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Multicenter Study
. 2021 Jan-Feb;73(1):56-62.
doi: 10.1016/j.ihj.2020.11.152. Epub 2020 Dec 19.

One-year clinical outcome of patients with nonvalvular atrial fibrillation: Insights from KERALA-AF registry

C G Bahuleyan  1 , Narayanan Namboodiri  2 , A Jabir  3 , Gregory Y H Lip  4 , George Koshy A  5 , Babu M Shifas  6 , Kartik Viswanathan S  2 , Geevar Zachariah  7 , K Venugopal  8 , Eapen Punnose  9 , K U Natarajan  10 , G K Mini  11 , Johny Joseph  12 , Ashokan Nambiar C  13 , P B Jayagopal  14 , P P Mohanan  15 , Raju George  16 , Govindan Unni  17 , C G Sajeev  18 , Shaffi Muhammed  19 , N Syam  20 , Anil Roby  21 , Rachel Daniel  22 , V V Krishnakumar  6 , Anand M Pillai  6 , Stigi Joseph  23 , A Jinbert Lordson  24
Affiliations
Multicenter Study

One-year clinical outcome of patients with nonvalvular atrial fibrillation: Insights from KERALA-AF registry

C G Bahuleyan et al. Indian Heart J. 2021 Jan-Feb.

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: 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 CHA2DS2-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.

Keywords: AF Registry; Cardiac arrhythmia; Kerala; Nonvalvular atrial fibrillation; Stroke.

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Conflict of interest statement

Declaration of competing interest None to declare.

Figures

Fig. 1
Fig. 1
Kerala AF Registry NVAF patient’s follow-up
Fig. 2
Fig. 2
Use of antithrombotics at baseline and at 1 month follow-up
Fig. 3
Fig. 3
Use of antithrombotics at baseline in relation to CHA2DS2-VASC score
Fig. 4
Fig. 4
Use of antithrombotics at 1 month follow-up in relation to CHA2DS2-VASC score
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