20 Mar Despite High Risk Of Stroke, Some Atrial Fibrillation Patients Not Adequately Anticoagulated
Dr. Halperin is a member of the Steering Committee for the GLORIA-AF program and a consultant to Boehringer Ingelheim, which sponsored this research.
Medical Research: What is the background for this study? What are the main findings?
Dr. Halperin: The two analyses come from the GLORIA-AF Registry Program, a global, prospective, observational study supported by Boehringer Ingelheim, which is designed to characterize the population of newly diagnosed patients with non-valvular atrial fibrillation (NVAF) at risk for stroke, and to study patterns, predictors and outcomes of different treatment regimens for stroke risk reduction in non-valvular atrial fibrillation patients. The data is based on treatment trends in 3,415 patients who entered the registry from November 2011 to February 2014 in North America. All patients had a recent diagnosis of NVAF, and 86.2 percent had a CHA2DS2-VASc score of 2 or higher.
Results from the first analysis demonstrated that patients with the paroxysmal (occasional) form of non-valvular atrial fibrillation and at a high risk for stroke (CHA2DS2-VASc score of 2 or higher) were given an anticoagulant medication less often than those with persistent or permanent forms of NVAF, and a CHA2DS2-VASc score of 2 or higher. This pattern runs counter to NVAF guidelines calling for patients to receive oral anticoagulant therapy based on their risk of stroke, rather than the type of atrial fibrillation.
In the second analysis, researchers found that despite high stroke risk, a considerable number of patients receive only aspirin or no medication.
Medical Research: What should clinicians and patients take away from your report?
Dr. Halperin: The two analyses suggest that despite available new treatment options for non-valvular atrial fibrillation, some patients at high risk of stroke are undertreated or receive no treatment. While clinical guidelines call for patients to receive antithrombotic therapy based on their risk of stroke or thromboembolism and bleeding, rather than the type of atrial fibrillation, the results of these analyses showed that 21.9 percent of patients with new-onset paroxysmal NVAF and a CHA2DS2-VASc score of 2 or higher were not given an oral anticoagulant medication, compared to 12.4 percent and 11.2 percent of those diagnosed with persistent or permanent NVAF, respectively, and a CHA2DS2-VASc score of 2 or higher.
Patients with NVAF should discuss with their physician which treatment is right for them.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Halperin: Ongoing studies of factors that contribute to prescribing patterns for NVAF patients, like GLORIA-AF, provide valuable information about the use of available treatments in clinical practice. I encourage more such research that examines the use of antithrombotic treatment for NVAF patients in daily clinical care.
Halperin JL, Huisman M, Diener H-C, et al. Antithrombotic Treatment in Relation to Age in Patients with Newly Diagnosed Atrial Fibrillation in North America (GLORIA-AF Phase II). Abstract No./Poster No: 1246-122, Presented at: the American College of Cardiology 64th Annual Scientific Session (ACC.15), March 14-16, 2015, San Diego, CA – available at: http://www.abstractsonline.com/pp8/#!/3658/presentation/36039
MedicalResearch.com Interview with: Jonathan L. Halperin, M.D. (2015). Despite High Risk Of Stroke, Some Atrial Fibrillation Patients Not Adequately Anticoagulated