SORA

Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

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

Sawhney, JP; Kothiwale, VA; Bisne, V; Durgaprasad, R; Jadhav, P; Chopda, M; Vanajakshamma, V; Meena, R; Vijayaraghavan, G; Chawla, K; et al. Sawhney, JP; Kothiwale, VA; Bisne, V; Durgaprasad, R; Jadhav, P; Chopda, M; Vanajakshamma, V; Meena, R; Vijayaraghavan, G; Chawla, K; Allu, J; Pieper, KS; John Camm, A; Kakkar, AK; GARFIELD-AF Investigators (2018) Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry. Indian Heart J, 70 (6). pp. 828-835. ISSN 2213-3763 https://doi.org/10.1016/j.ihj.2018.09.001
SGUL Authors: Camm, Alan John

[img]
Preview
PDF Published Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (1MB) | Preview

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.

Item Type: Article
Additional Information: © 2018 Cardiological Society of India. Published by Elsevier B.V. This is an open access article under theCC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: Anticoagulant therapy, Arrhythmia, Atrial fibrillation, GARFIELD-AF, Aged, Atrial Fibrillation, Electrocardiography, Female, Follow-Up Studies, Humans, Incidence, India, Male, Prevalence, Prognosis, Prospective Studies, Registries, Risk Assessment, Risk Factors, Survival Rate, Thromboembolism, Time Factors, GARFIELD-AF Investigators, Humans, Atrial Fibrillation, Thromboembolism, Electrocardiography, Prognosis, Registries, Incidence, Prevalence, Survival Rate, Risk Assessment, Risk Factors, Follow-Up Studies, Prospective Studies, Time Factors, Aged, India, Female, Male, Anticoagulant therapy, Arrhythmia, Atrial fibrillation, GARFIELD-AF, Cardiovascular System & Hematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Indian Heart J
ISSN: 2213-3763
Language: eng
Dates:
DateEvent
November 2018Published
12 September 2018Published Online
5 September 2018Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
PubMed ID: 30580852
Web of Science ID: WOS:000487589800012
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112180
Publisher's version: https://doi.org/10.1016/j.ihj.2018.09.001

Actions (login required)

Edit Item Edit Item