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

Nocturnalism induced by scheduled feeding in diurnal octodon degus

Octodon degus, a mainly diurnal rodent, characterized by its ability to shift to a nocturnal locomotor pattern under laboratory conditions, was studied to determine whether restricted food access during the scotophase could induce nocturnalism. To address this question, wheel running activity, feeding, and body temperature rhythms were analyzed for diurnal degus housed with a wheel and subjected to either long (12h) or short (2h) food availability periods, in the latter case with random or scheduled food access times. The results show that allowing nocturnal feeding for 2h, but not 12h, can shift a previous diurnal phase preference for wheel running activity and body temperature to the scotophase, with random feeding being more effective than scheduled food availability. However, this behavioral inversion proved to be unstable, as the degus returned to the diurnal phase within only a few days after the restricted feeding was discontinued. In addition, the negative masking effect induced by light, which is characteristic of the degus' nocturnal chronotype, was not observed when the animals were forced to feed at night. Thus, neither long, short, random, nor scheduled food-availability during the scotophase was able to induce all the characteristics of the nocturnal chronotype in Octodon degus. � Informa UK Ltd