Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

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. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Distribuição, abundância relativa e movimentos sazonais de bagres marinhos (Siluriformes, Ariidae) no estuário da Lagoa dos Patos (RS), Brasil

<abstract language="eng">Three ariid fish, Netuma barba, Netuma planifrons and Genidens genidens, use the estuary of the Patos Lagoon (32ºS), Rio Grande do Sul, Brazil, as a nursery and feeding ground in various stages of their life history. A comparative study was made of the temporal and spatial distribution and relative abundance. Seasonal movements were interpreted on the basis of distribution and abundance of the young of these coexisting sea catfishe. Monthly otter trawl samples were made between November, 1979 and April, 1983. Temperature, salinities and dissolved oxygen contents were taken at each of the 674 sample stations. All three species were caught in ample temperature (12,1 to 26,3ºC), salinity (0,3 to 35,5‰) and dissolved oxygen (4,7 to 11,5 mg/l) ranges. However, they were more abundant in stations of low temperature and in salinity with highly dissolved oxygen content. N. barba was the most abundant catfish caught in the estuary, it constituted 81,9% in number and 81,4% in weight of ali ariid trawl catches during the study. N. barba occurred throughout the estuary, from the adjacent coastal region to the upper reaches of the Patos Lagoon estuary near the liminetic zone. N. planifrons occurred from adjacent coastal regions to low saline parts of the Patos Lagoon estuary, whereas G. genidens were distributed mainly in low saline and freshwater parts of the lagoon. Young-of-the-year N. barba aggregated near of the entrance of the lagoon in fall and winter, then moved up to intermediary parts of the estuary in spring, and they went to the upper part of the estuary in summer. Yearlings N. barba moved into the estuary in common with young-of-the-year but did not reach the coastal adjacent area. Young-of-the-year and yearling N. planifrons moved in to the estuary as the same pattern as N. barba but they became scarce during the late summer and early fall. G. genidens were scarcely captured in the estuary throughout the year. The spatial and temporal segregations among Netuma and Genidens were evident. A hypothetical model for the life history of N. barba is suggested