Late-Stage (18) F-Difluoromethyl Labeling of N-Heteroaromatics with High Molar Activity for PET Imaging.

peer reviewedDespite a growing interest in CHF2 in medicinal chemistry, there is a lack of efficient methods for the insertion of CHF(18) F into druglike compounds. Herein described is a photoredox flow reaction for (18) F-difluoromethylation of N-heteroaromatics that are widely used in medicinal chemistry. Following the two-step synthesis for a new (18) F-difluoromethylation reagent, the photoredox reaction is completed within two minutes and proceeds by C-H activation, circumventing the need for pre-functionalization of the substrate. The method is operationally simple and affords straightforward access to radiolabeled N-heteroaromatics with high molar activity suitable for biological in vivo studies and clinical application.ISOTOPIC

Prognosis in Patients Hospitalized With Permanent and Nonpermanent Atrial Fibrillation in Heart Failure

International audienc

Ejection fraction and outcomes in patients with atrial fibrillation and heart failure: the Loire Valley Atrial Fibrillation Project

Heart failure (HF) increases the risk of stroke and thrombo-embolism (TE) in non-valvular atrial fibrillation (NVAF), and is incorporated in stroke risk stratification scores. We aimed to establish the role of ejection fraction (EF) in risk prediction in patients with NVAF and HF. Patients with NVAF, history of HF, and measured EF were included in a retrospective analysis. Patients with HF and preserved ejection fraction (HFPEF) were defined as those with clinical HF and EF epsilon 50 in this study. Among 7156 patients with NVAF, 1276 (17.8) patients with HF and measured EF were included. Of these, 747/1276 (58.5) patients were on vitamin K antagonists. The stroke/TE event rate per 100 person-years was 1.05 [95 confidence interval (CI) 0.871.25]. Patients with HFPEF were more likely to be female (P 0.001), older (P 0.001), and hypertensive (P 0.001), and less likely to have prior vascular disease (P 0.001). There were no differences in rates of stroke (P 0.17) and stroke/TE (P 0.11) between patients with HFPEF and those with HF and reduced EF. There were no significant differences in rates of all-cause mortality when patients were stratified by EF. In multivariate analyses, only previous stroke (hazard ratio 2.36, 95 CI 1.453.86) and vascular disease (1.57, 1.072.30) increased the risk of stroke/TE amongst NVAF patients with HF, but EF 35 did not (0.75, 0.441.30). In NVAF patients with HF, there were no differences in rates of stroke, TE, or death between EF categories. Only previous stroke and vascular disease (and not decreased EF) independently increased risk of stroke/TE in multivariate analyses