5 research outputs found
Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTICβHF: baseline characteristics and comparison with contemporary clinical trials
Aims:
The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTICβHF) trial. Here we describe the baseline characteristics of participants in GALACTICβHF and how these compare with other contemporary trials.
Methods and Results:
Adults with established HFrEF, New York Heart Association functional class (NYHA)ββ₯βII, EF β€35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokineticβguided dosing: 25, 37.5 or 50βmg bid). 8256 patients [male (79%), nonβwhite (22%), mean age 65βyears] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NTβproBNP 1971βpg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTICβHF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressureβ<β100βmmHg (n = 1127), estimated glomerular filtration rate <β30βmL/min/1.73 m2 (n = 528), and treated with sacubitrilβvalsartan at baseline (n = 1594).
Conclusions:
GALACTICβHF enrolled a wellβtreated, highβrisk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation
The Additive for the Bitumen on the Basis of the Modified Hydrolytic Lignin of the Organochlorine Wastes of the Chemical Industries
ΠΡΠΈ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π΅ ΡΠΏΠΈΡ
Π»ΠΎΡΠ³ΠΈΠ΄ΡΠΈΠ½Π° ΠΈΠ· ΠΏΡΠΎΠΏΠΈΠ»Π΅Π½Π° ΠΏΡΡΠ΅ΠΌ Ρ
Π»ΠΎΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ, Π° ΡΠ°ΠΊΠΆΠ΅ Π΄ΡΡΠ³ΠΈΡ
Π°Π½Π°Π»ΠΎΠ³ΠΈΡΠ½ΡΡ
ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ², Π½Π°ΠΏΡΠΈΠΌΠ΅Ρ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π° Π²ΠΈΠ½ΠΈΠ»Ρ
Π»ΠΎΡΠΈΠ΄Π°, Ρ
Π»ΠΎΡΠΈΡΡΠΎΠ³ΠΎ Π°Π»Π»ΠΈΠ»Π°,
Π΄ΠΈΡ
Π»ΠΎΡΡΡΠ°Π½Π°, ΠΎΠ±ΡΠ°Π·ΡΠ΅ΡΡΡ Π±ΠΎΠ»ΡΡΠΎΠ΅ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ ΠΏΠΎΠ±ΠΎΡΠ½ΡΡ
Ρ
Π»ΠΎΡΡΠΎΠ΄Π΅ΡΠΆΠ°ΡΠΈΡ
ΠΎΡΠ³Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΠ΅Π΄ΠΈΠ½Π΅Π½ΠΈΠΉ (Π₯ΠΠ‘). ΠΡΠΎ ΠΌΠΎΠ½ΠΎΡ
Π»ΠΎΡΠΏΡΠΎΠΏΠ΅Π½, Π΄ΠΈΡ
Π»ΠΎΡΠΏΡΠΎΠΏΠ°Π½Ρ, Π΄ΠΈΡ
Π»ΠΎΡΠΏΡΠΎΠΏΠ΅Π½Ρ, ΡΡΠΈΡ
Π»ΠΎΡΠΏΡΠΎΠΏΠ°Π½Ρ
ΠΈ Ρ.Π΄. Π ΡΠΈΠ»Ρ ΡΠ²ΠΎΠ΅ΠΉ ΡΠΎΠΊΡΠΈΡΠ½ΠΎΡΡΠΈ Π₯ΠΠ‘ Π½Π΅ ΡΡΠΈΠ»ΠΈΠ·ΠΈΡΡΡΡΡΡ ΠΌΠΈΠΊΡΠΎΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠ°ΠΌΠΈ, ΠΏΠΎΡΡΠΎΠΌΡ ΠΈΡ
ΡΡΠΈΠ»ΠΈΠ·Π°ΡΠΈΡ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΠ΅Ρ ΡΠΎΠ±ΠΎΠΉ ΡΠ΅ΡΡΠ΅Π·Π½ΡΡ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΡΡ ΠΈ ΡΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΡΡ ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ.
