Thrombosis Research Institute (TRI) to Announce New Real-World Insights in Atrial Fibrillation at ESC Congress 2018

PR74832

MUNICH, August 20, 2018 /PRNewswire=KYODO JBN/ --

    - Satellite symposium will highlight the breadth of evidence collected

      since the establishment of the registry in 2009

    - An analysis of the comparative effectiveness of oral anticoagulants

      in everyday practice will be presented

    - The economic burden of atrial fibrillation (AF) in nine European

      countries will be evaluated

    The latest results from the Global Anticoagulant Registry in the Field -

Atrial Fibrillation (GARFIELD-AF) will be presented at the forthcoming ESC

Congress 2018, organised by the European Society of Cardiology, to be held in

Munich, Germany, from 25th to 29th August.

    Data will be presented as posters, oral presentations and at the late

breaking science session on clinical registries, exploring a range of areas

including the burden attributable to AF in nine European countries, clinicians'

prescribing tendencies, and how the quality of stroke prevention has changed

over time.

    The late breaking science session "Registry Results 2" on Tuesday 28th

August, 14:30-15:45, (Centre Stage - The Hub) will see Professors John Camm and

Keith Fox present the latest results from the GARFIELD-AF Registry. Professor

Camm will highlight significant differences in the risk of mortality in favour

of OACs (vs. no OAC) and NOACs (vs. VKAS) even after adjustment for baseline

variables. Professor Fox will present findings that challenge the use of

combined OAC+AP therapy, particularly among those without a clear indication

for AP therapy.

    "We are excited to have a strong presence at this year's ESC Congress, as a

result of the wealth of new GARFIELD-AF data, which will be presented by some

of the leading investigators involved in the registry," said Rt Hon Professor

the Lord Ajay K. Kakkar, Professor of Surgery at University College London and

Director of the Thrombosis Research Institute (TRI), UK.

    GARFIELD-AF is the largest ongoing prospective registry of patients with

AF. It is a pioneering, independent outcomes research initiative led by an

international steering committee under the auspices of the TRI. It has

generated at least 2 years of follow-up data in over 52,000 patients with newly

diagnosed AF.

    Key results will be unveiled during the TRI Satellite Symposium which will

showcase the wealth of evidence collected since the establishment of

GARFIELD-AF in 2010.

    GARFIELD-AF: New light shed on Atrial Fibrillation and its management

    - Satellite Symposium

    - Saturday 25th August 2018 from 15.30 - 17.00 (all times CEST) - Room

Vienna - Village 3

    Members of the GARFIELD-AF Steering Committee will present a variety of

results, including new insights on the quality of stroke prevention and its

clinical effectiveness in routine care, and presentations on the real-world

record of change in prescribing practice and outcomes. The new GARFIELD-AF risk

score and its online application will also be discussed. The symposium will

also include a panel discussion led by Professors Jean-Pierre Bassand (France)

and Samuel Z. Goldhaber (USA).

    Other key data from GARFIELD-AF will be presented during the following

sessions:

    Rapid Fire Abstract Session entitled 'Atrial fibrillation - Detection,

treatment, outcomes' - (11:00 - 12:30, Sunday 26th August; Location: Agora 2 -

Agora)

    "The effect of non-recommended dosing of non-vitamin K antagonist oral

anticoagulants (NOACs) on 1-year mortality in patients with newly diagnosed AF.

Results from the GARFIELD-AF registry."

    Professor John Camm (UK) will highlight the impact of using non-recommended

doses of NOACs for stroke prevention in in patients with newly diagnosed AF.

    Poster Session 3 - (14.00 - 18.00, Sunday 26th August)

    Evaluation of the effect of oral anticoagulants on all-cause mortality

within 3 months of the diagnosis of atrial fibrillation  

    Karen Pieper (USA) will reveal significant early mortality in patients with

newly diagnosed AF and significant mortality differences in favour of OACs,

even after adjustment for 29 baseline variables.

    The economic burden attributable to atrial fibrillation in nine European

countries

    Paolo Cozzolino (Italy) will report that the economic burden of AF, a

growing public health problem, correlates with differences in management

between countries.

    Poster Session 5 - (14.00 - 18.00, Monday 27th August)

    Why do clinicians withhold anticoagulation in patients with atrial

fibrillation and CHA2DS2-VASc score ≥2?

    Dr Deborah Siegal (Canada) will report that guideline-based treatment with

oral anticoagulants was associated with better outcomes, results that emphasise

the need to better understand decision-making to improve oral anticoagulant

prescription rates and outcomes in AF.

    Why do clinicians prescribe oral anticoagulation in patients with atrial

fibrillation despite a low CHA2DS2-VASc score?

    Frederik Verbrugge (Belgium) will report on the discrepancy between patient

characteristics that predict OAC use in AF patients with a very low

CHA2DS2-VASc score and factors reported by clinicians that influence their

decision-making.

    About the GARFIELD-AF registry  

    GARFIELD-AF is a worldwide observational programme that aims to enhance the

breadth and depth of understanding of stroke prevention in atrial fibrillation

(AF), ultimately informing strategies to improve patient outcomes, safety and

utilisation of healthcare resources.

    It offers a unique opportunity to obtain a comprehensive and contemporary

description of the spectrum of patients with AF and their management worldwide

as they evolve over time. The registry is important in bridging the gap between

research and clinical practice, serving to increase awareness of the importance

of thrombosis and its treatment.

    GARFIELD-AF recruited patients with newly diagnosed nonvalvular AF and at

least one risk factor for stroke. A total of 57,262 patients were recruited

from over 1000 centres in 35 countries worldwide, including the Americas,

Europe, Africa and Asia-Pacific, over five sequential cohorts. Follow-up is

over a minimum of 2 years and up to 8 years after diagnosis, to create a

comprehensive database of treatment decisions and outcomes in everyday clinical

practice.

