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

Mesas de Trabajo de Aplicaciones: Bibliotecas Digitales

Durante las mesas de trabajo se expusieron diferentes puntos relevantes en la temática de Bibliotecas Digitales. La mesa de ¿Qué tan abierto es el acceso abierto a repositorios de tesis digitales en trece IES nacionales? habló sobre el proceso de entrada a las los contenedores digitales a través de la red. La mesa de trabajo de Preservación y Gestión del archivo histórico de la UV mediante Archon explica principalmente el software de código abierto ARCHON. La mesa de Redalyc 2.0 presenta la vía verde del acceso abierto y la vía dorada ¿son opuestas ó complementarias?. La mesa de Metadatos en repositorios institucionales comparte inquietudes en relación al desarrollo de perfiles de metadatos y el poblamiento de los mismos en colecciones digitales. Por su parte, la mesa de trabajo de Danza Digital expone el concepto del repositorio de productos de investigación del Centro Nacional de Investigación, Documentación e Información de la Danza “José Limón” Mientras que en la mesa de Experiencias en la integración de servicios de información para potenciar el OPAC el funcionamiento y la evolución del mismo.Durante la Reunión CUDI Primavera 2013 se presentaron ocho mesas de trabajo referente a las Bibliotecas Digitales. ¿Qué tan abierto es el acceso abierto a repositorios de tesis digitales en trece IES nacionales? por Haidy Arreola Semadeni (UADEC); Preservación y gestión del archivo histórico de la UV mediante Archon a cargo de María Elenena García Díaz y Leticia Peréz Macías (UV); Redalyc 2.0 expuesto por Arianna Bececrril (UAEMEX); Metadatos en repositorios institucionales: retos de la web semántica, el acceso abierto y la preservación presentado por Alma B. Rivera (UI); Danza Digital por Alejandra Medellín, Víctor Carrillo y Jorge García (INBA); El ranking de repositorios, como medida de presión a cargo de Carlos Villanueva Valadez (UANL); Experiencias en la integración de servicios de información para potenciar el OPAC comentado por Ángel Mario Cantú Morales (UANL), y Resultados y perspectivas de desarrollo de REMERI dirigida por Verónica Valderrama (UAEH).Mesa_Trabajo_Aplicaciones_Bibliotecas_Digitales.wm

Comparison of international normalized ratio audit parameters in patients enrolled in GARFIELD-AF and treated with vitamin K antagonists

Vitamin K antagonist (VKA) therapy for stroke prevention in atrial fibrillation (AF) requires monitoring of the international normalized ratio (INR). We evaluated the agreement between two INR audit parameters, frequency in range (FIR) and proportion of time in the therapeutic range (TTR), using data from a global population of patients with newly diagnosed non-valvular AF, the Global Anticoagulant Registry in the FIELD\u2013Atrial Fibrillation (GARFIELD-AF). Among 17\ua0168 patients with 1-year follow-up data available at the time of the analysis, 8445 received VKA therapy (\ub1antiplatelet therapy) at enrolment, and of these patients, 5066 with 653 INR readings and for whom both FIR and TTR could be calculated were included in the analysis. In total, 70\ua0905 INRs were analysed. At the patient level, TTR showed higher values than FIR (mean, 56\ub70% vs 49\ub78%; median, 59\ub77% vs 50\ub70%). Although patient-level FIR and TTR values were highly correlated (Pearson correlation coefficient [95% confidence interval; CI], 0\ub7860 [0\ub7852\u20130\ub7867]), estimates from individuals showed widespread disagreement and variability (Lin's concordance coefficient [95% CI], 0\ub7829 [0\ub7821\u20130\ub7837]). The difference between FIR and TTR explained 17\ub74% of the total variability of measurements. These results suggest that FIR and TTR are not equivalent and cannot be used interchangeably