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

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

Search for excited neutrinos in Z decay

Excited neutrinos decaying into a neutrino and a photon are searched for in the ALEPH detector at LEP. No evidence is found for Z decay into v̄v∗ or v̄∗v∗ final states. Upper limits are derived on excited neutrino couplings up to excited neutrino masses close to the Z mass. Lower limits on the v∗ mass, independent of the v∗ decay modes, are deduced from the total Z width

Measurement of charge asymmetry in hadronic Z decays

A significant charge asymmetry is observed in the hadronic Z decays with the ALEPH detector at LEP. The asymmetry expressed in terms of the difference in momentum weighted charges in the two event hemispheres is measured to be −= −0.0084±0.0015 (stat.) ±0.0004 (exp. sys.). In the framework of the standard model this can be interpreted as a measurement of the effective electroweak mixing angle, sin2Ow (Mz2=0.2300±0.0034 (stat.) ±0.0010 (exp. sys.) ±0.0038 (theor. sys.) or of the ratio of the vector to axual- vector coupling costants of the electron, gvegAe=+0.073±0.024

Search for a new weakly interacting particle

A search for events of the type e+e−→ℓ+ℓ−X0, where X0 can be any weakly interacting particle which couples to the Z, has been performed with the ALEPH detector at LEP, by searching for acollinear lepton pairs. Such particles can be excluded up to a mass of 7.0 GeV/c2 for a value of the ratio of branching fractions, Br(Z→X0l+l−)/Br(Z→l+l−), greater than 2.5 × 10−3 if the X0 has third component of isospin, I3 greater than and decays to a pair of virtual gauge bosons. When this analysis is combined with the previous results of the Higgs particle searches from ALEPH, this limit can be extended to an X0 mass of 60 GeV/c2

Measurement of the B hadron lifetime

The average lifetime of B hadrons has been measured by the ALEPH experiment at LEP. Events containing B hadrons are selected by the identification of leptons with high transverse momentum in hadronic Z decays, and the lifetime is extracted from a fit to the impact parameter distribution of the lepton tracks. From a sample of 1.7x10^5 hadronic Z decays a lifetime of 1.29 +/- 0.06 +/- 0.10 ps is measured