title: Stroke prevention in atrial fibrillation patients in Poland and other European countries: insights from the GARFIELD-AF registry.
abstract: BACKGROUND
  Atrial fibrillation (AF) is the most common clinically-significant arrhythmia in the adult population, and it is a strong independent risk factor for cerebrovascular accidents. Patients with non-valvular AF are five times more likely to suffer a stroke. Despite the clear recommendations for anticoagulant therapy, many clinicians are still reluctant to provide routine oral anticoagulation to patients with AF, despite the potential clinical benefits.
  
  
  OBJECTIVE
  To compare Polish and European populations of patients with AF and the every-day practice of stroke prevention in Poland and in the rest of Europe.
  
  
  METHODS
  We analysed the baseline data from the two first cohorts of patients enrolled in the GARFIELD-AF registry (an ongoing prospective, multicentre, international registry of patients newly diagnosed with AF) in Poland and in the rest of Europe.
  
  
  RESULTS
  Polish AF patients are generally younger (median age 67 years in both cohorts vs. 73 in cohort 1 in the rest of Europe and 72 in cohort 2), but they carry a burden of more concomitant diseases. There are some noticeable differences in stroke prevention between Poland and the rest of Europe. The use of vitamin K antagonists (VKAs) is generally higher in other European countries in both cohorts (in Poland 41.7% in cohort 1 and 36.9% in cohort 2 vs. 55.5% in cohort 1 and 41.9% in cohort 2 in the rest of Europe). Meanwhile, it is generally more common in Poland to treat patients with both VKAs and antiplatelets (in cohort 1 20.4% of patients in Poland received vs. 12.0% in the rest of Europe). A total of 5.6% of patients in cohort 1 in Poland receive no antithrombotic treatment (it means: no VKA, oral factor Xa or thrombin inhibitors, antiplatelets), meanwhile in other countries it amounts to 8.5%. The usage of non-vitamin K oral anticoagulants is growing in Poland similarly to the other European countries.
  
  
  CONCLUSIONS
  The GARFIELD-AF registry data shows how distant everyday clinical practice is from the guidelines. It shows that still in Poland, as well as in the rest of Europe, too many patients with low stroke risk are treated with anticoagulants, while too frequently patients at high stroke risk are left with no stroke prevention. Although the tendency to use non-vitamin K oral anticoagulants is growing comparably in Poland and in the rest of Europe, the proportion of patients with intermediate and high stroke risk is not growing and more patients at low stroke risk are treated with anticoagulants.
authors.forename: Janina
authors.initials: J
authors.lastname: Stępińska
authors.affiliation: Institute of Cardiology, Warsaw. ella.kremis@gmail.com.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Kremis
authors.forename: Anna
authors.initials: A
authors.lastname: Konopka
authors.forename: Beata
authors.initials: B
authors.lastname: Wożakowska-Kapłon
authors.forename: Piotr
authors.initials: P
authors.lastname: Ruszkowski
authors.forename: Piotr
authors.initials: P
authors.lastname: Kukla
authors.forename: Gloria
authors.initials: G
authors.lastname: Kayani
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011044:Poland; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012042:Registries; D020521:Stroke / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control; D014812:Vitamin K / Q000037:antagonists & inhibitors
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D014812:Vitamin K
keywords: atrial fibrillation; oral anticoagulants; stroke prevention