Takeshi Yoshimoto (Japan)
National Cerebral and Cardiovascular Center
Department of Neurology
As a neurointerventionalist, I perform about 40 mechanical thrombectomy cases a year as a surgeon and teach younger generations. As a researcher, I have published papers in Circulation, Stroke, and J Am Heart Assoc in the past. I reported to J Am Heart Assoc in 2019 that the lower the DWI-ASPECTS, the larger the range of core volume, and after that, it was cited in many papers of large core strokes (Stroke 2021;52:2220-2228, Stroke 2021;52:2229-2231. Stroke 2021;52:1561-1569, and Stroke 2020;51:3366-3370). I also reported to J Neurointerv Surg (2020 Dec 15; Neurosurg-2020-016934) about the range of cores that can be expected to be beneficial for MT. In 2021, I reported the BEMP technique for M2O to ISC2021 and received the Paul Dudley White International Scholar Award.

Presenter of 1 Presentation

 Conference Calendar

IMPACT OF PREVIOUS STROKE ON TWO-YEAR CLINICAL OUTCOMES IN PATIENTS WITH ELDERLY NON-VALVULAR ATRIAL FIBRILLATION: SUB-ANALYSIS OF ANAFIE REGISTRY

Session Name
0650 - Heart and Brain / Health Services Research (ID 52)
Session Type
Free Communication Session
Date
29.10.2021, Friday
Session Time
08:00 - 09:30
Room
FREE COMMUNICATIONS A
Presenter
Lecture Time
08:40 - 08:50

Abstract

Background and Aims

The All Nippon AF In the Elderly (ANAFIE) Registry is a prospective, multicenter, observational study for elderly non-valvular atrial fibrillation (NVAF) patients aged ≥75 years in Japan. This sub-study aimed to examine two-year outcomes between patients with and without a history of stroke/TIA.

Methods

Total 32,275 patients enrolled for the analysis set of ANAFIE Registry were divided into 2 groups according to a history of stroke/TIA. The incidence rates of outcome events and relevant factors for stroke/systemic embolism (SEE) were analyzed. These were also analyzed by a history of ischemic stroke (IS)/TIA or type of anticoagulant therapy.

Results

The stroke/TIA group (n=7,303) was less female and older (P<0.001 for both) than the no-stroke/TIA group (n=24,972). Compared to no-stroke/TIA group, the stroke/TIA group had higher incidence rate at 2 years for stroke/SEE (HR 2.25, 95% CI 1.97–2.58), major bleeding (HR, 1.25, 95% CI 1.05–1.49), and death (HR, 1.13, 95% CI 1.02–1.24). In the IS/TIA group, patients with direct oral anticoagulants (DOACs, n=4,960) had lower risk of major bleedings (HR 0.70, 95% CI 0.51–0.96) than those with warfarin (n=1,873). The following relevant factors for stroke/SEE were identified in the stroke/TIA group: persistent AF (HR, 1.42, 95% CI 1.06–1.89), long-standing persistent and permanent AF (HR, 1.51, 95% CI 1.19–1.93), and a history of thromboembolism (HR 1.44, 95% CI 1.10–1.87).

Conclusions

Elderly NVAF patients with a history of stroke/TIA had poorer prognosis than those without stroke/TIA. DOACs had a lower bleeding risk than warfarin for those with IS/TIA.

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