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simvastatin + triflusal (IRIST stent)

✓ Approved

Palau Pharma · HMGCR · Small Molecule

What is simvastatin + triflusal?

simvastatin + triflusal is a small molecule developed by Palau Pharma. It is approved for therapeutic indications via surgical implantation.

Drug Profile

Brand NamesIRIST stent
CompanyPalau Pharma
Drug ClassSmall Molecule
Molecular TargetHMGCR, PDE4A, PDE4B, PDE4C, PDE4D, PTGS1, PTGS2
RouteSurgical Implantation
StatusApproved
Sources: ClinicalTrials.gov, Palau Pharma

Mechanism of Action

Molecular Targets

simvastatin + triflusal acts on 7 molecular targets:

HMGCR3-hydroxy-3-methylglutaryl-CoA reductase (LDLCQ3, MYPLG)
PDE4Aphosphodiesterase 4A (PDE4, DPDE2)
PDE4Bphosphodiesterase 4B (PDEIVB, DPDE4)
PDE4Cphosphodiesterase 4C (DPDE1, PDE21)
PDE4Dphosphodiesterase 4D (PDE43, STRK1)
PTGS1prostaglandin-endoperoxide synthase 1 (PCOX1, COX3)
PTGS2prostaglandin-endoperoxide synthase 2 (PHS-2, GRIPGHS)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

simvastatin + triflusal is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Injury, poisoning and procedural complicationsRestenosis✓ Approved

Related Research Articles

PubMedCardiology in review2026-10-15

Extended Dual Antiplatelet Therapy Versus Aspirin Monotherapy After Drug-Eluting Stent Implantation: A Systematic Review and Meta-Analysis With GRADE Evaluation and Trial Sequential Analysis.

Ali Muhammad Abdullah MA, Nawaz Adil A, Sethi Furqan Ahmad FA, Alam Umama U et al.

The optimal duration of dual antiplatelet therapy (DAPT) following drug-eluting stent implantation remains uncertain. We evaluated extended DAPT versus aspirin monotherapy in patients who completed approximately 12 months of uneventful DAPT after percutaneous coronary intervention. PubMed, Embase, and Web of Science were searched through August 2026 for randomized controlled trials comparing these strategies. The primary outcome was myocardial infarction (MI); secondary outcomes included all-cause mortality, cardiac death, stent thrombosis, repeat revascularization, stroke, and clinically relevant bleeding (Bleeding Academic Research Consortium type 2-5). Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a Mantel-Haenszel random-effects model. Certainty was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE), and trial sequential analysis was performed for MI. Six trials involving 28,601 patients were included. Extended DAPT significantly reduced MI compared with aspirin monotherapy (RR, 0.66; 95% CI, 0.51-0.85; P = 0.001; I2 = 37%). No significant differences were observed in all-cause mortality, cardiac death, stent thrombosis, repeat revascularization, or stroke. Clinically relevant bleeding was also not significantly different (RR, 1.19; 95% CI, 0.66-2.15; P = 0.56), although substantial heterogeneity was observed (I2 = 87%) and certainty was low. GRADE certainty was high for MI, cardiac death, and repeat revascularization; moderate for all-cause mortality; and low for stent thrombosis and bleeding. Trial sequential analysis for MI crossed the conventional significance boundary but not the trial sequential monitoring boundary or required information size. Extended DAPT may reduce MI, but individualized assessment of ischemic and bleeding risk remains important, and further adequately powered trials are warranted.

PMID 42875834
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PubMedAdvanced science (Weinheim, Baden-Wurttemberg, Germany)2026-10-15

Loss of Intestinal MSTN Promotes GLP-1 Secretion Through SGLT1 Palmitoylation.

Han Sheng-Zhong SZ, Chang Shuang-Yan SY, Luo Zhaobo Z, Sun Ke K et al.

