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TPS294 Background: Approval of [ 177 Lu]Lu-PSMA-617 ( 177 Lu-PSMA-617) for the treatment of adult patients with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer, previously treated with androgen receptor pathway inhibitors and taxane-based chemotherapy, was based on the results of the Phase 3 VISION study (NCT03511664). It is important to further characterize long-term safety outcomes in 177 Lu-PSMA-617–treated patients, with particular regard to potential treatment-related risks. To this end, the long-term follow-up (LTFU) safety study (NCT05803941) has been established. Findings from the LTFU study will be crucial for assessing delayed toxicities for patients with PSMA-positive metastatic prostate cancer treated with 177 Lu-PSMA-617 globally. Methods: The LTFU study is a prospective, multi-center, non-EU post-authorization safety study. Patients who received ≥1 dose of 177 Lu-PSMA-617 within one of the prospective parent studies (Table 1) are eligible. Patients may enroll in the LTFU study after fulfilling the requirements of their corresponding parent study. The primary endpoint is the number and proportion of selected adverse events (AEs), including myelosuppression, xerostomia, renal failure, xerophthalmia, and second primary malignancies (eg, myelodysplastic syndrome or acute myeloid leukemia), other serious AEs, and changes in laboratory values. The secondary endpoint is the number and proportion of deaths. Following enrollment, patients will undergo assessments at baseline, and then every 6–8 months for up to 10 years after their first dose of 177 Lu-PSMA-617 or until death. At each visit, a review of selected treatment-related AEs (xerostomia, xerophthalmia, myelosuppression), any-cause AEs (renal toxicity, new diagnoses of second primary malignancies), and treatment-related serious AEs will be conducted. Physical and laboratory assessments, as well as details on concomitant medications and interventions, including anti-cancer therapies, will be collected. Patients may receive treatment with any medical intervention. Interim analyses are planned at 2 and 5 years post-study activation. Enrollment is ongoing (n=13). Clinical trial information: NCT05803941 . Parent studies of the long-term follow-up safety study. Trial Indication Phase N (all groups) ClinicalTrials.gov ID VISION (+sub-study) Post-taxane mCRPC 3 831 (+30) NCT03511664 PSMAfore Pre-taxane mCRPC 3 469 NCT04689828 PSMAddition mHSPC 3 1144 NCT04720157 177 Lu-PSMA-617 in patients with moderately or severely impaired, or normal renal function Post-taxane mCRPC 2 20 a NCT06004661 a Planned. mCRPC, metastatic castration-resistant prostate cancer; mHSPC, metastatic hormone-sensitive prostate cancer.

Background: Patients presenting with non-ST elevation myocardial infarction (NSTEMI) are often admitted to medical wards. We aimed to evaluate the impact of the admitting department on long-term outcomes. Methods: Patients admitted to a large tertiary center were categorized according to the admission ward, either the intensive cardiac care unit (ICCU) or internal medicine department (IMD). We compared major adverse cardiovascular events (MACEs), a composite of all-cause death, recurrent myocardial infarction (MI), and revascularization, along with the individual components of MACE, between the two groups during a long-term follow-up. Results: A total of 11,779 NSTEMI patients were included, with 4522 admitted to the ICCU and 7257 to the department of internal medicine. Patients admitted to the ICCU had lower systolic blood pressure, higher troponin levels and lower left ventricular ejection fraction (LVEF) compared to those in the IMD group, indicating greater initial clinical severity. Although patients admitted to the ICCU experienced a significantly higher rate of in-hospital complications, there were no significant differences in the incidence of in-hospital deaths between the two groups. During 5-year follow-up, NSTEMI patients initially admitted to the ICCU had significantly lower rates of mortality and MACEs. The estimated hazard ratio for 5-year MACE and 5-year mortality rates for NSTEMI patients admitted to the IMD vs. those admitted to the ICCU were 2.03 (95% CI, 1.04–3.34) and 2.5 (95% CI, 1.10–4.38), respectively. Conclusions: NSTEMI patients admitted to the ICCU experienced lower long-term mortality and MACE rates. These findings support the management of NSTEMI patients in cardiac wards and warrant further research into the reasons for the improved outcome.

