Aim: Hyperlipidemia and diabetic retinopathy increase the risk of cardiovascular disease (CVD). The standard versus intEnsive statin therapy for hypercholesteroleMic Patients with diAbetic retinopaTHY (EMPATHY) study examines whether intensive lipid-lowering therapy is superior to standard therapy in reducing the incidence of cardiovascular events in patients with hyperlipidemia and diabetic retinopathy, but without a history of coronary artery disease. Methods: Patients who had elevated low-density lipoprotein cholesterol (LDL-C) and diabetic retinopathy without a history of coronary artery disease were eligible for the study. Patients were randomly assigned in a 1:1 ratio to receive intensive or standard therapy. Patients are being treated with monotherapy with 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor (statin) for a maximum of 5.5 years to achieve the following LDL-C target: 70 mg/dL for the intensive therapy group or ≥ 100 and 120 mg/dL for the standard therapy group. The primary endpoint is a composite of incidence of CVD and death from CVD. Results: Between May 2010 and October 2013, 5,995 patients were assessed for eligibility, and 5,144 were assigned to the study treatment (2,571 and 2,573 in the intensive and standard therapy groups, respectively), and baseline data were analyzed from 5,107 (2,550 in the intensive therapy group and 2,557 in the standard therapy group). Conclusions: This is the first study assessing the benefits of intensive statin therapy in patients with hypercholesterolemia and diabetic retinopathy in a primary prevention setting. Furthermore, this study evaluates the appropriateness of the treat-to-target approach because all patients are treated to achieve specific LDL-C targets by titrating statin therapy. Clinical Trial Registration Number: UMIN000003486.
A superior method of conjugate allylation: The transmetalation of allyltin compounds with TaCl5 yielded active tantalum reagents for conjugate addition to enones. Even bulky allyl moieties could be introduced to enones in this manner (see scheme). Both cyclic and acyclic enones reacted facilely under extremely mild conditions.
We report a one-pot synthesis of nitrogen heterocyclic compounds initiated by the allylation of the formyl group of bifunctional carbonyl compounds accompanying chemo-, regio-, and diastereoselective carbon-carbon bond formation in side chain moieties.
Eine bessere Methode für die konjugierte Allylierung: Die Transmetallierung von Allylzinnverbindungen mit TaCl5 liefert aktive Tantalreagentien für die konjugierte Addition an Enone. Sogar sperrige Allylreste können auf diese Art in Enone eingeführt werden (siehe Schema), und sowohl cyclische als auch acyclische Enone reagieren unter den äußerst milden Bedingungen bereitwillig.
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