PMID- 33818226
OWN - NLM
STAT- MEDLINE
DCOM- 20211013
LR  - 20231102
IS  - 1365-2060 (Electronic)
IS  - 0785-3890 (Print)
IS  - 0785-3890 (Linking)
VI  - 53
IP  - 1
DP  - 2021 Dec
TI  - Risk profile, antithrombotic treatment and clinical outcomes of patients in 
      Nordic countries with atrial fibrillation - results from the GARFIELD-AF 
      registry.
PG  - 485-494
LID - 10.1080/07853890.2021.1893897 [doi]
AB  - AIMS: The objective was to evaluate the clinical characteristics, management and 
      two-year outcomes of patients with newly diagnosed non-valvular atrial 
      fibrillation at risk for stroke in Nordic countries. METHODS: We examined the 
      baseline characteristics, antithrombotic treatment, and two-year clinical 
      outcomes of patients from four Nordic countries. RESULTS: A total of 52,080 
      patients were enrolled in the GARFIELD-AF. Out of 29,908 European patients, 2,396 
      were recruited from Nordic countries. The use of oral anticoagulants, alone or in 
      combination with antiplatelet (AP), was higher in Nordic patients in all 
      CHA(2)DS(2)-VASc categories: 0-1 (72.8% vs 60.3%), 2-3 (78.7% vs 72.9%) and >/=4 
      (79.2% vs 74.1%). In Nordic patients, NOAC +/- AP was more frequently prescribed 
      (32.0% vs 27.7%) and AP monotherapy was less often prescribed (10.4% vs 18.2%) 
      when compared with Non-Nordic European patients. The rates (per 100 patient 
      years) of all-cause mortality and non-haemorrhagic stroke/systemic embolism (SE) 
      were similar in Nordic and Non-Nordic European patients [3.63 (3.11-4.23) vs 4.08 
      (3.91-4.26), p value = .147] and [0.98 (0.73-1.32) vs 1.02 (0.93-1.11), p 
      value = .819], while major bleeding was significantly higher [1.66 (1.32-2.09) vs 
      1.01 (0.93-1.10), p value < .001]. CONCLUSION: Nordic patients had significantly 
      higher major bleeding than Non-Nordic-European patients. In contrast, rates of 
      all-cause mortality and non-haemorrhagic stroke/SE were comparable. CLINICAL 
      TRIAL REGISTRATION: Unique identifier: NCT01090362. URL: 
      http://www.clinicaltrials.gov. KEY MESSAGE: Nordic countries had significantly 
      higher major bleeding than Non-Nordic-European countries. Rates of mortality and 
      non-haemorrhagic stroke/SE were similar .
FAU - Pope, Marita Knudsen
AU  - Pope MK
AD  - Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
AD  - Hamar Hospital, Innlandet Hospital Trust, Hamar, Norway.
FAU - Atar, Dan
AU  - Atar D
AUID- ORCID: 0000-0003-1513-8793
AD  - Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
AD  - Department of Cardiology, Oslo University Hospital, Ulleval, Oslo, Norway.
FAU - Svilaas, Arne
AU  - Svilaas A
AD  - Nymoen Medical Centre, Kongsberg, Norway.
AD  - Lipid Clinic, Oslo University Hospital, Oslo, Norway.
FAU - Hole, Torstein
AU  - Hole T
AD  - Clinic of Medicine and Rehabilitation, More and Romsdal Hospital Trust, Alesund, 
      Norway.
AD  - Department of Circulation and Medical Imaging, Faculty of Medicine and Health 
      Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, 
      Norway.
FAU - Nielsen, Jorn Dalsgaard
AU  - Nielsen JD
AD  - Department of Cardiology, Copenhagen University Hospital, Copenhagen University, 
      Copenhagen, Denmark.
FAU - Hintze, Ulrik
AU  - Hintze U
AD  - Department of Cardiology, Hospital of South West Jutland, Esbjerg, University of 
      Southern Denmark, Denmark.
FAU - Crisby, Milita
AU  - Crisby M
AD  - Department of Neurobiology, Care Science and Society, Karolinska University 
      Hospital, Stockholm, Sweden.
FAU - Raatikainen, Pekka
AU  - Raatikainen P
AD  - Department of Cardiology, Heart and Lung Center, Helsinki University Hospital, 
      Tampere, Finland.
FAU - Airaksinen, K E Juhani
AU  - Airaksinen KEJ
AUID- ORCID: 0000-0002-0193-568X
AD  - Heart Centre, Turku University Hospital and University of Turku, Turku, Finland.
