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3. A Review on Bioflocculant-Synthesized Copper Nanoparticles: Characterization and Application in Wastewater Treatment

Author

Nkanyiso C. Nkosi, Albertus K. Basson, Zuzingcebo G. Ntombela, Nkosinathi G. Dlamini, and Rajasekhar V. S. R. Pullabhotla

Subjects
bioflocculant, Cu nanoparticles, biosynthesis, characterization, application, Technology, Biology (General), QH301-705.5
Abstract

Copper nanoparticles (CuNPs) are tiny materials with special features such as high electric conductivity, catalytic activity, antimicrobial activity, and optical activity. Published reports demonstrate their utilization in various fields, including biomedical, agricultural, environmental, wastewater treatment, and sensor fields. CuNPs can be produced utilizing traditional procedures; nevertheless, such procedures have restrictions like excessive consumption of energy, low production yields, and the utilization of detrimental substances. Thus, the adoption of environmentally approachable “green” approaches for copper nanoparticle synthesis is gaining popularity. These approaches involve employing plants, bacteria, and fungi. Nonetheless, there is a scarcity of data regarding the application of microbial bioflocculants in the synthesis of copper NPs. Therefore, this review emphasizes copper NP production using microbial flocculants, which offer economic benefits and are sustainable and harmless. The review also provides a characterization of the synthesized copper nanoparticles, employing numerous analytical tools to determine their compositional, morphological, and topographical features. It focuses on scientific advances from January 2015 to December 2023 and emphasizes the use of synthesized copper NPs in wastewater treatment.

Published
2024
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6. Biosynthesis and Characterization of Copper Nanoparticles Using a Bioflocculant Produced by a Yeast Pichia kudriavzevii Isolated from Kombucha Tea SCOBY

Author

Phakamani H. Tsilo, Albertus K. Basson, Zuzingcebo G. Ntombela, Nkosinathi G. Dlamini, and Rajasekhar V. S. R. Pullabhotla

Subjects
copper nanoparticles, Pichia kudriavzevii, Kombucha tea SCOBY, bioflocculant, biosynthesis, characterization, Technology
Abstract

Over recent years, the ‘green’ chemistry approach to synthesizing nanoparticles has made significant developments. Because of their unique features, nanoparticles have received a lot of attention. The use of a bioflocculant to promote the environmentally friendly synthesis of copper nanoparticles is described in this paper. Copper nanoparticles were biosynthesized using bioflocculant which was produced from a yeast, Pichia kudriavzevii. The chemical reduction approach was used to synthesize copper nanoparticles (CuNPs) using a bioflocculant as a capping agent. Characterization of the as-synthesized copper nanoparticles was conducted using Fourier transform infrared (FT-IR) spectroscopy, UV-visible spectroscopy, X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM), and energy dispersive X-ray (EDX). The FT-IR spectra revealed characteristic peaks at 3267, 2956, 1656, 1059, and 511 cm−1 for the bioflocculant, while for the bioflocculant passivated CuNPs, the characteristic peaks were at 3482 (-OH), 3261, 1640, 1059, 580, and 519 cm−1 (Cu-O). These peaks revealed that functional groups such as hydroxyls, amines, and copper oxide bonds were present. The UV-Vis analysis showed surface plasmon resonance (SPR) at an absorbance range of 500–600 nm, with peak maxima at 555 and 575 nm for the as-synthesized CuNPs. The XRD pattern revealed planes such as (200) and (220) at 2θ = 43 and 52°, and the particle size (30 nm) was determined by the Debye–Scherrer equation. The transmission electron microscopy analysis revealed a spherical-shaped particle with an average size of 20 nm. The EDX analysis of the as-synthesized CuNPs revealed the presence of the element Cu, which was not present in the EDX image of the bioflocculant used in the synthesis of the CuNPs; this indicated the success of biosynthesis.

Published
2023
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7. Green Synthesis, Characterization and Application of Silver Nanoparticles Using Bioflocculant: A Review

Author

Nkanyiso C. Nkosi, Albertus K. Basson, Zuzingcebo G. Ntombela, Nkosinathi G. Dlamini, and Rajasekhar V. S. R. Pullabhotla

Subjects
bioflocculant, nanoparticles, biosynthesis, characterization, potential application, Technology, Biology (General), QH301-705.5
Abstract

Nanotechnology has emerged as an effective means of removing contaminants from water. Traditional techniques for producing nanoparticles, such as physical methods (condensation and evaporation) and chemical methods (oxidation and reduction), have demonstrated high efficiency. However, these methods come with certain drawbacks, including the significant energy requirement and the use of costly and hazardous chemicals that may cause nanoparticles to adhere to surfaces. To address these limitations, researchers are actively developing alternative procedures that are cost-effective, environmentally safe, and user-friendly. One promising approach involves biological synthesis, which utilizes plants or microorganisms as reducing and capping agents. This review discusses various methods of nanoparticle synthesis, with a focus on biological synthesis using naturally occurring bioflocculants from microorganisms. Bioflocculants offer several advantages, including harmlessness, biodegradability, and minimal secondary pollution. Furthermore, the review covers the characterization of synthesized nanoparticles, their antimicrobial activity, and cytotoxicity. Additionally, it explores the utilization of these NPs in water purification and dye removal processes.

