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Total documents retrieved: 87 Results Generated From: Embase <1980 to 2026 Week 15> Embase Weekly Updates (updates since 2026-04-03) - (87 records) <1> Accession Number 2044473884 Title Perioperative Effects of Epidural Anesthesia on Hemodynamics, Pain, and Pro-brain Natriuretic Peptide Levels in Vascular Surgery: A Prospective Randomized Study. Source Haseki Tip Bulteni. 64(2) (pp 92-100), 2026. Date of Publication: 2026. Author Sivacigil M.I.; Sivacigil L.; Yuceyar L.; Erolcay H. Institution (Sivacigil) University of Health Sciences Turkiye, Istanbul Beyoglu Eye Training and Research Hospital, Clinic of Anesthesiology and Reanimation, Istanbul, Turkey (Sivacigil) University of Health Sciences Turkiye, Taksim Training and Research Hospital, Clinic of Anesthesiology and Reanimation, Istanbul, Turkey (Yuceyar, Erolcay) Istanbul University-Cerrahpasa Faculty of Medicine, Department of Anesthesiology and Reanimation, Istanbul, Turkey Publisher Galenos Publishing House Abstract Aim: Vascular surgery is among the surgical procedures associated with the highest cardiac morbidity and mortality because the surgical stress response is pronounced in individuals with cardiogenic risk factors. The aim of this study is to evaluate the effect of epidural anesthesia on the surgical stress response during major vascular surgery. Method(s): Two groups (epidural group (EG), n=15; control group, n=15) were formed in the cardiovascular surgery operating room by prospective randomization. Hemodynamic fluctuations and visual analog scale (VAS) pain scores were monitored. The primary endpoint was defined as the change in N-terminal-proBNP (NT-proBNP) levels on postoperative day two compared with preoperative measurements. Troponin-I, changes in blood flow, pain scores, and sevoflurane use were secondary endpoints. Result(s): Sevoflurane consumption was lower in EG, whereas fluid volume was higher. >=11 tachycardia attacks were more frequent in CG, and >=11 decreases in mean arterial pressure were seen (33.3% vs. 0%; p=0.042). VAS was lower in favor of EG (Day-1: 4.33+/-0.98 vs. 5.27+/-0.70, p=0.011; Day-2: 1.67+/-1.13 vs. 2.13+/-0.64, p=0.041). No difference in NT-proBNP/troponin-I levels was observed between groups. Conclusion(s): In vascular surgery, epidural anesthesia can reduce hemodynamic fluctuations and early postoperative pain while limiting the rise in NT-proBNP. Biomarker findings are hypothesis-generating owing to methodological constraints and necessitate validation through studies with larger sample sizes. ©Copyright 2026 The Author(s). <2> Accession Number 2044370051 Title 'A leukin to the future': is low serum interleukin-2 (IL-2) a predictive biomarker for postoperative atrial fibrillation?. Source IJC Heart and Vasculature. 64 (no pagination), 2026. Article Number: 101910. Date of Publication: 01 Jun 2026. Author Quinn C.J.; Velasco E.S.; Wehrens X.H.T. Institution (Quinn, Velasco, Wehrens) Cardiovascular Research Institute, Houston, TX, United States (Quinn, Velasco, Wehrens) Department of Integrative Physiology, Houston, TX, United States (Wehrens) Department of Medicine (Division of Cardiology), Houston, TX, United States (Wehrens) Department of Neuroscience, Houston, TX, United States (Wehrens) Department of Pediatrics (Division of Cardiology), Houston, TX, United States (Wehrens) Center for Space Medicine, Baylor College of Medicine, Houston, TX, United States Publisher Elsevier Ireland Ltd Abstract The stubborn incidence of PoAF requires equally stubborn inroads to find novel regulatory proteins and/or trustworthy biomarkersz. This useful study by Cozac et al. [9] further establishes IL-2 as an important, yet poorly understood protein in the onset of PoAF and sets a solid basis for future investigations in the clinic and using innovative rodent models. Copyright © 2026 The Author(s) <3> Accession Number 2041115178 Title Controversies in valvular heart disease: insights from cardiac imaging. Source Trends in Cardiovascular Medicine. 36(3) (pp 147-154), 2026. Date of Publication: 01 Apr 2026. Author van der Bijl P.; Ajmone Marsan N.; Bax J.J. Institution (van der Bijl, Ajmone Marsan, Bax) Department of Cardiology, Leiden University Medical Centre, Leiden, Netherlands (van der Bijl) SAEndovascular, Netcare Kuils River Hospital, Cape Town, South Africa Publisher Elsevier Inc. Abstract Numerous controversies still exist in the diagnosis and management of valvular heart disease, for example, the benefit of treating moderate aortic stenosis (AS) or asymptomatic, severe AS and the appropriate selection criteria for transcatheter edge-to-edge mitral valve repair. While numerous imaging parameters have been linked to the risk of sudden cardiac death in mitral valve prolapse, their relative merits are unknown and this is a challenging population to risk-stratify. No large, randomized data exist to guide selection of patients for transcatheter repair of tricuspid regurgitation or valve intervention in severe pulmonary regurgitation. Multimodality cardiac imaging provides unique insights into these important questions. Copyright © 2025 The Author(s) <4> Accession Number 2044395055 Title Navigating Vascular Access Strategies for Transcatheter Aortic Valve Replacement in Patients With Peripheral Artery Disease: A Literature Review. Source Catheterization and Cardiovascular Interventions. (no pagination), 2026. Date of Publication: 2026. Author Aufazhafarin N.T.; Saputra P.B.T.; Widiarti W.; Putra R.M.; Luthfah N.; Budiarto R.M.; Putranto J.N.E.; Multazam C.E.C.Z.; Alkaff F.F. Institution (Aufazhafarin, Widiarti) Faculty of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia (Saputra, Putra, Luthfah, Budiarto, Putranto) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia (Saputra, Luthfah, Budiarto, Putranto) Department of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, East Java, Surabaya, Indonesia (Putra) Universitas Airlangga Hospital, East Java, Surabaya, Indonesia (Multazam) National Heart and Lung Institute, Imperial College London, London, United Kingdom (Alkaff) Department of Internal Medicine, University Medical Center Groningen, Groningen, Netherlands (Alkaff) Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia Publisher John Wiley and Sons Inc Abstract Transcatheter aortic valve replacement (TAVR) is the preferred treatment for severe aortic stenosis (AS) in high-risk surgical patients. The transfemoral (TF) access is the gold standard due to its minimally invasive nature and favorable outcomes. However, peripheral artery disease (PAD), common in TAVR candidates, can complicate TF access due to calcification, tortuosity, and vessel narrowing. This literature review evaluates vascular access strategies for TAVR in patients with PAD, highlighting recent advances that support expanded use of TF access. A narrative literature review was conducted in scientific databases up to 14 April 2025. Studies reporting on access strategies for TAVR in patients with PAD were included. The SANRA scale was utilized to ensure methodological quality. TF access remains the preferred route for TAVR, associated with lower mortality and complication rates compared to alternative approaches. Tools like the Hostile Score has further strengthened pre-procedural planning by quantifying iliofemoral complexity and helping clinicians determine the safest and most feasible access route. Advances in technology have enhanced TF feasibility in patients with PAD, enabling device delivery despite complex anatomy. When TF access is not viable, alternative routes remain feasible but are linked to increased risks, including stroke and vascular complications. Expanding the eligibility for TF access through vessel preparation and imaging-guided planning can improve safety and outcomes in PAD patients undergoing TAVR. A personalized approach based on anatomy feasibility, supported with risk stratification tools and multidisciplinary collaboration is essential to selecting the optimal vascular access strategy. Copyright © 2026 Wiley Periodicals LLC. <5> Accession Number 2044477058 Title Sodium nitroprusside: A comprehensive systematic review of its role across various clinical settings. Source Vascular Pharmacology. 163 (no pagination), 2026. Article Number: 107606. Date of Publication: 01 Jun 2026. Author Recchioni T.; Manzi G.; Caputo A.; Di Pietro G.; Rosa M.; Birtolo L.I.; Scoccia G.; Vizza C.D.; Badagliacca R. Institution (Recchioni, Manzi, Caputo, Di Pietro, Rosa, Birtolo, Scoccia, Vizza, Badagliacca) Department of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy Publisher Elsevier Inc. Abstract Sodium nitroprusside (SNP) is one of the oldest, yet most powerful intravenous vasodilators used in acute cardiovascular care. Although newer vasoactive agents have been introduced, SNP continues to play a relevant role in clinical practice, particularly when rapid and tightly controlled hemodynamic modulation is required. In this systematic review, conducted according to PRISMA recommendations, we provide a comprehensive overview of the pharmacological profile, clinical applications, and safety considerations of SNP in acute heart failure (AHF), cardiogenic shock, hypertensive emergencies, and acute aortic dissection. Through nitric oxide-mediated activation of the cGMP pathway, SNP induces balanced arterial and venous vasodilation, leading to effective preload and afterload reduction and prompt blood pressure control. Available evidence suggests meaningful hemodynamic improvement in selected patients with advanced AHF, with observational data indicating possible survival benefits. In hypertensive crises and acute aortic syndromes, SNP remains an effective option for rapid blood pressure reduction and wall stress control, consistent with current guideline recommendations. However, concerns regarding cyanide and thiocyanate toxicity, particularly during high-dose or prolonged infusions, limit its extended use. Overall, SNP remains a valuable therapeutic tool, but a more individualized approach and well-designed randomized trials are needed to better define its long-term clinical impact in contemporary vascular pharmacotherapy. Copyright © 2026 Elsevier Inc. <6> Accession Number 2038498679 Title Extrastimuli-assisted functional mapping improves ventricular tachycardia ablation outcomes: A systematic review, meta-analysis, and meta-regression. Source Heart Rhythm. 23(3) (pp 632-644), 2026. Date of Publication: 01 Mar 2026. Author Wilnes B.; Castello-Branco B.; Martins Pereira E.M.; Lopes L.M.; Santos V.B.; Bicalho A.C.; Melo L.; Silva Cupertino S.R.; Franca A.T.; Queiroz Franca M.R.; De Araujo Silva G.; Mayrink M.P.; Gonzalez Fonseca I.M.; Castro De Miranda R.; Padilha Da Silva J.L.; Pereira Nunes M.C.; Lopes Do Carmo A.A. Institution (Wilnes, Castello-Branco, Martins Pereira, Santos, Bicalho, Melo, Silva Cupertino) School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Wilnes, Castello-Branco) Interdisciplinary Laboratory of Medical Investigation, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Lopes) School of Medicine, Universidade Estadual do Centro Oeste (UNICENTRO), Guarapuava, Brazil (Franca, Queiroz Franca, De Araujo Silva, Mayrink, Gonzalez Fonseca, Castro De Miranda, Pereira Nunes, Lopes Do Carmo) Universidade Federal de Minas Gerais, Unit of Cardiology and Cardiovascular Surgery, Clinics Hospital, Belo Horizonte, Brazil (Franca, Queiroz Franca, De Araujo Silva, Mayrink, Gonzalez Fonseca, Castro De Miranda, Lopes Do Carmo) Advanced Arrhythmia Treatment Center (CTA), Belo Horizonte, Brazil (Padilha Da Silva) Department of Statistics, Universidade Federal do Parana, Curitiba, Brazil Publisher Elsevier B.V. Abstract Background In the context of ventricular tachycardia (VT) ablation, functional electroanatomic mapping techniques may help identify arrhythmogenic substrates in scarred and normal voltage areas. In addition, extrastimuli-assisted (dynamic) mapping may be more effective than intrinsic rhythm (static) approaches to uncover key ablation targets, potentially improving procedure outcomes. Objective We aimed to assess the efficacy and safety of functional mapping-assisted VT ablation and to compare procedural outcomes between dynamic and static mapping approaches. Methods PubMed/MEDLINE, Scopus, Web of Science, and Cochrane databases were searched using MeSH terms <ani:em>ventricular tachycardia ablation</ani:em>, <ani:em>functional mapping</ani:em>, <ani:em>recurrence</ani:em>, <ani:em>complications</ani:em>, and similar keywords. Meta-analyses of single proportions, rates, and means were performed, employing random effects models and <ani:em>P</ani:em> <.05. Subgroup analysis and meta-regression were performed. Results We included 16 studies, covering 674 patients, with follow-up ranging from 6 to 38.1 +/- 29.7 months. Ischemic cause represented 490 (72.7%) patients; left ventricular ejection fraction varied from 25% +/- 10% to 41.5% +/- 13.8%. Dynamic mapping was used in 9 (57.1%) studies, 6 (37.5%) studies employed static techniques, and 1 (6.3%) study used a mixed approach. Procedure duration (<ani:em>P</ani:em> =.520) and complication incidence (<ani:em>P</ani:em> =.110) were similar between dynamic and static mapping modalities. The dynamic mapping subgroup exhibited significantly lower VT recurrence rate compared with the static mapping population (<ani:em>P</ani:em> <.010). This result persisted on a meta-regression model adjusted for ischemic cause and left ventricular ejection fraction, demonstrating that dynamic functional mapping was independently associated with lower recurrence rates (<ani:em>P</ani:em> =.005). Conclusion Functional mapping was demonstrated to be safe for VT ablation. Dynamic functional mapping independently associated with reduced postablation recurrence rates without significantly increasing procedure duration. Copyright © 2025 Heart Rhythm Society. <7> Accession Number 2044526271 Title The Efficacy of Gabapentin in Reducing Perioperative Opioid Requirements in Pediatric Cardiac Surgery: A Randomized, Double-Blinded Controlled Study. