期刊论文详细信息
BMC Cardiovascular Disorders
An international longitudinal registry of patients with atrial fibrillation at risk of stroke (GARFIELD): the UK protocol
David A Fitzmaurice1  F D Richard Hobbs2  Roger Holder1  Ellen T Murray1  Patricia N Apenteng1 
[1] Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK;Primary Care Health Sciences, University of Oxford, 23-38 Hythe Bridge Street, Oxford, OX1 2ET, UK
关键词: Vitamin K antagonists;    Stroke;    Registry;    Atrial fibrillation;    Anticoagulation;   
Others  :  857724
DOI  :  10.1186/1471-2261-13-31
 received in 2012-11-26, accepted in 2013-04-18,  发布年份 2013
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【 摘 要 】

Background

Atrial fibrillation (AF) is an independent risk factor for stroke and a significant predictor of mortality. Evidence-based guidelines for stroke prevention in AF recommend antithrombotic therapy corresponding to the risk of stroke. In practice, many patients with AF do not receive the appropriate antithrombotic therapy and are left either unprotected or inadequately protected against stroke. The purpose of the Global Anticoagulant Registry in the FIELD (GARFIELD) is to determine the real-life management and outcomes of patients newly diagnosed with non-valvular AF.

Methods/design

GARFIELD is an observational, international registry of newly diagnosed AF patients with at least one additional investigator-defined risk factor for stroke. The aim is to enrol 55,000 patients at more than 1000 centres in 50 countries worldwide. Enrolment will take place in five independent, sequential, prospective cohorts; the first cohort includes a retrospective validation cohort. Each cohort will be followed up for 2 years. The UK stands to be a significant contributor to GARFIELD, aiming to enrol 4,582 patients, and reflecting the care environment in which patients with AF are managed. The UK protocol will also focus on better understanding the validity of the two main stroke risk scores (CHADS2 and CHA2DS2VASC) and the HAS-BLED bleeding risk score, in the context of a diverse patient population.

Discussion

The GARFIELD registry will describe how therapeutic strategies, patient care, and clinical outcomes evolve over time. This study will provide UK-specific comprehensive data that will allow a range of evaluations both at a national level and in relation to global data and contribute to a better understanding of AF management in the UK.

Trial registration

ClinicalTrial.gov: NCT01090362

【 授权许可】

   
2013 Apenteng et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Wolf PA, Abbott RD, Kannel WB: Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 1991, 22(8):983-988.
  • [2]Wolf PA, Abbott RD, Kannel WB: Atrial fibrillation: a major contributor to stroke in the elderly. The Framingham Study. Arch Intern Med 1987, 147(9):1561-1564.
  • [3]Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE: Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001, 285(18):2370-2375.
  • [4]DeWilde S, Carey IM, Emmas C, Richards N, Cook DG: Trends in the prevalence of diagnosed atrial fibrillation, its treatment with anticoagulation and predictors of such treatment in UK primary care. Heart 2006, 92(8):1064-1070.
  • [5]Quality and Outcomes Framework: Prevalence data tables. http://www.hscic.gov.uk/catalogue/PUB05551 webcite
  • [6]Ruigomez A, Johansson S, Wallander MA, Rodriguez LA: Incidence of chronic atrial fibrillation in general practice and its treatment pattern. J Clin Epidemiol 2002, 55(4):358-363.
  • [7]NHS Improvement: Heart and Stroke Improvement. Atrial fibrillation in primary care: making an impact on stroke prevention. Leicester: NHS Improvement; 2009. http://www.improvement.nhs.uk/LinkClick.aspx?fileticket=%2bLIKN1gSgOA%3d&tabid=62 webcite
  • [8]Jorgensen HS, Nakayama H, Reith J, Raaschou HO, Olsen TS: Acute stroke with atrial fibrillation. The Copenhagen Stroke Study. Stroke 1996, 27(10):1765-1769.
  • [9]Lin HJ, Wolf PA, Kelly-Hayes M, Beiser AS, Kase CS, Benjamin EJ, D'Agostino RB: Stroke severity in atrial fibrillation. The Framingham Study. Stroke 1996, 27(10):1760-1764.
  • [10]Lamassa M, Di Carlo A, Pracucci G, Basile AM, Trefoloni G, Vanni P, Spolveri S, Baruffi MC, Landini G, Ghetti A, Wolfe CD, Inzitari D: Characteristics, outcome, and care of stroke associated with atrial firbrillation in Europe: data from a multicenter multinational hospital-based registry (The European Community Stroke Project). Stroke 2001, 32(2):392-398.
  • [11]Waldo AL, Becker RC, Tapson VF, Colgan KJ: Hospitalized patients with atrial fibrillation and a high risk of stroke are not being provided with adequate anticoagulation. J Am Coll Cardiol 2005, 46(9):1729-1736.
  • [12]Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, Hindricks G, Kirchhof P, Guidelines ESCCP, Bax JJ: 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: An update of the 2010 ESC Guidelines for the management of atrial fibrillation * Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J 2012, 33(21):2719-2747.
  • [13]Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ: Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on atrial fibrillation. Chest 2010, 137(2):263-272.
  • [14]Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY: A novel user-friendly score (HAS-BLED) to assess one-year risk of major bleeding in atrial fibrillation patients: The Euro Heart Survey. Chest 2010, 138(5):1093-1100.
  • [15]National Institute for Health and Clinical Excellence: Atrial fibrillation. The management of atrial fibrillation. London: National Institute for Health and Clinical Excellence; 2006.
  • [16]Majeed A, Moser K, Carroll K: Trends in the prevalence and management of atrial fibrillation in general practice in England and Wales, 1994–1998: analysis of data from the general practice research database. Heart 2001, 86(3):284-288.
  • [17]Gallagher AM, Rietbrock S, Plumb J, van Staa TP: Initiation and persistence of warfarin or aspirin in patients with chronic atrial fibrillation in general practice: do the appropriate patients receive stroke prophylaxis? J Thromb Haemost 2008, 6(9):1500-1506.
  • [18]National Institute for Health and Clinical Excellence: Atrial fibrillation. The management of atrial fibrillation. Costing report Implementing NICE guidance in England. England, London: National Institute for Health and Clinical Excellence; 2006.
  • [19]Kakkar AK, Mueller I, Bassand JP, Fitzmaurice DA, Goldhaber SZ, Goto S, Haas S, Hacke W, Lip GY, Mantovani LG: International longitudinal registry of patients with atrial fibrillation at risk of stroke: Global Anticoagulant Registry in the FIELD (GARFIELD). Am Heart J 2012, 163(1):13-19. e1
  • [20]Singer DE, Albers GW, Dalen JE, Fang MC, Go AS, Halperin JL, Lip GY, Manning WJ: Antithrombotic therapy in atrial fibrillation: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008, 133(6 Suppl):546S-592S.
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