Published
2024
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8. Isolation and Optimization of Culture Conditions of a Bioflocculant-Producing Fungi from Kombucha Tea SCOBY

Author

Phakamani H. Tsilo, Albertus K. Basson, Zuzingcebo G. Ntombela, Tsolanku S. Maliehe, and Rajasekhar V. S. R. Pullabhotla

Subjects
bioflocculants, Pichia kudriavzevii, fungi, Kombucha tea SCOBY, Microbiology, QR1-502
Abstract

Biolocculants are gaining attention in research due to their environmental friendliness and innocuousness to human in comparison to the conventional flocculants. The present study aimed to investigate the ability of fungi from Kombucha tea SCOBY to produce effective bioflocculant in bulk. A 16S rRNA gene sequence analysis was utilized to identify the isolate. The medium composition (carbon and nitrogen sources) and culture conditions (inoculum size, temperature, shaking speed, pH, and time) were optimized using one-factor-at-a-time method. The functional groups, morphology, and crystallinity of the bioflocculant were evaluated using Fourier transform infrared (FT-IR), scan electron microscope (SEM) and X-ray diffractometry (XRD). The fungus was found to be Pichia kudriavzevii MH545928.1. It produced a bioflocculant with flocculating activity of 99.1% under optimum conditions; 1% (v/v) inoculum size, glucose and peptone as nutrient sources, 35 °C, pH 7 and the shaking speed of 140 rpm for 60 h. A cumulus-like structure was revealed by SEM; FT-IR displayed the presence of hydroxyl, carboxyl, amine, and thiocynates. The XRD analysis demonstrated the bioflocculant to have big particles with diffraction peaks at 10° and 40° indicating its crystallinity. Based on the obtained results, P. kudriavzevii MH545928.1 has potential industrial applicability as a bioflocculant producer.

Published
2021
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9. A Review on Bioflocculant-Synthesized Copper Nanoparticles: Characterization and Application in Wastewater Treatment.

Author

Nkosi, Nkanyiso C., Basson, Albertus K., Ntombela, Zuzingcebo G., Dlamini, Nkosinathi G., and Pullabhotla, Rajasekhar V. S. R.

Subjects
NANOPARTICLE synthesis, COPPER, ELECTRIC conductivity, MICROBIOLOGICAL synthesis, WASTEWATER treatment
Abstract

Copper nanoparticles (CuNPs) are tiny materials with special features such as high electric conductivity, catalytic activity, antimicrobial activity, and optical activity. Published reports demonstrate their utilization in various fields, including biomedical, agricultural, environmental, wastewater treatment, and sensor fields. CuNPs can be produced utilizing traditional procedures; nevertheless, such procedures have restrictions like excessive consumption of energy, low production yields, and the utilization of detrimental substances. Thus, the adoption of environmentally approachable "green" approaches for copper nanoparticle synthesis is gaining popularity. These approaches involve employing plants, bacteria, and fungi. Nonetheless, there is a scarcity of data regarding the application of microbial bioflocculants in the synthesis of copper NPs. Therefore, this review emphasizes copper NP production using microbial flocculants, which offer economic benefits and are sustainable and harmless. The review also provides a characterization of the synthesized copper nanoparticles, employing numerous analytical tools to determine their compositional, morphological, and topographical features. It focuses on scientific advances from January 2015 to December 2023 and emphasizes the use of synthesized copper NPs in wastewater treatment. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Production and characterization of a bioflocculant produced by Proteus mirabilis AB 932526.1 and its application in wastewater treatment and dye removal

Author

Nkanyiso C. Nkosi, Albertus K. Basson, Zuzingcebo G. Ntombela, Nkosinathi G. Dlamini, Tsolanku S. Maliehe, and Rajasekhar V. S. R. Pullabhotla

Subjects
General Chemical Engineering, General Chemistry
Abstract

Microbial flocculants affect the aggregation of suspended solutes in solutions, thus, they are a viable alternative to inorganic and organic synthetic flocculants which are associated with deleterious health problems. Moreover, a potential solution for wastewater treatment. The study aimed to produce and characterize a bioflocculant from Proteus mirabilis AB 932526.1 and apply it in domestic wastewater treatment and dye removal. The bioflocculant was extracted using butanol and chloroform (5:2 v/v). Carbohydrates, proteins, and uronic acid were identified using phenol-sulphuric acid, Bradford, and Carbazole essays. The morphology, crystallinity and elemental composition of the purified bioflocculant were determined using a Scanning electron microscope (SEM), X-ray diffraction analysis and SEM energy dispersive elemental detector (SEM-EDX). The antimicrobial properties and dye removal efficiencies were evaluated. About 3.8 g/L yields of the purified bioflocculant were attained. Chemical composition analysis revealed the presence of 65 % carbohydrates, 10 % proteins, and 24 % uronic acids. The bioflocculant displayed an amorphous and crystalline structure. Bioflocculant further shows some remarkable properties as they can be able to inhibit the growth of both Gram-positive and Gram-negative microorganisms. The removal efficiencies of 85 % (COD), 82 % (BOD), and 81 % (SO4 2−) in domestic wastewater were achieved. Moreover, the high removal efficiency of staining dyes such as methylene blue (71 %), carbol fuchsin (81 %), safranin (83 %), methylene orange (90 %), and Congo red (90 %) were found. The produced bioflocculant can imply industrial applicability.

