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GARFIELD-AF in Primary Care: Optimising prediction of mortality, stroke and major bleeding for patients with atrial fibrillation using routinely collected primary care electronic health records

Atrial fibrillation (AF) is a common heart rhythm disorder that increases the risk of stroke five-fold and doubles the risk of mortality. AF-related strokes are more severe with increased mortality and disability than strokes in people without AF. Anticoagulation therapy can reduce up to two-thirds of the risk of AF-related stroke and reduce mortality by up to 25%. However, anticoagulation increases the risk of bleeding, and risk scores are used to assess stroke and bleeding risk to guide decisions on anticoagulation. The current NICE guidelines recommend the use of the CHA2DS2VASc tool to assess stroke risk and HAS-BLED to assess bleeding risk.

The GARFIELD-AF tool is a novel risk prediction tool that simultaneously assesses the risk of mortality, stroke and major bleeding in patients with AF. Our study aims to validate the GARFIELD-AF tool using UK electronic primary care records.

Funded by


Research team

David Fitzmaurice, Siew Wan Hee, Patricia Apenteng


David Prieto-Merino - London School of Hygiene and Tropical Medicine

Rishi Caleyachetty - University of Oxford


1st March 2020 to 31st August 2021


Dr Patricia Apenteng

p dot apenteng at warwick dot ac dot uk