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

GARFIELD-AF Investigators

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)828-835
Number of pages8
JournalIndian Heart Journal
Volume70
Issue number6
DOIs
Publication statusPublished - Dec 26 2018
Externally publishedYes

Fingerprint

Anticoagulants
Atrial Fibrillation
Registries
India
International Normalized Ratio
Vitamin K
Stroke
Coronary Artery Disease
Therapeutics
Embolism
Clinical Trials
Confidence Intervals
Hemorrhage
Hypertension

Keywords

  • Aged
  • Atrial Fibrillation/complications
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • India/epidemiology
  • Male
  • Prevalence
  • Prognosis
  • Prospective Studies
  • Registries
  • Risk Assessment
  • Risk Factors
  • Survival Rate/trends
  • Thromboembolism/epidemiology
  • Time Factors

Cite this

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

In: Indian Heart Journal, Vol. 70, No. 6, 26.12.2018, p. 828-835.

Research output: Contribution to journalArticle

@article{f038f80bb09f4874853cc05cbaa8a2e6,
title = "Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry",
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.",
keywords = "Aged, Atrial Fibrillation/complications, Electrocardiography, Female, Follow-Up Studies, Humans, Incidence, India/epidemiology, Male, Prevalence, Prognosis, Prospective Studies, Registries, Risk Assessment, Risk Factors, Survival Rate/trends, Thromboembolism/epidemiology, Time Factors",
author = "{GARFIELD-AF Investigators} and Sawhney, {Jitendra Ps} and Kothiwale, {Veerappa A} and Vikas Bisne and Rajashekhar Durgaprasad and Praveen Jadhav and Manoj Chopda and Velam Vanajakshamma and Ramdhan Meena and Govindan Vijayaraghavan and Kamaldeep Chawla and Jagan Allu and Pieper, {Karen S} and {John Camm}, A and Kakkar, {Ajay K}",
note = "Copyright {\circledC} 2018 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.",
year = "2018",
month = "12",
day = "26",
doi = "10.1016/j.ihj.2018.09.001",
language = "English",
volume = "70",
pages = "828--835",
journal = "Indian Heart Journal",
issn = "0019-4832",
publisher = "Cardiology Society of India",
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TY - JOUR

T1 - Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India

T2 - Insights from the GARFIELD-AF Registry

AU - GARFIELD-AF Investigators

AU - Sawhney, Jitendra Ps

AU - Kothiwale, Veerappa A

AU - Bisne, Vikas

AU - Durgaprasad, Rajashekhar

AU - Jadhav, Praveen

AU - Chopda, Manoj

AU - Vanajakshamma, Velam

AU - Meena, Ramdhan

AU - Vijayaraghavan, Govindan

AU - Chawla, Kamaldeep

AU - Allu, Jagan

AU - Pieper, Karen S

AU - John Camm, A

AU - Kakkar, Ajay K

N1 - Copyright © 2018 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

PY - 2018/12/26

Y1 - 2018/12/26

N2 - 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.

AB - 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.

KW - Aged

KW - Atrial Fibrillation/complications

KW - Electrocardiography

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Incidence

KW - India/epidemiology

KW - Male

KW - Prevalence

KW - Prognosis

KW - Prospective Studies

KW - Registries

KW - Risk Assessment

KW - Risk Factors

KW - Survival Rate/trends

KW - Thromboembolism/epidemiology

KW - Time Factors

U2 - 10.1016/j.ihj.2018.09.001

DO - 10.1016/j.ihj.2018.09.001

M3 - Article

C2 - 30580852

VL - 70

SP - 828

EP - 835

JO - Indian Heart Journal

JF - Indian Heart Journal

SN - 0019-4832

IS - 6

ER -