Efficacy and Safety of Glycoprotein IIb/IIIa Inhibitors on Top of Ticagrelor in STEMI: A Subanalysis of the ATLANTIC Trial

BACKGROUND: Glycoprotein IIb/IIIa inhibitors (GPIs) in combination with clopidogrel improve clinical outcome in ST-elevation myocardial infarction (STEMI); however, finding a balance that minimizes both thrombotic and bleeding risk remains fundamental. The efficacy and safety of GPI in addition to ticagrelor, a more potent P2Y12-inhibitor, have not been fully investigated. METHODS: 1,630 STEMI patients who underwent primary percutaneous coronary intervention (PCI) were analyzed in this subanalysis of the ATLANTIC trial. Patients were divided in three groups: no GPI, GPI administration routinely before primary PCI, and GPI administration in bailout situations. The primary efficacy outcome was a composite of death, myocardial infarction, urgent target revascularization, and definite stent thrombosis at 30 days. The safety outcome was non-coronary artery bypass graft (CABG)-related PLATO major bleeding at 30 days. RESULTS: Compared with no GPI (n\u2009=\u2009930), routine GPI (n\u2009=\u2009525) or bailout GPI (n\u2009=\u2009175) was not associated with an improved primary efficacy outcome (4.2% no GPI vs. 4.0% routine GPI vs. 6.9% bailout GPI; p\u2009=\u20090.58). After multivariate analysis, the use of GPI in bailout situations was associated with a higher incidence of non-CABG-related bleeding compared with no GPI (odds ratio [OR] 2.96, 95% confidence interval [CI] 1.32-6.64; p\u2009=\u20090.03). However, routine GPI use compared with no GPI was not associated with a significant increase in bleeding (OR 1.78, 95% CI 0.88-3.61; p\u2009=\u20090.92). CONCLUSION: Use of GPIs in addition to ticagrelor in STEMI patients was not associated with an improvement in 30-day ischemic outcome. A significant increase in 30-day non-CABG-related PLATO major bleeding was seen in patients who received GPIs in a bailout situation

Immunological indices in the cerebrospinal fluid of patients with presenile dementia of the Alzheimer type

In ten patients with presenile dementia of the Alzheimer type and in a control group the levels of the different immunoglobulins were determined in both serum and cerebrospinal fluid (CSF), and gel electrophoretic techniques used to determine possible oligoclonal bands in the gamma-globulin region. There is no indication that patients with Alzheimer disease produce immunoglobulins within the central nervous syste

Laser Micromachining Fabrication of THz Components

Laser micromachining techniques can be used to fabricate high-quality waveguide structures and quasi-optical components to micrometer accuracies. Successful GHz designs can be directly scaled to THz frequencies. We expect this promising technology to allow the construction of the first fully integrated THz heterodyne imaging arrays. At the University of Arizona, construction of the first laser micromachining system designed for THz waveguide components fabrication has been completed. Once tested and characterized our system will be used to construct prototype THz lx4 focal plane mixer arrays, magic tees, AR coated silicon lenses, local oscillator source phase gratings, filters and more. Our system can micro-machine structures down to a few microns accuracy and up to 6 inches across in a short time. This paper discusses the design and performance of our micromachining system, and illustrates the type, range and performance of components this exciting new technology will make accessible to the THz community

Larvae and juveniles of the plunderfishes Artedidraco shackletoni and A. skottsbergi (Notothenioidei, Artedidraconidae) from the Indian sector of the Southern Ocean

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