Background: The uptake rate of non-vitamin K oral anticoagulants (NOAC) for the treatment of non-valvular atrial fibrillation (AF) differed greatly between the Netherlands (NL) and Belgium (BE).

Aims: To explore the effect of these differences on thromboembolism (TE) and bleeding.

Methods: Dutch and Belgian data from the worldwide GARFIELD-AF registry was used. Patients with new-onset AF and at least one investigator-determined risk factor for stroke were included between 2010-2016. Event rates from two years of follow-up were used.

Results: In total, 1186 and 1705 patients were included in NL and BE, respectively. Female sex (42.3% vs 42.2%), mean age (70.7 vs 71.3 years), CHA₂DS₂-VASc (3.1 vs 3.1) and HAS-BLED score (1.4 vs 1.5) were comparable between NL and BE, respectively. In NL and BE, mean INR was 2.9 (±1.0) and 2.4 (±1.0), respectively. Overall, at diagnosis in NL vs BE 72.1% vs 14.6% received vitamin K antagonists (VKA), 17.8% vs 65.5% NOACs and 4.8% vs 10.6% antiplatelet monotherapy, varying across cohorts (Figure 1).
Event rates per 100 patient-years in NL and BE, respectively, of all-cause mortality (3.38 vs 3.90; hazard ratio (HR) 0.86 [0.65-1.15]), ischemic stroke/TE (0.82 vs 0.72; HR 1.14 [0.62-2.11]) and major bleeding (2.06 vs 1.54; HR 1.33 [0.89-1.99]) did not differ significantly.

Conclusions: In GARFIELD-AF, despite similar characteristics, patients were treated distinctly different with predominantly VKA vs NOAC in NL and BE, respectively. Although the rate of major bleeding was 33% higher in NL, variations in bleeding, mortality and TE rates were not statistically significant.

[Figure 1 – Changes in oral anticoagulation (OAC) in NL and BE.]

« Back to ISTH 2020 Congress

ISTH Congress Abstracts - https://abstracts.isth.org/abstract/differences-in-treatment-and-outcomes-in-recently-diagnosed-atrial-fibrillation-between-the-netherlands-and-belgium-results-from-the-garfield-af-registry/