Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden

Measurement of the CP violating phase beta_s in B_s->J/psi phi decays

The CP violating phase {beta}{sub s}{sup J/{psi}{phi}} is measured in decays of B{sub s}{sup 0} {yields} J/{psi}{phi}. This measurement uses 5.2 fb{sup -1} of data collected in {radical}s = 1.96 TeV p{bar p} collisions at the Fermilab Tevatron with the CDF Run-II detector. CP violation in the B{sub s}{sup 0}-{bar B}{sub s}{sup 0} system is predicted to be very small in the Standard Model. However, several theories beyond the Standard Model allow enhancements to this quantity by heavier, New Physics particles entering second order weak mixing box diagrams. Previous measurements have hinted at a deviation from the Standard Model expectation value for {beta}{sub s}{sup J/{psi}{phi}} with a significance of approximately 2{sigma}. The measurement described in this thesis uses the highest statistics sample available to date in the B{sub s}{sup 0} {yields} J/{psi}{phi} decay channel, where J/{psi} {yields} {mu}{sup +}{mu}{sup -} and {phi} {yields} K{sup +}K{sup -}. Furthermore, it contains several improvements over previous analyses, such as enhanced signal selection, fully calibrated particle ID and flavour tagging, and the inclusion of an additional decay component in the likelihood function. The added decay component considers S-wave states of KK pairs in the B{sub s}{sup 0} {yields} J/{psi} K{sup +}K{sup -} channel. The results are presented as 2-dimensional frequentist confidence regions for {beta}{sub s}{sup J/{psi}{phi}} and {Delta}{Lambda} (the width difference between the B{sub s}{sup 0} mass eigenstates), and as a confidence interval for {beta}{sub s}{sup J/{psi}{phi}} of [0.02,0.52] {union} [1.08, 1.55] at the 68% confidence level. The measurement of the CP violating phase obtained in this thesis is complemented by the world's most precise measurement of the lifetime {tau}{sub s} = 1.53 {+-} 0.025 (stat.) {+-} 0.012 (syst.) ps and decay width difference {Delta}{Lambda} = 0.075 {+-} 0.035 (stat.) {+-} 0.01 (syst.) ps{sup -1} of the B{sub s}{sup 0} meson, with the assumption of no CP violation

Measurement of the CP violating phase β_s in B⁰_s J/ΨΦ decays

The CP violating phase {beta}{sub s}{sup J/{psi}{phi}} is measured in decays of B{sub s}{sup 0} {yields} J/{psi}{phi}. This measurement uses 5.2 fb{sup -1} of data collected in {radical}s = 1.96 TeV p{bar p} collisions at the Fermilab Tevatron with the CDF Run-II detector. CP violation in the B{sub s}{sup 0}-{bar B}{sub s}{sup 0} system is predicted to be very small in the Standard Model. However, several theories beyond the Standard Model allow enhancements to this quantity by heavier, New Physics particles entering second order weak mixing box diagrams. Previous measurements have hinted at a deviation from the Standard Model expectation value for {beta}{sub s}{sup J/{psi}{phi}} with a significance of approximately 2{sigma}. The measurement described in this thesis uses the highest statistics sample available to date in the B{sub s}{sup 0} {yields} J/{psi}{phi} decay channel, where J/{psi} {yields} {mu}{sup +}{mu}{sup -} and {phi} {yields} K{sup +}K{sup -}. Furthermore, it contains several improvements over previous analyses, such as enhanced signal selection, fully calibrated particle ID and flavour tagging, and the inclusion of an additional decay component in the likelihood function. The added decay component considers S-wave states of KK pairs in the B{sub s}{sup 0} {yields} J/{psi} K{sup +}K{sup -} channel. The results are presented as 2-dimensional frequentist confidence regions for {beta}{sub s}{sup J/{psi}{phi}} and {Delta}{Lambda} (the width difference between the B{sub s}{sup 0} mass eigenstates), and as a confidence interval for {beta}{sub s}{sup J/{psi}{phi}} of [0.02,0.52] {union} [1.08, 1.55] at the 68% confidence level. The measurement of the CP violating phase obtained in this thesis is complemented by the world's most precise measurement of the lifetime {tau}{sub s} = 1.53 {+-} 0.025 (stat.) {+-} 0.012 (syst.) ps and decay width difference {Delta}{Lambda} = 0.075 {+-} 0.035 (stat.) {+-} 0.01 (syst.) ps{sup -1} of the B{sub s}{sup 0} meson, with the assumption of no CP violation