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Anatol J Cardiol. 2019 Apr;21(5):272-280. doi: 10.14744/AnatolJCardiol.2019.78178.

Antithrombotic treatment patterns and stroke prevention in patients with atrial fibrillation in TURKEY: inferences from GARFIELD-AF registry.

Author information

1
Department of Cardiology, Memorial Ankara Hospital; Ankara-Turkey.
2
Department of Cardiology, Faculty of Medicine, Cumhuriyet University; Sivas-Turkey.
3
Department of Cardiology, Meram Faculty of Medicine, Konya Necmettin Erbakan University; Konya-Turkey.
4
Department of Cardiology, Faculty of Medicine, Uludağ University; Bursa-Turkey.
5
Department of Cardiology, Adana Numune Training and Research Hospital; Adana-Turkey.
6
Department of Cardiology, Başkent University İstanbul Health Practice and Research Center Hospital; İstanbul-Turkey.
7
Department of Cardiology, Ankara Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara-Turkey.
8
Department of Cardiology, Bağcılar Training and Research Hospital; İstanbul-Turkey.
9
Department of Cardiology, Faculty of Medicine, Gaziantep University; Gaziantep-Turkey.
10
Department of Cardiology, Cerrahpaşa Faculty of Medicine, İstanbul University; İstanbul-Turkey.
11
Department of Cardiology, İstanbul University Cardiology Institute; İstanbul-Turkey.
12
Department of Cardiology, Faculty of Medicine, Ondokuz Mayıs University; Samsun-Turkey.
13
Department of Cardiology, Faculty of Medicine, Çukurova University; Adana-Turkey.
14
Department of Cardiology, Faculty of Medicine, İnönü University, Turgut Özal Medical Center; Malatya-Turkey.
15
Department of Cardiology, Faculty of Medicine, Erciyes University; Kayseri-Turkey.
16
Department of Cardiology, Faculty of Medicine, Hacettepe University; Ankara-Turkey.
17
Department of Cardiology, Türkiye Yüksek İhtisas Training and Research Hospital; Ankara-Turkey.

Abstract

The corner stone of atrial fibrillation therapy includes the prevention of stroke with less adverse effects. The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) study provided data to compare treatment strategies in Turkey with other populations and every-day practice of stroke prevention management with complications.

METHODS:

GARFIELD-AF is a large-scale registry that enrolled 52,014 patients in five sequential cohorts at >1,000 centers in 35 countries.This study initiated to track the evolution of global anticoagulation practice, and to study the impact of NOAC therapy in AF. 756 patients from 17 enrolling sites in Turkey were in cohort 4 and 5.Treatment strategies at diagnosis initiated by CHA2DS2-VASc score, baseline characteristics of patients, treatment according to stroke and bleeding risk profiles, INR values were analyzed in cohorts.Also event rates during the first year follow up were evaluated.

RESULTS:

AF patients in Turkey were mostly seen in young women.Stroke risk according to the CHADS2 score and CHA2DS2-VASc score compared with world data. The mean of risk score values including HAS-BLED score were lower in Turkey than world data.The percentage of patients receiving FXa inhibitor with or without an antiplatelet usage was more than the other drug groups. All-cause mortality was higher in Turkey. Different form world data when HAS-BLED score was above 3, the therapy was mostly changed to antiplatelet drugs in Turkey.

CONCLUSION:

The data of GARFIELD-AF provide data from Turkey about therapeutic strategies, best practices also deficiencies in available treatment options, patient care and clinical outcomes of patients with AF.

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