Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
권호 표지
DOI QR코드

DOI QR Code

Stroke Prevention in Atrial Fibrillation: Focus on Asian Patients

  • Li, Yan-Guang (Institute of Cardiovascular Sciences, University of Birmingham) ;
  • Lee, So-Ryoung (Division of Cardiology, Department of Internal Medicine, Soon Chun Hyang University Hospital Seoul) ;
  • Choi, Eue-Keun (Department of Internal Medicine, Seoul National University Hospital) ;
  • Lip, Gregory Y.H. (Institute of Cardiovascular Sciences, University of Birmingham)
  • Received : 2018.06.07
  • Accepted : 2018.06.18
  • Published : 2018.08.30
⟨ Previous Next ⟩

Abstract

Atrial fibrillation (AF) is the most common arrhythmia conferring a fivefold increased risk of stroke. Stroke prevention is the cornerstone of management of patients with AF. Asians have a generally higher incidence of AF-related risks of stroke and bleeding (particularly intracranial bleeding), compared with non-Asians. Despite the well-documented efficacy and relative safety of oral anticoagulation for stroke prevention among Asians, the suboptimal use of oral anticoagulation remains common. The current narrative review aims to provide a summary of the available evidence on stroke prevention among patients with AF focused on the Asia region, regarding stroke and bleeding risk evaluation, the performance of oral anticoagulation, and current use of thromboprophylaxis.

Keywords

References

  1. Chao TF, Liu CJ, Tuan TC, et al. Lifetime risks, projected numbers, and adverse outcomes in Asian patients with atrial fibrillation: a report from the Taiwan nationwide AF cohort study. Chest 2018;153:453-66. https://doi.org/10.1016/j.chest.2017.10.001
  2. Lee SR, Choi EK, Han KD, Cha MJ, Oh S. Trends in the incidence and prevalence of atrial fibrillation and estimated thromboembolic risk using the CHA2DS2-VASc score in the entire Korean population. Int J Cardiol 2017;236:226-31. https://doi.org/10.1016/j.ijcard.2017.02.039
  3. Chiang CE, Wang KL, Lip GY. Stroke prevention in atrial fibrillation: an Asian perspective. Thromb Haemost 2014;111:789-97. https://doi.org/10.1160/TH13-11-0948
  4. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 1991;22:983-8. https://doi.org/10.1161/01.STR.22.8.983
  5. Gladstone DJ, Bui E, Fang J, et al. Potentially preventable strokes in high-risk patients with atrial fibrillation who are not adequately anticoagulated. Stroke 2009;40:235-40. https://doi.org/10.1161/STROKEAHA.108.516344
  6. Man-Son-Hing M, Laupacis A. Balancing the risks of stroke and upper gastrointestinal tract bleeding in older patients with atrial fibrillation. Arch Intern Med 2002;162:541-50. https://doi.org/10.1001/archinte.162.5.541
  7. Henninger N, Goddeau RP Jr, Karmarkar A, Helenius J, McManus DD. Atrial fibrillation is associated with a worse 90-day outcome than other cardioembolic stroke subtypes. Stroke 2016;47:1486-92. https://doi.org/10.1161/STROKEAHA.116.012865
  8. Perera KS, Vanassche T, Bosch J, et al. Global survey of the frequency of atrial fibrillation-associated stroke: embolic stroke of undetermined source global registry. Stroke 2016;47:2197-202. https://doi.org/10.1161/STROKEAHA.116.013378
  9. Tomita H, Hagii J, Metoki N, et al. Impact of sex difference on severity and functional outcome in patients with cardioembolic stroke. J Stroke Cerebrovasc Dis 2015;24:2613-8. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.07.016
  10. Kim D, Yang PS, Jang E, et al. Increasing trends in hospital care burden of atrial fibrillation in Korea, 2006 through 2015. Heart. 2018 [Epub ahead of print].
  11. Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest 2010;137:263-72. https://doi.org/10.1378/chest.09-1584
  12. Hart RG, Pearce LA, Aguilar MI. Adjusted-dose warfarin versus aspirin for preventing stroke in patients with atrial fibrillation. Ann Intern Med 2007;147:590-2.