Intestinal glucagon-like peptide-1 (GLP-1) is secreted by intestinal L cells in a glucose-dependent manner. The localization and surface abundance of glucose-sensing proteins on the cell membrane affect the response to glucose, but the regulatory mechanism remains poorly understood. Here, we show that S-palmitoylation is required for stable plasma membrane enrichment of SGLT1 and for SGLT1-mediated GLP-1 secretion. Notably, myostatin (MSTN) was identified as a key upstream regulator of this modification. Intestinal MSTN deficiency markedly enhanced SGLT1 palmitoylation, increased its plasma membrane abundance, and thereby promoted glucose-stimulated GLP-1 secretion. Importantly, simvastatin induced intestinal MSTN upregulation and impaired glucose homeostasis, whereas MSTN deficiency largely alleviated these effects. Mechanistically, MSTN regulated the expression of the palmitoyl acyltransferase ZDHHC20, which catalyzed SGLT1 S-palmitoylation at Cys301. Blocking SGLT1 palmitoylation attenuated SGLT1 membrane enrichment and markedly suppressed the induction of GLP-1 secretion caused by MSTN deficiency. Collectively, our research results have revealed a new mechanism by which MSTN regulates intestinal endocrine function and S-palmitoylation modification promotes GLP-1 secretion, providing potential targets for regulating endogenous GLP-1 secretion in the intestine and treating metabolic diseases related to glucose imbalance.

PMID 42876031
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PubMedPostgraduate medicine2026-10-15

Identification of perioperative risk factors for retrograde type A dissection after thoracic endovascular aortic repair for type B dissection.

Li Jiajun J, Zhang Yucong Y, Chen Xuegui X, Tan Xinyu X et al.

To identify risk factors and develop a predictive model for retrograde type A dissection (RTAD) following thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD). We analyzed TBAD patients who underwent TEVAR from 2014 to 2024 (IRB:No. TJ-IRB20230805). Patients developing RTAD within 1 year were matched with controls by age, sex, operation date, and location. Logistic regression identified risk factors, and a nomogram was constructed. Model performance was assessed using ROC curves. Of 2383 patients, 76 (3.19%) developed RTAD within one year. 65 RTAD cases and 195 matched controls were analyzed. RTAD patients had a greater horizontal distance of the ascending aorta (HDAA) than controls (53.34 mm vs. 43.05 mm, p < .001). Multivariate analysis identified younger age (OR = 0.95, p = .008), larger HDAA (OR = 1.14, p < .001), aortic root dilatation (OR = 2.85, p = .006), shorter stent length (OR = 0.99, p = .029), and absence of postoperative bradycardic drug use (OR = 0.31, p = .005) as independent RTAD risk factors. The model showed good discrimination (AUC = 0.85). Younger age, larger HDAA, aortic root dilatation, shorter stent length, and no bradycardic drugs postoperatively are independent predictors of RTAD after TEVAR. For TBAD patients with a high risk of RTAD, clinicians should consider the possibility of having connective tissue diseases, select stents appropriately, and optimize postoperative treatment with strict follow-up.

PMID 42876259
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PubMedMedical physics2026-10-15

Convolutional neural network metal artifact reduction in ultra-high resolution photon counting detector CT of middle- and inner-ear implants.

Treb Kevin J KJ, Sadeghian Maryam M, Cao Wenchao W, Farnsworth Paul J PJ et al.

Metallic inner- and middle-ear implants with submillimeter structures requiring ultra-high resolution (UHR) imaging invariably result in metal artifacts at CT, which can obscure adjacent microstructures and subtle pathologic findings. Current metal artifact reduction techniques can be less effective for small metal objects or metal in heterogeneous background anatomy, and can sometimes introduce new artifacts or noise. To develop and evaluate an image-domain convolutional neural network to reduce metal artifacts near inner- and middle-ear implants in UHR photon-counting-detector (PCD)-CT. For network training, three stapes prosthesis models containing titanium and platinum were randomly oriented within a head-sized phantom and imaged on a PCD-CT with a UHR protocol. Metal and metal+artifact images were isolated by subtraction of the phantom background followed by CT number thresholding. Isolated artifact signal was enhanced via multiplication with a randomized factor ranging from one to a pre-determined artifact amplification scalar hyperparameter. Paired training inputs (with artifacts) and labels (without artifacts) were created by adding metal-free patient temporal bone images with metal+artifact and metal images, respectively. Combinations of 9 patient CT volumes and 24 metal CT volumes were used to create 216 CT volumes for training and validation with an 80%/20% training/validation split. The network was retrained with different amplification scalars (5, 10, 20, 30, 40) and with either mean-squared-error or mean-absolute-error loss functions to determine the optimal combination of these hyperparameters. The network was tested on 7 CT volumes from patients with three different implant types: stapes prostheses, cochlear implants, and a transverse sinus stent. Network performance was quantified through the artifact index, noise magnitude, CT number preservation of metal and bone, and dimensions of metal measured as the full-width at half-maximum of CT number line profiles. Networks trained with mean-squared-error demonstrated a trade-off between metal artifact reduction and preservation of bone CT number as the artifact amplification scalar changed. The trade-off was not observed when mean-absolute error was used. Using the network with hyperparameters that best preserved bone and reduced artifacts simultaneously (mean-absolute-error, amplification scalar 20), the artifact index was improved by 83.2% (p < 0.001) across all implant types, and image noise was reduced by 46.8% (p < 0.001). Artifact reduction was significantly better for cases with stapes prostheses than the other implant types (p < 0.004), although artifact index was still greatly improved for all implant types (91.1% for the stapes prostheses, 81.3% for the CI, and 72.9% for the transverse sinus stent). Metal implant dimensions were not significantly different between the network input and output images (p = 0.67). An image-domain convolutional neural network with task-specific hyperparameters reduced artifact severity and image noise in UHR PCD-CT of different inner- and middle-ear implants without loss of fine image detail.

