Eitaro Kodani1, Hiroshi Inoue2, Hirotsugu Atarashi3, Ken Okumura4, Takeshi Yamashita5, Hideki Origasa6. 1. Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital, Tokyo, Japan. Electronic address: kodani@nms.ac.jp. 2. Saiseikai Toyama Hospital, Toyama, Japan. 3. Minamihachioji Hospital, Tokyo, Japan. 4. Saiseikai Kumamoto Hospital, Kumamoto, Japan. 5. The Cardiovascular Institute, Tokyo, Japan. 6. Division of Biostatistics and Clinical Epidemiology, University of Toyama, Toyama, Japan.
Abstract
BACKGROUND: To clarify the influence of hemoglobin concentration and platelet count on adverse outcomes of Japanese patients with non-valvular atrial fibrillation (NVAF), a post hoc analysis of the J-RHYTHM Registry was performed. METHODS: A consecutive series of outpatients with atrial fibrillation were enrolled from 158 institutions and followed up for 2 years or until an event occurred (thromboembolism, major hemorrhage, or all-cause death). Among 7406 patients with NVAF, 6536 with complete blood count data (69.8 ± 9.9 years, 71.0% men) were divided into 4 groups according to the baseline hemoglobin level (<10.0, 10.0-11.9, 12.0-13.9, and ≥14.0 g/dL) or platelet count (<10.0, 10.0-19.9, 20.0-29.9, and ≥30.0 × 104/μL). RESULTS: Incidence rates of major hemorrhage (p = 0.004 for trend), all-cause death (p < 0.001 for trend), and composite events (p < 0.001 for trend) increased as hemoglobin levels decreased, and composite events (p = 0.045 for trend) increased as platelet counts decreased. After adjusting for multiple confounders, the incidence of all-cause death and composite events was higher with hemoglobin levels <12.0 g/dL than a hemoglobin level ≥14.0 g/dL. In contrast, platelet count was not associated with any events. This was also true when multivariate analysis was performed using the stepwise forward method. CONCLUSIONS: A low hemoglobin level (<12.0 g/dL) was an independent risk factor for all-cause death and composite events in Japanese patients with NVAF. However, platelet count did not impact outcomes. CLINICAL TRIAL REGISTRATION: http://www.umin.ac.jp/ctr/ (unique identifier: UMIN000001569).
BACKGROUND: To clarify the influence of hemoglobin concentration and platelet count on adverse outcomes of Japanese patients with non-valvular atrial fibrillation (NVAF), a post hoc analysis of the J-RHYTHM Registry was performed. METHODS: A consecutive series of outpatients with atrial fibrillation were enrolled from 158 institutions and followed up for 2 years or until an event occurred (thromboembolism, major hemorrhage, or all-cause death). Among 7406 patients with NVAF, 6536 with complete blood count data (69.8 ± 9.9 years, 71.0% men) were divided into 4 groups according to the baseline hemoglobin level (<10.0, 10.0-11.9, 12.0-13.9, and ≥14.0 g/dL) or platelet count (<10.0, 10.0-19.9, 20.0-29.9, and ≥30.0 × 104/μL). RESULTS: Incidence rates of major hemorrhage (p = 0.004 for trend), all-cause death (p < 0.001 for trend), and composite events (p < 0.001 for trend) increased as hemoglobin levels decreased, and composite events (p = 0.045 for trend) increased as platelet counts decreased. After adjusting for multiple confounders, the incidence of all-cause death and composite events was higher with hemoglobin levels <12.0 g/dL than a hemoglobin level ≥14.0 g/dL. In contrast, platelet count was not associated with any events. This was also true when multivariate analysis was performed using the stepwise forward method. CONCLUSIONS: A low hemoglobin level (<12.0 g/dL) was an independent risk factor for all-cause death and composite events in Japanese patients with NVAF. However, platelet count did not impact outcomes. CLINICAL TRIAL REGISTRATION: http://www.umin.ac.jp/ctr/ (unique identifier: UMIN000001569).
Authors: Nicole Hanna-Rivero; Samuel J Tu; Adrian D Elliott; Bradley M Pitman; Celine Gallagher; Dennis H Lau; Prashanthan Sanders; Christopher X Wong Journal: BMC Cardiovasc Disord Date: 2022-05-04 Impact factor: 2.174