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J Am Coll Cardiol. 2017 Feb 21;69(7):777-785. doi: 10.1016/j.jacc.2016.11.061.

The Changing Landscape for Stroke Prevention in AF: Findings From the GLORIA-AF Registry Phase 2.

Collaborators (1014)

Abban D, Abdul N, Abelson M, Ackermann A, Adams F, Adams L, Adragão P, Ageno W, Aggarwal R, Agosti S, Marin JA, Aguilar F, Aguilar Linares JA, Aguinaga L, Ahmad Z, Ainsworth P, Al Ghalayini K, Al Ismail S, Alasfar A, Alawwa A, Al-Dallow R, Alderson L, Alexopoulos D, Ali A, Ali M, Aliyar P, Al-Joundi T, Al Mahameed S, Almassi H, Almuti K, Al-Obaidi M, Alshehri M, Altmann U, Alves AR Jr, Al-Zoebi A, Amara W, Amelot M, Amjadi N, Ammirati F, Andrawis N, Angoulvant D, Annoni G, Ansalone G, Antonescu SA, Ariani M, Arias JC, Armero S, Arora R, Arora C, Ashcraft W, Aslam MS, Astesiano A, Audouin P, Augenbraun C, Aydin S, Azar R, Azim A, Aziz S, Backes LM, Baig M, Bains S, Bakbak A, Baker S, Bakhtiar K, Bala R, Banayan J, Bandh S, Bando S, Banerjee S, Bank A, Barbarash O, Barón G, Barr C, Barrera C, Barton J, Kes VB, Baula G, Bayeh H, Bazargani N, Behrens S, Bell A, Benezet-Mazuecos J, Benhalima B, Berdagué P, Berg van den BJ, Bergen van PF, Berngard E, Bernstein R, Berrospi P, Berti S, Bertomeu V, Berz A, Bettencourt P, Betzu R, Beyer-Westendorf J, Bhagwat R, Black T, Blanco Ibaceta JH, Bloom S, Blumberg E, Bo M, Bockisch V, Bøhmer E, Bongiorni MG, Boriani G, Bosch R, Boswijk DJ, Bott J, Bottacchi E, Kalan MB, Brandes A, Bratland B, Brautigam D, Breton N, Brouwers PJ, Browne K, Bruguera J, Brunehaut M, Brunschwig C, Buathier H, Buhl A, Bullinga J, Butcher K, Cabrera Honorio JW, Caccavo A, Cadinot D, Cai S, Calvi V, Camm J, Candeias R, Capo J Jr, Capucci A, Cardoso JN, Duarte Vera YC, Carlson B, Carvalho P, Cary S, Casanova R, Casu G, Cattan S, Cavallini C, Cayla G, Cha TJ, Cha KS, Chaaban S, Chae JK, Challappa K, Chand S, Chandrashekar H, Chang M, Charbel P, Chartier L, Chatterjee K, Cheema A, Chen SA, Chevallereau P, Chiang FT, Chiarella F, Chih-Chan L, Cho YK, Choi DJ, Chouinard G, Danny, Chow HF, Chrysos D, Chumakova G, José Roberto Chuquiure Valenzuela EJ, Cieza-Lara T, Nica VC, Ciobotaru V, Cislowski D, Citerne O, Claus M, Clay A, Clifford P, Cohen S, Cohen A, Colivicchi F, Collins R, Compton S, Connors S, Conti A, Buenostro GC, Coodley G, Cooper M, Corbett L, Corey O, Coronel J, Corrigan J, Cotrina Pereyra RY, Cottin Y, Coutu B, Cracan A, Crean P, Crenshaw J, Crijns HJ, Crump C, Cucher F, Cudmore D, Cui L, Culp J, Darius H, Dary P, Dascotte O, Dauber I, Davee T, Davies R, Davis G, Davy JM, Dayer M, De La Briolle A, de Mora M, De Teresa E, De Wolf L, Decoulx E, Deepak S, Defaye P, Del-Carpio Munoz F, Brkljacic DD, Deluche L, Destrac S, Deumite NJ, Di Legge S, Dibon O, Diemberger I, Dillinger J, Dionísio P, Naydenov S, Dotani I, Dotcheva E, D'Souza A, Dubrey S, Ducrocq X, Dupljakov D, DuThinh V, Dutra OP, Dutta D, Duvilla N, Dy J, Dziewas R, Eaton C, Eaves W, Ebinger M, Eck van JW, Edwards T, Egocheaga I, Ehrlich C, Eisenberg S, El