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Impact of baseline blood pressure on adverse outcomes in Japanese patients with non-valvular atrial fibrillation: the J-RISK AF
AIMS: This study aimed to investigate the impact of baseline blood pressure (BP) on adverse outcomes in patients with atrial fibrillation (AF), using a pooled analysis performed on data from J-RISK AF, a large-scale cohort of Japanese patients with AF. METHODS AND RESULTS: Of the 16 918 patients fro...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9793850/ https://www.ncbi.nlm.nih.gov/pubmed/36583077 http://dx.doi.org/10.1093/ehjopen/oeac081 |
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author | Kodani, Eitaro Tomita, Hirofumi Nakai, Michikazu Akao, Masaharu Suzuki, Shinya Hayashi, Kenshi Sawano, Mitsuaki Goya, Masahiko Yamashita, Takeshi Fukuda, Keiichi Ogawa, Hisashi Tsuda, Toyonobu Isobe, Mitsuaki Toyoda, Kazunori Miyamoto, Yoshihiro Miyata, Hiroaki Okamura, Tomonori Sasahara, Yusuke Okumura, Ken |
author_facet | Kodani, Eitaro Tomita, Hirofumi Nakai, Michikazu Akao, Masaharu Suzuki, Shinya Hayashi, Kenshi Sawano, Mitsuaki Goya, Masahiko Yamashita, Takeshi Fukuda, Keiichi Ogawa, Hisashi Tsuda, Toyonobu Isobe, Mitsuaki Toyoda, Kazunori Miyamoto, Yoshihiro Miyata, Hiroaki Okamura, Tomonori Sasahara, Yusuke Okumura, Ken |
author_sort | Kodani, Eitaro |
collection | PubMed |
description | AIMS: This study aimed to investigate the impact of baseline blood pressure (BP) on adverse outcomes in patients with atrial fibrillation (AF), using a pooled analysis performed on data from J-RISK AF, a large-scale cohort of Japanese patients with AF. METHODS AND RESULTS: Of the 16 918 patients from five major AF registries including the J-RHYTHM Registry, Fushimi AF Registry, Shinken Database, Keio interhospital Cardiovascular Studies, and Hokuriku-Plus AF Registry, 15 019 non-valvular AF (NVAF) patients with baseline BP values (age, 70.0 ± 11.0 years; men, 69.1%) were analysed. Incidence rates of adverse events were evaluated between patients divided into baseline systolic BP quartiles or at 150 mmHg. During the follow-up period of 730 days, ischaemic stroke, major bleeding, all-cause death, and cardiovascular death occurred in 277, 319, 718, and 275 patients, respectively. Hazard ratios (HRs) for ischaemic stroke and major bleeding were comparable among the quartiles, whereas HRs for all-cause and cardiovascular deaths in the lowest quartile with systolic BP <114 mmHg were significantly higher [HR 1.43, 95% confidence interval (CI) 1.13–1.81; and HR 1.47, 95% CI 1.01–2.12, respectively] than in the third quartile, even after adjusting for known confounding factors. In patients with a systolic BP of ≥150 mmHg, adjusted HR for major bleeding was significantly higher than that of <150 mmHg (HR 1.64, 95% CI 1.12–2.40). CONCLUSION: In Japanese patients with NVAF, a baseline systolic BP <114 mmHg was significantly associated with higher all-cause and cardiovascular mortality. In contrast, a systolic BP ≥150 mmHg was an independent risk factor for major bleeding. |
format | Online Article Text |
