OBJECTIVES: New oral anticoagulants (NOACs) have the promise to change the management of patients with atrial fibrillation (AF), and can be used in lieu of vitamin K antagonists (VKAs) or antiplatelet drugs (AP). We aimed to obtain contemporary data on the health state of AF patients under everyday practice conditions at the time of introduction of NOACs.  METHODS: PREFER in AF is a non-interventional study that prospectively documents AF patients in terms of clinical characteristics, management, quality of life and other outcome parameters. The new EuroQol EQ-5D-5L descriptive system was applied in PREFER in AF to obtain patient-reported generic health-related quality of life information and utility scores to inform resource allocation decisions. RESULTS: Of the 7243 AF patients (63.1% males, mean age 71.5 ± 10.7 years), 2159 (30.0%) had paroxysmal, 1731 (24.0%) persistent, 517 (7.2%) long-standing persistent, and 2793 (38.8%) permanent AF. Comorbidities were highly prevalent. On the visual analogue scale, the mean score in 5674 patients (78.3% EQ-5D participation rate) was 67.7 ±18.4 points, with no major differences between patients on NOACs (68.4), VKAs (67.6), AP (69.7), or VKAs+AP (65.5), respectively. Problems of any severity  were reported for mobility, self-care, usual activities, pain/discomfort and anxiety/depression in 50.1%, 20.7%, 45.0%, 55.4%, and 47.1%.  The overall utility index was 0.85 ±0.17. The 319 patients on NOACs had the same utility index as the 182 patients without VKAs or AP (0.80 in both groups), whereas the 2937 patients on VKAs, the 342 on AP or the 425 patients on VKAs+AP had lower indices (0.77 vs. 0.77 vs. 074). CONCLUSIONS: Patients with AF present with reduced self-reported quality of life compared to the general population. Patients receiving NOACs had a slightly higher quality of life, possibly illustrating that this type of treatment is initially given to “healthier” populations compared to established VKA therapy.