  13. Lip GY, Wang KL, Chiang CE. Non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in Asian patients with atrial fibrillation: time for a reappraisal. Int J Cardiol 2015;180:246-54. https://doi.org/10.1016/j.ijcard.2014.11.182
  14. Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011;365:981-92. https://doi.org/10.1056/NEJMoa1107039
  15. Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2013;369:2093-104. https://doi.org/10.1056/NEJMoa1310907
  16. Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011;365:883-91. https://doi.org/10.1056/NEJMoa1009638
  17. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009;361:1139-51. https://doi.org/10.1056/NEJMoa0905561
  18. Cha MJ, Choi EK, Han KD, et al. Effectiveness and safety of non-vitamin K antagonist oral anticoagulants in Asian patients with atrial fibrillation. Stroke 2017;48:3040-8. https://doi.org/10.1161/STROKEAHA.117.018773
  19. Hori M, Connolly SJ, Zhu J, et al. Dabigatran versus warfarin: effects on ischemic and hemorrhagic strokes and bleeding in Asians and non-Asians with atrial fibrillation. Stroke 2013;44:1891-6. https://doi.org/10.1161/STROKEAHA.113.000990
  20. Wong KS, Hu DY, Oomman A, et al. Rivaroxaban for stroke prevention in East Asian patients from the ROCKET AF trial. Stroke 2014;45:1739-47. https://doi.org/10.1161/STROKEAHA.113.002968
  21. Yamashita T, Koretsune Y, Yang Y, et al. Edoxaban vs. warfarin in East Asian patients with atrial fibrillation - an ENGAGE AF-TIMI 48 subanalysis. Circ J 2016;80:860-9. https://doi.org/10.1253/circj.CJ-15-1082
  22. Goto S, Zhu J, Liu L, et al. Efficacy and safety of apixaban compared with warfarin for stroke prevention in patients with atrial fibrillation from East Asia: a subanalysis of the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial. Am Heart J 2014;168:303-9. https://doi.org/10.1016/j.ahj.2014.06.005
  23. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016;37:2893-962. https://doi.org/10.1093/eurheartj/ehw210
  24. Chiang CE, Okumura K, Zhang S, et al. 2017 consensus of the Asia Pacific Heart Rhythm Society on stroke prevention in atrial fibrillation. J Arrhythm 2017;33:345-67. https://doi.org/10.1016/j.joa.2017.05.004
  25. Jones C, Pollit V, Fitzmaurice D, Cowan CGuideline Development Group. The management of atrial fibrillation: summary of updated NICE guidance. BMJ 2014;348:g3655. https://doi.org/10.1136/bmj.g3655
  26. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2014;64:e1-76. https://doi.org/10.1016/j.jacc.2014.03.022
  27. Chao TF, Liu CJ, Tuan TC, et al. Comparisons of CHADS2 and CHA2DS2-VASc scores for stroke risk stratification in atrial fibrillation: which scoring system should be used for Asians? Heart Rhythm 2016;13:46-53. https://doi.org/10.1016/j.hrthm.2015.08.017
  28. Xiong Q, Chen S, Senoo K, Proietti M, Hong K, Lip GY. The CHADS2 and CHA2DS2-VASc scores for predicting ischemic stroke among East Asian patients with atrial fibrillation: a systemic review and meta-analysis. Int J Cardiol 2015;195:237-42. https://doi.org/10.1016/j.ijcard.2015.05.115
  29. Kim TH, Yang PS, Kim D, et al. CHA2DS2-VASc score for identifying truly low-risk atrial fibrillation for stroke: a Korean nationwide cohort study. Stroke 2017;48:2984-90. https://doi.org/10.1161/STROKEAHA.117.018551
  30. Kang SH, Choi EK, Han KD, et al. Risk of ischemic stroke in patients with non-valvular atrial fibrillation not receiving oral anticoagulants - Korean nationwide population-based study. Circ J 2017;81:1158-64. https://doi.org/10.1253/circj.CJ-16-1267
  31. Chao TF, Liu CJ, Wang KL, et al. Using the CHA2DS2-VASc score for refining stroke risk stratification in 'low-risk' Asian patients with atrial fibrillation. J Am Coll Cardiol 2014;64:1658-65. https://doi.org/10.1016/j.jacc.2014.06.1203
  32. Chan PH, Lau CP, Tse HF, Chiang CE, Siu CW. CHA2DS2-VASc recalibration with an additional age category (50-64 Years) enhances stroke risk stratification in Chinese patients with atrial fibrillation. Can J Cardiol 2016;32:1381-7. https://doi.org/10.1016/j.cjca.2016.05.009
  33. Chao TF, Wang KL, Liu CJ, et al. Age threshold for increased stroke risk among patients with atrial fibrillation: a nationwide cohort study from Taiwan. J Am Coll Cardiol 2015;66:1339-47. https://doi.org/10.1016/j.jacc.2015.07.026
  34. Chao TF, Lip GY, Liu CJ, et al. Validation of a modified CHA2DS2-VASc score for stroke risk stratification in Asian patients with atrial fibrillation: a nationwide cohort study. Stroke 2016;47:2462-9. https://doi.org/10.1161/STROKEAHA.116.013880
  35. Chao TF, Liu CJ, Wang KL, et al. Should atrial fibrillation patients with 1 additional risk factor of the CHA2DS2-VASc score (beyond sex) receive oral anticoagulation? J Am Coll Cardiol 2015;65:635-42. https://doi.org/10.1016/j.jacc.2014.11.046
  36. Hung Y, Chao TF, Liu CJ, et al. Is an oral anticoagulant necessary for young atrial fibrillation patients with a CHA2DS2-VASc score of 1 (men) or 2 (women)? J Am Heart Assoc 2016;5:e003839.
