Significant differences among atrial fibrillation patients across Asia

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The latest results from one of the largest, ongoing global disease registries in atrial fibrillation (AF)— GARFIELD-AF (global anticoagulant registry in the field-atrial fibrillation) —show that there are significant differences in the characteristics of patients with AF in Asia as well as in their risk factors and treatment patterns. The differences were observed between Asian and non-Asian patients, as well as between patients across Asia, and between the direct costs of AF in Asian countries.

These results were among the findings unveiled by the London-based Thrombosis Research Institute (TRI) in three oral presentations and at a Teatime Seminar at the joint meeting of the 10th Asia Pacific Heart Rhythm Society Session (APHRS) and the 64th Annual Meeting of the Japanese Heart Rhythm Society which took place in Yokohama, Japan (14-17 September).

A total of 52,081 patients were enrolled prospectively between March 2010 and August 2016 in GARFIELD-AF globally, including 13,835 (26.6%) patients from 419 centres in six Asian countries— China, India, Japan, Singapore, South Korea and Thailand. Examining the baseline characteristics and treatment patterns in patients with newly diagnosed AF, the GARFIELD-AF researchers found that:

  • The oldest cohorts of patients in the GARFIELD-AF registry with newly diagnosed AF were from Japan. The median age at diagnosis was 72 years in Japan, 69 years in China, 68 years in Singapore, 67 years in India and Thailand and 66 years in South Korea
  • Japanese patients had the highest frequency (24.6%) of congestive heart failure
  • More patients in Singapore than other Asian countries had a history of hypertension (76.7% vs 63.3-71.3%)
  • Diabetes was most frequent in India (36.3%) compared to the rest of Asia (18.3-29.5%)
  • Moderate-to-severe chronic kidney disease was prevalent in Singapore (20.1%) but not in South Korea or China (3.8 and 4.1%, respectively)
  • Prior stroke/transient ischaemic attack (16.2%) and vascular disease (23.7%) were most frequent in China
  • Use of antiplatelet monotherapy was highest in China, while vitamin K antagonists with or without antiplatelets were most commonly prescribed in Thailand and South Korea.
  • Use of non-vitamin K oral anticoagulants with or without antiplatelet prescription was highest in Japan.

At APHRS, Shinya Goto (Tokai University School of Medicine, Tokyo, Japan) commented: “GARFIELD-AF offers a unique opportunity to obtain a comprehensive and contemporary description of the spectrum of patients with AF and their management globally, and in regions including Asia, as they evolve over time. By enhancing the breadth and depth of understanding of stroke prevention in AF, we can ultimately inform strategies to improve patient outcomes, safety and use of healthcare resources.”

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