Π‘ ΡΠ΅Π»ΡΡ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΏΡΠΎΡΠ΅ΡΡΠ° ΡΠ²ΡΠ·ΡΠ²Π°Π½ΠΈΡ ΡΠΎΠΊΡΠΈΡΠ½ΡΡ
Ρ
Π»ΠΎΡΠΎΡΠ³Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΠ΅Π΄ΠΈΠ½Π΅Π½ΠΈΠΉ Π»ΠΈΠ³Π½ΠΈΠ½ΠΎΠΌ Ρ ΠΏΠΎΠ»ΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΡΡΡΠ΅ΠΉ Π΄ΠΎΠ±Π°Π²ΠΊΠΈ Π΄Π»Ρ Π±ΠΈΡΡΠΌΠ°, ΠΎΠ±Π»Π°Π΄Π°ΡΡΠ΅ΠΉ
ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΠΎΠΉ ΡΠΎΠ²ΠΌΠ΅ΡΡΠΈΠΌΠΎΡΡΡΡ Π»ΠΈΠ³Π½ΠΈΠ½Π° Ρ Π±ΠΈΡΡΠΌΠΎΠΌ, Π»ΠΈΠ³Π½ΠΈΠ½ Π°ΠΊΡΠΈΠ²ΠΈΡΡΡΡ Ρ
Π»ΠΎΡΠ½ΠΎΠΉ Π²ΠΎΠ΄ΠΎΠΉ ΠΈ
ΠΏΠΎΠ»ΠΈΡΡΠ»ΡΡΠΈΠ΄Π°ΠΌΠΈIn the production of the epichlorohydrin from the propylene by means of the chlorination, as well as the
other similar industries such as the manufacture of the vinyl chloride, chlorallylene, dichloroethane
form a large number of the accessory chlorinated organic compounds (ChOCs). These are the
monohlorpropen, dichloropropane, dichloropropene, trichloropropane and so on. Because of its
toxicity the chlorinated organic compounds are not utilized by the microorganisms, so their disposal
is the major technological and ecological problems. In order to improve the efficiency of the process
the banding of the toxic chlororganic compounds by the lignin to obtain the modifying additive for the
bitumen, possessing the increased compatibility of the lignin with the bitumen, the lignin is activated
with the chlorine water and polysulphide
The Additive for the Bitumen on the Basis of the Modified Hydrolytic Lignin of the Organochlorine Wastes of the Chemical Industries
ΠΡΠΈ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π΅ ΡΠΏΠΈΡ
Π»ΠΎΡΠ³ΠΈΠ΄ΡΠΈΠ½Π° ΠΈΠ· ΠΏΡΠΎΠΏΠΈΠ»Π΅Π½Π° ΠΏΡΡΠ΅ΠΌ Ρ
Π»ΠΎΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ, Π° ΡΠ°ΠΊΠΆΠ΅ Π΄ΡΡΠ³ΠΈΡ
Π°Π½Π°Π»ΠΎΠ³ΠΈΡΠ½ΡΡ
ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ², Π½Π°ΠΏΡΠΈΠΌΠ΅Ρ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π° Π²ΠΈΠ½ΠΈΠ»Ρ
Π»ΠΎΡΠΈΠ΄Π°, Ρ
Π»ΠΎΡΠΈΡΡΠΎΠ³ΠΎ Π°Π»Π»ΠΈΠ»Π°,
Π΄ΠΈΡ
Π»ΠΎΡΡΡΠ°Π½Π°, ΠΎΠ±ΡΠ°Π·ΡΠ΅ΡΡΡ Π±ΠΎΠ»ΡΡΠΎΠ΅ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ ΠΏΠΎΠ±ΠΎΡΠ½ΡΡ
Ρ
Π»ΠΎΡΡΠΎΠ΄Π΅ΡΠΆΠ°ΡΠΈΡ
ΠΎΡΠ³Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΠ΅Π΄ΠΈΠ½Π΅Π½ΠΈΠΉ (Π₯ΠΠ‘). ΠΡΠΎ ΠΌΠΎΠ½ΠΎΡ
Π»ΠΎΡΠΏΡΠΎΠΏΠ΅Π½, Π΄ΠΈΡ
Π»ΠΎΡΠΏΡΠΎΠΏΠ°Π½Ρ, Π΄ΠΈΡ
Π»ΠΎΡΠΏΡΠΎΠΏΠ΅Π½Ρ, ΡΡΠΈΡ
Π»ΠΎΡΠΏΡΠΎΠΏΠ°Π½Ρ
ΠΈ Ρ.Π΄. Π ΡΠΈΠ»Ρ ΡΠ²ΠΎΠ΅ΠΉ ΡΠΎΠΊΡΠΈΡΠ½ΠΎΡΡΠΈ Π₯ΠΠ‘ Π½Π΅ ΡΡΠΈΠ»ΠΈΠ·ΠΈΡΡΡΡΡΡ ΠΌΠΈΠΊΡΠΎΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠ°ΠΌΠΈ, ΠΏΠΎΡΡΠΎΠΌΡ ΠΈΡ
ΡΡΠΈΠ»ΠΈΠ·Π°ΡΠΈΡ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΠ΅Ρ ΡΠΎΠ±ΠΎΠΉ ΡΠ΅ΡΡΠ΅Π·Π½ΡΡ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΡΡ ΠΈ ΡΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΡΡ ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ.
