Antithrombotic treatment patterns and stroke prevention in patients with atrial fibrillation in Turkey: Inferences from GARFIELD-AF registry

OBJECTIVE: The corner stone of atrial fibrillation therapy includes the prevention of stroke with less adverse effects. The Global Anticoagulant Registry in the FIELD–Atrial Fibrillation (GARFIELD-AF) study provided data to compare treatment strategies in Turkey with other populations and every-day practice of stroke prevention management with complications. METHODS: GARFIELD-AF is a large-scale registry that enrolled 52,014 patients in five sequential cohorts at >1.000 centers in 35 countries. This study was initiated to track the evolution of global anticoagulation practice, and to study the impact of NOAC therapy in AF. A total of 756 patients from 17 enrolling sites in Turkey were in cohort 4 and 5. Treatment strategies at diagnosis initiated by CHA(2)DS(2)-VASc score, baseline characteristics of patients, treatment according to stroke and bleeding risk profiles, and INR values were analyzed in cohorts. Additionally, event rates during the first year follow up were evaluated. RESULTS: AF patients in Turkey were mostly seen in young women. Stroke risk according to the CHADS(2) score and CHA(2)DS(2)-VASc score compared with world data. The mean of risk score values, including HAS-BLED score were lower in Turkey than in the world data. The percentage of patients receiving FXa inhibitor with or without an antiplatelet usage was more than the other drug groups. All-cause mortality was higher in Turkey. Different form world data when HAS-BLED score was above 3, the therapy was mostly changed to antiplatelet drugs in Turkey. CONCLUSION: In addition to deficiencies in available treatment options, patient care and clinical outcomes of patients with AF, the data of GARFIELD-AF provide data from Turkey about therapeutic strategies and best practices.