Phytoplankton composition derived from CHEMTAX along 10°E during POLARSTERN cruise ANT-XXVIII/3, Jan-March 2012

Phytoplankton community structure and their physiological response in the vicinity of the Antarctic Polar Front (APF; 44°S to 53°S, centred at 10°E) were investigated as part of the ANT-XXVIII/3 Eddy-Pump cruise conducted in austral summer 2012. Our results show that under iron-limited (< 0.3 µmol/m**3) conditions, high total chlorophyll-a (TChl-a) concentrations (> 0.6 mg/m**3) can be observed at stations with deep mixed layer (> 60 m) across the APF. In contrast, light was excessive at stations with shallower mixed layer and phytoplankton were producing higher amounts of photoprotective pigments, diadinoxanthin (DD) and diatoxanthin (DT), at the expense of TChl-a, resulting in higher ratios of (DD+DT)/ TChl-a. North of the APF, significantly lower silicic acid (Si(OH)4) concentrations (< 2 mmol/m**3) lead to the domination of nanophytoplankton consisting mostly of haptophytes, which produced higher ratios of (DD+DT)/TChl-a under relatively low irradiance conditions. The Si(OH)4 replete (> 5 mmol/m**3) region south of the APF, on the contrary, was dominated by microphytoplankton (diatoms and dinoflagellates) with lower ratios of (DD+DT)/TChl-a, despite having been exposed to higher levels of irradiance. The significant correlation between nanophytoplankton and (DD+DT)/TChl-a indicates that differences in taxon-specific response to light are also influencing TChl-a concentration in the APF during summer. Our results reveal that provided mixing is deep and Si(OH)4 is replete, TChl-a concentrations higher than 0.6 mg/m**3 are achievable in the iron-limited APF waters during summer.

Under-ice export flux measurements by short-term drifting sediment traps at 27 stations in the Arctic Ocean during summer 1995, 1997, and 2012

A critical question regarding the organic carbon cycle in the Arctic Ocean is whether the decline in ice extent and thickness and the associated increase in solar irradiance in the upper ocean will result in increased primary production and particulate organic carbon (POC) export. To assess spatial and temporal variability in POC export, under-ice export fluxes were measured with short-term sediment traps in the northern Laptev Sea in July-August-September 1995, north of the Fram Strait in July 1997, and in the Central Arctic in August-September 2012. Sediment traps were deployed at 2-5 m and 20-25 m under ice for periods ranging from 8.5 to 71 h. In addition to POC fluxes, total particulate matter, chlorophyll a, biogenic particulate silica, phytoplankton, and zooplankton fecal pellet fluxes were measured to evaluate the amount and composition of the material exported in the upper Arctic Ocean. Whereas elevated export fluxes observed on and near the Laptev Sea shelf were likely the combined result of high primary production, resuspension, and release of particulate matter from melting ice, low export fluxes above the central basins despite increased light availability during the record minimum ice extent of 2012 suggest that POC export was limited by nutrient supply during summer. These results suggest that the ongoing decline in ice cover affects export fluxes differently on Arctic shelves and over the deep Arctic Ocean and that POC export is likely to remain low above the central basins unless additional nutrients are supplied to surface waters.

Novel free fatty acid receptor 1 (GPR40) agonists based on 1,3,4-thiadiazole-2-carboxamide scaffold

Free fatty acid receptor 1 (FFA1), previously known as GPR40 is a G protein-coupled receptor and a new target for treatment of type 2 diabetes. Two series of FFA1 agonists utilizing a 1,3,4-thiadiazole-2-caboxamide scaffold were synthetized. Both series offered significant improvement of the potency compared to the previously described 1,3,4-thiadiazole-based FFA1 agonists and high selectivity for FFA1. Molecular docking predicts new aromatic interactions with the receptor that improve agonist potency. The most potent compounds from both series were profiled for in vitro ADME properties (plasma and metabolic stability, LogD, plasma protein binding, hERG binding and CYP inhibition). One series suffered very rapid degradation in plasma and in presence of mouse liver microsomes. However, the other series delivered a lead compound that displayed a reasonable ADME profile together with the improved FFA1 potency.

