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The prevention of thromboembolic events European Registry in Atrial Fibrillation Prolongation Registry (PREFER Prolongation) enrolled consecutive patients with AF on NOACs between 2014 and 2016 in a multicentre, prospective, observational study with one-year follow-up, focusing on the time of introduction of NOACs. Overall, 3783 patients were enrolled, with follow-up information available in 3223 (85%). Mean age was 72.2\u2009\u00b1\u20099.4 years, 40% were women, mean CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>VASc score was 3.4\u2009\u00b1\u20091.6, and 2587 (88.6%) had a CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>VASc score\u2009\u2265\u20092. Rivaroxaban was used in half of patients, and dabigatran and apixaban were used in about a quarter of patients each; edoxaban was not available for use in Europe at the time. Major cardiovascular event rate was low: serious events occurred in 74 patients (84 events, 2%), including 24 strokes (1%), 62 major bleeds (2%), of which 30 were life-threatening (1%) and 3 intracranial (0.1%), and 28 acute coronary syndromes (1%). Mortality was 2%. Antiarrhythmic drugs were used in about 50% of patients, catheter ablation in 5%. Adverse events were low in this contemporary European cohort of unselected AF patients treated with NOACs already at the time of their first introduction, despite high thromboembolic risk.<\/jats:p>","DOI":"10.1007\/s11739-020-02442-9","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T07:03:51Z","timestamp":1600671831000},"page":"591-599","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Antithrombotic management and outcomes of patients with atrial fibrillation treated with NOACs early at the time of market introduction: Main results from the PREFER in AF Prolongation Registry"],"prefix":"10.1007","volume":"16","author":[{"given":"Giulia","family":"Renda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ladislav","family":"Pecen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Patti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Ricci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipak","family":"Kotecha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta M.","family":"Siller-Matula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renate B.","family":"Schnabel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Wachter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Marc","family":"Sellal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miklos","family":"Rohla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Lucerna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Huber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freek W. 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(81Z1710103); RW: speaker or consultant for Bayer, BMS, Boehringer-Ingelheim, CVRx, Medtronic, Novartis, Pfizer, Sanofi, Servier; research support from Boehringer-Ingelheim, Bundesministerium f\u00fcr Bildung und Forschung and European Union; JMS: speaker and consultancy fees from Boehringer-Ingelheim, Bayer and BMS-Pfizer; MR: advisory fees from Daiichi-Sankyo and Novartis and lecturing fees from Biotronik and Takeda Pharma, all outside of the submitted work; ML: employee of Daiichi-Sankyo Europe. KH: lecture fees from Bayer, Boehringer-Ingelheim, Bristol-Myers Squibb\/Pfizer, and Daiichi-Sankyo; FWAV: personal fees from Boehringer-Ingelheim, Bayer AG, BMS\/Pfizer, Daiichi-Sankyo and AstraZeneca: JLZ: speaker honoraria from Sanofi, Servier and Daiichi-Sankyo; BB: consultant for Daiichi-Sankyo. HD: Steering Committee member and National Coordinator for Germany RE-LY, APPRAISE- 1 and 2, Garfield Registry, and PREFER in AF; fees, honoraria, and research funding from AstraZeneca, Bayer, Berlin-Chemie, Boehringer-Ingelheim, Boston Scientific, Bristol-Myers Squibb, Daiichi-Sankyo, Lilly, MSD Sharp&Dohme, BMFT, Harvard Med. Res. Inst., and Thrombosis Research Institute; MD: grants for investigator-initiated studies and related travel expenses from Biosense Webster, Medtronic, St Jude Medical and Boston Scientific; J-YLH: consultant\/conferences\/advisory board for Sanofi-Aventis, BMS\/Pfizer, Meda, Boehringer-Ingelheim, MSD, Bayer, Servier and Daiichi-Sankyo; RJS: research funding from Biosense Webster, Medtronic, St. Jude Medical, Hansen Medical, and Boston Scientific; PK: research support from European Union, British Heart Foundation, Leducq Foundation, Medical Research Council (UK), and German Centre for Cardiovascular Research, from several drug and device companies active in atrial fibrillation; honoraria from several such companies; PK is listed as inventor on two patents held by University of Birmingham (Atrial Fibrillation Therapy WO 2015140571, Markers for Atrial Fibrillation WO 2016012783); RDC: grant support (to his institution) from Boehringer-Ingelheim, Bayer, BMS\/Pfizer, and Daiichi-Sankyo; speaker and consultancy fees from Boehringer-Ingelheim, Bayer, BMS\/Pfizer, Daiichi-Sankyo, Merck, Novartis, Roche, Portola.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"To be negotiated with the Sponsor and the Steering Committee.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Availability of data and material (data transparency)"}},{"value":"All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal rights"}},{"value":"All participants provided informed consent prior to their participation","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}