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  1. Article ; Online: Evaluation of the Johne's disease risk assessment and management plan on dairy farms in Ontario, Canada.

    Pieper, Laura / Sorge, Ulrike S / DeVries, Trevor J / Godkin, Ann / Lissemore, Kerry / Kelton, David F

    Journal of dairy science

    2015  Volume 98, Issue 10, Page(s) 6792–6800

    Abstract: Johne's disease (JD) is a production-limiting gastrointestinal disease in cattle. To minimize ... the effects of JD, the Ontario dairy industry launched the Ontario Johne's Education and Management Assistance ...

    Abstract Johne's disease (JD) is a production-limiting gastrointestinal disease in cattle. To minimize the effects of JD, the Ontario dairy industry launched the Ontario Johne's Education and Management Assistance Program in 2010. As part of the program, trained veterinarians conducted a risk assessment and management plan (RAMP), an on-farm questionnaire where high RAMP scores are associated with high risk of JD transmission. Subsequently, veterinarians recommended farm-specific management practices for JD prevention. Milk or serum ELISA results from the milking herd were used to determine the herd ELISA status (HES) and within-herd prevalence. After 3.5 yr of implementation of the program, the aim of this study was to evaluate the associations among RAMP scores, HES, and recommendations. Data from 2,103 herds were available for the analyses. A zero-inflated negative binomial model for the prediction of the number of ELISA-positive animals per farm was built. The model included individual RAMP questions about purchasing animals in the logistic portion, indicating risks for between-herd transmission, and purchasing bulls, birth of calves outside the designated calving area, colostrum and milk feeding management, and adult cow environmental hygiene in the negative binomial portion, indicating risk factors for within-herd transmission. However, farms which fed low-risk milk compared with milk replacer had fewer seropositive animals. The model additionally included the JD herd history in the negative binomial and the logistic portion, indicating that herds with a JD herd history were more likely to have at least 1 positive animal and to have a higher number of positive animals. Generally, a positive association was noted between RAMP scores and the odds of receiving a recommendation for the respective risk area; however, the relationship was not always linear. For general JD risk and calving area risk, seropositive herds had higher odds of receiving recommendations compared with seronegative herds if the section scores were low. This study suggests that the RAMP is a valuable tool to assess the risk for JD transmission within and between herds and to determine farm-specific recommendations for JD prevention.
    MeSH term(s) Animals ; Cattle ; Cattle Diseases/epidemiology ; Dairying/methods ; Enzyme-Linked Immunosorbent Assay/veterinary ; Ontario/epidemiology ; Paratuberculosis/epidemiology ; Prevalence ; Risk Assessment/methods ; Seroepidemiologic Studies ; Surveys and Questionnaires
    Language English
    Publishing date 2015-10
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 242499-x
    ISSN 1525-3198 ; 0022-0302
    ISSN (online) 1525-3198
    ISSN 0022-0302
    DOI 10.3168/jds.2014-8813
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Variability in Risk Assessment and Management Plan (RAMP) scores completed as part of the Ontario Johne's Education and Management Assistance Program(2010-2013).

    Pieper, Laura / DeVries, Trevor J / Sorge, Ulrike S / Godkin, Ann / Hand, Karen J / Perkins, Nicole R / Imada, Jamie / Kelton, David F

    Journal of dairy science

    2015  Volume 98, Issue 4, Page(s) 2419–2426

    Abstract: As a proactive measure toward controlling the nontreatable and contagious Johne's disease in cattle ... the Ontario dairy industry launched the voluntary Ontario Johne's Education and Management Assistance Program ...

