Estimated glomerular filtration ratio is a better index than creatinine clearance (Cockcroft–Gault) for predicting the prevalence of atrial fibrillation in the general Japanese population

2018 ◽  
Vol 41 (6) ◽  
pp. 451-459 ◽  
Author(s):  
Yutaka Yonezawa ◽  
Shigeo Horinaka ◽  
Chiaki Shirakawa ◽  
Yoshio Kogure
Keyword(s):  
Atrial Fibrillation ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Japanese Population ◽  
General Japanese Population

Abstract P004: Association Between The Liver Fibrosis-4 Score And Incident Atrial Fibrillation In A General Japanese Population Of Middle-aged To Older Adults

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Yoshihiro Tanaka ◽  
Sarah Chuzi ◽  
Nagisa Morikawa ◽  
Hayato Tada ◽  
Kenshi Hayashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Liver Fibrosis ◽  
Cumulative Incidence ◽  
Japanese Population ◽  
General Japanese Population ◽  
Increased Risk ◽  
Longitudinal Association ◽  
Cox Proportional Hazard Models

Background: There is increasing evidence that end-organ liver dysfunction is an important risk factor for atrial fibrillation (AF). Whether a non-invasive, laboratory-based marker of liver fibrosis, the fibrosis-4 score (FIB-4), is associated with incident AF is not known. Aim: To examine the longitudinal association of FIB-4 with incident AF in a general Japanese population with public health insurance. Methods: We used data from the National Japanese Health Check-Up performed in Kanazawa City, which included unemployed or retired participants aged ≥ 40 years. The baseline examination occurred in 2013 and participants were invited for annual routine examinations with follow-up data available through 2018. We excluded participants with pre-existing AF or missing data at baseline or follow-up. Incident AF was based on 12-lead electrocardiogram. We calculated the FIB-4 score (composed of age [years], aspartate and alanine aminotransferase, and platelet levels) for each participant and estimated the cumulative incidence of AF stratified by FIB-4 score quartiles. We also examined the association between quartiles of FIB-4 and incident AF using Cox proportional hazard models adjusted for risk factors with the lowest FIB-4 quartile as referent. Results: Of 37,892 participants, 37% were male and mean age was 72.4±9.6 years. Median (interquartile range [IQR]) of the FIB-4 score was 1.75 (IQR 1.38, 2.27). During a median (IQR) follow-up period of 5.0 years (4.0, 5.0), 707 cases of incident AF were identified. Cumulative incidence in the highest quartile of FIB-4 was 3.9% compared with 1.0% in the lowest quartile (log-rank p<0.001, Figure A ). Higher quartiles of the FIB-4 score had a dose-dependent increased risk of AF with adjusted HR of 1.70 (1.29, 2.23) in the highest quartile compared with the lowest quartile ( Figure B ). Conclusion: FIB-4 was independently associated with incident AF in a general, older Japanese population and may reflect risk of AF, in addition to traditional cardiovascular risk factors.

scholarly journals Gender-specific relationship between abdominal obesity and prevalence of new-onset atrial fibrillation in the general Japanese population

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Ninomiya ◽  
S Kawasoe ◽  
H Ichiki ◽  
T Kubozono ◽  
H Miyahara ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Waist Circumference ◽  
Abdominal Obesity ◽  
Japanese Population ◽  
Univariate Analysis ◽  
General Japanese Population ◽  
Increased Risk ◽  
Near Future ◽  
New Onset

Abstract Background The number of incidences of atrial fibrillation (AF) is expected to rise rapidly in the near future because of the increased number of geriatric patients in Japanese society. In addition, obesity is increasing in the general Japanese population. Although a higher body mass index is associated with a higher risk of AF, the relationship between abdominal obesity (large waist circumference) and new-onset AF is unclear. Methods and results We performed a longitudinal retrospective observational study from January 2007 to October 2018 using the annual health checkup data. Data from 58,844 adults (29,572 males, age 54±13 years) without baseline AF, who underwent routine health checkups, were analyzed. We performed logistic regression analyses to determine the strength of the association between abdominal obesity and new-onset AF. We also examined the effect of abdominal obesity on the incidences of AF stratified by gender. During a median follow-up of 4 years, we recorded new cases of AF in 322 (0.5%) individuals. In univariate analysis, a large waist circumference was significantly associated with new-onset AF, both in males [hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.02 to 1.05, p&lt;0.001] and in females (HR 1.04, 95% CI 1.01 to 1.06, p=0.002), respectively. In multivariate analysis adjusted for clinical variables (age, hypertension, dyslipidemia, estimated glomerular filtration rate, habitual drinking and diabetes), a large waist circumference was significantly and independently associated with new-onset AF in males (HR 1.04, 95% CI 1.03 to 1.06, p&lt;0.001), but not in females (HR 1.01, 95% CI 0.99 to 1.04, p=0.269). Conclusion Abdominal obesity is independently associated with an increased risk of new-onset AF in males. This association in males might imply some sex-specific mechanisms. There might be a gender difference in the effectiveness of interventions to decrease abdominal obesity to prevent AF. Funding Acknowledgement Type of funding source: None

scholarly journals Association between Cardiovascular Health and Incident Atrial Fibrillation in the General Japanese Population Aged ≥40 Years

