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).

Study Objectives: The cardiovascular complications caused by obstructive sleep apnea (OSA) decrease after continuous positive airway pressure treatment (CPAP). Mean platelet volume (MPV), platelet distribution width (PDW), and red cell distribution width (RDW) are newly recognized tools for assessing cardiovascular risk. Methods: From a selection of patients with symptoms of nocturnal snoring and/or excessive daytime sleepiness, 36 males with an apnea-hypopnea index (AHI) > 30/h and 22 age-matched normal male controls with AHI < 5/h were included. Patients with OSA underwent another night of CPAP titration, and 11 patients were excluded at the 6-month evaluation due to poor compliance with the home CPAP therapy. Complete blood count parameters of compliant patients and the control group were evaluated. S C I E N T I F I C I N V E S T I G A T I O N SO bstructive sleep apnea (OSA) is characterized by collapse of the upper airway during sleep, recurring apnea, intermittent hypoxemia, and daytime sleepiness. The severity of OSA is evaluated in terms of the number of apnea/hypopnea episodes per hour of sleep and is expressed as the apnea-hypopnea index (AHI). 1Red blood cell distribution width (RDW) is a numerical measure of the size variability of circulating erythrocytes and is routinely reported as a component of the complete blood count in the differential diagnosis of anemia. Disorders related to ineffective erythropoiesis or increased red blood cell destruction cause greater size heterogeneity and thus a higher RDW. 2,3Several studies have reported increased platelet activation and aggregation in patients with OSA. 4,5 It has been shown that platelet size, as measured by mean platelet volume (MPV), correlates with platelet reactivity, and is regarded as an easy and useful tool for indirect monitoring of platelet activity. As larger platelets have greater thrombotic potential, the RDW, MPV, and platelet distribution width (PDW) have been shown to be related to cardiovascular morbidity and mortality in patients with cardiac diseases. In OSA patients, RDW, MPV, and PDW are newly recognized indicators of the severity of the condition that are associated with no additional cost compared to a routinely performed complete blood count. 11-14Continuous positive airway pressure (CPAP) therapy is the gold standard in patients with severe OSA. MPV is reduced after CPAP therapy in severe OSA patients, indicating that CPAP therapy has cardioprotective effects. 15 To our knowledge, the effect of CPAP therapy on RDW and PDW in OSA patients has not been reported; thus, we decided to investigate this possibility. BRIEF SUMMARYCurrent Knowledge/Study Rationale: Mean platelet volume (MPV), platelet distribution width (PDW), and red cell distribution width (RDW) are newly recognized tools for assessing cardiovascular risk. These markers increase in patients with OSA. The effect of CPAP treatment on these parameters was evaluated. Study Impact: Our data suggest that complete blood count parameters such as MPV, PDW, and RDW changed ...

Some aspects of attentional processing are known to decline with normal aging. To understand how age affects the attentional control of perceptual stability, we investigated age-related changes in voluntarily controlled perceptual rivalry. Durations of the dominant percept, produced by an ambiguous Rubin vase-faces figure, were measured in conditions that required passive viewing and attentional control: holding and switching the dominant percept. During passive viewing, mean dominance duration in the older group was significantly longer (63%) than the dominance duration found in the young group. This age-related deficit could be due to a decline in the apparent strength of the alternating percepts as a result of higher contrast gain of visual cortical activity and a reduction in the amount of attentional resources allocated to the ambiguous stimulus in older people compared to young adults. In comparison to passive viewing, holding the dominant percept did not significantly alter the dominance durations in the older group, while the dominance durations in the young group were increased (∼100%). The dominance durations for both age groups in switch conditions were reduced compared to their passive viewing durations (∼40%). The inability of older people to voluntarily prolong the duration of the dominant percept suggests that they may have abnormal attentional mechanisms, which are inefficient at enhancing the effective strength of the dominant percept. Results suggest that older adults have difficulty holding attended visual objects in focus, a problem that could affect their ability to carry out everyday tasks.

Obstructive sleep apnea syndrome (OSAS) is a common disorder that can lead to significant cardiovascular complications. Several studies have reported increased platelet activation and aggregation in patients with OSAS. In this study we aimed to show a correlation between mean platelet volume (MPV) and severity of OSAS in patients with OSAS without any overt cardiac disease or diabetes. The polysomnography recordings of 556 consecutive patients admitted to the sleep laboratory between January 2012 and July 2012 were retrospectively evaluated. The relationship between polysomnographic parameters and biochemical parameters was assessed. Polysomnographic results of 200 patients (154 males [77%]; mean age, 44.5 ± 11.4 years) were included. No correlation was observed between MPV and the average oxygen saturation index, the minimum desaturation index, or the oxygen desaturation index in the study population as well as in severe OSAS group (AHI > 30). The only correlation was found between MPV and AHI in the severe OSAS group (P = 0.010). MPV was not correlated with OSAS severity in patients without any overt cardiac disease or diabetes. These findings raise doubts about the suggestion that MPV might be a marker for OSAS severity, as recommended in earlier studies. Thus, further prospective data are needed.