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Evolving antithrombotic treatment patterns for patients with newly diagnosed atrial fibrillation
Camm AJ, Accetta G, Ambrosio G, Atar D, Bassand JP, Berge E, Cools F, Fitzmaurice DA et al.. Heart (British Cardiac Society), 2016-09-19
Topic: Amyloid, tau and blood-test diagnosis
Objective We studied evolving antithrombotic therapy patterns in patients with newly diagnosed non-valvular atrial fibrillation (AF) and ≥1 additional stroke risk factor between 2010 and 2015. Methods 39 670 patients were prospectively enrolled in four sequential cohorts in the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF): cohort C1 (2010-2011), n=5500; C2 (2011-2013), n=11 662; C3 (2013-2014), n=11 462; C4 (2014-2015), n=11 046. Baseline characteristics and antithrombotic therapy initiated at diagnosis were analysed by cohort. Results Baseline characteristics were similar across cohorts. Median CHA 2 DS 2 -VASc (cardiac failure, hypertension, age ≥75 (doubled), diabetes, stroke (doubled)-vascular disease, age 65-74 and sex category (female)) score was 3 in all four cohorts. From C1 to C4, the proportion of patients on anticoagulant (AC) therapy increased by almost 15% (C1 57.4%; C4 71.1%). Use of vitamin K antagonist (VKA)±antiplatelet (AP) (C1 53.2%; C4 34.0%) and AP monotherapy (C1 30.2%; C4 16.6%) declined, while use of non-VKA oral ACs (NOACs)±AP increased (C1 4.2%; C4 37.0%). Most CHA 2 DS 2 -VASc ≥2 patients received AC, and this proportion increased over time, largely driven by NOAC prescribing. NOACs were more frequently prescribed than VKAs in men, the elderly, patients of Asian ethnicity, those with dementia, or those using non-steroidal anti-inflammatory drugs, and current smokers. VKA use was more common in patients with cardiac, vascular, or renal comorbidities. Conclusions Since NOACs were introduced, there has been an increase in newly diagnosed patients with AF at risk of stroke receiving guideline-recommended therapy, predominantly driven by increased use of NOACs and reduced use of VKA±AP or AP alone. Trial registration number NCT01090362; Pre-results.
Key findings
- Results Baseline characteristics were similar across cohorts.
- Trial registration number NCT01090362; Pre-results.
Study details
- Participants5,500
- Effect size57.4%; 71.1%; 53.2%
- Evidence strengthModerate
How this study scored 59/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record and institution's track record, so those were left out: it earned 36 of the 61 points we could judge it on, which is 59 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Heart (British Cardiac Society)) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2017 — within 10 year(s) of the newest study here |
| Sample size | 3 / 4 | 5,500 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 2 / 3 | PubMed indexes it as a multicentre study |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 27647168) |
| Free to read | 2 / 2 | Free to read |
| Points | 36 / 61 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 36 of the 61 points we could judge it on is 59 out of 100. |
| Total | 59 / 100 | — |
What each of these 20 components measures, and what this score is not →
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APA 7th
Camm, A. J., Accetta, G., Ambrosio, G., Atar, D., Bassand, J. P., Berge, E., et al. (2017). Evolving antithrombotic treatment patterns for patients with newly diagnosed atrial fibrillation. Heart (British Cardiac Society). https://doi.org/10.1136/heartjnl-2016-309832
Vancouver
Camm AJ, Accetta G, Ambrosio G, Atar D, Bassand JP, Berge E, et al. Evolving antithrombotic treatment patterns for patients with newly diagnosed atrial fibrillation. Heart (British Cardiac Society). 2017. doi:10.1136/heartjnl-2016-309832. PMID: 27647168.
BibTeX
@article{camm2017-27647168,
author = {Camm, A. J. and Accetta, G. and Ambrosio, G. and Atar, D. and Bassand, J. P. and Berge, E. and Cools, F. and Fitzmaurice, D. A. and others},
title = {{Evolving antithrombotic treatment patterns for patients with newly diagnosed atrial fibrillation}},
journal = {Heart (British Cardiac Society)},
year = {2017},
doi = {10.1136/heartjnl-2016-309832},
pmid = {27647168},
url = {https://doi.org/10.1136/heartjnl-2016-309832}
}