Published
2023
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14. An Autopsy Based Study of Deaths Due to Snake Bite in Kurnool Region of Andhra Pradesh.

Author

Rajasekhar, V., Bandaru, Sugnan, Sri Ram, Katta, Mandala, Mahesh, and Reddy, N. Sridhar

Subjects
SNAKEBITES, AUTOPSY, THANATOLOGY, NEGLECTED diseases, PUBLIC hospitals, AGRICULTURAL laborers
Abstract

Snakebite envenoming is a neglected tropical disease (NTD) that is responsible for enormous suffering, disability and premature death. This study is an autopsy based epidemiological study of deaths due to snake bite conducted in Kurnool medical college attached Government General Hospital, Kurnool, Andhra Pradesh. The results of the study indicated that snake bites are more common among middle-aged, uneducated, male agricultural laborers working in fields during monsoon season. In Majority of the them bitten by snake over lower extremities. The majority of patients could not reach the hospital in time because their habitats are rural areas and not well connected to the nearby health centers. [ABSTRACT FROM AUTHOR]

Published
2024
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18. A Study on Pattern of Suicidal Deaths Brought for Medicolegal Autopsy at Mortuary of Siddhartha Medical College and Govt. General Hospital, Vijayawada, Andhra Pradesh.

Author

Khan, Mohammad Ajas, Sushanth, Nelapati, and Rajasekhar, V.

Subjects
HANGING (Death), SUICIDE statistics, SUICIDE prevention, MEDICAL schools, CONSCIOUSNESS raising, AUTOPSY
Abstract

Background: The aim is to study the pattern of suicidal deaths, demographic profile including various contributary factors of victims and analyze the magnitude of deaths in and around Vijayawada part of Andhra Pradesh so that preventive measures can be set up to avoid such situation. A death by suicide is defined as the deliberate termination of life. For a death to be a suicide, it should be an un-natural death, the desire to die should originate within the person, and there should be a reason for ending their life, according to the National Crime Records Bureau. While India's suicide rate of 14.04/lakh population in 2019 puts it at 49th rank globally, the grim reality of the highest numbers of suicides being reported annually from India cannot be overlooked. When you look at suicide deaths, the highest suicide rates are in the south. In central India, including Maharashtra, Madhya Pradesh and Rajasthan, you have "middling suicide rates", and the rate falls up north, in Uttar Pradesh and Bihar. Material & Methods: A five years retrospective and cross-sectional study was conducted in Forensic Medicine and Toxicology Department, Siddhartha Medical College, Vijayawada, Andhra Pradesh. All the autopsies conducted on victims of suicidal deaths during the period from Jan, 2016 to Dec, 2020 were studied from the available data. Inclusion criteria includes all the suicidal deaths due to poisoning, hanging and self-immolation by burns. Exclusion criteria includes suicidal deaths from causes other than poisoning, hanging and suicidal burns like drowning, electrocution, fall from height etc. Results: It is clear that committing suicide by consuming poison accounts for major number of deaths followed by committing suicide by hanging and least followed by committing suicide by self-immolation. It is also clear that committing suicides has increased year by year from 2016 to 2020 irrespective of committing suicide by hanging, poisoning. Coming to sex pattern, suicide by hanging was observed more in males. Sex pattern in suicidal deaths due to poisoning clearly showed that females outnumbered males. Sex pattern in suicidal deaths due to selfimmolation clearly showed that females outnumbered males with high margin. Coming to the age pattern in committing suicidal deaths by hanging, 30 - 45 years age group showed highest incidence year by year followed by 45 - 60 years and least among 15 - 25 years age group. Where as in case of suicidal deaths by poisoning and self-immolation, incidence was highest in 30 - 45 age group followed by 15 - 30 years age group and least among 45 - 60 years group. Conclusion: According to the World Health Organization, in India, suicide is an emerging and serious public health issue. Suicide rates in India have been rising over the past five decades. India's contribution to global suicide deaths increased from 25.3% in 1990 to 36.6% in 2016 among women, and from 18.7% to 24.3% among men. In 2016, suicide was the most common cause of death in both the age groups of 15-29 years and 15-39 years in India. Factors such as frustration, family problems, love affairs, poverty, harassment, sexual violence, social boycott, chronic diseases and bankruptcy were studied as the main reasons leading to committing of suicides in people. The need for a strategy which will raise awareness and help make suicide prevention a national priority has to be recognized. Such a national strategy will need a comprehensive approach that encompasses the promotion, coordination, and support of activities to be implemented across the country at national, regional, and local levels. The program would need to be tailored for populations at risk. [ABSTRACT FROM AUTHOR]

Published
2024
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20. DETAILED INVESTIGATION ON THE ROLE OF MACHINE LEARNING (ML) APPROACHES IN THE MANAGEMENT FOR CONTEMPORARY ORGANISATIONS

Author

UmaMaheswaran SK, Sumeet Gupta, Nagarjuna, Dr B., Rajasekhar, V., Mohit Tiwari, and Rajya Laxmi, M.

