One-year clinical outcome of patients with nonvalvular atrial fibrillation: Insights from KERALA-AF registry
C.G. Bahuleyan, Narayanan Namboodiri, A. Jabir, Gregory Y.H. Lip, George Koshy A, Babu M. Shifas, Kartik Viswanathan S, Geevar Zachariah, K. Venugopal, Eapen Punnose, K Natarajan, GK Mini, Johny Joseph, Ashokan Nambiar C, P.B. Jayagopal, P.P. Mohanan, Raju George, Govindan Unni, C.G. Sajeev, Muhammed Shaffi, Nurbaya Syam, Anil Roby, Rachel Daniel, V.V. Krishnakumar, Anand Pillai, Stigi Joseph, A. Jinbert Lordson
Abstract
BACKGROUND: We report patient characteristics, treatment pattern and one-year clinical outcome of nonvalvular atrial fibrillation (NVAF) from Kerala, India. This cohort forms part of Kerala Atrial Fibrillation (KERALA-AF) registry which is an ongoing large prospective study. METHODS: KERALA-AF registry collected data of adults with previously or newly diagnosed atrial fibrillation (AF) during April 2016 to April 2017. A total of 3421 patients were recruited from 53 hospitals across Kerala state. We analysed one-year follow-up outcome of 2507 patients with NVAF. RESULTS: -VASc score was 3.18 (SD ± 1.7) and HAS-BLED score, 1.84 (SD ± 1.3). At baseline, use of oral anticoagulants (OAC) was 38.6% and antiplatelets 32.7%. On one-month follow-up use of OAC increased to 65.8% and antiplatelets to 48.3%. One-year all-cause mortality was 16.48 and hospitalization 20.65 per 100 person years. The main causes of death were cardiovascular (75.0%), stroke (13.1%) and others (11.9%). The major causes of hospitalizations were acute coronary syndrome (35.0%), followed by arrhythmia (29.5%) and heart failure (8.4%). CONCLUSIONS: Despite high risk profile of patients in this registry, use of OAC was suboptimal, whereas antiplatelets were used in nearly half of patients. A relatively high rate of annual mortality and hospitalization was observed in patients with NVAF in Kerala AF Registry.