The 1945-1949 droughts in Switzerland

This paper studies the representation of a drought period that affected Central Europe from 1945 to 1949 in the “Twentieth Century Reanalysis” (20CR). We analysed temperature and precipitation fields in 20CR and compared them to other data products. From the monthly precipitation rate at a 20CR grid point in the Swiss Plateau, the Standardised Precipitation Index over six months (SPI6) was calculated and compared with the corresponding index calculated from station data. For additional analyses, 20CR soil moisture, run off, and evaporation data were used. 20CR well reproduces the temperature and precipitation anomalies over Central Europe during this period, although during 1947, the precipitation anomaly is shifted to the east as compared to observations. With respect to the SPI6 index, the agreement between 20CR and station data is good except again for 1947 (conversely, drought was overestimated in 20CR for 1945 and 1949). Low SPI values in 20CR are accompanied by negative soil moisture anomalies and a negative water balance. Thus, apart from the shift in the spatial drought pattern in 1947, the drought is depicted in a realistic way in 20CR.

Lack of association between dual antiplatelet therapy use and stent thrombosis between 1 and 12 months following resolute zotarolimus-eluting stent implantation.

AIM The optimal duration of dual antiplatelet therapy (DAPT) following the use of new generation drug-eluting stents is unknown. METHODS AND RESULTS The association between DAPT interruption and the rates of stent thrombosis (ST) and cardiac death/target-vessel myocardial infarction (CD/TVMI) in patients receiving a Resolute zotarolimus-eluting stent (R-ZES) was analysed in 4896 patients from the pooled RESOLUTE clinical programme. Daily acetylsalicylate (ASA) and a thienopyridine for 6-12 months were prescribed. A DAPT interruption was defined as any interruption of ASA and/or a thienopyridine of >1 day; long interruptions were >14 days. Three groups were analysed: no interruption, interruption during the first month, and >1-12 months. There were 1069 (21.83%) patients with a DAPT interruption and 3827 patients with no interruption. Among the 166 patients in the 1-month interruption group, 6 definite/probable ST events occurred (3.61%; all long DAPT interruptions), and among the 903 patients in the >1-12 months (60% occurred between 6 and 12 months) interruption group, 1 ST event occurred (0.11%; 2-day DAPT interruption). Among patients with no DAPT interruption, 32 ST events occurred (0.84%). Rates of CD/TVMI were 6.84% in the 1-month long interruption group, 1.41% in the >1-12 months long interruption group, and 4.08% in patients on continuous DAPT. CONCLUSION In a pooled population of patients receiving an R-ZES, DAPT interruptions within 1 month are associated with a high risk of adverse outcomes. Dual antiplatelet therapy interruptions between 1 and 12 months were associated with low rates of ST and adverse cardiac outcomes. Randomized clinical trials are needed to determine whether early temporary or permanent interruption of DAPT is truly safe. CLINICAL TRIALSGOV IDENTIFIERS NCT00617084; NCT00726453; NCT00752128; NCT00927940.