Likelihood analysis of the pMSSM11 in light of LHC 13-TeV data.

We use MasterCode to perform a frequentist analysis of the constraints on a phenomenological MSSM model with 11 parameters, the pMSSM11, including constraints from ∼ 36 /fb of LHC data at 13 TeV and PICO, XENON1T and PandaX-II searches for dark matter scattering, as well as previous accelerator and astrophysical measurements, presenting fits both with and without the ( g - 2 ) µ constraint. The pMSSM11 is specified by the following parameters: 3 gaugino masses M 1 , 2 , 3 , a common mass for the first-and second-generation squarks m q ~ and a distinct third-generation squark mass m q ~ 3 , a common mass for the first-and second-generation sleptons m ℓ ~ and a distinct third-generation slepton mass m τ ~ , a common trilinear mixing parameter A, the Higgs mixing parameter µ , the pseudoscalar Higgs mass M A and tan ß . In the fit including ( g - 2 ) µ , a Bino-like χ ~ 1 0 is preferred, whereas a Higgsino-like χ ~ 1 0 is mildly favoured when the ( g - 2 ) µ constraint is dropped. We identify the mechanisms that operate in different regions of the pMSSM11 parameter space to bring the relic density of the lightest neutralino, χ ~ 1 0 , into the range indicated by cosmological data. In the fit including ( g - 2 ) µ , coannihilations with χ ~ 2 0 and the Wino-like χ ~ 1 ± or with nearly-degenerate first- and second-generation sleptons are active, whereas coannihilations with the χ ~ 2 0 and the Higgsino-like χ ~ 1 ± or with first- and second-generation squarks may be important when the ( g - 2 ) µ constraint is dropped. In the two cases, we present χ 2 functions in two-dimensional mass planes as well as their one-dimensional profile projections and best-fit spectra. Prospects remain for discovering strongly-interacting sparticles at the LHC, in both the scenarios with and without the ( g - 2 ) µ constraint, as well as for discovering electroweakly-interacting sparticles at a future linear e + e - collider such as the ILC or CLIC.

Using intravascular ultrasound with drug-eluting stents. What have we learned so far?

Drug-eluting stents (DES) promise to change the landscape of interventional cardiology, overcoming restenosis that is the major limitation of percutaneous coronary interventions. Intravascular ultrasound (IVUS) examination has been at the centre of our efforts to understand the mechanisms and define different treatment strategies during coronary interventions. IVUS interrogation and 3-dimensional IVUS measurements have been used to better define the mechanisms of benefit and potential drawbacks of DES. The findings of these studies are summarized in this article and the potential importance of IVUS in the era of DES is discussed. Evidence of neointimal hyperplasia (IH) suppression and assessment of any edge effect or vessel remodeling after implantation of DES has been evaluated by IVUS. The overall clinical importance of IVUS in the new era will depend on the amount and the clinical significance of any unsolved questions we will face and on its ability to provide answers to the evolving questions.

Clinical and angiographic outcome of directional atherectomy followed by stent implantation in de novo lesions located at the ostium of the left anterior descending coronary artery.

BACKGROUND: Lesions located at the ostium of the left anterior descending coronary artery (LAD) are considered an ideal target for directional atherectomy (DCA), but few data are available about the value of using this strategy before stenting in comparison with stenting alone. OBJECTIVES: To investigate the immediate and mid term clinical and angiographic results of DCA followed by stent implantation for ostial LAD lesions. DESIGN: Retrospective comparison of the immediate and mid term angiographic and clinical results of a series of 117 consecutive patients with de novo lesions located at the ostium of the LAD. Of these, 46 underwent DCA before stenting and 71 were treated with stenting alone. RESULTS: Technical success in the two groups was similar at around 98%. DCA plus stenting provided a larger minimum lumen diameter at the end of the procedure than stenting alone (3.57 (0.59) mm v 3.33 (0.49) mm, p = 0.022). There were no differences for in-hospital major adverse events (MACE) (7.5% for atherectomy plus stenting, and 5.3% for stenting alone; p = 0.41). All patients had clinical follow up at a mean of 7.9 (2.7) months. Angiographic follow up was done in 89 patients (76%) at a mean of 5.9 (2.2) months. The atherectomy plus stenting group had a larger minimum lumen diameter than the stenting group (2.79 (0.64) mm v 2.26 (0.85) mm, p = 0.004) and a lower binary restenosis rate (13.8% v 33.3%, p = 0.031). Six month MACE were reduced in the atherectomy plus stenting group (8.7% v 23.9%, p = 0.048). CONCLUSIONS: Debulking before stenting in de novo lesions located at the ostium of the LAD is safe and is associated with a high rate of technical success. Follow up data show that DCA plus stenting results in a significantly larger minimum lumen diameter and a lower incidence of restenosis than stenting alone.

Carotid artery stenting in the first 100 consecutive patients: results and follow up.

