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

Role of growth hormone in dairy cow ovarian function

Growth hormone is recognized as a key endocrine regulator of postnatal growth and production\nin dairy cattle. However, it is currently known that this hormone also affects reproduction in these\nanimals. Ovarian function in cattle is controlled by intraovarian control mechanisms that, concomitantly with endocrine signals, coordinate recruitment, selection and follicular growth. Although the role of gonadotropins in stimulating follicular growth and differentiation is clear, particularly during the final stages of maturation, growth hormone also plays an important modulating role, since it exerts multiple direct and indirect effects on the ovary, acting on steroidogenesis, folliculogenesis and oocyte maturation. Any advances in understanding intraovarian regulatory mechanisms will be helpful in the design of new approaches to manipulating ovarian function and improving fertility in dairy herds.Fil: Leiva, C.J. CONICET. Universidad Nacional del Litoral. Instituto de Ciencias Veterinarias del Litoral (ICiVet-Litoral). Laboratorio de Biología Celular y Molecular Aplicada. Santa Fe, ArgentinaFil: Leiva, C.J. Universidad Nacional del Litoral. Facultad de Ciencias Veterinarias. Santa Fe, ArgentinaFil: Durante, L.I. CONICET. Universidad Nacional del Litoral. Instituto de Ciencias Veterinarias del Litoral (ICiVet-Litoral). Laboratorio de Biología Celular y Molecular Aplicada. Santa Fe, ArgentinaFil: Durante, L.I. Universidad Nacional del Litoral. Facultad de Ciencias Veterinarias. Santa Fe, ArgentinaFil: Bértoli, J. Universidad Nacional del Litoral. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Santa Fe, ArgentinaFil: Bértoli, J. Universidad Nacional del Litoral. Facultad de Ciencias Veterinarias. Santa Fe, ArgentinaFil: Gatti, E. Universidad Nacional del Litoral. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Santa Fe, ArgentinaFil: Gatti, E. Universidad Nacional del Litoral. Facultad de Ciencias Veterinarias. Santa Fe, ArgentinaFil: Baravalle, E. Universidad Nacional del Litoral. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Santa Fe, ArgentinaFil: Baravalle, E. Universidad Nacional del Litoral. Facultad de Ciencias Veterinarias. Santa Fe, ArgentinaFil: Rey, F. CONICET. Universidad Nacional del Litoral. Instituto de Ciencias Veterinarias del Litoral (ICiVet-Litoral). Laboratorio de Biología Celular y Molecular Aplicada. Santa Fe, ArgentinaFil: Rey, F. Universidad Nacional del Litoral. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Santa Fe, ArgentinaFil: Ortega H.H. CONICET. Universidad Nacional del Litoral. Instituto de Ciencias Veterinarias del Litoral (ICiVet-Litoral). Laboratorio de Biología Celular y Molecular Aplicada. Santa Fe, ArgentinaFil: Ortega H.H. Universidad Nacional del Litoral. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Santa Fe, ArgentinaFil: Marelli B.E. CONICET. Universidad Nacional del Litoral. Instituto de Ciencias Veterinarias del Litoral (ICiVet-Litoral). Laboratorio de Biología Celular y Molecular Aplicada. Santa Fe, ArgentinaFil: Marelli B.E. Universidad Nacional del Litoral. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Santa Fe, ArgentinaLa hormona del crecimiento es reconocida como un regulador endocrino clave del crecimiento postnatal y la producción en bovinos de leche. No obstante, actualmente se conoce que esta hormona también afecta la reproducción de estos animales. La función ovárica en los bovinos está controlada por mecanismos de control intraováricos que, concomitantemente con señales endócrinas, coordinan el reclutamiento, la selección y el crecimiento folicular. Aunque el rol de las gonadotropinas en la estimulación del crecimiento y diferenciación folicular es claro, particularmente durante las etapas finales de la maduración, la hormona del crecimiento también cumple una función moduladora de relevancia, ya que ejerce múltiples efectos directos e indirectos en el ovario, actuando sobre la esteroidogénesis, la foliculogénesis y la maduración de los ovocitos. Todo avance en la comprensión de los mecanismos de regulación intraováricos resultará de utilidad en la planificación de nuevos enfoques para la manipulación de la función ovárica y la mejora de la fertilidad de los rodeos lecheros