Jean-Yves Le Heuzey1, Jean-Pierre Bassand2, Jean-Baptiste Berneau3, Paolo Cozzolino4, Lucia D'Angiolella4, Bernard Doucet5, Lorenzo G Mantovani6, Michel Martelet7, Joseph Mouallem7, Jean-Joseph Muller8, Karen Pieper9. 1. Georges Pompidou Hospital, René Descartes University, 75908 Paris cedex, France. Electronic address: jyleheu@gmail.com. 2. University of Besançon, 25000 Besançon, France; Thrombosis Research Institute, London SW3 6LR, UK. 3. Centre hospitalier de la Côte-Basque, 64100 Bayonne, France. 4. Villa Serena, University of Milano-Bicocca, 20900 Monza, Italy. 5. Centre hospitalier de Chambéry, 73000 Chambery, France. 6. University of Milano-Bicocca, 20126 Monza, Italy. 7. Centre hospitalier de Langres, 52200 Langres, France. 8. Nouvel Hôpital Civil, CHU Strasbourg, 67000 Strasbourg, France. 9. Duke Clinical Research Institute, Durham, NC 27705, USA.
Abstract
BACKGROUND: GARFIELD-AF is a non-interventional worldwide study of adults with atrial fibrillation. AIMS: To analyse the characteristics of the 1399 patients recruited in France from August 2010 to July 2015, their 1-year outcomes and healthcare resource utilization. METHOD: Patients aged ≥18 years with newly diagnosed atrial fibrillation (≤6 weeks' duration) and ≥1 stroke risk factor were eligible. Patient demographics, medical history and antithrombotic treatment were recorded at baseline. The incidences of stroke/systemic embolism, major bleeding, all-cause mortality, cardiovascular and non-cardiovascular mortality, new acute coronary syndrome and congestive heart failure were recorded during a 1-year follow-up. RESULTS: The median age was 76.0 years; 44.5% of patients were female. The median CHA2DS2-VASc and HAS-BLED scores were 4.0 and 2.0, respectively. At diagnosis, 78.9% of patients received anticoagulant therapy±antiplatelet therapy; more patients received vitamin K antagonists (VKAs; 46.0%) than direct oral anticoagulants (DOACs; 32.9%). The median proportion of time in the therapeutic range for VKAs was 65.6%. Between 2010 and 2015, anticoagulant prescription increased, driven by the growing use of DOACs±antiplatelet therapy (1.1% to 50.0%), whereas prescription of VKAs±antiplatelet therapy decreased (74.4% to 32.3%). All-cause mortality was the most frequent event (6.75 per 100 person-years). Risk-adjusted event rates for France showed that stroke/systemic embolism and all-cause mortality occurred more frequently than in GARFIELD-AF overall, whereas the rates of major bleeding were similar. In terms of healthcare resource utilization, the highest cost was associated with inpatients. CONCLUSIONS: Patients enrolled in France had higher rates of mortality and stroke/systemic embolism than in GARFIELD-AF overall. Conversely, the risk of major bleeding was not higher.
BACKGROUND: GARFIELD-AF is a non-interventional worldwide study of adults with atrial fibrillation. AIMS: To analyse the characteristics of the 1399 patients recruited in France from August 2010 to July 2015, their 1-year outcomes and healthcare resource utilization. METHOD:Patients aged ≥18 years with newly diagnosed atrial fibrillation (≤6 weeks' duration) and ≥1 stroke risk factor were eligible. Patient demographics, medical history and antithrombotic treatment were recorded at baseline. The incidences of stroke/systemic embolism, major bleeding, all-cause mortality, cardiovascular and non-cardiovascular mortality, new acute coronary syndrome and congestive heart failure were recorded during a 1-year follow-up. RESULTS: The median age was 76.0 years; 44.5% of patients were female. The median CHA2DS2-VASc and HAS-BLED scores were 4.0 and 2.0, respectively. At diagnosis, 78.9% of patients received anticoagulant therapy±antiplatelet therapy; more patients received vitamin K antagonists (VKAs; 46.0%) than direct oral anticoagulants (DOACs; 32.9%). The median proportion of time in the therapeutic range for VKAs was 65.6%. Between 2010 and 2015, anticoagulant prescription increased, driven by the growing use of DOACs±antiplatelet therapy (1.1% to 50.0%), whereas prescription of VKAs±antiplatelet therapy decreased (74.4% to 32.3%). All-cause mortality was the most frequent event (6.75 per 100 person-years). Risk-adjusted event rates for France showed that stroke/systemic embolism and all-cause mortality occurred more frequently than in GARFIELD-AF overall, whereas the rates of major bleeding were similar. In terms of healthcare resource utilization, the highest cost was associated with inpatients. CONCLUSIONS:Patients enrolled in France had higher rates of mortality and stroke/systemic embolism than in GARFIELD-AF overall. Conversely, the risk of major bleeding was not higher.