65 research outputs found
Ferritins: furnishing proteins with iron
- Author
- A Crow
- A Treffry
- AG Frey
- CC Philpott
- DM Lawson
- DM Lawson
- E Wajnberg
- EC Theil
- EC Theil
- EC Theil
- EC Theil
- EI Stiefel
- ER Bauminger
- F Barceló
- F Bou-Abdallah
- FA Fischbach
- FA Fischbach
- FH Kadir
- FHA Kadir
- GC Ford
- GC Papaefthymiou
- GD Watt
- GD Watt
- Geoffrey R. Moore
- GR Moore
- H Abdul-Tehrani
- H Aitken-Rogers
- H Shi
- H Yao
- H Yao
- H Yao
- J Yariv
- J-F Ma
- JD López-Castro
- JD Mancias
- JM Bradley
- JM Bradley
- JS Rohrer
- Justin M. Bradley
- L Swartz
- L Toussaint
- MA Quail
- MJ O’Connell
- ML Vasil
- MR Cheesman
- ND Chasteen
- NE Brun Le
- NE Brun Le
- NE Brun Le
- Nick E. Le Brun
- NM Reid
- O Sadeghi
- P Arosio
- P Doig
- PD Hempstead
- PL Ringeling
- PM Harrison
- PM Harrison
- RF Boyer
- RJ Ward
- RK Behera
- RP Garg
- S Bereswill
- S Granick
- S Granick
- S Levi
- S Macedo
- S Mann
- S Mann
- S Pfaffen
- SC Andrews
- SC Andrews
- SG Wong
- SK Weeratunga
- T Asano
- T Douglas
- T Jones
- T Tosha
- TJ Stillman
- TV O’Halloran
- TZ Kidane
- V Laufberger
- VJ Wade
- WH Massover
- X Liu
- X Yang
- Y Ha
- Y Wang
- YH Pan
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2016
- Field of study
Ferritins are a superfamily of iron oxidation, storage and mineralization proteins found throughout the animal, plant, and microbial kingdoms. The majority of ferritins consist of 24 subunits that individually fold into 4-α-helix bundles and assemble in a highly symmetric manner to form an approximately spherical protein coat around a central cavity into which an iron-containing mineral can be formed. Channels through the coat at inter-subunit contact points facilitate passage of iron ions to and from the central cavity, and intrasubunit catalytic sites, called ferroxidase centers, drive Fe2+ oxidation and O2 reduction. Though the different members of the superfamily share a common structure, there is often little amino acid sequence identity between them. Even where there is a high degree of sequence identity between two ferritins there can be major differences in how the proteins handle iron. In this review we describe some of the important structural features of ferritins and their mineralized iron cores and examine in detail how three selected ferritins oxidise Fe2+ in order to explore the mechanistic variations that exist amongst ferritins. We suggest that the mechanistic differences reflect differing evolutionary pressures on amino acid sequences, and that these differing pressures are a consequence of different primary functions for different ferritins
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Athar
- Abbasy Jibran
- Abbo Olivier
- Abbott Tom
- Abbouch Meryem
- Abd El-Latif Nadia Khalid
- Abd Elkhalek Esraa
- Abd-Elmawla Manar
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A.
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
- Abdelkhalek Mohamed
- Abdelmageed Eman
- Abdelmotaleb Ibrahem
- Abdelraouf Ahmed Mahmoud
- Abdelrouf Doaa Maher
- Abdelshakour Mahmoud
- Abdrabou Abdulshafi Khaled
- Abdul-Latif Saiba
- Abdulaziz Hager
- Abdulaziz Mustafa
- Abdulbagi Omar
- Abdulhakeem Eman Mahmoud
- Abdullah Mohamed Abozed
- Abdullah Nik Azim Nik
- Abdullah Noha
- Abdullahi Lawal
- Abdurrazzaaq Abdussemiu
- Abem Owusu Emmanuel
- Abiola Olajide
- Aboelella Majed
- Aboelmagd Omnia
- Aboelsoud Moustafa R.
- Aboul-Naga Mariam Saad
- Abouzaid Arwa
- Abu Qumbos Amjad
- Abu-toyour Maram
- Abubakr Marwan
- Abuowda Yousef
- Abuqwaider Eman
- Abusalem Lana
- Abushamleh Soha
- Ackom Eric
- Acquah Emmanuel
- Adam Ali
- Adam Nourhan
- Adamu Ahmed
- Adawi Ihdaa
- Adawi Mohammad
- Adebanjo Ademola
- Adebola Oluwaseyi
- Adedeji Adesina
- Adel Badr Eldin
- Adel Israa
- Adella Fidelis Jacklyn
- Adelshone Abdelrahman
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji O.
- Ademuyiwa Adesoji O.
- Adenekan Babajide
- Adeniran James
- Adeniyi Adewale
- Adesanya Opeoluwa
- Adesina Alaba
- Adeyeye Ademola
- Adeyeye Ademola
- Adhitama Novia
- Adil Muhammad
- Adisa Adewale O.
- Adiyaman Can
- Adu-Aryee Niiarmah
- Afana Samah
- Agalianos Christos
- Agarwal Arnav
- Agarwal Arnav
- Agbedinu Kwabena
- Aglan Amro
- Aguado Suarez Nuria
- Aguilera Maria Lorena
- Aguilera Maria Lorena
- Aguilera-Arevalo Maria-Lorena
- Ahlonsou Germain
- Ahlqvist Sandra
- Ahlqvist Sandra
- Ahmed Asdaq
- Ahmed Ataa
- Ahmed Hayam
- Ahmed Hussien
- Ahmed Lopna Ahmed Mohamed
- Ahmed Sara
- Ahmed Saraibrahim
- Ahounou Ernest Yemalin Stephane
- Ajah Jonathan
- Ajai Olalekan
- Ajao Akinlabi
- Ajiboye Anthony
- Akoto Elliot
- Akpenyi Onyinye
- Al Amin Shadid
- Al Attar Samaa Mahmoud
- Al Barraw Fayez Elian
- Al Bastawis Fatema
- Al Meligy Amgad
- Al Rafati Ahmad Abdel Razaq
- Al Raouf Eman Abd
- Al Saied Ghiath
- Al Subaie Norah
- Al-Bahrani Ahmed
- Al-Buhaisi Alaa
- Al-Dakka Emad
- Al-faqawi Maha
- Al-farram Hadeel
- Al-khatib Ahmed
- Al-Marakby Dina
- Al-saqqa Sara
- Al-Saqqa Sara W.
- Al-Slaibi Ibrahim
- Al-taher Taher
- AlaaelDein Shahinaz
- Alada Muslimat
- Alakaloko Felix
- Alaloul Enas
- Alamin Shadid
- Alamoudi Mohammed
- Albiety Adel
- Alcca Ticona Willy
- Alejos Bermudez Ysabel Esthefany
- Alexander Philip
- Alexander Philip
- Alexandre Challine
- Alghamdi Ahmed
- Alghamdi Mohammed Saleh A.
- Alhady Khaled
- Alhammali Tariq
- Alhassan Basmah
- Alhazmi Wedyan
- Alherz Mohammad
- Ali Ahmed
- Ali Citra Dewi Mohd
- Ali Elsayed
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- Ali Tebian Hassanein Ahmed
- Ali Wadah
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- Aljiffry Murad
- Alkaaki Aroub
- Alkelani Muhammad
- Allam Meran
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- Altaf Abdulmalik
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- Altibi Ahmed
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- Altinel Yuksel
- Altwijri Abdulaziz
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- Whitehurst Katharine
- Wiborg Joachim
- Widiastini T. Ariani
- Widmer Lukas Werner
- Wijayarathna L. S.
- Williams Omolara
- Wilson Ling
- Wilson Michael
- Wilson Michael
- Wimalge P. M. S. N.
