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

Super-Earths, M Dwarfs, and Photosynthetic Organisms: Habitability in the Lab

In a few years, space telescopes will investigate our Galaxy to detect evidence of life, mainly by observing rocky planets. In the last decade, the observation of exoplanet atmospheres and the theoretical works on biosignature gasses have experienced a considerable acceleration. The most attractive feature of the realm of exoplanets is that 40% of M dwarfs host super-Earths with a minimum mass between 1 and 30 Earth masses, orbital periods shorter than 50 days, and radii between those of the Earth and Neptune (1–3.8 R⊕). Moreover, the recent finding of cyanobacteria able to use far-red (FR) light for oxygenic photosynthesis due to the synthesis of chlorophylls d and f, extending in vivo light absorption up to 750 nm, suggests the possibility of exotic photosynthesis in planets around M dwarfs. Using innovative laboratory instrumentation, we exposed different cyanobacteria to an M dwarf star simulated irradiation, comparing their responses to those under solar and FR simulated lights. As expected, in FR light, only the cyanobacteria able to synthesize chlorophyll d and f could grow. Surprisingly, all strains, both able or unable to use FR light, grew and photosynthesized under the M dwarf generated spectrum in a similar way to the solar light and much more efficiently than under the FR one. Our findings highlight the importance of simulating both the visible and FR light components of an M dwarf spectrum to correctly evaluate the photosynthetic performances of oxygenic organisms exposed under such an exotic light condition.ISSN:2075-172