Cardiovascular Centre, Ananthapuri Hospitals and Research Institute, Trivandrum, India.
Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
Indian Heart J. 2021 Jan-Feb;73(1):56-62. doi: 10.1016/j.ihj.2020.11.152. Epub 2020 Dec 19.
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.
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.
Mean age at recruitment was 67.2 years (range 18-98) and 54.8% were males. Main co-morbidities were hypertension (61.2%), hyperlipidaemia (46.2%) and diabetes mellitus (37.2%). Major co-existing diseases were chronic kidney disease (42.1%), coronary artery disease (41.6%), and chronic heart failure (26.4%). Mean CHADS-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%).
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.
我们报告了来自印度喀拉拉邦的非瓣膜性心房颤动（NVAF）患者的特征、治疗模式和一年临床结局。该队列是正在进行的大型前瞻性研究 Kerala Atrial Fibrillation（KERALA-AF）登记处的一部分。
KERALA-AF 登记处收集了 2016 年 4 月至 2017 年 4 月期间新诊断或新确诊的成人房颤患者的数据。从喀拉拉邦的 53 家医院共招募了 3421 名患者。我们分析了 2507 名 NVAF 患者的一年随访结局。
招募时的平均年龄为 67.2 岁（范围 18-98 岁），54.8%为男性。主要合并症为高血压（61.2%）、高脂血症（46.2%）和糖尿病（37.2%）。主要共存疾病为慢性肾脏病（42.1%）、冠状动脉疾病（41.6%）和慢性心力衰竭（26.4%）。平均 CHADS-VASc 评分为 3.18（SD ± 1.7），HAS-BLED 评分为 1.84（SD ± 1.3）。基线时，口服抗凝剂（OAC）使用率为 38.6%，抗血小板药物使用率为 32.7%。在一个月的随访中，OAC 的使用率增加到 65.8%，抗血小板药物使用率增加到 48.3%。一年全因死亡率为 16.48%，住院率为 20.65/100 人年。死亡的主要原因是心血管疾病（75.0%）、中风（13.1%）和其他原因（11.9%）。住院的主要原因是急性冠状动脉综合征（35.0%），其次是心律失常（29.5%）和心力衰竭（8.4%）。
尽管该登记处患者的风险状况较高，但 OAC 的使用率不理想，而抗血小板药物的使用率接近一半。在 Kerala AF 登记处的 NVAF 患者中，观察到较高的年死亡率和住院率。