id | pubmed-9793850 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-97938502022-12-28 Impact of baseline blood pressure on adverse outcomes in Japanese patients with non-valvular atrial fibrillation: the J-RISK AF Kodani, Eitaro Tomita, Hirofumi Nakai, Michikazu Akao, Masaharu Suzuki, Shinya Hayashi, Kenshi Sawano, Mitsuaki Goya, Masahiko Yamashita, Takeshi Fukuda, Keiichi Ogawa, Hisashi Tsuda, Toyonobu Isobe, Mitsuaki Toyoda, Kazunori Miyamoto, Yoshihiro Miyata, Hiroaki Okamura, Tomonori Sasahara, Yusuke Okumura, Ken Eur Heart J Open Original Article AIMS: This study aimed to investigate the impact of baseline blood pressure (BP) on adverse outcomes in patients with atrial fibrillation (AF), using a pooled analysis performed on data from J-RISK AF, a large-scale cohort of Japanese patients with AF. METHODS AND RESULTS: Of the 16 918 patients from five major AF registries including the J-RHYTHM Registry, Fushimi AF Registry, Shinken Database, Keio interhospital Cardiovascular Studies, and Hokuriku-Plus AF Registry, 15 019 non-valvular AF (NVAF) patients with baseline BP values (age, 70.0 ± 11.0 years; men, 69.1%) were analysed. Incidence rates of adverse events were evaluated between patients divided into baseline systolic BP quartiles or at 150 mmHg. During the follow-up period of 730 days, ischaemic stroke, major bleeding, all-cause death, and cardiovascular death occurred in 277, 319, 718, and 275 patients, respectively. Hazard ratios (HRs) for ischaemic stroke and major bleeding were comparable among the quartiles, whereas HRs for all-cause and cardiovascular deaths in the lowest quartile with systolic BP <114 mmHg were significantly higher [HR 1.43, 95% confidence interval (CI) 1.13–1.81; and HR 1.47, 95% CI 1.01–2.12, respectively] than in the third quartile, even after adjusting for known confounding factors. In patients with a systolic BP of ≥150 mmHg, adjusted HR for major bleeding was significantly higher than that of <150 mmHg (HR 1.64, 95% CI 1.12–2.40). CONCLUSION: In Japanese patients with NVAF, a baseline systolic BP <114 mmHg was significantly associated with higher all-cause and cardiovascular mortality. In contrast, a systolic BP ≥150 mmHg was an independent risk factor for major bleeding. Oxford University Press 2022-12-16 /pmc/articles/PMC9793850/ /pubmed/36583077 http://dx.doi.org/10.1093/ehjopen/oeac081 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Article Kodani, Eitaro Tomita, Hirofumi Nakai, Michikazu Akao, Masaharu Suzuki, Shinya Hayashi, Kenshi Sawano, Mitsuaki Goya, Masahiko Yamashita, Takeshi Fukuda, Keiichi Ogawa, Hisashi Tsuda, Toyonobu Isobe, Mitsuaki Toyoda, Kazunori Miyamoto, Yoshihiro Miyata, Hiroaki Okamura, Tomonori Sasahara, Yusuke Okumura, Ken Impact of baseline blood pressure on adverse outcomes in Japanese patients with non-valvular atrial fibrillation: the J-RISK AF |
title | Impact of baseline blood pressure on adverse outcomes in Japanese patients with non-valvular atrial fibrillation: the J-RISK AF |
title_full | Impact of baseline blood pressure on adverse outcomes in Japanese patients with non-valvular atrial fibrillation: the J-RISK AF |
title_fullStr | Impact of baseline blood pressure on adverse outcomes in Japanese patients with non-valvular atrial fibrillation: the J-RISK AF |
title_full_unstemmed | Impact of baseline blood pressure on adverse outcomes in Japanese patients with non-valvular atrial fibrillation: the J-RISK AF |
title_short | Impact of baseline blood pressure on adverse outcomes in Japanese patients with non-valvular atrial fibrillation: the J-RISK AF |
title_sort | impact of baseline blood pressure on adverse outcomes in japanese patients with non-valvular atrial fibrillation: the j-risk af |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9793850/ https://www.ncbi.nlm.nih.gov/pubmed/36583077 http://dx.doi.org/10.1093/ehjopen/oeac081 |
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