  37. Eckman MH, Singer DE, Rosand J, Greenberg SM. Moving the tipping point: the decision to anticoagulate patients with atrial fibrillation. Circ Cardiovasc Qual Outcomes 2011;4:14-21. https://doi.org/10.1161/CIRCOUTCOMES.110.958108
  38. JCS Joint Working Group. Guidelines for pharmacotherapy of atrial fibrillation (JCS 2013). Circ J 2014;78:1997-2021. https://doi.org/10.1253/circj.CJ-66-0092
  39. Chiang CE, Wu TJ, Ueng KC, et al. 2016 guidelines of the Taiwan Heart Rhythm Society and the Taiwan Society of Cardiology for the management of atrial fibrillation. J Formos Med Assoc 2016;115:893-952. https://doi.org/10.1016/j.jfma.2016.10.005
  40. Jung BC, Kim NH, Nam GB, et al. The Korean Heart Rhythm Society's 2014 statement on antithrombotic therapy for patients with nonvalvular atrial fibrillation: Korean Heart Rhythm Society. Korean Circ J 2015;45:9-19. https://doi.org/10.4070/kcj.2015.45.1.9
  41. Lee JM, Joung B, Cha MJ, et al. 2018 KHRS guidelines for stroke prevention therapy in Korean patients with nonvalvular atrial fibrillation. Korean J Med 2018;93:87-109. https://doi.org/10.3904/kjm.2018.93.2.87
  42. Chao TF, Lip GY, Liu CJ, et al. Relationship of aging and incident comorbidities to stroke risk in patients with atrial fibrillation. J Am Coll Cardiol 2018;71:122-32. https://doi.org/10.1016/j.jacc.2017.10.085
  43. Yoon M, Yang PS, Jang E, et al. Dynamic changes of CHA2DS2-VASc score and the risk of ischaemic stroke in Asian patients with atrial fibrillation: a nationwide cohort study. Thromb Haemost. 2018 [Epub ahead of print].
  44. Lip GY, Lane DA. Bleeding risk assessment in atrial fibrillation: observations on the use and misuse of bleeding risk scores. J Thromb Haemost 2016;14:1711-4. https://doi.org/10.1111/jth.13386
  45. Wilke T, Bauer S, Mueller S, Kohlmann T, Bauersachs R. Patient preferences for oral anticoagulation therapy in atrial fibrillation: a systematic literature review. Patient 2017;10:17-37. https://doi.org/10.1007/s40271-016-0185-9
  46. Guo Y, Zhu H, Chen Y, Lip GY. Comparing bleeding risk assessment focused on modifiable risk factors only versus validated bleeding risk scores in atrial fibrillation. Am J Med 2018;131:185-92. https://doi.org/10.1016/j.amjmed.2017.09.009
  47. Esteve-Pastor MA, Rivera-Caravaca JM, Shantsila A, Roldan V, Lip GY, Marin F. Assessing bleeding risk in atrial fibrillation patients: comparing a bleeding risk score based only on modifiable bleeding risk factors against the HAS-BLED score. The AMADEUS trial. Thromb Haemost 2017;117:2261-6. https://doi.org/10.1160/TH17-10-0710
  48. Chao TF, Lip GY, Lin YJ, et al. Major bleeding and intracranial hemorrhage risk prediction in patients with atrial fibrillation: attention to modifiable bleeding risk factors or use of a bleeding risk stratification score? A nationwide cohort study. Int J Cardiol 2018;254:157-61. https://doi.org/10.1016/j.ijcard.2017.11.025
  49. Hijazi Z, Oldgren J, Lindback J, et al. The novel biomarker-based ABC (age, biomarkers, clinical history)-bleeding risk score for patients with atrial fibrillation: a derivation and validation study. Lancet 2016;387:2302-11. https://doi.org/10.1016/S0140-6736(16)00741-8
  50. O'Brien EC, Simon DN, Thomas LE, et al. The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation. Eur Heart J 2015;36:3258-64.