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3201
Author(s):  
Tetsuo Nishikawa ◽  
Yoshihiro Tanaka ◽  
Hayato Tada ◽  
Toyonobu Tsuda ◽  
Takeshi Kato ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Confidence Interval ◽  
Japanese Population ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Smoking Status ◽  
Lifestyle Behavior ◽  
General Japanese Population ◽  
Japanese Residents ◽  
The Individual

This study explores the association between lifestyle behavior and incident atrial fibrillation (AF) in the general Japanese population. Japanese residents aged ≥40 years undergoing a national health checkup in Kanazawa City were included. We hypothesized that better lifestyle behavior is associated with lower incidence of AF. Lifestyle behavior was evaluated by the total cardiovascular health (CVH) score (0 = poor to 14 = ideal), calculated as the sum of the individual scores on seven modifiable risk factors: smoking status, physical activity, obesity, patterns of eating schedule, blood pressure, total cholesterol, and blood glucose. The association between CVH and incident AF was assessed, adjusting for other factors. A total of 37,523 participants (mean age 72.3 ± 9.6 years, 36.8% men, and mean total CVH score 9 ± 1) were analyzed. During the median follow-up period of 5 years, 703 cases of incident AF were observed. Using a low CVH score as a reference, the upper group (ideal CVH group) had a significantly lower risk of incident AF (hazard ratio [HR] = 0.79, 95% confidence interval 0.65–0.96, p = 0.02), especially among those aged <75 years (HR = 0.68, 95% confidence interval 0.49–0.94, p = 0.02). Thus, ideal CVH is independently associated with a lower risk for incident AF, particularly in younger Japanese individuals (<75 years).

scholarly journals Association of proteinuria with incident atrial fibrillation in the general Japanese population

2021 ◽  
Vol 77 (1) ◽  
pp. 100-105
Author(s):  
Yoshihiro Tanaka ◽  
Hayato Tada ◽  
Satoshi Hara ◽  
Kenshi Hayashi ◽  
Ravi B. Patel ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Japanese Population ◽  
General Japanese Population

scholarly journals Potential risks of substituting estimated glomerular filtration rate for estimated creatinine clearance for dosing of direct oral anticoagulants in atrial fibrillation and chronic kidney disease

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J Vaclavik ◽  
M Kalina ◽  
M Hodacova ◽  
J Kryza ◽  
L Janusova
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Gault Formula

Abstract Background In the clinical trials with direct oral anticoagulants (DOAC) estimates of creatinine clearance (CrCl) with Cockcroft-Gault equation were used to assess renal functions. Recently, most laboratories report renal function estimated with the Modification of Diet in Renal Disease (MDRD) or Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, which may lead to impaired dosing of DOACs by physicians. Purpose To compare estimated glomerular filtration rate and estimated creatinine clearance in a large group of patients with atrial fibrillation and chronic kidney disease. Methods Physicians from 423 institutions in the Czech Republic were asked to enroll 5 consecutive outpatients with atrial fibrillation (AF) treated by a DOAC with stage 3 chronic kidney disease and glomerular filtration rate (eGFR) 30–59 ml/min estimated by MDRD or CKD EPI equations into the registry. Besides eGFR, serum creatinine values were recorded and CrCl calculated by the Cockroft-Gault formula. Results of CrCl and eGFR obtained in individual patients were compared and statistically analyzed using two-sample t-test. Results A total of 2115 patients were enrolled. Mean CrCl was 47.43 ml/min, mean eGFR calculated by MDRD and CKD-EPI was lower 43.88 and 43.53 ml/min (P for difference &lt;0.001 for both). Mean difference between CrCl and eGFR in individual patients calculated by MDRD and CKD-EPI was 8.8 and 9.41 ml/min. A difference beween CrCl and eGFR &gt;10 ml/min was found in 31.5% and 34.8% patients when using MDRD and CKD-EPI formulas. The respective differences between CrCl and eGFR between 4.1 and 10 ml/min were found in 28.5% (MDRD) and 30.8% (CKD-EPI). At CrCl above or below 50 ml/min, 24.0% and 24.2% were misclassified when using eGFR calculated by MDRD and CKD-EPI. At CrCl above or below 30 ml/min, 9.8% (MDRD) and 10.0% (CKD-EPI) patients were misclassified (please see Figures). Conclusions When eGFR estimated by MDRD or CKD-EPI is used to assess renal function and guide DOAC dosing instead of CrCl calculated by the Cockroft-Gault formula in patients with AF and stage 3 CKD, more than a third of patients is misclassified and wrong DOAC dose can be recommended. FUNDunding Acknowledgement Type of funding sources: Private company. Main funding source(s): Boehringer-Ingelheim Differences between CrCl and CKD-EPI Differences between CrCl and MDRD

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