Significant progress has been made in treating Coronavirus disease (COVID) – an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). An ominous turn in the pandemic is the evolving public health crisis emanating from persistent SARS-CoV-2 infection and its associated long-term impact. Long COVID or post–COVID syndrome describes protean symptoms that persist at least 3 months after the onset of acute illness and last for at least 2 months in individuals with a history of confirmed SARS-CoV-2 infection. Long COVID has become a public health concern. Millions of infected individuals are now facing chronic multi-organ failures, including neuropsychiatric, cardiovascular, pulmonary, and kidney complications. In general, the cause of long COVID syndrome is unclear but factors such as prolonged activation of immune responses, and viral persistence triggering transcription dysregulation of genes associated with normal thrombotic disease may play a role in cardiovascular complications. Although inflammatory biomarkers are reported in other disorders, it remains unclear whether similar biomarkers are associated with cardiovascular manifestations following COVID. Medications such as sulodexide directed at glycocalyx and coagulation have demonstrated benefits for long COVID in smaller studies. Here, we describe the outcomes of the symposium on the underlying cardiovascular mechanisms of the long COVID.

BACKGROUND: Increased specialty competitiveness, alongside the inception of virtual interviews, has increased the number of applications submitted to the Electronic Residency Application Service (ERAS) in anesthesiology. ERAS introduced signals to provide applicants with a means to demonstrate interest in a select group of residency programs. In the 2023 to 2024 application cycle, anesthesiology applicants had the opportunity to send 5 gold and 10 silver signals in a tiered system. METHODS: This multicenter, cross-sectional (exempt) research survey was created by members of the executive council of the Association of Anesthesiology Core Program Directors (AACPD) and housed and distributed through REDCap and the University of Nebraska Medical Center. Publicly available contact information of anesthesiology core program directors was obtained from the Accreditation Council for Graduate Medical Education (ACGME) website and membership roster of the AACPD. In total, 174 anesthesiology programs were identified. A survey invitation was distributed on March 12, 2024, to all programs via e-mail with reminders. The survey closed on April 30, 2024. Survey responses were collected anonymously, with instructions to provide 1 response per program. All statistical summaries and analyses were performed using SAS 9.3 (SAS Institute). RESULTS: The survey was sent to all 174 identified programs, with a response rate of 48.9%. Small programs were defined as having <44 residents, medium 44 to 62 residents, and large >62 residents. Small programs received significantly fewer applications (median 1255) than medium (1420) and large (1558) programs ( P = .0005). There was a statistically significant difference in the number of gold signals received based on program size, with large programs receiving significantly more than medium (169 vs 116, P = .0238) or small programs (168 vs 71, P < .0001). Applicants sending gold signals were more likely to receive an interview compared to those who sent silver signals (56.7% vs 31%, P ≤ .0001). Of the those interviewed, applicants who sent gold signals comprised 42% (28.7%–52.6%), whereas applicants who sent silver signals comprised 45.5% (33%–54.7%). Applicants who did not send a program signal but signaled geographically made up a smaller portion of the interview group at 3% (0%–15.4%). The percentage of matched residents sending gold signals made up 66.7% (47.1%–82.4%) of a program’s match list, whereas those sending silver signals were 25% (11.1%–33.3%) of the matched cohort. CONCLUSIONS: Anesthesiology applicants who sent program signals were selected for a large majority of available interview positions, and interviewed applicants who submitted gold and silver signals comprised the vast majority of matched resident cohorts.

SUMMARY Results of systolic time interval recordings obtained serially on 104 female New Zealand White rabbits were analyzed for reproducibility, variation with respect to changes in heart rate (hr), and interrelationship of the various systolic time intervals. A table of values for systolic time intervals in the healthy rabbit was constructed. The preejection period (pep), left ventricular ejection time (lvet), and pep/lvet ratio were 0.040 ± 0.008 s, 0.119 ± 0.014 s, and 0.337 ± 0.066 respectively. The major systolic time intervals, pep and lvet, varied with respect to hr according to the regression equations: pep = 0.057 − 0.000078 hr and lvet = 0.175 − 0.000251 hr. The QS2 interval, S1S2 interval and isovolumic contraction time also varied with changes in hr.

SUMMARY Systolic time interval recordings were performed serially on 104 healthy female New Zealand White rabbits and 51 rabbits with congestive heart failure (chf) induced by chronic anthracycline drug therapy. The results were analyzed and the comparisons were made with studies of systolic time interval recordings of chf in persons. In the rabbit, chf is manifested by prolongation of the isovolumic contraction time, the preejection period (pep), and by shortening of the left ventricular ejection time (lvet). The ratio of pep/lvet was a sensitive indicator of left ventricular failure, with values in excess of 0.466 reflecting significant cardiac dysfunction at the 95% confidence level. The mean pep/lvet = 0.337 ± 0.66 in healthy rabbits and pep/lvet = 0.502 ± 0.075 in rabbits with chf. The pep index increased from 0.057 ± 0.007 in healthy rabbits to 0.074 ± 0.007 in rabbits with heart failure. The lvet index decreased from 0.173 ± 0.007 in healthy rabbits to 0.166 ± 0.010 in rabbits with chf.