Original Article
Risk Factor Profiles of Stroke, Myocardial Infarction, and Atrial Fibrillation: A Japanese Multicenter Cooperative Registry

https://doi.org/10.1016/j.jstrokecerebrovasdis.2009.04.004Get rights and content

Objective

We sought to clarify risk factor profiles and current treatment of Japanese patients with stroke, myocardial infarction (MI), and nonvalvular atrial fibrillation (NVAF) using the database of the Japan Thrombosis Registry for Atrial Fibrillation, Coronary, or Cerebrovascular Events (J-TRACE).

Methods

J-TRACE is a nationwide multicenter cooperative cohort of Japanese patients with MI, stroke, and NVAF. Baseline characteristics of 8087 Japanese patients (5804 male, average age 68.7 years) with history of stroke (n = 3554), MI (n = 2291), or NVAF (n = 2242) were analyzed.

Results

History of stroke (14.7%) was more frequent than history of MI (2.6%) in patients with stroke, whereas history of stroke (6.6%) was less frequent than history of MI (7.6%) in patients with MI. In patients with NVAF, history of stroke (14.3%) was far more frequent than history of MI (3.4%). Hypertension was more frequent in stroke (74.4%) than MI (62.0%) or NVAF (57.7%), whereas hypercholesterolemia, diabetes mellitus, and cigarette smoking were more prevalent in patients with MI (56.1%, 35.1%, and 33.3%, respectively) than in those with stroke (35.7%, 22.4%, and 19.7%, respectively) or NVAF (26.9%, 17.2%, and 16.1%, respectively). Alcohol consumption (34.9%) and obesity (body mass index > 25) (32.8%) were most common in patients with NVAF. In all patients, nonmedication rates were higher in patients with hypercholesterolemia (29.8%) or diabetes (36.9%) than in those with hypertension (9.5%). Warfarin was used in 58.9% of patients with low-risk and 75.4% with high-risk NVAF.

Conclusion

Risk factor profiles and their modification were not similar among patients in Japan with MI, stroke, and NVAF, although they share a high risk of thrombotic events.

Section snippets

Patients Recruited

Recruitment was started in January 2005 and terminated in December 2006. The study protocol was reviewed by an institutional review board (IRB) at each site. A central IRB reviewed the study for those sites that did not have their own internal IRB. All patients gave informed consent after receiving a full explanation of the study from the investigators. Patients aged 20 to 90 years with history of stroke, MI, or NVAF were eligible to be enrolled in J-TRACE. Inclusion criteria for history of

Results

A total of 8087 patients were recruited into the J-TRACE from 201 sites. They included 3554 patients with history of stroke, 2291 patients with history of MI, and 2242 patients with history of NVAF. Table 1 shows the baseline characteristics of the recruited patients by disease category. Mean age was youngest for patients with MI and oldest for patients with NVAF. Male percentage was more than approximately 10% higher for MI than for stroke and NVAF. Prevalence of risk factors exhibited

Discussion

J-TRACE, a large nationwide multicenter cooperative registry, is unique in simultaneous recruitment of not only patients with stroke and MI but also those with NVAF, which are 3 major thromboembolic diseases that cause death or disability in the Japanese population, in order to prospectively investigate vascular event rates during a 3-year follow-up period. In this study, we examined baseline data to clarify risk factor profiles and present status of risk factor management and antithrombotic

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    Supported by the Japan Heart Foundation.

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