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

HAZID, a computer aid for hazard identification:3. The fluid model and consequence evaluation systems

The hazard and operability, or HAZOP, study is a prime method for the identification of hazards on process plants. This is the third in a series of papers which describes progress in the emulation of hazard identification in the style of HAZOP. The work reported is embodied in a computer aid for hazard identification, or HAZOP emulator, HAZID. The HAZID code is one of a suite of codes developed as part of the STOPHAZ project. The present paper describes the fluid model system and the evaluation of consequences.Companion papers describe: an overview of HAZID, with an account of HAZOP and HAZOP emulation, and of the issues underlying it; the unit model system; the evaluation and improvement of HAZID using case studies and other methods; some development topics. Conclusions from the work are given in the final paper

HAZID, a computer aid for hazard identification:1. The STOPHAZ package and the HAZID code: an overview, the issues and the structure

The hazard and operability, or HAZOP, study is a prime method for the identification of hazards on process plants. This is the first in a series of papers which describes progress in the emulation of hazard identification in the style of HAZOP. The work reported is embodied in a computer aid for hazard identification, or HAZOP emulator, HAZID. The HAZID code is one of a suite of codes developed as part of the STOPHAZ project. The present paper gives an overview of HAZID, with an account of HAZOP and HAZOP emulation, and of the issues underlying it.Companion papers describe the unit model system, the fluid model system and the evaluation of consequences, the evaluation and improvement of HAZID using case studies and other methods, and some development topics. Conclusions from the work are given in the final paper