{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:31:55Z","timestamp":1790962315845,"version":"4.1.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,3,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Effective stroke prevention with oral anticoagulants (OAC) is recommended for some patients with atrial fibrillation (AF). We aimed to describe OAC use by geographical region and type of site in patients with recent\u2010onset AF enrolled in a large global registry.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Eligible participants were recruited into GLORIA\u2010AF (Global Registry on Long\u2010Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation), a prospective observational cohort study from 2014 to 2016 in 4 international regions: North America, Europe, Asia, and Latin America. Cumulative incidence functions were generated for direct OACs (DOAC), vitamin K antagonists, and antiplatelet drugs considering competing risks, stratified by region and type of site. Time\u2010to\u2010treatment initiation after AF diagnosis was analyzed with Fine\u2010Gray subdistribution hazard models. A total of 21\u00a0237 patients eligible for analysis were identified. By 30\u00a0days after AF diagnosis, 40%, 16%, and 8.6% of patients had DOAC, vitamin K antagonists, and antiplatelet drugs initiated, respectively. Earlier initiation of DOACs was observed in Europe, with Asia and Latin America having lower hazard rates of DOAC time\u2010to\u2010treatment initiation than Europe (hazard ratio [HR], 0.66; 95% CI, 0.62\u20130.70 and HR, 0.79; 95% CI, 0.73\u20130.85, respectively). DOAC initiation was highest in community hospitals, vitamin K antagonists in outpatient health care centers\/anticoagulation clinics, and antiplatelet drugs in primary care clinics.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Important geographic variability exists with the use of OACs for patients with AF. Differences in the time\u2010to\u2010treatment initiation of OAC by type of site suggests suboptimal implementation of guideline recommendations and could result in less benefit and more harm. Optimizing OAC use for patients with AF may improve outcomes and reduce health care costs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifiers: NCT01468701, NCT01671007.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.023907","type":"journal-article","created":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T10:35:30Z","timestamp":1646390130000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":35,"title":["Global Oral Anticoagulation Use Varies by Region in Patients With Recent Diagnosis of Atrial Fibrillation: The GLORIA\u2010AF Phase III Registry"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0527-4310","authenticated-orcid":false,"given":"Valentina","family":"Bayer","sequence":"first","affiliation":[{"name":"Biostatistics and Data Sciences Boehringer Ingelheim Pharmaceuticals Inc. Ridgefield CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6762-3187","authenticated-orcid":false,"given":"Agnieszka","family":"Kotalczyk","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Heart &amp; Chest Hospital Liverpool United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9719-5988","authenticated-orcid":false,"given":"Bory","family":"Kea","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine School of Medicine Oregon Health &amp; Science University Portland OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8494-2876","authenticated-orcid":false,"given":"Christine","family":"Teutsch","sequence":"additional","affiliation":[{"name":"Department of Clinical Development and Medical Affairs Therapeutic Area Cardiometabolism Boehringer Ingelheim International GmbH Ingelheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Larsen","sequence":"additional","affiliation":[{"name":"MercyOne North Iowa Mason City IA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Button","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine School of Medicine Oregon Health &amp; Science University Portland OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1423-5348","authenticated-orcid":false,"given":"Menno V.","family":"Huisman","sequence":"additional","affiliation":[{"name":"Department of Thrombosis and Hemostasis Leiden University Medical Center Leiden Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Heart &amp; Chest Hospital Liverpool United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6044-045X","authenticated-orcid":false,"given":"Brian","family":"Olshansky","sequence":"additional","affiliation":[{"name":"University of Iowa Hospitals and Clinics Iowa City IA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.07.040"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000665"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joa.2017.05.004"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eux314"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1310907"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009638"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1107039"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0905561"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i3189"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62343-0"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1160\/TH17-08-0555"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-048839"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.006070"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.05.022"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2013.12.006"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1584"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0134"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7501"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2021.02.003"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.012988"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.12321"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2017.03.048"},{"key":"e_1_3_2_26_2","article-title":"Poor adherence to guideline\u2010directed anticoagulation in elderly Chinese patients with atrial fibrillation. 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