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Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights into the GARFIELD-AF Registry

Sawhney, JP; Kothiwale, VA; Bisne, V; Durgaprasad, R; Jadhav, P; Chopda, M; Vanajakshamma, V; ... Chen, MS; + view all (2018) Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights into the GARFIELD-AF Registry. Indian Heart Journal 10.1016/j.ihj.2018.09.001. (In press). Green open access

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Abstract

BACKGROUND: The Global Anticoagulant Registry in the FIELD–Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012–2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3–2.3) versus 2.3 (IQR 1.8–2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32–9.35) vs 4.34 (4.16–4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. Clinical trial registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362.

Type: Article
Title: Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights into the GARFIELD-AF Registry
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ihj.2018.09.001
Publisher version: https://doi.org/10.1016/j.ihj.2018.09.001
Language: English
Additional information: This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Anticoagulant therapy, Arrhythmia, Atrial fibrillation, GARFIELD-AF
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > VP Health
URI: http://discovery.ucl.ac.uk/id/eprint/10060917
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