The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Scienza e diritto:quale verit\ue0?

Fin dalla filosofia antica, la \u2018verit\ue0\u2019 ha rappresentato il riferimento costante nella ricerca della giustificazione del potere giuridico e politico. Le filosofie del personalismo e del solidarismo che caratterizzano l\u2019identit\ue0 costituzionale italiana, pongono il valore della persona umana come principio supremo condizionante la ricerca di ogni verit\ue0. L\u2019irrompere della scienza e della tecnica nel secolo del pos-moderno ripropone la questione del rapporto fra diritto e verit\ue0 in tutta la sua complessit\ue0. La risposta all\u2019incertezza che domina lo scenario attuale e futuro non pu\uf2 che risiedere nell\u2019unitariet\ue0 del sistema ordinamentale data dalla centralit\ue0 della dignit\ue0 umana.Since ancient philosophy, the 'truth' has been the constant reference in the search for justification of the juridical and political power. The philosophies of personalism and solidarity that characterize the Italian constitutional identity, place the value of the human person as the supreme principle of conditioning the search for all truths. The importance of science and technology in the post-modern century proposes the question of the relationship between law and truth into all its complexity. The answer to the uncertainty that dominates the current scenery and the future horizon can only reside in the unity of the ordinance system given by the centrality of human dignity