PMID- 33892489
OWN - NLM
STAT- MEDLINE
DCOM- 20220330
LR  - 20220531
IS  - 2058-1742 (Electronic)
IS  - 2058-5225 (Print)
IS  - 2058-1742 (Linking)
VI  - 8
IP  - 2
DP  - 2022 Mar 2
TI  - GARFIELD-AF risk score for mortality, stroke, and bleeding within 2 years in 
      patients with atrial fibrillation.
PG  - 214-227
LID - 10.1093/ehjqcco/qcab028 [doi]
AB  - AIMS: To determine whether the Global Anticoagulant Registry in the FIELD-Atrial 
      Fibrillation (GARFIELD-AF) integrated risk tool predicts mortality, 
      non-haemorrhagic stroke/systemic embolism, and major bleeding for up to 2 years 
      after new-onset AF and to assess how this risk tool performs compared with 
      CHA2DS2-VASc and HAS-BLED. METHODS AND RESULTS: Potential predictors of events 
      included demographic and clinical characteristics, choice of treatment, and 
      lifestyle factors. A Cox proportional hazards model was identified for each 
      outcome by least absolute shrinkage and selection operator methods. Indices were 
      evaluated in comparison with CHA2DS2-VASc and HAS-BLED risk predictors. Models 
      were validated internally and externally in ORBIT-AF and Danish nationwide 
      registries. Among the 52 080 patients enrolled in GARFIELD-AF, 52 032 had 
      follow-up data. The GARFIELD-AF risk tool outperformed CHA2DS2-VASc for all-cause 
      mortality in all cohorts. The GARFIELD-AF risk score was superior to CHA2DS2-VASc 
      for non-haemorrhagic stroke, and it outperformed HAS-BLED for major bleeding in 
      internal validation and in the Danish AF cohort. In very low- to low-risk 
      patients [CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)], the GARFIELD-AF risk 
      score offered strong discriminatory value for all the endpoints when compared to 
      CHA2DS2-VASc and HAS-BLED. The GARFIELD-AF tool also included the effect of oral 
      anticoagulation (OAC) therapy, thus allowing clinicians to compare the expected 
      outcome of different anticoagulant treatment decisions [i.e. no OAC, non-vitamin 
      K antagonist (VKA) oral anticoagulants, or VKAs]. CONCLUSIONS: The GARFIELD-AF 
      risk tool outperformed CHA2DS2-VASc at predicting death and non-haemorrhagic 
      stroke, and it outperformed HAS-BLED for major bleeding in overall as well as in 
      very low- to low-risk group patients with AF. CLINICAL TRIAL REGISTRATION: URL: 
      http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF: NCT01090362, 
      ORBIT-AF I: NCT01165710; ORBIT-AF II: NCT01701817.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of the 
      European Society of Cardiology.
FAU - Fox, Keith A A
AU  - Fox KAA
AUID- ORCID: 0000-0002-0140-2752
AD  - Centre for Cardiovascular Science, University of Edinburgh, Queen's Medical 
      Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
FAU - Virdone, Saverio
AU  - Virdone S
AUID- ORCID: 0000-0003-1849-6422
AD  - Thrombosis Research Institute, Manresa Road, London, SW3 6LR, UK.
FAU - Pieper, Karen S
AU  - Pieper KS
AUID- ORCID: 0000-0003-4190-8341
AD  - Thrombosis Research Institute, Manresa Road, London, SW3 6LR, UK.
FAU - Bassand, Jean-Pierre
AU  - Bassand JP
AUID- ORCID: 0000-0003-4492-1269
AD  - Thrombosis Research Institute, Manresa Road, London, SW3 6LR, UK.
AD  - Department of Cardiology, University of Besancon, Boulevard Fleming, 25000 
      Besancon, France.
FAU - Camm, A John
AU  - Camm AJ
AUID- ORCID: 0000-0002-2536-2871
AD  - Cardiology Clinical Academic Group Molecular & Clinical Sciences Research 
      Institute, St George's University of London, Cranmer Terrace, Tooting, London 
      SW17 0RE,UK.