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Sayedalahl M.A.; Hassan A.A.; Elmaddawy A.E.A.; Abdelbaser I.; Abdelfattah M.; Badr-Eldin M.N.; Elmorsi Hewidi G.Z.; Gabr M.A.; Elemam E.M.; Eltanany E.; Eissa A.A.; Hassanin Taraby A.I.; Bakrey S.; El Morsy M.M. Institution (Sayedalahl, Elmaddawy, Abdelbaser, Abdelfattah, Badr-Eldin, Elmorsi Hewidi, Elemam, Eltanany, Eissa, Hassanin Taraby, Bakrey) Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt (Hassan) Department of Anesthesiology and Intensive Care, Faculty of Medicine, Port Said University, Port Said, Egypt (Gabr) Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt (El Morsy) Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Damietta University, New Damietta, Egypt Publisher W.B. Saunders Abstract Objectives: To assess the efficacy of gabapentin administration in reducing perioperative opioid consumption among pediatric patients undergoing cardiac surgery with cardiopulmonary bypass. Design(s): A prospective, randomized, double-blinded, placebo-controlled trial. Setting(s): University children's hospital. Participant(s): Eighty patients aged 3 to 12 years undergoing elective corrective cardiac surgery. Intervention(s): Participants were randomly allocated to receive either gabapentin (10 mg/kg/d in 3 divided doses) (group G) or placebo (group P), starting preoperatively and continuing for 48 hours postoperatively. Measurements and Main Results: The primary outcome measured was the total rescue fentanyl consumption (in micrograms per kilogram) during the first 48 postoperative hours. Secondary outcomes included intraoperative fentanyl consumption, Modified Objective Pain Score (MOPS), time to extubation, duration of intensive care unit (ICU) stay, and adverse effects. Group G demonstrated a significantly lower requirement for fentanyl (4.04 +/- 1.59 microg/kg) compared with group P (7.01 +/- 1.53 microg/kg, p < 0.001). Gabapentin also resulted in reduced intraoperative opioid use, lower postoperative pain score, shorter time to extubation, and decreased ICU length of stay, without an increase in adverse events. Conclusion(s): Perioperative gabapentin administration effectively reduces opioid requirements, provides effective postoperative analgesia as assessed by the MOPS, and accelerates recovery in pediatric cardiac surgery. Copyright © 2026 Elsevier Inc. <8> Accession Number 650355039 Title Frailty and functional recovery after cardiac surgery: a randomized pilot trial of extended exercise-based rehabilitation. Source BMC geriatrics. 26(1) (no pagination), 2026. Date of Publication: 24 Feb 2026. Author Tamuleviciute-Prasciene E.; Balne K.; Kuznecova I.; Beigiene A.; Stonkuviene V.; Kubilius R. Institution (Tamuleviciute-Prasciene, Beigiene, Stonkuviene, Kubilius) Department of Rehabilitation, Lithuanian University of Health Sciences, Eiveniu Str. 2, Kaunas, Lithuania (Balne, Kuznecova) Department of Cardiology, Lithuanian University of Health Sciences, Eiveniu Str.. 2, Kaunas, Lithuania <9> Accession Number 2044035857 Title Comparison of the effects of dexmedetomidine and lidocaine on postoperative analgesia and recovery characteristics: a meta-analysis of randomized controlled trials. Source Systematic Reviews. 15(1) (no pagination), 2026. Article Number: 85. Date of Publication: 01 Dec 2026. Author Hung K.-C.; Chang L.-C.; Wang W.-T.; Liao S.-W.; Hsu C.-W.; Wu J.-Y.; Chen I.-W. Institution (Hung, Liao) Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan (Republic of China) (Hung) School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan (Republic of China) (Chang, Wang) Department of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan (Republic of China) (Liao) Center of General Education, Chia Nan University of Pharmacy and Science, Tainan City, Taiwan (Republic of China) (Hsu) Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan (Republic of China) (Wu) Department of Nutrition, Chi Mei Medical Center, Tainan City, Taiwan (Republic of China) (Wu) Department of Public Health, College of Medicine, National Cheng Kung University, Tainan City, Taiwan (Republic of China) (Chen) Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan City, Taiwan (Republic of China) Publisher BioMed Central Ltd Abstract Background: Dexmedetomidine and lidocaine are commonly used adjuvants in postoperative pain management; however, their comparative efficacy is unclear. This meta-analysis compared the effects of intravenous dexmedetomidine and lidocaine on postoperative analgesia and recovery. Method(s): Cochrane Library, Medline, Embase, and Google Scholar were searched from their inception to July 1, 2024, to identify relevant randomized controlled trials (RCTs) comparing intravenous dexmedetomidine and lidocaine in adult patients undergoing non-cardiac surgery under general anesthesia. The primary outcomes were the postoperative pain score at 24 h and postoperative opioid consumption. The secondary outcomes included early postoperative pain scores, intraoperative opioid/anesthetic requirements, hemodynamic parameters, recovery characteristics, and inflammatory markers. Result(s): Twenty-four studies (1,697 patients) were included. There was no significant difference between dexmedetomidine and lidocaine in terms of pain scores at 24 h (mean difference [MD]: 0.01, p = 0.88) or overall postoperative opioid consumption (standardized MD[SMD]: -0.51, p = 0.06). However, dexmedetomidine was associated with lower pain scores at 2-4 h postoperatively (MD:-0.41, p = 0.02), reduced intraoperative anesthetic agent requirements (SMD:-1.1, p = 0.004), a longer time to rescue analgesic (MD: -29.93 min, p < 0.00001), and improved quality of recovery scores (SMD: 1.72, p = 0.01). Dexmedetomidine resulted in lower heart rate and blood pressure compared to lidocaine, without differences in other recovery characteristics and inflammation. Conclusion(s): Both dexmedetomidine and lidocaine are effective adjuvants for improving postoperative outcomes. Nevertheless, dexmedetomidine has shown advantages in terms of early pain control, reduced anesthetic requirements, and improved quality of recovery. The choice of these agents should be based on individual patient factors and specific surgical procedures. Copyright © The Author(s) 2026. <10> Accession Number 2043821214 Title Comparison of Ozaki and Ross procedures for paediatric aortic valve disease: A systematic review and meta-analysis. Source Cardiology in the Young. 36(2) (pp 262-267), 2026. Date of Publication: 01 Feb 2026. Author Lu Q.; Xu K.; Li P.; Wang P.; Huang P.; Yuan Z.; Liu J. Institution (Lu, Xu, Li, Wang, Huang, Yuan, Liu) Beijing Anzhen Hospital of Capital Medical University, Nanchong Branch, Nanchong, China Publisher Cambridge University Press Abstract Objectives: To compare the clinical efficacy and prognosis of Ozaki procedure and Ross procedure in the treatment of paediatric aortic valve disease. Method(s): According to the predetermined inclusion and exclusion criteria, relevant clinical studies were comprehensively searched in three databases, and relevant data were extracted for analysis and comparison. Result(s): This meta-analysis included four retrospective cohort studies with a total of 243 patients (117 undergoing Ozaki procedure and 126 undergoing Ross procedure). There were no significant difference in the in-hospital all-cause mortality [odds ratio = 1.38; 95% confidence interval: 0.38, 5.07, p = 0.63] and all-cause mortality during the follow-up period [odds ratio = 1.85; 95% confidence interval: 0.54, 6.32, p = 0.32] between Ozaki procedure and Ross procedure. The reoperation on the aortic valve [odds ratio = 10.48; 95% confidence interval: 2.22, 49.40, p = 0.003] was higher in the Ozaki procedure than in the Ross procedure. There were no patients who underwent pulmonary valve reoperation after Ozaki procedure [odds ratio = 0.21; 95% confidence interval: 0.03, 1.23, p = 0.08]. The cumulative reoperation rate after Ozaki procedure [odds ratio = 2.29; 95% confidence interval: 0.93, 5.66, p = 0.07] was higher than that of Ross procedure, but the difference was not statistically significant. The cardiopulmonary bypass time after Ozaki procedure [odds ratio = -32.09; 95% confidence interval:-45.05, -19.14, p < 0.00001] was shorter than that of Ross procedure. The incidence of postoperative complications [odds ratio = 0.24; 95% confidence interval: 0.04, 1.62, p = 0.14], aortic cross-clamping time [odds ratio = -20.39; 95% confidence interval: -43.68, 2.90, p = 0.09], ventilator assistance time [odds ratio = 1.71; 95% confidence interval: -42.70, 46.13, p = 0.94], and ICU time [odds ratio = -0.38; 95% confidence interval: -0.93, 0.16, p = 0.17] in Ozaki procedure was not statistically significant compared to Ross procedure. Conclusion(s): In the treatment of children with aortic valve disease, there is no statistically significant difference between the Ozaki procedure and the Ross procedure in terms of freedom from reoperation and all-cause mortality. Copyright © The Author(s), 2026. <11> Accession Number 2041232787 Title Machine learning models for predicting postoperative delirium in non-cardiac surgery patients - systematic review and meta-analysis. Source GeroScience. 48(1) (pp 135-156), 2026. Date of Publication: 01 Feb 2026. Author Das O.; Tang L.Y.; Oh E.S.; Suarez J.; Theodore N.; Azad T.D. Institution (Das, Tang, Theodore, Azad) Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD, United States (Oh) Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States (Suarez) Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Early diagnosis of post-operative delirium (POD) in the older surgical population allows for timely interventions and reduces morbidities. Risk prediction models (RPMs) utilizing machine learning have emerged as promising tools to predict POD, but their performance and applicability in clinical settings remain uncertain. This systematic review evaluates the predictive accuracy and quality of RPMs for POD developed from 2014 to 2024 focusing on patients after non-cardiac surgery. PubMed and EMBASE were systematically searched for studies that developed RPMs predicting POD. Two authors independently screened 298 potential studies for eligibility, and quality assessment was performed using the Prediction model Risk of Bias Assessment Tool (PROBAST). Pooled performance metrics, including AUROC, sensitivity, specificity, and precision, were calculated. Twenty-two articles matched review criteria, with the majority employing machine learning techniques such as gradient boosting and random forests. The pooled AUROC was 0.82 (95% CI: 0.79-0.85), indicating moderate-to-high predictive accuracy. Sensitivity, specificity, and precision were 0.78, 0.83, and 0.55, respectively. Studies utilizing more predictors and complex model architectures did not show substantial increases in performance compared to simpler models developed pre-2014. We demonstrated that while newer RPMs for POD are more likely to be validated and utilize advanced machine learning algorithms, their interpretability and clinical applicability remain limited. ML models hold promise in reducing the incidence of POD, but significant effort is needed to facilitate the integration of these models into clinical practice. Future efforts should focus on validating models externally, reducing false positive predictions, and translating model predictions into clinical actions. Copyright © The Author(s), under exclusive licence to American Aging Association 2025. <12> Accession Number 2026762589 Title Reoperation rate and risk factors of reoperation for ossification of the posterior longitudinal ligament (OPLL): a systematic review and meta-analysis. Source Neurosurgical Review. 