FAU - Virdone, Saverio
AU  - Virdone S
AD  - Thrombosis Research Institute, London, UK.
FAU - Pieper, Karen
AU  - Pieper K
AD  - Thrombosis Research Institute, London, UK.
FAU - Kayani, Gloria
AU  - Kayani G
AD  - Thrombosis Research Institute, London, UK.
FAU - Le Heuzey, Jean-Yves
AU  - Le Heuzey JY
AD  - Georges Pompidou Hospital, Rene Descartes University, Paris, France.
FAU - Steffel, Jan
AU  - Steffel J
AD  - Division of Electrophysiology and Pacing, Department of Cardiology, University 
      Heart Center Zurich, Zurich, Switzerland.
FAU - Stepinska, Janina
AU  - Stepinska J
AD  - Institute of Cardiology, Intensive Cardiac Therapy Clinic, Warsaw, Poland.
FAU - Bassand, Jean-Pierre
AU  - Bassand JP
AD  - Thrombosis Research Institute, London, UK.
AD  - University of Besancon, Besancon, France.
FAU - Camm, A John
AU  - Camm AJ
AD  - Cardiology Clinical Academic Group Molecular & Clinical Sciences Research 
      Institute, St. George's University of London, London, UK.
CN  - GARFIELD-AF Investigators
LA  - eng
SI  - ClinicalTrials.gov/NCT01090362
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Ann Med
JT  - Annals of medicine
JID - 8906388
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/*therapeutic use
MH  - Atrial Fibrillation/complications/*drug therapy/mortality
MH  - Cause of Death
MH  - Drug Prescriptions/statistics & numerical data
MH  - Drug Therapy, Combination
MH  - Embolism/epidemiology/etiology/prevention & control
MH  - Europe/epidemiology
MH  - Female
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Platelet Aggregation Inhibitors/*therapeutic use
MH  - Prospective Studies
MH  - Registries
MH  - Risk Factors
MH  - Scandinavian and Nordic Countries/epidemiology
MH  - Stroke/epidemiology/etiology/*prevention & control
MH  - Treatment Outcome
PMC - PMC8023647
OTO - NOTNLM
OT  - Atrial fibrillation
OT  - Nordic countries
OT  - antithrombotic treatment
OT  - stroke prevention
COIS- DA: Personal fees from Bayer Healthcare, BMS/Pfizer, Boehringer-Ingelheim, MSD; 
      KSP reports personal fees from Thrombosis Research Institute, during the conduct 
      of the study; J-YLH: Personal fees from Boehringer-Ingelheim, Bayer, BMS/Pfizer, 
      Daiichi Sankyo, Servier, Meda; Dr. Steffel has received consultant and/or speaker 
      fees from Abbott, Amgen, Astra-Zeneca, Bayer, Berlin Chemie/Menarini, Biosense 
      Webster, Biotronik, Boehringer-Ingelheim, Boston Scientific, Bristol-Myers 
      Squibb, Daiichi Sankyo, Medscape, Medtronic, Merck/MSD, Novartis, Pfizer, 
      Sanofi-Aventis, WebMD, and Zoll. He reports ownership of CorXL. Dr. Steffel has 
      received grant support through his institution from Abbott, Bayer Healthcare, 
      Biosense Webster, Biotronik, Boston Scientific, Daiichi Sankyo, and Medtronic. 
      JS: Grants from Bayer, personal fees from Amgen, Astra Zeneca, Bayer, Boehringer 
      Ingelheim, BMS/Pfizer, Novartis, Sanofi, Servier, expert witness for Boehringer 
      Ingelheim; AJC: Institutional grants and personal fees from Bayer, Boehringer 
      Ingelheim, Pfizer/BristolMyers Squibb, and Daiichi-Sankyo, outside the submitted 
      work. All other authors have reported that they have no relationships relevant to 
      the contents of this paper to disclose.
EDAT- 2021/04/06 06:00
MHDA- 2021/10/14 06:00
PMCR- 2021/04/05
CRDT- 2021/04/05 12:21
PHST- 2021/04/05 12:21 [entrez]
PHST- 2021/04/06 06:00 [pubmed]
PHST- 2021/10/14 06:00 [medline]
PHST- 2021/04/05 00:00 [pmc-release]
AID - 1893897 [pii]
AID - 10.1080/07853890.2021.1893897 [doi]
PST - ppublish
SO  - Ann Med. 2021 Dec;53(1):485-494. doi: 10.1080/07853890.2021.1893897.