    GARFIELD-AF is a pioneering, independent academic research initiative led

by an international steering committee under the auspices of the TRI, London,

UK.

    Contemporary understanding of AF is based on data gathered in controlled

clinical trials. Whilst essential for evaluating the efficacy and safety of new

treatments, these trials are not representative of everyday clinical practice

and, hence, uncertainty persists about the real-life burden and management of

this disease. GARFIELD-AF seeks to provide insights into the impact of

anticoagulant therapy on thromboembolic and bleeding complications seen in this

patient population. It will provide a better understanding of the potential

opportunities for improving care and clinical outcomes amongst a representative

and diverse group of patients and across distinctive populations. This should

help physicians and healthcare systems to appropriately adopt innovation to

ensure the best outcomes for patients and populations.

    The registry started in December 2009. Four key design features of the

GARFIELD-AF protocol ensure a comprehensive and representative description of

AF; these are:

    - Five sequential cohorts of prospective, newly diagnosed patients,

facilitating comparisons of discrete time periods and describing the evolution

of treatments and outcomes;

    - Investigator sites that are selected randomly within carefully assigned

national AF care setting distributions, ensuring that the enrolled patient

population is representative;

    - Enrolment of consecutive eligible patients regardless of therapy to

eliminate potential selection bias;

    - Follow-up data captured for a minimum of 2 and up to 8 years after

diagnosis, to create a comprehensive database of treatment decisions and

outcomes in everyday clinical practice.

    Included patients must have been diagnosed with non-valvular AF within the

previous 6 weeks and have at least one risk factor for stroke; as such, they

are potential candidates for anticoagulant therapy to prevent blood clots

leading to stroke. It is left to the investigator to identify a patient's

stroke risk factor(s), which need not be restricted to those included in

established risk scores. Patients are included whether or not they receive

anticoagulant therapy, so that the merit of current and future treatment

strategies can be properly understood in relation to patients' individual risk

profiles.

    The GARFIELD-AF registry is funded by an unrestricted research grant from

Bayer AG, Berlin, Germany.

    For more information, visit our website: http://www.garfieldregistry.org

    The burden of AF  

    Up to 2% of the global population has AF,[1] including around 8.8 million

people in Europe[2] and 5-6.1 million in the United States.[3] It is estimated

that its prevalence will at least double by 2050 as the global population

ages.[3] AF is associated with a five-fold increase in stroke risk, and one out

of five strokes is attributed to this arrhythmia.[1] Ischaemic strokes related

to AF are often fatal, and those patients who survive are left more frequently

and more severely disabled and have a greater risk of recurrence than patients

with other causes of stroke.[1] Hence, the risk of mortality from AF-associated

stroke is doubled and the cost of care is 50% higher.[1]

    AF occurs when parts of the atria emit uncoordinated electrical signals.

This causes the chambers to pump too quickly and irregularly, not allowing

blood to be pumped out completely.[4] As a result, blood may pool, clot and

lead to thrombosis, which is the number one cardiovascular killer in the

world.[5] If a blood clot leaves the left atrium, it could potentially lodge in

an artery in other parts of the body, including the brain. A blood clot in an

artery in the brain leads to a stroke; 92% of fatal strokes are caused by

thrombosis.[5] Stroke is a major cause of death and long-term disability

worldwide - each year, 6.5 million people die[6] and 5 million are left

permanently disabled.[7] People with AF also are at high risk for heart

failure, chronic fatigue and other heart rhythm problems.[8]

    About the TRI   

    The TRI is dedicated to bringing new solutions to patients for the

detection, prevention and treatment of blood clots. The TRI's goal is to

advance the science of real-world enquiry so that the value of real-world data

is realised and becomes a critical link in the chain of evidence. Our

pioneering research programme, across medical disciplines and across the world,

continues to provide breakthrough solutions in thrombosis.

    For more information, visit: http://www.tri-london.ac.uk/.

    References:

    1. Camm A J, Kirchhof P, et al. Guidelines for the management of atrial

fibrillation: The Task Force for the Management of Atrial Fibrillation of the

European Society of Cardiology (ESC). Eur Heart J 2010; 31(19):2369-429.

    2. Krijthe B P, Kunst A, et al. Projections on the number of individuals

with atrial fibrillation in the European Union, from 2000 to 2060. Eur Heart J

2013; 34:2746-51.

    3. Colilla S, Crow A, Petkun W, et al. Estimates of current and future

incidence and prevalence of atrial fibrillation in the U.S. adult population.

Am J Cardiol 2013; 112(8):1142-7.

    4. National Heart, Lung, and Blood Institute. What is Atrial Fibrillation?

Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/af/. [Last

accessed: 10 August  

    5. World Thrombosis Day. Know Thrombosis. Available at:

http://www.worldthrombosisday.org/issue/thrombosis/. [Last accessed: 10 August

2018].

    6. World Stroke Organization. World Stroke Campaign. Available at:

http://www.worldstrokecampaign.org/. [Last accessed: 10 August 2018].

    7. Stroke Centre. Stroke Statistics. Available at:

http://www.strokecenter.org/patients/about-stroke/stroke-statistics/. [Last

accessed: 10 August 2018].

    8. American Heart Association. Why Atrial Fibrillation (AF or AFib)

Matters. Available at:

http://www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/Why-Atrial-Fibrillation-AF-or-AFib-Matters_UCM_423776_Article.jsp.

[Last accessed: 10 August 2018].

SOURCE: The Thrombosis Research Institute