24 research outputs found

    Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

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    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

    The Upper Edge of the Neptune Desert Is Stable Against Photoevaporation

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    Transit surveys indicate that there is a deficit of Neptune-sized planets on close-in orbits. If this ``Neptune desert' is entirely cleared out by atmospheric mass loss, then planets at its upper edge should only be marginally stable against photoevaporation, exhibiting strong outflow signatures in tracers like the metastable helium triplet. We test this hypothesis by carrying out a 12-night photometric survey of the metastable helium feature with Palomar/WIRC, targeting seven gas-giant planets orbiting K-type host stars. Eight nights of data are analyzed here for the first time along with reanalyses of four previously-published datasets. We strongly detect helium absorption signals for WASP-69b, HAT-P-18b, and HAT-P-26b; tentatively detect signals for WASP-52b and NGTS-5b; and do not detect signals for WASP-177b and WASP-80b. We interpret these measured excess absorption signals using grids of Parker wind models to derive mass-loss rates, which are in good agreement with predictions from the hydrodynamical outflow code ATES for all planets except WASP-52b and WASP-80b, where our data suggest that the outflows are much smaller than predicted. Excluding these two planets, the outflows for the rest of the sample are consistent with a mean energy-limited outflow efficiency of Δ=0.41−0.13+0.16\varepsilon = 0.41^{+0.16}_{-0.13}. Even when we make the relatively conservative assumption that gas-giant planets experience energy-limited outflows at this efficiency for their entire lives, photoevaporation would still be too inefficient to carve the upper boundary of the Neptune desert. We conclude that this feature of the exoplanet population is a pristine tracer of giant planet formation and migration mechanisms.Comment: 31 pages, 14 figures, accepted to A
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