    Abstract As a proactive measure toward controlling the nontreatable and contagious Johne's disease in cattle, the Ontario dairy industry launched the voluntary Ontario Johne's Education and Management Assistance Program in 2010. The objective of this study was to describe the results of the first 4 yr of the program and to investigate the variability in Risk Assessment and Management Plan (RAMP) scores associated with the county, veterinary clinic, and veterinarian. Of 4,158 Ontario dairy farms, 2,153 (51.8%) participated in the program between January 2010 and August 2013. For this study, RAMP scores and whole-herd milk or serum ELISA results were available from 2,103 farms. Herd-level ELISA-positive prevalence (herds with one or more test-positive cows were considered positive) was 27.2%. Linear mixed model analysis revealed that the greatest RAMP score variability was at the veterinarian level (24.2%), with relatively little variability at the county and veterinary clinic levels. Consequently, the annual RAMP should be done by the same veterinarian to avoid misleading or discouraging results.
    MeSH term(s) Agriculture ; Animals ; Antibodies, Bacterial/analysis ; Antibodies, Bacterial/blood ; Cattle ; Cattle Diseases/epidemiology ; Cattle Diseases/prevention & control ; Cooperative Behavior ; Dairying/education ; Dairying/methods ; Enzyme-Linked Immunosorbent Assay/veterinary ; Female ; Milk/microbiology ; Mycobacterium avium subsp. paratuberculosis/immunology ; Ontario/epidemiology ; Paratuberculosis/epidemiology ; Paratuberculosis/microbiology ; Paratuberculosis/prevention & control ; Risk Assessment
    Chemical Substances Antibodies, Bacterial
    Language English
    Publishing date 2015-04
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 242499-x
    ISSN 1525-3198 ; 0022-0302
    ISSN (online) 1525-3198
    ISSN 0022-0302
    DOI 10.3168/jds.2014-8812
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Evaluation of the Johne’s disease risk assessment and management plan on dairy farms in Ontario, Canada

    Pieper, Laura / Ann Godkin / David F. Kelton / Kerry Lissemore / Trevor J. DeVries / Ulrike S. Sorge

    American Dairy Science Association Journal of dairy science. 2015 Oct., v. 98, no. 10

    2015  

    Abstract: Johne’s disease (JD) is a production-limiting gastrointestinal disease in cattle. To minimize ... the effects of JD, the Ontario dairy industry launched the Ontario Johne’s Education and Management Assistance ...

    Abstract Johne’s disease (JD) is a production-limiting gastrointestinal disease in cattle. To minimize the effects of JD, the Ontario dairy industry launched the Ontario Johne’s Education and Management Assistance Program in 2010. As part of the program, trained veterinarians conducted a risk assessment and management plan (RAMP), an on-farm questionnaire where high RAMP scores are associated with high risk of JD transmission. Subsequently, veterinarians recommended farm-specific management practices for JD prevention. Milk or serum ELISA results from the milking herd were used to determine the herd ELISA status (HES) and within-herd prevalence. After 3.5 yr of implementation of the program, the aim of this study was to evaluate the associations among RAMP scores, HES, and recommendations. Data from 2,103 herds were available for the analyses. A zero-inflated negative binomial model for the prediction of the number of ELISA-positive animals per farm was built. The model included individual RAMP questions about purchasing animals in the logistic portion, indicating risks for between-herd transmission, and purchasing bulls, birth of calves outside the designated calving area, colostrum and milk feeding management, and adult cow environmental hygiene in the negative binomial portion, indicating risk factors for within-herd transmission. However, farms which fed low-risk milk compared with milk replacer had fewer seropositive animals. The model additionally included the JD herd history in the negative binomial and the logistic portion, indicating that herds with a JD herd history were more likely to have at least 1 positive animal and to have a higher number of positive animals. Generally, a positive association was noted between RAMP scores and the odds of receiving a recommendation for the respective risk area; however, the relationship was not always linear. For general JD risk and calving area risk, seropositive herds had higher odds of receiving recommendations compared with seronegative herds if the section scores were low. This study suggests that the RAMP is a valuable tool to assess the risk for JD transmission within and between herds and to determine farm-specific recommendations for JD prevention.
    Keywords adults ; bulls ; calves ; calving ; cattle diseases ; colostrum ; cows ; dairy farming ; dairy industry ; digestive system diseases ; education ; enzyme-linked immunosorbent assay ; farms ; herds ; hygiene ; milk ; milk replacer ; milking ; models ; purchasing ; questionnaires ; risk assessment ; risk factors ; seroprevalence ; veterinarians ; whey ; Ontario
    Language English
    Dates of publication 2015-10
    Size p. 6792-6800.
    Publishing place Elsevier Inc.
    Document type Article
    ZDB-ID 242499-x
    ISSN 1525-3198 ; 0022-0302
    ISSN (online) 1525-3198
    ISSN 0022-0302
    DOI 10.3168/jds.2014-8813
    Database NAL-Catalogue (AGRICOLA)

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  4. Article: Management Practices and Their Potential Influence on Johne’s Disease Transmission on Canadian Organic Dairy Farms—A Conceptual Analysis

    Pieper, Laura / Sorge, Ulrike / Godkin, Ann / DeVries, Trevor / Lissemore, Kerry / Kelton, David

    Sustainability. 2014 Nov. 18, v. 6, no. 11

    2014  

    Abstract: Johne’s disease (JD) is a chronic, production-limiting disease of ruminants. Control programs ...

