Abstract Number: PB2051
Meeting: ISTH 2020 Congress
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.
To cite this abstract in AMA style:Seelig J, Hemels MEW, Xhaët O, Bongaerts MCM, de Wolf A, Groenemeijer BE, Heyse A, Hoogslag P, Voet J, Herrman JPR, Vervoort G, Hermans W, Wollaert B, Boersma LVA, Hermans K, Lucassen A, Pieper K, Verheugt FWA, Cools F, ten Cate H, on behalf of the GARFIELD-AF Investigators . Differences in Treatment and Outcomes in Recently Diagnosed Atrial Fibrillation between the Netherlands and Belgium: Results from the GARFIELD-AF Registry [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). 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/. Accessed January 23, 2022.
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