- Wogensen Fredrik
- Wolf Bernhard
- Wondoh Paul
- Wondoh Paul
- Wong Chui Yee
- Wong Francisca
- Wong Hong Yee
- Wood Greta
- Worku Mengistu
- Worku Tewodros
- Wright Naomi
- Yahaya Muhammad Taqiyuddin
- Yakubu Musah
- Yam Sir Young
- Yang James
- Yap Suhhuey
- Yau Jih Dar
- Ye Joselyn
- Yeang Li Jing
- Yeung Man Hon Andrew
- Yifieyeh Abiboye
- Yildirim Reyyan
- Yip Chingwan
- Ymeri Shpetim
- Yoganathan Pigeneswaren
- Yolcu Sinem
- Yong Guo Liang
- Younis Abobaker
- Youssef Mohamed
- Yuksek Mahmut Arif
- Yusufali Taha
- Zaa'treh Rula
- Zadoroznas Antanas
- Zahran Diaaaldin
- Zakaria Esraay
- Zakaria Mahmoud
- Zakaria Yehia
- Zaki Ahmed
- Zammit Stefan
- Zampitis Nikolaos
- Zani Augusto
- Zani Augusto
- Zanini Nicola
- Zapata Felipe
- Zarb Ciskje
- Zeta Solis Ludwing Alexander
- Zielinski Martin
- Zilinskas Justas
- Zilinskas Justas
- Zilinskas Justas
- Zilinskiene Reda
- Ziubryte Greta
- Zohair Ahmed
- Zuber Markus
- Zuk Grzegorz
- Zulkifli Athirah
- Zumbuhl Lucius
- Publication venue
- Elsevier
- Publication date
- 01/06/2003
- Field of study
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Athar
- Abbasy Jibran
- Abbo Olivier
- Abbott Tom
- Abbouch Meryem
- Abd El-Latif Nadia Khalid
- Abd Elkhalek Esraa
- Abd-Elmawla Manar
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
- Abdelkhalek Mohamed
- Abdelmageed Eman
- Abdelmotaleb Ibrahem
- Abdelraouf Ahmed Mahmoud
- Abdelrouf Doaa Maher
- Abdelshakour Mahmoud
- Abdrabou Abdulshafi Khaled
- Abdul-Latif Saiba
- Abdulaziz Hager
- Abdulaziz Mustafa
- Abdulbagi Omar
- Abdulhakeem Eman Mahmoud
- Abdullah Mohamed Abozed
- Abdullah Nik Azim Nik
- Abdullah Noha
- Abdullahi Lawal
- Abdurrazzaaq Abdussemiu
- Abem Owusu Emmanuel
- Abiola Olajide
- Aboelella Majed
- Aboelmagd Omnia
- Aboelsoud Moustafa R
- Aboul-Naga Mariam Saad
- Abouzaid Arwa
- Abu Qumbos Amjad
- Abu-toyour Maram
- Abubakr Marwan
- Abuowda Yousef
- Abuqwaider Eman
- Abusalem Lana
- Abushamleh Soha
- Ackom Eric
- Acquah Emmanuel
- Adam Ali
- Adam Nourhan
- Adamu Ahmed
- Adawi Ihdaa
- Adawi Mohammad
- Adebanjo Ademola
- Adebola Oluwaseyi
- Adedeji Adesina
- Adel Badr Eldin
- Adel Israa
- Adella Fidelis Jacklyn
- Adelshone Abdelrahman
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji O
- Ademuyiwa Adesoji O
- Adenekan Babajide
- Adeniran James
- Adeniyi Adewale
- Adesanya Opeoluwa
- Adesina Alaba
- Adeyeye Ademola
- Adeyeye Ademola
- Adhitama Novia
- Adil Muhammad
- Adisa Adewale O
- Adiyaman Can
- Adu-Aryee Niiarmah
- Afana Samah
- Agalianos Christos
- Agarwal Arnav
- Agarwal Arnav
- Agbedinu Kwabena
- Aglan Amro
- Aguado Suarez Nuria
- Aguilera Maria Lorena
- Aguilera Maria Lorena
- Aguilera-Arevalo Maria-Lorena
- Ahlonsou Germain
- Ahlqvist Sandra
- Ahlqvist Sandra
- Ahmed Asdaq
- Ahmed Ataa
- Ahmed Hayam
- Ahmed Hussien
- Ahmed Lopna Ahmed Mohamed
- Ahmed Sara
- Ahmed Saraibrahim
- Ahounou Ernest Yemalin Stephane
- Ajah Jonathan
- Ajai Olalekan
- Ajao Akinlabi
- Ajiboye Anthony
- Akoto Elliot
- Akpenyi Onyinye
- Al Amin Shadid
- Al Attar Samaa Mahmoud
- Al Barraw Fayez Elian
- Al Bastawis Fatema
- Al Meligy Amgad
- Al Rafati Ahmad Abdel Razaq
- Al Raouf Eman Abd
- Al Saied Ghiath
- Al Subaie Norah
- Al-Bahrani Ahmed
- Al-Buhaisi Alaa
- Al-Dakka Emad
- Al-faqawi Maha
- Al-farram Hadeel
- Al-khatib Ahmed
- Al-Marakby Dina
- Al-saqqa Sara
- Al-Saqqa Sara W
- Al-Slaibi Ibrahim
- Al-taher Taher
- AlaaelDein Shahinaz
- Alada Muslimat
- Alakaloko Felix
- Alaloul Enas
- Alamin Shadid
- Alamoudi Mohammed
- Albiety Adel
- Alcca Ticona Willy
- Alejos Bermudez Ysabel Esthefany
- Alexander Philip
- Alexander Philip
- Alexandre Challine
- Alghamdi Ahmed
- Alghamdi Mohammed Saleh A
- Alhady Khaled
- Alhammali Tariq
- Alhassan Basmah
- Alhazmi Wedyan
- Alherz Mohammad
- Ali Ahmed
- Ali Citra Dewi Mohd
- Ali Elsayed
- Ali Safia
- Ali Syed Abdul Wahhab Eusoffee Wan
- Ali Tebian Hassanein Ahmed
- Ali Wadah
- Alihonou Thierry
- Alis Halil
- Aliyu Halima
- Aliyu Mohammad
- Aliyu Shamsudeen
- Aljboor Khaled
- Aljiffry Murad
- Alkaaki Aroub
- Alkelani Muhammad
- Allam Meran
- Allam Yomna
- Alnaby Mohamed Hassab
- Alnusairat Aseel
- Alqahtani Saleh
- Alsaggaf Mohammed Ubaid
- Alser Osaid H
- Alshareef Reham
- Altaf Abdulmalik
- Altamimi Abdullah
- Altamimi Afnan
- Altamini Afnan
- Altarayra Marwa
- Altibi Ahmed
- Altinel Yuksel
- Altinel Yuksel
- Altwijri Abdulaziz
- Alvi Abdul Rehman
- Aly Mohammed Yahia Mohamed
- Alyacoubi Said
- Alyahya Reem
- Alzahrani Ahmed
- Aman Nowrin F
- Amandito Radhian
- Amandito Radhian
- Ambrona-Zafra David
- Amin Hager Abdul Aziz
- Amjad Mohammadasim
- Amoah Michael
- Amoako Joachim
- Amoako Philip Taah
- Amoako-Boateng Mabel
- Amole Isaac
- Amreia Mahmoud
- Anderson Frank
- Andika Ferry Fitriya Ayu
- Andreotti Dario
- Andress Cedar
- Andriola Valeria
- Ang Yun Lin
- Angelieri Daniele
- Anis Echaieb
- Ansaloni Luca
- Ansaloni Luca
- Ansaloni Luca
- Antezana Diego
- Anthoulakis Christos
- Antoniozzi Angelo
- Anwar Nourhan
- Anyanwu Lofty-John
- Aonzo Paolo
- Appeadu-Mensah William
- Appiah Eric Kofi
- Aquilino Fabrizio
- Arafa Omar
- Arafa Sara
- Arango Maria Clara Mendoza
- Arcudi Claudio
- Armellini Andrea
- Arnaud Alexis
- Arnaud Alexis Pierre
- Arshad Mohammad Mohsin
- Arslan Ekin
- Arsyad Hasbi Maulana
- Arthur Tom
- Aruldas Neerav
- Asar Yomna Hosny
- Asare-Bediako Kwasi
- Ashour Ahmad
- Ashour Ahmad
- Ashour Khlood
- Ashtari Morvarid
- Asi Fatema
- Asilah Siti Mohd Desa
- Assal Abdelrahman
- Asturias Sabrina
- Asumah Hamza
- Ata Ahmed
- Ata Aya Yehia
- Atiyeh Anwar
- Atkins Ebenezer Takyi
- Attia Attia
- Augestad Knut Magne
- Aviles Susan
- Avoka Anthony
- Awad Israa
- Awad Sawsan Adel
- Awadallah Salwa
- Ayandipo Omobolaji
- Aydin Mehmet Can
- Aziz Dayang Nita Abdul
- Aziz Mohamed Rezal Abdul
- Aziz Nora Abdul
- Azizeldine Mohammed G
- Azzie Georges
- Azzis Olivier
- Baba Suleiman
- Bachri Houda
- Badawy Mahmoud
- Badenjki Mohamed Adel
- Badicel Maria
- Badr Mohamed Fawzy Mahrous
- Badwi Nermin Mohamed
- Bahar Suraya
- Baillie Katie
- Baki Bahadir Emre
- Bakr Ahmad
- Bakry Hesham Mohammed
- Bala Miklosh
- Balalis Dimitrios
- Balducci Genoveffa
- Ballouhey Quentin
- Balmaceda Ruben
- Balmaceda Ruben
- Balogun Fatai
- Baltrunas Robertas
- Baluch Fatima
- Bamford Rebecca
- Bamicha Athanasia
- Banaitis Vincas Jonas
- Bandi Ashwath
- Bandoh Dickson
- Bani-Sadar Ahmad
- Banipal Gurpreet Singh
- Baquero Suarez Alibeth Andres
- Baraka Heba
- Barendegere Venerand
- Barkolias Christos
- Barmayehvar Behrad
- Barnabas Gandau Naa
- Barrios Emmanuel
- Basilico Silvia
- Basir Elissa Rifhan Mohd
- Bassem Monica
- Bassit Khalil Abdul
- Basso Stefano MM
- Bayram Sefa
- Beamon Mieshia
- Bedada Alemayehu Ginbo
- BediakoBowan Antoinette
- Bekhet Amira Hassan
- Bekhet Nada Mohamed
- Beleno Alvaro Enrique Mendoza
- Belkouchi Abdelkader
- Belli Andrea
- Bello Bashir
- Benammi Sarah
- Benevento Angelo
- Bennai Redouane Mammar
- Bentounsi Zineb
- Benyaiche Chaymae
- Berti Stefano
- Bertuello Isaac
- Beuran Mircea
- Bhangu Aneel
- Bhangu Aneel
- Bhangu Anna
- Bhatnagar Ankur
- Bhopal Kamran Faisal
- Bianco Federica
- Bigaran Annamaria
- Billy Matthew
- Bin Adnan Ahmad
- Bin Hasnan Muhammad
- Bin Ismail Mohamad Jeffrey
- Birindelli Arianna
- Bisset Carly
- Bjorklund Ida
- Blacker Sarah
- Blackwell James
- Blanco Ruth
- Blanco-Colino Ruth
- Blencowe Natalie
- Bliksoen Marte
- Bluelle Rafael
- Bocchetti Tommaso
- Bode Chris
- Bodur Selim
- Boggon Adam
- Bonavia Karl
- Bonavina Luigi
- Bond-Smith Giles
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- Borg Elaine
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- Boukhal Khaoula
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- Bowling Kirk
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- Bratu Matei
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- Breaud Jean
- Breistrand Michaela
- Breslin Ryan
- Brincat Svetlana Doris
- Broch Aline
- Brunoni Beatrice
- Bsisu Isam
- Bucci Luigi
- Buisson Philippe
- Bunting David
- Burger Sule
- Burmistrovas Andrius
- Bustangi Nasir
- Bustangi Nasir
- Butt Muhammad Talha
- Cakaloglu Haluk Cem
- Caliman Celeste
- Callan Rory
- Camilleri Georgette Marie
- Camilleri-Brennan Julian
- Campagnaro Tommaso
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- Capito Carmen
- Carabott Kurt
- Carmela Lapitan Marie
- Carmona Juan Manuel
- Carpio Juan
- Carrasco Nahilia
- Cassar Kristina
- Catani Marco
- Cautiero Roberto
- Caydiid Hanaan
- Cecilia Tolg
- Celik Saban
- Cengiz Turgut Bora
- Cengiz Yucel
- Cengiz Yucel
- Cevik Muazzez
- Chabok Abbas
- Chai Chu-Ann
- Chai Feng Yih
- Chan Luke
- Chan Tsz-Yan Katie