  51. Fang MC, Go AS, Chang Y, et al. A new risk scheme to predict warfarin-associated hemorrhage: the ATRIA (anticoagulation and risk factors in atrial fibrillation) study. J Am Coll Cardiol 2011;58:395-401. https://doi.org/10.1016/j.jacc.2011.03.031
  52. Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest 2010;138:1093-100. https://doi.org/10.1378/chest.10-0134
  53. Guo YT, Zhang Y, Shi XM, et al. Assessing bleeding risk in 4824 Asian patients with atrial fibrillation: the Beijing PLA Hospital Atrial Fibrillation Project. Sci Rep 2016;6:31755. https://doi.org/10.1038/srep31755
  54. Chao TF, Lip GY, Lin YJ, et al. Incident risk factors and major bleeding in patients with atrial fibrillation treated with oral anticoagulants: a comparison of baseline, follow-up and delta HAS-BLED scores with an approach focused on modifiable bleeding risk factors. Thromb Haemost 2018;118:768-77.
  55. Park CS, Choi EK, Kim HM, et al. Increased risk of major bleeding in underweight patients with atrial fibrillation who were prescribed non-vitamin K antagonist oral anticoagulants. Heart Rhythm 2017;14:501-7. https://doi.org/10.1016/j.hrthm.2016.12.036
  56. Zoppellaro G, Granziera S, Bertozzo G, et al. Consequences of warfarin suspension after major bleeding in very elderly patients with non valvular atrial fibrillation. Thromb Haemost 2017;117:1828-30. https://doi.org/10.1160/TH16-11-0846
  57. Rivera-Caravaca JM, Roldan V, Esteve-Pastor MA, et al. Cessation of oral anticoagulation is an important risk factor for stroke and mortality in atrial fibrillation patients. Thromb Haemost 2017;117:1448-54. https://doi.org/10.1160/TH16-12-0961
  58. Wu S, Yang YM, Zhu J, et al. Meta-analysis of efficacy and safety of new oral anticoagulants compared with uninterrupted vitamin K antagonists in patients undergoing catheter ablation for atrial fibrillation. Am J Cardiol 2016;117:926-34. https://doi.org/10.1016/j.amjcard.2015.12.027
  59. Cardoso R, Knijnik L, Bhonsale A, et al. An updated meta-analysis of novel oral anticoagulants versus vitamin K antagonists for uninterrupted anticoagulation in atrial fibrillation catheter ablation. Heart Rhythm 2018;15:107-15. https://doi.org/10.1016/j.hrthm.2017.09.011
  60. Ntaios G, Papavasileiou V, Makaritsis K, Vemmos K, Michel P, Lip GY. Real-world setting comparison of nonvitamin-K antagonist oral anticoagulants versus vitamin-K antagonists for stroke prevention in atrial fibrillation: a systematic review and meta-analysis. Stroke 2017;48:2494-503. https://doi.org/10.1161/STROKEAHA.117.017549
  61. Ruff CT, Giugliano RP, Braunwald E, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 2014;383:955-62. https://doi.org/10.1016/S0140-6736(13)62343-0
  62. Li YG, Pastori D, Lip GY. Fitting the right non-vitamin K antagonist oral anticoagulant to the right patient with non-valvular atrial fibrillation: an evidence-based choice. Ann Med 2018;50:288-302. https://doi.org/10.1080/07853890.2018.1460489
  63. Shimada YJ, Yamashita T, Koretsune Y, et al. Effects of regional differences in Asia on efficacy and safety of edoxaban compared with warfarin--insights from the ENGAGE AF-TIMI 48 trial. Circ J 2015;79:2560-7. https://doi.org/10.1253/circj.CJ-15-0574
  64. Hori M, Matsumoto M, Tanahashi N, et al. Rivaroxaban vs. warfarin in Japanese patients with atrial fibrillation - the J-ROCKET AF study. Circ J 2012;76:2104-11. https://doi.org/10.1253/circj.CJ-12-0454
  65. Wang KL, Lip GY, Lin SJ, Chiang CE. Non-vitamin K antagonist oral anticoagulants for stroke prevention in Asian patients with nonvalvular atrial fibrillation: meta-analysis. Stroke 2015;46:2555-61. https://doi.org/10.1161/STROKEAHA.115.009947
  66. Kohsaka S, Katada J, Saito K, Terayama Y. Safety and effectiveness of apixaban in comparison to warfarin in patients with nonvalvular atrial fibrillation: a propensity-matched analysis from Japanese administrative claims data. Curr Med Res Opin 2018:1-8.
