Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: 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 (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤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 (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF 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 pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk 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 British army in 1868 /

Includes bibliographical references.Mode of access: Internet.Talbot collection of British pamphlets

Trevelyan papers ...

[pt. I] Prior to A.D. 1558. Ed. by J. Payne Collier.--pt. II. A.D. 1446-1643. Ed. by J. Payne Collier--pt. III. With introduction to parts I., II., and III. Ed. by Sir Walter Calverley Trevelyan, Bart., and Sir Charles Edward Trevelyan, K.C.B.Mode of access: Internet.SML: 67a is no. 84; 67b is no. 105

Islamic education and colonial secularism: the Amroha experiment of 1895–96

In September 1895, a boldly innovative trial was begun with the teaching of Islam in a British government school in the town of Amroha, near Delhi. This article returns to the Amroha experiment to consider what it reveals about Indian Muslim exchanges with European administrators on the subject of secular colonial education and, more broadly, to bring under scrutiny the historical engagement of Muslim parties with colonial secularism. By the final decade of the nineteenth century, European officials had joined a number of their Muslim subjects in rejecting the imparting of exclusively secular education in schools and colleges under the management of the colonial state. Arguing for the reconciliation of religious and secular instruction, Viqar-ul-Mulk and his contemporaries capitalized upon growing British anxieties about the moral deficiency of Indian students taught in state educational institutions, exposing colonial concerns over the likelihood of inculcating moral improvement in the absence of religious teaching. Challenging the official separation of religion and pedagogy, they raised the possibility of the accommodation of multiple faiths within the modern Indian nation and state. The Amroha experiment served as a precedent for elite Muslim attempts to found an Indian Muslim university in which Islamic instruction would be imparted. Viqar-ul-Mulk’s successful negotiations with the government inspired further efforts for the revitalization of religious education on the part of Muslim leaders concerned about the survival and strengthening of Islam under colonial rule

Alirocumab and cardiovascular outcomes after acute coronary syndrome

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