Event Rate in Patients with Atrial Fibrillation who Discontinue Oral Anticoagulant Therapy Early: Results from the GARFIELD Registry

Purpose: To investigate outcomes in patients with non-valvular atrial fibrillation (AF) who discontinue oral anticoagulant (OAC) therapy within 12 months compared with those who persist on OAC therapy after 12 months. Methods: In the ongoing, international GARFIELD Registry, a total of 12,458 prospective newly diagnosed AF patients were enrolled at 739 sites in 30 countries between March 2010 and January 2013. Results are reported at 1-year follow-up. Event rates over a period of 12 months in patients on OAC therapy were analysed for patients who discontinued therapy and those who persisted. Results: Of the 7350 patients prescribed an OAC after AF diagnosis, 1729 discontinued therapy within 12 months (23.5%). Risk scores were similar between groups. Patients treated with OAC/antiplatelet combination at baseline were more likely to discontinue therapy than those on OAC alone. Event rates for stroke/systemic embolism (SE), major bleeding, and all-cause death were significantly higher in patients who discontinued OAC therapy. Conclusion: Markedly higher rates of death along with increased stroke/SE and serious bleeding were observed in patients who discontinued OAC therapy within 12 months.