- Chan Xue Wei
- Charles Angeline
- Cheah Alvin Ee Zhiun
- Chen Kar Yan
- Chen Tzu-Ling
- Cheong Yih Jeng
- Chetta Nicola
- Cheung Yuk Hong Eric
- Chibuye Chali
- Chiesa Deborah
- Chilton Gareth
- Chin Pui Xin
- Chin Ye Ru
- Chiu Seehui
- Choi Philip
- Chong Choon Seng
- Chong Hoong-Yin
- Choudhry Asad
- Chow Crystal Yern Nee
- Chowdhury Debkumar
- Chu Kathryn
- Chung Kuet Jun
- Chungui Bravo Jorge Armando
- Ciccioli Eleonora
- Ciubotaru Cezar
- Claire Raquillet
- Clarissa Audrey
- Clegg-Lampety Joe-Nat
- Clegg-Lamptey Joe-Nat
- Clerico Giuseppe
- Coccolini Federico
- Coccolini Federico
- Cocorullo Gianfranco
- Cohen Fraser
- Cole Simon
- Coletta Diego
- Coletti Massimo
- Collaborative GlobalSurg
- Cona Camilla
- Conci Simone
- Confalonieri Gianmaria
- Conlon Kevin C
- Connor Katie
- Contreras Elisa
- Coompson Christian Lari
- Corbellini Carlo
- Corbellino Mario
- Cornick Jen
- Coronel Jazmin
- Corral Moreno Sara
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- Costa Cecilia
- Costa-Maia Jose
- Costas-Chavarri Ainhoa
- Courboin Etienne
- Cox Daniel
- Cox Michael
- Coyoy-Gaitan Otto
- Craus-Miguel Andrea
- Cullen Fraser
- Curletti Gianluca
- Currow Chelise
- D'Amours Scott
- D'Souza Michelle S
- Dabboor Majd
- Dabbour Kareem
- Dagoe Enoch
- Dahy Ahmed
- Dainius Edvinas
- Dakubo Jonathan
- Dalli Jeffrey
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- Daniyan Muhammad
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- Darwish Abdelrhman KZ
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- Davor Anthony
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- Dayie Makafui
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- Deal Rebecca
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- Domini Edgar
- Donnelly Philippa
- Dorani Radin Mohd Nurrahman Radin
- Dorisme Asnel
- Dossou Francis
- Dousset Bertrand
- Dragatas Deividas
- Drake Thomas M
- Drake Thomas M
- Drungilas Mantas
- du Plooy Flip
- Du Toit Frederick
- Duane Therese
- Duinhouwer Lucia
- Dulskas Audrius
- Ebidy Mai
- Ebidy Mai Mohamed
- Eid Mostafa Mahmoud
- El Dahab Ali Abo
- El Gendy Noran Halim
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- El Kashash Ahmed
- El Sayed Islam Magdy
- El-Dien Khalid Salah
- El-Din Reham Alaa
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- El-Gizawy Esraa
- El-Sagheer Nada
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- Elashry Rehab
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- Eldin Mostafa Ahmed Bahaa
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- Elfouly Nesma
- Elfouly Yasmin
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- Elgheriany Mohammed
- Elhadad Alaa
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- Elhadry Shady
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- Elhamouly Sara
- Elhelbawy Mohamed Salah
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- Ellison Quinn
- Elmashala Amjad
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- Elnagar Ahmedglal
- Elnajjar Mahmoud A
- Elrazek Aly Abd
- Elsabbagh Nourhan
- Elsameea Ahmed Abd
- Elsawy Amira
- Elsayed Nada Ahmed Reda
- Elsemelawy Rofida
- Elshaar Mohammed
- Elshaer Mohamed
- Elshami Mohamedraed
- Elsharkawy Aya Adel
- Elsherbiney Saged
- Elsherif Fawzia Abdellatif
- Elwy Eman
- Elzahed Nada
- Emadeldin Hossam
- Emara Eman
- Emile Sameh
- Eng Calvin
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- Esam Abeer
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- Espinoza Fernando
- Essam AA
- Essam Ahmed
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- Etienne Sara
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- Evans Elizabeth
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- Falco Nicolo
- Falzon Malcolm
- Farag Ahmed
- Farag Sameh
- Farahat Mahitab Morsy
- Fares Mohamed
- Farhan-Alanie Muhamed MH
- Farhangmehr Neda
- Farouk Sara Amr Mohamed
- Farrugia Alexia
- Farrugia Alexia
- Faruq Amreen
- Fathy Aya Mohamed
- Fatuga Adedeji
- Faturoti Olubukola
- Favero Alessandro
- Feidantsis Thomas
- Fergany Alaa
- Fergusson Stuart J
- Fergusson Stuart J
- Fermani Claudio Gabriel
- Fernandes Cristina
- Fernandez Carmen
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- Ferousis Christoforos
- Ferrero Esther
- Filatau Aliaksandr
- Firdouse Mohammed
- Firdouse Mohammed
- Firwana Aya
- Fitsum Agazi
- Fitzgerald J Edward
- Fitzgerald J Edward
- Florez Farfan Erick Samuel
- Foco Maurizio
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- Gaafar Shireen
- Gaarder Tina
- Gad Ahmed
- Gad Mariam O
- Gadelkarim Mohamed
- Gado Ammar
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- Galiqi Gezim
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- Haraux Elodie
- Harrison Ewen M
- Harrison Ewen M
- Harrison Ewen M
- Hartford Leila
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- Ulusahin Mehmet
- Upadhyaya Vijaid
- Urbonas Tomas
- Urniezius Zigmantas
- Uscinas Laimonas
- Uzabumwana Norbert
- Vaicius Arturas
- Valcarcel-Saldana Maria
- Valioulis Ioannis
- Van Der Naald Niels
- Van Niekerk Michael
- Van Straten Stephanie
- Vargas Marvin
- Vartanoglu Talar
- Vartic Mihaela
- Vasquez Giorgio
- Vasquez Idelso
- Veen Torhild
- Velasquez Ricardo
- Venclauskas Linas
- Vendramin Elena
- Venskutonis Donatas
- Venskutonis Donatas
- Verbeek Anna
- Vergara Mejia Angelica Genoveva
- Verjee Azmina
- Vermaas Maarten
- Vicario Erika
- Vicenta Collado Maria
- Vida Lucian Corneliu
- Vilcinskas Mantas
- Villalobos Santiago
- Violi Paola
- Visinskas Petras
- Voulgaris Evangelos
- Wael Noha
- Wakefield Rebecca
- Waledziak Maciej
- Walker Michael
- Walker Nathan
- Walls Luke
- Walsh Michael
- Waqar Muhammad
- Warren Oliver
- Waterman Ade
- Werder Gabriela
- Whitaker John
- White Rebecca
- Whitehurst Katharine
- Wiborg Joachim
- Widiastini T Ariani
- Widmer Lukas Werner
- Wijayarathna LS
- Williams Omolara
- Wilson Ling
- Wilson Michael
- Wilson Michael
- Wimalge PMSN
- Wogensen Fredrik
- Wolf Bernhard
- Wondoh Paul
- Wondoh Paul
- Wong Chui Yee
- Wong Francisca
- Wong Hong Yee
- Wood Greta
- Worku Mengistu
- Worku Tewodros
- Wright Naomi
- Yahaya Muhammad Taqiyuddin
- Yakubu Musah
- Yam Sir Young
- Yang James
- Yap Suhhuey
- Yau Jih Dar
- Ye Joselyn
- Yeang Li Jing
- Yeung Man Hon Andrew
- Yifieyeh Abiboye
- Yildirim Reyyan
- Yip Chingwan
- Ymeri Shpetim
- Yoganathan Pigeneswaren
- Yolcu Sinem
- Yong Guo Liang
- Younis Abobaker
- Youssef Mohamed
- Yuksek Mahmut Arif
- Yusufali Taha
- Zaa'treh Rula
- Zadoroznas Antanas
- Zahran Diaaaldin
- Zakaria Esraay
- Zakaria Mahmoud
- Zakaria Yehia
- Zaki Ahmed
- Zammit Stefan
- Zampitis Nikolaos
- Zani Augusto
- Zani Augusto
- Zanini Nicola
- Zapata Felipe
- Zarb Ciskje
- Zeta Solis Ludwing Alexander
- Zielinski Martin
- Zilinskas Justas
- Zilinskas Justas
- Zilinskas Justas
- Zilinskiene Reda
- Ziubryte Greta
- Zohair Ahmed
- Zuber Markus
- Zuk Grzegorz
- Zulkifli Athirah
- Zumbuhl Lucius
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2018
- Field of study
Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.
Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.
Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001).
Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication
Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study
- Author
- Abduljalal Maryam
- Abdullaev Alisher A.
- Abdullaeva Guzal J.
- Abifadel Marianne
- Acevedo Rivera Karina J.
- Adamidis Petros-Spyridon
- Aguilar Humberto Garcia
- Aguilar-Salinas Carlos A.
- Al-Khateeb Alyaa
- Al-Rasadi Khalid
- Al-Sarraf Ahmad
- Al-Sayed Nasreen
- Alammari Dalal
- Alareedh Mohammed
- Alcala Hector Garcia
- Alfil Sarmad
- Alhabib Khalid
- Alieva Rano B.
- Alkhnifsawi Mutaz
- Almahmeed Wael
- Almeida Ana Filipa
- Alnouri Fahad
- Alonso Rodrigo
- Alrowaily Nawal Lafi
- Alsahari Atif
- Alvarado Rocio Martinez
- Alvarez Jose A.
- Alves Ana Catarina
- Amezcua Martinez Jose C.
- Anagnostis Panagiotis
- Anastasiou Georgia
- Antonio-Villa Neftali Eduardo
- Antza Christina
- Aouchiche Karine
- Aparicio Berenice Pe~na
- Arca Marcello
- Arjona Villica~na Ruy D.
- Arriaga Cazares Hector E.
- Ashavaid Tester F.
- Ates Sara
- Attilakos Achilleas
- Averna Maurizio
- Ayoub Carine
- Balligand Jean-Luc
- Banach Maciej
- Barrera Bustillo Manuel de los Reyes
- Bartkova Ivana
- Batool Hijab
- Battelino Tadej
- Baumgartner-Kaut Margot
- Bañares Virginia
- Bendary Ahmed
- Benn Marianne
- Benso Andrea
- Berteotti Martina
- Bertolini Stefano
- Bielecka-Dąbrowa Agata
- Bilhoto Carla
- Binder Christoph
- Biolo Gianni Biolo
- Bizjan Barbara Jenko
- Blom Dirk
- Boccara Franck
- Bogsrud Martin P.
