Treatment patterns in anticoagulant therapy in patients with newly diagnosed atrial fibrillation in Belgium: results from the GARFIELD-AF registry
Acta Cardiologica. 2018-10-27; 74(4): 309-318
DOI: 10.1080/00015385.2018.1494089
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1. Acta Cardiol. 2019 Aug;74(4):309-318. doi: 10.1080/00015385.2018.1494089. Epub
2018 Oct 27.
Treatment patterns in anticoagulant therapy in patients with newly diagnosed
atrial fibrillation in Belgium: results from the GARFIELD-AF registry.
Cools F(1), Wollaert B(2), Vervoort G(3), Verstraete S(4), Voet J(5), Hermans
K(6), Heyse A(7), De Wolf A(8), Hollanders G(9), Boussy T(10), Anné W(11),
Vercammen J(12), Faes D(13), Beutels M(14), Mairesse G(15), Purnode P(16),
Blankoff I(17), Vandergoten P(18), Capiau L(19), Allu J(20), Bassand JP(20)(21),
Kayani G(20); GARFIELD-AF Investigators.
Author information:
(1)a AZ Klina, Brasschaat , Antwerp , Belgium.
(2)b ZNA Antwerpen , Belgium.
(3)c AZ Sint-Maarten , Mechelen , Belgium.
(4)d AZ Zeno Knokke , Belgium.
(5)e AZ Nikolaas Sint Niklaas , Belgium.
(6)f AZ Sint Lucas Gent , Belgium.
(7)g AZ Glorieux Ronse , Belgium.
(8)h Heilig Hart Ziekenhuis Tienen , Belgium.
(9)i Private Practice De Pinte , Belgium.
(10)j AZ Groeninge, Kortrijk , Belgium.
(11)k AZ Delta, Roeselare , Belgium.
(12)l Yperman Ziekenhuis Ieper , Belgium.
(13)m Mariaziekenhuis Noord Limburg , Belgium.
(14)n Huisartsen Het Laar , Merksem , Belgium.
(15)o Cliniques Sud Luxembourg Arlon , Belgium.
(16)p Cliniques St. Jean Bruxelles , Belgium.
(17)q CHU de Charleroi , Belgium.
(18)r Private Practice , Overijse , Belgium.
(19)s Wetteren , Belgium.
(20)t Thrombosis Research Institute , London , UK.
(21)u University of Besançon , France.
Comment in
Acta Cardiol. 2020 Feb;75(1):95.
Background: AF, anticoagulation, NOACs, changing patterns of prescription.
Methods: We describe baseline data and treatment patterns of patients recruited
in Belgium in the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation
(GARFIELD-AF). Recruitment began when novel oral anticoagulants (NOACs) were
introduced and provides a unique picture of changing treatment patterns over
time. 1713 patients with a new (≤6 weeks duration) diagnosis of non-valvular
atrial fibrillation (NVAF) and at least one investigator-defined stroke risk
factor were recruited between May 2012 and August 2016, and will be prospectively
followed for at least 2 years. Results: Overall, anticoagulant use in Belgium was
higher than in the rest of Europe: 80.1% of patients received an
anticoagulant ± antiplatelet (AP) therapy (14.5% on vitamin K antagonists; 65.6%
on NOAC), 10.7% AP therapy and 9.3% no antithrombotic therapy. Over time, we
observed an increase in anticoagulant use and a decrease in AP use for stroke
prevention. NOAC use in Belgium was the highest of Europe at the study start,
with many countries catching up later. In high stroke risk patients (CHA2DS2-VASc
≥2), anticoagulants were used in 84.3%, leaving 15.7% unprotected. In low risk
patients (CHA2DS2-VASc 0-1) anticoagulants were overused (58.7%). Factor Xa
inhibitors were used more frequently than direct thrombin inhibitors. Conclusion:
Guideline adherence on stroke prevention was higher in Belgium than in the rest
of Europe, and increased over time. NOAC use in Belgium was the highest of Europe
at the study start, with many countries catching up later. Possible reasons are
discussed. Clinical Trial Registration: http://www.clinicaltrials.gov . Unique
identifier: NCT01090362.
DOI: 10.1080/00015385.2018.1494089
PMID: 30369290 [Indexed for MEDLINE]