Biochemical indices of piglets blood under the action of feed additive “Butaselmevit-plus”

The purpose of the search was to investigate the influence of feed additive “Butaselmevit-plus” on the biochemical indices of piglets blood when weaned. The experiments were conducted on the basis of Ltd. “KOSHET” of Mukachevo district, Transcarpathian region. Two groups of pigs were formed – control (C) and experimental (E), in the number of 10 individuals in each group, selected on the basis of analogues – age, breed and body weight. In the suckling period, pigletss were kept under sows in special machines, had constant access to the mother, and from 5 days of age – free access to concentrated feed. The research material was blood collected in the morning by puncture of the cranial vena cava on the 20th day of life (period before weaning), on the 25th day of life (period before weaning), on the 30th day of life (2 days after weaning), for 35 days of life (7 days after weaning), for 40 days of life (12 days after weaning). Weaning of piglets from sows at 28 days of age leads to a slight decrease in total protein and increased activity of aminotransferases. Increased activity of ALAT and ASAT in pigs' serum after weaning from sows reflects the nonspecific response of the organism to the action of stress factors and indicates an increased release of enzymes into the extracellular space. Feeding of piglets with feed additives “Butaselmevit-plus” promotes to enhance the protein synthesizing function of the liver and reduce the activity of aminotransferases. The decrease in the activity of aminotransferases in the blood of piglets of the experimental group, indicates that the components of the feed additive counteract the influence of stress, and also contribute to the maintenance the integrity of cell membranes specific to these organ enzymes, which prevents their output from the cells

Вплив бровітакокциду сукупно з плодами розторопші плямистої на стан імунної системи індиків за еймеріозної інвазії

The immune system provides resistance of the organism against bacterial and viral infections in the body of the poultry. In the intestinal mucosa of eymeria it was secrete metabolic products, that are toxic to various systems and tissues of turkeys. Eymeria, parasitizing in the gut, inhibit specific phase of immunity presented by antibodies (humoral type), reduce the activity of sensitized cells (cell type), slow down nonspecific phase of immunity, represented by various immune cells. The rapid and complete recovery of functional state of the immune system in turkeys, affected by eymeriozic invasion it was found if brovitatoxide was given if the aggregate of the fruits of milk thistle. Fruits contain group of flavius lignans named «Sylimaryn», acting immune stimulatory for the development of secondary immuno deficiencies state of body.Імунна система забезпечує резистентність організму проти бактеріальних і вірусних інфекцій у організмі птиці. У слизовій оболонці кишечника еймерії виділяють продукти метаболізму, що діють токсично на різні системи і тканини індиків. Еймерії, паразитуючи в кишечнику, пригнічують специфічну фазу імунітету представлену антитілами (гуморальний тип), знижують активність сенсибілізованих клітин (клітинний тип), сповільнюють неспецифічну фазу імунітету, що представлена різними імунними клітинами. За виникнення еймеріозної інвазії, при застосуванні для лікування бровітакокциду, на період клінічного одужання, стан клітинного і гуморального імунітетів суттєво поліпшився. Проте, на 5-у добу після одужання на 20% нижче нормальних величин була загальна кількість лімфоцитів та на 10% кількість Т- і В- лімфоцитів, що вказує на неповне відновлення функціонального стану клітинної ланки імунітету. Низька лізоцимна активність сироватки крові, та високий рівень у ній циркулюючих імунних комплексів на 5-у добу після клінічного одужання вказує на неповне відновлення функціонального стану гуморальної ланки імунітету. Підтвердженням цього є низька фагоцитарна активність нейтрофілів. Швидке і повне відновлення функціонального стану імунної системи у індиків, уражених еймеріозною інвазією встановлено якщо бровітакокцид задавали сукупно із плодами розторопші плямистої. Плоди містять групу флаволігнанів під назвою «Силімарин», що діє імуностимулювально за розвитку вторинного імунодефіцитнього стану організму

The effectiveness of the use of the feed additive “Butaselmevit-plus” as part of compound feed for young pigs

