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

Autor:	Sawhney JP; Sir Ganga Ram Hospital, New Delhi, India. Electronic address: jpssawhney@yahoo.com., Kothiwale VA; K.L.E.S. Dr. Prabhakar Kore Hospital and Medical Research Centre, Karnataka, India., Bisne V; Bisne's Heart Institute, Maharashtra, India., Durgaprasad R; Sri Venkateswara Institute of Medical Sciences, Andhra Pradesh, India., Jadhav P; Sujata Birla Hospital & Medical Research Centre, Maharashtra, India., Chopda M; Chopda Medicare & Research Centre, Maharashtra, India., Vanajakshamma V; Sri Venkateswara Institute of Medical Sciences, Andhra Pradesh, India., Meena R; S.R. Kalla Memorial General Hospital, Jaipur, India., Vijayaraghavan G; Kerala Institute of Medical Sciences, Trivandrum, India., Chawla K; Sterling Hospital, Gujarat, India., Allu J; Thrombosis Research Institute, London, UK., Pieper KS; Thrombosis Research Institute, London, UK; Duke Clinical Research Institute, Durham, NC, USA., John Camm A; St George's University of London, London, UK., Kakkar AK; Thrombosis Research Institute, London, UK; University College London, London, UK.
Jazyk:	angličtina
Zdroj:	Indian heart journal [Indian Heart J] 2018 Nov - Dec; Vol. 70 (6), pp. 828-835. Date of Electronic Publication: 2018 Sep 12.
DOI:	10.1016/j.ihj.2018.09.001
Abstrakt:	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. (Copyright © 2018 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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