Hallak A, El Jabali A, El Mahmoud R, El Shahawy M, Eldadah Z, Elghelbazouri F, Elhag O, El-Hamdani M, Elias D, Ellery A, El-Sayed H, Elvan A, Erickson B, Espaliat E, Essandoh L, Everington T, Evonich R 3rd, Ezhov A, Fácila L, Farsad R, Fayard M, Fedele F, Gomes Ferreira LG, Ferreira D, Santos JF, Ferrier A, Finsen A, First B, Fisher R, Floyd J, Folk T, Fonseca C, Fonseca L, Forman S, Forsgren M, Foster M, Foster N, Frais M, Frandsen B, Frappé T, Freixa R, French W, Freydlin M, Frickel S, Fruntelata AG, Fujii S, Fujino Y, Fukunaga H, Furukawa Y, Gabelmann M, Gabris M, Gadsbøll N, Galin P, Galinier M, Ganim R, Garcia R, Quintana AG, Gartenlaub O, Genz C, Georger F, Georges JL, Georgeson S, Ghanbasha A, Giedrimas E, Gierba M, Gillespie E, Giniger A, Gkotsis A, Gmehling J, Gniot J, Goethals P, Goldberg R, Goldmann B, Goldscher D, Golitsyn S, Gomez Lopez EA, Gomez Mesa JE, Gonzalez E, Cocina EG, Juanatey CG, Gorbunov V, Gordon B, Gorka H, Gornick C, Gorog D, Goss F, Götte A, Goube P, Goudevenos I, Goulden D, Graham B, Grande A, Greco C, Green M, Greer G, Gremmler U, Grena P, Grinshstein Y, Grond M, Gronda E, Grondin F, Grönefeld G, Groot de JR, Guardigli G, Guarnieri T, Caiedo CG, Guignier A, Gulizia M, Gumbley M, Gupta D, Hack T, Haerer W, Hakas J, Hall C, Hampsey J, Hananis G, Hanbali B, Handel F, Hargrove J, Hargroves D, Harris K, Hartley D, Haruna T, Hata Y, Hayek E, Healey J, Hearne S, Heggelund G, Hemels ME, Hemery Y, Henein S, Henz B, Her SH, Hermany P, Hernandes ME, Higashino Y, Hill M, Hisadome T, Hishida E, Hitchcock J, Hoffer E, Hoghton M, Holmes C, Hong SK, Houppe Nousse MP, Howard V, Hsu LF, Huang CH, Huckins D, Huehnergarth K, Huizenga A, Huntley R, Hussein G, Hwang GS, Igbokidi O, Iglesias I, Ikpoh M, Imberti D, Ince H, Indolfi C, Ionova T, Ip J, Irles D, Iseki H, Ismail Y, Israel N, Isserman S, Iteld B, Ivanchura G, Iyer R, Iyer V, Iza Villanueva RO, Jackson-Voyzey E, Jaffrani N, Jäger F, Jain M, James M, Jamon Y, Jang SW, Pereira Jardim CA, Jarmukli N, Jeanfreau R, Jenkins R, Jiang X, Jiang H, Jiang T, Jiang N, Jimenez J, Jobe R, Joffe I, Johansson B, Jones N, Moura Jorge JC, Jouve B, Jundi M, Jung W, Jung BC, Jung KT, Kabbani S, Kabour A, Kafkala C, Kajiwara K, Kalinina L, Kampus P, Kanda J, Kapadia S, Karim A, Karolyi L, Kashou H, Kastrup A, Katsivas A, Kaufman E, Kawai K, Kawajiri K, Kazmierski J, Keeling P, Kerfes GA, Kerr Saraiva JF, Ketova G, Khaira A, Khalid M, Khludeeva E, Khripun A, Kim DI, Kim DK, Kim NH, Kim KS, Kim YH, Kim JB, Kim JS, Kim JS, Kinova E, Klein A, Kleinschnitz C, Kmetzo J, Kneller GL, Knezevic A, Koch S, Koenig K, Angela Koh SM, Köhrmann M, Koons J, Korabathina R, Korennova O, Koschutnik M, Kosinski E, Kovacic D, Kowalczyk J, Koziolova N, Kragten JA, Krause LU, Kreidieh I, Krenning BJ, Krishnaswamy K, Krysiak W, Kuck KH, Kumar S, Kümler T, Kuniss M, Kuo JY, Küppers A, Kurrelmeyer K, Kwan T, Kyo E, Labovitz A, Lacroix A, Lam A, Lanas Zanetti FT, Landau C, Landini G, Lang W, Larsen TB, Laske V, Lavandier K, Law N, Lee MH, Lee D, Leitão A, Lejay