Frank Cools1, Bart Wollaert2, Geert Vervoort3, Stefan Verstraete4, Joeri Voet5, Kurt Hermans6, Alex Heyse7, Axel De Wolf8, Geert Hollanders9, Tim Boussy10, Wim Anné11, Jan Vercammen12, Dirk Faes13, Michel Beutels14, Georges Mairesse15, Philippe Purnode16, Ivan Blankoff17, Peter Vandergoten18, Luc Capiau19, Jagan Allu20, Jean-Pierre Bassand20,21, Gloria Kayani20. 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.
Abstract
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.
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.
Authors: Maxim Grymonprez; Andreas Capiau; Stephane Steurbaut; Els Mehuys; Koen Boussery; Tine L De Backer; Lies Lahousse Journal: Front Cardiovasc Med Date: 2022-09-29
Authors: Jaap Seelig; Martin E W Hemels; Olivier Xhaët; Maarten C M Bongaerts; Axel de Wolf; Björn E Groenemeijer; Alex Heyse; Pieter Hoogslag; Joeri Voet; Jean-Paul R Herrman; Geert Vervoort; Walter Hermans; Bart Wollaert; Lucas V A Boersma; Kurt Hermans; Andreas Lucassen; Stefan Verstraete; Henk J Adriaansen; Georges H Mairesse; Willem F Terpstra; Dirk Faes; Mathijs Pieterse; Saverio Virdone; Freek W A Verheugt; Frank Cools; Hugo Ten Cate Journal: J Thromb Haemost Date: 2020-09-25 Impact factor: 16.036