Many atrial fibrillation patients at high risk of stroke fail to receive guideline-recommended oral anticoagulant treatment


Boehringer Ingelheim has announced two analyses from the GLORIA-AF Registry programme examining the use of anticoagulant treatments for stroke prevention in patients with atrial fibrillation.

These new analyses found that although oral anticoagulant use is increasing in the USA, approximately a fifth of North American atrial fibrillation patients in the GLORIA-AF Registry were either inadequately treated with the antiplatelet acetylsalicylic acid or did not receive any treatment at all. This is despite current US guidelines stating that atrial fibrillation patients with a CHA2DS2-VASc score of 2 or above are considered at high risk for stroke and require anticoagulant treatment. The new findings were presented during poster sessions at the American College of Cardiology 64th Annual Scientific Sessions (14–16 March, San Diego, USA).

“These real-world analyses highlight that while physicians have a variety of factors to consider when deciding on antithrombotic treatment options for atrial fibrillation patients, the fact remains that oral anticoagulants, the standard of care for significantly reducing the risk of stroke and systemic embolism in these patients, are underutilised,” said Jonathan L Halperin, the Robert and Harriet Heilbrunn professor of medicine at Mount Sinai School of Medicine, lead author of the study, and member of the GLORIA-AF steering committee. “We need to continue to uncover why that is and what we can do to bridge that treatment gap.”

The new data are the first reported prescribing patterns from phase II of the GLORIA-AF Registry programme, which began in November 2011 after the first novel oral anticoagulant, Pradaxa (dabigatran etexilate), was approved in the USA. The data is based on treatment trends in 3,415 atrial fibrillation patients who entered the GLORIA-AF Registry from November 2011 to February 2014. All patients had a recent diagnosis of atrial fibrillation and 86% had a CHA2DS2-VASc score of 2 or higher, placing them at high risk of stroke. The data show that dabigatran etexilate was the most widely prescribed novel oral anticoagulant for stroke prevention among the patients included in the study.

“We still face challenges in ensuring that patients with atrial fibrillation receive the most effective anticoagulant treatment to reduce their risk of stroke, which can be debilitating or even fatal,” said Jörg Kreuzer, vice president Medicine Therapeutic Area Cardiovascular, Boehringer Ingelheim. “These latest data from GLORIA-AF, as well as further analyses from the registry, will shed light on the strategies needed to eliminate disparities in treatment and ensure that all patients are optimally protected against stroke”.