Evolution of antithrombotic therapy for patients with atrial fibrillation:The prospective global GLORIA-AF registry program

OBJECTIVE: To assess baseline characteristics and antithrombotic treatment (ATT) prescription patterns in patients enrolled in the third phase of the GLORIA-AF Registry Program, evaluate predictors of treatment prescription, and compare results with phase II. METHODS: GLORIA-AF is a large, global, prospective registry program, enrolling patients with newly diagnosed nonvalvular atrial fibrillation (AF) at risk of stroke. Patients receiving dabigatran were followed for two years in phase II, and all patients were followed for 3 years in phase III. Phase II started when dabigatran became available; phase III started when the characteristics of patients receiving dabigatran became roughly comparable with those receiving vitamin K antagonists (VKAs). RESULTS: Between 2014 and 2016, 21,241 patients were enrolled in phase III. In total, 82% of patients were prescribed oral anticoagulation ([OAC]; 59.5% novel/nonvitamin K oral anticoagulants [NOACs], 22.7% VKAs). A further 11% of patients were prescribed antiplatelets without OAC and 7% were prescribed no ATT. A high stroke risk was the main driver of OAC prescription. Factors associated with prescription of VKA over NOAC included type of site, region, physician specialty, and impaired kidney function. CONCLUSION: Over the past few years, data from phase III of GLORIA-AF show that OACs have become the standard treatment option, with most newly diagnosed AF patients prescribed a NOAC. However, in some regions a remarkable proportion of patients remain undertreated. In comparison with phase II, more patients received NOACs in phase III while the prescription of VKA decreased. VKAs were preferred over NOACs in patients with impaired kidney function

Dabigatran versus vitamin K antagonists for atrial fibrillation in clinical practice: final outcomes from Phase III of the GLORIA-AF registry.

BackgroundProspectively collected, routine clinical practice-based data on antithrombotic therapy in non-valvular atrial fibrillation (AF) patients are important for assessing real-world comparative outcomes. The objective was to compare the safety and effectiveness of dabigatran versus vitamin K antagonists (VKAs) in patients with newly diagnosed AF.Methods and resultsGLORIA-AF is a large, prospective, global registry program. Consecutive patients with newly diagnosed AF and CHA2DS2-VASc scores ≥ 1 were included and followed for 3 years. To control for differences in patient characteristics, the comparative analysis for dabigatran versus VKA was performed on a propensity score (PS)-matched patient set. Missing data were multiply imputed. Proportional-hazards regression was used to estimate hazard ratios (HRs) for outcomes of interest. Between 2014 and 2016, 21,300 eligible patients were included worldwide: 3839 patients were prescribed dabigatran and 4836 VKA with a median age of 71.0 and 72.0 years, respectively; > 85% in each group had a CHA2DS2-VASc-score ≥ 2. The PS-matched comparative analysis for dabigatran and VKA included on average 3326 pairs of matched initiators. For dabigatran versus VKAs, adjusted HRs (95% confidence intervals) were: stroke 0.89 (0.59-1.34), major bleeding 0.61 (0.42-0.88), all-cause death 0.78 (0.63-0.97), and myocardial infarction 0.89 (0.53-1.48). Further analyses stratified by PS and region provided similar results.ConclusionsDabigatran was associated with a 39% reduced risk of major bleeding and 22% reduced risk for all-cause death compared with VKA. Stroke and myocardial infarction risks were similar, confirming a more favorable benefit-risk profile for dabigatran compared with VKA in clinical practice. Clinical trial registration https://www.Clinicaltrialsgov . NCT01468701, NCT01671007

Kinetic Phenomena in Thin Film Electronic Materials

Contains reports on twelve research projects.National Science Foundation (Grant ECS 85-06505)U.S. Air Force - Office of Scientific Research (Contract AFOSR-85-0154)Semiconductor Research Corporation (Contract 87-SP-080)National Science Foundation (Grant ECS 85-06565)International Business Machines, Inc.Sony International Business Machines, Inc.National Science Foundation (Grant DMR 84-18718)International Business Machines, Thomas J. Watson Research CenterJoint Services Electronics Program (Contract DAALO3-86-K-0002)National Science Foundation (Grant DMR 85-06030)Charles Stark Draper Laboratory (Contract DL-H-261827)Nippon Telegraph and Telephone, Inc

Microstructural Evolution in Thin Films of Electronic Materials

Contains reports on eight research projects.National Science Foundation (Grant ECS 85-06565)U.S. Air Force - Office of Scientific Research (Contract AFOSR 85-0154)National Science Foundation-Materials Research Laboratory(Grant DMR 81-19285)National Science Foundation (Grant DMR 85-06030)International Business Machines, Inc. Faculty Development AwardMitsui Career Development AwardInternational Business Machines, Inc.Semiconductor Research Corporation (Contract 86-05-080)Joint Services Electronics Program (Contract DAAG-29-83-K-0003)Charles Stark Draper LaboratoryDefense Advanced Research Projects Agency (DARPA)Nippon Telegraph and Telephone, Inc