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

Mecanismos de regeneração natural em diferentes ambientes de remanescente de Floresta Ombrófila Mista, São Francisco de Paula, RS Mechanisms of natural regeneration in different environments in the remaining Mixed Rain Forest, São Francisco de Paula, RS

O objetivo deste trabalho foi avaliar os mecanismos de regeneração natural em três agrupamentos florísticos em remanescente de Floresta Ombrófila Mista, localizado em São Francisco de Paula, RS. A coleta dos dados foi realizada em seis conglomerados de um hectare, subdivididos em 16 parcelas cada, nas quais foram coletadas amostras da chuva de sementes, do banco de sementes no solo e do banco de plântulas. Os grupos florísticos apresentaram diferenças significativas para a densidade de indivíduos na chuva de sementes e no banco de plântulas. Para o banco de sementes no solo, o grupo G1 diferiu dos grupos G2 e G3. A riqueza de espécies observada no banco de plântulas sugere que este pode ser o mecanismo principal de manutenção da diversidade no remanescente. A chuva de sementes foi abundante e representou uma fonte expressiva de propágulos para abastecer o banco de sementes e banco de plântulas local e das áreas circunvizinhas. O banco de sementes do solo não apresentou potencial florístico para representar a riqueza de espécies presentes na vegetação arbórea, corroborando o estágio sucessional avançado desta floresta, uma vez que o banco de sementes é formado principalmente de espécies pioneiras.<br>The aim of this study was to evaluate the natural regeneration mechanisms in three floristic groups of the remaining Mixed Rain Forest, located in San Francisco de Paula, RS. The data were collected in six conglomerates of one hectare, subdivided into 16 plots, in which seed rain, soil seed bank, and seedling bank were collected. The groups presented differences in the density of individuals in the seed rain and in the seedling banks. For the soil seed bank, the group G1 differed from the groups G2 and G3. The seedlings bank, due to the wealth of species, may be the primary mechanism for maintaining diversity in the remnant. Seed rain was abundant and represented an expressive source of seeds to supply the seed bank and the seedling bank site and surrounding areas. The seed bank of soil did not show potential to replace the floristic richness of species in the arboreal vegetation, confirming the advanced stage of forest succession, once the seed bank is composed mainly of pioneer specie