Subjects
Machine Learning (ML), Internet-of-Things (IoT), Big data analytics (BDA), artificial intelligence (AI), technology, management
Abstract

Machine Learning (ML) is an area of artificial intelligence that uses information to construct answers to problems. Additionally, critical thinkers are models who have received formal experience in resolving issues related to business duties successfully. The term "Internet-of-Things" (IoT) refers to a wildly diverse network made up of smart gadgets that are connected to the Internet. Machine learning (ML) and deep learning (DL) processes will play a critical part in bringing intelligence to the IoT networks in the aftermath of the disruptive IoT with its massive amount and variety of data. ML and DL can be quite helpful in addressing the problems associated with resource management in large-scale IoT networks, among other things. The resource management strategies in cellular wireless and IoT networks are systematically and in-depth investigated in this study. Secondary data collection method is considered to gather relevant and factual data as well as statistical information from different sources. Keyword Machine Learning (ML), Internet-of-Things (IoT), Big data analytics (BDA), artificial intelligence (AI), technology, management.

Published
2022
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21. Nanocomposite based Electrochemical Sensors for Determination of Some Biologically Important Compounds: A Review.

Author

Vashistha, Vinod Kumar, Bala, Renu, Mittal, Ankit, Das, Dipak Kumar, Sharma, Shubham, and Pullabhotla, Rajasekhar V. S. R.

Subjects
ELECTROCHEMICAL sensors, DRUG analysis, ADENINE, NANOCOMPOSITE materials, URIC acid, DRUGS, GUANINE, CYCLIC voltammetry
Abstract

Electrochemical methods have become increasingly popular in the pharmaceutical and drug analysis sectors due to their numerous benefits, such as high sensitivity, selectivity, and specificity. Electrochemical-based nanomaterials are adjustable and can be influenced by the type of electrode used and the applied potential. Electroanalytical methods have proven to be a useful analytical technology that has seen increased utility in the pharmaceutical business in recent years. In the last five years, there have been significant developments in the synthesis and use of novel electrochemical sensors in drug analysis. These developments have been driven by advancements in instrumentation and an increased understanding of electrochemical methods. This review concludes the current state-of-the-art in electrochemical sensors for pharmaceutical analysis and future perspectives in this field. We highlight the need for more standardized methods for the determination of biologically important compounds such as dopamine, guanine, adenine, and uric acid using electrochemical sensors and the development of multiplexed sensors for simultaneous analysis of multiple drugs. [ABSTRACT FROM AUTHOR]

Published
2023
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30. Response of

Author

Sibongokuhle, Ndlovu, Rajasekhar V S R, Pullabhotla, and Nontuthuko R, Ntuli

Subjects
hormesis, morphological traits, cadmium toxicity, phytoremediation, Corchorus olitorius, Article
Abstract

Corchorus olitorius, a leafy vegetable with high nutrient content, is normally collected from the wild, in areas that are prone to cadmium (Cd) toxicity. However, studies on how Cd accumulation affects vegetative and reproductive traits of leafy vegetables in South Africa are limited. Therefore, this study tested the effect of Cd accumulation on C. olitorius morphological traits. Plants were grown under various Cd concentrations and studied for variation in vegetative and reproductive traits as well as accumulation in roots and shoots. Plants exposed to 5 mg/kg Cd had longer roots with higher moisture content, heavier fresh and dried stems, as well as dried leaves, which indicated a hormetic effect in C. olitorius after exposure to low Cd concentration in the soil. Again, plants treated with 5–10 mg/kg Cd, accumulated toxic (>10 mg/kg dry weight) Cd within shoots and roots, with minor morphological alterations. Plants could survive, with some morphological defects, Cd toxicity up to 20 mg/kg in soil. Only plants exposed to 5 mg/kg could reproduce. Cd accumulation increased with an increase in the soil, with higher accumulation in shoots. The translocation factor was high (>1) in all Cd concentrations. In conclusion, C. olitorius can accumulate toxic Cd, and yet grow and reproduce either normally or better than the control. The proposed dose of Cd that induces hormesis in C. olitorius is 5 mg/kg in the soil. Therefore, C. olitorius is suitable for phytoremediation of Cd contaminated soils, but unsafe for consumption when it grows in such areas.

Published
2020

41. Surface modification of graphitic foam.

Author

Mukhopadhyay, Sharmila M., Pulikollu, Rajasekhar V., Ripberger, Erik, and Roy, Ajit K.