The results of the production approval fully confirmed the high efficiency of introducing the feed additive “Butaselmevit-plus” into the compound feed for piglets. It was established that at the end of the piglet rearing period (at the age of 75 days), the average weight of one head in the experimental group was 32.6 kg, which is 1.1 kilograms or 3.5% higher (P < 0.05). Then their peers from the control group. During the period of rearing, the absolute increase in body weight in young animals of the experimental group was higher by 1.2 kg, or by 4.7 %, and the average daily weight gain by 21.8 g, or by 4.7 %, compared to similar indicators in piglets of the control group, and were 26.5 kg and 481.8 g, respectively. Among the numerous indicators determining the economic efficiency of production, the cost per unit of production is considered the most important. One of the reserves for reducing the cost of pig production is increasing young animals' productivity and preservation. The above results of the production inspection convincingly prove that using the feed additive “Butaselmevit-plus” in compound feed for piglets at the rate of 100 mg/kg of body weight increases their product qualities and, as a result, improves economic indicators. In the experimental group, the cost of 1 kg of live weight of piglets during rearing decreased by UAH 0.57, or 3.0 %, compared to the young of the control group and amounted to UAH 18.25. The cost of 1 kg of live weight gain in control and experimental groups was slightly higher (23.44 and 22.46 UAH, respectively), and the difference in favor of the latter was 4.2 %. The decrease in the unit cost of production in the experimental group was due to the increase in body weight and the survival of young pigs during the rearing period. The economic effect of using the feed additive “Butaselmevit-plus” as part of compound feed, calculated per 1 head of young pigs, was UAH 25.97 at the prices set for feed and feed additive in 2019. To increase the adaptability of piglets at an early age when weaning from the sow and to prevent the development of oxidative stress, for further maintenance during the period of rearing and fattening, it is recommended to use the feed additive “Butaselmevit-plus” in the amount of 100 mg/kg of body weight per day together with concentrates diet in the period from 21 to 40 days of age

The state of the body's immune system of beef cows with signs of endotoxicosis

During the development of endotoxicosis of various etiologies, secondary immunodeficiency occurs in animals, which progresses due to exposure to toxic metabolites. The work aimed to study the influence of endotoxicosis on the dynamics of indicators of the immune system of beef cows. The research was conducted on the Ukrainian black and spotted dairy breed beef cows. In cows with signs of endotoxicosis, clinical signs such as swelling of the external genital organs and mammary gland, anemia of the mucous membranes, depressed state, impaired appetite, and functional disorders of the antrum and intestines were characteristic. The main immunological tests characterizing the state of the immune system of beef cows are indicators of humoral immunity (bactericidal and lysozyme activity of blood serum), cellular immunity (T- and B-lymphocytes), indicators of non-specific resistance of the organism (phagocytic activity and phagocytic index). In beef cows with clinical manifestations of endotoxicosis, inhibition of cellular, humoral, and non-specific links of the immune system was established, which led to the development of the so-called secondary immunodeficiency. This is evidenced by a decrease in the bactericidal and lysozyme activity of blood serum, a decrease in the number of T- and B-lymphocytes, and a decrease in the phagocytic index and phagocytic activity of the blood of sick cows. In particular, it was established that the lowest indicator of bactericidal and lysozyme activity was observed in the 9th month of pregnancy in the experimental group of cows, where it decreased by 15.9 and 4.91 %, respectively, compared to the control. In the above study periods, a decrease in the phagocytic activity of neutrophils by 5.04 % and the phagocytic index by 33.3 % was established compared to the indicators of the control group. During the analysis of cellular immunity, similar changes were found in determining the number of T- and B-lymphocytes; they were lower by 12.5 % and 4.19 %, respectively. Changes in the indicators of the immune system are significant and objective markers of the state of the cow's body during the development of endotoxicosis, regardless of its causes

The influence of the feed additive “Metisevit” on the activity of the antioxi-dant defense system of piglets under conditions of nitrate-nitrite load