  67. Lee KH, Park HW, Lee N, et al. Optimal dose of dabigatran for the prevention of thromboembolism with minimal bleeding risk in Korean patients with atrial fibrillation Europace 2017;19:iv1-9. https://doi.org/10.1093/europace/eux247
  68. Hong KS, Kwon SU, Lee SH, et al. Rivaroxaban vs warfarin sodium in the ultra-early period after atrial fibrillation-related mild ischemic stroke: a randomized clinical trial. JAMA Neurol 2017;74:1206-15. https://doi.org/10.1001/jamaneurol.2017.2161
  69. Dillinger JG, Aleil B, Cheggour S, et al. Dosing issues with non-vitamin K antagonist oral anticoagulants for the treatment of non-valvular atrial fibrillation: Why we should not underdose our patients. Arch Cardiovasc Dis 2018;111:85-94. https://doi.org/10.1016/j.acvd.2017.04.008
  70. Okumura Y, Yokoyama K, Matsumoto N, et al. Current use of direct oral anticoagulants for atrial fibrillation in Japan: Findings from the SAKURA AF Registry. J Arrhythm 2017;33:289-96. https://doi.org/10.1016/j.joa.2016.11.003
  71. Wang KL, Giugliano RP, Goto S, et al. Standard dose versus low dose non-vitamin K antagonist oral anticoagulants in Asian patients with atrial fibrillation: a meta-analysis of contemporary randomized controlled trials. Heart Rhythm 2016;13:2340-7. https://doi.org/10.1016/j.hrthm.2016.09.010
  72. Holmes DR, Reddy VY, Turi ZG, et al.PROTECT AF Investigators. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet 2009;374:534-42. https://doi.org/10.1016/S0140-6736(09)61343-X
  73. Holmes DR Jr, Kar S, Price MJ, et al. Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial fibrillation versus long-term warfarin therapy: the PREVAIL trial. J Am Coll Cardiol 2014;64:1-12. https://doi.org/10.1016/j.jacc.2014.04.029
  74. Reddy VY, Doshi SK, Kar S, et al. 5-Year Outcomes After Left Atrial Appendage Closure: From the PREVAIL and PROTECT AF Trials. J Am Coll Cardiol 2017;70:2964-75. https://doi.org/10.1016/j.jacc.2017.10.021
  75. Lam YY, Yip GW, Yu CM, et al. Left atrial appendage closure with AMPLATZER cardiac plug for stroke prevention in atrial fibrillation: initial Asia-Pacific experience. Catheter Cardiovasc Interv 2012;79:794-800. https://doi.org/10.1002/ccd.23136
  76. Lee OH, Kim JS, Pak HN, et al. Feasibility of left atrial appendage occlusion for left atrial appendage thrombus in patients with persistent atrial fibrillation. Am J Cardiol 2018;121:1534-9. https://doi.org/10.1016/j.amjcard.2018.02.045
  77. Kim JS, Lee H, Suh Y, et al. Left atrial appendage occlusion in non-valvular atrial fibrillation in a Korean Multi-Center Registry. Circ J 2016;80:1123-30. https://doi.org/10.1253/circj.CJ-15-1134
  78. Chen Y, Zhang Y, Huang W, Huang K, Xu B, Su XI. Primary and secondary stroke prevention using left atrial appendage closure with Watchman devices in atrial fibrillation patients: a single center experience from Mainland China. Pacing Clin Electrophysiol 2017;40:607-14. https://doi.org/10.1111/pace.13020
  79. Landmesser U, Schmidt B, Nielsen-Kudsk JE, et al. Left atrial appendage occlusion with the AMPLATZER Amulet device: periprocedural and early clinical/echocardiographic data from a global prospective observational study. EuroIntervention 2017;13:867-76. https://doi.org/10.4244/EIJ-D-17-00493
  80. Phan QT, Shin SY, Cho IS, et al. Impact of left atrial appendage closure on cardiac functional and structural remodeling: a Difference-in-Difference analysis of propensity score matched samples. Cardiol J. 2018 [Epub ahead of print].
