循環器ジャーナル72巻3号

2024年07月発行

特集 心房細動—予防・早期発見・治療の進化 Ⅰ.病態

AFの疫学からみた脳梗塞リスク—CHADS₂，CHA₂DS₂-VAScスコアは日本人にあてはまるか？

著者： 赤尾昌治¹

所属機関： ¹国立病院機構京都医療センター循環器内科

ページ範囲：P.358 - P.365

POINT
●欧米発のCHADS₂スコアやCHA₂DS₂-VAScスコアの，日本人心房細動患者における脳梗塞リスク予測性能は高くない．
●わが国発のHELT-E₂S₂スコアが，日本人心房細動患者のデータから開発され，ガイドラインに採用された．

参考文献

1）Akao M, Ogawa H, Masunaga N, et al. 10-year trends of antithrombotic therapy status and outcomes in Japanese atrial fibrillation patients - The Fushimi AF Registry. Circ J 2022 ; 86 : 726-36.

2）Gage BF, Waterman AD, Shannon W, et al. Validation of clinical classification schemes for predicting stroke : results from the National Registry of Atrial Fibrillation. JAMA 2001 ; 285 : 2864-70.

3）Lip GY, Nieuwlaat R, Pisters R, et al. 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.

4）Suzuki S, Yamashita T, Okumura K, et al. Incidence of ischemic stroke in Japanese patients with atrial fibrillation not receiving anticoagulation therapy --pooled analysis of the Shinken Database, J-RHYTHM Registry, and Fushimi AF Registry. Circ J 2015 ; 79 : 432-8.

5）Akao M, Chun Y, Wada H, et al. Current status of clinical background of patients with atrial fibrillation in a community-based survey : The Fushimi AF Registry. J Cardiol 2013 ; 61 : 260-6.

6）Akao M, Chun YH, Esato M, et al. Inappropriate use of oral anticoagulants for patients with atrial fibrillation. Circ J 2014 ; 78 : 2166-72.

7）Iguchi M, Tezuka Y, Ogawa H, et al. Incidence and risk factors of stroke or systemic embolism in patients with atrial fibrillation and heart failure - The Fushimi AF Registry. Circ J 2018 ; 82 : 1327-35.

8）Hayashi K, Tsuda T, Nomura A, et al. Impact of B-Type Natriuretic Peptide Level on Risk Stratification of Thromboembolism and Death in Patients With Nonvalvular Atrial Fibrillation - The Hokuriku-Plus AF Registry. Circ J 2018 ; 82 : 1271-8.

9）Ishii M, Ogawa H, Unoki T, et al. Relationship of hypertension and systolic blood pressure with the risk of stroke or bleeding in patients with atrial fibrillation : The Fushimi AF Registry. Am J Hypertens 2017 ; 30 : 1073-82.

10）Kodani E, Atarashi H, Inoue H, et al. Impact of blood pressure control on thromboembolism and major hemorrhage in patients with nonvalvular atrial fibrillation : A subanalysis of the J-RHYTHM Registry. J Am Heart Assoc 2016 ; 5 : e004075.

11）Yamashita Y, Hamatani Y, Esato M, et al. Clinical characteristics and outcomes in extreme elderly（age≥85 years）Japanese patients with atrial fibrillation : The Fushimi AF Registry. Chest 2016 ; 149 : 401-12.

12）Hamatani Y, Ogawa H, Uozumi R, et al. Low body weight is associated with the incidence of stroke in atrial fibrillation patients - Insight from the Fushimi AF Registry. Circ J 2015 ; 79 : 1009-17.

13）Kodani E, Atarashi H, Inoue H, et al. Impact of Blood Pressure Control on Thromboembolism and Major Hemorrhage in Patients With Nonvalvular Atrial Fibrillation : A Subanalysis of the J-RHYTHM Registry. J Am Heart Assoc 2016 ; 5 : e004075.

14）Ashburner JM, Go AS, Chang Y, et al. Effect of Diabetes and Glycemic Control on Ischemic Stroke Risk in AF Patients : ATRIA Study. J Am Coll Cardiol 2016 ; 67 : 239-47.

15）Inoue H, Atarashi H, Okumura K, et al. Impact of gender on the prognosis of patients with nonvalvular atrial fibrillation. Am J Cardiol 2014 ; 113 : 957-62.

16）Ogawa H, Hamatani Y, Doi K, et al. Sex-related differences in the clinical events of patients with atrial fibrillation - The Fushimi AF Registry. Circ J 2017 ; 81 : 1403-10.

-VASc in Japanese Patients With Nonvalvular Atrial Fibrillation - Subanalysis of the J-RHYTHM Registry. Circ J 2015 ; 79 : 1719-26.

-VASc? Circulation 2018 ; 137 : 832-40.

19）Takabayashi K, Hamatani Y, Yamashita Y, et al. Incidence of stroke or systemic embolism in paroxysmal versus sustained atrial fibrillation : The Fushimi Atrial Fibrillation Registry. Stroke 2015 ; 46 : 3354-61.

20）Ogawa H, An Y, Ikeda S, et al. Progression from paroxysmal to sustained atrial fibrillation is associated with increased adverse events. Stroke 2018 ; 49 : 2301-8.

21）Abe M, Ogawa H, Ishii M, et al. Relation of stroke and major bleeding to creatinine clearance in patients with atrial fibrillation（from the Fushimi AF Registry）. Am J Cardiol 2017 ; 119 : 1229-37.

22）Inoue H, Kodani E, Atarashi H, et al. Impact of body mass index on the prognosis of Japanese patients with non-valvular atrial fibrillation. Am J Cardiol 2016 ; 118 : 215-21.

23）Kodani E, Atarashi H, Inoue H, et al. Impact of creatinine clearance on outcomes in patients with non-valvular atrial fibrillation : a subanalysis of the J-RHYTHM Registry. Eur Heart J Qual Care Clin Outcomes 2018 ; 4 : 59-68.

24）Hamatani Y, Ogawa H, Takabayashi K, et al. Left atrial enlargement is an independent predictor of stroke and systemic embolism in patients with non-valvular atrial fibrillation. Sci Rep 2016 ; 6 : 31042.

25）Tezuka Y, Iguchi M, Hamatani Y, et al. Association of relative wall thickness of left ventricle with incidence of thromboembolism in patients with non-valvular atrial fibrillation : The Fushimi AF Registry. Eur Heart J Qual Care Clin Outcomes 2020 ; 6 : 273-83.

26）Okumura K, Tomita H, Nakai M, et al. Risk factors associated with ischemic stroke in Japanese patients with nonvalvular atrial fibrillation. JAMA Netw Open 2020 ; 3 : e202881.

27）Okumura K, Tomita H, Nakai M, et al. A novel risk stratification system for ischemic stroke in Japanese patients with non-valvular atrial fibrillation. Circ J 2021 ; 85 : 1254-62.