Subjects
*GRAPHITE, *PHYSICS
Abstract

This article discusses surface-related issues and possible modification approaches in high-porosity graphitic foam. The microcellular solid is made of graphitic carbon walls, ligaments, and beams supporting a network of interconnected pores. This makes the exposed surface area very high and its understanding a necessity for most applications. Graphitic planes are seen to be stacked at various orientations with respect to exposed surfaces. Therefore, a simplified analytical model that assumes "random" graphitic planes forming a three-dimensional array of tetrahedral cells may be an appropriate approximation. The influence of oxidizing chemicals such as nitric acid and hydrogen peroxide on surface properties has been studied using electron microscopy, photoelectron spectroscopy, and water absorption tests. Bulk properties such as density measurements and mechanical tests have been performed in parallel. It is seen that exposure to nitric acid results in an increase in oxygen-containing functional groups on the surface, which may lead to increased infiltration of polar matrix fluids such as water and epoxy resins. This possibility is further supported by water absorption studies that show increased water infiltration in foam after nitric acid treatment. Electron microscopy and density studies indicate that some surface etching occurs with concentrated nitric acid exposure, but not significant enough to decrease density. Strength of the stand-alone foam is reduced for concentrated nitric acid treatment, but the elastic modulus is unaffected. The scientific significance of these results in terms of future surface modification of microcellular solids has been discussed. [ABSTRACT FROM AUTHOR]

Published
2003
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42. Shear Bond Strength of Repaired Composites Using Surface Treatments and Repair Materials: An In vitro Study

Author

Hemadri, M, Saritha, G, Rajasekhar, V, Pachlag, K Amit, Purushotham, R, and Reddy, Veera Kishore Kumar

Subjects
composite resin repair, surface treatments, shear bond strength, Adhesive systems, Original Research
Abstract

Background: Enhancement of bond strength between new and old composite usually requires increased surface roughness of old composite to promote mechanical interlocking and subsequent coating with bonding agents to improve surface wetting and chemical bonding. So this study was carried out to evaluate and compare the effects of different surface treatments and repair materials on the shear bond strength (SBS) of composite repairs The mode of failure of repaired composites whether cohesive or adhesive was also evaluated. Materials and Methods: The substrates for 60 composite specimens were fabricated and aged with water treatment and subjected to various surface treatments. The surface treatment regimens used in the study were: No surface treatment, abraded with diamond bur, air abraded (sandblasted) with 50 µ aluminum oxide particles. Specimens were then repaired with fresh composite using either Clearfil™ repair or all-bond two adhesive systems. Specimens were water stored, thermocycled and tested for SBS using universal testing machine. Fractured specimens were then examined under stereomicroscope to determine the mode of failure. Results: It was clearly showed that surface roughening of the aged composite substrate with air abrasion, followed by the application of Clearfil™ repair adhesive system (Group IIIa) yielded the highest repair bond strength (32.3 ± 2.2 MPa). Conclusion: Surface treatment with air abrasion followed by bonding with Clearfil™ repair adhesive system can be attempted clinically for the repair of composite restorations.

Published
2014

45. Cause of death and predictors of all-cause mortality in anticoagulated patients with nonvalvular atrial fibrillation: Data from ROCKET AF

