Assessment of Long‐Term Use Versus Discontinuation of Direct Oral Anticoagulant After Catheter Ablation for Atrial Fibrillation—RYOUMA Registry Subanalysis
ABSTRACT Background The relationship between oral anticoagulant (OAC) status after catheter ablation (CA) for atrial fibrillation (AF) and the risks of ischemic stroke or major bleeding events is still unknown. Methods This is a subanalysis of the RYOUMA registry, a prospective multicenter observati...
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Wiley
2025-05-01
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| Series: | Annals of Noninvasive Electrocardiology |
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| Online Access: | https://doi.org/10.1111/anec.70067 |
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| author | Yuka Oda Akihiko Nogami Yuki Komatsu Kyoko Soejima Itsuro Morishima Kenichi Hiroshima Ritsushi Kato Satoru Sakagami Fumiharu Miura Keisuke Okawa Masayuki Fukuzawa Atsushi Takita Kikuya Uno Koichiro Kumagai Takashi Kurita Masahiko Gosho Tomoko Ishizu Kazutaka Aonuma the RYOUMA Investigators |
| author_facet | Yuka Oda Akihiko Nogami Yuki Komatsu Kyoko Soejima Itsuro Morishima Kenichi Hiroshima Ritsushi Kato Satoru Sakagami Fumiharu Miura Keisuke Okawa Masayuki Fukuzawa Atsushi Takita Kikuya Uno Koichiro Kumagai Takashi Kurita Masahiko Gosho Tomoko Ishizu Kazutaka Aonuma the RYOUMA Investigators |
| author_sort | Yuka Oda |
| collection | DOAJ |
| description | ABSTRACT Background The relationship between oral anticoagulant (OAC) status after catheter ablation (CA) for atrial fibrillation (AF) and the risks of ischemic stroke or major bleeding events is still unknown. Methods This is a subanalysis of the RYOUMA registry, a prospective multicenter observational study of Japanese patients who underwent CA for AF in 2017–2018. Results Of the 2844 patients, the rate of DOAC continuation was 48.1%, 69.6%, and 80.9% in patients with a CHADS2 score of 0–1, 2, and 3–6, respectively. Among the patients taking DOACs with a CHADS2 score of 0–1 and 2, the incidence rates of major bleeding were significantly higher than those of ischemic stroke or systemic embolic events (SEEs) (1.3%/year [95% CI, 0.6–2.1] vs. 0.3%/year [95% CI, 0.0–0.7], p = 0.019; 1.8%/year [95% CI, 0.6–3.0] vs. 0.2%/year [95% CI, 0.0–0.6], p = 0.018, respectively). However, there was no difference between the incidence rates of major bleeding events and ischemic stroke or SEEs in patients taking DOACs with a CHADS2 score of 3–6 (1.6%/year [95% CI, 0.2–3.0] vs. 1.0%/year [95% CI, 0.0–2.1], p = 0.474). Conclusions In patients with a CHADS2 score of 2, those who continued taking DOACs had a higher incidence rate of major bleeding events compared to ischemic stroke/SEEs, similar to those with a CHADS2 score of 0–1. Conversely, in patients with a CHADS2 score of 3–6, the incidence rates of both ischemic stroke/SEEs and major bleeding were similarly high. Trial Registration: The study was registered as UMIN000026092 (University Hospital Medical Information Network‐Clinical Trial Registry) |
| format | Article |
| id | doaj-art-4f94e3e0b5874e04a2554e8ff8d29c7b |
| institution | OA Journals |
| issn | 1082-720X 1542-474X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wiley |
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| series | Annals of Noninvasive Electrocardiology |
| spelling | doaj-art-4f94e3e0b5874e04a2554e8ff8d29c7b2025-08-20T02:29:04ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2025-05-01303n/an/a10.1111/anec.70067Assessment of Long‐Term Use Versus Discontinuation of Direct Oral Anticoagulant After Catheter Ablation for Atrial Fibrillation—RYOUMA Registry SubanalysisYuka Oda0Akihiko Nogami1Yuki Komatsu2Kyoko Soejima3Itsuro Morishima4Kenichi Hiroshima5Ritsushi Kato6Satoru Sakagami7Fumiharu Miura8Keisuke Okawa9Masayuki Fukuzawa10Atsushi Takita11Kikuya Uno12Koichiro Kumagai13Takashi Kurita14Masahiko Gosho15Tomoko Ishizu16Kazutaka Aonuma17the RYOUMA InvestigatorsDepartment of Cardiology Institute of Medicine, University of Tsukuba Tsukuba JapanDepartment of Cardiology Institute of Medicine, University of Tsukuba Tsukuba JapanDepartment of Cardiology Institute of Medicine, University of Tsukuba Tsukuba JapanDepartment of Cardiology Kyorin University School of Medicine Tokyo JapanDepartment of Cardiology Ogaki Municipal Hospital Ogaki JapanCardiovascular Division Kokura Memorial Hospital Fukuoka JapanDepartment of Arrhythmia