STOPPFrail (Screening Tool of Older Persons Prescriptions in Frail Adults with Limited Life Expectancy): Consensus Validation

Background: To validate STOPPFrail, a list of explicit criteria for potentially inappropriate medications (PIMs) in frailer older adults with limited life expectancy. A Delphi consensus survey of an expert panel (n = 17) comprising specialists in geriatric medicine, clinical pharmacology, palliative care, psychiatry of old age, clinical pharmacy and general practice.
Methods: STOPPFrail criteria was initially created by the authors based on clinical
experience and appraisal of the available literature. Criteria were organised according to physiological system. Each criterion was accompanied by an explanation. Panellists ranked their agreement with each criterion on a 5-point Likert scale and invited to provide written feedback. Criteria with a median Likert response of 4/5 (agree/strongly agree) and a 25th centile of ≥4 were included in the final criteria.
Results: Three Delphi rounds were required. All panellists completed all rounds. Thirty criteria were proposed for inclusion; 26 were accepted. No new criteria were added. The first two criteria suggest deprescribing medications with no indication or where compliance is poor. The remaining 24 criteria include lipid-lowering therapies, alpha-blockers for hypertension, anti-platelets, neuroleptics, proton pump inhibitors, H-2 receptor antagonists, anti-spasmodics, theophylline, leukotriene antagonists, calcium supplements, bone anti-resorptive therapy, selective oestrogen receptor modulators, non-steroidal antiinflammatories, corticosteroids, 5-alpha reductase inhibitors, alpha-1 selective blockers, muscarinic antagonists, oral diabetic agents, ACE-inhibitors, angiotensin receptor blockers, systemic oestrogens, multivitamins, nutritional supplements and prophylactic antibiotics. Anticoagulants and anti-depressants were excluded. Despite incorporation of panellists’ suggestions, memantine and acetyl-cholinesterase inhibitors remained inconclusive.
Conclusion: STOPPFrail comprises 26 criteria, which have been judged by broad consensus, to be potentially inappropriate in frailer older patients with limited life expectancy. STOPPFrail may assist in deprescribing medications in these patients.

Measurement of the doubly-polarized He3→(γ→,n)pp reaction at 16.5 MeV and its implications for the GDH sum rule

We report new measurements of the double-polarized photodisintegration of 3He at an incident photon energy of 16.5 MeV, carried out at the High Intensity γ-ray Source (HIγS) facility located at Triangle Universities Nuclear Laboratory (TUNL). The spin-dependent double-differential cross sections and the contribution from the three-body channel to the Gerasimov–Drell–Hearn (GDH) integrand were extracted and compared with the state-of-the-art three-body calculations. The calculations, which include the Coulomb interaction and are in good agreement with the results of previous measurements at 12.8 and 14.7 MeV, deviate from the new cross section results at 16.5 MeV. The GDH integrand was found to be about one standard deviation larger than the maximum value predicted by the theories.

Odour flux from litter of broiler chickens fed diets differing in protein levels and additives

The effect of dietary crude protein (CP) and additives on odour flux from broiler litter was investigated using 180 day-old Ross 308 male chicks randomly allocated to five dietary treatments with three replications of 12 birds each. A 5×3 factorial arrangement of treatments was employed. Factors were: diet (low CP, high CP, high CP+antibiotic, high CP+probiotic, high CP+saponin) and age (15, 29, 35 days). Low CP (LCP) and high CP (HCP) diets differed in CP levels by 4.5-5%. The low CP diets were supplemented with L-valine, L-isoleucine, L-arginine, L-lysine, D,L-methionine and L-threonine. The antibiotic used was Zn Bacitracin, the probiotic was a blend of three Bacillus subtilis strains and the saponin came from a blend of Yucca and Quillaja. Odorants were measured from litter headspace using a flux hood and selective ion flow tube mass spectrometry (SIFT-MS). Results were log tranformed and analysed by two-way ANOVA with repeated measures using JMP statistical software v.8, and means were separated by Tukey's HSD test at P<0.05.The results showed that LCP group produced lower flux of dimethyl amine, trimethyl amine, H2S, NH3 and phenol in litter compared to HCP group (P<0.05). Similarly, HCP+probiotic group produced lower flux of H2S (P<0.05) and HCP+saponin group produced lower flux of trimethylamine and phenol in litter compared to HCP group (P<0.05). The dietary treatments tended (P=0.065) to have higher flux of methanethiol in HCP group compared to others. There was a diet x age interaction for litter flux of diacetyl, acetoin, 3-methyl-1-butanol, 3-methylbutanal, ethanethiol, propionic acid and hexane (P<0.05). Concentrations of diacetyl, acetoin, propionic acid and hexane in litter were higher from LCP group compared to all other treatments on d 35 (P<0.05) but not on days 15 and 29. Thus, the low CP diet, Bacillus subtilis based probiotic and Yucca/Quillaja based saponin were effective in reducing the emissions of some key odorants from broiler litter.