    Abstract Johne’s disease (JD) is a chronic, production-limiting disease of ruminants. Control programs aiming to minimize the effects of the disease on the dairy industry have been launched in many countries, including Canada. Those programs commonly focus on strict hygiene and management improvement, often combined with various testing methods. Concurrently, organic dairy farming has been increasing in popularity. Because organic farming promotes traditional management practices, it has been proposed that organic dairy production regulations might interfere with implementation of JD control strategies. However, it is currently unclear how organic farming would change the risk for JD control. This review presents a brief introduction to organic dairy farming in Canada, JD, and the Canadian JD control programs. Subsequently, organic practices are described and hypotheses of their effects on JD transmission are developed. Empirical research is needed, not only to provide scientific evidence for organic producers, but also for smaller conventional farms employing organic-like management practices.
    Keywords dairy farming ; dairy industry ; disease transmission ; empirical research ; farms ; hygiene ; milk production ; organic production ; risk assessment ; ruminants ; Canada
    Language English
    Dates of publication 2014-1118
    Size p. 8237-8261.
    Publishing place Multidisciplinary Digital Publishing Institute
    Document type Article
    Note Review
    ZDB-ID 2518383-7
    ISSN 2071-1050
    ISSN 2071-1050
    DOI 10.3390/su6118237
    Database NAL-Catalogue (AGRICOLA)

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  5. Article ; Online: Comparing ELISA test-positive prevalence, risk factors and management recommendations for Johne's disease prevention between organic and conventional dairy farms in Ontario, Canada.

    Pieper, Laura / Sorge, Ulrike S / DeVries, Trevor / Godkin, Ann / Lissemore, Kerry / Kelton, David

    Preventive veterinary medicine

    2015  Volume 122, Issue 1-2, Page(s) 83–91

    Abstract: Johne's disease (JD) is a chronic, infectious disease in cattle. Between 2010 and 2013, a voluntary ...

    Abstract Johne's disease (JD) is a chronic, infectious disease in cattle. Between 2010 and 2013, a voluntary JD control program was successfully launched in Ontario, Canada, including a Risk Assessment and Management Plan (RAMP) and JD ELISA testing of the entire milking herd. Over the last decade, the organic dairy sector has been growing. However, organic farming regulations and philosophies may influence the risk for JD transmission on Ontario organic dairy farms. The aim of this cross-sectional study was to investigate differences in JD ELISA test positive prevalence, risk factors for JD and recommendations for JD prevention between organic and conventional dairy herds in Ontario. RAMP results (i.e. RAMP scores and recommendations) and ELISA results were available for 2103 dairy herds, including 42 organic herds. If available, additional data on milk production, milk quality, and herd characteristics were gathered. Organic and conventional herds had a similar herd-level JD ELISA test-positive prevalence (26.2% and 27.2%, respectively). Organic herds (4.2%) had a higher within-herd JD ELISA test-positive prevalence compared to conventional herds (2.3%) if they had at least one JD test-positive animal on the farm. Organic farms had lower risk scores for biosecurity (9 points lower), and higher scores in the calving (7 points higher) and the calf-rearing management areas (4 points higher). After accounting for RAMP score, organic farms received fewer recommendations for the calving management area (Odds Ratio=0.41) and more recommendations in the adult cow management area (Odds Ratio=2.70). A zero-inflated negative binomial model was built with purchase of animals and the herd size included in the logistic portion of the model. Herd type (organic or conventional), colostrum and milk feeding practices, average bulk tank somatic cell count, and presence of non-Holstein breeds were included in the negative binomial portion of the model. Organic farms had a higher number of test positive animals (Count Ratio=2.02). Further research is necessary to investigate the apparent disconnect between risk factors and recommendations on organic dairy farms.
    MeSH term(s) Animals ; Cattle ; Cattle Diseases/epidemiology ; Cattle Diseases/microbiology ; Cattle Diseases/prevention & control ; Cattle Diseases/transmission ; Cross-Sectional Studies ; Dairying/methods ; Enzyme-Linked Immunosorbent Assay/veterinary ; Models, Theoretical ; Ontario/epidemiology ; Organic Agriculture ; Paratuberculosis/epidemiology ; Paratuberculosis/microbiology ; Paratuberculosis/prevention & control ; Paratuberculosis/transmission ; Prevalence ; Risk Factors
    Language English
    Publishing date 2015-11-01
    Publishing country Netherlands
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 43399-8
    ISSN 1873-1716 ; 0167-5877
    ISSN (online) 1873-1716
    ISSN 0167-5877
    DOI 10.1016/j.prevetmed.2015.09.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Management Practices and Their Potential Influence on Johne’s Disease Transmission on Canadian Organic Dairy Farms—A Conceptual Analysis

