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

Isolation of gram amounts of arginine vasopressin, oxytocin, and α-MSH

A simple method is described for the isolation, on a preparative scale, of arginine vasopressin, oxytocin, and α-MSH, from a single beef posterior pituitary extract. These hormones are obtained in a high state of purity and with maximal biological activities. The method involves a preliminary precipitation, which is followed by chromatography on carboxymethylcellulose and gel filtration

Alteration of LH and FSH release in rats treated with clomiphene or its isomers

The effects of clomiphene citrate and its two isomers on release of LH and FSH-RH were evaluated in ovariectomized adult rats using biosassay and radioimmunoassay techniques. At doses of 2,500 to 10,000 μg per rat per day given subcutaneously for 3 days, the 3 compounds lowered plasma LH levels. Transclomiphene was more effective in suppressing LH levels than cisclomiphene. Administration of LRH to rats previously treated with these high doses of clomiphene and its isomers raised plasma LH levels. Lower doses of the compounds (15 to 135 μg per rat per day for 3 days) appeared to increase further the high plasma LH found in ovariectomized rats; cisclomiphene gave the greatest and most consistent elevation. The low doses of clomiphene and cisclomiphene also seemed to enhance slightly the response to LRH in ovariectomized estrogen-progesterone-treated or untreated rats. In castrated, testosterone-treated male rats, 10,000 μg of clomiphene per rat given for 3 days did not affect pituitary FSH levels or the depletion of pituitary FSH content following administration of FSH-RH. Radioimmunoassay showed that serum FSH was raised by low doses of clomiphene and its isomers and decreased by the high doses of transclomiphene. Thus, clomiphene and its isomers at high doses seemed to inhibit LH release, but at low doses possibly to stimulate either LH release or facilitate the effect of LRH on the pituitary. The response to LRH and FSH-RH was not blocked by the higher doses, thereby providing evidence for a central blocking site which is not the pituitary but a CNS center, possibly the hypothalamus