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ABSTRACT: Background
Limited data are available on the characteristics, clinical management, and outcomes of patients with atrial fibrillation at risk of stroke, from a worldwide perspective. The aim of this study was to describe the baseline characteristics and initial therapeutic management of patients with non-valvular atrial fibrillation across the spectrum of sites at which these patients are treated.Methods and findings
The Global Anticoagulant Registry in the FIELD (GARFIELD) is an observational study of patients newly diagnosed with non-valvular atrial fibrillation. Enrollment into Cohort 1 (of 5) took place between December 2009 and October 2011 at 540 sites in 19 countries in Europe, Asia-Pacific, Central/South America, and Canada. Investigator sites are representative of the distribution of atrial fibrillation care settings in each country. Cohort 1 comprised 10,614 adults (?18 years) diagnosed with non-valvular atrial fibrillation within the previous 6 weeks, with ?1 investigator-defined stroke risk factor (not limited to those in existing risk-stratification schemes), and regardless of therapy. Data collected at baseline included demographics, medical history, care setting, nature of atrial fibrillation, and treatments initiated at diagnosis. The mean (SD) age of the population was 70.2 (11.2) years; 43.2% were women. Mean±SD CHADS2 score was 1.9±1.2, and 57.2% had a score ?2. Mean CHA2DS2-VASc score was 3.2±1.6, and 8,957 (84.4%) had a score ?2. Overall, 38.0% of patients with a CHADS2 score ?2 did not receive anticoagulant therapy, whereas 42.5% of those at low risk (score 0) received anticoagulant therapy.Conclusions
These contemporary observational worldwide data on non-valvular atrial fibrillation, collected at the end of the vitamin K antagonist-only era, indicate that these drugs are frequently not being used according to stroke risk scores and guidelines, with overuse in patients at low risk and underuse in those at high risk of stroke.Trial registration
ClinicalTrials.gov TRI08888.
SUBMITTER: Kakkar AK
PROVIDER: S-EPMC3660389 | biostudies-literature | 2013
REPOSITORIES: biostudies-literature
Kakkar Ajay K AK Mueller Iris I Bassand Jean-Pierre JP Fitzmaurice David A DA Goldhaber Samuel Z SZ Goto Shinya S Haas Sylvia S Hacke Werner W Lip Gregory Y H GY Mantovani Lorenzo G LG Turpie Alexander G G AG van Eickels Martin M Misselwitz Frank F Rushton-Smith Sophie S Kayani Gloria G Wilkinson Peter P Verheugt Freek W A FW
PloS one 20130521 5
<h4>Background</h4>Limited data are available on the characteristics, clinical management, and outcomes of patients with atrial fibrillation at risk of stroke, from a worldwide perspective. The aim of this study was to describe the baseline characteristics and initial therapeutic management of patients with non-valvular atrial fibrillation across the spectrum of sites at which these patients are treated.<h4>Methods and findings</h4>The Global Anticoagulant Registry in the FIELD (GARFIELD) is an ...[more]