ABSTRACT
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.
ABSTRACT
A pesar de la tragedia que el último atentado terrorista provocó en las ramblas de Barcelona, la comunidad cardiológica catalana tuvo que reponerse rápidamente para ser anfitriona del mayor evento cardiovascular de Europa: el ESC CONGRESS 2017. Del 26 al 30 de agosto, en decenas de mesas redondas, más de 31.000 cardiólogos de todo el mundo se reunieron para actualizar sus conocimientos e intercambiar novedades en ciencia, innovación e investigación en cardiología en más de 500 sesiones y más de 4.500 presentaciones de abstracts (1). Se presentaron nuevas guías para el manejo del infarto agudo de miocardio, enfermedad valvular, enfermedad arterial periférica y recomendaciones para el uso de terapia antiplaquetaria dual. Se celebraron los 40 años de la intervención coronaria percutánea (PCI), realizada por Andreas Grüntzig por primera vez el 16 de setiembre de 1977(1). Realizaremos un breve resumen de algunos de los principales trabajos científicos presentados durante este evento que sin duda tendrán un impacto en nuestra práctica clínica diaria. - Canakinumab Anti-Inflammatory Thrombosis Outcome Study: CANTOS. - Global Anticoagulant Registry in the Field-Atrial Fibrillation (Registro Global de Anticoagulantes en el Campo de la Fibrilación Auricular): GARFIELD-AF. - Catheter ablation versus standard conventional treatment in patients with left ventricular dysfunction and atrial fibrillation: CASTLE-AF. - Cardiovascular OutcoMes for People using Anticoagulation StrategieS (COMPASS) trial: Primary Results
Despite the last terrorist attack tragedy at La Rambla in Barcelona, Catalonian cardiologic community had to quickly recover from the episode to host the major European cardiovascular event: the ESC CONGRESS 2017. From august 26th to 30th, more than 31.000 cardiologists from all over the world met to update their knowledge and share the state of the art science, innovation and cardiologic investigation in more than 500 sessions and more than 4.500 abstracts presentations. New guidelines for the management of acute ST-segment elevation myocardial infarction, valvular heart disease, peripheral vascular disease and recommendations on dual antiplatelet therapy were presented. Fourty years of percutaneous coronary intervention (PCI), performed for the first time by Andreas Grüntzig on September 16th, 1977, was celebrated. We will expose a brief summary of some of the main scientific works presented at the congress which will undoubtedly have an impact on our daily clinical practice. - Canakinumab Anti-Inflammatory Thrombosis Outcome Study: CANTOS. - Global Anticoagulant Registry in the Field-Atrial Fibrillation: GARFIELD-AF. - Catheter ablation versus standard conventional treatment in patients with left ventricular dysfunction and atrial fibrillation: CASTLE-AF. - Cardiovascular OutcoMes for People using Anticoagulation StrategieS (COMPASS) trial: Primary Results