  81. Siu CW, Tse HF. Net clinical benefit of warfarin therapy in elderly Chinese patients with atrial fibrillation. Circ Arrhythm Electrophysiol 2014;7:300-6. https://doi.org/10.1161/CIRCEP.113.000858
  82. Huisman MV, Rothman KJ, Paquette M, et al. Antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation: the GLORIA-AF Registry, Phase II. Am J Med 2015;128:1306-1313.e1. https://doi.org/10.1016/j.amjmed.2015.07.013
  83. Bassand JP, Accetta G, Camm AJ, et al. Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF. Eur Heart J 2016;37:2882-9. https://doi.org/10.1093/eurheartj/ehw233
  84. Guo Y, Wang H, Tian Y, Wang Y, Lip GY. Time trends of aspirin and warfarin use on stroke and bleeding events in Chinese patients with new-onset atrial fibrillation. Chest 2015;148:62-72. https://doi.org/10.1378/chest.14-2018
  85. Chang SS, Dong JZ, Ma CS, et al. Current status and time trends of oral anticoagulation use among Chinese patients with nonvalvular atrial fibrillation: the Chinese atrial fibrillation registry study. Stroke 2016;47:1803-10. https://doi.org/10.1161/STROKEAHA.116.012988
  86. Siu CW, Lip GY, Lam KF, et al. Risk of stroke and intracranial hemorrhage in 9727 Chinese with atrial fibrillation in Hong Kong. Heart Rhythm 2014;11:1401-8. https://doi.org/10.1016/j.hrthm.2014.04.021
  87. Son MK, Lim NK, Park HY. Trend of prevalence of atrial fibrillation and use of oral anticoagulation therapy in patients with atrial fibrillation in South Korea (2002-2013). J Epidemiol 2018;28:81-7. https://doi.org/10.2188/jea.JE20160149
  88. Lee SR, Choi EK, Han KD, Cha MJ, Oh S, Lip GY. Temporal trends of antithrombotic therapy for stroke prevention in Korean patients with non-valvular atrial fibrillation in the era of non-vitamin K antagonist oral anticoagulants: a nationwide population-based study. PLoS One 2017;12:e0189495. https://doi.org/10.1371/journal.pone.0189495
  89. Lee SR, Han K, Cha MJ, et al. Prevalence of non-valvular atrial fibrillation based on geographical distribution and socioeconomic status in the entire Korean population. Korean Circ J 2018;48:e58.
  90. Kim H, Kim TH, Cha MJ, et al. A prospective survey of atrial fibrillation management for real-world guideline adherence: COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF) Registry. Korean Circ J 2017;47:877-87. https://doi.org/10.4070/kcj.2017.0146
  91. Suzuki S, Otsuka T, Sagara K, et al. Nine-year trend of anticoagulation use, thromboembolic events, and major bleeding in patients with non-valvular atrial fibrillation - Shinken Database analysis. Circ J 2016;80:639-49. https://doi.org/10.1253/circj.CJ-15-1237
  92. Miyazaki S, Miyauchi K, Hayashi H, et al. Registry of Japanese patients with atrial fibrillation focused on anticoagulant therapy in the new era: The RAFFINE registry study design and baseline characteristics. J Cardiol 2018;71:590-6. https://doi.org/10.1016/j.jjcc.2017.10.021
  93. Apostolakis S, Sullivan RM, Olshansky B, Lip GY. Factors affecting quality of anticoagulation control among patients with atrial fibrillation on warfarin: the SAMe-TT2R2 score. Chest 2013;144:1555-63. https://doi.org/10.1378/chest.13-0054
  94. Singer DE, Hellkamp AS, Piccini JP, et al. Impact of global geographic region on time in therapeutic range on warfarin anticoagulant therapy: data from the ROCKET AF clinical trial. J Am Heart Assoc 2013;2:e000067.