Author

Pokorney, Sean D, Piccini, Jonathan P., Stevens, Susanna R., Patel, Manesh R., Pieper, Karen S., Halperin, Jonathan L., Breithardt, Günter, Singer, Daniel E., Hankey, Graeme J., Hacke, Werner, Becker, Richard C., Berkowitz, Scott D., Nessel, Christopher C., Mahaffey, Kenneth W., Fox, Keith A. A., Califf, Robert M., Anderson, J., Bedwell, N., Bilsker, M., Bruce, G., Agah, R., Desantis, M., Eisenberg, S., Flores, A., Herzog, W., Klein, S., Snyder, H., Krueger, S., Almaguer, E., Lavie, E., Lee, C., Mallis, G., Modi, M., Woodworth, G., Niazi, I., Peart, B., Sundaram, S., Snoddy, B., Sotolongo, R., Moloney, J., Vijayaraghavan, K., Whittier, F., Yellen, L., Banerjee, S., Lustgarten, D., Suresh, D., Gelernt, M., Levinson, L., Ghanekar, R., Kneller, G., Hall, C., Fadl, Y., Pirwitz, M., French, W., Mayer, N., Pugeda, J., Steel, K., Mody, F., Malik, A., Chandna, H., Go, A., Emlein, G., Bowden, W., Moscoso, R., Hodson, R., Berk, M., Pan, D., Pappas, J., Orchard, R., Lynchard, G., Vijay, N., Khan, W., El Khadra, M., Antonishen, M., Cucher, F., Staab, M., Zebrack, J., Borromeo, S., Heilman, J., Chaturvedi, S., Makam, S., Turk, S., Hyers, T., Williams, G., Labroo, A., Gill, S., Myears, D., Weinstein, J., Shanes, J., Chandrashekhar, Y., Shah, S., Reiter, W., Logemann, T., Almquist, A., Bhagwat, R., Tak, T., Shen Ling, J., Patel, P., Artis, A., Arouni, A., Lauer, M., Kinney, K., Elsen, J., Roan, P., Villafria, R., Sumpter, M., Ip, J., Welka, S., Schifferdecker, B., Sandoval, R., Speirs, S., Jones, A., Haldis, T., Kazmierski, J., Sutherland, J., Dietrich, D., Telfer, E., Berry, J., Mcelveen, A., Russell, J., Sackett, M., Antonios, N., Smith, D., Vora, K., Kirby, A., Lui, H., Mego, D., Ziada, K., Navas, J., Taussig, A., Koren, M., Vogel, C., Saba, F., Parrott, C., Schneider, R., Shirwany, A., Rubin, M., Treasure, C., Bertolet, B., Chang, M., Langberg, J., Becker, R., Cohen, Y., Mcgrew, F., White, J., Arzola, F., Zelenka, J., Tannenbaum, A., Fernandes, V., Jamnadas, P., Agamasu, J., Collins, B., Jauch, W., Sasseen, B., Hotchkiss, D., Abadier, R., Osunkoya, A., Schlau, A., Chappel, C., Foster, M., Braun, E., Mostel, E., Capo, J., Ashchi, M., Howard, V., Albirini, A., Burger, A., Rolston, D., Staniloae, C., Bacon, J., Wiseman, A., Mcgarvey, J., Sonel, A., Hamroff, G., Chang, D., Daboul, N., Broderick, G., Meholick, A., Corbelli, J., Silverman, R., Raffetto, J., Fishberg, R., Georgeson, S., Held, J., Seidner, M., Saint Jacques, H., Heitner, J., Kutalek, S., Friedlander, I., Hutchinson, B., Walia, J., Kondo, N., Smiley, N., Blitz, L., Dale, H., Sulman, S., Szulawski, I., Modares, F., Martin, R., Nahhas, A., Renzi, M., Akyea Djamson, A., Alfieri, A., Sandhu, J., Voyce, S., Amaram, S., Meyerrose, G., Shoukfeh, M., Lee, F., Villegas, B., Idowu, O., Khera, A., Sam, C., Vo, A., Lieber, I., Smith, T., Awan, N., Tsai, C., Ganim, R., Alzaghrini, G., Pitt, W., Shepherd, A., Tang, S., Stoltz, S., Nelson, W., Cox, S., Meymandi, S., Melucci, M., Thomas, G., Gogia, H., Machell, C., Chandrasekaran, S., Brown, C., Jetty, P., Miller, G., Dykstra, G., Jaffrani, N., Zakhary, B., Caruso, A., Zolty, R., Fox, D., Jacobs, G., Lebenthal, M., Mukherjee, S., Zimetbaum, P., Kingsley, J., Jones, R., Robinson, V., Kenton, D., Usedom, J., Williams, S., Snipes, C., Wilson, V., Hasty, R., Shoemaker, J., Donahue, M., Al