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Antithrombotic therapy use in patients with atrial fibrillation before the era of non-vitamin K antagonist oral anticoagulants: the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) Phase I cohort

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机构: [1]Leiden Univ, Dept Thrombosis & Hemostasis, Med Ctr, Albinusdreef 2, NL-2333 LA Leiden, Netherlands; [2]Capital Med Univ, Beijing AnZhen Hosp, Dept Cardiol, Atrial Fibrillat Ctr, Beijing, Peoples R China; [3]Univ Hosp Essen Ruhr, Dept Neurol, Essen, Germany; [4]Univ Hosp Essen Ruhr, Stroke Ctr, Essen, Germany; [5]Clin & Maternidad Suizo Argentina, Buenos Aires, DF, Argentina; [6]Icahn Sch Med Mt Sinai, New York, NY 10029 USA; [7]RTI Hlth Solut, Res Triangle Inst, Durham, NC USA; [8]Boehringer Ingelheim Pharma GmbH & Co KG, Med TA Cardiol, Ingelheim, Germany; [9]Boehringer Ingelheim GmbH & Co KG, Corp Dept Global Epidemiol, Ingelheim, Germany; [10]Boehringer Ingelheim GmbH & Co KG, Global Biometr & Clin Applicat, Ingelheim, Germany; [11]Hannover Med Sch, Inst Epidemiol Social Med & Hlth Syst Res, Hannover, Germany; [12]Univ Birmingham, Ctr Cardiovasc Sci, Birmingham, W Midlands, England
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关键词: Atrial fibrillation Stroke Oral anticoagulation Registry

摘要:
Aims The introduction of non-VKA oral anticoagulants (NOACs), which differ from the earlier vitamin K antagonist (VKA) treatments, has changed the approach to stroke prevention in atrial fibrillation (AF). GLORIA-AF is a prospective, global registry programme describing the selection of antithrombotic treatment in newly diagnosed AF patients at risk of stroke. It comprises three phases: Phase I, before the introduction of NOACs; Phase II, during the time of the introduction of dabigatran, the first NOAC; and Phase III, once NOACs have been established in clinical practice. Methods and results In Phase I, 1063 patients were eligible from the 1100 enrolled (54.3% male; median age 70 years); patients were from China (67.1%), Europe (EU; 27.4%), and the Middle East (ME; 5.6%). The majority of patients using VKAs had high stroke risk (CHA(2)DS(2)-VASc >= 2; 86.5%); 13.5% had moderate risk (CHA(2)DS(2)-VASc = 1). Vitamin K antagonist use was higher for persistent/permanent AF (47.7%) than that for paroxysmal (23.9%). Most patients in China were treated with antiplatelet agents (53.7%) vs. 27.1% in EU and 28.8% in ME. In China, 25.9% of patients had no antithrombotic therapy, vs. 8.6% in EU and 8.5% in ME. Conclusion Phase I of GLORIA-AF shows that VKAs were mostly used in patients with persistent/permanent (vs. paroxysmal) AF and in those with high stroke risk. Furthermore, there were meaningful geographical differences in the use of VKA therapy in the era before the availability of NOACs, including a much lower use of VKAs in China, where most patients either received antiplatelet agents or no antithrombotic treatment.

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出版当年[2015]版:
大类 | 3 区 医学
小类 | 3 区 心脏和心血管系统
最新[2023]版:
大类 | 1 区 医学
小类 | 2 区 心脏和心血管系统
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出版当年[2014]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

影响因子: 最新[2023版] 最新五年平均 出版当年[2014版] 出版当年五年平均 出版前一年[2013版] 出版后一年[2015版]

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第一作者机构: [1]Leiden Univ, Dept Thrombosis & Hemostasis, Med Ctr, Albinusdreef 2, NL-2333 LA Leiden, Netherlands;
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通讯机构: [1]Leiden Univ, Dept Thrombosis & Hemostasis, Med Ctr, Albinusdreef 2, NL-2333 LA Leiden, Netherlands;
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