Π‘ ΡΠ΅Π»ΡΡ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΏΡΠΎΡΠ΅ΡΡΠ° ΡΠ²ΡΠ·ΡΠ²Π°Π½ΠΈΡ ΡΠΎΠΊΡΠΈΡΠ½ΡΡ
Ρ
Π»ΠΎΡΠΎΡΠ³Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΠ΅Π΄ΠΈΠ½Π΅Π½ΠΈΠΉ Π»ΠΈΠ³Π½ΠΈΠ½ΠΎΠΌ Ρ ΠΏΠΎΠ»ΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΡΡΡΠ΅ΠΉ Π΄ΠΎΠ±Π°Π²ΠΊΠΈ Π΄Π»Ρ Π±ΠΈΡΡΠΌΠ°, ΠΎΠ±Π»Π°Π΄Π°ΡΡΠ΅ΠΉ
ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΠΎΠΉ ΡΠΎΠ²ΠΌΠ΅ΡΡΠΈΠΌΠΎΡΡΡΡ Π»ΠΈΠ³Π½ΠΈΠ½Π° Ρ Π±ΠΈΡΡΠΌΠΎΠΌ, Π»ΠΈΠ³Π½ΠΈΠ½ Π°ΠΊΡΠΈΠ²ΠΈΡΡΡΡ Ρ
Π»ΠΎΡΠ½ΠΎΠΉ Π²ΠΎΠ΄ΠΎΠΉ ΠΈ
ΠΏΠΎΠ»ΠΈΡΡΠ»ΡΡΠΈΠ΄Π°ΠΌΠΈIn the production of the epichlorohydrin from the propylene by means of the chlorination, as well as the
other similar industries such as the manufacture of the vinyl chloride, chlorallylene, dichloroethane
form a large number of the accessory chlorinated organic compounds (ChOCs). These are the
monohlorpropen, dichloropropane, dichloropropene, trichloropropane and so on. Because of its
toxicity the chlorinated organic compounds are not utilized by the microorganisms, so their disposal
is the major technological and ecological problems. In order to improve the efficiency of the process
the banding of the toxic chlororganic compounds by the lignin to obtain the modifying additive for the
bitumen, possessing the increased compatibility of the lignin with the bitumen, the lignin is activated
with the chlorine water and polysulphide
Cardiac myosin activation with omecamtiv mecarbil in systolic heart failure
BACKGROUND The selective cardiac myosin activator omecamtiv mecarbil has been shown to improve cardiac function in patients with heart failure with a reduced ejection fraction. Its effect on cardiovascular outcomes is unknown. METHODS We randomly assigned 8256 patients (inpatients and outpatients) with symptomatic chronic heart failure and an ejection fraction of 35% or less to receive omecamtiv mecarbil (using pharmacokinetic-guided doses of 25 mg, 37.5 mg, or 50 mg twice daily) or placebo, in addition to standard heart-failure therapy. The primary outcome was a composite of a first heart-failure event (hospitalization or urgent visit for heart failure) or death from cardiovascular causes. RESULTS During a median of 21.8 months, a primary-outcome event occurred in 1523 of 4120 patients (37.0%) in the omecamtiv mecarbil group and in 1607 of 4112 patients (39.1%) in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.86 to 0.99; P = 0.03). A total of 808 patients (19.6%) and 798 patients (19.4%), respectively, died from cardiovascular causes (hazard ratio, 1.01; 95% CI, 0.92 to 1.11). There was no significant difference between groups in the change from baseline on the Kansas City Cardiomyopathy Questionnaire total symptom score. At week 24, the change from baseline for the median N-terminal pro-B-type natriuretic peptide level was 10% lower in the omecamtiv mecarbil group than in the placebo group; the median cardiac troponin I level was 4 ng per liter higher. The frequency of cardiac ischemic and ventricular arrhythmia events was similar in the two groups. CONCLUSIONS Among patients with heart failure and a reduced ejection, those who received omecamtiv mecarbil had a lower incidence of a composite of a heart-failure event or death from cardiovascular causes than those who received placebo. (Funded by Amgen and others; GALACTIC-HF ClinicalTrials.gov number, NCT02929329; EudraCT number, 2016 -002299-28.)