Long-term effect of 2 intensive statin regimens on treatment and incidence of cardiovascular events in familial hypercholesterolemia : The SAFEHEART study

Funding: This study was supported by Fundación Hipercolesterolemia Familiar; Grant G03/181 Grant 08-2008 Centro Nacional de Investigaci?n Cardiovascular (CNIC).Background: Maximal doses of potent statins are the basement of treatment of familial hypercholesterolemia (FH). Little is known about the use of different statin regimens in FH. Objectives: The objectives of the study were to describe the treatment changes and low-density lipoprotein cholesterol (LDL-C) goal achievement with atorvastatin (ATV) and rosuvastatin (RV) in the SAFEHEART cohort, as well as to analyze the incidence of atherosclerotic cardiovascular events (ACVEs) and changes in the cardiovascular risk. Methods: SAFEHEART is a prospective follow-up nationwide cohort study in a molecularly defined FH population. The patients were contacted on a yearly basis to obtain relevant changes in life habits, medication, and ACVEs. Results: A total of 1939 patients were analyzed. Median follow-up was 6.6 years (5-10). The estimated 10-year risk according the SAFEHEART risk equation was 1.61 (0.67-3.39) and 1.22 (0.54-2.93) at enrollment for ATV and RV, respectively (P <.001). There were no significant differences at the follow-up: 1.29 (0.54-2.82) and 1.22 (0.54-2.76) in the ATV and RV groups, respectively (P =.51). Sixteen percent of patients in primary prevention with ATV and 18% with RV achieved an LDL-C <100 mg/dL and 4% in secondary prevention with ATV and 5% with RV achieved an LDL-C <70 mg/dL. The use of ezetimibe was marginally greater in the RV group. One hundred sixty ACVEs occurred during follow-up, being its incidence rate 1.1 events/100 patient-years in the ATV group and 1.2 in the RV group (P =.58). Conclusion: ATV and RV are 2 high-potency statins widely used in FH. Although the reduction in LDL-C levels was greater with RV than with ATV, the superiority of RV for reducing ACVEs was not demonstrated

Spread of a SARS-CoV-2 variant through Europe in the summer of 2020.

Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3–5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes. © 2021, The Author(s), under exclusive licence to Springer Nature Limited

The Origin of Mercury

Mercury’s unusually high mean density has always been attributed to special circumstances that occurred during the formation of the planet or shortly thereafter, and due to the planet’s close proximity to the Sun. The nature of these special circumstances is still being debated and several scenarios, all proposed more than 20 years ago, have been suggested. In all scenarios, the high mean density is the result of severe fractionation occurring between silicates and iron. It is the origin of this fractionation that is at the centre of the debate: is it due to differences in condensation temperature and/or in material characteristics (e.g. density, strength)? Is it because of mantle evaporation due to the close proximity to the Sun? Or is it due to the blasting off of the mantle during a giant impact? In this paper we investigate, in some detail, the fractionation induced by a giant impact on a proto-Mercury having roughly chondritic elemental abundances. We have extended the previous work on this hypothesis in two significant directions. First, we have considerably increased the resolution of the simulation of the collision itself. Second, we have addressed the fate of the ejecta following the impact by computing the expected reaccretion timescale and comparing it to the removal timescale from gravitational interactions with other planets (essentially Venus) and the Poynting–Robertson effect. To compute the latter, we have determined the expected size distribution of the condensates formed during the cooling of the expanding vapor cloud generated by the impact. We find that, even though some ejected material will be reaccreted, the removal of the mantle of proto-Mercury following a giant impact can indeed lead to the required long-term fractionation between silicates and iron and therefore account for the anomalously high mean density of the planet. Detailed coupled dynamical–chemical modeling of this formation mechanism should be carried out in such a way as to allow explicit testing of the giant impact hypothesis by forthcoming space missions (e.g. MESSENGER and BepiColombo)