RESULTS: Among 26,862 patients, the majority received statins (73.4%), whereas 867 selleck compound (3.2%) received ERN. The mean age of

ERN patients was 62 years and 75% were male. After one year, adherence with ERN was below that of statins (62.0% versus 74.9%), as was persistence (36.1% versus 46.7%), while discontinuation rates were higher (64.0% versus 53.3%). The median time until discontinuation for ERN was shorter than for statins (66 days versus 99 days). After one year, 5.8% of patients were taking 1500 mg or more and 3.2% were on 2000 mg.

CONCLUSIONS: In the present cohort of patients from regular clinical practice in Quebec, ERN use was associated with low prescription rates, inferior adherence and persistence compared with other LMDs, high discontinuation rates, and very low 2000 mg dose attainment.”
“BACKGROUND: Herein we study the role of donor-specific antibodies (DSA) to mismatched human SYN-117 mouse leukocyte antigen (HLA) and antibodies (Abs) to the cardiac self-antigens myosin (MYO) and vimentin (VIM) in the pathogenesis of acute antibody-mediated rejection (AMR) in the early post-transplant period (EP, <12 months) and cardiac allograft vasculopathy (CAV) in the late post-transplant period (LP, >12 months) after heart transplantation (HTx).

METHODS: One hundred forty-eight

HTx recipients (65 in EP, 83 in LP) were enrolled in the study: Development of DSA was determined by Luminex. Circulating Abs against MYO and VIM in sera were measured using enzyme-linked immunoassay (ELISA). Frequency of CD4(+) T-helper cells (CD4(+) Th) secreting interferon (IFN)-gamma, interleukin (IL,)-17, IL-10 or IL-5 specific to either MYO or VIM were analyzed in vitro using ELISpot assays.

RESULTS: AMR patients were more likely DSA positive (AMR(-): 15%; AMR(+): 70%; p = 0.03) and demonstrated increased Abs to MYO (AMR(-): 144 +/- 115 mu g/ml; AMR(+): 285 +/- 70 mu g/ml; p = 0.033) and VIM (AMR(-): 37 +/- 19 mu g/ml; AMR(+): 103 +/- 43 mu g/ml; p = 0.014). AMR patients demonstrated increased IL-5 CD4(+) Th

cells specific to MYO (5.2 +/- 0.9 fold, p = 0.003) and VIM (7.3 +/- 2.9-fold, p = 0.004) and decreased IL-10 CD4(+) Th cells specific to MYO (2.2 +/- 0.4-fold, p = 0.009) and VIM (1.7 +/- 0.2-fold, p selleck chemicals llc = 0.03). CAV patients were more likely DSA positive (CAV(-): 25%; CAV(+): 79%; p = 0.03) and demonstrated increased Abs to MYO (CAV(-): 191 +/- 120 mu g/ml; CAV(+): 550 +/- 98 mu g/ml; p = 0.025) and VIM (CAV(-): 55 +/- 25 mu g/ml; CAV(+): 255 +/- 49 mu g/ml; p = 0.001). CAV patients demonstrated increased IL-17 CD4(+) Th cells specific to MYO (10.5 +/- 7.3-fold, p = 0.002) and VIM (7.0 +/- 3.9-fold, p = 0.003).

CONCLUSIONS: The presence of DSA in AMR and CAV is significantly associated with development of Abs to MYO and VIM in post-HTx patients.