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Clopidogrel is the most commonly used anti–P2Y12 drug in DAPT. Impaired pharmacological response and antithrombotic efficacy associated with cytochrome–P450 and/or ABCB1 gene mutations is observed in about 1/3 of treated patients. To circumvent this problem, guided therapy has been tested, based on either identification of predisposing gene mutations or results of platelet function tests (PFTs). Patients with with predisposing gene mutations or high platelet reactivity on clopidogrel (HPR) were treated with alternative, potentially more effective regimens: higher clopidogrel doses, prasugrel, ticagrelor, or additional cylostazol. In this meta–analysis, we tested the efficacy and safety of these two different strategies of guided therapy separately. We searched relevant articles published in English until October 1th 2022 on MEDLINE, Embase and Central. Articles included all RCTs comparing standard anti–P2Y12 therapy (ST) versus genotype–guided or PFTs–guided anti–P2Y12 therapy in patients with acute coronary syndromes (ACS) or chronic coronary artery disease (CCAD) undergoing PCI. Two reviewers independently assessed study eligibility and risk of bias, and extracted data. Hazard ratios with 95% CI were calculated based on fixed effects models. Efficacy outcomes comprised major adverse cardiovascular events (MACE) as defined in each study. Main safety outcome included major bleedings (MB) according to BARC. Different sub–analyses were also performed based on type of anti–P2Y12 drug in ST, type of alternative drug, type of PFT, patients’ ethnicity, prevalence of ACS. We retrieved 6 RCTs testing genotype–guided anti–P2Y12 therapy on 10443 patients and 14 RCTs testing PFTs–guided anti–P2Y12 therapy on 11596 patients. MACE were lower in genotype–guided therapy than in ST, RR 0.68 (95% CI, 0.49–0.94) while MB did not significantly differ between the two groups, RR 0.88 (95% CI, 0.63–1.23). MACE and MB did not significantly differ between PFTs–guided anti–P2Y12 therapy and ST: RR 0.83 (95% CI, 0.58–1.18) and 1.24 (95% CI, 1.00–1.53), respectively. Sub–analyses revealed that MACE were lower in PFTs–guided anti–P2Y12 therapy compared to ST in patients of Asian descent. In conclusion, gentotype–guided anti–P2Y12 therapy reduced the incidence of MACE without increasing MB, compared with ST, in patients with ACS or CCAD undergoing PCI; in contrast, PFTs–guided anti–P2Y12 therapy did not affect the incidence of MACE or MB in these patients.

Newly synthesized mono-, di-, and triphosphate of 2-alkynyl adenosines showed very different behavior in human platelet P2Y receptor models, according to the different alkynyl chains. In fact, 2-hexynyladenosine di- (5) and triphosphate (7) induced platelet shape change and aggregation and inhibited PGE1-induced increase in platelet cyclic AMP. On the contrary, the corresponding 2-phenylethynyladenosine di- (6) and triphosphate (8) did not induce platelet shape change or aggregation, but inhibited platelet aggregation induced by ADP.

A set of aminoalkoxy‐substituted, differently annullated furocoumarins, differing in the position of the aminoalkoxy chain and in the unsaturation level of the fused ring, has been subjected to electron impact and electrospray ionisation (ESI) experiments. In order to achieve a distinct characterisation of isomeric compounds, which partially failed under electron impact conditions, collision‐induced dissociation experiments were performed on protonated molecules. The breakdown curves obtained by varying the tickle voltage on an ion trap ESI instrument led to the desired characterisation. Copyright © 2001 John Wiley & Sons, Ltd.

A set of aminoalkoxy-substituted, differently annullated furocoumarins, differing in the position of the aminoalkoxy chain and in the unsaturation level of the fused ring, has been subjected to electron impact and electrospray ionisation (ESI) experiments. In order to achieve a distinct characterisation of isomeric compounds, which partially failed under electron impact conditions, collision-induced dissociation experiments were performed on protonated molecules. The breakdown curves obtained by varying the tickle voltage on an ion trap ESI instrument led to the desired characterisation. Copyright © 2001 John Wiley & Sons, Ltd.

DielsAlder reactions between the furan double bond of 8methoxypsoralen and 1,2,4,5tetrazine or 3,6bistrifluoromethyl1,2,4,5tetrazine were accompanied by the release of diatomic nitrogen and the opening of the furan ring to leave a 6pyridazinocoumarin. When 3,6bismethoxycarbonyl1,2,4,5tetrazine was used as diene with 8methoxy, 5methoxy or 8hydroxypsoralen as substrate a previously unknown heterocyclic framework was created. Formation of the fourth ring was accompanied by conversion of the furan ring to a pyrone, presumably by intramolecular transestenfication with release of methanol. The characterization of the products of these reactions by exhaustive mass spectrometric analysis is discussed.

The electron ionisation induced decomposition pathways of a series of new coumarins, three psoralens, one allopsoralen and one angelicine have been studied in detail with the aid of mass analysed ion kinetic energy spectrometry. The examined compounds exhibit decomposition patterns well related to their structures and the characterisation of some isomer pairs has been obtained. Copyright © 1998 John Wiley & Sons, Ltd.

The electron ionisation induced decomposition pathways of a series of new coumarins, three psoralens, one allopsoralen and one angelicine have been studied in detail with the aid of mass analysed ion kinetic energy spectrometry. The examined compounds exhibit decomposition patterns well related to their structures and the characterisation of some isomer pairs has been obtained. Copyright © 1998 John Wiley & Sons, Ltd.

The mass spectrometric behaviour of seven neuroleptic amino alkyl thieno[β]cycloalkanones has been studied under electron ionization conditions and with the aid of metastable ion studies, low energy collisional experiments and accurate mass measurements. The most relevant fragmentation pathways are discussed and the power of the different methodologies for the characterization of structural isomers has been tested. © 1998 John Wiley & Sons, Ltd.

A very important parameter during the insertion of dental implants is the amount of bone present in a site. A regenerative procedure to increase the width and the height of bone is proposed with the use of occlusive barrier membranes and biomaterials. The authors used, in six patients with deficient alveolar ridges, prior to implant insertion, Biocoral ® gel particles in connection with expanded polytetrafluoroethylene membranes. After 6 months it was observed that a tissue similar to mature bone had regenerated under the membrane and microscopically it was observed that the Biocoral particles were still present and almost all were completely surrounded by mature bone

The mass spectrometric behaviour of seven neuroleptic amino alkyl thieno[β]cycloalkanones has been studied under electron ionization conditions and with the aid of metastable ion studies, low energy collisional experiments and accurate mass measurements. The most relevant fragmentation pathways are discussed and the power of the different methodologies for the characterization of structural isomers has been tested. © 1998 John Wiley & Sons, Ltd.

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The polypodands (Ia) ‐ (Ic), whose preparation is described in a former publication, are excellent agents for the complexation of alkali metal salts in low polarity solvents.

The brenzcatechols (I) react with cyclohexanone (II) yielding the spirocycles (III), which are coupled with epibromohydrine (VI) to give the compounds (IV).

Reaction of hexachlorocyclophosphazene (I) with the polyethylene glycol mono alkyl ethers (II) yields the hexasubstituted derivatives (III).