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

Hard X-ray photon-in photon-out spectroscopy

X-ray absorption spectroscopy (XAS) has become an indispensable tool in catalysis research. The instrumentation at synchrotron radiation sources as well as analysis and calculation of XAS has reached such a high level that this technique is now attractive to a very large user community. Standard XAS, however, cannot answer all questions and complementary techniques that address the electronic structure in more detail and help to investigate low Z elements as ligand or absorber add to the repertoire of hard X-ray techniques. We discuss in this contribution how energy analysis of the scattered photons [1] in addition to control of the incident photon energy (cf. Figure 1) extends the range of applications of XAS and addresses some problems that XAS cannot solve [2]

A combined in situ time-resolved UV–Vis, Raman and high-energy resolution X-ray absorption spectroscopy study on the deactivation behavior of Pt and Pt-Sn propane dehydrogenation catalysts under industrial reaction conditions

The catalytic performances of Pt/Al2O3 and Pt–Sn/Al2O3 catalysts for the dehydrogenation of propane through consecutive reaction–regeneration cycles have been studied under realistic reaction conditions. A 10-fold successive dehydrogenation–regeneration cycling study, similar to that employed in an industrial propane dehydrogenation reactor, was performed in order to examine the catalyst activity and stability as well as the propene selectivity. Combined in situ UV–Vis/Raman spectroscopy measurements were taken in order to follow the coke formation processes during propane dehydrogenation. This approach allowed correlating propane conversion and propene formation with the on-line determined Raman D over G band intensity ratio and amount of coke formed. These in situ measurements on coke formation and related catalyst deactivation were supplemented by in situ high-energy resolution fluorescence detected (HERFD) XANES measurements in order to characterize the structural and electronic properties of the supported Pt and PtASn nanoparticles during the successive dehydrogenation–regeneration cycles. This combination of powerful spectroscopic techniques revealed unique information regarding the activity behavior and deactivation mechanism of Pt- and PtASn-based propane dehydrogenation catalysts, enabling us to identify important structure-electronic-performance relationships as well as fundamental insight into the dynamics of PtASn alloy formation processes in Pt nanoparticles at elevated temperatures

Hard X-ray photon-in photon-out spectroscopy

X-ray absorption spectroscopy (XAS) has become an indispensable tool in catalysis research. The instrumentation at synchrotron radiation sources as well as analysis and calculation of XAS has reached such a high level that this technique is now attractive to a very large user community. Standard XAS, however, cannot answer all questions and complementary techniques that address the electronic structure in more detail and help to investigate low Z elements as ligand or absorber add to the repertoire of hard X-ray techniques. We discuss in this contribution how energy analysis of the scattered photons [1] in addition to control of the incident photon energy (cf. Figure 1) extends the range of applications of XAS and addresses some problems that XAS cannot solve [2]

Kβ-detected XANES of framework-substituted FeZSM-5 zeolites

The valence and local symmetry of iron in framework-substituted FeZSM-5 with a high Fe dilution (Si/Fe = 360) was studied by means of Kbeta-detected X-ray absorption spectroscopy. This technique combines high-resolution (DeltaE similar to1 eV) fluorescence detection of the 3p to 1s (Kbeta) transition with the X-ray absorption near-edge structure (XANES) at the Fe K-edge. An absorption-like spectrum is recorded by detecting the Kbeta fluorescence intensity as a function of the incident energy that is scanned through the K absorption edge. Kbeta-detected XANES spectra allow for a more precise separation of the weak K pre-edge structure from the main edge as compared to conventional absorption spectroscopy. Subsequent analysis and interpretation of the pre-edge spectral features therefore is more accurate. The pre-edge is sensitive to changes in the local coordination and oxidation state of Fe. Using this technique we were able to quantitatively determine the degree of iron extraction out of a zeolite framework upon steaming. With the use of appropriate reference compounds, the pre-edge analysis was used to monitor the activation of low-loaded, framework-substituted FeZSM-5 (0.3 wt % Fe). Template removal and calcination distort the zeolite framework and induce a deviation from T-d symmetry for incorporated iron. The (deliberate) presence of water at high temperature (T > 500 degreesC) facilitates the hydrolysis of the Si-O-Fe bonds and increases the formation of extraframework iron species. The amount of Fe-III occupying tetrahedral sites in the MFI-type zeolite decreases to 32% and 19%, respectively, for mild- and hard-steamed samples

Kβ-detected XANES of framework-substituted FeZSM-5 zeolites

The valence and local symmetry of iron in framework-substituted FeZSM-5 with a high Fe dilution (Si/Fe = 360) was studied by means of Kbeta-detected X-ray absorption spectroscopy. This technique combines high-resolution (DeltaE similar to1 eV) fluorescence detection of the 3p to 1s (Kbeta) transition with the X-ray absorption near-edge structure (XANES) at the Fe K-edge. An absorption-like spectrum is recorded by detecting the Kbeta fluorescence intensity as a function of the incident energy that is scanned through the K absorption edge. Kbeta-detected XANES spectra allow for a more precise separation of the weak K pre-edge structure from the main edge as compared to conventional absorption spectroscopy. Subsequent analysis and interpretation of the pre-edge spectral features therefore is more accurate. The pre-edge is sensitive to changes in the local coordination and oxidation state of Fe. Using this technique we were able to quantitatively determine the degree of iron extraction out of a zeolite framework upon steaming. With the use of appropriate reference compounds, the pre-edge analysis was used to monitor the activation of low-loaded, framework-substituted FeZSM-5 (0.3 wt % Fe). Template removal and calcination distort the zeolite framework and induce a deviation from T-d symmetry for incorporated iron. The (deliberate) presence of water at high temperature (T > 500 degreesC) facilitates the hydrolysis of the Si-O-Fe bonds and increases the formation of extraframework iron species. The amount of Fe-III occupying tetrahedral sites in the MFI-type zeolite decreases to 32% and 19%, respectively, for mild- and hard-steamed samples