- Bonanni Luca
- Borghi Claudio
- Borowiec-Wolna Justyna
- Bossi Antonio Carlo
- Bourbon Mafalda
- Branchi Adriana
- Brandts Julia M.
- Bruckert Eric
- Brunham Liam
- Buganova Ingrid
- Buonuomo Paola Sabrina
- Buresova Kristyna
- Béliard Sophie
- Calabrò Paolo
- Calandra Sebastiano
- Capra Maria Elena
- Cariou Bertrand
- Carrera Ricardo Allende
- Carrié Alain
- Casula Manuela
- Catapano Alberico L.
- Cavallaro Raimondo
- Cefalù Angelo Baldassare
- Cepova Jana
- Chacon Roberto Contreras
- Charrières Sybil
- Chlebus Izabela
- Chlebus Krzysztof
- Chmara Magdalena
- Chua Yung-An
- Cipollone Francesco
- Citroni Nadia
- Coelho Raquel
- Cohen Hofit
- Cooremans Elizabeth Ramirez
- Corral Pablo
- Correia Susana
- Cottin Yves
- Cruz Diogo
- Cuevas Ada
- Dalal Jamshed J.
- Davletov Kairat
- de Andrés Raimundo
- de Gier Charlotte
- De los Rios Ibarra Manuel O.
- Debeljak Marusa
- Debreova Marianna
- Del Ben Maria
- Deltas Constantinos
- Demeure Fabian
- Descamps Olivier S.
- Dharmayat Kanika Inamdar
- Di Filippo Mathilde
- Dieplinger Hans
- Do Doan-Loi
- Dominguez Guadalupe Jimenez
- Doumas Michalis
- Dourmap Caroline
- Drogari Euridiki
- Durlach Vincent
- Durst Ronen
- Dvorakova Jana
- Dwiputra Bambang
- Díaz-Díaz Jose Luis
- Elbahry Atef
- Elias-Lopez Daniel
- Encinas Bethsabel Rodriguez
- Ezhov Marat V.
- Fabryova Lubomira
- Farnier Michel
- Federici Massimo
- Ferreira Patrícia
- Ferreira-Hermosillo Aldo
- Ferri Claudio
- Ferrieres Dorota
- Ferrières Jean
- Figueroa Andrade Mario H.
- Filippatos Theodosios
- Fiorenza Anna Maria
- Fortunato Giuliana
- Fozilov Khurshid G.
- Freiberger Tomas
- Fuentes-Jiménez Francisco
- Futema Marta
- Gach Agnieszka
- Gaita Dan
- Galema-Boers Annette
- Galimberti Federica
- Gallo Antonio
- Gama Guida
- Ganokroj Poranee
- Garcia de Leon Laura E.
- Garcia Alinna Y. Ruiz
- Garcia Anell Hernandez
- Garcia Paula
- Gardu~no Garcia Jose J.
- Garnica Cuellar Juan C.
- Garoufi Anastasia
- Gaudet Daniel
- Gazzotti Marta
- Genest Jacques
- Georgiou Anthoula
- Ghaleb Youmna
- Gilis-Malinowska Natasza
- Giorgino Francesco
- Gomez Cruz Jose R.
- Gomez Herrera Laura G.
- Gonova Katarina
- Gonzalez Gonzalez Jesus R.
- Gonzalez Perla A. Carrillo
- Goudev Assen
- Greber-Platzer Susanne
- Groselj Urh
- Guardamagna Ornella
- Guerra António
- Guzman Berenice Garcia
- Hankard Regis
- Harada-Shiba Mariko
- Harangi Mariann
- Hegele Robert A
- Hellmann Marcin
- Hennig Matylda
- Herrera Ursulo Juarez
- Holguin Almada Jesus R.
- Holven Kirsten B.
- Hosseini Susan
- Hovingh G. Kees
- Humphries Steve E.
- Huong Truong Thanh
- Hyanek Josef
- Höllerl Florian
- Iacovides Paris
- Iannuzzo Gabriella
- Innerhofer Reinhold
- Ioannou Andreas
- Iughetti Lorenzo
- Jambart Selim
- Jamialahmadi Tannaz
- Jesina Pavel
- Jóźwiak Jacek
- Kadir Siti Hamimah Sheikh Abdul
- Kadurova Michaela
- Kan Liliya E.
- Karall Daniela
- Kareem Huda
- Kasim Noor Alicezah Mohd
- Kayikcioglu Meral
- Khan Sabeen Abid
- Khoshimov Shavkat U.
- Khovidhunkit Weerapan
- Khudary Alia Abdullah
- Kim Ngoc-Thanh
- Kiouri Estela
- Klabnik Alexander
- Kleinschmidt Mariola
- Kolovou Genovefa
- Kolovou Vana
- Konopka Agnieszka
- Kostis Andreas
- Kotsis Vasileios
- Koumaras Charalambos
- Koutagiar Iosif
- Kovac Jernej
- Kozárová Miriam
- Lalic Katarina
- Lalic Nebojsa M.
- Lamari Frida
- Lambadiari Vaia
- Latif Ahmad Zubaidi Abd
- Latkovskis Gustavs
- Laufs Ulrich
- Le Hong-An
- Le Thanh-Tung
- Leitersdorf Eran
- Lemale Julie
- Lewek Joanna
- Lia Salvatore
- Liamis George
- Liberopoulos Evangelos
- Lima-Martinez Marcos Miguel
- Lin Jie
- Lischka Julia
- Lobarinhas Goreti
- Lopes Andreia
- Lopez Humberto Alvares
- Ludvik Bernhard
- Lupi Alessandro
- Lyons Alexander R. M.
- Macias Jose J. Ceballos
- Maher Vincent
- Mahfouz Linda
- Malik Munir
- Maly Jan
- Mandraffino Giuseppe
- Marais A. David
- Maroni Lorenzo
- Martagon Alexandro J.
- Masuda Daisaku
- Mata Pedro
- Matos Luísa Diogo
- Mawlawi Horia Ahmed
- McCrindle Brian
- Medeiros Ana Margarida
- Medrano Rodriguez Alma B.
- Mehta Roopa
- Mendez Valencia Carla V.
- Mertens Ann
- Michalska-Grzonkowska Aleksandra
- Milionis Haralambos
- Miltiadous George
- Minicocci Ilenia
- Mirrakhimov Erkin
- Miserez André R.
- Miserez Eleonore B.
- Mitchenko Olena
- Mlinaric Matej
- Moffa Simona
- Molk Neza
- Mollaki Vicky
- Mombelli Giuliana
- Morales Oyervides Jose C.
- Moulin Philippe
- Moura Márcio de
- Mourre Florian
- Mouzarou Angeliki
- Muntoni Sandro
- Muñiz-Grijalvo Ovidio
- Myśliwiec Małgorzata
- März Winfried
- Mäser Martin
- Nascimbeni Fabio
- Nawawi Hapizah
- Nazli Sukma Azureen
- Nguyen Mai-Ngoc-Thi
- Nikolov Fedya
- Nizamov Ulugbek I.
- Nociar Jan
- Nor Noor Shafina Mohd
- Nordestgaard Børge G.
- Novodvorsky Peter
- Olmastroni Elena
- Ortega Ashanty Flores
- Osorio Ma. Ludivina Robles
- Padilla Padilla Francisco G.
- Paillard François
- Pais Patrícia
- Pajkowski Marcin
- Palma Isabel
- Panayiotou Andrie G.
- Paragh György
- Parati Gianfranco
- Parczewska Aleksandra
- Passaro Angelina
- Pecchioli Valerio
- Pederiva Cristina
- Pellegatta Fabio
- Peng Fabian Kok
- Peretti Noel
- Perez Vazquez Daniel I.
- Perica Dražen
- Petakov Ana
- Petrov Ivo
- Petrulioniene Zaneta
- Pipek Michal
- Pipolo Antonio
- Pirro Matteo
- Pisciotta Livia
- Pistkova Eva
- Podkrajsek Katarina Trebusak
- Pojskic Belma
- Polychronopoulos Georgios
- Ponde Chandrashekhar K.
- Popovic Ljiljana
- Portano Julieta D. Morales
- Portilla Nacu Caracas
- Postadzhiyan Arman
- Potočňáková Ludmila
- Pradignac Alain
- Prado Ramon Madriz
- Proyias Pavlos
- Pujia Arturo
- Raal Frederick
- Rabès Jean-Pierre
- Rajkovic Natasa
- Rallidis Loukianos
- Ramaswami Uma
- Ramirez Gabriela A. Galan
- Rana Muhammad Asim
- Ranai Norashikin Mohd
- Raslova Katarina
- Rasulic Iva
- Ray Kausik K.
- Razman Aimi Zafira
- Reda Ashraf
- Reddy Lakshmi Lavanya
- Reiner Željko
- Repetti Elena
- Retana Gustavo Gonzalez
- Reyes Rodriguez Eduardo A.
- Reyes Ximena
- Reynaud Rachel
- Rhadi Sabah Hasan
- Ribeiro Raquel
- Rinaldi Elisabetta
- Rizos Christos V.
- Rodriguez Eduardo Marquez
- Roeters van Lennep Jeanine
- Romanowska-Kocejko Marzena
- Ruel Isabelle
- Sadiq Fouzia
- Sadoh Wilson
- Sadykova Dinara
- Sahebkar Amirhossein
- Salgado José Miguel
- Sanin Veronika
- Santos Raul
- Sarzani Riccardo
- Saucedo Juan Rosas
- Sauque-Reyna Leobardo
- Sawhney Jitendra P. S.
- Sbrana Francesco
- Schiele François
- Schmieder Roland
- Scholl-Bürgi Sabine
- Schreier Laura
- Schunkert Heribert
- Schurr Daniel
- Scicali Roberto
- Sfikas George
- Shaghee Foaad
- Shah Saeedullah
- Shah Swarup A. V
- Shek Aleksandr B.
- Shipton Janine L.
- Shpitzen Shoshi
- Sibaja Cristina Martinez
- Sikonja Jaka
- Silva Francisco
- Simental Mendia Luis E.
