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

Decarburization of Levitated Fe-Cr-C Droplets by Carbon Dioxide

Experiments have been conducted at 1873K (1600°C) to study the kinetics of decarburization of Fe-Cr-C levitated droplets containing 10, 17 and 20 wt pct Cr using argon-carbon dioxide gas mixtures containing up to 30 pct CO2, at flow rates of 100, 1000, 3000 and 12200 mL per min. It was found that chromium did not have a strong influence on the kinetics of decarburization while showing only minor effects on the extent of carbon removal. The results indicate that, for high carbon concentrations in the melt, the decarburization rates were controlled by mass transfer in the gas phase. Conventional formulation of governing mass transport numbers did not adequately describe the experimental observations made in this work. The observed rates are consistently higher than the values predicted using either the Ranz-Marshall correlation or the Steinberger-Treybal equation. A new correlation has been proposed to express the decarburization kinetics of levitated droplets for gas-flows in the range of Reynolds numbers between 2 and 100. The experimentally-derived model was found to be in excellent agreement with rate data derived from studies conducted by other researchers using levitated droplets.Appreciation is expressed to the Natural Sciences and Engineering Research Council of Canada who provided funding in support of this project