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

Ibn Kathir (d. 774/1373): His intellectual circle, major works and Qur'anic exegesis

This dissertation focuses on one of the most popular medieval Muslim figures in modern times, Ibn Kathir. I argue that Ibn Kathir's work reflects a critical theological struggle in the history of Islam between those who emphasized the original sources of the Qur'an and prophetic practice (traditionalists) and those who insisted on the incorporation of scholastic theology and the accumulated experience of the community (Ash'aris). Previous scholarship considers Ibn Kathir simply a student of the great traditionalist jurist and theologian Ibn Taymiyya (d. 1328). Ibn Taymiyya was the symbolic leader of the traditionalist movement and was imprisoned multiple times because of his attempts to challenge the established Ash'ar i social order. Ibn Kathir's ardent support of Ibn Taymiyya led many Arabic biographers to subsume Ibn Kath ir under the hagiography of Ibn Taymiyya. Modern Western scholarship builds off the Arabic biographical literature to the point that Ibn Kathir is perceived as the mere "spokesperson" for Ibn Taymiyya and his Qur'anic exegesis a simple implementation of Ibn Taymiyya's Qur'anic hermeneutic. Yet, through examining Ibn Kathir's intellectual circle, major works, and Qur'anic exegesis, this dissertation demonstrates that Ibn Taymiyya and Ibn Kathir represent two different types of traditionalism. Ibn Taymiyya believed in an intellectualized traditionalism which delved deeply into philosophy and scholastic theology to argue for scripture's rationality. Ibn Kathir, on the other hand, subscribed to a fideist traditionalism which was content with the superiority of the transmitted sources and the use of rational tools to analyze scripture. Ibn Kathir's Qur'anic exegesis, his most famous work, was thus less a product of Ibn Taymiyya than that of his fideist traditionalism and his attempt to respond to the dominant Ash'ar ism