  95. Wallentin L, Yusuf S, Ezekowitz MD, et al. Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial. Lancet 2010;376:975-83. https://doi.org/10.1016/S0140-6736(10)61194-4
  96. Oh S, Goto S, Accetta G, et al. Vitamin K antagonist control in patients with atrial fibrillation in Asia compared with other regions of the world: Real-world data from the GARFIELD-AF registry. Int J Cardiol 2016;223:543-7. https://doi.org/10.1016/j.ijcard.2016.08.236
  97. Bernaitis N, Ching CK, Chen L, et al. The sex, age, medical history, treatment, tobacco use, race risk (SAMe TT2R2) score predicts warfarin control in a Singaporean population. J Stroke Cerebrovasc Dis 2017;26:64-9. https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.08.030
  98. Hong KS, Kim YK, Bae HJ, et al. Quality of anticoagulation with warfarin in Korean patients with atrial fibrillation and prior stroke: a multicenter retrospective observational study. J Clin Neurol 2017;13:273-80. https://doi.org/10.3988/jcn.2017.13.3.273
  99. Saokaew S, Sapoo U, Nathisuwan S, Chaiyakunapruk N, Permsuwan U. Anticoagulation control of pharmacist-managed collaborative care versus usual care in Thailand. Int J Clin Pharm 2012;34:105-12. https://doi.org/10.1007/s11096-011-9597-8
  100. Thanimalai S, Shafie AA, Hassali MA, Sinnadurai J. Comparing effectiveness of two anticoagulation management models in a Malaysian tertiary hospital. Int J Clin Pharm 2013;35:736-43. https://doi.org/10.1007/s11096-013-9796-6
  101. Bernaitis N, Ching CK, Teo SC, et al. Factors influencing warfarin control in Australia and Singapore. Thromb Res 2017;157:120-5. https://doi.org/10.1016/j.thromres.2017.07.007
  102. Yang QD, Niu Q, Zhou YH, et al. Incidence of cerebral hemorrhage in the Changsha community. A prospective study from 1986 to 2000. Cerebrovasc Dis 2004;17:303-13. https://doi.org/10.1159/000077341
  103. Guo Y, Pisters R, Apostolakis S, et al. Stroke risk and suboptimal thromboprophylaxis in Chinese patients with atrial fibrillation: would the novel oral anticoagulants have an impact? Int J Cardiol 2013;168:515-22. https://doi.org/10.1016/j.ijcard.2012.09.187
  104. Gamra H, Murin J, Chiang CE, et al. Use of antithrombotics in atrial fibrillation in Africa, Europe, Asia and South America: insights from the International RealiseAF Survey. Arch Cardiovasc Dis 2014;107:77-87. https://doi.org/10.1016/j.acvd.2014.01.001
  105. Huisman MV, Ma CS, Diener HC, et al. Antithrombotic therapy use in patients with atrial fibrillation before the era of non-vitamin K antagonist oral anticoagulants: the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) Phase I cohort. Europace 2016;18:1308-18. https://doi.org/10.1093/europace/euw073
  106. Amerena J, Chen SA, Sriratanasathavorn C, et al. Insights into management of atrial fibrillation in Asia Pacific gained from baseline data from REgistry on cardiac rhythm disORDers (RecordAF-Asia Pacific [AP]) registry. Am J Cardiol 2012;109:378-82. https://doi.org/10.1016/j.amjcard.2011.08.046
  107. Chang CH, Yang YH, Chen JH, Lin LJ. Cost-effectiveness of dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation in Taiwan. Thromb Res 2014;133:782-9. https://doi.org/10.1016/j.thromres.2014.02.024
  108. Chan EW, Lau WC, Siu CW, et al. Effect of suboptimal anticoagulation treatment with antiplatelet therapy and warfarin on clinical outcomes in patients with nonvalvular atrial fibrillation: a population-wide cohort study. Heart Rhythm 2016;13:1581-8. https://doi.org/10.1016/j.hrthm.2016.03.049
  109. Chao TF, Liu CJ, Lin YJ, et al. Oral anticoagulation in very elderly patients with atrial fibrillation - a nationwide cohort study. Circulation. 2018 [Epub ahead of print].
  110. Bai Y, Guo SD, Deng H, et al. Effectiveness and safety of oral anticoagulants in older patients with atrial fibrillation: a systematic review and meta-regression analysis. Age Ageing 2018;47:9-17.
  111. Sato H, Ishikawa K, Kitabatake A, et al. Low-dose aspirin for prevention of stroke in low-risk patients with atrial fibrillation: Japan Atrial Fibrillation Stroke Trial. Stroke 2006;37:447-51. https://doi.org/10.1161/01.STR.0000198839.61112.ee
  112. Yasaka M, Lip GY. Impact of non-vitamin k antagonist oral anticoagulants on intracranial bleeding in Asian patients with non-valvular atrial fibrillation. Circ J 2014;78:2367-72. https://doi.org/10.1253/circj.CJ-14-0720
  113. Martinez C, Katholing A, Wallenhorst C, Freedman SB. Therapy persistence in newly diagnosed non-valvular atrial fibrillation treated with warfarin or NOAC. A cohort study. Thromb Haemost 2016;115:31-9. https://doi.org/10.1160/TH15-04-0350
  114. Yao X, Abraham NS, Alexander GC, et al. Effect of adherence to oral anticoagulants on risk of stroke and major bleeding among patients with atrial fibrillation. J Am Heart Assoc 2016;5:e003074.
