In patients with newly diagnosed nonvalvular atrial fibrillation, NOACs were prescribed to 47.6% of patients compared to 32.3% for VKAs, becoming more frequently prescribed in Europe and North America.
Cross-Sectional (n=15,092)
Yes
What are the global antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation following the introduction of NOACs?
NOACs have been highly adopted for stroke prevention in newly diagnosed nonvalvular AF, surpassing VKAs in Europe and North America, though undertreatment remains common globally.
Absolute Event Rate: 47.6% vs 32.3%
BACKGROUND: GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non-vitamin K antagonist oral anticoagulant (NOAC), became available. OBJECTIVES: This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. METHODS: During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients' baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. RESULTS: -VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. CONCLUSIONS: The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation GLORIA-AF; NCT01468701).
Huisman et al. (Wed,) conducted a cross-sectional in newly diagnosed nonvalvular atrial fibrillation (n=15,092). Non-vitamin K antagonist oral anticoagulants (NOAC) vs. Vitamin K antagonists (VKA) was evaluated on Antithrombotic treatment patterns. In patients with newly diagnosed nonvalvular atrial fibrillation, NOACs were prescribed to 47.6% of patients compared to 32.3% for VKAs, becoming more frequently prescribed in Europe and North America.