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

Figure 2. Lepidepecreoides bassi n in The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae)

Figure 2. Lepidepecreoides bassi n.sp. Holotype, 10.0 mm, NMV J47713, Point Hicks, Australia. Scales represent 0.2 mm.Published as part of &lt;i&gt;Lowry, J.K. &amp; Stoddart, H.E., 2002, The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae), pp. 335-364 in Records of the Australian Museum 54 (3)&lt;/i&gt; on page 338, DOI: 10.3853/j.0067-1975.54.2002.1329, &lt;a href="http://zenodo.org/record/10092532"&gt;http://zenodo.org/record/10092532&lt;/a&gt

Figure 25. Lepidepecreum tourville n in The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae)

Figure 25. Lepidepecreum tourville n.sp. Holotype female, 5.8 mm, NMV J47730; paratype male, 5.6 mm, NMV J17159; Cape Tourville, Australia. Scales for U1–3 represent 0.1 mm, remainder represent 0.5 mm.Published as part of &lt;i&gt;Lowry, J.K. &amp; Stoddart, H.E., 2002, The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae), pp. 335-364 in Records of the Australian Museum 54 (3)&lt;/i&gt; on page 362, DOI: 10.3853/j.0067-1975.54.2002.1329, &lt;a href="http://zenodo.org/record/10092532"&gt;http://zenodo.org/record/10092532&lt;/a&gt

Figure 13. Lepidepecreum baudini n in The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae)

Figure 13. Lepidepecreum baudini n.sp. Holotype female, 5.5 mm, NMV J47715; paratype male, 6.5 mm, NMV J47717; Point Hicks, Australia. Scales for U1–3, T represent 0.1 mm, remainder represent 0.5 mm.Published as part of &lt;i&gt;Lowry, J.K. &amp; Stoddart, H.E., 2002, The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae), pp. 335-364 in Records of the Australian Museum 54 (3)&lt;/i&gt; on page 350, DOI: 10.3853/j.0067-1975.54.2002.1329, &lt;a href="http://zenodo.org/record/10092532"&gt;http://zenodo.org/record/10092532&lt;/a&gt

Figure 14. Lepidepecreum dampieri n in The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae)

Figure 14. Lepidepecreum dampieri n.sp. Holotype male, 3.5 mm, NMV J7670, North West Shelf, Australia.Published as part of &lt;i&gt;Lowry, J.K. &amp; Stoddart, H.E., 2002, The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae), pp. 335-364 in Records of the Australian Museum 54 (3)&lt;/i&gt; on page 351, DOI: 10.3853/j.0067-1975.54.2002.1329, &lt;a href="http://zenodo.org/record/10092532"&gt;http://zenodo.org/record/10092532&lt;/a&gt

Figure 11. Lepidepecreum baudini n in The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae)

Figure 11. Lepidepecreum baudini n.sp. Paratype immature male, 6.5 mm, NMV J47717, Point Hicks, Australia.Published as part of &lt;i&gt;Lowry, J.K. &amp; Stoddart, H.E., 2002, The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae), pp. 335-364 in Records of the Australian Museum 54 (3)&lt;/i&gt; on page 348, DOI: 10.3853/j.0067-1975.54.2002.1329, &lt;a href="http://zenodo.org/record/10092532"&gt;http://zenodo.org/record/10092532&lt;/a&gt

Figure 9. Lepidepecreoides torresi n in The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae)

Figure 9. Lepidepecreoides torresi n.sp. Holotype, female, 6.8 mm, AM P57734, Cape York, Australia. Scales represent 0.2 mm.Published as part of &lt;i&gt;Lowry, J.K. &amp; Stoddart, H.E., 2002, The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae), pp. 335-364 in Records of the Australian Museum 54 (3)&lt;/i&gt; on page 346, DOI: 10.3853/j.0067-1975.54.2002.1329, &lt;a href="http://zenodo.org/record/10092532"&gt;http://zenodo.org/record/10092532&lt;/a&gt

Figure 18. Lepidepecreum flindersi n in The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae)

Figure 18. Lepidepecreum flindersi n.sp. Holotype female, 4.0 mm, NMV J47720; paratype male, 4.8 mm, NMV J47721; Bass Strait, Australia.Published as part of &lt;i&gt;Lowry, J.K. &amp; Stoddart, H.E., 2002, The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae), pp. 335-364 in Records of the Australian Museum 54 (3)&lt;/i&gt; on page 355, DOI: 10.3853/j.0067-1975.54.2002.1329, &lt;a href="http://zenodo.org/record/10092532"&gt;http://zenodo.org/record/10092532&lt;/a&gt

Figure 16. Lepidepecreum dampieri n in The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae)

Figure 16. Lepidepecreum dampieri n.sp. Holotype male, 3.5 mm, NMV J7670, North West Shelf, Australia. Scales represent 0.1 mm.Published as part of &lt;i&gt;Lowry, J.K. &amp; Stoddart, H.E., 2002, The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae), pp. 335-364 in Records of the Australian Museum 54 (3)&lt;/i&gt; on page 353, DOI: 10.3853/j.0067-1975.54.2002.1329, &lt;a href="http://zenodo.org/record/10092532"&gt;http://zenodo.org/record/10092532&lt;/a&gt

Figure 23. Lepidepecreum tourville n in The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae)

Figure 23. Lepidepecreum tourville n.sp. Holotype female,Published as part of &lt;i&gt;Lowry, J.K. &amp; Stoddart, H.E., 2002, The Lysianassoid Amphipod Genera Lepidepecreoides and Lepidepecreum in Southern Waters (Crustacea: Lysianassidae: Tryphosinae), pp. 335-364 in Records of the Australian Museum 54 (3)&lt;/i&gt; on page 360, DOI: 10.3853/j.0067-1975.54.2002.1329, &lt;a href="http://zenodo.org/record/10092532"&gt;http://zenodo.org/record/10092532&lt;/a&gt