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

DARN/SuperDARN

International audienceThe Dual Auroral Radar Network (DARN) is a global-scale network of I-IF and VHF radars capable of sensing backscatter from ionospheric irregularities in the E and F-regions of the high-latitude ionosphere. Currently, the network consists of the STARE VHF radar system in northern Scandinavia, a northern-hemisphere, longitudinal chain of HF radars that is funded to extend from Saskatoon, Canada to central Finland, and a southern-hemisphere chain that is funded to include Halley Station, SANAE and Syowa Station in Antarctica. When all of the HF radars have been completed they will operate in pairs with common viewing areas so that the Doppler information contained in the backscattered signals may be combined to yield maps of high-latitude plasma convection and the convection electric field. In this paper, the evolution of DARN and particularly the development of its SuperDARN HF radar element is discussed. The DARN/SuperDARN network is particularly suited to studies of large-scale dynamical processes in the magnetosphere-ionosphere system, such as the evolution of the global configuration of the convection electric field under changing IMF conditions and the development and global extent of large-scale Mi-ID waves in the magnetosphere-ionosphere cavity. A description of the HF radars within SuperDARN is given along with an overview of their existing and intended locations, intended start of operations, Principal Investigators, and sponsoring agencies. Finally, the operation of the DARN experiment within ISTP/GGS, the availability of data, and the form and availability of the Key Parameter files is discussed

Large-scale fields and flows in the magnetosphere-ionosphere system

Advances in our understanding of the large-scale electric and magnetic fields in the coupled magnetosphere-ionosphere system are reviewed. The literature appearing in the period January 1991–June 1993 is sorted into 8 general areas of study. The phenomenon of substorms receives the most attention in this literature, with the location of onset being the single most discussed issue. However, if the magnetic topology in substorm phases was widely debated, less attention was paid to the relationship of convection to the substorm cycle. A significantly new consensus view of substorm expansion and recovery phases emerged, which was termed the ‘Kiruna Conjecture’ after the conference at which it gained widespread acceptance. The second largest area of interest was dayside transient events, both near the magnetopause and the ionosphere. It became apparent that these phenomena include at least two classes of events, probably due to transient reconnection bursts and sudden solar wind dynamic pressure changes. The contribution of both types of event to convection is controversial. The realisation that induction effects decouple electric fields in the magnetosphere and ionosphere, on time scales shorter than several substorm cycles, calls for broadening of the range of measurement techniques in both the ionosphere and at the magnetopause. Several new techniques were introduced including ionospheric observations which yield reconnection rate as a function of time. The magnetospheric and ionospheric behaviour due to various quasi-steady interplanetary conditions was studied using magnetic cloud events. For northward IMF conditions, reverse convection in the polar cap was found to be predominantly a summer hemisphere phenomenon and even for extremely rare prolonged southward IMF conditions, the magnetosphere was observed to oscillate through various substorm cycles rather than forming a steady-state convection bay