The work aimed to investigate the effect of the “Metisevit” feed additive on the activity of the enzymes of the antioxidant system of the blood of piglets under conditions of nitrate-nitrite load. The research was carried out on 60-day-old piglets of the large white breed. For the experiment, 10 clinically healthy piglets were selected, from which 2 groups of five animals were formed. Piglets of the control group were fed sodium nitrate at a dose of 0.3 g NO3-/kg body weight for three months. Piglets of the research group were also fed sodium nitrate at a dose of 0.3 g NO3-/kg of body weight, together with Metisevit at a dose of 0.36 g/kg of feed for three months. The “Metisevit” feed additive was developed at the Department of Pharmacology and Toxicology of the Stepan Gzhytskyi National University of Veterinary Medicine and Biotechnology Lviv, which contains vitamin E, selenium, and methiphene (methionine, phenarone, zeolite). Under the conditions of feeding piglets with sodium nitrate feed at a dose of 0.3 g of NO3ˉ/kg, a decrease in the activity of enzymes of the antioxidant defense system was established: superoxide dismutase by 14.8 %, catalase by 20%, glutathione peroxidase by 15.1 %. Metisevit in piglets increased the activity of the enzyme link of the antioxidant protection system, preventing the development of oxidative stress that occurs in nitrate-nitrite toxicosis. During our experiments, it was found that the introduction of Metisevit into the diet of piglets with excessive consumption of nitrates prevented the development of chronic nitrate-nitrite toxicosis. It was established that Metisevit increases the activity of enzymes – superoxide dismutase, catalase, and glutathione peroxidase. These enzymes reduce the high level of lipid peroxidation products in the body of piglets under conditions of nitrate-nitrite load

System of antioxidant protection of young cattle under cadmium load

It is known that free radical oxidation of lipids is an essential stage in the influence of heavy metals on the animal body. That is why the work aimed to investigate the indicators of the antioxidant system in young cattle under conditions of cadmium loading. For research, 15 clinically healthy six-month-old bulls of the black and spotted breed were selected, from which 3 groups of five animals were formed. The animals in the control group were on a regular diet. The animals of the experimental groups with compound feed were fed cadmium chloride in doses of 0.03 and 0.05 mg/kg of body weight. Feeding young cattle with cadmium chloride feed caused a decrease in the activity of the enzyme system of antioxidant protection of their body. These changes are confirmed by a decrease in their blood activity of superoxide dismutase by 31 %, catalase by 13.4 %, glutathione peroxidase by 23.2 %, glutathione reductase by 22.2 %, and glucose-6-phosphate dehydrogenase by 32.4 %, respectively. A decrease in the level of indicators of the non-enzymatic link of the system of antioxidant protection of the body of young cattle under cadmium load was also established, where, accordingly, a decrease in the content of reduced glutathione was established – by 10.4 %, selenium – by 14.8 %, vitamin A – by 31.3%, of vitamin E – by 30.8% in their blood compared to the control. It is worth noting that on the sixteenth and twenty-fourth days of the experiment, the lowest value of the enzymatic and non-enzymatic links of the antioxidant protection systems of young cattle under conditions of cadmium loading was observed. In the future, a practical scheme for preventing cadmium toxicosis in young cattle by studying indicators of the antioxidant system is planned

Рівень продуктів пероксидного окиснення ліпідів у крові поросят за дії кормової добавки “Силімевіт”