- Simoneau Isabelle
- Simões Fernando
- Singh Sandra
- Skalidis Emmanouil
- Skoumas Ioannis
- Slastnikova Evgenia
- Sobrevilla Fabiola Lugo
- Sokal Etienne
- Soran Handrean
- Spenerova Michaela
- Stabouli Stella
- Starostecka Ewa
- Stephenne Xavier
- Stevens Christophe A. T.
- Stroes Eric
- Stróżyk Aneta
- Stylianou Andreas
- Su Ta-Chen
- Subramaniam Tavintharan
- Sultan Ariane
- Suppressa Patrizia
- Susekov Andrey
- Sustar Ursa
- Sykora Josef
- Symeonides Phivos
- S|ulakova Astrid
- Tamayo Margarita Torres
- Tarugi Patrizia
- Tavares Mónica
- Thajer Alexandra
- Thushara Matthias Anne
- Tichy Lukas
- Tilney Myra
- Tisheva Snejana
- Tomlinson Brian
- Toplak Hermann
- Torres María Teresa Magaña
- Toukalkova Lenka
- Tounian Patrick
- Trenti Chiara
- Trogkanis Efstratios
- Tsaroumi Anastasia
- Tselepis Alexandros D.
- Tybjærg-Hansen Anne
- Tziomalos Konstantinos
- Tzvetkov Ivajlo
- Urbanova Zuzana
- Valdez Talavera Luis A.
- Valero René
- Vallejo-Vaz Antonio J.
- Varga Tibor
- Vargas Gonzalo Carazo
- Vargas-Vazquez Arsenio
- Vasanwala Rashida Farhan
- Venkatesh Sreedharan Aravind
- Vera Arroyo Luis E.
- Verges Bruno
- Verma Ishwar C.
- Viigimaa Margus
- Virtuoso Maria João
- Vohnout Branislav
- Vrablik Michal
- Vázquez Cárdenas Alejandra
- Wang Luya
- Wasąg Bartosz
- Watts Gerald F.
- Weigman Albert
- Werba José Pablo
- Wojtecka Agnieszka
- Yamashita Shizuya
- Yelnik Cecile
- Yotov Yoto
- Zacharis Evangelos
- Zakirova Daria V.
- Zambon Alberto
- Zazueta Alejandro Romero
- Zdrojewski Tomasz
- Zenti Maria Grazia
- Zepeda Carrillo Eloy A.
- Zubieta Victoria Mendoza
- Šaligova Jana
- Żarczyńska-Buchowiecka Marta
- Publication venue
- Publication date
- 12/12/2023
- Field of study
Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life
Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy
- Author
- Abdallah J
- Abdul Ghani R
- Abdul Kadir K
- Abdullah R
- Abejuela Z
- Abouglila K
- Abraham O
- Abrahamsen I
- Abraira Munoz Ld
- Abramowitz M
- Abusnana S
- Accini Mendoza Jl
- Acosta I
- Agafyina A
- Agarwal R
- Agarwal Rajiv
- Aggarwal N
- Agra J
- Ahmed F
- Ahuad Guerrero Ra
- Aiello J
- Ainsworth P
- Aizenberg D
- Akiyama H
- Akright L
- Akyea-Djamson A
- Al-Karadsheh A
- Alamartine E
- Alappan R
- Albisu Jp
- Ali N
- Ali Z
- Alicic R
- Allison Dc
- Alvarez Garcia P
- Alvarisqueta A
- Alves da Costa Fa
- Amerena J
- Amigo A
- Amodeo C
- Andreeva V
- Andreotti Turatti La
- Angelescu Lm
- Angelova A
- Anghel V
- Antic S
- Aoki H
- Aquitania G
- Arauz-Pacheco C
- Arcos E
- Arfeen S
- Arif A
- Aronson R
- Arutchelvam V
- Arvind M
- Asano A
- Asmarats Mercadal L
- Atray N
- August P
- Avendano J
- Avram Ri
- Awad A
- Babikova J
- Badat A
- Bajaj H
- Baker J
- Bakris G
- Bakris George
- Barbarash O
- Barna O
- Barnard M
- Barnhill P
- Barranco E
- Barrera C
- Barrios C
- Bartaskova D
- Bartolacci I
- Barton P
- Barysheva O
- Beacom M
- Behara V
- Bellary S
- Belo D
- Belobradkova J
- Bentley-Lewis R
- Benusova O
- Berenguer R
- Berli Ma
- Bermudez L
- Bernardo M
- Bhushan Rs
- Bijata-Bronisz R
- Bilyk Sd
- Bin Shudim Ss
- Biscoveanu M
- Bompoint Severine
- Bonadonna R
- Bordonava A
- Borot S
- Botsyurko V
- Bowman-Stroud C
- Brandon D
- Breedt J
- Bregman R
- Brenner Barry M
- Brenner Bm
- Brusco O
- Buganova I
- Bull Scott
- Burst V
- Busch R
- Busegeanu Mm
- Calella P
- Camelo Sanches Fc
- Canaan Y
- Canani Lh
- Cannon Christopher P
- Cannon Cp
- Cantero Mc
- Capuano George
- Caringal C
- Cariou B
- Cartasegna Lr
- Castellino P
- Cercos E
- Cereto Castro F
- Ceriello A
- Chacra Ar
- Chae Dw
- Chang Ct
- Chang T
- Chapin L
- Charytan David M
- Charytan Dm
- Che Yusof Md
- Cheifetz A
- Chen E
- Chen N
- Chen Q
- Cherney D 3rd
- Chertow G
- Cheung Nw
- Chilito A
- Chiovato L
- Chizhov D
- Cho Ym
- Chouinard G
- Christensen T
- Christiano C
- Christofides E
- Chu Pei-Ling
- Chuang Lm
- Chuateco C
- Cif A
- Cigarran Guldris S
- Coffee L
- Cohen K
- Cohen R
- Cohen S
- Cohen-Stein D
- Coloma Gc
- Colombo H
- Comia Rs
- Commendatore V
- Conway J
- Cook C
- Correa Rotter Jr
- Cosma D
- Cournoyer S
- Coyne D
- Crisan C
- Cruz Jb
- Csecsei G
- Csiky B
- Cuadrado J
- Culak J
- Cuneo Ca
- Cunha Borges Jl
- Cunha V\ueancio Sa
- Cusumano Am
- D'Avila D
- da Silva Franco Rj
- Daboul N
- Danos P
- Daroza G
- Darwish R
- Daswani A
- David C
- Davies E
- Davies M
- Davies S
- Dawson A
- De Brouwer K
- de Carvalho Contieri Fl
- De Cosmo S
- De Nicola L
- De Serres S
- de Souza Portes E
- de Souza P
- de Zeeuw D
- de Zeeuw Dick
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- Zinman Bernard
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- Publication venue
- 'Massachusetts Medical Society'
- Publication date
- 01/01/2019
- Field of study
BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to 300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m 2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years
Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).
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- A'Court C.
- Aaroe H.
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- Abdalla Saad J.
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- Abdelrahman H.
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- Abe M. (Masatake)
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- Accetta Gabriele
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- Zyczynska-Szmon M.
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2018
- Field of study
Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)
Canagliflozin and renal outcomes in type 2 diabetes and nephropathy
- Author
- A Kaldun Nossuli
- Aamir Jamal
- Adalbert Schiller
- Adam Cheifetz
- Adarsh Daswani
- Adeera Levin
- Adline Ghazi
- Adrian Guinsburg
- Adriana Cif
- Adriana Gabriela Onaca
- Adriana Ilavska
- Adriana Villarino
- Agarwal R.
- Agnieszka Starzec
- Ahmed Arif
- Ahmed Awad
- Aiping Yin
- Akimichi Asano
- Alan Jackson
- Alan McMahon
- Alan Perlman
- Alberto Di Carlo
- Alberto Esquenazi
- Alejandra Oviedo
- Alejandro Valdes Depeda
- Aleksandra Kendereski
- Alex Valenzuela
- Alexander Dreval
- Alexander Gonzalez
- Alexander Shinkov
- Alexander Turchin
- Alexandre Klein
- Alfonso Soto Gonzalez
- Alfred Penfornis
- Alfredo Chew Wong
- Alfredo Wassermann
- Ali Torshizi
- Alicia Chilito
- Alina Agafyina
- Alison Dawson
- Alva Hansraj
- Amer Al-Karadsheh
- Amorin Remus Popa
- Amrendra Kumar
- Amy Sprague
- Ana Limos
- Ana Maria Cusumano
- Ana Maria Elosegui
- Anabella Amigo
- Anatoliy Kazmirchuk
- Andrea Phillips
- Andrea Stella
- Andreas Maddux
- Andrej Dzupina
- Andres Alvarisqueta
- Andrew Johnson
- Andrew O'Shaughnessy
- Andrew Steele
- Andrian Yakov
- Andrzej Januszewicz
- Andrzej Madej
- Angelina Angelova
- Anibal Gastaldi
- Anil Gupta
- Anita Bhajan Manocha
- Anjanette Tan
- Anna Kaminska
- Anna Maria Veronelli
- Anna Strzelecka
- Anna Zateyshchikova
- Anselmo Bordonava
- Antanas Navickas
- Anthony Gunstone
- Anthony Roberts
- Antonio Ceriello
- Antonio Galan Serrano
- Antonio Scafuto Scotton
- Antonio Terrelonge
- Antônio Roberto Chacra
- Anupama Gowda
- Arjun D Sinha
- Armando Perez
- Ashot Mkrtumyan
- Atanas Koundurdjiev
- Augusto Vallejos
- Aurelian-Emil Ranetti
- Ayim Akyea-Djamson
- Aysha Badat
- Bakris G.
- Baldev Singh
- Barbara Greco
- Barbara Kaczmarek
- Barbara Rewerska
- Barry M Brenner
- Belia Martin Del Camp Blanco
- Bernard Zinman
- Bertrand Cariou
- Bertrand Dussol
- Bhasker Mehta
- Bhimavarapu Sudhakar
- Björn Paschen
- Bompoint S.
- Borys Mankovskyy
- Botond Csiky
- Boyan Nonchev
- Brenner B. M.
- Brett Kissela
- Brian Nichol
- Bruce Neal
- Bruce Trippe
- Bruno Geloneze Neto
- Bull S.
- Byung-Wan Lee
- C B Keshavamurthy
- Cannon C. P.
- Capuano G.