Characterisation and quantification of changes in odorants from litter headspace of meat chickens fed diets varying in protein levels and additives

The effect of dietary crude protein (CP) and additives on odor flux from meat chicken litter was investigated using 180 day-old Ross 308 male chicks randomly allocated to five dietary treatments with three replicates of 12 birds each. A 5 × 3 factorial arrangement of treatments was employed. Factors were: diet (low CP, high CP, high CP+antibiotic, high CP+probiotic, high CP+saponin) and age (15, 29, 35 days). The antibiotic used was Zn bacitracin, the probiotic was a blend of three Bacillus subtilis strains and the saponin came from a blend of Yucca and Quillaja. Odorants were collected from litter headspace with a flux hood and measured using selective ion flow tube mass spectrometry (SIFT-MS). Litter moisture, water activity (Aw), and litter headspace odorant concentrations were correlated. The results showed that low CP group produced lower flux of dimethyl amine, trimethyl amine, H2S, NH3, and phenol in litter compared to high CP group (P < 0.05). Similarly, high CP+probiotic group produced lower flux of H2S (P < 0.05) and high CP+saponin group produced lower flux of trimethylamine and phenol in litter compared to high CP group (P < 0.05). The dietary treatments tended (P = 0.065) to have higher flux of methanethiol in high CP group compared to others. There was a diet × age interaction for litter flux of diacetyl, 3-hydroxy-2-butanone (acetoin), 3-methyl-1-butanol, 3-methylbutanal, ethanethiol, propionic acid, and hexane (P < 0.05). Concentrations of diacetyl, acetoin, propionic acid, and hexane in litter were higher from low CP group compared to all other treatments on d 35 (P < 0.05) but not on d 15 and 29. A high litter moisture increased water activity (P < 0.01) and favored the emissions of methyl mercaptan, hydrogen sulfide, dimethyl sulfide, ammonia, trimethyl amine, phenol, indole, and 3-methylindole over others. Thus, the low CP diet, Bacillus subtilis based probiotic and the blend of Yucca/Quillaja saponin were effective in reducing the emissions of some key odorants from meat chicken litter.

Prevalencia, presentación y manejo antitrombótico de la fibrilación auricular en la consulta cardiológica ambulatoria

Antecedentes: la fibrilación auricular (FA) es la arritmia sostenida más frecuente en la clínica. Existen pocos datos en nuestro medio sobre la prevalencia, modo de presentación, perfil de riesgo tromboembólico y tratamiento antitrombótico de los pacientes con FA asistidos en la consulta cardiológica general ambulatoria. Método: se identificaron los casos de FA entre las consultas ambulatorias programadas consecutivas en 30 días (junio-julio de 2015) de diez cardiólogos a través de la historia clínica electrónica. Se estudiaron factores demográficos, score de riesgo tromboembólico, tipo de FA y utilización de medicación antitrombótica. Las variables cualitativas se analizaron mediante test exacto de Fisher y las cuantitativas mediante test t de Student o Mann-Whitney, según correspondiera. Resultados: entre 1.875 consultas analizadas, tenían registros de FA 282 (15%), correspondientes a 272 pacientes. La edad de los que tenían FA fue 78,4 ± 8,3 años, mientras que fue 68,3 ± 14 años en el resto (p<0,001). En el sexo masculino tenían FA 136 de 810 consultas (16,7%) y en el sexo femenino en 136 de 1.065 consultas (12,7%) (p=0,0171). En los 257 pacientes con FA no valvular el score CHA2DS2-VASc promedio fue 3,8 ± 1,4, mientras que el 95,3 % tenía un score ³2. El 70,2% tenía FA permanente/persistente y 29,8% la forma paroxística. En FA permanente/persistente la edad media fue 79,2 ± 7,9 años y en FA paroxística fue 76,5 ± 9 años (p=0,0207), el score CHA2DS2-VASc promedio fue 3,9 ± 1,3 y 3,5 ± 1,6 (p=0,0099) respectivamente. Recibían algún tratamiento antitrombótico 252 (92,6%), un anticoagulante oral (ACO) 207 (76,1%), antiagregantes plaquetarios 55 (20,2%) y ambos 10 (3,7%). En FA permanente/persistente recibían ACO 171 de 191 pacientes (89,5 %) y en FA paroxística 36 de 81 (44,4%) (p< 0,0001). El ACO utilizado fue warfarina en 64 (23,5%) y un anticoagulante directo (NOAC) en 143 (52,6%). Conclusiones: la prevalencia de FA en la consulta cardiológica ambulatoria fue elevada, con mayor frecuencia en el sexo masculino y con una media de edad superior en diez años al resto de la población. El 95,3 % de las FA no valvulares tenía score de riesgo ³2 por lo que eran elegibles para ACO. La utilización de ACO fue elevada, pero fue más del doble en FA permanente/persistente que en FA paroxística, aunque la diferencia en edad o score de riesgo entre ambos tipos fue pequeña. La utilización de NOAC superó a la warfarina por más de 2 a 1.

