title: Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.
abstract: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year.
  
  
  
  GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death.
  
  
  
  The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death.
  
  
  
  http://www.clinicaltrials.gov. Unique identifier: NCT01090362.
authors.affiliation: University of Besançon, Besançon, France jpbassand@tri-london.ac.uk jpbassand@orange.fr.|Thrombosis Research Institute, Emmanuel Kaye Building, Manresa Road, London SW3 6LR, UK.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bassand
authors.affiliation: Thrombosis Research Institute, Emmanuel Kaye Building, Manresa Road, London SW3 6LR, UK.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Accetta
authors.affiliation: St George's University of London, London, UK.
authors.forename: Alan John
authors.initials: AJ
authors.lastname: Camm
authors.affiliation: AZ Klina, Brasschaat, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Cools
authors.affiliation: University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: David A
authors.initials: DA
authors.lastname: Fitzmaurice
authors.affiliation: University of Edinburgh, Edinburgh, UK.
authors.forename: Keith A A
authors.initials: KA
authors.lastname: Fox
authors.affiliation: Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Samuel Z
authors.initials: SZ
authors.lastname: Goldhaber
authors.affiliation: Tokai University, Kanagawa, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Goto
authors.affiliation: Formerly Technical University of Munich, Munich, Germany.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Haas
authors.affiliation: University of Heidelberg, Heidelberg, Germany.
authors.forename: Werner
authors.initials: W
authors.lastname: Hacke
authors.affiliation: Thrombosis Research Institute, Emmanuel Kaye Building, Manresa Road, London SW3 6LR, UK.
authors.forename: Gloria
authors.initials: G
authors.lastname: Kayani
authors.affiliation: University of Milano-Bicocca, Milan, Italy.
authors.forename: Lorenzo G
authors.initials: LG
authors.lastname: Mantovani
authors.affiliation: Bayer HealthCare Pharmaceuticals, Berlin, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Misselwitz
authors.affiliation: Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands.
authors.forename: Hugo
authors.initials: H
authors.lastname: Ten Cate
authors.affiliation: McMaster University, Hamilton, Canada.
authors.forename: Alexander G G
authors.initials: AG
authors.lastname: Turpie
authors.affiliation: University Hospital, Nijmegen.|Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Freek W A
authors.initials: FW
authors.lastname: Verheugt
authors.affiliation: Thrombosis Research Institute, Emmanuel Kaye Building, Manresa Road, London SW3 6LR, UK.|University College London, London, UK.
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Kakkar
mesh_terms: D000368:Aged; D000925:Anticoagulants; D001281:Atrial Fibrillation; D005260:Female; D006470:Hemorrhage; D006801:Humans; D008297:Male; D012307:Risk Factors; D020521:Stroke
chemical_list: D000925:Anticoagulants
keywords: Anticoagulation; Atrial fibrillation; Bleeding; Stroke; Stroke prevention