title: Antithrombotic Treatment Patterns in Patients with Newly Diagnosed Nonvalvular Atrial Fibrillation: The GLORIA-AF Registry, Phase II.
abstract: BACKGROUND
  The Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) was designed to provide prospectively collected information on patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke, with the aim of addressing treatment patterns and questions of effectiveness and safety.
  
  
  RESULTS
  In this predefined analysis from GLORIA-AF, the baseline characteristics and initial antithrombotic management of the first 10,000 patients in Phase II of this large Registry Program are presented. Overall, 32.3% of patients received vitamin K antagonists (VKAs) and 47.7% received non-VKA oral anticoagulants (NOACs), while 12.3% received antiplatelet treatment and 7.6% did not receive any antithrombotic treatment. Among patients with CHA2DS2-VASc score ≥2, 6.7% received no antithrombotic treatment and 10.0% received aspirin. In Europe, treatment with dabigatran was as common as treatment with VKAs (38.8% and 37.8%, respectively). More than half of the patients were treated with NOACs (52.4%), while antiplatelet treatment was given to 5.7%, and 4.1% did not receive any antithrombotic treatment. In North America, treatment with dabigatran (25.0%) was as common as with VKAs (26.1%), but overall NOAC use was more common (52.1%) than with VKAs (26.1%); however, 14.1% received antiplatelet treatment, while 7.6% received no antithrombotic treatment. In Asia, treatment with VKAs (31.9%) was more prevalent than NOACs (25.5%), but antiplatelet treatment was given to 25.8%, and 16.9% did not receive any antithrombotic treatment. In Asia, only 60.7% of patients with high stroke risk received oral anticoagulants (OACs). Paroxysmal atrial fibrillation and minimally symptomatic (or asymptomatic) patients were often undertreated with OACs.
  
  
  CONCLUSIONS
  In this analysis, OAC use was high in Europe and North America, with overall NOAC use higher than VKA use. A considerable percentage of high-risk patients in North America still received antiplatelet treatment or were untreated, while Asian patients had a high proportion of aspirin use and nontreatment.
authors.affiliation: Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Menno V
authors.initials: MV
authors.lastname: Huisman
authors.affiliation: RTI Health Solutions, Research Triangle Institute, Research Triangle Park, NC.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Rothman
authors.affiliation: Boehringer Ingelheim, Burlington, ON, Canada.
authors.forename: Miney
authors.initials: M
authors.lastname: Paquette
authors.affiliation: Boehringer Ingelheim, Frankfurt am Main, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Teutsch
authors.affiliation: University of Duisburg-Essen, Germany.
authors.forename: Hans Christoph
authors.initials: HC
authors.lastname: Diener
authors.affiliation: Clínica y Maternidad Suizo Argentina, Buenos Aires, Argentina.
authors.forename: Sergio J
authors.initials: SJ
authors.lastname: Dubner
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Halperin
authors.affiliation: Beijing AnZhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Changsheng
authors.initials: C
authors.lastname: Ma
authors.affiliation: Boehringer Ingelheim, Frankfurt am Main, Germany.
authors.forename: Kristina
authors.initials: K
authors.lastname: Zint
authors.affiliation: Boehringer Ingelheim, Frankfurt am Main, Germany.
authors.forename: Amelie
authors.initials: A
authors.lastname: Elsaesser
authors.affiliation: Boehringer Ingelheim, Frankfurt am Main, Germany.
authors.forename: Dorothee B
authors.initials: DB
authors.lastname: Bartels
authors.affiliation: University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK. Electronic address: g.y.h.lip@bham.ac.uk.
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy*; D000069604:Dabigatran / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012042:Registries; D020521:Stroke / Q000517:prevention & control; D016896:Treatment Outcome; D014812:Vitamin K / Q000037:antagonists & inhibitors
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D014812:Vitamin K; D000069604:Dabigatran; D001241:Aspirin
keywords: Anticoagulation; Atrial fibrillation; Registry; Stroke