    Laura Pieper / Ulrike Sorge / Ann Godkin / Trevor DeVries / Kerry Lissemore / David Kelton

    Sustainability, Vol 6, Iss 11, Pp 8237-

    2014  Volume 8261

    Abstract: Johne’s disease (JD) is a chronic, production-limiting disease of ruminants. Control programs ...

    Abstract Johne’s disease (JD) is a chronic, production-limiting disease of ruminants. Control programs aiming to minimize the effects of the disease on the dairy industry have been launched in many countries, including Canada. Those programs commonly focus on strict hygiene and management improvement, often combined with various testing methods. Concurrently, organic dairy farming has been increasing in popularity. Because organic farming promotes traditional management practices, it has been proposed that organic dairy production regulations might interfere with implementation of JD control strategies. However, it is currently unclear how organic farming would change the risk for JD control. This review presents a brief introduction to organic dairy farming in Canada, JD, and the Canadian JD control programs. Subsequently, organic practices are described and hypotheses of their effects on JD transmission are developed. Empirical research is needed, not only to provide scientific evidence for organic producers, but also for smaller conventional farms employing organic-like management practices.
    Keywords organic farming ; paratuberculosis ; control program ; disease prevention ; dairy cows ; Environmental effects of industries and plants ; TD194-195 ; Renewable energy sources ; TJ807-830 ; Environmental sciences ; GE1-350
    Subject code 630
    Language English
    Publishing date 2014-11-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Histoplasty Modification of the Tumor Microenvironment in a Murine Preclinical Model of Breast Cancer.

    Pieper, Alexander A / Stowe, Nicholas A / Periyasamy, Sarvesh / Burkel, Brian M / Tsarovsky, Noah W / Singh, Ajay P / Rakhmilevich, Alexander L / Sondel, Paul M / Ponik, Suzanne M / Laeseke, Paul F / Yu, John-Paul J

    Journal of vascular and interventional radiology : JVIR

    2024  

    Abstract: Purpose: To develop a noninvasive therapeutic approach able to alter the biophysical organization and physiology of the extracellular matrix (ECM) in breast cancer.: Materials and methods: In a 4T1 murine model of breast cancer, histoplasty treatment ...

    Abstract Purpose: To develop a noninvasive therapeutic approach able to alter the biophysical organization and physiology of the extracellular matrix (ECM) in breast cancer.
    Materials and methods: In a 4T1 murine model of breast cancer, histoplasty treatment with a proprietary 700-kHz multielement therapy transducer using a coaxially aligned ultrasound (US) imaging probe was used to target the center of an ex vivo tumor and deliver subablative acoustic energy. Tumor collagen morphology was qualitatively evaluated before and after histoplasty with second harmonic generation. Separately, mice bearing bilateral 4T1 tumors (n = 4; total tumors = 8) were intravenously injected with liposomal doxorubicin. The right flank tumor was histoplasty-treated, and tumors were fluorescently imaged to detect doxorubicin uptake after histoplasty treatment. Next, 4T1 tumor-bearing mice were randomized into 2 treatment groups (sham vs histoplasty, n = 3 per group). Forty-eight hours after sham/histoplasty treatment, tumors were harvested and analyzed using flow cytometry.
    Results: Histoplasty significantly increased (P = .0023) liposomal doxorubicin diffusion into 4T1 tumors compared with untreated tumors (2.12- vs 1.66-fold increase over control). Flow cytometry on histoplasty-treated tumors (n = 3) demonstrated a significant increase in tumor macrophage frequency (42% of CD45 vs 33%; P < .05) and a significant decrease in myeloid-derived suppressive cell frequency (7.1% of CD45 vs 10.3%; P < .05). Histoplasty-treated tumors demonstrated increased CD8+ (5.1% of CD45 vs 3.1%; P = .117) and CD4+ (14.1% of CD45 vs 11.8%; P = .075) T-cell frequency.
    Conclusions: Histoplasty is a nonablative focused US approach to noninvasively modify the tumor ECM, increase chemotherapeutic uptake, and alter the tumor immune microenvironment.
    Language English
    Publishing date 2024-03-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1137756-2
    ISSN 1535-7732 ; 1051-0443
    ISSN (online) 1535-7732
    ISSN 1051-0443
    DOI 10.1016/j.jvir.2024.03.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Variability in Risk Assessment and Management Plan (RAMP) scores completed as part of the Ontario Johne’s Education and Management Assistance Program(2010–2013)