- Carlo Giorda
- Carlos Alberto Cuneo
- Carlos Arauz-Pacheco
- Carlos Barrera
- Carlos Perez
- Carmel Hawley
- Carmen Crisan
- Carol Pollock
- Carolyn Droste
- Caroucel Chuateco
- Caryl David
- Cecilia Garcia Ballesteros
- Cecilia Jimeno
- Celso Amodeo
- Cesar Javier Zaidman
- Cesar Yoiti Hayashida
- Chamberlain Obialo
- Chang-Hsun Hsieh
- Charles Cook
- Charles Kaupke
- Charytan D. M.
- Chek Loong Loh
- Chen Leia
- Cheol-Young Park
- Chih-Ching Lin
- Christopher P Cannon
- Christy Yao
- Chu P. -L.
- Chwen-Tzuei Chang
- Chye Lee Gan
- Clara Barrios
- Claude Galphin
- Claudia Goycoa
- Claudia Moreira de Brito
- Clodoaido Caringal
- Cristian Serafinceanu
- Cristina Toarba
- Cristobal Morales Portillo
- Csaba Kovesdy
- Cynthia Bowman-Stroud
- Cynthia Christiano
- Cynthia Mustieles Rocha
- Cyrus Desouza
- Cássio Slompo Ramos
- Dagmar Bartaskova
- Dale Crawford Allison
- Dalia Kozloviene
- Dan Scharfstein
- Dana Cosma
- Daniel Coyne
- Daniel Hiser
- Daniel Kolansky
- Daniel Panarotto
- Daniel Pella
- Daniel Weiner
- Daniil Chizhov
- Dariusz Sowinski
- Darren K McGuire
- Davesh Sennik
- David C Wheeler
- David Cherney 3rd
- David Gorson
- David Johnson
- David M Charytan
- David Packham
- David Scott
- David Wheeler
- De Zeeuw D.
- Debbie Cohen-Stein
- Debbie Mascaro
- Deepak Koppolu
- Dennis Levinson
- Derek Lewis
- Detian Li
- Devasmita Dev
- Devesh Patel
- Dewan Deepak
- Dick de Zeeuw
- Diego Aizenberg
- Dinesh Jain
- Dinesh Khullar
- Diogo Belo
- Dmitry Zateyshshikov
- Domenico Santoro
- Domingos d'Avila
- Donald Brandon
- Donald Fraser
- Dong-Wan Chae
- Dora Inés Molina de Salazar
- Dorota Mlodawska-Choluj
- Doru Negru
- Edgar Arcos
- Edoardo Mannucci
- Eduardo Farias
- Edward Watson
- Edwards R.
- Egle Gaupsiene
- Egle Urbanaviciene
- Ekaterina Velichkova
- Elena Christofides
- Elena Grineva
- Elena Kolmakova
- Elena Shutemova
- Eleonora Harcsa
- Elizabeth Barranco
- Elizabeth Gelersztein
- Elizabeth Kern
- Elizete Keitel
- Eloisa Tellez Chavez
- Emanuela Orsi
- Emil Martinka
- Emyr Davies
- Enrique Gonzalez
- Eric Alamartine
- Eric Hernandez Triana
- Eric Thervet
- Erick Turcios Juarez
- Esteban Cercos
- Eugenia Galindo-Ramos
- Eva Peterfai
- Evaly Chen
- Evandro de Souza Portes
- Evgueniy Vazelov
- Fabian Otreras
- Fabiana Loss de Carvalho Contieri
- Fabio Malberti
- Fadi Saba
- Fadlo Fraige Filho
- Favio Edmundo Enriquez Sosa
- Fayzal Ahmed
- Ferdinando Carlo Sasso
- Fernanco Augusto Alves da Costa
- Fernanda Cristina Camelo Sanches
- Fernando Cereto Castro
- Fernando Flores Lozano
- Fernando Jimenez Florez
- Fernando Krynski
- Fernando M Edwin
- Fernando Thomé
- Fernando Trespalacios
- Florence Santos
- Florencia Kraft
- Fracisco Javier Gonzalez Martinez
- Fran Morren
- Franciso Jose Tinahones Madueno
- Frank Eder
- Franklin Joseph
- Franklin Paul Haase
- Frantisek Saudek
- François Dubé
- François Madore
- Freemu Varghese
- Gabriela Cecilia Coloma
- Gabriela Genova-Hristova
- Gabriele von Ingersleben
- Gaetano Serviddio
- Galina Nagibovich
- Gary Meininger
- Gema Fernandez Fresnedo
- Georg Plassmann
- George Bakris
- George Hon
- George Newman
- Gerald DaRoza
- Gerald Keightley
- Gerry Tan
- Giacomo Garibotto
- Giorgio Fuiano
- Giovanni Frascà
- Giovanni Gambaro
- Giuseppe Derosa
- Gizella Petro
- Glenn Chertow
- Gnyandev Patel
- Godwin Simon
- Goga Vukotic
- Gopal Krishna
- Grace Aquitania
- Grace Lin
- Graham Hillis
- Graziano Di Cianni
- Grazyna Orlowska-Kowalik
- Grazyna Popenda
- Greene T.
- Greg Fulcher
- Gregorio Obrador
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- Grit Faulmann
- Guadalupe Morales Franco
- Guillermo Fragale
- Guixia Wang
- Gulam Latiff
- Gustavo Cristian Greloni
- Guy Chouinard
- Gyongyi Csecsei
- Gyorgy Paragh
- Halyna Tomashkevych
- Hans Prozesky
- Harpreet Bajaj
- Hasnain Khandwala
- Hector Rodriguez
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- Hiroko Oishi
- Hiromi Aoki
- Hiromi Rodriguez Pattzi
- Hiroshi Kono
- Hitoshi Akiyama
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- Hong Mao
- Hong Zhang
- Hongguang Zheng
- Hongli Lin
- Horacio Sessa
- Hugo Colombo
- Hugo Laviada Molina
- Hugo Roberto Kurtz Lisboa
- Humberto Pavon
- Hyuk-Sang Kwon
- Iain MacDougall
- Ian Fraser
- Idalia Acosta
- Ildiko Halmagyi
- In-Kyung Jeong
- Ines Bartolacci
- Ingrid Abrahamsen
- Ingrid Buganova
- Inna Kolesnyk
- Ioana Emilia Ferariu
- Irene Noronha
- Irina Glinkina
- Irina Osipova
- Iryna Dudar
- Isabel Erika Rucker Joerg
- Isabel Garcia
- Isam Marar
- Israel Hartman
- Iuliia Komisarenko
- Ivan Fushtey
- Ivan Ory
- Ivan Rychlik
- Ivan Rychlík
- Ivan Smirnov
- Ivan Topchii
- Ivan Villegas
- Iveta Smatanova
- Jaco Jurgens
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- Jamal Hammoud
- James Conway
- James Januzzi
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- Jana Babikova
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- Janos Mucsi
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- Javier Narvarte
- Javier Nieto Iglesias
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- Jean Carlo Tibes Hachmann
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- Jeevren Reddy
- Jeffrey Kropp
- Jeffrey Stephens
- Jeimeen Agra
- Jelena Ignjatovic
- Jesus Cuadrado
- Jesus Egido de Los Rios
- Jian Liu
- Jiao Sun
- Jinkui Yang
- Jiri Lastuvka
- Jiri Pumprla
- Joaquin Pablo Gonzalez
- Johannes Breedt
- John Amerena
- John Baker
- John Ervin
- John Evans
- John Lentz
- John Middleton
- John Padron
- John Sensenbrenner
- John Updegrove
- John Wakeling
- Jonay Pantoja Perez
- Jorge Archibaldo Glenny
- Jorge Avendano
- Jorge Ernesto Andres Diaz Ruiz
- Jorge Hector Resk
- Jorge Kusnir
- Jorge Mordujovich
- Jorgelina Sala
- Jose Antonio Sánchez Arenales
- Jose Chevaile Ramos
- Jose David Gomez Rangel
- Jose Esteban Jodar Gimeno
- Jose Francisco Kerr Saraiva
- Jose Hector Sanchez Mijangos
- Jose L Górriz
- Jose Luis Accini Mendoza
- Jose Ma Portoles Perez
- Jose Osvaldo Fretes
- Jose Ricardo Correa Rotter
- Joseph Abdallah
- Joseph Aiello
- Joseph Feuerstein
- Joseph O'Hare
- Joseph Proietto
- Josier Nisnisan
- José Vicente Sanchez Polo
- João Lindolfo Cunha Borges
- João Soares Felício
- Juan Alfredo Tamayo Y Orozco
- Juan Baas Cruz
- Juan Carlos Santos
- Juan Diego Higuera
- Juan Frias
- Juan Gonzalo Godoy Jorquera
- Juan Pablo Albisu
- Juan Pablo Moreira Diaz
- Juan Peralta Calcaneo
- Juan Rosas Guzman
- Juan Villagordoa Mesa
- JungEun Lee
- Kamal Abouglila
- Karel Peterka
- Karina Hufert
- Karlton Pettis
- Katalin Keltai
- Katalin Revesz
- Katarina Halciakova
- Katarina Lalic
- Kathy Nicholls
- Kati De Brouwer
- Kazuhiro Yanagida
- Kazunori Koyama
- Kazuyuki Mizuyama
- Kee Sing Ng
- Kenneth Cohen
- Kenneth Deck
- Kenneth Hershon
- Kenneth Liss
- Kenneth W Mahaffey
- Khalid Abdul Kadir
- Khurram Wadud
- Kim Travis
- Kiril Hristozov
- Kook-Hwan Oh
- Krisztian Kiss
- Kun Ho Yoon
- Lachezar Lozanov
- Lajos Major
- Lalaine Delos Santos
- Landman Lombard
- Larisha Pillay-Ramaya
- Larry Distiller
- Larysa Pererva
- Laszlo Deak
- Laszlo Konyves
- Laura Akright
- Laura Coffee
- Lawrence Distiller
- Lawrence Lehrner
- Lawrence Leiter
- Lech Lazuka
- Lee-Ming Chuang
- Lenka Dohnalova
- Leslie Spry
- Levin A.