46(1) (no pagination), 2023. Article Number: 313. Date of Publication: 01 Dec 2023. Author Tayal A.; Pahwa B.; Garg K. Institution (Tayal, Pahwa) University College of Medical Sciences and G.T.B. Hospital, Delhi, India (Garg) Department of Neurosurgery, All India Institute of Medical Sciences, Delhi, India Publisher Springer Science and Business Media Deutschland GmbH Abstract Revision surgery for OPLL is undesirable for both patients and physicians. However, the risk factors for reoperation are not clear. Thus, we sought to review the existing literature and determine the factors associated with higher reoperation rates in patients with OPLL. A search was performed using Pubmed, Embase, Web of Sciences, and Ovid to include studies regarding the risk factors of reoperation for OPLL. RoBANS (Risk of Bias Assessment tool for Nonrandomized Studies) was used for risk of bias analysis. Heterogeneity of studies and publication bias was assessed, and sensitivity analysis was performed. Statistical analysis was performed with a p-value < 0.05 using SPSS software (version 23). Twenty studies with 129 reoperated and 2,793 non-reoperated patients were included. The pooled reoperation rate was 5% (95% CI: 4% to 7). The most common cause of reoperation was residual OPLL or OPLL progression (n = 51, 39.53%). An increased risk of additional surgery was found with pre-operative cervical or thoracic angle (Standardized mean difference = -0.44; 95% CI: -0.69 to -0.19; p = 0.0061), post-operative CSF leak (Odds ratio, OR = 4.97; 95% CI: 2.48 to 9.96; p = 0.0005), and graft and/or hardware failure (OR = 192.09; 95% CI: 6.68 to 5521.69; p = 0.0101). Apart from the factors identified in our study, the association of other variables with the risk of second surgery could not be ruled out, owing to the complexity of the relationship and significant bias in the current literature. Copyright © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. <13> Accession Number 2044512279 Title Year in Review 2025: New and Noteworthy Literature in Cardiothoracic Critical Care. Source Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Alber S.M.; Kim K.K.; Li X.; Tanabe K.; Gilliland S. Institution (Alber, Kim, Li, Tanabe, Gilliland) Department of Anesthesiology, University of Colorado, Aurora, CO, United States Publisher SAGE Publications Inc. Abstract This article reviews noteworthy literature published in 2025 pertinent to the care of critically ill cardiothoracic surgical patients. We reviewed over 9000 articles to identify 12 publications that provided new or supportive evidence on a diverse range of topics including the management of cardiogenic shock, pulmonary and renal failure, precision immunotherapy in sepsis care, and resuscitation. Additional topics included outcomes following mechanical thrombectomy and methods of hemodynamic monitoring. Copyright © The Author(s) 2026 <14> Accession Number 2044470429 Title Effect of Colchicine Treatment in Primary Percutaneous Coronary Intervention for ST Segment Elevation Myocardial Infarction. Source International Journal of Drug Delivery Technology. 16(3 Supplement) (pp 354-359), 2026. Date of Publication: 2026. Author Ibrahim M.; Elhawry A.; Oraby M.; Abdel Shafee M.; Sabbah M. Institution (Ibrahim, Elhawry, Oraby, Abdel Shafee, Sabbah) Department of Cardiology, Faculty of Medicine, Suez Canal University, Egypt Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Inflammation during primary percutaneous coronary intervention (PCI) has negative outcomes. Colchicine's anti-inflammatory effects may reduce cardiovascular risks in acute myocardial infarction, but evidence post-PCI is limited. Aim(s): The efficacy of colchicine therapy in reducing inflammation and adverse ischemic cardiovascular events in patients with ST segment elevation myocardial infarction (STEMI) managed by primary PCI. Method(s): A randomized, controlled patients with STEMI were randomly assigned to the intervention colchicine group in addition to standard therapy versus the other group who received the standard therapy alone. The primary end point was a composite of all death, spontaneous myocardial infarction (MI), resuscitated cardiac arrest, ischemic stroke, ischemia-driven coronary revascularization or hospitalization for unstable angina at 6 months follow up. The secondary end points were components of the primary end point and the group difference in cardiac systolic function by echocardiography from baseline to 1 month after PCI. Result(s): A total of 267 patients underwent randomization during February 2022 to February 2024; 89 patients were randomized into the colchicine group, 93 patients in the control groups and 85 patients were excluded. The primary-outcome event was similar between both groups (21 events in colchicine group Vs 26 events in control group, Log Rank test 0.451). The incidence of individual components of the primary outcome appeared to be similar in the two groups. There was no difference in systolic function by echocardiography between the two groups. Conclusion(s): The addition of colchicine did not yield a significant benefit in enhancing the outcomes of patients with STEMI at a 6-month follow-up. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <15> Accession Number 2043805222 Title Surgical management of double outlet right ventricle with outflow obstruction: A systematic review of biventricular strategies. Source Cardiology in the Young. 36(2) (pp 318-324), 2026. Date of Publication: 01 Feb 2026. Author Semyashkin A.; Nesteruk J.; Ben Mime L. Institution (Semyashkin) Department of Pediatric Cardiac Surgery, Klinikum Stuttgart Olgahospital Frauenklinik, Germany (Nesteruk) University Heart Center Freiburg Bad Krozingen, Germany (Ben Mime) Center for Congenital Heart Defects and Pediatric Heart Center, Pediatric Heart Surgery, HDZ-NRW, University Hospital of the Ruhr University Bochum, Medical Faculty Owl University Bielefeld, Bad Oeynhausen, Germany Publisher Cambridge University Press Abstract Background: Double outlet right ventricle is a heterogeneous congenital defect in which both great arteries arise predominantly from the right ventricle. Several operative strategies exist, but contemporary paediatric outcome data have not been systematically synthesised. Material(s) and Method(s): A systematic search of PubMed, Embase, Scopus, the Cochrane Library, and medRxiv (2000-2025) identified cohort studies and case series including >=10 children undergoing biventricular repair strategies reported in double outlet right ventricle cohorts, including intraventricular rerouting procedures, root-based realignment techniques, and neonatal pathway operations such as the Yasui procedure. Two reviewers independently screened studies, extracted anatomical and operative data, and assessed risk of bias. Early mortality and 10-year survival were pooled using random-effects models with logit transformation. Result(s): Thirteen studies (413 children; median follow-up ~7 years) met inclusion criteria. Early mortality ranged from 0% to 6.8%. Pooled early mortality was 2.7% for Rastelli, 3.6% for REV, and 5.8% for Nikaidoh/Bex operations. Ten-year survival exceeded 90% across all major strategies. Conduit replacement was frequent after Rastelli and Nikaidoh/Bex repair. REV avoided a conduit but required right ventricular outflow tract reinterventions in about one-quarter of patients. Nikaidoh/Bex procedures provided durable left ventricular outflow but showed 19-35% conduit failure. Yasui repairs achieved excellent neonatal survival but required frequent conduit replacement. Conclusion(s): Contemporary double outlet right ventricle repair provides excellent long-term survival with early mortality <6%. Procedure selection should consider ventricular septal defect position, risk of postoperative left ventricular outflow tract obstruction, coronary anatomy, and patient size. Copyright © The Author(s), 2026. <16> Accession Number 2044319328 Title Effect of Probiotic Supplementation on Muscle Strength After Myocardial Revascularization: A Randomized, Controlled, Triple-Blind Clinical Trial. Source Nutraceuticals. 6(1) (no pagination), 2026. Article Number: 12. Date of Publication: 01 Mar 2026. Author Gimenes I.M.; Silvestre E.G.; Cabral L.Q.T.; Cantero M.A.; Gomes R.L.; Silva A.K.F.D.; Trindade E.B.S.D.M.; Fernandes R. Institution (Gimenes, Silvestre, Cabral, Gomes, Fernandes) Postgraduate Program in Food, Nutrition, and Health, School of Health Sciences, Federal University of Grande Dourados, Dourados-Itahum Highway, Km 12-Unit IIMS, Dourados, Brazil (Cantero) Postgraduate Program in Health Sciences, School of Health Sciences, Federal University of Grande Dourados, Dourados-Itahum Highway, Km 12-Unit IIMS, Dourados, Brazil (Silva) Faculty of Science and Technology, Sao Paulo State University Julio de Mesquita Filho, Presidente Prudente CampusRua Roberto Simonsen, SP, Presidente Prudente, Brazil (Trindade) Postgraduate Program in Nutrition, Center of Health Sciences, Federal University of Santa Catarina, Delfino Conti Street, SC, Florianopolis, Brazil Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Evidence suggests that gut dysbiosis may contribute to acute myocardial infarction (AMI) and its complications, including reduced physical performance and muscle weakness. We hypothesized that probiotic supplementation could improve muscle strength during post-AMI recovery. In a randomized, controlled, triple-blind clinical trial, adults and older adults undergoing myocardial revascularization received either a multistrain probiotic formulation (Lacticaseibacillus paracasei, Lacticaseibacillus rhamnosus, Lacticaseibacillus acidophilus, and Bifidobacterium lactis) or placebo for 90 days. The primary outcome was handgrip strength (HGS). Forty-five participants completed the study. No significant between-group differences were observed in the main analysis. However, in an exploratory subgroup of men aged 50 years and older with low baseline HGS (n = 30), probiotic supplementation led to a greater improvement in non-dominant HGS after 90 days compared with placebo (mean difference: +4.6 kg/f; p = 0.04). A baseline-adjusted ANCOVA confirmed a significant baseline-by-treatment interaction for the non-dominant hand (beta = +0.33; 95% CI: +0.02 to +0.62; p = 0.038), indicating greater improvements among participants with lower initial strength. Although the primary analysis yielded null results, these exploratory findings indicate a potential benefit of probiotic supplementation in a clinically vulnerable subgroup of revascularized men with low baseline strength. Larger and prospectively powered trials are warranted to confirm these observations. Trial registration: RBR-6ztyb7. Copyright © 2026 by the authors. <17> Accession Number 2044393185 Title A history that matters: a systematic review and meta-analysis on prior heart failure hospitalization and outcomes after transcatheter aortic valve implantation. Source Journal of Echocardiography. (no pagination), 2026. Date of Publication: 2026. Author Ahmed M.; Kumar A.; Ridham F.N.U.; Azad I.F.; Lohana R.R.; Qadir Z.; Kumari M.; Moosani F.; Saleh S.; Shaikh A.S.; Dito A.; Alam M. Institution (Ahmed, Kumar, Ridham, Azad, Qadir, Kumari, Moosani, Saleh, Shaikh, Dito) Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, Pakistan (Lohana) Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan (Alam) Department of Cardiology, The Texas Heart Institute, Baylor College of Medicine, Houston, TX, United States Publisher Springer Abstract Aortic stenosis in older adults often requires valve replacement and transcatheter aortic valve implantation (TAVI) is an option with good outcomes. However, recent hospitalizations due to heart failure (HF) may worsen results. This systematic review and meta-analysis adhering to PRISMA guidelines. We systematically searched PubMed, Cochrane Library and Scopus from database inception until July 2025. Data were analyzed by Review Manager using Risk Ratio (RRs) and 95% confidence interval (95% CIs) were used, and result was considered significant when the p-value is less than 0.05. Our primary outcome was 30-day mortality. Secondary outcomes included long-term mortality, major vascular complication, stroke, bleeding complications, pacemaker implantation, acute kidney injury (AKI) and long-term hospitalization. We included six studies, consisting of a population of 3,800 in the group with recent HF hospitalization and 12,949 in the group without recent HF hospitalization. Our pooled estimate shows a significantly higher rate of mortality in 30-day in the patients with group with recent HF hospitalization compared to the patients without recent HF hospitalization (RR: 2.28; 95% CI: [1.84-3.61]; p = 0.00001; I2 = 40%). Among the secondary outcomes, long-term mortality (RR = 1.75; 95% CI: [1.53-2.01]; p < 0.00001, I2 = 43%), stroke (RR = 1.30; 95% CI: [1.01-1.68]; p = 0.04, I2 = 0%), bleeding complications (RR = 1.36; 95% CI: [1.18-1.56]; p = 0.00001, I2 = 0%), AKI (RR = 1.42; 95% CI: [1.117-1.74]; p = 0.0005, I2 = 23%) and long-term hospitalization (RR = 1.39; 95% CI: [1.09-1.78]; p = 0.007, I2 = 93%) were associated with higher risk in the patients with recent HF hospitalization as compared to the patients without prior HF hospitalization. While major vascular complication and pacemaker implantation were statistically insignificant. Patients with recent HF hospitalization had significantly higher 30-day mortality, long-term mortality, stroke, bleeding complications, AKI and long-term hospitalization than those without recent hospitalization. Copyright © Japanese Society of Echocardiography 2026. <18> Accession Number 2039540940 Title Network meta-analysis of cardioplegic methods, in elective isolated coronary artery bypass grafting. Source Perfusion (United Kingdom). 