The mutable nature of particle-core excitations with spin in the one-valence-proton nucleus Sb-133

The gamma-ray decay of excited states of the one-valence-proton nucleus Sb-133 has been studied using cold-neutron induced fission of U-235 and Pu-241 targets, during the EXILL campaign at the ILL reactor in Grenoble. By using a highly efficient HPGe array, coincidences between gamma-rays prompt with the fission event and those delayed up to several tens of microseconds were investigated, allowing to observe, for the first time, high-spin excited states above the 16.6 mu s isomer. Lifetimes analysis, performed by fast-timing techniques with LaBr3(Ce) scintillators, revealed a difference of almost two orders of magnitude in B(M1) strength for transitions between positive-parity medium-spin yrast states. The data are interpreted by a newly developed microscopic model which takes into account couplings between core excitations (both collective and non-collective) of the doubly magic nucleus Sn-132 and the valence proton, using Skyrme effective interaction in a consistent way. The results point to a fast change in the nature of particle-core excitations with increasing spin. (C) 2016 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license.

Cytogenotoxicity biomarkers in fat snook Centropomus parallelus from Cananeia and Sao Vicente estuaries, SP, Brazil

The aquatic environment receives many contaminants that can induce damages at the molecular, biochemical, cellular and physiological levels. Centropomus parallelus, an important food resource for local populations, is a predator fish that feeds on small fishes and benthic invertebrates, thus being vulnerable to the bioconcentration and biomagnification processes. This study aimed to evaluate cytogenotoxic responses in erythrocytes from C. parallelus juveniles collected in the Cananeia and Sao Vicente estuaries, both in winter and in summer. After anesthesia, blood samples were collected by caudal puncture. Blood smears were prepared on glass slides and stained with May-Grunwald-Giemsa dye. Two thousand cells were analyzed per slide (1000x), and nuclear abnormalities (NA) and micronuclei (MN) were scored. The Sao Vicente sample showed MN and NA frequencies (%/1000 cells) of 0.325 and 3.575, in winter, and of 0.125 and 2.935 in summer respectively; the Cananeia sample showed frequencies of 0.0325 and 0.03, in winter, and of 0.065 and 0.355 in summer, respectively. The rates found in Sao Vicente were significantly higher than those found in Cananeia, evidencing that the levels of pollution in that estuary were high enough to induce genetic damages.

Relación de la enzima alfa-amilasa salivar con la presencia de sintomatología psicopatologica internalizada auto- y hetero-observada en una muestra de niños y niñas de entre 7 y 12 años de edad: un estudio piloto.

