@article {ApentengBJGP.2021.0548, author = {Patricia N Apenteng and Saverio Virdone and FD Richard Hobbs and A John Camm and Keith AA Fox and Karen S Pieper and Gloria Kayani and David Fitzmaurice}, editor = {,}, title = {Two-year outcomes of UK patients newly diagnosed with atrial fibrillation: findings from the prospective observational cohort study GARFIELD-AF}, elocation-id = {BJGP.2021.0548}, year = {2022}, doi = {10.3399/BJGP.2021.0548}, publisher = {Royal College of General Practitioners}, abstract = {Background The outcomes of patients newly diagnosed with atrial fibrillation (AF) following the introduction of direct-acting oral anticoagulants are not well known.Aim To determine the 2-year outcomes of patients newly diagnosed with AF, and the effectiveness of oral anticoagulants in everyday practice.Design and setting This was a prospective observational cohort study in UK primary care.Method In total, 3574 patients aged >=18 years with a new AF diagnosis were enrolled. A propensity score was applied using an overlap weighting scheme to obtain unbiased estimates of the treatment effect of anticoagulation versus no anticoagulation on the occurrence of death, non-haemorrhagic stroke/systemic embolism, and major bleeding within 2 years of diagnosis.Results Overall, 65.8\% received anticoagulant therapy, 20.8\% received an antiplatelet only, and 13.4\% received neither. During the study period, the overall incidence rates of all-cause mortality, non-haemorrhagic stroke/systemic embolism, and major bleeding were 4.15 (95\% confidence interval [CI] = 3.69 to 4.65), 1.45 (95\% CI = 1.19 to 1.77), and 1.21 (95\% CI = 0.97 to 1.50) per 100 person{\textendash}years, respectively. Anticoagulation treatment compared with no anticoagulation treatment was associated with significantly lower all-cause mortality adjusted hazard ratio (aHR) 0.70 (95\% CI = 0.53 to 0.93), significantly lower risk of non-haemorrhagic stroke/systemic embolism (aHR 0.39, 95\% CI = 0.24 to 0.62), and a non-significant higher risk of major bleeding (aHR 1.31, 95\% CI = 0.77 to 2.24).Conclusion The data support a benefit of anticoagulation in reducing stroke and death, without an increased risk of a major bleed in patients with new-onset AF. Anticoagulation treatment in patients at high risk of stroke who are not receiving anticoagulation may further improve outcomes.}, issn = {0960-1643}, URL = {https://bjgp.org/content/early/2022/05/12/BJGP.2021.0548}, eprint = {https://bjgp.org/content/early/2022/05/12/BJGP.2021.0548.full.pdf}, journal = {British Journal of General Practice} }