Steinberg, BA;
Gao, H;
Shrader, P;
Pieper, K;
Thomas, L;
Camm, AJ;
Ezekowitz, MD;
Fonarow, GC;
Gersh, BJ;
Goldhaber, S;
et al.
Steinberg, BA; Gao, H; Shrader, P; Pieper, K; Thomas, L; Camm, AJ; Ezekowitz, MD; Fonarow, GC; Gersh, BJ; Goldhaber, S; Haas, S; Hacke, W; Kowey, PR; Ansell, J; Mahaffey, KW; Naccarelli, G; Reiffel, JA; Turpie, A; Verheugt, F; Piccini, JP; Kakkar, A; Peterson, ED; Fox, KAA; GARFIELD-AF; ORBIT-AF Investigators
(2017)
International trends in clinical characteristics and oral anticoagulation treatment for patients with atrial fibrillation: Results from the GARFIELD-AF, ORBIT-AF I, and ORBIT-AF II registries.
Am Heart J, 194.
pp. 132-140.
ISSN 1097-6744
https://doi.org/10.1016/j.ahj.2017.08.011
SGUL Authors: Camm, Alan John
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Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world. We aimed to provide comprehensive data on international patterns of AF stroke prevention treatment. METHODS: Demographics, comorbidities, and stroke risk of the patients in the GARFIELD-AF (n=51,270), ORBIT-AF I (n=10,132), and ORBIT-AF II (n=11,602) registries were compared (overall N=73,004 from 35 countries). Stroke prevention therapies were assessed among patients with new-onset AF (≤6 weeks). RESULTS: Patients from GARFIELD-AF were less likely to be white (63% vs 89% for ORBIT-AF I and 86% for ORBIT-AF II) or have coronary artery disease (19% vs 36% and 27%), but had similar stroke risk (85% CHA2DS2-VASc ≥2 vs 91% and 85%) and lower bleeding risk (11% with HAS-BLED ≥3 vs 24% and 15%). Oral anticoagulant use was 46% and 57% for patients with a CHA2DS2-VASc=0 and 69% and 87% for CHA2DS2-VASc ≥2 in GARFIELD-AF and ORBIT-AF II, respectively, but with substantial geographic heterogeneity in use of oral anticoagulant (range: 31%-93% [GARFIELD-AF] and 66%-100% [ORBIT-AF II]). Among patients with new-onset AF, non-vitamin K antagonist oral anticoagulant use increased over time to 43% in 2016 for GARFIELD-AF and 71% for ORBIT-AF II, whereas use of antiplatelet monotherapy decreased from 36% to 17% (GARFIELD-AF) and 18% to 8% (ORBIT-AF I and II). CONCLUSIONS: Among new-onset AF patients, non-vitamin K antagonist oral anticoagulant use has increased and antiplatelet monotherapy has decreased. However, anticoagulation is used frequently in low-risk patients and inconsistently in those at high risk of stroke. Significant geographic variability in anticoagulation persists and represents an opportunity for improvement.
Item Type: | Article | ||||||||
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Additional Information: | © 2017 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). | ||||||||
Keywords: | Administration, Oral, Aged, Anticoagulants, Atrial Fibrillation, Female, Global Health, Humans, Male, Middle Aged, Prevalence, Prospective Studies, Registries, Risk Assessment, Risk Factors, Stroke, Cardiovascular System & Hematology, 1102 Cardiovascular Medicine And Haematology, 1117 Public Health And Health Services | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Cardiac (INCCCA) |
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Journal or Publication Title: | Am Heart J | ||||||||
ISSN: | 1097-6744 | ||||||||
Language: | eng | ||||||||
Dates: |
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Publisher License: | Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0 | ||||||||
PubMed ID: | 29223431 | ||||||||
Web of Science ID: | WOS:000417602600015 | ||||||||
Go to PubMed abstract | |||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/109451 | ||||||||
Publisher's version: | https://doi.org/10.1016/j.ahj.2017.08.011 |
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