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Observational Study
. 2019 Jul 27;9(7):e025901.
doi: 10.1136/bmjopen-2018-025901.

Kerala Atrial Fibrillation Registry: a prospective observational study on clinical characteristics, treatment pattern and outcome of atrial fibrillation in Kerala, India, cohort profile

Bahuleyan Charantharayil Gopalan  1 , Narayanan Namboodiri  2 , Jabir Abdullakutty  3 , Gregory Yh Lip  4   5 , Allumootil George Koshy  6 , Venugopal Krishnan Nair  7 , Shifas Babu  8 , Shaffi Muhammed  9 , Jinbert Lordson Azariah  10   11 , Raju George  12 , Ashokan Nambiar  13 , Unni Govindan  14 , Geevar Zachariah  15 , Natarajan Kumaraswamy  16 , Sajeev Chakanalil Govindan  17 , Syam Natesan  18 , Anil Roby  19 , Krishnakumar Velayudhan Nair  8 , Anand M Pillai  8 , Rachel Daniel  20 ; Kerala AF Registry Investigators
Collaborators, Affiliations
Observational Study

Kerala Atrial Fibrillation Registry: a prospective observational study on clinical characteristics, treatment pattern and outcome of atrial fibrillation in Kerala, India, cohort profile

Bahuleyan Charantharayil Gopalan et al. BMJ Open. .

Abstract

Purpose: Limited published data exist on the clinical epidemiology of atrial fibrillation (AF) in South Asia including India. Most of the published data are from the Western countries and the Far East. The Kerala AF registry was initiated to collect systematic, prospective data on clinical characteristics, risk factors, treatment pattern and outcomes of consecutive AF patients who consulted cardiologists across the state of Kerala, India.

Participants: All newly diagnosed and previously reported patients aged ≥18 years with documented evidence of AF on ECG were included. Patients with transient AF due to infection, acute myocardial infarction, alcohol intoxication, metabolic abnormalities and AF seen in postoperative cases and critically ill patients with life expectancy less than 30 days were excluded.

Findings to date: A total of 3421 patients were recruited from 53 hospitals across Kerala from April 2016 to April 2017. There were 51% (n=1744) women. The median age of the cohort was 65 (IQR 56-74) years. Hypertension, diabetes mellitus and dyslipidaemia were present in 53.8%, 34.5% and 42.2% patients, respectively. Chronic kidney disease was observed in 46.6%, coronary artery disease in 34.8% and heart failure (HF) in 26.5% of patients. Mean CHA2DS2-VASc score of the cohort was 2.9, and HAS-BLED score was 1.7. Detailed information of antithrombotic and antiarrhythmic drugs was collected at baseline and on follow-up. During 1-year follow-up, 443 deaths (12.9%) occurred of which 332 (9.7%) were cardiac death and 63 (1.8%) were due to stroke. There were 578 (16.8%) hospitalisations mainly due to acute coronary syndrome, arrythmias and HF.

Future plans: Currently, this is the largest prospective study on AF patients from India, and the cohort will be followed for 5 years to observe the treatment patterns and clinical outcomes. The investigators encourage collaborations with national and international AF researchers.

Trial registration number: CTRI/2017/10/010097.

Keywords: atrial fibrillation; cardiac arrhythmia; disease registry; prospective study; stroke.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Map of Kerala showing the distribution of study sites.
Figure 2
Figure 2
Incidence of hospitalisations among different age groups of male and female patients with AF.
Figure 3
Figure 3
Incidence of mortality among different age groups of male and female patients with AF.
See this image and copyright information in PMC

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