    Pieper, Laura / Ann Godkin / David F. Kelton / Jamie Imada / Karen J. Hand / Nicole R. Perkins / Trevor J. DeVries / Ulrike S. Sorge

    American Dairy Science Association Journal of dairy science. 2015 Apr., v. 98, no. 4

    2015  

    Abstract: As a proactive measure toward controlling the nontreatable and contagious Johne’s disease in cattle ... the Ontario dairy industry launched the voluntary Ontario Johne’s Education and Management Assistance Program ...

    Abstract As a proactive measure toward controlling the nontreatable and contagious Johne’s disease in cattle, the Ontario dairy industry launched the voluntary Ontario Johne’s Education and Management Assistance Program in 2010. The objective of this study was to describe the results of the first 4 yr of the program and to investigate the variability in Risk Assessment and Management Plan (RAMP) scores associated with the county, veterinary clinic, and veterinarian. Of 4,158 Ontario dairy farms, 2,153 (51.8%) participated in the program between January 2010 and August 2013. For this study, RAMP scores and whole-herd milk or serum ELISA results were available from 2,103 farms. Herd-level ELISA-positive prevalence (herds with one or more test-positive cows were considered positive) was 27.2%. Linear mixed model analysis revealed that the greatest RAMP score variability was at the veterinarian level (24.2%), with relatively little variability at the county and veterinary clinic levels. Consequently, the annual RAMP should be done by the same veterinarian to avoid misleading or discouraging results.
    Keywords cattle diseases ; cows ; dairy farming ; dairy industry ; education ; enzyme-linked immunosorbent assay ; farms ; herds ; paratuberculosis ; risk assessment ; statistical models ; veterinarians ; veterinary clinics ; whey ; Ontario
    Language English
    Dates of publication 2015-04
    Size p. 2419-2426.
    Publishing place Elsevier Inc.
    Document type Article
    ZDB-ID 242499-x
    ISSN 1525-3198 ; 0022-0302
    ISSN (online) 1525-3198
    ISSN 0022-0302
    DOI 10.3168/jds.2014-8812
    Database NAL-Catalogue (AGRICOLA)

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  9. Article: Comparing ELISA test-positive prevalence, risk factors and management recommendations for Johne’s disease prevention between organic and conventional dairy farms in Ontario, Canada

    Pieper, Laura / Ann Godkin / David Kelton / Kerry Lissemore / Trevor DeVries / Ulrike S. Sorge

    Preventive veterinary medicine. 2015 Nov. 01, v. 122, no. 1-2

    2015  

    Abstract: Johne’s disease (JD) is a chronic, infectious disease in cattle. Between 2010 and 2013, a voluntary ...

