Introduction of a methyl group in alpha- or beta-position of 1-heteroarylethyl-4-phenylpiperazines affects their dopaminergic/serotonergic properties

1-(2-Heteroarylalkyl)-4-phenylpiperazines containing methyl group in either the alpha- or the beta-position of the side alkyl chain were synthesized as racemic mixtures. They were evaluated for in vitro binding affinity at the D1 and D2 dopamine and 5-HT1A serotonin receptors using synaptosomal membranes of the bovine caudate nucleus and hippocampus, respectively, as a source of the corresponding receptors. Tritiated SCH 23390 (D1 receptor-selective), spiperone (D2 receptor-selective), and 8-OH-DPAT (5-HT1A receptor-selective) were employed as the radioligands. None of the new compounds expressed significant affinity for the D1 receptor. Introduction of the methyl group into the beta-position of the parent molecules increased the affinity for the D2 receptor (10b-13b), and decreased the affinity for the 5-HT1A receptor with the exception of imidazole (11b) which was a rather efficient displacer of 8-OH-DPAT. Most potent of the newly synthesized compounds in [3H]spiperone assay were compounds (+/-)6-[1-methyl-2- (4-phenylpiperazin-1-yl)-ethyl]-1,4-dihydroquinoxaline-2,3-dione (10b), Kd = 6.0 nM and (+/-)5-[1-methyl-2-(4-phenylpiperazin-1-yl)-ethyl]-1,3-dihydrobenzoimidazol- 2-thione (13b), Kd = 5.3 nM. However, compounds containing methyl group in alpha-position (10a-13a) of the parent molecules expressed a decreased affinity for the D2 receptor, while the affinity for the 5-HT1A receptor remained in the same range of concentrations as that of closely related achiral parent compounds (14-17) run in the same binding assays as references.

Interactions of N-{[2-(4-phenyl-piperazin-1-yl)-ethyl]-phenyl}-2-aryl-2-yl-acetamides and 1-{[2-(4-phenyl-piperazin-1-yl)-ethyl]-phenyl}-3-aryl-2-yl-ureas with dopamine D2 and 5-hydroxytryptamine 5HT(1A) receptors

It is suggested that the ratio of dopamine D(2) to 5-hydroxytryptamine 5-HT(1A) activity is an important parameter that determines the efficiency of antipsychotic drugs. Here we present the synthesis of N-{[2-(4-phenyl-piperazin-1-yl)-ethyl]-phenyl}-2-aryl-2-yl-acetamides and 1-{[2-(4-phenyl-piperazin-1-yl)-ethyl]-phenyl}-3-aryl-2-yl-ureas and their structure-activity relationship studies on dopamine D(2) and 5-hydrohytryptamine 5-HT(1A) receptors. It was shown that ligand selectivity and affinity strongly depends on their topology and the presence of a pyridyl group in the head of molecules. Molecular modeling studies using homology modeling and docking simulation revealed a rational explanation for the ligand behavior. The observed binding modes and receptor-ligand interactions provided us with a clue for optimizing the optimal selectivity towards 5-HT(1A) receptors.

Identification of NQO1 and ferrochelatase as interaction partners for neuroprotective N-{[2-(4-phenyl-piperazin-1-yl)-ethyl]-phenyl}-arylamides

Affinity chromatography was used to identify potential cellular targets that are responsible for neuroprotective activity of N-{[2-(4-phenyl-piperazin-1-yl)-ethyl]-phenyl}-arylamides. Active and inactive representatives of N-{[2-(4-phenyl-piperazin-1-yl)-ethyl]-phenyl}-arylamides bearing an extended linker were synthesized and immobilized on an agarose-based matrix. This was followed by the identification of specifically bound proteins isolated out of the whole rat brain extract. Inducible flavoprotein NAD(P)H:quinone oxidoreductase (NQO1) was identified as candidates for cellular targets.

Obesity and decreased vibration perception associated with premature cardiovascular mortality in a single center prospective study of people with diabetes

Background and aims

The aim of this prospective, single center study was to define factors associated with early cardiovascular mortality in diabetes.

Materials and methods

1345 patients under age 75 were included who were undergoing assessment of their diabetes between January 2008 and May 2010 as part of standard practice in a specialist clinic at a regional teaching hospital in Serbia. Peripheral artery disease (PAD) was assessed by audible Doppler waveform and ABPI with cut-offs >1.4 and <0.9. Peripheral neuropathy was assessed by vibration perception threshold (VPT, using a semi-quantitative tuning fork: abnormal if ≤5), ankle reflexes (AR) and sudomotor function of the foot. Diabetic retinopathy (DR) was assessed by fundoscopy. Evidence of vascular disease: thromboendarterectomy and/or cerebrovascular insult (TEA/CVI), myocardial infarction (MI), heart failure (HF), diabetic foot ulcer (DFU), minor amputations (sAMP) and major amputations (mAMP) was also collected. Outcome was determined in 2021 and baseline characteristics were compared between those who had and had not suffered cardiovascular death under age 75 years within 10 years of review in two casually selected cohorts.