BACKGROUND: Carotid artery stenting is now used as an alternative to surgical endarterectomy. The availability of cerebral protection systems has expanded the area of application of this procedure. OBJECTIVE: To assess the feasibility, safety, and immediate and late clinical outcome in patients undergoing percutaneous carotid interventions. METHODS: Between January 1999 and December 2000, 100 consecutive patients with 102 carotid artery stenoses were treated (71 men, 29 women, mean (SD) age 67 (8) years): 49 had coronary artery disease, 28 had previous stroke or transient ischaemic attack (TIA). On the basis of the Mayo Clinic carotid endarterectomy risk scale, 73 patients were grade III-IV and 13 grade VI. RESULTS: Baseline diameter stenosis was 78.8 (10)%, with a mean lesion length of 12.6 (5.8) mm. Angiographic success was obtained in 99 lesions (97.0%) with a final diameter stenosis of 2.4 (3.5)%. Procedural success was obtained in 96 patients (96%). Selective cannulation of three carotid arteries was impossible owing to severe vessel tortuosity. Carotid stenting was performed in 97 of the treated lesions, and protection devices were used in 67 lesions. In-hospital complications occurred in seven patients (six TIA, one (category 1) minor stroke). No major stroke or death occurred. All patients were discharged from the hospital after an average of 2.5 days. At 12 (6.2) months of follow up restenosis occurred in three patients (3.4%) (one patient with carotid occlusion had TIA). Six patients had died: two from cerebrovascular events (5 and 11 months after the procedure) and four from cardiovascular causes. CONCLUSIONS: Carotid stenting appears feasible and safe, with few major complications. Long term follow up is affected by a high incidence of cardiovascular mortality.

Predictors of re-occlusion after successful recanalization of chronic total occlusion.

UNLABELLED: The objective of this study was to highlight the incidence and predictors of re-occlusion after successful recanalization of chronic total coronary occlusions. METHODS AND RESULTS: Following successful recanalization and stent implantation in 716 coronary lesions (665 patients) with chronic total occlusion, four hundred and five (56.6%) lesions (375 patients) underwent repeat angiography within 6 months. Restenosis (> or = 50% lumen narrowing) was observed in 151 (37.3%) lesions; forty-three (10.6%) of these lesions had complete re-occlusion and constituted the study population. In this group, final angiographic minimal lumen diameter (MLD) was 2.6 +/- 0.51 mm and final percent diameter stenosis was 18 +/- 11. Univariate analysis revealed significant correlation between re-occlusion and restenotic lesions, final balloon diameter, final percent diameter stenosis, final angiographic MLD, number of stents per lesion and total stent length. By multivariate analysis, the only independent predictor of re-occlusion was total stent length (OR = 1.46, 95% CI = 1.12-1.82; p = 0.0069). CONCLUSION: Re-occlusion occurs in about 11% of cases after stenting chronic total occlusion. The most important predictor of re-occlusion seems to be stent length.

Impaired compensatory coronary artery enlargement in atherosclerosis contributes to the development of coronary artery stenosis in diabetic patients. An in vivo intravascular ultrasound study.

AIMS: Coronary arteries affected by atherosclerosis undergo focal compensatory enlargement, which can be detected by intracoronary ultrasound but not by angiography. Diabetic patients when compared with non-diabetics have a more accelerated progression of coronary artery disease and a more diffuse narrowing of the coronary arteries. Intracoronary ultrasound can clarify if this is due to less compensatory coronary artery enlargement as a response to atherosclerosis. METHODS AND RESULTS: Ten non-diabetic and 15 diabetic patients with coronary artery disease, with angiographically determined one- or two-vessel disease, underwent intracoronary ultrasound examination of the non-stenotic coronary artery. Forty-five sites with luminal stenosis, detected by intracoronary ultrasound, were analysed (15 in non-diabetics, 30 in diabetics). Vessel and lumen area, atherosclerotic plaque area and plaque composition were evaluated. Vessel area was also measured proximal and distal to the healthy segment. In the diabetic patients, there was less vessel area increase from the proximal healthy segment into the atherosclerotic segment than in the non-diabetic patients (99% separate-variance confidence intervals for differences between diabetics' and non-diabetics' means = 0.29 mm2, 2.71 mm2). The proximal plaque free vessel area, the atherosclerotic plaque area and plaque composition were similar between the two groups. CONCLUSION: Diabetics with atherosclerosis have less compensatory coronary artery enlargement than non-diabetics. This may explain the diffuse and accelerated course of coronary artery disease in these patients.

Relationship between erythrocyte 2,3-diphosphoglycerate and age in a normal population.

The concentration of 2,3-diphosphoglycerate in erythrocytes was determined in 369 male and 376 female normal subjects, 1 to 86 years of age, derived from the Greek population. It was inversely correlated (P less than 0.01) with age. Persons over age 60 showed a decrease (P less than 0.05) in 2,3-diphosphoglycerate concentrations as compared those 1-20 years of age.