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

Critical Factors Underpinning the e-CRM Activities of SMEs

Small and medium-sized enterprises (SMEs) are vital components of our economies, but many struggle to perform the marketing prescribed theoretically for large organisations. In practice, marketing is performed in SMEs through an intrinsic customer orientation, which exhibits striking resemblances to customer relationship management (CRM) theory. A quantitative approach was adopted to provide broad understanding and classification to the under-researched area of e-CRM in SMEs. Exploratory factor analysis uncovered eight distinct yet inter-related factors underpinning the practices and processes of e-CRM in SMEs. Findings show that SMEs are performing e-CRM to varying extents, reaping a range of performance benefits and facing a range of challenges. It is true that SMEs are not adopting e-CRM per se, as described in the large organisation-biased literature, but they are adopting relatively simple IBTs to improve their customer communication and information management capabilities and thus to create competitive advantage in their own strategic way. From a theoretical perspective, this study has shed significant light on what is driving SMEs’ e-CRM activities, thus providing long-awaited theoretical support for a practical reality. From a managerial perspective, the study has delineated eight principal issues that require attention if e-CRM is to be implemented successfully in SME