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

POST WEANING FEEDING MANAGEMENT AND PERFORMANCE OF MERINO EWES GRAZING ON NATURAL AND IMPROVED PASTURES AT MATING SEASON MANEJO ALIMENTAR PÓS-DESMAME E PERFORMANCE DE OVELHAS MERINO EM PASTAGENS NATURAIS E ARTIFICIAIS NA ÉPOCA DE ENCARNEIRAMENTO

In the uruguayan Basalt region, the reproductive performance of 300 Merino ewes and the effect of 3 post-weaning feeding managements (PWFM: I: 1.2 cm height of available forage and 16 ewes/ha; II: 2.03 cm height of available forage and 5 ewes/ha; III: 2.5cm height of available forage and 1 ewe/ha) as well as 2 feeding levels before and during the breeding season (FLM: native pastures: green DM/ha: 883kg, CP: 114g/kg DM, NDF: 781g/kg DM and improved pastures: DM /ha: 1270kg, CP: 194g/kg DM, NDF: 598g/kg DM) were studied with a factorial arrangement of treatments. The PWFM extended for 70 days, ewes were mated in the period from 13/4/96 to 13/5/96 and FLM were applied for 30 days, starting 15 days before beginning of breeding. There were not differences on the ovulation rate (P>0.05); however, the P values might indicate some effect of the treatments. The number of born lambs/ewe served increased with the ovulation rate because the higher number of ovulations balanced their less viability, individually considered. Actually, the number of born lambs/ewe served was higher with animals coming from PWFM III (1.18, 1.11 and 0.96, PWFM III, II and I, respectively; P = 0.02) and with the animals grazing on improved pastures at mating period (1.13 and 1.03, improved pastures and natural pastures, respectively; P = 0.10), were those which showed slight higher ovulation rate.<br>Na região de solos de Basalto (Salto, Uruguai: 32.5º de latitude sul e 58º de longitude oeste), estudou-se, em um delineamento em blocos casualizados com arranjo fatorial, o efeito de 3 manejos alimentares pos-desmame (MAPD: I : 1,2cm de altura da forragem disponível e 16 ovelhas/ha; II: 2,03cm de altura da forragem disponível e 5 ovelhas/ha; III: 2,5cm de altura da forragem disponível e 1 ovelha/ha) e 2 níveis de alimentacão no período de encarneiramento (NAE: campo natural: 883kg MS verde/ha, PB: 114g/kg MS e FDN: 781g/kg MS; pastagem artificial: 1270kg MS/ha, PB: 194g/kg MS e FDN: 598g/kg MS), no desempenho reprodutivo de 300 ovelhas Merino. O MAPD estendeu-se por 70 dias. O período de encarneiramento foi de 13/4-13/5/96 e os NAE foram aplicados por 30 dias, iniciando-se 15 dias antes do início do período de cobertura. O número de cordeiros nascidos/ovelha cobertas incrementou-se ao aumentar a taxa ovulatória devido ao fato de o maior número de óvulos liberados compensar a menor viabilidade destes. O número de cordeiros nascidos/ovelha coberta foi maior nas ovelhas provenientes do MAPD III (1,18, 1,11 e 0,96, MAPD III, II e I, respectivamente, P = 0,02) e naquelas que foram submetidas às pastagens artificiais durante o período de encarneiramento (1,13 e 1,03, pastagem artificial e natural, respectivamente, P = 0,10). Essas foram as que apresentaram uma tendência de valores superiores em taxa ovulatória