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Gegevens uit wereldwijde atriumfibrillatieregister tonen aan dat antistollingsmiddelen niet optimaal worden gebruikt ter preventie van beroerte
Date:9/2/2014

jke en toenemende klinische en maatschappelijke belasting.

"De meest recente gegevens uit GARFIELD-AF illustreren de introductie van innovatieve behandelingen om de manier te veranderen waarop SF-patiënten werden behandeld om beroerte te voorkomen," aldus professor Lord Ajay Kakkar, hoogleraar in de chirurgie aan het University College London en directeur van het TRI. "Uit eerder onderzoek is gebleken dat de uitkomsten voor deze patiënten kunnen worden verbeterd als behandeling met antistollingsmiddelen op de juiste manier wordt toegepast. Observaties van de dagelijkse klinische praktijk in GARFIELD-AF suggereren echter dat er nog belangrijk werk moet worden gedaan om de implementatie te verzekeren van op bewijs gebaseerde best practice, inhoudende de selectie van geschikte patiënten voor antistolling als de optimale behandeling van die patiënten."

De voorlopige behandelingsgegevens voor 31.666 GARFIELD-AF patiënten ingeschreven in 34 landen gedurende de eerste drie van vijf geplande cohorten werden gepresenteerd bij een ESC Congress 2014 satellietsymposium.[2] Sinds de start van GARFIELD-AF in 2009, heeft de goedkeuring van de regelgevende instanties voor NOACs, bestaande uit factor Xa-remmers (rivaroxaban, apixaban) en een directe trombineremmer (dabigatran), de voorschrijfpatronen veranderd door een alternatief te bieden voor vitamine K-antagonisten (VKA), de vastgestelde standaard van zorg. De proportie AF-patiënten die een NOAC krijgen, is gestegen van 3,1% tijdens cohort 1 (december 2009-oktober 2011) tot 26,4% tijdens cohort 3 (juni 2013-juni 2014). Echter, de proportie patiënten die een antistollingsmiddel kregen steeg slechts van 60,6% tot 67,5% in dezelfde periode, omdat minder patiënten een VKA kregen (57,5% tot 41,1%).

De 12.448 prospectieve patiënten met minimaal één jaar follow-upgegevens na de diagnose AF ten
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SOURCE GARFIELD-AF
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1. Gegevens over één jaar van wereldwijd register voor atriumfibrillatie (AF) tonen dat antitrombosemiddelen niet optimaal worden gebruikt ter voorkoming van beroertes
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