Atrial Fibrillation
Conditions
Keywords
Observational Study, Real-World Evidence, Atrial Fibrillation, Stroke, Bleeding, Systemic Thromboembolic Event
Brief summary
The GARDENIA registry will collect real-world clinical data on the anticoagulant strategies in patients with AF at elevated risk of stroke but also elevated risk of bleeding.
Detailed description
The GARDENIA registry will collect real-world clinical data on the utilization of oral anticoagulants in patients with atrial fibrillation (AF) at elevated risk of stroke. Patients with AF who meet 1 or more of the following criteria will be recruited: advanced age, renal dysfunction, the need for concomitant antiplatelet use, or otherwise judged to be at a higher risk of bleeding. Patients with these criteria are frequently not treated with currently approved oral anticoagulants or they are 'undertreated' based on the use of non-recommended doses of anticoagulants. These patients will be described with regards to baseline demographics and characteristics with particular attention focused on physician and patient factors that may play a role in the under use of guideline-recommended anticoagulation therapy for stroke prevention in patients with AF. Patients in the registry will also be followed to determine the rates of discontinuation/switching of their anticoagulation therapy, incidence of major adverse cardiovascular events and clinically relevant outcome events related to the selection of their anticoagulation therapy. The collected real-world data will be used to inform future studies of patients with AF at elevated risk of stroke.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
* Written informed consent from the patient, or legally authorized representative, must be obtained before any assessment is performed * Patients with diagnosed AF or atrial flutter(documented on an electrocardiogram or monitor recording) * CHA2DS2-VASc score ≥2 excluding female as a factor * Judged by the investigator to be at increased risk of bleeding because of at least 1 of the following: * Age ≥70on the day of informed consent * Reduced renal function (creatinine clearance \<30mL/min by Cockcroft-Gault) * Chronic use of NSAIDs or antiplatelet agents * Any other condition associated with increased risk such as a prior history of major or clinically relevant nonmajor bleeding, increased fall risk, or frailty * Patients who are not treated with oral anticoagulants (only applies to the initial feasibility cohort)
Exclusion criteria
* Mechanical heart valve or valve disease that is expected to require valve replacement intervention (surgical or invasive) during the course of the registry study * AF due to a reversible cause (eg, cardiac surgery, pulmonary embolism, untreated hyperthyroidism, ethanol use) * Clinical unstable or active endocarditis or endovascular infection * Patients with a medical condition other than AF for which chronic use of an oral anticoagulant is indicated * History of left atrial appendage closure or removal * Life expectancy \<1 year at the time of enrollment as assessed by the investigator * Any medical or psychiatric condition which in the judgment of the Investigator may preclude patients from complying with study requirements for the duration of the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Distribution of characteristics of patients with AF, including reasons anticoagulation is not used | 24 Months | Information collected from physicians will provide the clinical reasons for treatment or nontreatment with OACs as assessed by the treating physicians |
| Bleeding | 24 Months | Number of all bleeding events in patients with AF who are treated with guideline recommended doses of oral anticoagulants for stroke prevention versus those who are not |
| Stroke and systemic embolic events | 24 Months | Number of stroke and systemic embolic events in patients with AF who are treated with guideline recommended doses of oral anticoagulants for stroke prevention versus those who are not |
Countries
Argentina, Brazil, Canada, Czechia, Germany, Hungary, Italy, Mexico, Poland, Spain, United Kingdom, United States