Saghir, Y., Thomsen, E., Yarows, S., Chastain, S., Mclaughlin, P., Wakham, M., Shrestha, D., Simmons, J., Fisher, D., Seymour, Z., Frandsen, B., First, B., Sharpe, C., Popeil, L., Guthrie, R., Hunter, J., Alvarado, O., Sandberg, J., Gutman, N., Belber, A., Arkhipov, M., Ballyzek, M., Baranov, A., Barbarash, O., Barbarich, V., Belenky, D., Berkovich, O., Bokarev, I., Boyarkin, M., Vaniev, S., Volkova, E., Gratsiansky, N., Demin, A., Zadionchenko, V., Zateyshchikov, D., Zrazhevsky, K., Mazaev, V., Martynov, A., Mikhailov, S., Mkrtchian, V., Novozhenov, V., Raskina, T., Rebrov, A., Sanina, N., Simanekov, V., Sitnikova, M., Smolenskaya, O., Stryuk, R., Storozhakov, G., Tankhilevich, B., Tereschenko, S., Khokhlov, A., Khrustalev, O., Chernov, S., Shvarts, Y., Shubik, Y., Shulman, V., Yakushin, S., Bugrova, O., Ivleva, A., Libis, R., Khozyainova, N., Maslov, S., Baranova, E., Sherenkov, A., Libov, I., Lusov, V., Chumakova, G., Kuznetsov, V., Ryamzina, I., Reshetko, O., Boldueva, S., Alekseeva, N., Novikova, T., Dvornikov, V., Idrisova, E., Shostak, N., Yarokhno, N., Tebloev, K., Treshkur, T., Mazurov, V., Loktin, E., Sedavnyh, I., Alexeeva, O., Yakhontova, P., Repin, A., Izmozherova, N., Kostenko, V., Fokin, A., Ketova, G., Kouz, S., Leader, R., Ayala Paredes, F., Luton, R., Ma, P., Pandey, S., Pesant, Y., Senior, R., Vertes, G., Bell, A., Crowley, D., Vizel, S., Lasko, B., Landry, D., Berger, L., Heath, J., Bessoudo, R., Ling, M., Tellier, G., Berlingieri, J., Kafka, H., Hill, L., Mazza, G., O'Mahony, W., Chilvers, M., O'Mahony, M., Newman, D., Silagy, S., Heffernan, M., Bennett, M., Bhesania, T., Rockman, G., Ng, K., Kalra, B., Meneses, G., Liang, W., Cheung, M., Kozak, J., Pugen, G., Vavougios, J., Kates, M., Nunes Vaz, C., Jaffer, S., Orfi, J., Faiers, A., Chung, C., Felsen, S., Bergman, S., Bernstein, I., Brownscombe, L., Stockdill, J., Silver, E., Ezekiel, D., Jagan, N., Khurana, M., Reisler, H., Goldman, H., Maung, 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Subjects
Male, Time Factors, medicine.medical_treatment, Administration, Oral, Comorbidity, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, THERAPY, Sudden Cardiac Death, 3124 Neurology and psychiatry, Sudden cardiac death, 0302 clinical medicine, Rivaroxaban, Risk Factors, Cause of Death, Atrial Fibrillation, 80 and over, Medicine, Arrhythmia and Electrophysiology, atrial fibrillation, 030212 general & internal medicine, Stroke, Cause of death, Original Research, CATHETER ABLATION, Aged, 80 and over, DABIGATRAN, Age Factors, Atrial fibrillation, 3. Good health, Intention to Treat Analysis, Treatment Outcome, Mortality, Warfarin, Aged, Anticoagulants, Double-Blind Method, Drug Administration Schedule, Factor Xa Inhibitors, Female, Humans, Multivariate Analysis, Proportional Hazards Models, Risk Assessment, Sex Factors, Cardiology and Cardiovascular Medicine, Administration, medicine.drug, Oral, medicine.medical_specialty, Catheter ablation, Dabigatran, 03 medical and health sciences, RISK-FACTOR, Intensive care medicine, METAANALYSIS, Ischemic Stroke, Intracranial Hemorrhage, Heart Failure, CONGESTIVE-HEART-FAILURE, business.industry, EFFICACY, medicine.disease, warfarin, Emergency medicine, FOLLOW-UP, business
Abstract

