• Marita Knudsen Pope, Dan Atar, Arne Svilaas, Torstein Hole, Jørn Dalsgaard Nielsen, Ulrik Hintze, Milita Crisby, Pekka Raatikainen, AiraksinenK E JuhaniKEJ0000-0002-0193-568XHeart Centre, Turku University Hospital and University of Turku, Turku, Finland., Saverio Virdone, Karen Pieper, Gloria Kayani, Jean-Yves Le Heuzey, Jan Steffel, Janina Stepinska, Jean-Pierre Bassand, A John Camm, and GARFIELD-AF Investigators.
• Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
• Ann. Med. 2021 Dec 1; 53 (1): 485494485-494.

AimsThe objective was to evaluate the clinical characteristics, management and two-year outcomes of patients with newly diagnosed non-valvular atrial fibrillation at risk for stroke in Nordic countries.MethodsWe examined the baseline characteristics, antithrombotic treatment, and two-year clinical outcomes of patients from four Nordic countries.ResultsA total of 52,080 patients were enrolled in the GARFIELD-AF. Out of 29,908 European patients, 2,396 were recruited from Nordic countries. The use of oral anticoagulants, alone or in combination with antiplatelet (AP), was higher in Nordic patients in all CHA2DS2-VASc categories: 0-1 (72.8% vs 60.3%), 2-3 (78.7% vs 72.9%) and ≥4 (79.2% vs 74.1%). In Nordic patients, NOAC ± AP was more frequently prescribed (32.0% vs 27.7%) and AP monotherapy was less often prescribed (10.4% vs 18.2%) when compared with Non-Nordic European patients. The rates (per 100 patient years) of all-cause mortality and non-haemorrhagic stroke/systemic embolism (SE) were similar in Nordic and Non-Nordic European patients [3.63 (3.11-4.23) vs 4.08 (3.91-4.26), p value = .147] and [0.98 (0.73-1.32) vs 1.02 (0.93-1.11), p value = .819], while major bleeding was significantly higher [1.66 (1.32-2.09) vs 1.01 (0.93-1.10), p value < .001].ConclusionNordic patients had significantly higher major bleeding than Non-Nordic-European patients. In contrast, rates of all-cause mortality and non-haemorrhagic stroke/SE were comparable.Clinical Trial RegistrationUnique identifier: NCT01090362. URL: http://www.clinicaltrials.gov.Key MessageNordic countries had significantly higher major bleeding than Non-Nordic-European countries. Rates of mortality and non-haemorrhagic stroke/SE were similar .

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