41(3) (pp 240-253), 2026. Date of Publication: 01 Apr 2026. Author Kalogerakos P.D.; Kokkinakis S.; Akoumianakis E.; Karagkounis T.; Gavalaki A.; Kiparakis M.; Akoumianakis I.; Lazopoulos L.; Gaitanaki T.; Andreou A.; Lasithiotakis K.; Kontopodis N.; Lazopoulos G. Institution (Kalogerakos, Karagkounis, Gavalaki, Kiparakis, Lazopoulos, Lazopoulos) Department of Cardiac Surgery, General University Hospital of Heraklion, Crete, Greece (Kokkinakis) Department of General, Visceral, Tumor, and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany (Akoumianakis) Department of Otorhinolaryngology - Head and Neck Surgery, General University Hospital of Heraklion, Crete, Greece (Akoumianakis) Cardiovascular Medicine Division, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (Gaitanaki) Department of Cardiology, General University Hospital of Heraklion, Crete, Greece (Andreou, Lasithiotakis) Department of General Surgery, General University Hospital of Heraklion, Crete, Greece (Kontopodis) Department of Vascular Surgery, General University Hospital of Heraklion, Crete, Greece Publisher SAGE Publications Ltd Abstract BackgroundCardioplegic arrest can be induced by various methods, fueling a long-standing controversy about their comparative merit. We aim to compare cardioplegic methods in coronary artery disease.MethodsPubMed, Embase, and Cochrane databases were interrogated for randomized trials that compared various cardioplegic methods in adult patients undergoing elective isolated coronary artery bypass grafting. Differences in cardioplegic composition - crystalloid or blood, route of delivery - antegrade or retrograde, and temperature, were evaluated in a network meta-analysis. The endpoints were mortality, myocardial infarction, insertion of intra-aortic balloon pump, low cardiac output syndrome, increased inotropic support, as well as cardiopulmonary bypass time, aortic cross-clamp time, intensive care stay, hospital stay, new onset atrial fibrillation, reperfusion ventricular fibrillation, and neurologic event. Confidence In Network Meta-Analysis web application was employed.Results75 studies were included, with 6131 patients receiving one of 13 cardioplegic methods. Warm ante/retrograde blood cardioplegia was associated with fewer deaths (P-score 0.81), fewer intra-aortic balloon pumps (P-score 0.77), and shorter intensive care (P-score 0.69) and hospital stay (P-score 0.81). Cross clamp time was shorter with crystalloid cardioplegias, while reperfusion ventricular fibrillation was less frequent with warm blood cardioplegias. Cold cardioplegias were associated with lower rates of new onset atrial fibrillation and stroke. Confidence varied greatly across the endpoints.ConclusionThe outcomes of this network study indicate presumable advantages of warm ante/retrograde blood cardioplegia in elective isolated coronary artery bypass grafting. Under the light of certain biases and mixed confidence, the results should be cautiously interpreted. More studies are needed. Copyright © The Author(s) 2025 <19> Accession Number 2043072194 Title A Bayesian Meta-Analysis of Renin-Angiotensin System Inhibitors Following TAVR. Source Catheterization and Cardiovascular Interventions. 107(5) (pp 1554-1561), 2026. Date of Publication: 01 Apr 2026. Author Oliveira V.M.R.; Barbosa L.M.; Sousa P.A.D.; Lima A.P.D.; Akabane M.A.C.; Borges A.; Bertoli E.D.; Bulhoes E.; Farias C.A.; Mazetto R.; Tartuce Filho P.R.F.; Alcantara R.W.A.; Bignoto T.; Pileggi B.; Moreira H.G.; Tartuce L.P. Institution (Oliveira, Borges, Moreira) Federal University of Goias, Goiania, Brazil (Oliveira, Tartuce Filho, Tartuce) Instituto de Cardiologia e Radiologia Intervencionista de Rio Verde, Rio Verde, Brazil (Barbosa) Federal University of Minas Gerais, Belo Horizonte, Brazil (Barbosa, Bignoto, Pileggi) Instituto do Coracao-InCor-Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil (Sousa) Federal University of Uberlandia, Uberlandia, Brazil (Lima) University of Rio Verde, Rio Verde, Brazil (Akabane) Federal University of Juiz de Fora, Juiz de Fora, Brazil (Bertoli) Hospital e Maternidade Marieta Konder Bornhausen, Itajai, Brazil (Bulhoes) Universidade da Amazonia Reunida, Redencao, Brazil (Farias) Universidade Nove de Julho, Sao Paulo, Brazil (Mazetto) State University of Amazon, Manaus, Brazil (Alcantara) Clinica Aurus, Oliveira, Brazil (Alcantara) Interventional Cardiology Unit, Hospital Sao Judas Tadeu, Oliveira, Brazil Publisher John Wiley and Sons Inc Abstract Background: Aortic stenosis leads to left ventricular remodeling, hypertrophy, and fibrosis, increasing the risk of heart failure. Renin-angiotensin system (RAS) inhibitors may mitigate these adverse effects and improve clinical outcomes. Despite advancements in transcatheter aortic valve replacement (TAVR), substantial mortality, heart failure readmissions, and other complications persist. Aim(s): This study aimed to evaluate the impact of RAS inhibitor therapy following TAVR on clinical outcomes. Method(s): We conducted a systematic review and Bayesian meta-analysis following the Cochrane Handbook for Systematic Reviews of Interventions. A comprehensive search of PubMed, Embase, and Cochrane was performed to identify studies comparing RAS inhibitor (RASi) use versus non-use in patients undergoing TAVR for aortic stenosis. Odds ratios (OR) and 95% credible intervals (CrI) were estimated using a Bayesian random-effects model. Between-study heterogeneity was quantified using the posterior distribution of the heterogeneity parameter (tau). Posterior probabilities (PP) of treatment benefit were calculated, with clinically meaningful effects defined as P (OR < 0.8). All analyses were performed using R version 4.5.0. Result(s): A total of 12 studies comprising 35,988 patients were included, of whom 17,026 (47.3%) received RASi therapy. The mean age ranged from 78.9 to 84.4 years. Post-TAVR RASi use was associated with a 79.4% probability of a clinically relevant reduction in all-cause mortality and a 99.5% probability of a clinically relevant reduction in cardiovascular mortality. There was a 54% probability of a clinically relevant reduction in heart failure hospitalization and a negligible (2.26%) probability of a reduction in the odds of myocardial infarction in the RASi group. Conclusion(s): RASi therapy following TAVR is associated with reduced odds of mortality and heart failure readmission. Copyright © 2026 Wiley Periodicals LLC. <20> Accession Number 2043825336 Title Reading the Signature of Autophagy in the Ischemic and Infarcted Heart: A Systematic Review of Circulating Biomarkers. Source International Journal of Molecular Sciences. 27(5) (no pagination), 2026. Article Number: 2116. Date of Publication: 01 Mar 2026. Author Radaelli D.; Alshaeb A.; Al-Habash I.; Belakaposka Srpanova V.; Jakovski Z.; Sinagra G.; Mihic A.G.; D'Errico S. Institution (Radaelli, Sinagra, D'Errico) Department of Medical Surgical and Health Sciences, Cattinara University Hospital, University of Trieste, Strada di Fiume, Trieste, Italy (Alshaeb) Department of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, Zarqa, Jordan (Al-Habash) Forensic Medicine Department, Mutah University, Karak, Jordan (Belakaposka Srpanova, Jakovski) Institute for Forensic Medicine, Criminalistic and Medical Deontology, Medical Faculty, Skopje, North Macedonia (Mihic) School of Medicine, University of Zagreb, Salata 11, Zagreb, Croatia Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Ischemic heart disease is the main cause of death worldwide. Classic cardiac biomarkers, such as troponin, which are released due to myocyte necrosis, are widely used for diagnosis, but they provide limited information about the initial underlying cellular processes involved in myocardial infarction. Autophagy is now considered fundamental in the pathophysiology of cardiac ischemia and related reperfusion injury. This systematic review aims to identify and highlight candidate autophagy-related biomarkers in cardiac ischemia and infarction with potential benefits for early diagnosis, prognosis, and therapy. A comprehensive literature search was conducted up to 1 June 2025. We included studies that examined biomarkers involved in the autophagy process in cardiac ischemia/infarction, which involved humans and animal models. A total of 14 eligible articles were reviewed. Thirteen autophagy-related biomarkers were identified, including LC3-II/I, Beclin-1, ATG5, ATG7, p62, WIPI1, FGF21, CHRF, Rubicon, IL-1beta, IL-18, and adiponectin. These biomarkers have a dynamic pattern, and they exhibited time-dependent changes during the different stages of myocardial infarction. Autophagy biomarkers present a promising understanding of the molecular mechanism of early myocardial ischemia and infarction. Integration of autophagy biomarkers with the classic markers should improve risk stratification, therapeutic decision-making, and prognosis in patients with ischemic heart disease. Copyright © 2026 by the authors. <21> [Use Link to view the full text] Accession Number 2032793584 Title Factors Associated With Coronary Angiography Performed Within 6 Months of Randomization to the Conservative Strategy in the ISCHEMIA Trial. Source Circulation: Cardiovascular Interventions. 17(6) (pp 457-473), 2024. Date of Publication: 01 Jun 2024. Author Spertus J.A.; Broderick S.; Rockhold F.W.; Demchenko E.; Grossman G.B.; Stone G.W.; Mancini G.B.J.; Hochman J.S.; Boden W.E.; Mavromatis K.; Doan J.; Linefsky J.; Lee R.; Patel R.; Miller T.; Cho S.Y.; Milbrandt S.; Shelstad D.; Banerjee S.; Kamath P.; Tejani I.; Reynolds H.R.; Newman J.D.; Bangalore S.; Phillips L.M.; Saric M.; Abdul-Nour K.; Schley A.; Golden H.; Stone P.H.; Osseni H.; Wiyarand C.; Douglass P.; Pomeroy H.; Craft A.; Harvey B.; Jang J.J.; Anaya O.; Yee G.; Goold P.; Weitz S.; Giovannone S.; Pritchard L.; Arnold S.; Gans R.; O'Keefe J.H.; Kennedy P.; Shapiro M.D.; Ganesan S.; Schlichting D.; Naher A.; Fein S.A.; Stewart W.L.; Torosoff M.T.; Salmi K.M.; Lyubarova R.; Mookherjee S.; Drzymalski K.; McFalls E.O.; Garcia S.A.; Bertog S.C.; Johnson D.K.; Siddiqui R.A.; Herrmann R.R.; Ishani A.; Hansen R.A.; Khouri M.G.; Arges K.; LeFevre M.; Tomfohr J.; Goldberg J.L.; Byrne K.A.; Zappernick T.; Goldweit R.; Canada S.; Kakade M.; Mieses P.; Cohen R.A.; Mirrer B.; Navarro V.; Rantinella M.; Rodriguez J.; Mancilla O.; Winchester D.E.; Stinson S.; Kronenberg M.; Weyand T.; Crook S.C.; Heitner J.F.; Ho J.; Khan S.; Mohamed M.; Dauber I.M.; Soltau M.R.; Rose D.K.; Wimmer R.J.; Siegel K.E.; Derbyshire S.; Cannan C.; Dixon M.; Leonard G.; Sudarshan S.; Heard C.; Gabriel V.; Desire S.; Mehta P.K.; McDaniel M.; Rashid F.; Lerakis S.; Asier S.; Quyyumi A.; Patel K.; Wenger N.K.; Hedgepeth C.M.; Gillis J.; Hurlburt H.; Manocchia M.; Rosen A.; Moore S.; Congdon E.; Sahul Z.; Brandt G.; Marchelletta N.; Wippler K.; Leung S.; Reda H.; Ziada K.; Setty S.; Halverson K.E.; Roraff C.; Thorsen J.; Barua R.S.; Ojajuni A.; Olurinde O.; Surineni K.; Hage F.; Valaiyapathi B.; Davies J.E.; Leesar M.; Heo J.; Iskandrian A.; Al Solaiman F.; Dajani K.; Kartje C.M.; El-Hajjar M.; Mesropian P.D.; Sacco J.; Rawlins M.; McCandless B.; Thomson J.; Orgera M.; Sidhu M.S.; Rogge M.C.; Arif I.; Bunke J.; Kerr H.; Unterbrink K.; Fannon J.; Burman C.; Trejo J.F.; Dubin M.F.; Fletcher G.; Lane G.E.; Neeson L.M.; Parikh P.P.; Pollak P.M.; Shapiro B.P.; Landolfo K.; Gemignani A.; Beaudry S.; O'Rourke D.; Meadows J.L.; Tirado S.A.; Halliday J.; Julian P.; Call J.T.; Lane S.M.; Stanford J.L.; Hannan J.; Bojar R.; Arsenault P.; Kumar D.; Sigel P.; Mukai J.; Martin E.T.; Brooks M.; Vorobiof G.; Douangvila L.; Gevorgyan R.; Moor-Man A.; Ranjbaran F.; Smith B.; Ohmart C.; Kinlay S.; Hamburger R.J.; Rocco T.P.; Ly S.; Bhatt D.L.; Quinn M.C.; Croce K.; Temiyasathit S.; Quin J.A.; Do J.; Anumpa J.; Tobin D.; Zenati M.; Faxon D.P.; Rayos G.; Langdon J.; Bayer M.W.; Seedhom A.; O'Malley A.; Sullenberger L.; Orvis E.; Kumkumian G.; Murphy M.; Greenberg A.; Iraola M.; Sedlis S.P.; Maranan L.C.; Donnino R.M.; Lorin J.; Tamis-Holland J.E.; Malinay A.; Kornberg R.; Leber R.; Saba S.; Edillo C.P.; Lee M.W.; Small D.R.; Nona W.; Alexander P.B.; Rehman I.; Badami U.; Ostrander A.; Wasmiller S.; Marzo K.; Drewes W.; Patel D.; Robbins I.H.; Levite H.A.; White J.M.; Shetty S.; Hallam A.; Patel M.; Hamroff G.S.; Spooner B.J.; Hollenweger L.M.; Little R.W.; Little H.; Zimbelman B.D.; Little T.; Lui C.Y.; Eskelson N.A.; Smith B.R.; Vezina D.P.; Khor L.L.; Abraham J.D.; Bull D.A.; McKellar S.H.; Booth D.; Taul Y.; Kotter J.; Rodgers C.; Abdel-Latif A.; Isaacs J.; Bulkley V.; Hu B.; Kaneshiro R.; Labovitz A.J.; Berlowitz M.; Kirby B.J.; Rogal P.; Tran N.N.; McFarren C.; Jahrsdorfer C.; Matar F.; Caldeira C.; Maron D.J.; Rodriguez F.; Yunis R.; Schnittger I.; Patro J.; Fearon W.F.; Deedwania P.; Vega A.; Reddy K.; Sweeny J.; Bloise-Adames H.; Jimenez S.; Vrestil N.S.; Bhandari R.; Spizzieri C.; Schade D.; Yost R.; Hochberg C.P.; Beardsley P.; Fine D.; Salerno W.D.; Tancredi J.; Arakelian P.; Mathus S.; O'Neill D.; Wyman R.; Burkhardt J.; Hosino S.; Lubyanaya O.A.; Salas J.D.; Zarka A.; Aguirre M.; Shah A.V.; Dhawan M.; Parra D.; Tran T.; Haldis T.; Fowler-Lehman K.; Spitzer N.; Riedberger C.; Weick C.; Kohn J.A.; Girotra S.; Drum C.; Miller-Cox K.; Ollinger A.; Almousalli O.; Capasso-Gulve E.; Loehr A.M.; Mosley M.; Krishnam M.S.; Heydari S.; Mil-Liken J.C.; Lundeen A.M.; Patel P.M.; Karanjah E.; Seto A.H.; Marfori W.C.; Harley K.T.; Hernandez-Rangel E.; Gibson M.A.; Singh P.; Allen B.J.; Coram R.; Webb A.M.; Fridell E.; Wilson H.; Thomas S.; Kim A.; Schwartz R.G.; Wilmot P.; Chen W.; El Shahawy M.; Stevens R.; Stafford J.; Black L.; Abernethy W.B.; Hull A.B.; Lim O.J.; Tucker H.C.; Putnam N.C.; Hall L.L.; Cauthren T.; Tucker T.; Zurick A.; Horton H.; Orga J.; Meyer T.M.; White J.R.; Morford R.G.; Baumann C.; Rutkin B.; Seeratan V.; Bokhari S.; Jimenez M.; Sokol S.I.; Schultz C.; Meisner J.; Russo J.; Hamzeh I.; Misra A.; Huda Z.; Wall M.; Boan A.; De Rosen V.L.; Alam M.; Turner M.C.; Hinton C.R.; Mulhearn T.J.; Good A.P.; Archer B.A.; Dionne J.S.; Allardyce C.A.; Sikora L.N.; Czerniak J.H.; Mull J.A.; Ferguson E.; Laube F.; Shammas N.W.; Shammas G.A.; Christensen L.; Park H.; Chilton R.; Hecht J.; Nguyen P.K.; Vo D.; Hirsch J.; Jezior M.; Bindeman J.; Salkind S.; Desimone L.