Intensive pig breeding has been reported in the literature to suggest that early weaning of piglets from sows is an extreme stimulus that reduces the protective and adaptive responses of piglets. That is why the aim of the study was to study the effect of the feed additive “Sylimevit” on the level of lipid peroxidation products of piglets after weaning. Two groups of piglets were formed – control and experimental in the amount of 10 individuals in each group, selected on the principle of analogs – age, breed and body weight. During the weaning period, the piglets were kept under the sow in special machines, had constant access to the mother, and from the age of 5 days – free access to concentrated feed. While feeding of animals was carried out in accordance with the norms for a given age of pigs. Prior to the study, a clinical and physiological examination of the piglets was performed. Their general condition and activity when eating food were taken into account. On the 28th day of life, the piglets were weaned from the sow and regrouped from different nests in order to be further maintained during the period of fattening and rearing with a change in the structure of the diet, which served as technological stress for the animals. From the age of 5 days, piglets of all groups were fed pre-starter feed. Piglets of the experimental group, from 21 to 40 days of age, were additionally fed the feed supplement “Sylimevit” at a dose of 100 mg/kg body weight per day. The technological stress of weaning piglets from sows is accompanied by a gradual probable intensification of lipid peroxidation processes. Feeding Sylimevit feed to piglets after weaning helped to reduce the content of intermediate and final products of lipid peroxidation: lipid hydroperoxides – by 52 % (P &lt; 0.001) and TBA-active products – by 22.5 % (P &lt; 0.01). Thus, feeding the piglets of the experimental group of the feed additive “Sylimevit” helped to suppress the processes of lipid peroxidation in animals. Thus, the results of the use of feed additive “Sylimevit” in weaned piglets showed a pronounced antioxidant effect. The components of the feed additive directly interacted with reactive oxygen species and free radicals, preventing the development of oxidative stress.При інтенсивному веденні свинарства з повідомлень в літературі відомо, що раннє відлучення поросят від свиноматок є екстремальним подразником, який спричиняє зниження захисно-пристосувальних реакцій організму поросят. Саме тому метою проведених досліджень було вивчити вплив кормової добавки “Силімевіт” на рівень продуктів пероксидного окиснення ліпідів організму поросят після відлучення. Було сформовано дві групи поросят – контрольну і дослідну в кількості 10 особин у кожній групі, підібраних за принципом аналогів – віком, породою і масою тіла. У підсисний період поросята утримувалися під свиноматкою у спеціальних станках, мали постійний доступ до матері, а з 5-добового віку – вільний доступ до концентрованих кормів. Годівля тварин проводилась відповідно до норм для даного віку свиней. Перед проведенням досліджень здійснювали клінічно-фізіологічне обстеження поголів’я поросят. Враховували їхній загальний стан та активність при поїданні корму. На 28 добу життя поросят відлучали від свиноматки та перегруповували з різних гнізд з метою подальшого утримання у період відгодівлі та дорощування зі зміною структури раціону, що слугувало технологічним стресом для організму тварин. Починаючи з 5-добового віку поросят усіх груп підгодовували престартерним комбікормом. Поросятам дослідної групи, починаючи з 21- до 40-добового віку, додатково згодовували кормову добавку “Силімевіт” у дозі 100 мг/кг маси тіла на добу. Технологічний стрес відлучення поросят від свиноматок супроводжується поетапним вірогідним посиленням процесів пероксидного окиснення ліпідів. Згодовування кормової добавки “Силімевіт” поросятам після відлучення сприяло зниженню вмісту проміжних і кінцевих продуктів пероксидного окиснення ліпідів: гідроперекисів ліпідів – на 52&nbsp;% (Р &lt; 0,001) і ТБК-активних продуктів – на 22,5 % (Р &lt; 0,01). Отже, згодовування поросятам дослідної групи кормової добавки “Силімевіт” сприяло пригніченню процесів пероксидного окиснення ліпідів в організмі тварин. Таким чином, результати застосування кормової добавки “Силімевіт” поросятам при відлученні показали виражену антиоксидантну дію. Складники кормової добавки безпосередньо взаємодіяли з активними формами кисню та вільними радикалами, запобігаючи розвитку оксидаційного стресу

The influence of feed additive “Sylimevit” on indicators of the immune system of piglets at weaning

