Anticoagulation and AF:
Emerging Insights
Professor the Lord Kakkar
Thrombosis Research Institute and
University College London
The GARFIELD Registry is funded by an unrestricted research grant
from Bayer Pharma AG
www.tri-london.ac.uk
Register of Interests for Ajay Kakkar
Research Support/P.I.
Bayer HealthCare, Sanofi-Aventis, Boehringer
Ingelheim, Pfizer, Bristol–Myers Squibb, Eisai
Employee
N/A
Consultant
Bayer HealthCare, Sanofi-Aventis, Boehringer
Ingelheim, Pfizer, Bristol–Myers Squibb, Eisai,
Novartis, Adventrix, Daiichi Sankyo, Shire
Major Stockholder
N/A
Speakers Bureau
N/A
Honoraria
Bayer HealthCare, Sanofi-Aventis, Boehringer
Ingelheim, Pfizer, Bristol–Myers Squibb, Eisai, GSK
Scientific Advisory Board
Bayer HealthCare, Sanofi-Aventis, Boehringer
Ingelheim, Pfizer, Bristol–Myers Squibb, Eisai,
Novartis, Daiichi Sankyo
The Global Anticoagulant Registry in the Field:
Ongoing representative, worldwide outcomes research programme
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Independent academic research initiative
55,000 newly-diagnosed AF patients in 34 countries
Randomized selection of sites representative of national AF care settings
Unselected prospective patients enrolled consecutively
Long-term follow-up (minimum of 2 years, up to 8 years)
5 sequential prospective cohorts
Extensive monitoring (20% of CRFs)
2010
2011
2012
Cohort 1 Dec-09
2013
2014
2015
2016
2017
Oct-13
Jun-18
Cohort 2 Oct-11
Recruitment
Minimum follow-up
Extended follow-up
2018
Jun-15
Cohort 3 Jun-13
Jun-18
Jun-16
Cohort 4 Aug-14
Cohort 5 Jul-15
Jun-18
Jun-17
Jun-18
Jun-18
The Global Anticoagulant Registry in the Field:
Already one of the largest outcomes research programmes in AF
 34,205 AF patients recruited in 34 countries
 29,117 prospective patients
 Cohort 3 recruitment completed July 2014 (n=11,405)
 Cohort 4 recruitment opened August 2014 (n=456)
2010
2011
2012
Cohort 1 Dec-09
2013
2014
2015
2016
2017
Oct-13
Jun-18
Cohort 2 Oct-11
Recruitment
Minimum follow-up
Extended follow-up
2018
Jun-15
Cohort 3 Jun-13
Jun-18
Jun-16
Cohort 4 Aug-14
Cohort 5 Jul-15
Jun-18
Jun-17
Jun-18
Jun-18
Antithrombotic prescribing patterns in Garfield-AF
Dec 09-Oct 11
N=10,278
Oct 11-Jun 13
N=11,557
Jun 13-Jun 14
N=9831
Dec 09-Jun14
N=31,666
Preliminary data
30 June 2014
The use of NOACs has increased
Dec 09-Oct 11
Oct 11-Jun 13
Jun 13-Jun 14
Dec 09-Jun13
Preliminary data
30 June 2014
Acknowledgements
This research programme would not be possible
without the hard work and dedication of the:
• Steering Committee
• National Coordinator Council
• Garfield-AF Investigators
Anticoagulation and AF: Emerging Insights
Agenda
• Understanding risk, Professor Dan Atar
• The role of anticoagulants, Professor Keith Fox
• Preventing a second stroke, Professor John Camm
• Lessons beyond AF, Professor Samuel Z Goldhaber
• Future challenges, Professor Alexander GG Turpie
• Panel discussion: Stroke prevention in AF 2014,
Case Presenter: Professor Sylvia Haas
Discussant: Dr Bernard J Gersh
• Closing remarks, Professor Jean-Pierre Bassand