- Li Yuan Lee
- Lidia Bermudez
- Ligia Petrica
- Lilia Beatriz Schiavi
- Liliana Monica Angelescu
- Liliia Zub
- Liliya Martynyuk
- Lin Sun
- Lincoln Chapin
- Linong Ji
- Lisa Rich
- Liudmila Kvitkova
- Lori Yost
- Luca Chiovato
- Luca De Nicola
- Luca Zanoli
- Lucas Rista
- Luciane Mônica Deboni
- Lucyna Hotlos
- Ludger Rose
- Luigi Gnudi
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- Luis Asmarats Mercadal
- Luis David Abraira Munoz
- Luis Enrique Herrera Jimenez
- Luis Fernando Flota Cervera
- Luis Henrique Canani
- Luis Hernando Garcia Ortiz
- Luis Isaias Juncos
- Luis Quesada-Suarez
- Luis Rodolfo Cartasegna
- Luis Valderrama Cometa
- Luis Venegas Carrillo
- Luiz Alberto Andreotti Turatti
- Luiza Despina Demian
- László Rosivall
- Ma Dovie Lallaine Ygpuara
- Mahaffey K. W.
- Manel Terns Riera
- Manish Saxena
- Manthi Hettiarachchi
- Manuel Muñoz Lopez Mendoza
- Manuel Muñoz Torres
- Manuela Schmidt
- Marc Rendell
- Marcel Twahirwa
- Marcelo Medina Fariña
- Marcora Mandreoli
- Marcus Gomes
- Margarita Temelkova
- Margarita Vejar
- Margit Mileder
- Margo Hudson
- Maria Antonia Munar Vila
- Maria Barnard
- Maria Cecilia Cantero
- Maria Florencia Fernandez
- Maria Isabel Klyver
- Maria Jaime
- Maria Rosa Ulla
- Maria Teresa Zanella
- Maria Valdez
- Marializa Bernardo
- Marianna Zsom
- Mario Alberto Berli
- Mario Burgos Soto
- Mark Davies
- Mark Vannorsdall
- Mark Warren
- Markus Faghih
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- Marta Dominquez Lopez
- Marta Molnar
- Martin Lukac
- Martin Valis
- Martine Destree
- Mary Anne Lim-Abrahan
- Mary Lawrence
- Mary Seeber
- Maryna Vlasenko
- María Alicia Fernández Montenegro
- María Angustias Quesada Simón
- Masahiko Takai
- Masahiro Koizumi
- Masakiyo Wakasugi
- Masayo Yamada
- Mastura Ismail
- Matthew Abramowitz
- Matthew Beacom
- Meg J Jardine
- Meg Jardine
- Meininger G.
- Melchor Alpizar Salazar
- Melemadathil Sreelatha
- Merce Perez Vera
- Mercedes Velo Plaza
- Michael Oliver
- Michael Robinson
- Michael Shanik
- Michael Thompson
- Michael Williams
- Michal Nowicki
- Michał Nowicki
- Michelle Zaniewski-Singh
- Mick Kumwenda
- Miguel Nazzer Hissa
- Migues Angel Reyes Rosano
- Mihaela Biscoveanu
- Mihaela-Magdalena Busegeanu
- Mihaly Dudas
- Milan Gupta
- Min Jeong Kwon
- Minara Shamkhalova
- Minghui Zhao
- Miodrag Djordjevic
- Mircea Munteanu
- Mitsuru Tsujimoto
- Mohamed El-Shahawy
- Mohamed Mookadam
- Mohamed Railey
- Mohamed Sekkarie
- Mohanram Narayanan
- Mohd Daud Che Yusof
- Mohsen El Kossi
- Mona Wahba
- Monica Alexandra Terront Lozano
- Monika Dhillon
- Moogali Arvind
- Moon-Kyu Lee
- Moon-Suk Nam
- Moustafa Moustafa
- Muhammad Shakeel
- Mukesh Joshi
- Mykola Kolesnyk
- Márcio Antônio Pereira
- Nadia Zalunardo
- Nadiya Tryshchuk
- Nan Chen
- Narayan Prasad
- Naresh Aggarwal
- Natalia Malaver
- Nataliia Pashkovska
- Natarajan Gopalakrishnan
- Navdeep Tangri
- Naveen Atray
- Neal B.
- Nebojsa Lalic
- Neil Kumar
- Nelson Kopyt
- Nelson Rodriguez Papini
- Nestor Horacio Garcia
- Ngai Wah Cheung
- Nicolae Hancu
- Nicole Li
- Nik Nur Fatnoon Nik Ahmad
- Nina Patel
- Nizar Daboul
- Noble Gracious
- Nomangesi Ngcakani
- Nonna Kravchun
- Nora Marchetta
- Norman Muirhead
- Norsiah Ali
- Oleg Legun
- Oleg Nagibovich
- Oleg Uriasyev
- Oleksandr Golovchenko
- Oleksandr Samoylov
- Oleksii Korzh
- Olga Barbarash
- Olga Barna
- Olga Barysheva
- Olga Benusova
- Olga Godlevska
- Olga Gyrina
- Olga Sazonova
- Olivert Gomez
- Oomman Abraham
- Osamu Tomonaga
- Oscar Tarsicio Moreno Loza
- Osvaldo Brusco
- Pablo Antonio Novoa
- Pablo Mele
- Pablo Raffaele
- Pablo Serrano Sanson
- Paranthaman Vengadasalam
- Patricia Del Carmen Gonzalez Colaso
- Patrick English
- Patrick Parfrey
- Paul Ainsworth
- Paul Frenk Baron
- Paul Nixon
- Paul Noonan
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- Paulina Virginia Lanchiotti
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- Perkovic V.
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- Peter Fulop
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- Petr Barton
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- Philip Home
- Philip Nicol
- Philippe Zaoui
- Phyllis August
- Piermarco Piatti
- Pierre Gourdy
- Pierre-Jean Saulnier
- Pietro Castellino
- Pilar Trueba
- Ping Tu
- Pollock C.
- Prasanth Surampudi
- Pusadee Suchinda
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- Rachel Bregman
- Radica Alicic
- Radu Jacob
- Rafael Simo Canonge
- Raied Abdullah
- Rajendran Alappan
- Rajiv Agarwal
- Rajiv Ranjan
- Raju Sree Bhushan
- Rakesh Gulati
- Rakhi Khanna
- Rallabhandi Sankaram
- Raman Purighalla
- Ramesh Chandra Vyasam
- Ramesh Thimmaiah
- Ramon Berenguer
- Ramon Moreda
- Rangel Rangelov
- Rao K Satyanarayana
- Ravendran Govender
- Ravi Sarin
- Reddy Sreedhar
- Reginald Parker
- Rehan Symonds
- Reinhold Jerwan-Keim
- Remi Rabasa-Lhoret
- Renan Montenegro Junior
- Renata Bijata-Bronisz
- Rhea Severina Comia
- Rhonda Bentley-Lewis
- Riad Darwish
- Ricardo Alfonso Leon de la Fuente
- Ricardo Dario Dran
- Ricardo Rosero
- Riccardo Bonadonna
- Richard Ferkl
- Richard Kovar
- Richard Lindley
- Richard Orozco Castellanos
- Richard Solomon
- Robert Busch
- Robert Cohen
- Robert Schreiman
- Robert Takacs
- Robert Walker
- Roberto Abrão Raduan
- Roberto Jorge da Silva Franco
- Roberto Pecoits Filho
- Roberto Pecoits-Filho
- Roberto Simões de Almeida
- Roberto Trevisan
- Rodica-Ioana Avram
- Rodolfo Andres Ahuad Guerrero
- Rohana Abdul Ghani
- Rohit Pankhaniya
- Rolando Zamarripa Escobedo
- Ronald Goldenberg
- Ronald Harris
- Ronald Watts
- Ronaldo Arturo Gonzalez Orellana
- Ronan Roussel
- Ronnie Aronson
- Rosa Isela Luna Ceballos
- Rosângela Milagres
- Ruben Dario Vargas Alonso
- Rury Holman
- Russell Scott
- Sacha De Serres
- Sahay Manisha
- Saiful Shahrizal Bin Shudim
- Sailaja Ventrapragada
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- Salvatore De Cosmo
- Sam Henein
- Sam Philip
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- Samy Hadjadj
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- Sanjeev Rastogi
- Sara Jaffer
- Sarah Olelewe
- Satoshi Ota
- Satu Pesickova
- Scott Kasner
- Secundino Cigarran Guldris
- Senan Sultan
- Serge Cournoyer
- Sergei Nedogoda
- Sergey Vorobyev
- Sergio Saul Irizar Santana
- Shahabul Arfeen
- Shahnaz Shahinfar
- Shang-Jyh Hwang
- Shelley Williams
- Shenaz Ramtoola
- Shenglian Gan
- Sherry Sussman
- Shizuo Kajiyama
- Shozo Miyauchi
- Silvia Ines Orio
- Silvia Nicolai
- Simon Davies
- Simon Roger
- Simon Young
- Sin Gon Kim
- Singhan Krishnan
- Sini George
- Slobodan Antic
- Sohan Dua
- Sonia Hermida
- Soo Kun Lim
- Sophie Borot
- Souhila Ounadjela
- Sreedhar Mandayam
- Srikanth Bellary
- Stanislav Zemek
- Stanislaw Mazur
- Stefan Dimitrov
- Stephan Maxeiner
- Stephen Grubb
- Stephen Smith
- Steven Fishbane
- Stuart Handelsman
- Suely Keiko Kohara
- Sun Kim
- Sun-Hee Park
- Sunil Sheth
- Susumu Kashine
- Svetlana Goykhman
- Svitlana D Bilyk
- Swee Win Lam
- Sylvia Rosas
- Sylvia Shaw
- Szilard Vasas
- Sérgio Alberto Cunha Vêncio
- Sérgio Yamada
- Tadashi Iitsuka
- Takamoto Kodera
- Takashi Wada
- Takayuki Watanabe
- Tamara Malek Marin
- Tamas Oroszlan
- Tara Chang
- Tareq Nassar
- Tarissa Beatrice Zanata Petry
- Tatiana Koroleva
- Tatiana Morugova
- Tatiana Raskina
- Tatyana Zykova
- Te-Lin Hsia
- Terue Sakakibara
- Tetiana Zlova
- Tetsuji Niiya
- Tetyana Pertseva
- Tiago Schuch
- Timothy Hall
- Tom Christensen
- Tom Greene
- Tomas Drasnar
- Tomas Smith Casabella
- Tonatiu Diaz Escalante
- Toshihiko Yanase
- Toshio Kawada
- Vadym Vizir
- Vanassa Ratnasingam
- Venessa Tsang
- Venkata Behara
- Vera Klokocnikova
- Vera Krane
- Veronica Anghel
- Veselka Genadieva
- Vesna Popovic-Radinovic
- Viacheslav Marasaev
- Victor Commendatore
- Victor Saavedra Gajardo
- Vijayaraman Arutchelvam
- Viktor Margaritov
- Viktor Zaviriukha
- Viktoria Andreeva
- Vimladhevi Govender
- Vincent Pichette
- Vincent Woo
- Vira Tseluyko
- Virginia Esther Visco
- Vivek Sood
- Vivekan Jha
- Vladimir Dobronravov
- Vladimir Khirmanov
- Vladimir Tesar
- Vlado Perkovic
- Volker Burst
- Volodymyr Botsyurko
- Walter Guillermo Douthat
- Walter Pharr
- Wasim Hanif
- Wataru Yumita
- Wayne H-H Sheu
- Wayne Turner
- Wei Yen Kong
- Weihong Song
- Weiping Lu
- Wendy Lane
- Wenge Li
- Wheeler D. C.