    Abstract Johne’s disease (JD) is a chronic, infectious disease in cattle. Between 2010 and 2013, a voluntary JD control program was successfully launched in Ontario, Canada, including a Risk Assessment and Management Plan (RAMP) and JD ELISA testing of the entire milking herd. Over the last decade, the organic dairy sector has been growing. However, organic farming regulations and philosophies may influence the risk for JD transmission on Ontario organic dairy farms. The aim of this cross-sectional study was to investigate differences in JD ELISA test positive prevalence, risk factors for JD and recommendations for JD prevention between organic and conventional dairy herds in Ontario. RAMP results (i.e. RAMP scores and recommendations) and ELISA results were available for 2103 dairy herds, including 42 organic herds. If available, additional data on milk production, milk quality, and herd characteristics were gathered. Organic and conventional herds had a similar herd-level JD ELISA test-positive prevalence (26.2% and 27.2%, respectively). Organic herds (4.2%) had a higher within-herd JD ELISA test-positive prevalence compared to conventional herds (2.3%) if they had at least one JD test-positive animal on the farm. Organic farms had lower risk scores for biosecurity (9 points lower), and higher scores in the calving (7 points higher) and the calf-rearing management areas (4 points higher). After accounting for RAMP score, organic farms received fewer recommendations for the calving management area (Odds Ratio=0.41) and more recommendations in the adult cow management area (Odds Ratio=2.70). A zero-inflated negative binomial model was built with purchase of animals and the herd size included in the logistic portion of the model. Herd type (organic or conventional), colostrum and milk feeding practices, average bulk tank somatic cell count, and presence of non-Holstein breeds were included in the negative binomial portion of the model. Organic farms had a higher number of test positive animals (Count Ratio=2.02). Further research is necessary to investigate the apparent disconnect between risk factors and recommendations on organic dairy farms.
    Keywords adults ; biosecurity ; breeds ; calving ; cattle diseases ; colostrum ; cows ; cross-sectional studies ; dairy farming ; dairy herds ; disease prevention ; enzyme-linked immunosorbent assay ; farms ; herd size ; infectious diseases ; milk ; milk production ; milking ; models ; organic production ; risk assessment ; risk factors ; somatic cell count ; Ontario
    Language English
    Dates of publication 2015-1101
    Size p. 83-91.
    Publishing place Elsevier B.V.
    Document type Article
    ZDB-ID 43399-8
    ISSN 1873-1716 ; 0167-5877
    ISSN (online) 1873-1716
    ISSN 0167-5877
    DOI 10.1016/j.prevetmed.2015.09.004
    Database NAL-Catalogue (AGRICOLA)

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  10. Article: Rhythm versus rate control in patients with newly diagnosed atrial fibrillation - Observations from the GARFIELD-AF registry.

    Knudsen Pope, Marita / Hall, Trygve S / Virdone, Saverio / Atar, Dan / John Camm, A / Pieper, Karen S / Jansky, Petr / Haas, Sylvia / Goto, Shinya / Panchenko, Elizaveta / Baron-Esquivias, Gonzalo / Angchaisuksiri, Pantep / Kakkar, Ajay K

    International journal of cardiology. Heart & vasculature

    2023  Volume 49, Page(s) 101302

    Abstract: Background: Investigate real-world outcomes of early rhythm versus rate control in patients with recent onset atrial fibrillation.: Methods: The Global Anticoagulant Registry in the FIELD-AF (GARFIELD-AF) is an international multi-centre, non- ... ...

    Abstract Background: Investigate real-world outcomes of early rhythm versus rate control in patients with recent onset atrial fibrillation.
    Methods: The Global Anticoagulant Registry in the FIELD-AF (GARFIELD-AF) is an international multi-centre, non-interventional prospective registry of newly diagnosed (≤6 weeks' duration) atrial fibrillation patients at risk for stroke. Patients were stratified according to treatment initiated at baseline (≤48 days post enrolment), and outcome risks evaluated by overlap propensity weighted Cox proportional-hazards models.
    Results: Of 45,382 non-permanent atrial fibrillation patients, 23,858 (52.6 %) received rhythm control and 21,524 (47.4 %) rate control. Rhythm-controlled patients had lower median age (68.0 [Q1;Q3: 60.0;76.0] versus 73.0 [65.0;79.0]), fewer histories of stroke/transient ischemic attack/systemic embolism (9.4 % versus 13.0 %), and lower expected probabilities of death (median GARFIELD-AF death score 4.0 [2.3;7.5] versus 5.1 [2.8;9.2]). The two groups had the same median CHA
    Conclusion: Rhythm control strategy was initiated in about half of the patients with newly diagnosed non-valvular non-permanent atrial fibrillation. After balancing confounders, significantly lower risks of all-cause mortality and non-haemorrhagic stroke were observed in patients who received early rhythm control.
    Language English
    Publishing date 2023-11-16
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 2818464-6
    ISSN 2352-9067
    ISSN 2352-9067
    DOI 10.1016/j.ijcha.2023.101302
    Database MEDical Literature Analysis and Retrieval System OnLINE

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