Results

Those who died (n2=70) were more frequently male (60 vs. 45.3%, p=0.08), younger (66.4±7.4 vs. 79.9±3.4, p<0.000), had a shorter period of follow-up (3.6±2.3 vs. 11.2±1.7 years, p<0.000) when compared to those still alive (n1=75). Those who died were also significantly (p<0.01) more likely to have had TEA/CVI (34.3 vs. 10.7%), HF (21.4 vs. 1.3%), MI (44.3 vs. 20%), PAD (48.6 vs. 9.3%), DFU (25.7 vs. 9.3%), mAMP (17.1 vs. 1.3%) at baseline. There were no differences in proliferative DR (17.1 vs. 8%, p=0.10) and laser photocoagulation (25.7 vs. 13.3%, p=0.06) Following multivariable logistic regression analysis significant differences between groups remained for only creatinine (123±45 vs. 88.9±16.9 mmol/L, p<0.003) and VPT <5 (7.8 [95% CI: 3.7–16.4)], p=0.008), estimated maximum lifetime BMI (3.4 [95% CI: 1.7–6.8)], p<0.000), alcohol usage (4.7 [95% CI: 1.5–14.7)], p=0.005), smoking habit (2.2 [95% CI: 1.1–4.3)], p<0.03) and earlier age of diabetes onset (43.4±12.5 vs. 49.2±9.9, p=0.0029). When the 72 patients with impaired vibration sense were compared with 73 with VPT>6, there were significant differences in TEA/CVI (4.2 [95% CI: 1.6–10.9)], p=0.003), PAD (3.9 [95% CI: 1.8–8.8)], p<0.001) and estimated maximum lifetime BMI (9.4 [95% CI: 3.4–25.7), p<0.000). Finally, when those who had had a previous MI at baseline (n=46) were compared with those who hadn't (n=99), MI was associated with increased death rate (3.2 [95% CI: 1.5–6.6)], p=0.002), as was PAD (2.9 [(1.3–6.1)], p=0.007).

Conclusion

Decreased VPT, the presence of PAD on clinical testing and higher maximum estimated lifetime BMI are strongly associated with premature cardiovascular death. These measures may be independent markers of greater risk of reduced life expectancy.

Funding Acknowledgement

Type of funding sources: None.

P2662Factors associated with in-hospital and long-term mortality in STEMI patients: does primary ventricular fibrillation matter?

Introduction

There are still contrary data about causes and long-term prognosis in patients (pts) with primary ventricular fibrillation (PVF) as a complication of ST-elevation myocardial infarction (STEMI).

Purpose

The aim was to analyze characteristics of STEMI patients associated with PVF occurrence and mortality.

Methods

Our study included 755 pts hospitalised due to STEMI between January 2016 and December 2016. One year follow up was done. Study compared pts with cardiac arrest due to PVF and those without PVF. Only pts treated with urgent coronarography and primary percutaneous coronary intervention (PPCI) in whom TIMI 3 in infarct-related artery was acheved were included. Pts with Killip class 4 as well as pts with mechanical complications or complications due to procedure were excluded.

Results

We found 56/755 (7.42%) STEMI pts had PVF. Compared to pts without PVF (n=699), those with PVF (n=56) were younger (57.8±12.9 vs. 61.8±11.9 years, p 0.02) and more frequently had diabetes mellitus (DM) (52.3% vs. 33.4%, p 0.01) alone or DM with abnormal glucoregulation (AGR) (77.3% vs. 58.4%, p 0.01). Pts with STEMI and PVF had more frequently Killip class 2 (32.7% vs. 21.2%, p 0.02) and class 3 (7.3% vs. 3%, p 0.08), most frequently left anterior descending coronary artery affected (51.8% vs. 36.9%, p 0.03) and proximal occlusion of coronary arteries (44.6% vs. 23%, p 0.000), lower left ventricle ejection fraction (LVEF) (45.4±9.8% vs. 48.7±7.5%, p 0.02), longer duration of hospitalisation (7.3±5.7 vs. 5.7±3.2 days, p 0.001) and higher in-hospital mortality (12.5% vs. 4.9%, p 0.02), but with no difference in long-term mortality (14.3% vs. 11.6%, p 0.40). After multivariable logistic regression analysis (MVLR), model with the differences in proximal coronary artery occlusions (OR 2.4 [95% CI: 1.3–4.7], p 0.008) and DM presence (OR 1.9 [95% CI: 1–3.6], p 0.05) persisted. After one year patients who died compared to those still alive were older (70.8±12.8 vs. 61±11.8 years, p 0.000), more frequently male (52% vs. 32.2%, p 0.01), had higher appearance of anterior wall STEMI (46.7% vs. 24.5%, p 0.001), more frequently Killip class 2 and class 3 (50% vs. 20.9% and 23.5 vs. 2.4% respectively, both p 0.000), lower EF (38.6±10.5 vs. 48.8±7.3%) and higher prevalence of DM (75.8% vs. 32.4%) or DM with AGR (87.9% vs. 57.9%) (both p 0.000). After MVLR model with differences in Killip class 3 (OR 4.2 [95% CI: 1.1–84.6], p 0.000), EF (OR 0.93 [95% CI: 0.87–0.99], p 0.04) and DM presence (OR 3.3 [95% CI: 1.1–10.2], p 0.04), all persisted.

Conclusions

Proximal coronary occlusions and DM presence as indicators of coronary artery disease severity and ischaemic area size are strongly associated with PVF in STEMI patients. Only in-hospital mortality is higher in patients with STEMI and PVF. Long-term mortality in STEMI patients is strongly associated with heart failure (lower EF and higher Killip class) and again DM presence.