Species-specific densities of saproxylic beetles in cut 4-m high, medium to large diameter stumps of spruce, birch, aspen and oak were monitored for 7 years after cutting, by trapping emerging insects within seasonally applied net enclosures. A total of 47,038 individuals, representing 316 saproxylic beetle species including 40 red-listed species, were recorded. Densities of 86 species were modelled in relation to stump diameter and measured levels of sun-exposure. Two thirds of the species favoured semi-or fully exposed substrates, while one third performed better in shade. Few species seemed to be specifically adapted to semi-exposed conditions. Diameter was generally of less importance than exposure, and similar numbers of species favoured medium and large diameter substrates. Group mean diameter and exposure calculated from means per individual and species were similar for groups of modelled and non-modelled species, and for groups of red-listed and non-red-listed species, respectively. This indicates that the proportions found in the models are representative for the diverse regional fauna of saproxylic beetles that utilise high stumps of spruce, birch, aspen and oak in early stages of decay. The results suggest that sunexposed dead wood substrates generated and retained in managed forest landscapes are potentially important for many species. However, stands of unmanaged self-thinning successions of deciduous trees, as well as substantial areas of old-growth spruce-forests are also necessary to address the wide spectrum of saproxylic beetles.

In the PLATelet inhibition and patient Outcomes (PLATO) study of patients with acute coronary syndromes, ticagrelor reduced mortality compared to clopidogrel but the mechanisms for this mortality reduction remain uncertain. We analysed adverse events (AEs) consistent with either pulmonary infection or sepsis, and subsequent mortality, in 18,421 PLATO patients treated with ticagrelor or clopidogrel. AEs occurring within 7 days of last dose of study medication were defined as “on-treatment”. Serial measurements of blood leukocyte counts, C-reactive protein and interleukin-6 were performed. Fewer on-treatment pulmonary AEs occurred in the ticagrelor compared to the clopidogrel group (275 vs. 331 respectively; p = 0.019), with fewer deaths following these AEs (33 vs. 71; p < 0.001), particularly in those who remained on study medication three days after AE onset (10 vs. 43; p < 0.001). There were fewer deaths attributed to sepsis in the ticagrelor group (7 vs. 23; p = 0.003). Leukocyte counts were lower in the clopidogrel group during treatment (p < 0.0001 at 1, 3 and 6 months) but not at 1 month post-discontinuation. C-reactive protein increased more at discharge in the ticagrelor group (28.0 ± 38.0 vs. 26.1 ± 36.6 mg/l; p < 0.001) and interleukin-6 remained higher during the first month of treatment with ticagrelor. We conclude that the mortality risk following pulmonary AEs and sepsis in acute coronary syndrome patients appears to be lower during ticagrelor compared to clopidogrel therapy. Further work should assess whether ticagrelor and clopidogrel have differential effects on immune signalling.

In the subgroup of patients undergoing CABG within 7 days after the last study drug intake, ticagrelor compared with clopidogrel was associated with a substantial reduction in total and CV mortality without excess risk of CABG-related bleeding.

No abstract

The mortality reduction with ticagrelor versus clopidogrel following CABG in the PLATO trial was associated with fewer deaths from cardiovascular, bleeding, and infection complications. (Platelet Inhibition and Patient Outcomes [PLATO]; NCT00391872).