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

Large-scale establishment of Ammophila arenaria and quantitative assessment by remote-sensing

New methods for the establishment of Ammophila arenaria (marram grass), i.e. sowing seeds and disk-harrowing rhizomes, were compared with the traditional method (planting bundles of culms). A large-scale experiment was undertaken on 120 ha of fortified foredune ridge and approximately 40 percent of this area was evaluated by airborne remote sensing (false colour photography). Above-ground biomass production and percentage cover of one- and two-year-old stands were determined by combining field data with colour density measurements on the images. A linear empirical relationship could be established between colour density ratio on the photographs and above-ground biomass, as well as percentage cover. This relationship depended on the age of the plantation. Planting method or relief did not influence this relationship. After the first growing season, planted culms had produced less biomass and percentage cover than stands established via the new methods. In the second growing season the traditional method was the most productive. During the first growing season more than 90 percent of the total area had been stabilized successfully by the new vegetation. Therefore, the alternative methods could be as effective for sand stabilization as the traditional method of planting. Effectiveness of the temporary sand stabilization after sowing and the origin of the culms and rhizomes used for planting affected productivity of the new stands more than the method of establishment. Therefore, if applied properly A. arenaria can be established at a practical level from seeds or rhizomes, instead of from culms. It is also shown that remote sensing could be used to assess above- ground biomass, percentage cover and heterogeneity of foredune vegetation