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 (US)
Pages (from-to)828-835
Number of pages8
JournalIndian Heart Journal
Volume70
Issue number6
DOIs
StatePublished - Nov 1 2018

Fingerprint

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

Keywords

  • Anticoagulant therapy
  • Arrhythmia
  • Atrial fibrillation
  • GARFIELD-AF

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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, 01.11.2018, p. 828-835.

Research output: Contribution to journalArticle

@article{462c148f98cb4ca6b84178e992d6be2e,
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 = "Anticoagulant therapy, Arrhythmia, Atrial fibrillation, GARFIELD-AF",
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.} and Bassand, {Jean Pierre} and Fitzmaurice, {David A.} and Goldhaber, {Samuel Z.} and Shinya Goto and Sylvia Haas and Werner Hacke and Mantovani, {Lorenzo G.} and Frank Misselwitz and Turpie, {Alexander G.G.} and {van Eickels}, Martin and Verheugt, {Freek W.A.} and Gloria Kayani and Fox, {Keith A.A.} and Gersh, {Bernard J.} and Luciardi, {Hector Lucas} and Harry Gibbs and Marianne Brodmann and Frank Cools and Barretto, {Antonio Carlos Pereira} and Connolly, {Stuart J.} and Alex Spyropoulos and John Eikelboom and Ramon Corbalan and Dayi Hu and Petr Jansky and Nielsen, {J{\o}rn Dalsgaard} and Hany Ragy and Pekka Raatikainen and {Le Heuzey}, {Jean Yves} and Harald Darius and Matyas Keltai and Sanjay Kakkar and Sawhney, {Jitendra Pal Singh} and Giancarlo Agnelli and Giuseppe Ambrosio and Kunihiro Matsushita",
year = "2018",
month = "11",
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language = "English (US)",
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.

AU - Bassand, Jean Pierre

AU - Fitzmaurice, David A.

AU - Goldhaber, Samuel Z.

AU - Goto, Shinya

AU - Haas, Sylvia

AU - Hacke, Werner

AU - Mantovani, Lorenzo G.

AU - Misselwitz, Frank

AU - Turpie, Alexander G.G.

AU - van Eickels, Martin

AU - Verheugt, Freek W.A.

AU - Kayani, Gloria

AU - Fox, Keith A.A.

AU - Gersh, Bernard J.

AU - Luciardi, Hector Lucas

AU - Gibbs, Harry

AU - Brodmann, Marianne

AU - Cools, Frank

AU - Barretto, Antonio Carlos Pereira

AU - Connolly, Stuart J.

AU - Spyropoulos, Alex

AU - Eikelboom, John

AU - Corbalan, Ramon

AU - Hu, Dayi

AU - Jansky, Petr

AU - Nielsen, Jørn Dalsgaard

AU - Ragy, Hany

AU - Raatikainen, Pekka

AU - Le Heuzey, Jean Yves

AU - Darius, Harald

AU - Keltai, Matyas

AU - Kakkar, Sanjay

AU - Sawhney, Jitendra Pal Singh

AU - Agnelli, Giancarlo

AU - Ambrosio, Giuseppe

AU - Matsushita, Kunihiro

PY - 2018/11/1

Y1 - 2018/11/1

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 - Anticoagulant therapy

KW - Arrhythmia

KW - Atrial fibrillation

KW - GARFIELD-AF

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JO - Indian Heart Journal

JF - Indian Heart Journal

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