LDE-PACLI promoted strong improvement of cardiac allograft vasculopathy, but the decrease in coronary stenosis by LDE-MTX and LDE-MTX/PACLI was not significant. All three treatments decreased macrophage infiltration in the graft. These results may encourage future clinical trials to test this new therapeutic approach to coronary allograft vasculopathy.

Introduction Postoperative atrial fibrillation is the most common arrhythmia in cardiac surgery, its incidence range between 20% and 40%. Objective Quantify the occurrence of stroke and acute renal insufficiency after myocardial revascularization surgery in patients who had atrial fibrillation postoperatively. Methods Cohort longitudinal bidirectional study, performed at Portuguese Beneficent Hospital (SP), with medical chart survey of patients undergoing myocardial revascularization surgery between June 2009 to July 2010. From a total of 3010 patients were weaned 382 patients that presented atrial fibrillation preoperatively and/or associated surgeries. The study was conducted in accordance with national and international following resolutions: ICH Harmonized Tripartite Guidelines for Good Clinical Practice - 1996; CNS196/96 Resolution, and Declaration of Helsinki. Results The 2628 patients included in this study were divided into two groups: Group I, who didn't show postoperative atrial fibrillation, with 2302 (87.6%) patients; and group II, with 326 (12.4%) who developed postoperative atrial fibrillation. The incidence of stroke in patients was 1.1% without postoperative atrial fibrillation vs. 4% with postoperative atrial fibrillation (P<0.001). Postoperative acute renal failure was observed in 12% of patients with postoperative atrial fibrillation and 2.4% in the group without postoperative atrial fibrillation (P<0.001), that is a relation 5 times greater. Conclusion In this study there was a high incidence of stroke and acute renal failure in patients with postoperative atrial fibrillation, with rates higher than those reported in the literature.

Background Recently, the COMPASS trial demonstrated that dual therapy reduced cardiovascular outcomes compared with aspirin alone in patients with stable atherosclerotic disease. Methods and Results We sought to assess the proportion of patients eligible for the COMPASS trial and to compare the epidemiology and outcome of these patients with those without COMPASS inclusion or with any exclusion criteria in a contemporary, nationwide cohort of patients with stable coronary artery disease (CAD). Among the 4068 patients with detailed information allowing evaluation of eligibility, 1416 (34.8%) did not fulfill the inclusion criteria (COMPASS-Not-Included), 841 (20.7%) had exclusion criteria (COMPASS-Excluded) and the remaining 1811 (44.5%) were classified as COMPASS-Like. At 1 year, the incidence of major adverse cardiovascular event (MACE), a composite of cardiovascular death, myocardial infarction and stroke, was 0.9% in the COMPASS-Not-Included and 2.0% in the COMPASS-Like (p = 0.01), and 5.0% in the COMPASS-Excluded group (p &lt; 0.0001 for all comparisons). Among the COMPASS-Like population, patients with multiple COMPASS enrichment criteria presented a significant increase in the risk of MACE (from 1.0% to 3.3% in those with 1 and ≥3 criteria, respectively; p = 0.012), and a modest absolute increase in major bleeding risk (from 0.2% to 0.4%, respectively; p = 0.46). Conclusions In a contemporary real-world cohort registry of stable CAD, most patients resulted as eligible for the COMPASS. These patients presented a considerable annual risk of MACE that consistently increases in the presence of multiple risk factors.

Objective The aim of the present analysis was to evaluate the incidence and predictors of in-hospital adverse outcomes in nonagenarian patients undergoing primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI). Methods Consecutive nonagenarian patients undergoing pPCI for STEMI from 2009 to 2019 were retrospectively included in an international multicenter registry. In-hospital all-cause death was the primary outcome. Results A total of 308 patients were included (mean age 92.5±2.5 years, 65.6% female). Mean systolic blood pressure (SBP) at hospital admission was 130.7±33.5 mmHg, 46 (17%) patients presented with a Killip class III-IV, mean left ventricle ejection fraction (LVEF) was 40.0±11.5% and 147 (58%) patients were independent in everyday activities. In-hospital death occurred in 99 patients (32%). [Figure 1] After multivariate adjustment, lower LVEF (OR per unit reduction 1.08, 95% CI 1.03–1.11, p-value &lt;0.001), lower SBP (OR 0.98 per mmHg reduction, 95% CI 1.01–1.03, p-value 0.001) and being not independent at home (OR 2.56, 95% CI 1.25–5.26, p-value 0.01) resulted independent predictors of in-hospital mortality. [Figure 2] A sensitivity analysis performed in final TIMI 3 flow population confirmed the prognostic role of LVEF and independency on in-hospital mortality. Conclusion Nonagenarian patients presenting with STEMI and undergoing pPCI have high in-hospital mortality. Independency in everyday life is a strong independent predictor of survival to hospital discharge. FUNDunding Acknowledgement Type of funding sources: None. Figure 1 Figure 2