FAU - Fitzmaurice, David A
AU  - Fitzmaurice DA
AUID- ORCID: 0000-0002-9104-6252
AD  - Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
FAU - Goldhaber, Samuel Z
AU  - Goldhaber SZ
AD  - Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 
      75 Francis Street, Boston, MA 02115, USA.
FAU - Goto, Shinya
AU  - Goto S
AUID- ORCID: 0000-0002-6821-1504
AD  - Department of Medicine (Cardiology), Tokai School of medicine, 143 Shimokasuya, 
      Isehara, Kanagawa 259-1143, Japan.
FAU - Haas, Sylvia
AU  - Haas S
AUID- ORCID: 0000-0003-0837-7892
AD  - Department of Medicine, Formerly Technical University of Munich, Normannenstr. 
      34a, Munich 80333, Germany.
FAU - Kayani, Gloria
AU  - Kayani G
AD  - Thrombosis Research Institute, Manresa Road, London, SW3 6LR, UK.
FAU - Oto, Ali
AU  - Oto A
AUID- ORCID: 0000-0002-0501-882X
AD  - Department of Cardiology, Memorial Ankara Hospital, Sihhiye, 06100, Ankara, 
      Turkey.
FAU - Misselwitz, Frank
AU  - Misselwitz F
AUID- ORCID: 0000-0003-1366-7958
AD  - Formerly, Bayer AG, Mullerstrasse 178, 13353 Berlin, Germany.
FAU - Piccini, Jonathan P
AU  - Piccini JP
AUID- ORCID: 0000-0003-0772-2404
AD  - Duke Clinical Research Institute, 40 Duke Medicine Circle, Clinic 2F/2G, Durham, 
      NC 27710, USA.
FAU - Dalgaard, Frederik
AU  - Dalgaard F
AUID- ORCID: 0000-0002-7287-4191
AD  - Department of Cardiology, Herlev & Gentofte Hospital, 2900 Hellerup, Copenhagen, 
      Denmark.
FAU - Turpie, Alexander G G
AU  - Turpie AGG
AUID- ORCID: 0000-0003-0052-2020
AD  - Department of Medicine, McMaster University, 237 Barton St E Hamilton, Ontario 
      L8L 2X2, Canada.
FAU - Verheugt, Freek W A
AU  - Verheugt FWA
AUID- ORCID: 0000-0002-5831-6951
AD  - Department of Cardiology, Onze Lieve Vrouwe Gasthuis (OLVG), Oosterpark 9, 
      NL-1091-AC Amsterdam, Netherlands.
FAU - Kakkar, Ajay K
AU  - Kakkar AK
AUID- ORCID: 0000-0003-4054-606X
AD  - Thrombosis Research Institute, Manresa Road, London, SW3 6LR, UK.
AD  - University College London, Gower St, London WC1E 6BT, UK.
CN  - GARFIELD-AF Investigators
LA  - eng
SI  - ClinicalTrials.gov/NCT01701817
SI  - ClinicalTrials.gov/NCT01165710
SI  - ClinicalTrials.gov/NCT01090362
PT  - Clinical Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur Heart J Qual Care Clin Outcomes
JT  - European heart journal. Quality of care & clinical outcomes
JID - 101677796
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Anticoagulants/therapeutic use
MH  - *Atrial Fibrillation/complications/drug therapy
MH  - Female
MH  - Hemorrhage/chemically induced/epidemiology
MH  - Humans
MH  - Male
MH  - Registries
MH  - Risk Assessment
MH  - Risk Factors
MH  - *Stroke/drug therapy/epidemiology/etiology
PMC - PMC8888127
OTO - NOTNLM
OT  - Atrial fibrillation
OT  - CHA2DS2-VASc
OT  - Risk stratification
OT  -  GARFIELD-AF
EDAT- 2021/04/24 06:00
MHDA- 2022/03/31 06:00
PMCR- 2021/05/25
CRDT- 2021/04/23 20:30
PHST- 2021/03/15 00:00 [received]
PHST- 2021/04/08 00:00 [revised]
PHST- 2021/04/20 00:00 [accepted]
PHST- 2021/04/24 06:00 [pubmed]
PHST- 2022/03/31 06:00 [medline]
PHST- 2021/04/23 20:30 [entrez]
PHST- 2021/05/25 00:00 [pmc-release]
AID - 6248089 [pii]
AID - qcab028 [pii]
AID - 10.1093/ehjqcco/qcab028 [doi]
PST - ppublish
SO  - Eur Heart J Qual Care Clin Outcomes. 2022 Mar 2;8(2):214-227. doi: 
      10.1093/ehjqcco/qcab028.