title: Vitamin K antagonist control in patients with atrial fibrillation in Asia compared with other regions of the world: Real-world data from the GARFIELD-AF registry.
abstract: OBJECTIVE
  To compare the distribution of international normalized ratios (INRs) in patients receiving vitamin K antagonist (VKA) for newly diagnosed atrial fibrillation in Eastern and Southeastern Asia and in other regions of the world (ORW) represented in the ongoing, global observational study GARFIELD-AF.
  
  
  RESULTS
  3621 and 13,541 patients were recruited prospectively in 2010-2013 from Asia and ORW, respectively. At baseline, excluding patients with unknown antithrombotic treatment, 1356 (37.8%) in Asia and 7081 (53.3%) in ORW received VKA (±antiplatelets). INR readings during 1-year follow-up were analyzed for VKA-treated patients with ≥3 measurements (878 [64.7%] patients in Asia, 4452 [62.9%] in ORW). VKA-treated patients in Asia were younger than those in ORW (mean 67.1 vs 71.3years), with a lower CHA2DS2-VASc score (3.0 vs 3.5), but a similar HAS-BLED score (1.3 vs 1.4). Mean INR was lower in Asia than in ORW (2.0 vs 2.4). The proportion of time in the therapeutic range, defined using the multinational target of 2.0-3.0, was substantially lower in Asia (31.1% vs 54.1%). In Asia and ORW, 59.3% and 28.2% of INRs were <2, and 9.6% and 17.7% were >3, respectively. The same trend was found in different age groups (<65, 65-74, ≥75years).
  
  
  CONCLUSIONS
  GARFIELD-AF data demonstrate a difference in the distribution of INRs in patients from Asia versus other regions under current real-world practice. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362.
authors.affiliation: Seoul National University Hospital, Seoul, South Korea. Electronic address: seil@snu.ac.kr.
authors.forename: Seil
authors.initials: S
authors.lastname: Oh
authors.affiliation: Tokai University, Kanagawa, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Goto
authors.affiliation: Thrombosis Research Institute, London, UK.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Accetta
authors.affiliation: Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Pantep
authors.initials: P
authors.lastname: Angchaisuksiri
authors.affiliation: St George's University of London, London, UK.
authors.forename: A John
authors.initials: AJ
authors.lastname: Camm
authors.affiliation: AZ Klina, Brasschaat, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Cools
authors.affiliation: Formerly Technical University of Munich, Munich, Germany.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Haas
authors.affiliation: Thrombosis Research Institute, London, UK.
authors.forename: Gloria
authors.initials: G
authors.lastname: Kayani
authors.affiliation: Institute for Clinical Research, National Hospital Organization, Osaka National Hospital, Osaka, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Koretsune
authors.affiliation: National University Hospital, Singapore.
authors.forename: Toon Wei
authors.initials: TW
authors.lastname: Lim
authors.affiliation: Bayer Pharma AG, Berlin, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Misselwitz
authors.affiliation: Bayer Pharma AG, Berlin, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: van Eickels
authors.affiliation: Thrombosis Research Institute, London, UK; University College London, London, UK.
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Kakkar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use*; D001208:Asia / Q000453:epidemiology; D001281:Atrial Fibrillation / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology*; D003627:Data Interpretation, Statistical; D005260:Female; D014943:Global Health / Q000706:statistics & numerical data*; D006801:Humans; D019934:International Normalized Ratio / Q000706:statistics & numerical data; D038622:Internationality; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data*; D014812:Vitamin K / Q000037:antagonists & inhibitors*
chemical_list: D000925:Anticoagulants; D014812:Vitamin K
keywords: Atrial fibrillation; International normalized ratio; Vitamin K antagonist