Introducción: La medición de la actividad enzimática (AAAs) y del flujo de secreción (FSAAs) de la enzima alfa-amilasa salivar han sido propuestos por diversos grupos de investigación como posibles marcadores biológicos indirectos, no invasivos, y de bajo coste, del nivel de actividad noradrenérgica periférica/central. Dicha actividad noradrenérgica se sustenta, esencialmente, gracias a la actividad preponderante del denominado Sistema Locus Coeruleus-Noradrenalina (LC-NA), un sistema básico en la modulación de diversas funciones atencionales, cognitivas ejecutivas, así como en la regulación de los estados de ánimo. Material y Método: En nuestro estudio piloto (N = 13; 9 niños, 4 niñas; Edad media ± DT = 10,23 ± 1,53) se analizó la relación entre ambos marcadores salivares junto al parámetro flujo de secreción salivar total (registrados a lo largo de un proceso de evaluación neuropsicológica escolar) y diversas medidas auto (CDI; ansiedad, depresión y depresión total) y hetero-reportadas (escalas de psicopatología internalizada del TRF: ansiedad- depresión, depresión-aislamiento, alteraciones psicosomáticas y psicopatología internalizante total). Resultados: Los análisis estadísticos basados en el cálculo de coeficientes de correlación producto-momento de Pearson (de tipo parcial al controlar el efecto de la variable IMC), revelaron correlaciones estadísticamente significativas y directas entre el FSAAs y las puntuaciones en la escala ansiedad-depresión (p < 0,039) y psicopatología internalizante total del TRF (p < 0,012), así como una tendencia a la significación en el caso de las puntuaciones para la escala de alteraciones psicosomáticas (p = 0,054) de esa misma prueba. Del mismo modo, se observaron tendencias a la significación en la asociación directa entre las subescalas ansiedad-depresión (p = 0.065) y psicopatología internalizante total (p = 0.083) y la medida del flujo salivar total. Por otro lado, se observaron asociaciones inversas estadísticamente significativas entre la variable flujo salivar total y las puntuaciones de ansiedad (p < 0.01) y depresión total (p < 0.01) obtenidas a través del CDI. Discusión: Estos resultados preliminares de este estudio piloto abren una interesante línea de trabajo en nuestro laboratorio acerca de la utilidad de la medición de la AAAs, FSAAs y FST como posibles marcadores biológicos, no invasivos, y de bajo coste, aptos para su empleo con poblaciones pediátricas. Dichos marcadores, están relacionados con el grado de actividad noradrenérgica periférica/central desarrollada por el sistema LC y con la actividad del SNV, que a su vez están implicados en la regulación de los estados afectivos. Estudios recientes han mostrado bajos niveles basales de alfa-amilasa salivar en el caso de pacientes jóvenes diagnosticados de su primer episodio depresivo (Cubala y Landoski, 2014) y en participantes infantiles con mayor sintomatología depresiva heteroobservada (Vigil et al., 2006; Maldonado et al., 2014; Maldonado, enviado). Estos resultados complementan las observaciones realizadas anteriormente por nuestra laboratorio (Maldonado et al., 2014; Maldonado, enviado).

Overweight/obesity and HIV disease progression in HIV+ adults in Botswana

Studies indicate that overweight and obesity protect against HIV-disease progression in antiretroviral therapy (ART)-naïve patients. We examined retrospectively the relationship of overweight/obesity with HIV-disease progression in ART-naïve HIV+ adults in Botswana in a case-control study with 18-month follow-up, which included 217 participants, 139 with BMI 18.0-24.9 kg/m 2 and 78 with BMI ≥25 kg/m2. Archived plasma samples were used to determine inflammatory markers: leptin and bacterial endotoxin lipopolysaccharide (LPS), and genotype single nucleotide polymorphisms (SNPs) of the Fat Mass and Obesity Associated Gene (FTO). ^ At baseline, BMI was inversely associated with risk for AIDS-defining conditions (HR=0.218; 95%CI=0.068, 0.701, P=0.011), and higher fat mass was associated with reduced risk of the combined outcome of CD4+cell count ≤250/µL and AIDS-defining conditions, whichever occurred earlier (HR=0.918; 95%CI=0.847, 0.994, P=0.036) over 18 months, adjusting for age, gender, marriage, children, and baseline CD4+cell count and HIV-viral load. ^ FTO-SNP rs17817449 was associated with BMI (OR=1.082; 95%CI=1.001, 1.169; P=0.047). Fat mass was associated with the risk alleles of rs1121980 (OR=1.065; 95%CI=1.009, 1.125, P=0.021), rs8050136 (OR=1.078; 95%CI=1.021, 1.140; P=0.007), and rs17817449 (OR=1.086; 95%CI=1.031, 1.145; P=0.002), controlling for age, gender, tribe, total energy intake, and activity. There were no associations of SNPs with markers of disease progression. ^ Leptin levels were positively associated with BMI (β=1.764; 95%CI=0.788, 2.739; P=0.022) and fat mass (β=0.112; 95%CI=0.090, 0.135; P<0.001), but inversely with viral load (β=-0.305; 95%CI=-0.579, -.031; P=0.030). LPS levels were inversely associated with BMI (OR=0.790, 95%CI=0.630, 0.990; P=0.041), and fat mass (OR=0.852, 95%CI=0.757, 0.958; P=0.007) and directly with viral load (OR=2.608, 95%CI=1.111, 6.124; P=0.028), adjusting for age, gender, smoking and %fat mass. ^ In this cohort, overweight/obesity predicted slower HIV-disease progression. Obesity may confer an advantage in maintaining fat stores to support the overactive immune system. FTO-SNPs may contribute to the variation in fat mass; however, they were not associated with HIV-disease progression. Our findings suggest that the obesity paradox may be explained by the association of increased LPS with lower BMI and higher viral load; while viral load decreased with increasing leptin levels. Studies in African populations are needed to clarify whether genetic variation and inflammation mediate the obesity paradox in HIV-disease progression.^

