• Journal Article

Antithrombotic treatment patterns in patients with newly diagnosed non-valvular atrial fibrillation: The GLORIA-AF Registry Program, Phase II

Citation

Huisman, M. V., Rothman, K., Paquette, M., Teutsch, C., Diener, H. C., Dubner, S. J., ... Lip, G. Y. (2015). Antithrombotic treatment patterns in patients with newly diagnosed non-valvular atrial fibrillation: The GLORIA-AF Registry Program, Phase II. American Journal of Medicine, Advance Online Publication. DOI: 10.1016/j.amjmed.2015.07.013

Abstract

BACKGROUND: The Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) was designed to provide prospectively collected information on patients with newly diagnosed non-valvular atrial fibrillation at risk of stroke, with the aim of addressing treatment patterns and questions of effectiveness and safety. METHODS AND RESULTS: In this predefined analysis from GLORIA-AF, the baseline characteristics and initial antithrombotic management of the first 10 000 patients in Phase II of this large Registry Program are presented. Overall, 32.3% of patients received VKAs and 47.7% received NOACs, whilst 12.3% received antiplatelet treatment and 7.6 % did not receive any antithrombotic treatment. Amongst patients with CHA2DS2VASc score >/=2, 6.7 % received no antithrombotic treatment and 10.0% received aspirin. In Europe, treatment with dabigatran was as common as treatment with VKAs (38.8% and 37.8%, respectively). More than half of the patients were treated with NOACs (52.4%), whilst antiplatelet treatment was given to 5.7 %, and 4.1% did not receive any antithrombotic treatment. In North America, treatment with dabigatran (25.0%) was as common as with VKAs (26.1%), but overall NOAC use was more common (52.1%) than with VKAs (26.1%); however, 14.1% received antiplatelet treatment, while 7.6 % received no antithrombotic treatment. In Asia, treatment with VKAs (31.9%) was more prevalent than NOACs (25.5 %), but antiplatelet treatment was given to 25.8% and 16.9% did not receive any antithrombotic treatment. In Asia, only 60.7% of patients with high stroke risk received oral anticoagulants (OACs). Paroxysmal atrial fibrillation and minimally symptomatic (or asymptomatic) patients were often undertreated with OACs. CONCLUSION: In this analysis, OAC use was high in Europe and North America, with overall NOAC use higher than VKA use. A considerable percentage of high-risk patients in North America still received antiplatelet treatment or were untreated, whilst Asian patients had a high proportion of aspirin use and non-treatment