PMID- 30873623
OWN - NLM
STAT- Publisher
LR  - 20190409
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Linking)
DP  - 2019 Mar 15
TI  - Stroke prevention in patients from Latin American countries with non-valvular
      atrial fibrillation: Insights from the GARFIELD-AF registry.
LID - 10.1002/clc.23176 [doi]
AB  - BACKGROUND: Atrial fibrillation (AF) is an important preventable cause of stroke.
      Anticoagulation (AC) therapy can reduce this risk. However, prescribing patterns 
      and outcomes in patients with non-valvular AF (NVAF) from Latin American
      countries are poorly described. METHODS: Using data from the Global Anticoagulant
      Registry in the FIELD-AF (GARFIELD-AF), we examined the stroke prevention
      strategies and the 1-year outcomes in patients from four Latin American
      countries: Argentina, Brazil, Chile, and Mexico. RESULTS: A total of 4162
      patients (2010-2014) were included in this analysis. At the time of AF diagnosis,
      39.9% of patients were prescribed vitamin K antagonists (VKA) +/- antiplatelet
      (AP) therapy, 21.8% non-VKA oral anticoagulant (NOAC) +/- AP, 24.1% AP only and
      14.1% no antithrombotic treatment. The proportion of moderate-high risk patients 
      receiving no AC therapy at participating centers was highest in Mexico (46.4%)
      and lowest in Chile (14.3%). During 1-year follow-up, the rates of all-cause
      mortality, stroke/SE and major bleeding were: 5.77 (95% CI) (5.06-6.56), 1.58
      (1.23-2.02), and 0.99 (0.72-1.36) and per 100 person-years, respectively, which
      are higher than the global rates across all countries in GARFIELD-AF. Unadjusted 
      rates of all-cause mortality were highest in Argentina, 6.95 (5.43-8.90), and
      lowest in Chile, 4.01 (2.92-5.52). CONCLUSIONS: GARFIELD-AF results describes the
      marked variation in the baseline characteristics and patterns of antithrombotic
      treatments in patients with NVAF in four Latin American countries. Over one-third
      of patients with a moderate-to-high risk of stroke received no AC therapy,
      highlighting the need for improved management of patients according to national
      guideline. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique
      identifier: NCT01090362.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Jerjes-Sanchez, Carlos
AU  - Jerjes-Sanchez C
AD  - Instituto de Cardiologia y Medicina Vascular, TEC Salud, Tecnologico de
      Monterrey, Monterrey, Mexico.
FAU - Corbalan, Ramon
AU  - Corbalan R
AD  - Cardiovascular Division, Pontificia Universidad Catolica, Santiago, Chile.
FAU - Barretto, Antonio C P
AU  - Barretto ACP
AD  - Hospital das Clinicas da Faculdad de Medicina da USP, Sao Paulo, Brazil.
FAU - Luciardi, Hector L
AU  - Luciardi HL
AD  - Universidad Nacional de Tucuman, San Miguel de Tucuman, Argentina.
FAU - Allu, Jagan
AU  - Allu J
AD  - Thrombosis Research Institute, London, UK.
FAU - Illingworth, Laura
AU  - Illingworth L
AD  - Thrombosis Research Institute, London, UK.
FAU - Pieper, Karen S
AU  - Pieper KS
AD  - Thrombosis Research Institute, London, UK.
AD  - Duke Clinical Research Institute, Durham, North Carolina.
FAU - Kayani, Gloria
AU  - Kayani G
AD  - Thrombosis Research Institute, London, UK.
CN  - GARFIELD-AF Investigators
LA  - eng
SI  - ClinicalTrials.gov/NCT01090362
GR  - Bayer AG
GR  - Bayer
PT  - Journal Article
DEP - 20190315
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
OTO - NOTNLM
OT  - Latin American
OT  - antithrombotic treatment
OT  - atrial fibrillation
OT  - outcomes
EDAT- 2019/03/16 06:00
MHDA- 2019/03/16 06:00
CRDT- 2019/03/16 06:00
PHST- 2018/12/10 00:00 [received]
PHST- 2019/03/01 00:00 [revised]
PHST- 2019/03/14 00:00 [accepted]
PHST- 2019/03/16 06:00 [pubmed]
PHST- 2019/03/16 06:00 [medline]
PHST- 2019/03/16 06:00 [entrez]
AID - 10.1002/clc.23176 [doi]
PST - aheadofprint
SO  - Clin Cardiol. 2019 Mar 15. doi: 10.1002/clc.23176.