  115. Bai Y, Wang YL, Shantsila A, Lip GY. The global burden of atrial fibrillation and stroke: a systematic review of the clinical epidemiology of atrial fibrillation in Asia. Chest 2017;152:810-20. https://doi.org/10.1016/j.chest.2017.03.048
  116. Bai Y, Guo SD, Shantsila A, Lip GY. Modelling projections for the risks related with atrial fibrillation in East Asia: a focus on ischaemic stroke and death. Europace. 2017 [Epub ahead of print].
  117. Lip GY. The ABC pathway: an integrated approach to improve AF management. Nat Rev Cardiol 2017;14:627-8. https://doi.org/10.1038/nrcardio.2017.153
  118. Lip G, Freedman B, De Caterina R, Potpara TS. Stroke prevention in atrial fibrillation: Past, present and future. Comparing the guidelines and practical decision-making. Thromb Haemost 2017;117:1230-9. https://doi.org/10.1160/TH16-11-0876
  119. Fauchier L, Villejoubert O, Clementy N, et al. Causes of death and influencing factors in patients with atrial fibrillation. Am J Med 2016;129:1278-87. https://doi.org/10.1016/j.amjmed.2016.06.045
  120. Pokorney SD, Piccini JP, Stevens SR, et al. Cause of death and predictors of all-cause mortality in anticoagulated patients with nonvalvular atrial fibrillation: data from ROCKET AF. J Am Heart Assoc 2016;5:e002197.

Cited by

  1. Optimal Rivaroxaban Dose in Asian Patients With Atrial Fibrillation and Normal or Mildly Impaired Renal Function vol.50, pp.5, 2018, https://doi.org/10.1161/strokeaha.118.024210
  2. Increased risk of atrial fibrillation in patients with inflammatory bowel disease: A nationwide population-based study vol.25, pp.22, 2018, https://doi.org/10.3748/wjg.v25.i22.2788
  3. Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation and Valvular Heart Disease vol.8, pp.10, 2018, https://doi.org/10.3390/jcm8101624
  4. Fluctuating renal function and the risk of incident atrial fibrillation: a nationwide population-based study vol.9, pp.1, 2019, https://doi.org/10.1038/s41598-019-54528-w
  5. Blood Pressure Variability and Incidence of New-Onset Atrial Fibrillation : A Nationwide Population-Based Study vol.75, pp.2, 2020, https://doi.org/10.1161/hypertensionaha.119.13708
  6. Effectiveness and Safety of Direct Oral Anticoagulants in Relation to Temporal Changes in Their Use vol.13, pp.3, 2018, https://doi.org/10.1161/circoutcomes.119.005894
  7. Outcomes in relation to antithrombotic therapy among patients with atrial fibrillation after percutaneous coronary intervention vol.15, pp.10, 2018, https://doi.org/10.1371/journal.pone.0240161
  8. Association between clustering of unhealthy lifestyle factors and risk of new-onset atrial fibrillation: a nationwide population-based study vol.10, pp.1, 2018, https://doi.org/10.1038/s41598-020-75822-y
  9. Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial Fibrillation and Prior Gastrointestinal Bleeding vol.52, pp.2, 2018, https://doi.org/10.1161/strokeaha.120.030761
  10. Can the CHA2DS2‐VA schema be used to decide on anticoagulant therapy in Aboriginal and other Australians with non‐valvular atrial fibrillation? vol.51, pp.4, 2018, https://doi.org/10.1111/imj.15282
  11. Predictors of ischemic stroke for low-risk patients with atrial fibrillation: A matched case-control study vol.18, pp.5, 2018, https://doi.org/10.1016/j.hrthm.2021.01.016
  12. Impact of Non-Vitamin K Antagonist Oral Anticoagulants on the Change of Antithrombotic Regimens in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention vol.51, pp.5, 2021, https://doi.org/10.4070/kcj.2020.0407
  13. A prospective, observational study of rivaroxaban for stroke prevention in atrial fibrillation: the XANAP Korea vol.36, pp.4, 2018, https://doi.org/10.3904/kjim.2020.217
  14. Rivaroxaban: striking two birds with one stone vol.36, pp.4, 2021, https://doi.org/10.3904/kjim.2021.275