D, Lelonek M, Lenarczyk R, Leprince P, Lequeux B, Leschke M, Ley N, Li Z, Li Y, Li X, Li Z, Li W, Liang J, Lieber I, Lillestol M, Limon Rodriguez RH, Lin H, Lip G, Litchfield J, Liu Z, Liu X, Liu Y, Liu F, Liu W, Llamas Esperon GA, Llisterri JL, Lo T, Lo E, Lobos JM, Lodde BP, Loiselet P, López-Sendón J, Lorga Filho AM, Lori I, Luo M, Lupovitch S, Lyrer P, Zuhairy HM, Ma C, Ma G, Ma H, Madariaga I, Maeno K, Magnin D, Mahmood S, Mahood K, Maid G, Mainigi S, Makaritsis K, Maldonado Villalon JA, Malhotra R, Malik A, Mallecourt C, Mallik R, Manning R, Manolis A, Mantas I, Manzur Jattin FG, Marcionni N, Marín F, Santana AM, Martinez J, Martinez L, Maskova P, Hernández NM, Matskeplishvili S, Matsuda K, Mavri A, May E, Mayer N, Mazon P, McClure J, McCormack T, McGarity W, McGuire M, McIntyre H, McLaughlin P, McLaurin B, Medina Palomino FA, Mehta P, Mehzad R, Meinel A, Melandri F, Mena A, Meno H, Menzies D, Metcalf K, Meyer B, Miarka J, Mibach F, Michalski D, Michel P, Chreih RM, Mikdadi G, Mikhail M, Mikus M, Milicic D, Militaru C, Miller G, Milonas C, Minescu B, Mintale I, Miralles A, Mirault T, Mistry D, Mitchell G, Miu NV, Miyamoto N, Moccetti T, Mohammed A, Nor AM, Molina de Salazar DI, Molon G, Molony D, Mondillo S, Mont L, Moodley R, Moore R, Ribeiro Moreira DA, Mori K, Moriarty A, Morka J, Moschos N, Mota Gomes MA, Mousallem N, Moya A, Mügge A, Mulhearn T, Muller JJ, Muresan CM, Muse D, Musial W, Musumeci F, Nadar V, Nageh T, Nair P, Nakagawa H, Nakamura Y, Nakayama T, Nam KB, Napalkov D, Natarajan I, Nayak H, Nechvatal L, Neiman J, Nerheim P, Neuenschwander FC, Nishida K, Nizov A, Novikova T, Novo S, Nowalany-Kozielska E, Nsah E, Nunez Fragoso JC, Nyvad O, de Los Rios Ibarra MO, O'Donnell M, O'Donnell P, Oh DJ, Oh YS, Daniel Oh CT, O'Hara G, Oikonomou K, Olalla JJ, Olivari Z, Oliver R, Olympios C, Osborne J, Osca J, Osman R, Osunkoya A, Padanilam B, Panchenko E, Pandey AS, Vicenzo de Paola AA, Paraschos A, Pardell H, Park HW, Park JS, Parkash R, Parker I, Parrens E, Parris R, Passamonti E, Patel J, Patel R, Pentz WH, Persic V, Perticone F, Peters P, Petkar S, Pezo LF, Pham D, Cao Phai GP, Phlaum S, Pineau J, Pineda-Velez A, Pini R, Pinter A, Pinto F, Pirelli S, Pivac N, Pizzini AM, Pocanic D, Calin Podoleanu CG, Polanczyk CA, Polasek P, Poljakovic Z, Pollock S, Polo J, Poock J, Poppert H, Porro Y, Pose A, Poulain F, Poulard JE, Pouzar J, Povolny P, Pozzer D, Pras A, Prasad N, Prevot S, Protasov K, Prunier L, Puleo J, Pye M, Qaddoura F, Quedillac JM, Raev D, Rahimi S, Raisaro A, Rama B, Ranadive N, Randall K, Ranjith N, Raposo N, Rashid H, Raters C, Rauch-Kroehnert U, Rebane T, Regner S, Renzi M, Reyes Rocha MA, Reza S, Ria L, Richter D, Rickli H, Rickner K, Rieker W, Rigo F, Ripoll T, Fonteles Ritt LE, Roberts D, Pascual CR, Briones IR, Reyes HR, Roelke M, Roman M, Romeo F, Ronner E, Ronziere T, Rooyer FA, Rosenbaum D, Roth S, Rozkova N, Rubacek M, Rubalcava F, Rubanenko O, Rubin A, Borret MR, Rybak K, Sabbour H, Morales OS, Sakai T, Salacata A, Salecker I, Salem A, Salfity