- Wladmir Saporito
- Xuemei Li
- Xueqing Yu
- Yamil Canaan
- Yan Ren
- Yannick Le Meur
- Yaozhong Kong
- Yasuro Kumeda
- Yasushi Wakida
- Yavin Y.
- Yeong Hoon Kim
- Yevgeniya Svyshchenko
- Young Min Cho
- Yulia Samoylova
- Yung-Chuan Lu
- Yuriy Mostovoy
- Yuriy Shwartz
- Yvette Ethel Yap
- Zaynab Abejuela
- Zdravko Kamenov
- Zeid Khitan
- Zhang H.
- Zinman B.
- Zishan Ali
- Zuzana Ochodnicka
- Ângela Regina Nazario Sabbag
- Publication venue
- 'Massachusetts Medical Society'
- Publication date
- 01/01/2019
- Field of study
BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years
Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.
- Author
- A. Abd El-Aziz
- A. Abdul
- A. Agakhanyan
- A. Aggarwala
- A. Agrawal
- A. Al Mulla
- A. Al Naeemi
- A. Alfieri
- A. Ali
- A. Altun
- A. Alvarez D'Amelio
- A. Andersson
- A. Argena
- A. Austria
- A. Aydinlar
- A. Babyesiza
- A. Barai
- A. Barreau
- A. Barszcz
- A. Bartes
- A. Bazzoni Ruiz
- A. Beattie
- A. Bianchi
- A. Biernacka
- A. Black
- A. Blenkhorn
- A. Branjovich Tijuan
- A. Bremmelgaard
- A. Brown
- A. Browne
- A. Capucci
- A. Caspar
- A. Catanchin
- A. Chmielowski
- A. Choi
- A. Cieszynska
- A. Conde Y Bolado
- A. Connelly
- A. Cortada Cabrera
- A. Davids
- A. De Blasio
- A. De Wolf
- A. Dickerson
- A. Domenech Borras
- A. Dumikyan
- A. Edin
- A. Egilsson
- A. El-Etreby
- A. Elbahry
- A. Elorriaga Madariaga
- A. Espallargas
- A. Ewert
- A. Fearon
- A. Fedorowsky
- A. Ferreira-Jardim
- A. Ferrer
- A. Filippi
- A. Fleck
- A. Flynn
- A. Forero
- A. Frankiewicz
- A. Fujisawa
- A. Gallagher
- A. Ganatra
- A. Gegenhuber
- A. Gieroba
- A. Gilliland
- A. Giombolini
- A. Gonzales Segovia
- A. Grande Ruiz
- A. Grau
- A. Grytzmann
- A. Gubanov
- A. Guerrero Molina
- A. Guinand
- A. Haideri
- A. Hajimirsadeghi
- A. Hallaråker
- A. Halpin
- A. Hay
- A. Heer
- A. Heyse
- A. Horak
- A. Hot-Bjelac
- A. Howitt
- A. Iglesias Garcia
- A. Ishihara
- A. Ivanov
- A. Iñiguez Romo
- A. Jackun-Podlesna
- A. Jaremczuk-Kaczmarczyk
- A. Jarzebowski
- A. Jefferies
- A. Jekthammer
- A. Jerzewski
- A. John Camm
- A. John Camm
- A. John Camm
- A. Jones
- A. Kaczmarzyk-Radka
- A. Karczmarczyk
- A. Katta
- A. Kemmel
- A. Khan
- A. Khokhlov
- A. Koch
- A. Kolesnikova
- A. Kolodzinska
- A. Komlo
- A. Konopka
- A. Kopf
- A. Krueger
- A. Krzesiak-Lodyga
- A. Lavoie
- A. Lawande
- A. Lee
- A. Lettenström
- A. Leyva Rendón
- A. Lindberg
- A. Lindh
- A. Lindourkova
- A. Lischka-Lindner
- A. Lo Buglio
- A. Lopes
- A. Lopez
- A. Lucassen
- A. Ludkova
- A. Lysek-Jozefowicz
- A. Mannermyr
- A. Manzanal Rey
- A. Mariani
- A. Markiewicz
- A. Marquand
- A. Martin Vila
- A. Martinelli
- A. Maselli
- A. Matoltsy
- A. Mauric
- A. Meirino
- A. Menezes Lorga Filho
- A. Merliss
- A. Metzgier-Gumiela
- A. Mielot
- A. Mirtl
- A. Miyashita
- A. Mizuno
- A. Mowafy
- A. Murray
- A. Naguib
- A. Nagy
- A. Nakagomi
- A. Nakata
- A. Navarro
- A. Negrete Palma
- A. Negri
- A. Niemirycz-Makurat
- A. Nowak
- A. Nygaard
- A. Ohanissian
- A. Ohlsson
- A. Olofsson
- A. Ortiz
- A. Osberg
- A. Ota
- A. Oto
- A. Ovsannikova
- A. Page
- A. Papp
- A. Parkhomenko
- A. Pawelska-Buczen
- A. Pedersen
- A. Phrommintikul
- A. Pinter
- A. Pizzini
- A. Plauskat
- A. Podczeck-Schweighofer
- A. Postolache
- A. Pronk
- A. Pustelnik
- A. Quick
- A. Quietzsch
- A. Quisi
- A. Raczynska
- A. Raisaro
- A. Ramdass
- A. Reda
- A. Rodrigues
- A. Ross
- A. Sabir
- A. Sage
- A. Said
- A. Salinas
- A. Sapatyi
- A. Sasaki
- A. Scaccianoce
- A. Seoane Blanco
- A. Sidor
- A. Singal
- A. Skein
- A. Soliman
- A. Soma
- A. Sossich
- A. Spyropoulos
- A. Srinivas
- A. Sriwichian
- A. Stallinga-de Vos
- A. Steffens
- A. Suissa
- A. Sulc
- A. Svilaas
- A. Sword
- A. Szczepanska
- A. Szilagyi
- A. Szulowska
- A. Taguchi
- A. Talkenberger
- A. Tangsirira
- A. Tetlak
- A. Thatcher
- A. Therkelsen
- A. Thomson
- A. Tomasello
- A. Ushakov
- A. Vandorpe
- A. Vertes
- A. Vishnevsky
- A. Vonbank
- A. Wakeman
- A. Waldman
- A. Warke
- A. Wassef
- A. Wierzbicka
- A. Williams
- A. Wilson
- A. Wirdby
- A. Wutthimanop
- A. Yagensky
- A. Yoshimura
- A. Zateyshchikova
- A. Østrem
- A.-B. Ekstrand
- A.-K. Ascoop
- A.-M. Barbuto
- A.-M. Ohlin
- A.A. Damonte
- A.A. Fernandez
- A.B. Lensebraaten
- A.C. Billiaux
- A.C. Ingaramo
- A.C. Rothwell
- A.C. Tovar Castaneda
- A.C.P. Barretto
- A.D. Hrabar
- A.G. Ravi Shankar
- A.J. Kleiban
- A.J. McLeod
- A.L. Baek
- A.L. Cappi
- A.L. Tufare
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- Ajay K. Kakkar
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- I. Blankoff
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- Y.H. Sun
- Y.H. Yin
- Y.J. Yang
- Y.J. Yang
- Y.K. On
- Y.M. Chen
- Y.M. Lee
- Y.M. Sohn
- Y.R. Jeon
- Y.S. Oh
- Y.S. Son
- Y.S. Zhao
- Y.Y. Liu
- Ying Wang
- Yoichi Nakamura
- Yong Wang
- Yoshihisa Fujiura
- Yoshitake Fujiura
- Yuhei Shiga
- Yuichiro Nakamura
- Yukihiro Koretsune
- Yukio Shiga
- Z. Babjakova
- Z. Boda
- Z. Djaidani
- Z. Lajkowski
- Z. Laszlo
- Z. May
- Z. Monhart
- Z. Ongen
- Z. Radics
- Z.C. Lu
- Z.H. Zhou
- Z.M. Yang
- Publication venue
- Indian Heart J
- Publication date
- 01/01/2018
- Field of study
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
Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.
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- Aaroe H.
- Abdel-Qader M.
- Abdelrahman H.
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- Zhuravleva E.
- Zhurba S.
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- Zurita F. M.
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- Publication venue
- BMJ Open
- Publication date
- 01/01/2017
- Field of study
OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)
Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.
- Author
- A'Court C.
- Aaroe H.
- Abdel-Qader M.
- Abdelrahman H.
- Abdul A.
- Abe M.
- Abe M.
- Abe M.
- Abe S.
- Abe Y.
- Abhayaratna W.
- Abraham S.
- Abu-Mahfouz M.
- Abushal S.
- Accetta G.
- Accogli M.
- Adachi S.
- Adachi S.
- Adachi S.
- Adachi T.
- Adak D.
- Adriaansen H.
- Agakhanyan A.
- Agata J.
- Ageta M.
- Aggarwala A.
- Agliardi P.
- Agnelli G.
- Agrawal A.
- Aguilar J.
- Ahbeck E.
- Ahlmark H.
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- Akahane K.
- Akiyama M.
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- Alaguibe E. D.
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- Publication venue
- Eur Heart J
- Publication date
- 01/01/2016
- Field of study
AIMS: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year. METHODS AND RESULTS: GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death. CONCLUSION: The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT01090362
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