Landmark GARFIELD-AF Data to be Presented at ESC 2017 Congress Will Feature 1-year Outcomes on 52,000 Prospective Patients
Landmark GARFIELD-AF Data to be Presented at ESC 2017 Congress Will Feature 1-year Outcomes on 52,000 Prospective Patients and the First Insights From the Registry on Health Economics in Atrial Fibrillation (AF)
PR69722
LONDON, August 22, 2017 /PRNewswire=KYODO JBN/ --
- One-year stroke/systemic embolism and major bleeding rates for all five
cohorts will be discussed, as well as the impact of comorbidities
- Global data are expected to show significant geographical variation in the
amount and type of health services used by patients
- The results will confirm that premature mortality adds substantially to the
already considerable direct cost of AF
The latest results from the Global Anticoagulant Registry in the Field - Atrial
Fibrillation (GARFIELD-AF) will be presented at the European Society of
Cardiology (ESC) Congress 2017, to be held in Barcelona, Spain, from August
26th to 30th. Data will be presented during congress sessions as well as at a
dedicated Satellite Symposium.
The registry has started to yield health economic data, which will be presented
for the first time at ESC Congress 2017, confirming the high financial,
economic and human burden AF imposes on societies, and the vast amount of
healthcare resource utilised. Based on data from around 40,000 patients with
atrial fibrillation from 35 countries worldwide, the poster presentation will
describe the geographical variation in the amount and type of health services
used by patients, which is potentially associated with the actual availability
of services and different models of organisation of care.
"With GARFIELD-AF data showing how the significant burden of AF in terms of
morbidity and mortality from stroke and heart failure translates to significant
effects on healthcare costs and resource use, we need clinical strategies that
can reduce AF-related hospitalisations, improve clinical outcomes and reduce
the economic burden," 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. In total,
57,262 patients have been enrolled, of which 52,000 are prospective. This is
the first time 1-year outcomes data from all of the prospective patients will
be presented.
Key results will be unveiled during the TRI Satellite Symposium and at an ESC
Congress Best Poster session:
Atrial fibrillation - a bystander or cause of morbidity and mortality: insights
from the GARFIELD-AF registry
- Satellite Symposium
- Saturday 26th August 2017 at 15:30 - 17:00 (all times CEST), Beirut -
Village 3
Members of the GARFIELD-AF Steering Committee will present a range of results,
including 1-year outcomes for 52,000 prospective patients and perspectives on
the comprehensive treatment of AF with comorbidities such as heart failure,
acute coronary syndrome, chronic kidney disease and obesity.
TRI will also be broadcasting the Satellite Symposium live via Periscope.
Follow the GARFIELD registry @GARFIELD_reg on Twitter to tune in and be part of
the conversation.
One-year clinical outcomes and management of patients with ischaemic vs
non-ischaemic cardiomyopathy and newly diagnosed atrial fibrillation: results
from GARFIELD-AF [P3237]
- Best Posters
- Monday 28th August at 08:30, Best poster screen - Poster Area
Professor Ramon Corbalan will report that the one-third of patients with
congestive heart failure (CHF) who also had ischaemic cardiomyopathy had worse
outcomes compared to those with non-ischaemic cardiomyopathy. In addition, they
were less frequently anticoagulated, more frequently received antiplatelet
therapy, and were prescribed fewer CHF medications than patients with
non-ischaemic cardiomyopathy.
This poster will be on display at 08:30 - 12:30 on a Best Poster plasma screen,
and during the viewing time (10:05 - 10:55) a discussant will lead a discussion
on the poster.
An additional six GARFIELD-AF posters will also be presented on Monday 28th
August. They will be on display either in the morning session (08:30 - 12:30)
or in the afternoon session (14:00 - 18:00). Presenters will be by their
posters at 10:00 - 11:00 and 15:30 -16:30, respectively.
Poster Session 4 - Poster Area (08:30 - 12:30)
Impact of body mass index in newly diagnosed atrial fibrillation in the
GARFIELD-AF registry [P3569]
Professor Samuel Goldhaber (Boston, USA) will describe how patients with morbid
obesity (and associated metabolic syndrome) were almost 10 years younger
(median) than patients of normal weight when diagnosed with AF. As body mass
index increased, mortality paradoxically decreased in GARFIELD-AF. Furthermore,
underweight patients were at higher risk of death (versus normal weight
patients) in the 2 years after AF diagnosis.