In the development of adaptive reactions during weaning, biological mechanisms are involved with the complete mobilization of the functional reserve, an increase in the level of catecholamines, corticosteroids, and mediators, which is accompanied by a violation of the nitrogen balance in the body, enzymopathy, and endotoxemia—the work aimed to investigate humoral and non-specific immunity indicators in piglets after weaning. Experiments were conducted based on the Ltd “KOSHET” of the Mukachiv district of the Zakarpattia region. Two groups of piglets were formed – control and experimental in the number of 10 individuals in each group, selected according to the principle of analogs – age, breed, and body weight. Weaning piglets from sows at 28 days suppress the humoral link of natural resistance. A decrease in lysocin and bactericidal activity of blood serum was established at 40.56 ± 1.75 and 21.22 ± 1.05 %. The content of circulating immune complexes in the blood of piglets of the control group remained high after weaning. Along with a decrease in the activity of the humoral link of immunity in weaned piglets, suppression of the non-specific link of the immune system was established, manifested by a decrease in phagocytic activity and a decrease in the number of phagocytes. Feeding the feed supplement “Sylimevit” to the piglets of the research group helped to strengthen the immune status of the piglets' bodies. In piglets of the research group on the 35th day of life, when feeding the feed additive “Sylimevit”, an increase in the phagocytic activity of neutrophils by 4.26 % was established. Similar differences were obtained regarding the effect of the Butaselmevit-plus feed additive on the phagocytic number and the phagocytic index, in particular, in piglets of the experimental group on the 35th day of the experiment; they were 7.63 and 11.1 % higher than in control. These research results confirm the effectiveness of using milk thistle, methifen, selenium, and vitamins as part of the feed supplement “Sylimevit” for piglets before and after weaning to activate the protective systems of their body

Дослідження гострої та хронічної токсичності експериментального препарату «Феросел Т»