Saitama Medical University International Medical Center Saitama JapanDepartment of Cardiology National Hospital Organization Kanazawa Medical Center Kanazawa Ishikawa JapanDepartment of Cardiovascular Medicine Hiroshima Prefectural Hospital Hiroshima JapanDepartment of Cardiovascular Medicine Kagawa Prefectural Central Hospital Takamatsu Kagawa JapanPrimary Medical Science Department DAIICHI SANKYO co., Ltd. Tokyo JapanData Intelligence Department DAIICHI SANKYO co., Ltd. Tokyo JapanDepartment of Cardiology Tokyo Heart Rhythm Hospital Tokyo JapanHeart Rhythm Center Fukuoka Sanno Hospital Fukuoka JapanDivision of Cardiovascular Center Kindai University School of Medicine Osaka JapanDepartment of Biostatistics Faculty of Medicine, University of Tsukuba Tsukuba JapanDepartment of Cardiology Institute of Medicine, University of Tsukuba Tsukuba JapanDepartment of Cardiology Institute of Medicine, University of Tsukuba Tsukuba JapanABSTRACT Background The relationship between oral anticoagulant (OAC) status after catheter ablation (CA) for atrial fibrillation (AF) and the risks of ischemic stroke or major bleeding events is still unknown. Methods This is a subanalysis of the RYOUMA registry, a prospective multicenter observational study of Japanese patients who underwent CA for AF in 2017–2018. Results Of the 2844 patients, the rate of DOAC continuation was 48.1%, 69.6%, and 80.9% in patients with a CHADS2 score of 0–1, 2, and 3–6, respectively. Among the patients taking DOACs with a CHADS2 score of 0–1 and 2, the incidence rates of major bleeding were significantly higher than those of ischemic stroke or systemic embolic events (SEEs) (1.3%/year [95% CI, 0.6–2.1] vs. 0.3%/year [95% CI, 0.0–0.7], p = 0.019; 1.8%/year [95% CI, 0.6–3.0] vs. 0.2%/year [95% CI, 0.0–0.6], p = 0.018, respectively). However, there was no difference between the incidence rates of major bleeding events and ischemic stroke or SEEs in patients taking DOACs with a CHADS2 score of 3–6 (1.6%/year [95% CI, 0.2–3.0] vs. 1.0%/year [95% CI, 0.0–2.1], p = 0.474). Conclusions In patients with a CHADS2 score of 2, those who continued taking DOACs had a higher incidence rate of major bleeding events compared to ischemic stroke/SEEs, similar to those with a CHADS2 score of 0–1. Conversely, in patients with a CHADS2 score of 3–6, the incidence rates of both ischemic stroke/SEEs and major bleeding were similarly high. Trial Registration: The study was registered as UMIN000026092 (University Hospital Medical Information Network‐Clinical Trial Registry)https://doi.org/10.1111/anec.70067anticoagulationatrial fibrillationcatheter ablationhemorrhagestroke |
| spellingShingle | Yuka Oda Akihiko Nogami Yuki Komatsu Kyoko Soejima Itsuro Morishima Kenichi Hiroshima Ritsushi Kato Satoru Sakagami Fumiharu Miura Keisuke Okawa Masayuki Fukuzawa Atsushi Takita Kikuya Uno Koichiro Kumagai Takashi Kurita Masahiko Gosho Tomoko Ishizu Kazutaka Aonuma the RYOUMA Investigators Assessment of Long‐Term Use Versus Discontinuation of Direct Oral Anticoagulant After Catheter Ablation for Atrial Fibrillation—RYOUMA Registry Subanalysis Annals of Noninvasive Electrocardiology anticoagulation atrial fibrillation catheter ablation hemorrhage stroke |
| title | Assessment of Long‐Term Use Versus Discontinuation of Direct Oral Anticoagulant After Catheter Ablation for Atrial Fibrillation—RYOUMA Registry Subanalysis |
| title_full | Assessment of Long‐Term Use Versus Discontinuation of Direct Oral Anticoagulant After Catheter Ablation for Atrial Fibrillation—RYOUMA Registry Subanalysis |
| title_fullStr | Assessment of Long‐Term Use Versus Discontinuation of Direct Oral Anticoagulant After Catheter Ablation for Atrial Fibrillation—RYOUMA Registry Subanalysis |
| title_full_unstemmed | Assessment of Long‐Term Use Versus Discontinuation of Direct Oral Anticoagulant After Catheter Ablation for Atrial Fibrillation—RYOUMA Registry Subanalysis |
| title_short | Assessment of Long‐Term Use Versus Discontinuation of Direct Oral Anticoagulant After Catheter Ablation for Atrial Fibrillation—RYOUMA Registry Subanalysis |
| title_sort | assessment of long term use versus discontinuation of direct oral anticoagulant after catheter ablation for atrial fibrillation ryouma registry subanalysis |
| topic | anticoagulation atrial fibrillation catheter ablation hemorrhage stroke |
| url | https://doi.org/10.1111/anec.70067 |
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