Rationale The ACCRUE (Meta-Analysis of Cell-based CaRdiac stUdiEs) is the first prospectively declared collaborative multinational database including individual data of patients (IPD) with ischemic heart disease treated with cell therapy. Objective We analyzed the safety and efficacy of intracoronary cell therapy after acute myocardial infarction (AMI) including IPDs from 12 randomized trials (ASTAMI, Aalst, BOOST, BONAMI, CADUCEUS, FINCELL, REGENT, REPAIR-AMI, SCAMI, SWISS-AMI, TIME, LATE-TIME; n=1252). Methods and Results The primary endpoint was freedom from combined major adverse cardiac and cerebrovascular events (MACCE; including all-cause death, re-AMI, stroke, and target vessel revascularization). The secondary endpoint was freedom from hard clinical endpoints (death, re-AMI, or stroke), assessed with random-effects meta-analyses and Cox regressions for interactions. Secondary efficacy endpoints included changes in end-diastolic volume (ΔEDV), end-systolic volume (ΔESV), and ejection fraction (ΔEF), analyzed with random-effects meta-analyses and analysis of covariance. We reported weighted mean differences between cell therapy and control groups. No effect of cell therapy on MACCE (14.0% vs. 16.3%, hazard ratio 0.86, 95%CI: 0.63;1.18) or death (1.4% vs 2.1%) or death/re-AMI/stroke (2.9% vs 4.7%) was identified in comparison to controls. No change in ΔEF (mean difference: 0.96%, 95%CI: −0.2;2.1), ΔEDV, or ΔESV was observed compared to controls. These results were not influenced by anterior AMI location, reduced baseline EF, or the use of MRI for assessing left ventricular parameters. Conclusions This meta-analysis of IPD from randomized trials in patients with recent AMI revealed that intracoronary cell therapy provided no benefit, in terms of clinical events or changes in left ventricular function.

Abstract. We aimed to examine the rate of thrombotic events after discontinuation of one year clopidogrel therapy in patients with implanted coronary stent, and to determine platelet aggregability by multiple electrode analyzer after cessation of clopidogrel. This prospective, multicenter study enrolled 200 patients subjected to coronary stent implantation and treated with aspirin + clopidogrel one year after the stent placement. Platelet aggregation was measured using 3 agonists [adenosine diphosphate with PGE 1 (ADPHS), arachidonic-acid (ASPI), and thrombin receptor activating peptide (TRAP)] on the day of cessation of clopidogrel and at 10, 45, and 90 days after clopidogrel was stopped. Two thrombotic events were registered during the 6-months follow up (one ischemic stroke and one myocardial infarction; incidence of 1%). The mean values of ADP + PGE 1 -and ASPI-induced aggregation 10 -90 days after the cessation of clopidogrel were significantly higher than values obtained before the termination of the drug (P < 0.001, all). Cessation of clopidogrel did not influence the TRAP-induced aggregation, which reached the plateau in all measurements. In conclusion, the incidence of thrombotic events after the cessation of one-year clopidogrel treatment might be lower than expected in patients with implanted coronary stent.Keywords: clopidogrel, cessation, rebound effect, thrombotic event Full Paper13 Clopidogrel Cessation and Adverse Events our study was to assess the rate of the adverse cardiovascular events after abrupt, but "on time" cessation of one-year clopidogrel treatment in patients with coronary artery disease (CAD) who underwent PCI. Also, we tested the platelet function after termination of clopidogrel therapy by a multiplate electrode analyzer. Materials and Methods Study designThis prospective multicentric study enrolled 200 patients who underwent coronary stent implantation at the Clinical Centre of Serbia and Military Medical Academy, from September 2008 to March 2009. Half of those patients (n = 100) received a bare-metal stent (BMS), while the other half (n = 100) received a DES. Both groups of patients were treated with dual antiplatelet therapy (aspirin at 300 mg daily for the first month and 100 mg per day after that + clopidogrel at 75 mg/day) for one year after the implantation of stent(s). Clopidogrel treatment was subsequently stopped in both groups of patients after clinical and electrocardiographic (ECG) examination. Patients continued taking all other drugs that they used previously, including aspirin.Exclusion criteria for enrollment were age ≤ 20 years and age > 80 years, thrombotic events during clopidogrel therapy, use of oral anticoagulant drugs, selected hematological abnormalities (hemoglobin < 100 g/l, platelet count < 100 × 10 9 cells/l or > 600 × 10 9 cells/l), malignancies, and chronic inflammatory diseases. Blood samplesBlood samples from all patients (n = 200) were taken four times for Multiple Electrode Aggregometry (MEA). The first sample was taken on the day of cessation o...

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Abstract-Changes in the network topology such as large-scale power outages or Internet worm attacks are events that may induce routing information updates. Border Gateway Protocol (BGP) is by Autonomous Systems (ASes) to address these changes. Network reachability information, contained in BGP update messages, is stored in the Routing Information Base (RIB). Recent BGP anomaly detection systems employ machine learning techniques to mine network data. In this paper, we evaluated performance of several machine learning algorithms for detecting Internet anomalies using RIB. Naive Bayes (NB), Support Vector Machine (SVM), and Decision Tree (J48) classifiers are employed to detect network traffic anomalies. We evaluated feature discretization and feature selection using three data sets of known Internet anomalies.

High aggregatory responses despite antiplatelet treatment is associated with an increased risk of thrombotic complications following percutaneous coronary intervention (PCI). In the present study, we investigated the relationship between platelet aggregatory responses to ADP and the release of CD40L (sCD40L): an immunomodulatory compound involved in atherothrombosis - in patients undergoing PCI. ADP-induced platelet aggregation, sCD40L and soluble P-selectin (sP-selectin) were determined before and 24 h after PCI, in samples from 52 patients receiving aspirin and thienopyridines. Platelet aggregation to ADP above the median was defined as 'high aggregation', and aggregation below the median as 'low aggregation'. Data below are medians and interquartile ranges. Patients with 'high platelet aggregability' had a significantly higher increase in both sCD40L (Delta-values: 0.78 (-0.19-3.18) vs. -0.65 (-2.10-0.00) ng/ml, P = 0.002) and sP-selectin (Delta-values: 8.0 (-2.00-16.00) vs. 4.50 (-13.00-0.50) ng/ml, P = 0.001) compared with patients with 'low platelet aggregability'. In a multivariate linear regression analysis adjusted for clinical characteristics and type of preintervention therapy, the only independent predictors of sCD40L and sP-selectin were platelet aggregation to ADP before PCI (P < 0.001) and the combination of platelet aggregation to ADP before PCI and urgency of PCI (P < 0.001). Circulating CD40L is more markedly increased after PCI in patients with high ADP-induced platelet aggregation.