Www.tri-london.ac.uk The GARFIELD Registry is funded by an unrestricted research grant from Bayer Pharma AG Closing Remarks Jean-Pierre Bassand, MD, FESC,

Slides:



Advertisements
Similar presentations
THE NATIONAL ANTICOAGULATION INITIATIVE
Advertisements

The GARFIELD Registry is funded by an unrestricted research grant from Bayer Pharma AG Lessons Beyond Atrial Fibrillation: Focus on.
The GARFIELD Registry is funded by an unrestricted research grant from Bayer Pharma AG The Role of Anticoagulants Keith A A Fox Edinburgh.
Apixaban versus Aspirin in Atrial Fibrillation Patients ≥ 75 years old: An Analysis from the AVERROES Trial Kuan H Ng, Olga O Shestakovska, John W. Eikelboom,
Nuovi Anticoagulanti orali: dai criteri di scelta all’esperienza sul campo RIVAROXABAN Dr. Elisabetta Toso SOC Cardiologia Ospedale Cardinal Massaia -
ARISTOTLE TRIAL Dr R Nyabadza GPST1 Ward 32. Structure AF, stroke and CHA 2 -DS 2 VASC Anticoagulant choices ARISTOTLE trial Cost NICE guidance and the.
Anticoagulation and AF: Emerging Insights
AF and NOACs An UPDATE JULY 2014
Understanding Risk Professor Dan Atar, MD, FESC Dept. of Cardiology
The GARFIELD Registry is funded by an unrestricted research grant from Bayer Pharma AG Case discussion The patient caught between.
ROCKET AF Renal Dysfunction Substudy Objective Evaluate the 2950 patients in the per-protocol cohort with a baseline CrCl of 30 to 49 mL/min who received.
1 Objectives, design and initial results from Phase I Nils Schoof Corp. Dept. Global Epidemiology, Boehringer Ingelheim GmbH.
Managing Patients Who Cannot Take Anticoagulants Kenneth W. Mahaffey, MD, FACC Professor of Medicine, Cardiology Faculty Associate Director, DCRI Director,
Presented by Renato D. Lopes, MD, PhD, Duke Clinical Research Institute, Duke University, USA for the ARISTOTLE investigators. Efficacy and Safety of Apixaban.
CHADS 2 -> CHA 2 DS 2 VASc. CHA2DS2-VASc Risk Score CHF or LVEF < 40% 1 Hypertension1 Age > 752 Diabetes1 Stroke/TIA/ Thromboembolism 2 Vascular Disease.
Long-Term Tolerability of Ticagrelor for Secondary Prevention: Insights from PEGASUS-TIMI 54 Trial Marc P. Bonaca, MD, MPH on behalf of the PEGASUS-TIMI.
Long-Term Tolerability of Ticagrelor for Secondary Prevention: Insights from PEGASUS-TIMI 54 Trial Marc P. Bonaca, MD, MPH on behalf of the PEGASUS-TIMI.
Blood pressure control: Where do we stand? Latest data from Italy Tocci G et al. J Hypertens. 2012;30:
Stoke On Trent CCG – Atrial Fibrillation Service AF Nurse in GP Practice Interfacing Primary and Secondary Care for AF Stroke Prevention Jodie Williams.
Clinical pathway for people with atrial fibrillation or at risk of atrial fibrillation Dr Ruth Chambers OBE LTC Priority Lead, West Midlands Academic Health.
Net clinical benefit of OAC
Cardiovascular Risk: A global perspective
Clinical Trial Design for Second Generation TAVI - Academic View
Identifying patients with atrial fibrillation and "truly low" thromboembolic risk who are poorly characterized by CHA2DS2-VASc: Superior performance of.
Difficult situations in anticoagulation after stroke
When should aspirin be dropped from triple therapy?
You can never be too Thin…. An Update on NOACs
Addressing the Challenges in Primary and Secondary Stroke Prevention
AHSN Business Case User Guide: Improving AF Identification and Optimising Management to Prevent AF-Related Stroke Version: 8 March 2017.
2016/17 GRASP AF data for Lancashire CCGs (excluding East Lancs CCG)
Sites of Action in Coagulation System Novel Factor Xa and DT Inhibitors.
Anticoagulant Safety Remains a Problem Emergency Hospitalizations for Adverse Drug Events.
Click here for title Click here for subtitle
US Guidelines US Guidelines Low-risk Patients.
When Is Adding Aspirin to NOACs Worth the Risk?
Access to NOAC Therapy:
NOACs in Clinical Practice: Are They All the Same?
Nat. Rev. Cardiol. doi: /nrcardio
Introduction ESC Annual Meeting in Review: NOACs and NVAF: Real-World Data, Guidelines, and More.
New Strategies to Prevent CV Events After Hospital Discharge
Emergency Management of NOAC Bleeding
Anticoagulation Highlights From the American Heart Association Meeting 2017.
Up to Date on Which NOAC for Which Patient
Oral Anticoagulants in AFa,b A Brief History.
Surveying the Safety of NOACs in the Real World
Selecting NOACs for High-Risk Patients
NOAC Use in AF: REAL-WORLD Studies WITH REAL RESULTS
Revealing Characteristics of Patients at High Risk for Developing Atrial Fibrillation.
Assessing the Risk for Stroke in Patients With Atrial Fibrillation
Efficacy and Safety of Edoxaban in Patients With AF and HF
Access to NOAC Therapy:
Adherence in SPAF: Measures to Improve Care
What Anticoagulant Registries Are Revealing
Atrial Fibrillation.
Treatment of Thromboembolic Disease The Need for Multiple Perspectives
Atrial Fibrillation Clinical Update
Identifying High-Risk AF Patients
Factor Xa Inhibitors in PAD
Cancer-Associated Thrombosis
Improving Outcomes in AF: Do the NOACs Hold Their Promise In The Real World?
Which NOAC and When for Stroke Prevention in AF?
NOAC Studies in VTE AF Studies Superior Outcomes.
An Unmet Need.
5 Good Minutes on Atrial Fibrillation-related Stroke
Björn Redfors et al. JACEP 2017;j.jacep
Björn Redfors et al. JACEP 2017;j.jacep
Erratum Canadian Journal of Cardiology
Figure 8. Stroke prevention strategy in patients with AF
Figure 1. Decision-making process of stroke prevention in patients with AF from Asia. The decision-making process includes stroke risk evaluation, OAC.
What's New in NOACs in AF?.
Presentation transcript:

The GARFIELD Registry is funded by an unrestricted research grant from Bayer Pharma AG Closing Remarks Jean-Pierre Bassand, MD, FESC, FACC, FRCP Emeritus Professor of Cardiology University of Besançon France

Disclosures None for this presentation

Closing Remarks Garfield-AF registry is doing well; first 3 cohorts completed recruitment, 4 th cohort has started Gradual increase in the uptake of NOACs over the course of the first 3 cohorts, particularly but not only factor Xa inhibitors Still many patients remain inadequately treated, low risk patients are overtreated and high risk patients undertreated

Closing Remarks In this context anticoagulation with VKA remains a challenge as FIR or TTR is often suboptimal. Inadequate control of coagulation is associated with higher risk of death, stroke and bleeding complications: the triple penalty Remarkable consistency in efficacy and safety across NOACs: class effect FIR=frequency in range

Closing Remarks Risk stratification should focus on truly low risk patients as all the other patients should be anti- coagulated unless contraindication. CHA 2 -DS 2 -VASc score in this regard has a better discriminative power than CHADS 2

Closing Remarks Obesity is a risk factor for many CV disease including VTE, CAD, hypertension … But it also emerges as a risk factor for AF though not included in the currently available risk scores. Garfield may help clarify the situation. Monitoring of VKA is less adequate in obese patients than in non obese. FIR inversely related to BMI> 30%

Closing Remarks Preventing a second stroke is still a challenging situation, even in the era of NOACs The growing burden of AF on the population and on the health care systems, understanding the reasons why a still sizeable proportion of patients are undertreated are among the future challenges that we will be confronted to