In the article the brought results over of sharp and chronic toxicness of new preparation dextran of iron «Ferosel Т», that in the composition contains Iron and Selenium. It was set that preparation of «Ferosel Т» in prophylactic and therapeutic doses and in a dose in 3 times of any more than therapeutic, at peroral introduction a 3 twenty-four hours in succession did not show a toxic action laboratory rats. At the terms of hypodermic introduction of preparation the death of white rats it was not, it is only set brief oppression of laboratory animals, animals preparations were given that in a dose 10 ml/kg. It is set that in prophylactic and optimal therapeutic doses preparation did not influence on the detoxication function of liver. For rats, what was entered Ferosel T in maximal therapeutic and maybe toxic doses, duration of a dream from Hexenalum was on 32 and 35 percents more relation than control sizes. The toxicness of Ferosel Т was also studied on the indexes of irritating action(after dermic test and testis on conjunctiva), action of allergy (a method of applique on a skin) and determined the coefficients of mass of internalss at great while of introduction of preparation. For animals Ferosel Т was entered that in a dose 10 ml/kg during a 21 twenty-four hours, motive activity some went down. Research of emotional and behavior reactions of laboratory animals after introduction of Ferosel Т during a 21 twenty-four hours in therapeutic and maximally therapeutic doses did not show substantial influence on the nervous system. On the indexes of hyperemia and edema of skin and thickness of skin fold of Ferosel Т in prophylactic and therapeutic doses at an applique on the skin of crawls did not cause a local irritating action. Separate injection of preparation of «Ferosel Т» for 0,1 ml did not cause the filling out reaction of paws guinea-pigs. As a result of undertaken studies it is not educed allergen properties at preparation of «Ferosel Т». For laboratory rats, Ferosel Т was entered that in a prophylactic dose it is not set reliable changes of coefficients of mass of heart, liver, spleen and kidneys. For rats Ferosel Т was entered that in an optimal therapeutic dose, in comparing to control mass of spleen and liver was accordingly on 10.3 and 6.4% anymore. At introduction of Ferosel Т to the maximally therapeutic dose mass of spleen and liver was accordingly on 14.0 and 15.0% anymore. The got results of researches specify that preparation of Ferosel Т is safe at application for a prophylaxis and treatment of animals.В статье приведены результаты острой и хронической токсичности нового феродекстранового препарата «Феросел Т», который в своем составе содержит Ферум и Селен. Установлено, что препарат «Феросел Т» в профилактической и терапевтической дозах и в дозе в 3 раза большей за терапевтическую, за перорального введения лабораторным крысам 3 сутки подряд ни проявлял токсического действия. В условиях подкожного введения препарата гибели белых крыс не было, только установлено кратковременное угнетение лабораторных животных, которым задавали препарат в дозе 10 мл/кг м.ж. Установлено, что в профилактической и оптимальной терапевтической дозах не влиял на детоксикационную функцию печени. У крыс, которым феросел Т вводили в максимальной терапевтической и возможно токсической дозах, продолжительность гексеналового сна была на 32 и 35% больше относительно контрольных величин. Токсичность феросела Т также изучали по показателям раздражающего действия (по кожной и конъюнктивальной пробами), аллергизирующего действия (метод аппликации на кожу) и определяли коэффициенты массы внутренних органов при длительном введения препарата. У животных, которым вводили феросел Т в дозе 10 мл/кг в течение 21 суток, несколько снижалась двигательная активность. Исследование эмоционально-поведенческих реакций лабораторных животных после введения феросела Т течение 21 суток в терапевтической и максимально терапевтической дозах не показало существенного влияния на нервную систему. По показателям гиперемии и отека кожи и толщины кожной складки феросел Т в профилактической и терапевтических дозах при аппликации на кожу кроликов не вызывало местной раздражающего действия. Разделение инъекция препарата «Феросел Т» субплантарно морским свинкам по 0,1 мл не вызывала отечной реакции лап. В результате проведенных исследований не выявлено аллергенных свойств у препарата «Феросел Т». У лабораторных крыс, которым вводили феросел Т в профилактической дозе возможных изменений коэффициентов массы сердца, печени, селезенки и почек не установлено. У крыс, которым вводили феросел Т в оптимальной терапевтической дозе, по сравнению с контрольными, масса селезенки и печени была соответственно на 10,3 и 6,4% больше. При введении феросела Т в максимально терапевтической дозе масса селезенки и печени была соответственно на 14,0% и 15,0% больше. Полученные результаты исследований указывают о том, что препарат «Феросел Т» является безопасным при применении для профилактики и лечения животных.У статті наведені результати гострої та хронічної токсичності нового феродекстранового препарату «Феросел Т», який у своєму складі містить ферум і селен. Встановлено, що препарат «Феросел Т» в профілактичній і терапевтичній дозах та в дозі в 3 рази більшої за терапевтичну, за перорального введення лабораторним щурам 3 доби поспіль не проявляв токсичної дії. За умов підшкірного введення препарату загибелі білих щурів не було, лише встановлено короткочасне пригнічення лабораторних тварин, яким задавали препарат у дозі 10 мл/кг м.т. Встановлено, що в профілактичній і оптимальній терапевтичній дозах препарат не впливав на детоксикаційну функцію печінки. У щурів, яким феросел Т вводили в максимальній терапевтичній та можливо токсичній дозах, тривалість гексеналового сну була на 32 і 35% більшою відносно контрольних величин. Токсичність фероселу Т також вивчали за показниками подразнювальної дії (за шкірною та кон’юктивальною пробами), алергізуючої дії (метод аплікації на шкіру) та визначали коефіцієнти маси внутрішніх органів за тривалого введення препарату. У тварин, яким вводили феросел Т у дозі 10 мл/кг протягом 21 доби, дещо знижувалася рухова активність. Дослідження емоційно-поведінкових реакцій лабораторних тварин після введення фероселу Т протягом 21 доби у терапевтичній та максимально терапевтичній дозах не показало істотного впливу на нервову систему. За показниками гіперемії і набряку шкіри та товщини шкірної складки феросел Т в профілактичній та терапевтичних дозах при аплікації на шкіру кролів не спричиняв місцевої подразнювальної дії. Роздільна ін'єкція препарату «Феросел Т» субплантарно морським свинкам по 0,1 мл не викликала набряклої реакції лап. У результаті проведених досліджень не виявлено алергенних властивостей у препарата «Феросел Т». У лабораторних щурів, яким вводили феросел Т в профілактичній дозі вірогідних змін коефіцієнтів маси серця, печінки, селезінки і нирок не встановлено. У щурів, яким вводили феросел Т в оптимальній терапевтичній дозі, у порівнянні з контрольними маса селезінки і печінки була відповідно на 10,3 і 6,4% більшою. При введенні фероселу Т у максимально терапевтичній дозі маса селезінки і печінки була відповідно на 14,0 і 15,0% більшою. Одержані результати досліджень вказують про те, що препарат «Феросел Т» є безпечним при застосуванні для профілактики і лікування твари

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.

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)