaller in patients with PAF (1.87±1.31 vs. 2.24±1.35; p≤0.001). Patients receiving the prescription of oral anticoagulants at enrollment were much less in PAF (38.8% vs. 68.6%; p≤0.001). During the one-year follow-up period, the incidence of stroke was less, but not statistically significant, in the patients with PAF (2.3% vs. 3.2%; p=0.15). In the PAF group, the incidence of hospitalization for heart failure was less (2.9% vs. 6.5%; p≤0.001), but there was no significant difference in mortality or major bleeding between PAF and SAF (6.5% vs. 7.2%; p=0.45, 4.7% vs. 4.1%; p=0.46, respectively).
Conclusion: The Fushimi AF registry represents the clinical profile of real-world Japanese AF patients. Patients with PAF were younger, had less co-morbidities and thus had lower CHADS2 score, compared with those with SAF. Despite that they receive less anticoagulation, the incidence of stroke during one-year follow-up was less.
- © 2013 by American Heart Association, Inc.