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Risk profile, antithrombotic treatment and clinical outcomes of patients in Nordic countries with atrial fibrillation - results from the GARFIELD-AF registry.

Pope, MK; Atar, D; Svilaas, A; Hole, T; Nielsen, JD; Hintze, U; Crisby, M; Raatikainen, P; Airaksinen, KEJ; Virdone, S; et al. Pope, MK; Atar, D; Svilaas, A; Hole, T; Nielsen, JD; Hintze, U; Crisby, M; Raatikainen, P; Airaksinen, KEJ; Virdone, S; Pieper, K; Kayani, G; Le Heuzey, J-Y; Steffel, J; Stepinska, J; Bassand, J-P; Camm, AJ; GARFIELD-AF Investigators (2021) Risk profile, antithrombotic treatment and clinical outcomes of patients in Nordic countries with atrial fibrillation - results from the GARFIELD-AF registry. Ann Med, 53 (1). pp. 485-494. ISSN 1365-2060 https://doi.org/10.1080/07853890.2021.1893897
SGUL Authors: Camm, Alan John

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Abstract

AIMS: The objective was to evaluate the clinical characteristics, management and two-year outcomes of patients with newly diagnosed non-valvular atrial fibrillation at risk for stroke in Nordic countries. METHODS: We examined the baseline characteristics, antithrombotic treatment, and two-year clinical outcomes of patients from four Nordic countries. RESULTS: A total of 52,080 patients were enrolled in the GARFIELD-AF. Out of 29,908 European patients, 2,396 were recruited from Nordic countries. The use of oral anticoagulants, alone or in combination with antiplatelet (AP), was higher in Nordic patients in all CHA2DS2-VASc categories: 0-1 (72.8% vs 60.3%), 2-3 (78.7% vs 72.9%) and ≥4 (79.2% vs 74.1%). In Nordic patients, NOAC ± AP was more frequently prescribed (32.0% vs 27.7%) and AP monotherapy was less often prescribed (10.4% vs 18.2%) when compared with Non-Nordic European patients. The rates (per 100 patient years) of all-cause mortality and non-haemorrhagic stroke/systemic embolism (SE) were similar in Nordic and Non-Nordic European patients [3.63 (3.11-4.23) vs 4.08 (3.91-4.26), p value = .147] and [0.98 (0.73-1.32) vs 1.02 (0.93-1.11), p value = .819], while major bleeding was significantly higher [1.66 (1.32-2.09) vs 1.01 (0.93-1.10), p value < .001]. CONCLUSION: Nordic patients had significantly higher major bleeding than Non-Nordic-European patients. In contrast, rates of all-cause mortality and non-haemorrhagic stroke/SE were comparable. CLINICAL TRIAL REGISTRATION: Unique identifier: NCT01090362. URL: http://www.clinicaltrials.gov. KEY MESSAGE: Nordic countries had significantly higher major bleeding than Non-Nordic-European countries. Rates of mortality and non-haemorrhagic stroke/SE were similar .

Item Type: Article
Additional Information: © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/),which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Atrial fibrillation, Nordic countries, antithrombotic treatment, stroke prevention, GARFIELD-AF Investigators, Atrial fibrillation, Nordic countries, antithrombotic treatment, stroke prevention, 11 Medical and Health Sciences, Cardiovascular System & Hematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Ann Med
ISSN: 1365-2060
Language: eng
Dates:
DateEvent
December 2021Published
5 April 2021Published Online
16 February 2021Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
PubMed ID: 33818226
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/113166
Publisher's version: https://doi.org/10.1080/07853890.2021.1893897

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