Which definition of hypertension best defines thromboembolic risk in patients
with atrial fibrillation? Data from the GARFIELD-AF registry [P3609]
Professor John Camm (London, UK) will explain that the majority of patients
with newly diagnosed AF had a history of hypertension. This history conferred a
higher risk of stroke than observed in those without a hypertension history.
Trends in unadjusted event rates indicate that increasing severity of
uncontrolled hypertension may contribute to the risks of stroke and major
bleeding, but not all-cause mortality in this population.
Poster Session 5 - Poster Area (14:00 - 18:00)
Global healthcare resource use in 39,670 patients with AF: perspectives from
GARFIELD-AF [P4594]
Dr Paolo Cozzolino (Monza, Italy) will review the vast amount of healthcare
resource utilised in nearly 40,000 patients with AF from 35 countries worldwide
as well as the significant geographical variation in the amount and type of
health services used by patients.
Differences in 2-year outcomes according to type of atrial fibrillation:
results from the GARFIELD-AF registry [P4601]
Professor Dan Atar (Oslo, Norway) will report that persistent and permanent AF
were associated with higher mortality risk versus paroxysmal AF but had similar
adjusted risks of stroke/systemic embolism and major bleeding during 2 years of
follow-up.
Similar clinical outcomes of asymptomatic and symptomatic patients with newly
diagnosed atrial fibrillation: results from GARFIELD-AF [P4602]
Dr Harry Gibbs (Melbourne, Australia) will discuss the one-fifth of patients
newly diagnosed with AF who had no symptoms. Prescription of antithrombotic
therapies was similar in asymptomatic and symptomatic patients. Adjusted 1-year
mortality, stroke/systemic embolism and major bleeding were similar in each
group, indicating that asymptomatic newly diagnosed AF is not benign. This
supports systematic approaches to detect and treat asymptomatic AF.
The burden of atrial fibrillation in the more populated European countries:
perspectives from the GARFIELD-AF registry [P4603]
Professor Lorenzo Mantovani (Monza, Italy) will explain that AF imposes a high
financial, economic and human burden to societies - and that, based on
population dynamics, the burden is likely to grow in the future. Premature
mortality substantially adds to the already considerable direct cost of the
disease.
National Data Showcases
Data showcases for Chile, Germany, Japan, Spain and the UK are also scheduled
throughout ESC Congress 2017 at the TRI exhibition stand (Stand G500 - Village
3):
Sunday 27th August
11:00 - 11:30 UK data showcase Professor David A Fitzmaurice
13:00 - 13:30 Japan data showcase Professor Yukihiro Koretsune
Monday 28th August
12:00 - 12:30 Chile data showcase Professor Ramon Corbalan
14:00 - 14:30 Spain data showcase Dr Xavier Viñolas
Tuesday 29th August
12:00 - 12:30 Germany data showcase Professor Harald Darius
About the GARFIELD-AF registry
GARFIELD-AF is the largest ongoing prospective registry of patients with AF.
2016 marked the end of the enrolment phase for GARFIELD-AF, with 57,262
patients enrolled of which 52,000 are prospective. The real-world insights that
continue to be gathered from the GARFIELD-AF registry are being converted into
real-world evidence that helps inform and identify areas where the medical
community can continue to improve patient outcomes.
GARFIELD-AF is a pioneering, independent academic research initiative led by an
international steering committee under the auspices of the TRI, London, UK.
It is an international, non-interventional study of stroke prevention in
patients with newly diagnosed AF. Patients were enrolled from over 1,000
centres in 35 countries worldwide, including from the Americas, Europe, Africa
and Asia-Pacific.
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/.
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: 1 August 2017].
5. World Thrombosis Day. Know Thrombosis. Available at:
http://www.worldthrombosisday.org/issue/thrombosis/ . [Last accessed: 1 August
2017].
6. World Stroke Organization. World Stroke Campaign. Available at:
http://www.worldstrokecampaign.org/ . [Last accessed: 1 August 2017].
7. Stroke Centre. Stroke Statistics. Available at:
http://www.strokecenter.org/patients/about-stroke/stroke-statistics/ . [Last
accessed: 1 August 2017].
8. American Heart Association. Why Atrial Fibrillation (AF or AFib) Matters.
Available at:
. [Last accessed: 1 August 2017].
Thrombosis Research Institute
Emmanuel Kaye Building
Manresa Road
Chelsea
London SW3 6LR
United Kingdom
Media Contact
Rae Hobbs
RHobbs@tri-london.ac.uk
+44(0)7753-825-217
SOURCE: The Thrombosis Research Institute
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