-A.; Gordon P.C.; Felix-Stern L.; Crain T.; Gomes J.; Gordon C.; Stenberg R.; Mann A.; McCreary T.; Pedalino R.P.; Cobos S.E.; Dwyer R.R.; Espinosa D.; Quiles K.J.; Wiesel J.; Juang G.J.; Gopaul C.; Hultberg K.; Huk T.; Hussain A.; Al-Amoodi M.; Zambrano Y.; Rodriguez S.M.; Milner T.; Wohns D.; Mulder A.; Van Oosterhout S.; Lader E.W.; Meyer M.; Mumma M.; Clapp N.L.; Barrentine H.; Dharmarajan L.; Jose J.M.; Manchery J.; McGarvey J.F.X.; McKinney V.; Schwarz L.; Downes T.R.; Kaczkowski S.M.; Luckasen G.J.; Jaskowiak A.J.; Klitch J.; Cheong B.; Dees D.; Potluri S.; Vasquez P.; Mastouri R.A.; Breall J.A.; Hannemann E.L.; Revtyak G.E.; Foltz J.M.; Bazeley J.W.; DeRosa E.; Jorgenson B.; Riestenberg-Smith J.; Giedd K.; Old W.; Bariciano R.; Burt F.; Sokhon K.; Waldron J.; Mayon M.; Gopal D.; Valeti U.S.; Peichel G.A.; Kobashigawa J.; Starks B.; Garcia L.; Thottam M.; Anand A.; Govindan S.C.; Raj J.; Nair R.G.; Ravindran R.; Rajalekshmi V.S.; Manjunath C.N.; Nataraj N.; Moorthy N.; Nayak S.; Manjunath S.C.; Mylarappa M.; Narayanappa S.; Pandit N.; Bajaj S.; Nath R.K.; Yadav V.; Mishra G.; Dwivedi S.K.; Tewari R.; Narain V.S.; Mishra M.; Chandra S.; Patel S.; Wander G.S.; Tandon R.; Ralhan S.; Kaur B.; Aslam N.; Gupta S.; Pharmacy B.; Goyal A.; Bhargava B.; Suvarna C.; Karthikeyan G.; Ramakrishnan S.; Seth S.; Yadav R.; Singh S.; Roy A.; Parakh N.; Verma S.K.; Narang R.; Mishra S.; Naik N.; Sharma G.; Choudhary S.K.; Patel C.; Gulati G.; Sharma S.; Bahl V.K.; Mathew A.; Kurian B.M.; Punnoose E.; Gadkari M.A.; Karwa S.R.; Gadage S.; Kolhe S.; Pillay T.U.; Satheesh S.; Vindhya R.J.; Jain P.; Seth A.; Meharwal Z.S.; Mathur A.; Verma A.; Bhatia M.; Sachdeva A.; Devi T.I.; Jungla N.; Rani K.M.; Menon R.; Reddy M.S.; Oomman A.; Sidh R.R.; Mao R.; Ramakrishnan T.; Solomon H.; Francis R.; Priya V.P.; Khan S.P.; Preethi K.; Kumar N.; Grant P.; Hande S.; Sonawane P.; Kachru R.; Dubey A.; Rawat K.; Kumar A.V.K.; Ganapathi S.; Jayakumar K.; Vineeth C.P.; Sivadasanpillai H.; Chacko M.; Sasidharan B.; Babu S.; Kapilamoorthy T.R.; Christopher J.; Reddy S.; Polamuri P.; Rani M.; Kaul U.; Arambam P.; Singh B.; Senior R.; Fox K.A.A.; Carruthers K.; Elghamaz A.; Gurunathan S.; Karogiannis N.; Young G.M.; Shah B.N.; Kinsey C.; Trimlett R.H.J.; Kavalakkat R.; Rubens M.B.; Evans J.; Nicol E.D.; Hassan I.; Mittal T.K.; Hampson R.; Gamma R.A.; Williams S.; Holland K.; Swan K.; de Belder M.A.; Atkinson B.; Thambyrajah J.; Nageh T.; Kunhunny S.; Davies J.R.; Lindsay S.J.; Atkinson C.; Kurian J.; Krannila C.; Jamil H.; Vinod M.; Raheem O.; Hoye A.; Chaytor L.; Cox L.; Morrow J.; Rowe K.; Donnelly P.; Kelly S.; Valecka B.; Regan S.; Turnbull D.; Chauhan A.; Fleming C.; Ghosh A.; Gratrix K.; Preston S.; Barr C.; Cartwright A.; Alfakih K.; Knighton A.; Byrne J.; Martin K.; Webb I.; Henriksen P.; Flint L.; Harrison J.; OKane P.; Lake-Man N.; Ljubez A.; de Silva R.; Conway D.S.G.; Wright J.; Exley D.; Sirker A.A.; Andiapen M.; Richards A.J.; Hoole S.P.; Wong L.; Witherow F.N.; Munro M.J.; Harbinson M.; McEvoy M.; Walsh S.; Bao B.; Brown C.; Douglas H.; Luckie M.; Charles T.; Kolakaluri L.; Phillips H.; Sobolewska J.; Morby L.; Hallett K.; Corbett C.; Winstanley L.; Jeetley P.; Smit A.; Patel N.; Kotecha T.; Travill C.; Gent S.; Karimullah I.; Hussain N.; Al-Bustami M.; Braganza D.; Haines F.; Taaffe J.; Henderson R.; Burton J.; Pointon K.; Colton M.; Naik S.; King R.; Mathew T.; Brown A.; Docherty A.; Berry C.; McCloy L.; Collison D.; Robb K.; Roditi G.; Paterson C.; Crawford W.; Kelly J.; McGregor L.; Moriarty A.J.; Mackin A.; Glover J.D.; Knight J.P.; Pradhan J.; Mikhail G.; Bose T.; Francis D.P.; Dzavik V.; Proietti A.; Brousseau M.; Corfias M.; Blaise P.; Harvey L.; Diaz A.; Rheault P.; Barrero M.; Gagne C.-E.; Alarie P.; Pepin-Dubois Y.; Arcand L.; Costa R.; Roy I.; Sia Y.T.; Montpetit E.; Lemay C.; Gisbert A.; Gervais P.; Rheault A.; Drouin K.; Phaneuf D.C.; Bergeron C.; Gosselin G.; Shelley C.; Masson C.; Garg P.; Carr S.; Bone C.; Chow B.J.W.; Moga E.; Hessian R.C.; Kourzenkova J.; Beanlands R.S.; Walter O.; Davies R.F.; Bainey K.R.; Hogg N.; Welsh S.; Bagai A.; Wald R.; Goodman S.; Graham J.J.; Peterson M.; Bello O.; Chow C.-M.; Abramson B.; Cheema A.N.; Syed I.; Vakani M.T.; Hussain M.; Kushniriuk K.; Cha J.; Otis J.; Otis R.; Howarth A.G.; Seib M.M.; Rivest S.M.; Sandonato R.; Chow J.; Starovoytov A.; Uchida N.; Meadows N.; Uxa A.; Asif N.; Tavares S.; Galiwango P.; Bozek B.; Kassam S.; Shier M.; Mukherjee A.; Larmand L.-A.; Ricci A.J.; Janmohamed A.; Hart B.; Lam A.; Marucci J.; Tai S.; Mehta S.; Brons S.; Beck C.; Wong G.; Etherington K.; Arumairajah T.; Udell J.; Aprile M.; Karlsson S.; Webber S.; Genereux P.; Mercure C.; Hameed A.; Aedy N.; Daba L.; Farquharson F.; Siddiqui A.; Lopes R.D.; Hueb W.; Takiuti M.E.; Rezende P.C.; Silva E.E.R.; Hueb A.C.; Smanio P.E.P.; Caetano L.P.; de Quadros A.S.; Kalil R.A.K.; Deiro A.P.; da Costa Vieira J.L.; Muller A.M.; Grossmann G.; de Moraes M.A.P.; de Oliveira P.P.; Ascoli B.M.; Bridi L.; Poletti S.Z.; Savaris S.; Vitola J.V.; Cerci R.J.; Zier S.S.; Farias F.R.; Veiga V.; Fernandes M.M.; Marin-Neto J.A.; Schmidt A.; de Oliveira Lima Filho M.; da Cunha D.F.; Oliveira R.M.; Chierice J.R.A.; Polanczyk C.A.; Rucatti G.G.; Furtado M.V.; Igansi F.; Smidt L.F.; Haeffner M.P.; Carvalho A.C.; Almeida V.; Pucci G.; de Souza G.S.; Lyra F.; Alves A.R.; Almeida M.; dos Santos V.; Dracoulakis M.D.A.; Oliveira N.S.; Lima R.G.S.D.; Figueiredo E.; Azevedo B.E.P.; Caramori P.R.; Santos M.B.; Germann A.; Gomes V.; Homem R.; Magedanz E.; Tumelero R.; Laimer R.; Tognon A.; Dall'Orto F.; Mesquita C.T.; Santos R.P.; Colafranseschi A.S.; Oliveira A.C.; Carvalho L.A.; Palazzo I.C.; Sousa A.S.; da Silva E.E.R.; de Barros e Silva P.G.M.; Okada M.Y.; de Padua Silva Baptista L.; Batista A.P.; Rodrigues M.J.; Rabaca A.N.; de Resende M.V.C.; Saraiva J.F.; Trama L.M.; de Souza Ormundo C.T.; Vicente C.; Costantini C.; Pinheiro C.; Komar D.; Ruzyllo W.; Demkow M.; Pracon R.; Kepka C.; Teresinska A.; Walesiak O.; Kryczka K.; Malinowska K.; Henzel J.; Solecki M.; Kaczmarska E.; Mazurek T.; Maksym J.; Wojtera K.; Fojt A.; Szczerba E.; Drozdz J.; Czarniak B.; Frach M.; Szymczyk K.; Niedzwiecka I.; Sobczak S.; Ciurus T.; Jakubowski P.; Misztal-Teodorczyk M.; Teodorczyk D.; Swiderek M.; Fratczak A.; Wojtala E.; Szkopiak M.; Lebioda P.; Wlodarczyk M.; Plachcinska A.; Kusmierek J.; Miller M.; Marciniak H.; Wojtczak-Soska K.; Luczak K.; Tarchalski T.; Cichocka-Radwan A.; Szwed H.; Karwowski J.; Szulczyk G.A.; Witkowski A.; Kukula K.; Celinska-Spodar M.; Zalewska J.; Gajos G.; Bury K.; Pruszczyk P.; Labyk A.; Roik M.; Szramowska A.; Zdonczyk O.; Loboz-Grudzien K.; Jaroch J.; Sokalski L.; Brzezinska B.; Lesiak M.; Lanocha M.; Reczuch K.W.; Kolodziej A.; Kalarus Z.; Swiatkowski A.; Szulik M.; Musial W.J.; Marcinkiewicz-Siemion M.; Bockeria O.; Bockeria L.; Petrosyan K.; Kudzoeva Z.; Trifonova T.; Aripova N.; Chernyavskiy A.M.; Naryshkin I.A.; Kretov E.I.; Kuleshova A.; Grazhdankin I.O.; Malaev D.; Bershtein L.L.; Sayganov S.A.; Subbotina I.; Kuzmina-Krutetskaya A.M.; Gumerova V.; Zbyshevskaya E.V.; Katamadze N.O.; Demchenko E.A.; Nikolaeva O.B.; Kozlov P.S.; Kozulin V.Y.; Lubinskaya E.I.; Lopez-Sendon J.L.; Castro A.; Lopez-Sendon J.; Fernandez-Figares V.; Salicio E.R.; Guzman G.; Galeote G.; Valbuena S.; Peteiro J.; Martinez-Ruiz M.D.; Perez-Fernandez R.; Blanco-Calvo M.; Cuenca-Castillo J.J.; Alonso-Alvarez E.; Flores-Rios X.; Garcia-Gonzalez P.; Prada-Delgado O.; Barge-Caballero G.; Juanatey J.R.G.; Amigo J.S.; Bayarri M.S.; Nunez V.P.; Sanchez R.O.; Alvarez B.C.; Gil C.P.; Monzonis A.M.; Sionis A.; Martinez A.F.; Perales M.V.; Padro J.M.; Penaranda A.S.; Picart J.G.; Iglesias A.G.; Marimon X.G.-M.; Llado G.P.; Costa F.C.; Miro V.; Igual B.; Diez J.L.; Calvillo P.; Ortuno F.M.; Chavarri M.V.; Giner M.Q.; Montolliu A.T.; Aniorte A.I.R.; Bermudez E.P.; Caravaca J.M.R.; De La Morena G.; Blancas M.G.; Canavate O.; Guerrero S.; Riera S.; Luena J.E.C.; Lasala M.; Fernandez-Aviles F.; Lorenzo M.; Sobrino O.; Vazquez A.; Jiang L.; Chen J.; Dong H.; He P.; Xia C.; Yang J.; Zhong Q.; Wu Y.; Tian Y.; Li D.; Ma Y.; Yang Y.; Ma X.; Yu Z.; Zhao Q.; Ji Z.; Li C.; Zhu B.; Yang X.; Chen M.; Chi H.; Zhang J.; Lin W.; Jing R.; Liu J.; Zeng H.; Zhou Q.; Xu C.; Li Z.; Xiong L.; Fu X.; Gao D.; Jiang D.; Leng R.; Yuan Q.; Zhang L.; Bai Z.; Li J.; Qi J.; Wang F.; Wang H.; Yang B.; Yue Z.; Zhang Z.; Wang S.; Dong Y.; Mao J.; Zhang B.; Cheng G.; Li X.; Yao X.; Zhong N.; Zhou N.; Huang Y.; Zhou P.; Fang X.; Su W.; Zeng Q.; Kunwu Y.; Peng Y.; Su X.; Wang C.; Zhao Y.; Li Q.; Geng Y.; Wang Y.; Nie S.-P.; Fan J.-Y.; Feng S.-T.; Wang X.; Yan Y.; Zhang H.-M.; Yu Q.; Chi L.; Liu F.; Chen H.; Jiang J.; Li H.; Wang J.; Han Y.; Xu L.; Zhang S.; Liu Z.; Chen G.; Hu R.; Perna G.P.; Pietrucci F.; Marini M.; Gabrielli G.; Provasoli S.; Di Donato A.; Verna E.; Monti L.; Nardi B.; Di Chiara A.; Pezzetta F.; Mortara A.; Casali V.; Galvani M.; Attanasio C.; Ottani F.; Sicuro M.; Leone G.; Pisano F.; Bare C.; Calabro P.; Fimiani F.; Formisano T.; Tarantini G.; Barioli A.; Cucchini U.; Ramani F.; Andres A.L.; Racca E.; Rolfo F.; Goletto C.; Briguori C.; De Micco F.; Amati R.; Di Marco S.; Vergoni W.; Tricoli M.; Russo A.; Villella M.; Fanelli R.; Poh K.-K.; Chai P.; Lau T.; Loh J.P.; Tay E.L.; Teoh K.; Tan S.-Y.V.; Teo L.L.; Sia W.C.; Ong C.-C.; Leong A.W.; Wong R.C.; Loh P.-H.; Kofidis T.; Chan W.X.; Chan K.H.; Foo D.; Yan L.H.; Kong J.L.K.; Er C.M.; Jafary F.-H.H.; Chua T.; Ismail N.; Kyaw M.T.; Yip D.; Doerr R.; Stumpf J.; Grahl D.; Matschke K.; Guenther F.; Simonis G.; Bonin K.; Kadalie C.T.; Sechtem U.; Wenzelburger I.; Ong P.; Gruensfelder S.; Schulze P.C.; Goebel B.; Lenk K.; Nickenig G.; Sinning J.-M.; Weber M.; Werner N.; Schuchlenz H.; Steinmaurer G.; Weikl S.; Lang I.M.; Winter M.-P.; Andric T.; Huber K.; Maximilian T.; Gabriele J.-K.; Claudia W.; Bernhard J.; Florian E.; Keltai M.; Vertes A.; Sebo J.; Davidovits Z.; Matics L.; Varga A.; Agoston G.; Fontos G.; Dekany G.; Merkely B.; Bartykowszki A.; Maurovich-Horvat P.; Kerecsen G.; Jakal A.; Hinic S.; Djokic J.; Zdravkovic M.; Mudrenovic V.; Crnokrak B.; Beleslin B.D.; Boskovic N.N.; Djordjevic-Dikic A.D.; Petrovic M.T.; Giga V.L.; Dobric M.R.; Stepanovic J.J.; Markovic Z.Z.; Mladenovic A.S.; Cemerlic-Adjic N.; Velicki L.; Pupic L.; Davidovic G.; Simovic S.M.; Vucic R.; Dekleva M.N.; Martinovic M.S.; Stevanovic G.; Stankovic G.; Dobric M.; Apostolovic S.; Martinovic S.S.; Stanojevic D.; Escobedo J.; de Jesus-Perez R.; Juarez B.; Baleon-Espinosa R.; Campos-Santaolalla A.S.; Duran-Cortes E.; Flores-Palacios J.M.; Garcia-Rincon A.; Jimenez-Santos M.; Penafiel J.V.; Ortega-Ramirez J.A.; Valdespino-Estrada A.; Rosas E.A.; Brassetti M.F.C.; Anaya D.A.V.; Garcia M.P.; Juarez I.E.C.; Rovalo M.M.; Rodriguez E.D.M.; Selvanayagam J.B.; Rankin J.; Murphy D.; Lee S.; Joseph M.X.; Thomas P.; Thambar S.T.; Chaplin M.D.; Boer S.C.; Beltrame J.F.; Stansborough J.K.; Black M.; Hillis G.S.; Bonner M.M.; Ireland K.F.; Venn-Edmonds C.; Steg P.-G.; Thobois C.; Thuaire C.; Tachot E.; Dutoiu T.; Laure C.; Vassaliere C.; Steg P.G.; Abergel H.; Juliard J.-M.; Fuentes A.; Slama M.S.; Eliahou L.; Mahmoud R.E.; Dubourg O.; Michaud P.; Nicollet E.; Hadjih S.; Goube P.; Brito P.; Barone-Rochette G.; Furber A.; Cornet C.; Biere L.; Rautureau J.; Juceviciene A.; Kalibataite-Rutkauskiene I.; Keinaite L.; Laucevicius A.; Laukyte M.; Celutkiene J.; Mikolaitiene G.; Smigelskaite A.; Tamasauskiene I.; Urboniene A.; Kedhi E.; Timmer J.; Bouwhuis I.; Hermanides R.; Nijmeijer L.; Kaplan E.; Riezebos R.K.; Samadi P.; Schoep J.J.M.; van Dongen E.; Janzen E.M.; Niehe S.R.; Suryapranata H.; Ahoud S.; van Vugt S.; Ramos R.; Cacela D.; Santana A.; Fiarresga A.; Sousa L.; Marques H.; Patricio L.; Selas M.; Bernanrdes L.; Silva F.; Rio P.; Freixo C.; Carvalho R.; Ferreira R.; Silva T.; Rodrigues I.; Modas P.; Portugal G.; Fragata J.; Pinto F.J.; Cabrita I.Z.; Menezes M.N.; Rocha A.; Lopes G.C.; Figueiras F.P.; Almeida A.G.; Coelho A.; Silva P.C.; Capinha M.; Nobre A.; Caetano M.I.; Francisco A.R.; Silva S.; Ferreira N.; Lopes R.L.; Diaz R.; Guzman L.; Tinnirello V.; Figal J.C.; Mungo M.N.; Mendiz O.; Cortes C.; Favaloro R.R.; Alvarez C.; Garcia M.; Courtis J.; Godoy V.; Zeballos G.; Schiavi L.; Actis M.V.; Rubio M.; Scaro G.; Devlin G.P.; Low L.; Fisher R.; Scales J.; Abercrombie K.; Stewart R.A.H.; Howell L.; Patten C.; Benatar J.; Kedev S.; Mitevska I.P.; Kostovska E.S.; Pejkov H.; Held C.; Eggers K.; Frostfelt G.; Bjorklund C.; Johnston N.; Andreasson M.; Olsowka M.; Essermark M.; Akerblom A.; Soveri I.; Aspberg J.; Persson L.; Beyar R.; Nikolsky E.; Sharir T.; Harel O.; Elian D.; Kerner A.; Bentzvi M.; Massalha S.; Helmer L.; Fukuda K.; Ueda I.; Kohsaka S.; Fujita J.; Yasuda S.; Furukawa A.; Nagai T.; Otsuka F.; Nishimura S.; Nakano S.; Goetschalckx K.; Robesyn V.; Van de Werf F.; Claes K.; Hung C.-L.; Yang Y.-H.; Yun C.-H.; Hou C.J.-Y.; Kuo J.-Y.; Yeh H.-I.; Hung T.-C.; Li J.-Y.; Chien C.-Y.; Tsai C.-T.; Liu C.-C.; Yu F.-C.; Lin Y.-H.; Lan W.-R.; Yen C.-H.; Tsai J.-P.; Sung K.