Background Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all‐cause mortality may guide interventions. Methods and Results In 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 CI 1.51–1.90, P Conclusions In a large population of patients anticoagulated for nonvalvular atrial fibrillation, ≈7 in 10 deaths were cardiovascular, whereas Clinical Trial Registration URL : https://www.clinicaltrials.gov/ . Unique identifier: NCT 00403767.

Published
2016
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49. Cause of Death and Predictors of All‐Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation: Data From ROCKET AF

Author

Pokorney, Sean D., primary, Piccini, Jonathan P., additional, Stevens, Susanna R., additional, Patel, Manesh R., additional, Pieper, Karen S., additional, Halperin, Jonathan L., additional, Breithardt, Günter, additional, Singer, Daniel E., additional, Hankey, Graeme J., additional, Hacke, Werner, additional, Becker, Richard C., additional, Berkowitz, Scott D., additional, Nessel, Christopher C., additional, Mahaffey, Kenneth W., additional, Fox, Keith A. A., additional, Califf, Robert M., additional, Anderson, J., additional, Bedwell, N., additional, Bilsker, M., additional, Bruce, G., additional, Agah, R., additional, DeSantis, M., additional, Eisenberg, S., additional, Flores, A., additional, Herzog, W., additional, Klein, S., additional, Snyder, H., additional, Krueger, S., additional, Almaguer, E., additional, Lavie, E., additional, Lee, C., additional, Mallis, G., additional, Modi, M., additional, Woodworth, G., additional, Niazi, I., additional, Peart, B., additional, Sundaram, S., additional, Snoddy, B., additional, Sotolongo, R., additional, Moloney, J., additional, Vijayaraghavan, K., additional, Whittier, F., additional, Yellen, L., additional, Banerjee, S., additional, Lustgarten, D., additional, Suresh, D., additional, Gelernt, M., additional, Levinson, L., additional, Ghanekar, R., additional, Kneller, G., additional, Hall, C., additional, Fadl, Y., additional, Pirwitz, M., additional, French, W., additional, Mayer, N., additional, Pugeda, J., additional, Steel, K., additional, Mody, F., additional, Malik, A., additional, Chandna, H., additional, Go, A., additional, Emlein, G., additional, Bowden, W., additional, Moscoso, R., additional, Hodson, R., additional, Berk, M., additional, Pan, D., additional, Pappas, J., additional, Orchard, R., additional, Lynchard, G., additional, Vijay, N., additional, Khan, W., additional, El Khadra, M, additional, Antonishen, M., additional, Cucher, F., additional, Staab, M., additional, Zebrack, J., additional, Borromeo, S, additional, Heilman, J., additional, Chaturvedi, S., additional, Makam, S., additional, Turk, S., additional, Hyers, T., additional, Williams, G., additional, Labroo, A., additional, Gill, S., additional, Myears, D., additional, Weinstein, J., additional, Shanes, J., additional, Chandrashekhar, Y., additional, Shah, S., additional, Reiter, W., additional, Logemann, T., additional, Almquist, A., additional, Bhagwat, R., additional, Tak, T., additional, Shen‐Ling, J., additional, Patel, P., additional, Artis, A., additional, Arouni, A., additional, Lauer, M., additional, Kinney, K., additional, Elsen, J., additional, Roan, P., additional, Villafria, R., additional, Sumpter, M., additional, Ip, J., additional, Welka, S., additional, Schifferdecker, B., additional, Sandoval, R., additional, Speirs, S., additional, Jones, A., additional, Haldis, T., additional, Kazmierski, J., additional, Sutherland, J., additional, Dietrich, D., additional, Telfer, E., additional, Berry, J., additional, McElveen, A., additional, Russell, J., additional, Sackett, M., additional, Antonios, N., additional, Smith, D., additional, Vora, K., additional, Kirby, A., additional, Lui, H., additional, Mego, D., additional, Ziada, K., additional, Navas, J., additional, Taussig, A., additional, Koren, M., additional, Vogel, C., additional, Saba, F., additional, Parrott, C., additional, Schneider, R., additional, Shirwany, A., additional, Rubin, M., additional, Treasure, C, additional, Bertolet, B., additional, Chang, M., additional, Langberg, J., additional, Becker, R., additional, Cohen, Y., additional, McGrew, F., additional, White, J., additional, Arzola, F., additional, Zelenka, J., additional, Tannenbaum, A., additional, Fernandes, V., additional, Jamnadas, P., additional, Agamasu, J., additional, Collins, B., additional, Jauch, W., additional, Sasseen, B., additional, Hotchkiss, D., additional, Abadier, R., additional, Osunkoya, A., additional, Schlau, A., additional, Chappel, C., additional, Foster, M., additional, Braun, E., additional, Mostel, E., additional, Capo, J., additional, Ashchi, M., additional, Howard, V., additional, Albirini, A., additional, Burger, A., additional, Rolston, D., additional, Staniloae, C., additional, Bacon, J., additional, Wiseman, A., additional, McGarvey, J, additional, Sonel, A., additional, Hamroff, G., additional, Chang, D., additional, Daboul, N., additional, Broderick, G., additional, Meholick, A., additional, Corbelli, J., additional, Silverman, R., additional, Raffetto, J., additional, Fishberg, R., additional, Georgeson, S., additional, Held, J., additional, Seidner, M., additional, Saint‐Jacques, H., additional, Heitner, J., additional, Kutalek, S., additional, Friedlander, I., additional, Hutchinson, B., additional, Walia, J., additional, Kondo, N., additional, Smiley, N., additional, Blitz, L., additional, Dale, H., additional, Sulman, S., additional, Szulawski, I., additional, Modares, F., additional, Martin, R., additional, Nahhas, A., additional, Renzi, M., additional, Akyea‐Djamson, A., additional, Alfieri, A., additional, Sandhu, J., additional, Voyce, S., additional, Amaram, S., additional, Meyerrose, G., additional, Shoukfeh, M., additional, Lee, F., additional, Villegas, B., additional, Idowu, O., additional, Khera, A., additional, Sam, C., additional, Vo, A., additional, Lieber, I., additional, Smith, T., additional, Awan, N., additional, Tsai, C., additional, Ganim, R., additional, Alzaghrini, G., additional, Pitt, W., additional, Shepherd, A., additional, Tang, S., additional, Stoltz, S., additional, Nelson, W., additional, Cox, S., additional, Meymandi, S., additional, Melucci, M., additional, Thomas, G., additional, Gogia, H., additional, Machell, C., additional, Chandrasekaran, S., additional, Brown, C., additional, Jetty, P., additional, Miller, G., additional, Dykstra, G., additional, Jaffrani, N., additional, Zakhary, B., additional, Caruso, A., additional, Zolty, R., additional, Fox, D., additional, Jacobs, G., additional, Lebenthal, M., additional, Mukherjee, S., additional, Zimetbaum, P., additional, Kingsley, J., additional, Jones, R., additional, Robinson, V., additional, Kenton, D., additional, Usedom, J., additional, Williams, S., additional, Snipes, C., additional, Wilson, V., additional, Hasty, R., additional, Shoemaker, J., additional, Donahue, M., additional, Al‐Saghir, Y., additional, Thomsen, E., additional, 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additional, Ho, D., additional, Tse, H., additional, Yu, C., additional, Wong, L., additional, Yeh, H., additional, Pai, P., additional, Hsieh, I., additional, Huang, C., additional, Hsieh, Y., additional, Yin, W., additional, Tsai, L., additional, Huang, T., additional, Chen, C., additional, Chiang, F., additional, Ueng, K., additional, Charng, M., additional, Marmor, A., additional, Katz, A., additional, Butnaru, A., additional, Lewis, B., additional, Eldar, M., additional, Rosenhack, S., additional, Elias, N., additional, Koifman, B., additional, Shochat, M., additional, Swissa, M., additional, Zimlichman, R., additional, Bental, T., additional, Weiss, A., additional, Ganam, R., additional, Elias, M., additional, Nseir, W., additional, Oliven, A., additional, Brenner, B., additional, and Dayan, M., additional

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