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 non-valvular atrial fibrillation at risk of stroke, with the aim of addressing treatment patterns and questions of effectiveness and safety.
METHODS AND 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 VKAs and 47.7% received NOACs, whilst 12.3% received antiplatelet treatment and 7.6% did not receive any antithrombotic treatment. Amongst patients with CHA2DS2VASc 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%), whilst 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.
CONCLUSION: 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, whilst Asian patients had a high proportion of aspirin use and non-treatment.