M, Salguero R, Salvioni A, Samson M, Sanchez G, Sandesara C, Saporito WF, Sasaoka T, Sattar P, Savard D, Scala PJ, Scemama J, Schaupp T, Schellinger P, Scherr C, Schmitz KH, Schmitz B, Schmitz L, Schnitzler R, Schnupp S, Schoeniger P, Schön N, Schuster S, Schwimmbeck P, Seamark C, Seebass R, Seidl KH, Seidman B, Sek J, Sekaran L, Seko Y, Sepulveda Varela PA, Sevilla B, Shah V, Shah A, Shah N, Shah A, Shanes J, Sharareh A, Sharma VK, Shaw L, Shimizu Y, Shimomura H, Shin DG, Shin ES, Shite J, Shoukfeh M, Shoultz C 3rd, Silver F, Sime I, Simmers TA, Singal D, Singh N, Siostrzonek P, Sirajuddin M, Skeppholm M, Smadja D, Smith R, Smith D, Soda H, Sofley CW Jr, Sokal A, Sotolongo R, de Souza OF, Sparby JA, Spinar J, Sprigings D, Spyropoulos A, Stakos D, Steinberg A, Steinwender C, Stergiou G, Stites HW, Stoikov A, Strasser R, Streb W, Styliadis I, Su G, Su X, Suarez RM, Sudnik W, Sueyoshi A, Sukles K, Sun L, Suneja R, Svensson P, Ziekenhuis A, Szavits-Nossan J, Taggeselle J, Takagi Y, Takhar A, Tallet J, Tamm A, Tanaka S, Tanaka K, Tang A, Tang S, Tassinari T, Tayama S, Tayebjee M, Tebbe U, Teixeira J, Tesloianu DN, Tessier P, The SH, Thevenin J, Thomas H, Timsit S, Topkis R, Torosoff M, Touze E, Traissac T, Trendafilova E, Troyan B, Tsai WK, Tse HF, Tsutsui H, Tsutsui T, Tuininga YS, Turakhia M, Turk S, Turner W, Tveit A, Twiddy S, Tytus R, Ukrainski G, Valdovinos Chavez SB, Van De Graaff E, Vanacker P, Vardas P, Vargas M, Vassilikos V, Vazquez J, Venkataraman A, Verdecchia P, Vester EG, Vial H, Vinereanu D, Vlastaris A, Vogel C, Vom Dahl J, von Mering M, Vora K, Wakefield P, Walia J, Walter T, Wang M, Wang N, Wang F, Wang X, Wang Z, Wang KY, Watanabe K, Wei J, Weimar C, Weinrich R, Wen MS, Wheelan K, Wicke J, Wiemer M, Wild B, Wilke A, Willems S, Williams M, Williams D, Winkler A, Wirtz JH, Witzenbichler B, Wong DH, Lawrence Wong KS, Wong B, Wozakowska-Kaplon B, Wu Z, Wu S, Wyatt N, Xu Y, Xu X, Yamada A, Yamamoto K, Yamanoue H, Yamashita T, Bryan Yan PY, Yang Y, Yang T, Yao J, Yarlagadda C, Yeh KH, Yotov Y, Yvorra S, Zahn R, Zamorano J, Zanini R, Zarich S, Zebrack J, Zenin S, Zeuthen EL, Zhang X, Zhang Q, Zhang D, Zhang D, Zhang H, Zhao S, Zhao X, Zheng Y, Zheng Q, Zhou J, Zhou J, Zimmermann SL, Zimmermann R, Zukerman LS, Zwaan van der C.

Abstract

BACKGROUND:

GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non-vitamin K antagonist oral anticoagulant (NOAC), became available.

OBJECTIVES:

This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1.

METHODS:

During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients' baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics.

RESULTS:

Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score ≥2; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment.

CONCLUSIONS:

The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701).

KEYWORDS:

atrial fibrillation; oral anticoagulation; registry

PMID:
28209218
DOI:
10.1016/j.jacc.2016.11.061
[Indexed for MEDLINE]
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