PMID 42875916
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PubMedFrontiers in medicine2026-10-15

Risk factors for recurrent variceal bleeding after TIPS in cirrhotic patients with esophagogastric variceal hemorrhage: a single-center retrospective study.

Chen Zhiliang Z, Gou Yi Y, Li Wenke W, Yu Daowu D et al.

Transjugular intrahepatic portosystemic shunt (TIPS) effectively reduces portal pressure but post-procedural rebleeding remains a major clinical challenge. Risk factors for rebleeding are not fully defined. This single-center retrospective cohort study included 114 cirrhotic patients who underwent TIPS for EGVB (2019-2024). Patients were categorized into rebleeding (n = 35) and non-rebleeding (n = 79) groups based on 1-year post-TIPS rebleeding. Clinical, laboratory, procedural, prior endoscopic treatment history and follow-up data were analyzed. Univariate and multivariate Cox proportional hazards models were used to identify risk factors. Cumulative rebleeding incidence was compared between serum sodium groups (<135 vs. ≥135 mmol/L) using Kaplan-Meier analysis with log-rank test. The 1-year rebleeding rate was 30.7% (35/114). Multivariate Cox regression identified lower serum sodium (HR = 0.85; 95% CI: 0.77-0.93; P < 0.001) and shunt dysfunction (HR = 4.60; 95% CI: 2.21-9.58; P < 0.001) as independent risk factors for rebleeding. Stent type was not independently associated after adjustment. The low sodium group (<135 mmol/L) showed a significantly higher cumulative rebleeding incidence than the high sodium group (log-rank P = 0.041). Conclusion: Serum sodium preoperatively and post-TIPS shunt dysfunction are independent risk factors for 1-year rebleeding. Optimizing serum sodium preoperatively and implementing regular surveillance for shunt dysfunction may help reduce rebleeding risk in these patients.

PMID 42876481
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PubMedCardiovascular intervention and therapeutics2026-10-15

Temporal patterns of the association between Achilles tendon thickening and clinical outcomes after percutaneous coronary intervention in acute and chronic coronary syndromes.

Abe Kaori K, Kitahara Hideki H, Tateishi Kazuya K, Saito Yuichi Y et al.

Although Achilles tendon thickening (ATT) is associated with adverse outcomes after percutaneous coronary intervention (PCI), whether its prognostic impact differs over time between acute (ACS) and chronic coronary syndromes (CCS) remains unclear. We retrospectively analyzed 1,362 patients who underwent successful PCI and assessment of ATT using soft X-ray radiography. ATT was defined as Achilles tendon thickness ≥8.0 in men and ≥7.5 mm in women. MACE, including death, myocardial infarction, stent thrombosis, stroke, and target vessel revascularization, were investigated for up to 3 years. To evaluate temporal differences, we conducted the Kaplan-Meier method with landmark analysis and time-segmented Cox proportional hazards analyses dividing follow-up into ≤ 1 year and 1-3 years after PCI. ATT was observed in 228 patients (16.7%), who had a significantly higher incidence of MACE compared to patients without ATT. In ACS patients (n = 387), ATT was independently associated with an increased risk of MACE within 1 year, but not beyond 1 year. Conversely, in CCS patients (n = 975), ATT was not associated with early events, but was significantly associated with increased MACE risk during 1-3 years after PCI. Similar trends were observed after excluding familial hypercholesterolemia. These findings suggest different temporal patterns in the association between ATT and MACE after PCI in patients with ACS and CCS, which may provide additional insights into risk stratification during follow-up.

PMID 42875710
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