Isolated coronary artery bypass grafting in septuagenarians.

As life expectancy increases, the number of elderly patients with coronary artery disease requiring coronary artery bypass grafting (CABG) also increases. This study aims to analyse the outcomes of isolated CABG in septuagenarians. Isolated CABG patients between 70 and 79 years from January 1, 2017, to December 31, 2022, were included. Clinical data were obtained from medical records and through a phone call. Out of 618 isolated CABG patients, 132 (21.35%) were septuagenerians. Off-pump and on-pump beating heart CABG was performed in 123 (93.18%) and 9 (6.81%), respectively. Emergency CABG was performed in two patients (1.51%). The mean expected EuroSCORE II (European System for Cardiac Operative Risk evaluation) operative mortality was 2.51%. The incidence of in-hospital mortality, stroke and atrial fibrillation was 1.5%, 0.85% and 6.06%, respectively. An intra-aortic balloon pump was used in six patients (4.5%). The actuarial survival at 1 year, 5 years and 6 years were 98.1 ± 1.4%, 85.5 ± 4.7% and 85.5 ± 4.7%, respectively. The average duration of ventilation, intensive care unit (ICU) and hospital stay were 14.18 ± 10.37 h, 2.48 ± 0.89 days and 6.07 ± 1.8 days, respectively. EuroSCORE-II grading was associated with major adverse cardiovascular events. We conclude that performing CABG on septuagenarians in Indian population is safe.

Azatricyclic Inverse Agonists of RORγt That Demonstrate Efficacy in Models of Rheumatoid Arthritis and Psoriasis.

Structure-activity relationship studies directed toward the replacement of the fused phenyl ring of the lead hexahydrobenzoindole RORγt inverse agonist series represented by 1 with heterocyclic moieties led to the identification of three novel aza analogs 5-7. The hexahydropyrrolo[3,2-f]quinoline series 5 (X = N, Y = Z=CH) showed potency and metabolic stability comparable to series 1 but with improved in vitro membrane permeability and serum free fraction. This structural modification was applied to the hexahydrocyclopentanaphthalene series 3, culminating in the discovery of 8e as a potent and selective RORγt inverse agonist with an excellent in vitro profile, good pharmacokinetic properties, and biologic-like in vivo efficacy in preclinical models of rheumatoid arthritis and psoriasis.