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Multicenter Study
. 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

Begüm Sayın  1 , Sercan Okutucu  1 , Mehmet Birhan Yılmaz  2 , Kurtuluş Özdemir  3 , Ali Aydınlar  4 , Durmuş Yıldıray Şahin  5 , Armağan Altun  6 , Sadık Açıkel  7 , Ertuğrul Okuyan  8 , Murat Sucu  9 , Zeki Öngen  10 , Murat Kazim Ersanlı  11 , Özcan Yılmaz  12 , Mesut Demir  13 , Hasan Pekdemir  14 , Ramazan Topsakal  15 , Mehmet Levent Şahiner  16 , Dursun Aras  17 , Ali Oto  1
Affiliations
Multicenter Study

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

Begüm Sayın et al. Anatol J Cardiol. 2019 Apr.

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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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Treatment at diagnosis in different countries VKA - vitamin K antagonists, AP - antiplatelets, FXa - factor Xa inhibitors, DTI - direct thrombin inhibitors
Figure 2
Figure 2
Prescribing patterns at diagnosis VKA - vitamin K antagonists, AP - antiplatelets, FXa - factor Xa inhibitors, DTI - direct thrombin inhibitors
Figure 3
Figure 3
Comparison of CHADS2 and CHA2DS2-VASc scores in Turkey and world population
Figure 4
Figure 4
Stroke risk profiles according to HAS-BLED score.
Figure 5
Figure 5
Comparing data from world and Turkey- Treatment at diagnosis according to CHA2DS2-VASc risk scores. VKA - vitamin K antagonists, AP - antiplatelets, FXa - factor Xa inhibitors, DTI - direct thrombin inhibitors
Figure 6
Figure 6
Comparing data from world and Turkey- Treatment at diagnosis according to HAS-BLED scores. VKA - vitamin K antagonists, AP - antiplatelets, FXa - factor Xa inhibitors, DTI - direct thrombin inhibitors
See this image and copyright information in PMC

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