Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Larval abundance and spat collection of the lion’s paw scallop Nodipecten subnodosus in Ojo de Liebre Lagoon, Baja California Sur, Mexico

Large numbers of spat of giant lion’s paw scallop Nodipecten subnodosus are required for the development of the scallop aquaculture industry. Despite the large adult populations of this species in Ojo de Liebre Lagoon, Baja California Sur, Mexico, attempts to collect spat with onion bag collectors during the reproductive season (September–November) have not been successful. We assessed lion’s paw spatfall at three sites (La Ventana, El Conchalito, and El Borbollón) within the lagoon, where high recruitment was previously recorded. Netlon collectors instead of onion bags were used and they were deployed at each site at a depth of 1 m on two occasions (October and November 2007) when pediveliger larvae were more abundant. Collectors were retrieved and evaluated in February 2008, after being submerged for 118 or 82 days. Pediveliger larvae were present from late September to late November at all three sites. Densities peaked at 1 m in mid-November and were significantly higher at La Ventana, accounting for 12,400 larvae m–3. Collectors installed in October at El Conchalito showed higher (P < 0.05) mean recruitment (1.7 ± 0.2 spat per collector) than collectors set in November (0.4 ± 0.3 spat per collector). Collectors installed in October and November at La Ventana had 0.6 ± 0.3 and 0.9 ± 0.2 spat per collector, respectively. No significant differences were observed in the growth rates of the juveniles collected. High densities of larvae in the plankton during November indicated that high reproductive activity occurred earlier that month or in late October. La Ventana showed the highest potential for spat collection based on larval abundance, followed by El Borbollón and El Conchalito; however, El Conchalito showed the highest spat recruitment, followed by La Ventana and El Borbollón. Since spat collection was relatively low at all sites, more efforts to determine better collection sites and techniques, as well as appropriate deployment times are required.

THE RELATIONSHIP OF PLASMA pH AND ANION PATTERN TO MERCURIAL DIURESIS

Summer mortalities have been observed in French shellfish areas (including Normandy) since 1994, but origin of this syndrome remains unclear and is suspected to be caused by a combination of several interacting extrinsic (biotic and abiotic) and intrinsic (genetic, physiological, immunological) factors. The French research program, MOREST aimed to identify the origin of oyster summer mortality along the French coast, focusing on the interactions between oysters, their pathogens, and the environment. The present study analyzed spatio-temporal variation in growth, condition and mortality in spat, and half-grown and market-sized oysters reared from February 2000 to October 2003 at six stations within two different areas in the Bay of Veys, Normandy: Grandcamp (GR), and Gefosse (GE) that is more estuarine. These biological parameters were compared between years, age groups, and areas. Results showed that shell growth was significantly lower in the station highest on the shore and similar in the four other sites, whereas tissue growth and condition index were higher in the Gefosse area. Results also showed large interannual, interage, seasonal and spatial variation in oyster mortality. In 2001, mortalities were markedly higher than in other years and all batches and sites were affected by high mortality rates. Moreover oysters suffered much higher mortalities in their second and third years than as spat, and the difference between age classes was accentuated when mortality was high. Increases in mortality occurred when the gonad was most extensively developed and the peak coincided with the spawning and postspawning periods when gonad volume began to decrease. Spatial variability showed that mortality was higher in Gefosse than Grandcamp. Chronology and spatial variations in mortality highlighted the importance of timing and confirmed that mass mortalities may be closely linked to reproduction. The risk seems to be associated with high reproductive effort, partial spawning, and/or slow gonad resorption. Spatial variation also suggests that the study sites experience varying degrees of stress caused by biological changes and probable differences in water quality reflecting the influence of freshwater input in Gefosse where mortality is higher