The London-based Thrombosis Research Institute has announced the launch of a worldwide research initiative that will compile comprehensive information about the global burden of atrial fibrillation (AF).

The six-year Global Anticoagulant Registry in the Field (GARFIELD) registry will prospectively track 50,000 patients with newly diagnosed AF who are candidates for chronic anticoagulation therapy with vitamin K antagonists.

Overall, 1,000 clinical sites worldwide will participate in the registry and will be randomly selected from a cross-section of care settings (including hospitals, emergency departments, anticoagulant clinics, and general /family practices). The newly launched database is the first to randomly choose participating sites, a feature which helps prevent the selection of only sites that are considered expert in AF management.

“The burden of atrial fibrillation is grossly underestimated but with an aging population, the frequency and impact of this disease will continue to increase,” Professor Ajay Kakkar, Director of the Thrombosis Research Institute, pointed out in a news release. The Thrombosis Research Institute is a charitable foundation and affiliated institute of Queen Mary University of London.

Professor Kakkar, who is also Professor of Surgical Sciences at Queen Mary University of London, also said that an improved understanding of AF should lead to better methods for preventing AF’s often life-threatening sequelae.

Regrettably, while AF patients have five times the risk of stroke as the general population and would thus benefit from prophylactic anticoagulation, few at-risk patients are appropriately treated, he added. What’s more, most AF patients are elderly, and presently available therapies like vitamin K antagonists may provide unpredictable anticoagulation in this age group.

Patients with AF are also at increased risk of additional heart rhythm disturbances, heart failure, and chronic fatigue.

All eligible patients will be enrolled whether or not they receive appropriate therapy to allow the investigators to gauge the true burden of current treatment failure.

Data will be collected at multiple time points for six years and will include the following: the incidence of thromboembolic stroke, transient ischemic attacks, and systemic embolization; the frequency of bleeding events; therapy persistence; and the duration and cause of treatment interruption or termination. Investigators will also analyze hospitalization and outcomes associated with major bleeding events, health care resource use, mortality, and major adverse cardiac events.

For patients treated with anticoagulant therapy, data will also be collected on the following: the frequency and timing of monitoring needed to maintain therapeutic anticoagulation, INR recordings in relation to therapeutic range, and the use of bridging anticoagulation necessitated because vitamin K antagonists have been stopped.

Written by Jill Stein
Jill Stein is a Paris-based freelance medical writer.
jillstein03(at)gmail.com