The posttraumatic growth inventory: Factor structure and invariance in a sample ofbreast cancer patients and in a non-clinical sample

The Posttraumatic Growth Inventory (PTGI) is frequently used to assess positive changes following a traumatic event. The aim of the study is to examine the factor structure and the latent mean invariance of PTGI. A sample of 205 (M age = 54.3, SD = 10.1) women diagnosed with breast cancer and 456 (M age = 34.9, SD = 12.5) adults who had experienced a range of adverse life events were recruited to complete the PTGI and a socio-demographic questionnaire. We use Confirmatory Factor Analysis (CFA) to test the factor-structure and multi-sample CFA to examine the invariance of the PTGI between the two groups. The goodness of fit for the five-factor model is satisfactory for breast cancer sample (χ2(175) = 396.265; CFI = .884; NIF = .813; RMSEA [90% CI] = .079 [.068, .089]), and good for non-clinical sample (χ2(172) = 574.329; CFI = .931; NIF = .905; RMSEA [90% CI] = .072 [.065, .078]). The results of multi-sample CFA show that the model fit indices of the unconstrained model are equal but the model that uses constrained factor loadings is not invariant across groups. The findings provide support for the original five-factor structure and for the multidimensional nature of posttraumatic growth (PTG). Regarding invariance between both samples, the factor structure of PTGI and other parameters (i.e., factor loadings, variances, and co-variances) are not invariant across the sample of breast cancer patients and the non-clinical sample.

Long-term benefit of early pre-reperfusion metoprolol administration in patients with acute myocardial infarction: Results from the Metocard-CNIC trial (Effect of Metoprolol in Cardioprotection during an Acute Myocardial Infarction)

The goal of this trial was to study the long-term effects of intravenous (IV) metoprolol administration before reperfusion on left ventricular (LV) function and clinical events. Early IV metoprolol during ST-segment elevation myocardial infarction (STEMI) has been shown to reduce infarct size when used in conjunction with primary percutaneous coronary intervention (pPCI). The METOCARD-CNIC (Effect of Metoprolol in Cardioprotection During an Acute Myocardial Infarction) trial recruited 270 patients with Killip class ≤II anterior STEMI presenting early after symptom onset (<6 h) and randomized them to pre-reperfusion IV metoprolol or control group. Long-term magnetic resonance imaging (MRI) was performed on 202 patients (101 per group) 6 months after STEMI. Patients had a minimal 12-month clinical follow-up. Left ventricular ejection fraction (LVEF) at the 6 months MRI was higher after IV metoprolol (48.7 ± 9.9% vs. 45.0 ± 11.7% in control subjects; adjusted treatment effect 3.49%; 95% confidence interval [CI]: 0.44% to 6.55%; p = 0.025). The occurrence of severely depressed LVEF (≤35%) at 6 months was significantly lower in patients treated with IV metoprolol (11% vs. 27%, p = 0.006). The proportion of patients fulfilling Class I indications for an implantable cardioverter-defibrillator (ICD) was significantly lower in the IV metoprolol group (7% vs. 20%, p = 0.012). At a median follow-up of 2 years, occurrence of the pre-specified composite of death, heart failure admission, reinfarction, and malignant arrhythmias was 10.8% in the IV metoprolol group versus 18.3% in the control group, adjusted hazard ratio (HR): 0.55; 95% CI: 0.26 to 1.04; p = 0.065. Heart failure admission was significantly lower in the IV metoprolol group (HR: 0.32; 95% CI: 0.015 to 0.95; p = 0.046). In patients with anterior Killip class ≤II STEMI undergoing pPCI, early IV metoprolol before reperfusion resulted in higher long-term LVEF, reduced incidence of severe LV systolic dysfunction and ICD indications, and fewer heart failure admissions.