How do cardiologists select patients for dual antiplatelet therapy continuation beyond 1 year after a myocardial infarction? Insights from the EYESHOT Post-MI Study

Background: Current guidelines suggest to consider dual antiplatelet therapy (DAPT) continuation for longer than 12 months in selected patients with myocardial infarction (MI). Hypothesis: We sought to assess the criteria used by cardiologists in daily practice to select patients with a history of MI eligible for DAPT continuation beyond 1 year. Methods: We analyzed data from the EYESHOT Post-MI, a prospective, observational, nationwide study aimed to evaluate the management of patients presenting to cardiologists 1 to 3 years from the last MI event. Results: Out of the 1633 post-MI patients enrolled in the study between March and December 2017, 557 (34.1%) were on DAPT at the time of enrolment, and 450 (27.6%) were prescribed DAPT after cardiologist assessment. At multivariate analyses, a percutaneous coronary intervention (PCI) with multiple stents and the presence of peripheral artery disease (PAD) resulted as independent predictors of DAPT continuation, while atrial fibrillation was the only independent predictor of DAPT interruption for patients both at the second and the third year from MI at enrolment and the time of discharge/end of the visit. Conclusions: Risk scores recommended by current guidelines for guiding decisions on DAPT duration are underused and misused in clinical practice. A PCI with multiple stents and a history of PAD resulted as the clinical variables more frequently associated with DAPT continuation beyond 1 year from the index MI

Plakohypaphorines A-C, Iodine-Containing Alkaloids From The Caribbean Sponge Plakortis simplex

Investigation of the most polar fractions obtained from the organic extract of the Caribbean marine sponge Plakortis simplex has led to the isolation of three novel iodine-containing tryptophan betaines structurally related to the known hypaphorine (5), which have been named plakohypaphorine A (2), B (3) and C (4), respectively. Their structures have been determined by application of spectroscopic methods. Isolation of compounds 2-4 is particularly remarkable since it represents the first finding of iodoindole derivatives in a natural source, either marine or terrestrial

The Caribbean sponge Plakortis simplex: a prolific source of new secondary metabolites

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The Caribbean sponge Plakortis simplex: a prolific source of new secondary metabolites

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Feroxosides A-B, Two Norlanostane Tetraglycosides from the Caribbean Sponge Ectyoplasia ferox.

Feroxosides A and B, have been isolated from the polar extract of the Caribbean sponge Ectyoplasia ferox. Their structures have been determined to be unusual C-4 nor-lanostane triterpenes glycosylated with a rhamnose containing tetrasaccharide chain, by interpretation of spectral data and chemical degradation. Absolute stereochemistry at C-23 has been determined by application of the modified Mosher method for secondary alcohols. Feroxosides A-B are moderately cytotoxic (IC50 19 microg/mL) against murine monocyte-macrophage cell line

La spugna caraibica Plakortis simplex: una prolifica fonte di nuovi metaboliti secondari

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Nuovi furano-diterpeni bioattivi da cascarilla (Croton eluteria Bennet)

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