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

Silicification of peridotites at the stalemate fracture zone (Northwestern Pacific): Reconstruction of the conditions of low-temperature weathering and tectonic interpretation

During cruise SO201-1b of the joint Russian–German expedition on the R/V Sonne in 2009, mantle peridotites affected by varying secondary alteration were dredged on the eastern slope of the north- western segment of the Stalemate transverse ridge adjacent to the eponymous fracture zone. The collection discussed in this paper included four samples of silicified serpentinites after dunites and 11 lherzolite samples serpentinized to a varying degree. The abundance of amorphous silica and quartz, very high SiO2 content (up to 88.7 wt %), and unusually low MgO (up to 1.4 wt %) in the serpentinized dunites strongly distinguish these rocks from the known products of hydrothermal alteration and low-temperature (seafloor) weathering of peridotites in the oceanic crust. In order to determine the conditions and processes resulting in the silicifica- tion of peridotites at the Stalemate Fracture Zone, thermodynamic modeling accounting for the kinetics of mineral dissolution implemented in the GEOCHEQ program package was used in this study. The results of modeling allowed us to suppose that the geochemical and mineralogical effects observed in the silicified ser- pentinized dunites of the Stalemate Fracture Zone are consequences of low-temperature deserpentinization of oceanic materials under subaerial conditions