Among patients with unstable angina or myocardial infarction without ST-segment elevation, prasugrel did not significantly reduce the frequency of the primary end point, as compared with clopidogrel, and similar risks of bleeding were observed. (Funded by Eli Lilly and Daiichi Sankyo; TRILOGY ACS ClinicalTrials.gov number, NCT00699998.).

SMVT substrate can be identified by ceMRI scar heterogeneity analysis. This information could help identify patients at risk of VT and facilitate VT ablation.

Introduction and objectives The COVID-19 outbreak has had an unclear impact on the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to assess changes in STEMI management during the COVID-19 outbreak. Methods Using a multicenter, nationwide, retrospective, observational registry of consecutive patients who were managed in 75 specific STEMI care centers in Spain, we compared patient and procedural characteristics and in-hospital outcomes in 2 different cohorts with 30-day follow-up according to whether the patients had been treated before or after COVID-19. Results Suspected STEMI patients treated in STEMI networks decreased by 27.6% and patients with confirmed STEMI fell from 1305 to 1009 (22.7%). There were no differences in reperfusion strategy (> 94% treated with primary percutaneous coronary intervention in both cohorts). Patients treated with primary percutaneous coronary intervention during the COVID-19 outbreak had a longer ischemic time (233 [150-375] vs 200 [140-332] minutes, P < .001) but showed no differences in the time from first medical contact to reperfusion. In-hospital mortality was higher during COVID-19 (7.5% vs 5.1%; unadjusted OR, 1.50; 95%CI, 1.07-2.11; P < .001); this association remained after adjustment for confounders (risk-adjusted OR, 1.88; 95%CI, 1.12-3.14; P = .017). In the 2020 cohort, there was a 6.3% incidence of confirmed SARS-CoV-2 infection during hospitalization. Conclusions The number of STEMI patients treated during the current COVID-19 outbreak fell vs the previous year and there was an increase in the median time from symptom onset to reperfusion and a significant 2-fold increase in the rate of in-hospital mortality. No changes in reperfusion strategy were detected, with primary percutaneous coronary intervention performed for the vast majority of patients. The co-existence of STEMI and SARS-CoV-2 infection was relatively infrequent.

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A simple method for determining the presence of cadmium (Cd) in thermoformed and biodegradable flexible films and flour and starch samples from cassava, using graphite furnace-atomic absorption spectrometry (GF-AAS), is proposed. The biopolymers used in contact with foods can contain Cd due to contamination from the origin of the material used to make them. The nitric: perchloric acid digestion with reflux was optimized, and the statistical quality parameters were standardized. The GF-AAS instrumental conditions and the graphite furnace heating program were adjusted through pyrolysis and atomization curves, and the optimal temperatures were 530 and 1750°C, respectively. In addition, under optimal conditions, the working range was from 0.1 µg/L to 1.0 µg/L, with limits of detection and quantification of 0.02 and 0.07 µg/L, respectively. The precision was evaluated using intermediate precision and repeatability of the method, which showed standard deviations of 1.6–4.8% and 2.1–4.8%, respectively. The percentage of recovery of Cd ranged from 96.2% to 97.3%. The results obtained support the suitability of the method for determining the presence of Cd in these samples. Cd concentrations in flexible films and starch were below the quantification limit. The other samples (thermoformed and flours) contained less than 1 mg/kg (maximum level set by the NTC 4096), indicating that these polymers meet this standard and therefore can be used for food containers and packaging for fresh fruits and vegetables.