Elsevier

American Heart Journal

Volume 163, Issue 1, January 2012, Pages 13-19.e1
American Heart Journal

Trial Design
International longitudinal registry of patients with atrial fibrillation at risk of stroke: Global Anticoagulant Registry in the FIELD (GARFIELD)

https://doi.org/10.1016/j.ahj.2011.09.011Get rights and content

Background

Atrial fibrillation (AF) is associated with high rates of morbidity and mortality. Patients with AF carry a fivefold increased risk of stroke and the risk of death from AF-related stroke is doubled. Current management is often inadequate, leaving patients at risk for a potentially fatal or disabling event. The purpose of the GARFIELD registry is to evaluate the management and outcomes of patients with newly diagnosed non-valvular AF at risk for stroke.

Design

The GARFIELD registry is an observational, multicenter, prospective study of patients with newly diagnosed AF and one or more additional risk factors for stroke. The aim is to enroll 55,000 patients at >1,000 centers in 50 countries. Enrollment will take place in five independent, sequential, prospective cohorts. An additional retrospective validation cohort of 5,000 patients with established AF and at least one additional risk factor for stroke will be conducted in parallel with cohort one. The study started in December 2009, with a planned recruitment period of 4 years and a minimum of 2-year follow-up for each patient.

Summary

The GARFIELD registry will provide valuable insights into the clinical management and related outcomes of AF patients throughout many regions of the world and across the spectrum of healthcare systems. By capturing data from unselected patients treated in everyday practice, the registry has the potential to identify best practices as well as deficiencies in available treatment options for specific patient populations and to describe how therapeutic strategies, patient care, and outcomes will evolve over time.

Section snippets

Registry design

The GARFIELD registry is an observational, multicenter, international prospective study of men and women with newly diagnosed AF and at least one additional risk factor for stroke. The aim is to enroll 55,000 patients at more than 1,000 centers in 50 countries.

Enrollment will take place in five independent, sequential, prospective cohorts (Figure 1). For the first cohort, the aim is to enroll 10,000 patients at 500 active sites in 19 countries (Australia, Austria, Brazil, Canada, China,

Discussion

The GARFIELD registry will describe the management and clinical outcomes of a cross section of patients with AF in real-life practice. Data will be collected from newly diagnosed patients with AF irrespective of whether they receive any intervention and will offer insights into treatment failure in patients who have, or who should have, commenced anticoagulant therapy or other pharmacologic treatment to prevent stroke. Patients in whom anticoagulant therapy would be appropriate but is not

Summary

The GARFIELD registry will provide unique and valuable insights into real-life treatment-initiation strategies, and the long-term clinical management and related outcomes of AF patients throughout the world. The inclusion of consecutive, treatment-naive patients with newly diagnosed non-valvular AF, irrespective of age and comorbidities or whether they receive anticoagulant therapy, will provide a representative perspective of AF management in unselected patient populations and across the

Acknowledgements

We thank the physicians, nurses, and patients involved in the GARFIELD registry.

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  • Cited by (0)

    Registry number: TRI08888.

    n

    For the GARFIELD Registry Investigators. See online Appendix A for complete listing.

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