Prodromal angina and risk of 2-year cardiac mortality in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous intervention

We sought to investigate the prognostic significance of prodromal angina (PA) in unselected patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) and its additive predictive value to the GRACE score.We prospectively enrolled 3015 consecutive STEMI patients undergoing PPCI. Patients were divided in 2 groups according to the presence or absence of PA. Multivariable Cox regression was used to establish the relation to 2-year cardiac mortality of PA.The mean age of the study population was 68 (±14) years; 2178 patients (72%) were male. During follow-up, 395 (13%) patients died with 278 of these (9.2%) suffering from cardiac mortality. Kaplan-Meier estimates showed a survival rate of 95% and 87% for patients with PA and no PA, respectively (log rank test < 0.001). After multivariable analysis, patients with PA had still a lower risk of 2 years' cardiac mortality compared with patients without PA (adjusted hazard ratio = 0.50; 95% confidence interval [CI] 1.06-1.81, P = .001). Evaluation of net reclassification improvement showed that reclassification improved by 0.16% in case patients, whereas classification worsened in control patients by 1.08% leading to a net reclassification improvement of -0.93% (95% CI: -0.98, -0.88).In patients with STEMI undergoing PPCI the presence of PA is independently associated with a lower risk of 2-year cardiac mortality. However, the incorporation of this variable to the GRACE score slightly worsened the classification of risk. Accordingly, it seems unlikely that the evaluation of PA may be useful in clinical practice

Ascophillum nodosum and Lithothamnium calcareum and their prebiotic potential on Lactobacillus strains

Functional ingredients became essential for sustainable development to improve health status, prevent disease, and reduce the use of medication. This study aimed to determine the potential prebiotic role of Ascophyllum nodosum and Lithothamnium calcareum using Lactiplantibacillus plantarum and Limosilactobacillus reuteri as microorganism models. Key bioactive compounds of algae were identified using LC-QTOF-MS/MS. The influence of algae inclusion on the growth of Lactobacilli strains was evaluated. Functional activities of the co-culture were evaluated after 24, 48, 72, and 96 incubation hours. Antioxidant capacity (by ABTS assay) increased for both Lactobacilli cultures, with a PI% increase of 30 % for L. plantarum (p < 0.01) and a PI% increase of 25 % for L. reuteri (p < 0.01). Algal extracts significantly inhibited (p < 0.05) E. coli growth after 48 hrs for L. plantarum and after 72 hrs for L. reuteri. The results suggested that A. nodosum and L. calcareum can be considered valid prebiotics for both strains

Field performance of Trelleborg PneuTrac tyres

Tractors have become heavier and more powerful, so bigger tyres are necessary to the exert adequate traction forces and to limit the soil compaction. Nevertheless, in the last 50 years, wheel load has increased more than twice the tyre-soil contact area, consequently, soil compaction caused by tractors has been increased as well. A tractor equipped with Trelleborg PneuTrac tyres could be an exception to this trend, because these tyres can attain large tyre flexibility, so that they allow a larger tyre footprint and lower inflating pressure than any standard tyre. The aim of this paper was the drawbar performance comparison between a set of PneuTrac tyres and a set of equivalent radial tyres with the same external drawing. Both of these tyres were mounted in two 115 kW tractors with the same mass configuration. On each tractor, a load cell was installed in order to measure the drawbar pull and a CAN-Bus data logger was fitted to measure the vehicle operating parameters. Drawbar tests were carried out with the two tractors in the same soil at different water contents. From the acquired data, the drawbar pull and the efficiency were calculated. The obtained results demonstrate that Trelleborg PneuTrac permits to increase the drawbar pull up to 5.7% and to reduce the slip. Moreover, its performance was slightly less affected by the soil conditions

Prognostic significance of shockable and non-shockable cardiac arrest in ST-segment elevation myocardial infarction patients undergoing primary angioplasty

Objective To determine, in patients with ST-segment Elevation Myocardial Infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI), the prognostic weight of cardiac arrest (CA) according to the type of rhythm (shockable vs. non-shockable). Methods We prospectively enrolled 3278 consecutive STEMI patients undergoing PPCI. Multivariable Cox regression was used to establish the relation to 1-year cardiac mortality of both type of CA. In patients suffering from CA we identified predictors of both poor neurological outcome (cerebral performance categories 3\ue2\u80\u935) and cardiac mortality at 1 year. Results The incidence of CA was 7.26% (n = 238). Of these, 196 (5.98%) had an initial shockable rhythm and 42 (1.28%) a non shockable rhythm. During 1-year follow up 311(9.48%) patients died from cardiac causes. Shockable rhythm (adjusted-HR = 1.61; 95%CI 1.08\ue2\u80\u932.43, p = 0.02) and non-shockable rhythm (adjusted-HR = 3.83; 95%CI 2.36\ue2\u80\u936.22, p < 0.001) were independently associated with 1-year cardiac mortality. Among patients with CA those with shockable rhythm had a lower risk of poor neurological outcome at 1 year follow up (adjusted OR = 0.22: 95%CI; 0.08\ue2\u80\u930.55, p = 0.001). Independent predictors of 1-y cardiac mortality were: non shockable rhythm (adjusted HR = 2.6; 95%CI; 1.48\ue2\u80\u934.5, p = 0.001), crew-witnessed CA, diabetes mellitus, left ventricle ejection fraction and creatinine on admission. There was a significant interaction between type of rhythm and crew-witnessed CA (p = 0.026). Conclusions In patients with STEMI undergoing PPCI patients with both shockable and non shockable CA are at increased risk of 1-year cardiac mortality. Among patients with CA those with non shockable rhythm have an higher risk of both poor neurological outcome and cardiac mortality at 1 year