-T.; Ntsekhe M.; Pandie S.; Philander C.; Viljoen C.A.; Mtana N.; De Andrade M.; Maggioni A.P.; Moccetti T.; Anesini A.; Rossi M.G.; Maspoli S.; Mombelli M.; Abdelhamid M.; Talaat A.; Adel A.; Kamal A.; Mahrous H.; El Kaffas S.; El Fishawy H.; Pop C.; Claudia M.; Popescu B.A.; Ginghina C.; Rosca M.; Deleanu D.; Beladan C.C.; Iliescu V.A.; Al-Mallah M.H.; Zahrani S.; Aljzeeri A.; Najm H.; Alghamdi A.; Ramos W.E.M.; Davila M.A.M.; Kuanprasert S.; Prommintikul A.; Nawarawong W.; Khwakhong S.; Woragidpoonpol S.; Chaiyasri A.; Tepsuwan T.; Mekara W.; Taksaudom N.; Kulthawong S.; Rimsukcharoenchai C.; Amaritakomol A.; Euathrongchit J.; Wannasopha Y.; Yamwong S.; Panpunuan P.; Sritara P.; Aramcharoen S.; Meemuk K.; White H.D.; Alsweiler C.; Khairuddin A.; Mokhtar N.S.; Hadi H.A.; Basri N.A.; Yahaya S.A.; Yusnida I.; Hashim H.; Bugiardini R. Institution (Pracon, Ruzyllo) National Institute of Cardiology, Warsaw, Poland (Spertus) Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Durham, NC, United States (Broderick, Rockhold) Duke Clinical Research Institute, Durham, NC, United States (Bangalore, Newman, Reynolds, Hochman) Cardiovascular Clinical Research Center, New York University Grossman School of Medicine, Durham, NC, United States (Rockhold) Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, United States (Demchenko) Almazov National Medical Research Centre, Saint Petersburg, Russian Federation (Nageh) Southend University Hospital, United Kingdom (Grossman) Moinhos de Vento Hospital, Porto Alegre, Brazil (Grossman) Cardionuclear Clinic, Porto Alegre, Brazil (Mavromatis) Emory University, Atlanta VA Healthcare System, GA, United States (Manjunath) Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India (Smanio) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil (Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United States (Mancini) Center for Cardiovascular Innovation, The University of British Columbia, Vancouver, Canada (Boden) VA New England Healthcare System, Boston University School of Medicine, MA, United States (Maron) Department of Medicine, Stanford University, CA, United States (Boden, Mavromatis, Doan) Atlanta VA Medical Center, Decatur, GA, United States (Linefsky, Lee, Patel, Miller, Cho) Mayo Clinic, Rochester, MN, United States (Milbrandt, Shelstad, Banerjee, Kamath) V.A. North Texas Health Care System, Dallas, TX, United States (Tejani) NYU Langone Medical Center-Bellevue Hospital, New York, NY, United States (Reynolds, Newman, Bangalore, Donnino, Phillips, Saric, Abdul-Nour, Schley) Henry Ford Health System, Detroit, MI, United States (Golden, Stone, Osseni) Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States (Wiyarand, Douglass, Pomeroy, Craft, Harvey, Jang, Anaya) Kaiser Permanente San Jose, San Jose, CA, United States (Yee, Goold, Weitz, Giovannone) Cardiology Associates of Schenectady P.C., Schenectady, NY, United States (Pritchard, Arnold, Gans) Saint Luke's Hospital, Kansas City, MO, United States (O'Keefe, Kennedy, Shapiro, Ganesan) Oregon Health & Science University, Portland, OR, United States (Schlichting, Naher) Albany Medical Center Hospital, Albany, NY, United States (Fein, Stewart, Torosoff, Salmi, Lyubarova, Mookherjee, Drzymalski, McFalls) Minneapolis VAMC, Minneapolis, MN, United States (Garcia, Bertog, Johnson, Siddiqui, Herrmann, Ishani, Hansen, Khouri, Arges) Duke University Medical Center, Durham, NC, United States (LeFevre, Tomfohr, Goldberg, Byrne) Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, United States (Zappernick, Goldweit, Canada) Englewood Hospital and Medical Center, Englewood, NJ, United States (Kakade) NYU-HHC Woodhull Hospital, Brooklyn, NY, United States (Mieses, Cohen, Mirrer, Navarro, Rantinella, Rodriguez, Mancilla, Winchester, Stinson) Malcom Randall VAMC, Gainesville, FL, United States (Kronenberg, Weyand) Vanderbilt University Medical Center, Nashville, TN, United States (Rogal, Crook, McFarren, Heitner, Ho) New York -Presbyterian/Brooklyn Methodist Hospital, Brooklyn, NY, United States (Khan, Mohamed, Dauber, Soltau) South Denver Cardiology Associates, P.C., Littleton, CO, United States (Rose, Wimmer, Siegel, Derbyshire, Cannan, Dixon) Providence Heart and Vascular Institute, Portland, OR, United States (Leonard, Sudarshan, Heard) Wichita Falls Heart Clinic, Wichita Falls, TX, United States (Gabriel, Desire, Mehta) Emory University, Atlanta, GA, United States (McDaniel, Rashid, Lerakis, Asier, Quyyumi, Patel, Wenger, Hedgepeth, Gillis) Kent Hospital, Warwick, RI, United States (Hurlburt, Manocchia, Rosen, Moore, Congdon, Sahul, Brandt) Michigan Heart, PC, Ypsilanti, MI, United States (Marchelletta, Wippler, Booth, Taul) University of Kentucky, Lexington, KY, United States (Leung, Isaacs, Abdel-Latif, Bulkley, Reda, Rodgers, Ziada, Setty, Halverson) Gundersen Lutheran Medical Center, La Crosse, WI, United States (Roraff, Thorsen, Barua, Ojajuni) Kansas City VA Medical Center, Kansas City, MO, United States (Olurinde, Surineni, Hage, Valaiyapathi) UAB Vascular Biology and Hypertension Program, Birmingham, AL, United States (Caldeira, Davies, Leesar, Heo, Iskandrian, Al Solaiman, Singh, Dajani, Kartje) Loyola University Medical Center, Maywood, IL, United States (El-Hajjar) Samuel Stratton VA Medical Center of Albany NY, Albany, NY, United States (Mesropian, Sacco, Rawlins, McCandless, Thomson, Orgera, Sidhu, Rogge) Cincinnati VA Medical Center, Cincinnati, OH, United States (Arif, Bunke, Kerr, Unterbrink, Fannon, Burman, Trejo, Dubin) Mayo Clinic Florida, Jacksonville, FL, United States (Fletcher, Lane, Neeson, Parikh, Pollak, Shapiro, Landolfo, Gemignani, Beaudry) VAMC-White River Junction, White River Junction, VT, United States (O'Rourke, Meadows, Tirado) VA Connecticut Healthcare System, West Haven, CT, United States (Halliday, Julian, Call, Lane) Winchester Cardiology and Vascular Medicine, PC, Winchester, VA, United States (Stanford, Hannan) Saint Vincent Hospital, Worcester Medical Center, Worcester, MA, United States (Bojar, Arsenault, Kumar, Sigel, Mukai, Martin, Brooks) Oklahoma Heart Institute, Tulsa, OK, United States (Vorobiof, Douangvila) Ronald Reagan UCLA Medical Center, Los Angeles, CA, United States (Gevorgyan, Moor-Man, Ranjbaran) University of Washington Medical Center, Seattle, WA, United States (Smith, Ohmart, Kinlay) VA Boston Healthcare System, West Roxbury, MA, United States (Hamburger, Rocco, Ly, Bhatt, Quinn, Croce, Temiyasathit, Quin, Do, Anumpa, Tobin, Zenati, Faxon, Rayos, Langdon) Daytona Heart Group, Daytona Beach, FL, United States (Bayer, Seedhom, O'Malley) Capital Cardiology Associates, Albany, NY, United States (Sullenberger, Orvis, Kumkumian, Murphy) NIH Heart Center, Suburban Hospital, Bethesda, MD, United States (Greenberg, Iraola, Sedlis, Maranan) VA New York Harbor Health Care System, New York, NY, United States (Donnino, Lorin, Tamis-Holland, Malinay) Mount Sinai Saint Luke's Hospital, Ridgewood, NJ, United States (Kornberg, Leber, Saba, Edillo) Providence - Providence Park Hospital, Southfield, MI, United States (Lee, Small, Nona, Alexander, Rehman, Badami, Ostrander) Covenant Medical Center, Inc., Saginaw, MI, United States (Wasmiller, Marzo, Drewes) NYU Winthrop, Mineola, NY, United States (Patel, Robbins) AtlantiCare Regional Medical Center, Pomona, NJ, United States (Levite, White, Shetty, Hallam, Patel, Hamroff, Spooner) NYP Medical Medical Group Hudson Valley Cardiology, Cortlandt Manor, NY, United States (Hollenweger, Little, Little) Houston Heart & Vascular Associates, Houston, TX, United States (Zimbelman, Little, Lui, Eskelson) Salt Lake City VA Medical Center, Salt Lake City, UT, United States (Smith, Vezina, Khor, Abraham, Bull, McKellar, Booth, Taul) Lexington VA Medical Center, Lexington, KY, United States (Kotter, Rodgers, Abdel-Latif, Isaacs, Bulkley, Hu, Kaneshiro) Palo Alto Medical Foundation Research Institute, Palo Alto, CA, United States (Labovitz) University of South Florida, Tampa, FL, United States (Berlowitz, Kirby, Rogal, Tran, McFarren, Jahrsdorfer, Matar, Caldeira, Maron) Stanford University School of Medicine, Stanford, CA, United States (Rodriguez, Yunis, Schnittger, Patro, Fearon, Deedwania, Vega) UCSF - Fresno Community Regional Medical Center, Fresno, CA, United States (Reddy, Sweeny, Bloise-Adames) Icahn School of Medicine at Mount Sinai, New York, NY, United States (Jimenez, Vrestil, Bhandari, Spizzieri, Schade) Holy Spirit Hospital Cardiovascular Institute, Camp Hill, PA, United States (Yost, Hochberg, Beardsley) Boston Medical Center, Boston, MA, United States (Fine, Salerno, Tancredi) Hackensack University Medical Center, Saddle Brook, NJ, United States (Arakelian, Mathus, O'Neill, Wyman, Burkhardt) Torrance Memorial Medical Center, Torrance, CA, United States (Hosino, Lubyanaya) Coastal Heart Medical Group, Santa Ana, CA, United States (Salas, Zarka, Aguirre, Shah, Dhawan, Parra, Tran, Haldis, Weick) Sanford Health, Fargo, ND, United States (Fowler-Lehman, Spitzer, Riedberger, Weick, Kohn) NYU New York Medical Associates, New York, NY, United States (Cobos, Quiles, Girotra, Drum) University of Iowa Hospitals and Clinics, Iowa City, IA, United States (Miller-Cox, Ollinger, Almousalli, Capasso-Gulve) Advanced Heart Care Group, Fairview Heights, IL, United States (Loehr, Mosley, Krishnam, Heydari) University of California Irvine Medical Center, Orange, CA, United States (Mil-Liken, Lundeen, Patel, Karanjah, Seto, Marfori, Harley, Hernandez-Rangel, Gibson, Singh, Allen, Coram, Webb) University of Louisville, Louisville, KY, United States (Fridell, Wilson, Thomas, Kim) University of Rochester, Rochester, NY, United States (Schwartz, Wilmot, Chen, El Shahawy, Stevens) Cardiovascular Center of Sarasota, Sarasota, FL, United States (Stafford, Black) University of Maryland Medical Center, Baltimore, MD, United States (Abernethy, Hull) Asheville Cardiology Associates, Asheville, NC, United States (Lim, Tucker, Putnam, Hall, Cauthren, Tucker, Zurick, Horton) Saint Thomas Hospital, Nashville, TN, United States (Orga, Meyer, White) Stroobants Cardiovascular Center, Lynchburg, VA, United States (Morford, Baumann, Rutkin, Seeratan) Northwell Health - Manhasset, Manhasset, NY, United States (Bokhari, Jimenez) Columbia University Medical Center, New York, NY, United States (Sokol, Schultz) Jacobi Medical Center, Bronx, NY, United States (Meisner, Russo, Hamzeh) Baylor College of Medicine, Houston, TX, United States (Misra, Huda, Wall, Boan, De Rosen, Alam, Turner, Hinton) Cardiovascular Specialists of Southwest Louisiana, Lake Charles, LA, United States (Mulhearn, Good, Archer) Ohio Health Grant Medical Center, Columbus, OH, United States (Dionne, Allardyce, Sikora, Czerniak, Mull, Ferguson, Laube, Shammas, Shammas) Midwest Cardiovascular Research Foundation, Davenport, IA, United States (Christensen, Park, Chilton, Hecht) Audie Murphy V.A., San Antonio, TX, United States (Nguyen, Vo) VA Palo Alto Healthcare System, Palo Alto, CA, United States (Hirsch, Jezior, Bindeman) Walter Reed National Military Medical Center, Bethesda, MD, United States (Salkind, Espinosa) Miriam Hospital, Providence, RI, United States (Desimone, Gordon, Felix-Stern, Crain, Gomes, Gordon, Stenberg, Mann) Conemaugh Valley Memorial Hospital, Johnstown, PA, United States (McCreary, Pedalino, Cobos) NYU-HHC Kings County Hospital Center, Brooklyn, NY, United States (Dwyer, Espinosa, Quiles, Wiesel) New York University - Langone Cardiovascular Associates, Flushing, NY, United States (Juang, Gopaul) Coney Island Hospital, Brooklyn, NY, United States (Hultberg, Huk, Hussain, Al-Amoodi, Zambrano) Yuma Regional Medical Center, Yuma, AZ, United States (Rodriguez, Milner, Wohns, Mulder) Spectrum Health, Grand Rapids, MI, United States (Van Oosterhout, Lader, Meyer) Mid Valley Cardiology, Kingston, NY, United States (Mumma, Clapp) Sarasota Memorial Hospital, Sarasota, FL, United States (Barrentine, Dharmarajan, Jose) NYU-HHC Lincoln Medical and Mental Health Center, Bronx, NY, United States (Manchery, McGarvey, McKinney) Doylestown Health Cardiology, Doylestown, PA, United States (Schwarz, Downes, Kaczkowski) Medical Center of the Rockies, Loveland, CO, United States (Luckasen, Jaskowiak, Klitch, Cheong, Dees) Baylor St. Luke's Medical Center, Houston, TX, United States (Potluri, Vasquez) Baylor Research Institute, Legacy Heart Center, Plano, TX, United States (Mastouri) Indiana University, Krannert Institute of Cardiology, Indianapolis, IN, United States (Breall, Hannemann, Revtyak, Foltz, Bazeley, Li, DeRosa) HealthEast Saint Joseph's Hospital, St. Paul, MN, United States (Jorgenson, Riestenberg-Smith, Giedd) Beth Israel Medical Center, New York, NY, United States (Old, Bariciano) Cardiovascular Associates, Ltd., Chesapeake, VA, United States (Burt) Saint Luke's Hospital and Health Network, Bethlehem, PA, United States (Sokhon, Waldron) Medicus Alliance Clinical Research Org., Inc., Sugar land, TX, United States (Mayon, Gopal) The Heart Hospital Baylor, Plano, TX, United States (Valeti, Peichel) University of Minnesota, Minneapolis, MN, United States (Kobashigawa, Starks) Cedars Sinai Medical Center, Beverly Hills, CA, United States (Garcia, Thottam, Bhargava, Anand) Government Medical College, Calicut, India (Govindan, Raj, Nair, Ravindran, Rajalekshmi, Manjunath, Nataraj) Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India (Moorthy, Nayak, Manjunath, Mylarappa, Narayanappa, Pandit, Bajaj) Dr Ram Manohar Lohia Hospital, New Delhi, India (Nath, Yadav, Mishra, Dwivedi, Tewari) King George's Medical University, Department of Cardiology, Lucknow, India (Narain, Mishra, Chandra, Patel, Singh, Wander) Hero DMC Heart Institute, Dayanand Medical College and Hospital, Ludhiana, India (Tandon, Ralhan, Kaur, Aslam, Gupta, Pharmacy, Goyal, Bhargava, Suvarna) All India Institute of Medical Sciences, New