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

Dinâmica da composição botânica numa pastagem natural sob efeito de diferentes ofertas de forragem Dynamic botanical composition in rangeland under forage allowances

A intensidade de pastejo e suas alterações ao longo do tempo podem afetar a composição botânica e a estrutura do pasto. Este trabalho buscou avaliar o efeito de distintas ofertas de forragem (OF) sobre a dinâmica populacional de espécies de uma pastagem natural dos Campos Sulinos. As avaliações da composição botânica foram realizadas em 12 de janeiro e 17 de julho através do método BOTANAL. Os tratamentos constaram de diferentes OF (kg MS 100kg-1 de peso vivo dia-1): 8, 12 e 16 durante todo ano e diferentes combinações de sequências: 8 na primavera e 12 no resto do ano (8-12); 12 na primavera e 8 no resto do ano (12-8); 16 na primavera e 12 no resto do ano (16-12). O delineamento utilizado foi o de blocos casualizados com duas repetições. A oferta de forragem provocou alterações na composição botânica da vegetação. A manipulação da OF na primavera alterou a composição botânica da vegetação e apresentou maior impacto nas menores OF.<br>Grazing intensity manipulation can affect structure and botanical composition of the pasture. The objective of this research was to evaluate the effects of different forage allowances and different seasonal sequences of forage allowance (FA) on the species population dynamics in the rangelands of Campos Sulinos. The botanical composition evaluations were made in January 12th and July 17th, using BOTANAL method. Treatments were of different FA (kg DM 100kg-1 of live weight day-1): 8, 12, 16 all around the year; and different sequences of FA: 8 on spring and 12 at the rest of year (8-12); 12 on spring and 8 at the rest of year (12-8) and 16 on spring and 12 at the rest of year (16-12). The statistical design used was randomized blocks with two replications. The forage allowance led to changes in botanical and structural composition of vegetation. It can be inferred that the forage allowance variation on the vegetation had higher impact on smaller forage allowances