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BackgroundAtrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all‐cause mortality may guide interventions.Methods and ResultsIn the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose‐adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all‐cause mortality in the 14 171 participants in the intention‐to‐treat population. The median age was 73 years, and the mean CHADS 2 score was 3.5. Over 1.9 years of median follow‐up, 1214 (8.6%) patients died. Kaplan–Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all‐cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33–1.70, P<0.0001) and age ≥75 years (hazard ratio 1.69, 95% CI 1.51–1.90, P<0.0001) were associated with higher all‐cause mortality. Multiple additional characteristics were independently associated with higher mortality, with decreasing creatinine clearance, chronic obstructive pulmonary disease, male sex, peripheral vascular disease, and diabetes being among the most strongly associated (model C‐index 0.677).ConclusionsIn a large population of patients anticoagulated for nonvalvular atrial fibrillation, ≈7 in 10 deaths were cardiovascular, whereas <1 in 10 deaths were caused by nonhemorrhagic stroke or systemic embolism. Optimal prevention and treatment of heart failure, renal impairment, chronic obstructive pulmonary disease, and diabetes may improve survival.Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT00403767.

There is a high prevalence of hypertension in the slums of Kolkata. Although the awareness of the condition is high, the control of hypertension is poor.

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50 patients with cirrhosis of liver admitted in SMS Hospital, Jaipur were selected for the study. Ultrasonography was performed in all the cases and diameter of portal vein and spleen size was recorded. Endoscopy was performed in all the selected cases to look for oesophageal varices. Out of 50 patients 40(80%) had oesophageal varices at the time of presentation. Average Spleen size in variceal group (14.69±1.08)cm was higher than in non-variceal group(12.45±0.65)cm, p<0.01. The average portal vein diameter of patients in nonvariceal group was 11.78±1.58mm and that of patients with varices 14.05±2.26 mm, p <0.01. There was a positive correlation between spleen size and the Grades of oesophageal varices (r=0.6771) and the difference was statistically significant(p<0.01). There was a positive correlation between Portal vein Diameter and grades of oesophageal vaices (r=0.7465),p<0.01. In our study it was also found that there was a weak but definite correlation between Portal Vein Diameter and Spleen size(r=0.5369) which was statistically significant (p<0.01). Hence from the present study it can be concluded that as the Grades of Varices increases the Spleen size and Portal Vein Diameter also increases.