Delhi, India (Karthikeyan, Ramakrishnan, Seth, Yadav, Singh, Roy, Parakh, Verma, Narang, Mishra, Naik, Sharma, Choudhary, Patel, Gulati, Sharma, Bahl, Mathew, Kurian) MOSC Medical College Hospital, Kolenchery, India (Punnoose, Gadkari, Karwa) KEM Hospital Pune, Pune, India (Gadage, Kolhe, Pillay, Satheesh, Vindhya) Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, India (Jain) Fortis Escort Heart Institute, New Delhi, India (Seth, Meharwal, Mathur, Verma, Kaul, Bhatia, Sachdeva, Devi, Jungla, Christopher, Rani) Gurunanak CARE Hospital, Hyderabad, India (Menon, Reddy, Kumar, Preethi, Oomman, Sidh) Apollo Research and Innovation, Chennai, India (Mao, Ramakrishnan, Solomon, Francis, Naik, Priya) Apollo Research & Innovations, Hyderabad, India (Khan, Christopher, Preethi) CARE Nampally, Hyderabad, India (Kumar, Grant, Hande) Ruby Hall Clinic, Grant Medical Foundation, Pune, India (Sonawane, Kachru, Dubey) Fortis Healthcare Fl.t Lt. Rajan Dhall Hospital, New Delhi, India (Rawat, Kumar) Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India (Ganapathi, Jayakumar, Vineeth, Sivadasanpillai, Chacko, Sasidharan, Babu, Kapilamoorthy, Christopher, Reddy) CARE Hospital, Hyderabad, India (Polamuri, Rani, Kaul, Arambam) Batra Hospital and Medical Research Centre (BHMRC), New Delhi, India (Singh, Senior, Fox, Young, Carruthers) Northwick Park Hospital Harrow, Royal Brompton Hospital London, Harrow, United Kingdom (Elghamaz, Gurunathan, Karogiannis, Young, Shah, Kinsey, Trimlett, Kavalakkat, Rubens, Evans, Nicol, Hassan, Mittal, Hampson, Gamma, Williams) Broomfield Hospital, Chelmsford, United Kingdom (Holland, Swan, de Belder, Atkinson) The James Cook University Hospital, Middlesbrough, Middlesbrough, United Kingdom (Thambyrajah, Nageh, Kunhunny) Southend University Hospital, Westcliffe on Sea, United Kingdom (Davies, Lindsay, Atkinson) Bradford Royal Infirmary, Bradford, United Kingdom (Kurian, Krannila, Jamil, Vinod, Raheem, Hoye, Chaytor) The University of Hull, Castle Hill Hospital, Cottingham, United Kingdom (Cox, Morrow, Rowe, Donnelly, Kelly) South Eastern Health and Social Care, Belfast, United Kingdom (Valecka, Regan, Turnbull, Chauhan, Fleming) Blackpool Teaching Hospitals, Blackpool, United Kingdom (Ghosh, Gratrix, Preston, Barr, Cartwright) Russells Hall Hospital, Dudley, United Kingdom (Alfakih, Knighton) King's College NHS Foundation Hospital, London, United Kingdom (Byrne, Martin, Webb, Henriksen, Flint) Royal Infirmary of Edinburgh, Edinburgh, United Kingdom (Harrison, OKane, Lake-Man) Royal Bournemouth Hospital, Bourneouth, United Kingdom (Ljubez, de Silva) Bedford Hospital NHS Trust, Bedford, United Kingdom (Conway, Wright) Pinderfields Hospital, Wakefield, United Kingdom (Exley, Sirker, Andiapen) University College London Hospitals NHS Foundation Trust, London, United Kingdom (Richards) BartsHealth NHS Trust, United Kingdom (Hoole, Wong) Papworth Hospital, Cambridge, United Kingdom (Witherow, Munro) Dorset County Hospital, Dorchester, United Kingdom (Johnston, Bao) Belfast Trust, Belfast, United Kingdom (Harbinson, Bao, McEvoy, Walsh, Bao, Brown, Douglas, Luckie, Charles) Central Manchester University Hospital, Manchester, United Kingdom (Kolakaluri, Phillips, Sobolewska, Morby) The Pennine Acute Hospitals NHS Trust, Oldham, United Kingdom (Hallett, Corbett, Winstanley, Jeetley, Smit) Royal Free London NHS Foundation Trust, London, United Kingdom (Patel, Kotecha, Travill, Gent) Luton and Dunstable University Hospital NHS FT, Luton, United Kingdom (Karimullah, Hussain, Al-Bustami, Braganza, Haines) Peterborough City Hospital, Peterborough, United Kingdom (Taaffe, Henderson, Burton) Nottingham University Hospitals, Nottingham, United Kingdom (Pointon, Colton, Naik, King, Mathew, Brown) University of Glasgow, Clydebank, United Kingdom (Docherty, Berry, McCloy, Collison, Robb, Roditi, Paterson, Crawford, Kelly, McGregor, Moriarty, Mackin) Cardiovascular Research Unit, Craigavon Area Hospital, Craigavon, United Kingdom (Glover, Knight) Hampshire Hospitals NHS Foundation Trust, Basingstoke, United Kingdom (Pradhan, Mikhail, Bose) Imperial College Healthcare NHS Trust, London, United Kingdom (Francis, Dzavik, Goodman, Gosselin, Proietti) Montreal Heart Institute, Montreal, QC, Canada (Brousseau, Corfias, Blaise, Harvey, Diaz) Centre Hospitalier de Regional Trois-Rivieres, Trois-Rivieres, QC, Canada (Rheault, Barrero, Gagne, Alarie, Pepin-Dubois, Arcand, Costa, Roy, Sia, Montpetit, Lemay, Gisbert, Gervais, Rheault, Drouin) CISSSL - Hopital Pierre-Le Gardeur, Terrebonne, QC, Canada (Phaneuf, Bergeron, Gosselin, Shelley, Masson, Garg, Carr) London Health Sciences Centre, London, ON, Canada (Bone, Chow, Moga) University of Ottawa Heart Institute, Ottawa, ON, Canada (Hessian, Kourzenkova, Beanlands, Walter, Davies, Bainey, Hogg) University of Alberta, Edmonton, AB, Canada (Welsh, Cheema) St. Michael's Hospital, Toronto, ON, Canada (Bagai, Wald, Goodman, Kushniriuk, Graham, Hussain, Peterson, Bello, Chow, Abramson, Cheema, Syed) Dixie Medical Group, Mississauga, ON, Canada (Vakani, Hussain, Kushniriuk, Cha, Otis) Dr James Cha, Oshawa, ON, Canada (Otis, Howarth, Seib) University of Calgary, Calgary, AB, Canada (Rivest, Sandonato, Wong, Chow) Vancouver General Hospital, Vancouver, BC, Canada (Starovoytov, Uchida, Meadows, Uxa, Asif) University Health Network, Toronto, ON, Canada (Tavares, Galiwango, Bozek) Scarborough Cardiology Research, Scarborough, ON, Canada (Kassam, Shier, Mukherjee, Larmand, Ricci, Janmohamed, Hart, Lam, Marucci) West Lincoln Memorial Hospital East Grimsby, ON, Canada (Tai, Mehta, Brons) Hamilton General Hospital, Hamilton, ON, Canada (Beck, Wong, Etherington, Arumairajah, Udell, Aprile) Women's College Hospital, Toronto, ON, Canada (Karlsson, Webber, Genereux, Mercure) Centre Integre Universitaire de Sante et de Services Sociaux du Montreal, Montreal, QC, Canada (Hameed, Aedy) Saint Catharines General Hospital, Catharines, ON, Canada (Daba, Farquharson) Northwest GTA Cardiovascular and Heart Rhythm Program, Vaughan, ON, Canada (Siddiqui, Carvalho, Lopes, Hueb, Takiuti) Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (Rezende, Silva, Hueb, Smanio, Caetano) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil (de Quadros) Instituto de Cardiologia de Porto Alegre, Porto Alegre, Brazil (Kalil, Deiro, da Costa Vieira, Muller, Grossmann, de Moraes, de Oliveira, Ascoli, Bridi, Poletti, Savaris, Vitola) Quanta Diagnostico & Terapia, Curitiba, Brazil (Cerci, Zier, Farias, Veiga, Fernandes, Marin-Neto) Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, Ribeirao Preto, Brazil (Schmidt, de Oliveira Lima Filho, da Cunha, Oliveira, Chierice, Polanczyk, Rucatti) Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil (Furtado, Igansi, Smidt, Haeffner, Carvalho, Almeida) Unifesp - Hospital Sao Paulo, Sao Paulo, Brazil (Pucci, de Souza, Lyra, Alves, Almeida) Fundacao Bahiana de Cardilogia, Salvador, Brazil (dos Santos, Dracoulakis, Oliveira) Hospital da Bahia, Salvador, Brazil (Lima, Figueiredo, Azevedo) Hospital Lifecenter, Belo Horizonte, Brazil (Caramori, Santos) Hospital Sao Lucas da Pontificia Universidade Catolica do Rio Grande do Sol, Porto Alegre, Brazil (Germann, Gomes, Homem, Magedanz, Tumelero, Laimer) Hospital Sao Vicente de Paulo Fundo, Brazil (Tognon, Dall'Orto) Hospital Maternidade e Pronto Socorro Santa Lucia, Pocos de Caldas, Brazil (Mesquita, Santos) Hospital Pro-Cardiaco Botafogo, Brazil (Colafranseschi, Oliveira, Carvalho, Palazzo, Sousa, da Silva) Hospital TotalCor, Sao Paulo, Brazil (de Barros e Silva, Okada, de Padua Silva Baptista, Batista, Rodrigues, Rabaca, de Resende, Saraiva, Trama) Hospital Celso Pierro, Sao Paulo, Brazil (Silva, de Souza Ormundo, Vicente, Costantini, Pinheiro, Pracon) Hospital Cardiologico Costantini, Curitiba, Brazil (Komar, Ruzyllo, Szwed, Demkow, Pracon) Coronary and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland (Kepka, Teresinska, Walesiak, Kryczka, Malinowska, Henzel, Solecki, Kaczmarska, Mazurek, Maksym) Medical University of Warsaw, Warszawa, Poland (Wojtera, Fojt, Szczerba, Drozdz) Cardiology Clinic, Medical University in Lodz, Lodz, Poland (Czarniak, Frach, Szymczyk, Niedzwiecka, Sobczak, Ciurus, Jakubowski, Misztal-Teodorczyk, Teodorczyk, Swiderek, Fratczak, Wojtala, Szkopiak, Lebioda, Wlodarczyk, Plachcinska, Kusmierek, Miller, Marciniak, Wojtczak-Soska, Luczak, Tarchalski, Cichocka-Radwan, Szwed, Karwowski) National Institute of Cardiology, Warsaw, Warsaw, Poland (Szulczyk, Witkowski) Department of Interventional Cardiology & Angiology, Institute of Cardiology, Warsaw, Poland (Kukula, Celinska-Spodar, Zalewska, Gajos) Department of Coronary Disease, John Paul II Hospital, Jagiellonian University Medical College, Krakow, Poland (Bury, Pruszczyk, Labyk) Department of Internal Medicine and Cardiology, Infant Jesus Teaching Hospital, Medical University of Warsaw, Warszawa, Poland (Roik, Szramowska, Zdonczyk, Loboz-Grudzien, Jaroch) T.Marciniak Hospital, Wroclaw, Poland (Sokalski, Brzezinska, Lesiak) Szpital Kliniczny Przemienienia Panskiego, Poznan, Poland (Lanocha, Reczuch, Kolodziej) Military Hospital, Medical University, Wroclaw, Poland (Kalarus) Medical University of Silesia, School of Medicine, The Division of Dentistry, Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, Zabrze, Poland (Swiatkowski, Szulik, Musial, Marcinkiewicz-Siemion) University Hospital in Bialystok, Bialystok, Poland (Bockeria, Bockeria) National Medical Research Center for Cardiovascuar Surgery, Moscow, Russian Federation (Petrosyan, Kudzoeva, Trifonova, Aripova, Chernyavskiy, Naryshkin) E.Meshalkin National Medical Research Center, The Ministry of Health of the Russian Federation, Novosibirsk, Russian Federation (Kretov, Kuleshova, Grazhdankin, Malaev, Bershtein) North-Western State Medical University, Saint Petersburg, Russian Federation (Sayganov, Subbotina, Kuzmina-Krutetskaya, Gumerova, Zbyshevskaya, Katamadze, Demchenko, Nikolaeva) Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russian Federation (Kozlov, Kozulin, Lubinskaya, Lopez-Sendon, Castro, Lopez-Sendon, Fernandez-Figares) Hospital La Paz. IdiPaz, Madrid, Spain (Castro, Salicio, Guzman, Galeote, Valbuena, Peteiro) Complexo Hospitalario Universitario A Coruna (CHUAC) Sergas, Department of Cardiology, INIBIC A Coruna. CIBER-CV., Universidad de A Coruna, A Coruna, Spain (Martinez-Ruiz, Perez-Fernandez, Blanco-Calvo, Cuenca-Castillo, Alonso-Alvarez, Flores-Rios, Garcia-Gonzalez, Prada-Delgado, Barge-Caballero, Juanatey, Amigo) Hospital Clinico Universitario de Santiago, Santiago de Compostela, Spain (Bayarri, Nunez, Sanchez, Alvarez, Gil, Monzonis, Sionis, Martinez) Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (Perales, Padro, Penaranda, Picart, Iglesias, Marimon, Llado, Costa, Miro, Igual) Hospital Universitario y Politecnico La Fe, Valencia, Spain (Diez, Calvillo, Ortuno) HUVA, Hospital Clinico Universitario Virgen De La Arrixaca, Murcia, Spain (Chavarri, Giner, Montolliu, Aniorte, Bermudez, Caravaca, De La Morena, Blancas, Canavate) Hospital De Bellvitge, Barcelona, Spain (Guerrero, Riera, Luena, Luena) Hospital Universitario Miguel Servet, Zaragoza, Spain (Lasala, Fernandez-Aviles, Lorenzo) Hospital General Universitario Gregorio Maranon, Madrid, Spain (Sobrino, Vazquez, Jiang, Chen, Dong) Guangdong General Hospital, Guangzhou, China (He, Xia, Yang, Zhong, Wu, Tian) Chinese Academy of Medical Sciences, Fuwai Hospital, Beijing, China (Li) First Affiliated Hospital of Xinjiang Medical University, Urumqi, China (Ma, Li, Yang, Ma, Yu, Zhao, Ji, Li) Tangshan Gongren Hospital, Tangshan, China (Zhang, Zhao, Zhu, Yang, Chen) Beijing Chao-yang Hospital, Capital Medical University, Beijing, China (Chi, Wang, Zhang, Lin, Jing) TEDA International Cardiovascular Hospital, Tianjing, China (Liu, Zeng, Zhou) Tongji Medical College, Wuhan, China (Xu, Li, Li, Xiong, Fu, Gao) The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (Jiang, Leng, Wang, Yuan, Zhang, Yang, Bai) Shanxi Cardiovascular Hospital, Taiyuan, China (Li, Qi, Wang, Wang, Yang, Yue, Zhang, Wang, Dong) Qingdao Fuwai Hospital, Qingdao, China (Mao, Zhang, Cheng, Li) Shanxi Provincial People's Hospital, Xian, China (Yao, Zhong, Zhou, Zhao, Huang) The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China (Zhou, Fang, Su) Liangxiang Hospital, Beijing, Fangshan District, Beijing, China (Zeng, Kunwu) Wuhan Union Hospital, Tongji Medical College, Huazhong Science and Tech University, Wuhan, China (Peng, Su, Su, Wang) Wuhan Asia Heart Hospital, Wuhan, China (Zhao, Li, Geng) Affiliated Hospital of Jining Medical University, Jining, China (Wang, Nie, Fan) Beijing Anzhen Hospital, Beijing, China (Feng, Wang, Yan, Zhang, Yu, Chi) Affiliated Zhongshan Hospital of Dalian University, Dalian, China (Liu, Wang, Chen) The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China (Jiang, Li, Wang, Han) Peking Union Medical College Hospital, Beijing, China (Xu, Zhang, Liu, Liu, Chen, Hu, Maggioni, Perna, Pietrucci) Cardiology and CCU - Ospedali Riuniti Ancona, Ancona, Italy (Marini, Gabrielli, Provasoli, Di Donato) Ospedale di Circolo e Fondazione Macchi, Varese, Italy (Verna, Monti) Humanitas Research Hospital, Rozzano (MI), Rozzano, Italy (Nardi, Di Chiara, Pezzetta) Azienda Servizi Sanitaria n.3 Alto Friuli-Collinare-Medio Friuli, Tolmezzo, Italy (Mortara, Casali) Policlinico di Monza, Monza, MB, Monza, Italy (Galvani, Attanasio) Ospedale "G.B. Morgagni - L. Pierantoni" Forli (AUSL della Romagna), Forli, Italy (Ottani, Sicuro, Leone) Ospedale Regionale Umberto Parini, Aosta, Italy (Pisano, Bare, Calabro, Fimiani) AORN Dei Colli "V. Monaldi" UOC Cardiologia Universita della Campania "L.Vanvitelli", Napoli, Italy (Formisano, Tarantini, Barioli) University of Padua- Cardiology Clinic, Padua, Italy (Cucchini, Ramani, Andres, Racca, Rolfo) Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy (Goletto, Briguori, De Micco) Clinica Mediterranea, Naples, Italy (Amati, Di Marco) UO Cardiologia Ospedale SS Cosma e Damiano, Pescia, Italy (Vergoni, Tricoli, Russo, Villella) IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy (Fanelli, White, Alsweiler, Poh) National University Heart Center Singapore, Singapore, Singapore (Chai, Lau, Loh, Tay, Teoh, Tan, Teo, Sia, Ong, Leong, Wong, Loh, Kofidis, Chan, Chan, Foo, Yan) Tan Tock Seng Hospital, Singapore, Singapore (Kong, Er, Jafary, Chua, Ismail) National Heart Centre Singapore, Singapore, Singapore (Kyaw, Yip, Doerr) Praxisklinik Herz und Gefaesse, Dresden, Germany (Stumpf, Grahl, Matschke, Guenther, Simonis, Bonin, Kadalie, Sechtem, Wenzelburger) Robert-Bosch-Krankenhaus, Stuttgart, Germany (Ong, Gruensfelder, Schulze) University Hospital Jena, Jena, Germany (Goebel, Lenk, Nickenig, Sinning) Universitatsklinikum Bonn, Bonn, Germany (Weber, Werner, Lang, Huber, Schuchlenz, Steinmaurer) LKH Graz West, Graz, Austria (Weikl, Lang, Winter) Medical University of Vienna, Department of Cardiology, Vienna, Austria (Andric) Wilhelminen Hospital Vienna, Vienna, Austria (Huber, Maximilian, Gabriele, Claudia, Bernhard, Florian, Keltai, Vertes, Sebo) Eszszk- Szent Istvan Hospital, Budapest, Hungary (Davidovits, Matics, Varga, Agoston) University of Szeged, Szeged, Hungary (Fontos, Dekany) George Gottsegen National Institute of Cardiology, Budapest, Hungary (Merkely, Bartykowszki) Heart and Vascular Center, Semmelweis University, Budapest, Hungary (Maurovich-Horvat, Kerecsen, Jakal) Military Hospital, Budapest, Budapest, Hungary (Hinic, Djokic) University Hospital Center Bezanijska Kosa, Belgrade, Serbia (Zdravkovic, Mudrenovic, Crnokrak, Beleslin) Faculty of Medicine, University of Belgrade, Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia (Boskovic, Djordjevic-Dikic, Petrovic, Giga, Dobric, Stepanovic, Markovic, Mladenovic, Cemerlic-Adjic, Velicki) Institute of Cardiovascular Diseases Vojvodina, Sremska Kamenica, Serbia (Pupic, Davidovic, Simovic) Clinical Center Kragujevac, Kragujevac, Serbia (Vucic, Dekleva, Martinovic) University Clinical Hospital Zvezdara, Belgrade, Serbia (Stevanovic, Stankovic, Dobric) Clinical Center of Serbia, Belgrade, Serbia (Apostolovic, Martinovic) Clinic for Cardiovascular Diseases, Clinical Center Nis, Nis, Serbia (Stanojevic, Escobedo, de Jesus-Perez, Juarez) Instituto Mexicano del Seguro Social, Mexico (Baleon-Espinosa, Campos-Santaolalla, Duran-Cortes, Flores-Palacios, Garcia-Rincon, Jimenez-Santos, Penafiel, Ortega-Ramirez, Valdespino-Estrada, Rosas, Brassetti, Selvanayagam) Instituto Nacional de Cardiologia "Ignacio Chavez", Mexico City, Mexico (Anaya, Garcia, Juarez, Rovalo, Rodriguez, Selvanayagam, Rankin, Murphy, Lee) Flinders Medical Centre, Adelaide, Australia (Joseph, Thomas, Thambar, Chaplin) John Hunter Hospital, New Lambton Heights, Australia (Boer, Beltrame, Stansborough) The Queen Elizabeth Hospital, Woodville South, Australia (Black, Hillis, Bonner) Royal Perth Hospital, Perth, Australia (Ireland, Venn-Edmonds, Steg, Abergel, Juliard, Thobois) C.H. Louis Pasteur, Chartres, France (Thuaire, Tachot, Dutoiu, Laure, Vassaliere, Steg, Abergel) Bichat Hospital, Paris, France (Juliard, Fuentes, Slama, Eliahou) Antoine-Beclere Hospital, Clamart, France (Mahmoud, Dubourg) Ambroise Pare Hospital, Boulogne, France (Michaud, Nicollet, Hadjih) Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France (Goube, Brito, Barone-Rochette, Barone-Rochette) Grenoble University Hospital, Grenoble, France (Furber, Cornet) Centre Hospitalier Universitaire d'Angers, Angers, France (Biere, Rautureau, Juceviciene) Vilnius University Hospital Santariskes Clinic, Vilnius, Lithuania (Kalibataite-Rutkauskiene, Keinaite, Laucevicius, Laukyte, Celutkiene, Mikolaitiene, Smigelskaite, Tamasauskiene, Urboniene, Kedhi) Isala Klinieken, Zwolle, Netherlands (Timmer, Bouwhuis, Hermanides, Nijmeijer, Kaplan, Riezebos) Cardio Research Hartcentrum OLVG, Amsterdam, Netherlands (Samadi, Schoep, van Dongen, Janzen, Niehe, Suryapranata, Ahoud) Radboudumc, Nijmegen, Netherlands (van Vugt, Ramos) Hospital de Santa Marta, Lisbon, Portugal (Cacela, Santana, Fiarresga, Sousa, Marques, Patricio, Selas, Bernanrdes, Silva, Rio, Freixo, Carvalho, Ferreira, Silva, Rodrigues, Modas, Portugal, Fragata, Pinto, Cabrita) Santa Maria University Hospital, Cardiology Department, CHLN, Lisbon, Portugal (Menezes, Rocha, Lopes, Figueiras, Almeida, Coelho, Silva, Capinha, Nobre, Caetano, Francisco, Silva, Ferreira) Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Vila Nova de Gaia, Portugal (Lopes, Diaz, Guzman, Tinnirello) Instituto Medico DAMIC, Cordoba, Argentina (Figal, Mungo) Fundacion Favaloro, Ciudad Autonoma de Buenos Aires, Argentina (Mendiz, Cortes, Favaloro, Alvarez, Garcia) Hospital Italiano Regional del Sur Bahia Blanca, Bahia Blanca, Argentina (Courtis, Godoy) Clinica Romagosa and Clinica De La Familia, Cordoba, Spain (Zeballos, Schiavi, Actis) Clinica Del Prado, Cordoba, Spain (Rubio) Clinica Privada Velez Sarsfield, Cordoba, Spain (Scaro, Devlin, Low) Waikato Hospital, Hamilton, New Zealand (Fisher, Scales, Abercrombie, Stewart) Auckland City Hospital, Auckland, New Zealand (Howell, Patten, Benatar, Kedev, Held) University Clinic of Cardiology, Skopje, North Macedonia (Mitevska, Kostovska, Pejkov, Held) Uppsala University, Uppsala, Sweden (Eggers, Frostfelt, Bjorklund, Johnston, Andreasson, Olsowka, Essermark, Akerblom, Soveri, Aspberg, Persson, Sharir) Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden (Beyar, Nikolsky, Sharir, Harel) Assuta Medical Centers, Tel-Aviv, Israel (Elian, Kerner, Bentzvi) Rambam Medical Center, Haifa, Israel (Massalha, Helmer, Kohsaka, Fukuda, Ueda) Keio University, Shinjuku-ku, Japan (Kohsaka, Fujita, Yasuda, Furukawa) National Cerebral and Cardiovascular Center, Kanae Hirase, RN, -4, Suita-shi, Japan (Nagai, Otsuka, Nishimura, Nakano) Saitama Medical University, Hidaka, Japan (Van de Werf, Goetschalckx, Robesyn) University Hospital Leuven, Leuven, Belgium (Van de Werf, Claes, Hung, Yang) Mackay Memorial Hospital, Taipei City, Taiwan (Republic of China) (Yun, Hou, Kuo, Yeh, Hung, Li, Chien, Tsai, Liu, Yu, Lin, Lan, Yen, Tsai, Sung, Ntsekhe) Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa (Pandie, Philander, Viljoen, Mtana, De Andrade, Maggioni, Moccetti, Anesini) Cardiocentro, Lugano, Switzerland (Rossi, Maspoli, Mombelli, Abdelhamid, Talaat) Cairo University, Cairo, Egypt (Adel, Kamal, Mahrous, El Kaffas, El Fishawy, Pop) Emergency County Hospital Baia Mare, Bucharest, Romania (Claudia, Popescu) Emergency Institute of Cardiovascular Diseases ''Prof. Dr. C. C. Iliescu'', Bucharest, Romania (Ginghina, Rosca, Deleanu, Beladan, Iliescu, Al-Mallah, Zahrani) King AbdulAziz Cardiac Center, Central Province, Saudi Arabia (Aljzeeri, Najm, Alghamdi, Ramos) Instituto Neuro Cardiovascular De Las Americas, Mirafloes, Peru (Davila, Kuanprasert) Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand (Prommintikul, Nawarawong, Khwakhong, Woragidpoonpol, Chaiyasri, Tepsuwan, Mekara, Taksaudom, Kulthawong, Rimsukcharoenchai, Amaritakomol, Euathrongchit, Wannasopha, Yamwong, Panpunuan) Ramathibodi Hospital, Bangkok, Thailand (Sritara, Aramcharoen, Meemuk, White, Alsweiler, Khairuddin, Mokhtar) Institut Jantung Negara, Kuala Lumpur, Malaysia Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) did not find an overall reduction in cardiovascular events with an initial invasive versus conservative management strategy in chronic coronary disease; however, there were conservative strategy participants who underwent invasive coronary angiography early postrandomization (within 6 months). Identifying factors associated with angiography in conservative strategy participants will inform clinical decision-making in patients with chronic coronary disease. METHOD(S): Factors independently associated with angiography performed within 6 months of randomization were identified using Fine and Gray proportional subdistribution hazard models, including demographics, region of randomization, medical history, risk factor control, symptoms, ischemia severity, coronary anatomy based on protocol-mandated coronary computed tomography angiography, and medication use. RESULT(S): Among 2591 conservative strategy participants, angiography within 6 months of randomization occurred in 8.7% (4.7% for a suspected primary end point event, 1.6% for persistent symptoms, and 2.6% due to protocol nonadherence) and was associated with the following baseline characteristics: enrollment in Europe versus Asia (hazard ratio [HR], 1.81 [95% CI, 1.14-2.86]), daily and weekly versus no angina (HR, 5.97 [95% CI, 2.78-12.86] and 2.63 [95% CI, 1.51-4.58], respectively), poor to fair versus good to excellent health status (HR, 2.02 [95% CI, 1.23-3.32]) assessed with Seattle Angina Questionnaire, and new/more frequent angina prerandomization (HR, 1.80 [95% CI, 1.34-2.40]). Baseline low-density lipoprotein cholesterol <70 mg/dL was associated with a lower risk of angiography (HR, 0.65 [95% CI, 0.46-0.91) but not baseline ischemia severity nor the presence of multivessel or proximal left anterior descending artery stenosis >70% on coronary computed tomography angiography. CONCLUSION(S): Among ISCHEMIA participants randomized to the conservative strategy, angiography within 6 months of randomization was performed in <10% of patients. It was associated with frequent or increasing baseline angina and poor quality of life but not with objective markers of disease severity. Well-controlled baseline low-density lipoprotein cholesterol was associated with a reduced likelihood of angiography. These findings point to the importance of a comprehensive assessment of symptoms and a review of guideline-directed medical therapy goals when deciding the initial treatment strategy for chronic coronary disease. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01471522. GRAPHIC ABSTRACT: A graphic abstract is available for this article. Copyright © 2024 American Heart Association, Inc. <22> Accession Number 2044236909 Title Safety and efficacy of tirzepatide in transplant recipients: a systematic review and meta-analysis. Source Frontiers in Pharmacology. 17 (no pagination), 2026. Article Number: 1735987. Date of Publication: 2026. Author Provenzani A.; Mancuso B.; Stitch R.; Tuzzolino F.; Giusti M.A.; Mattina A. Institution (Provenzani, Tuzzolino, Giusti, Mattina) IRCCS ISMETT, Palermo, Italy (Provenzani, Giusti, Mattina) UPMC Italy, Palermo, Italy (Mancuso, Stitch) Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, United States Publisher Frontiers Media SA Abstract Introduction: Tirzepatide has demonstrated cardiovascular and metabolic benefits in the general population; however, evidence in post-transplant patients is very limited. The aim of this systematic review and meta-analysis is to evaluate the safety and efficacy of tirzepatide in solid organ transplant recipients. Method(s): We searched PubMed-MEDLINE, Embase, and Cochrane Library databases. All randomized controlled trials (RCTs) and observational studies were considered. Efficacy outcomes included improvements to glycemic outcomes demonstrated by reductions to hemoglobin A1c and changes to weight, measured by body mass index. Safety was assessed through patients who discontinued tirzepatide treatment due to adverse drug reactions. Result(s): No randomized controlled trials (RCTs) or other interventional clinical trials were identified in the available literature. Four non-randomized observational studies were found and included. Using the Weighted Median of the Difference of Medians statistical test, tirzepatide was associated with absolute reductions in hemoglobin A1c of -1.4% (95% CI: -1.7 to -0.4) and body mass index of -1.2 kg/m2 (95% CI: -5.9 to -1.1) in solid organ transplant recipients. Pooled proportions indicated a tirzepatide discontinuation rate of 3.1% (95% CI: 0.0-7.1) due to adverse drug reactions, suggesting the therapy was well tolerated in this population. Conclusion(s): Tirzepatide was associated with reductions in hemoglobin A1c and body mass index and was generally well tolerated in solid organ transplant recipients. These findings suggest a potential role for tirzepatide in the management of obesity and post-transplant diabetes mellitus, pending confirmation in larger prospective studies. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251154851, identifier CRD420251154851. Copyright © 2026 Provenzani, Mancuso, Stitch, Tuzzolino, Giusti and Mattina. <23> Accession Number 2044473447 Title Radial Versus Femoral Secondary Access in Patients Undergoing TAVI: Rationale and Design of the RADIAL-TAVI Trial. Source American Journal of Cardiology. 265 (pp 27-31), 2026. Date of Publication: 15 Apr 2026. Author von Ehr A.; Zeymer U.; Schneider S.; Besler C.; Valina C.; Seiffert M.; Mahfoud F.; Sossalla S.; Hilgendorf I.; Wolf D.; Moser M.; Ziegler L.; Niehoff M.; Olivier C.B.; Westermann D.; von zur Muhlen C. Institution (von Ehr, Zeymer, Besler, Valina, Hilgendorf, Wolf, Moser, Ziegler, Niehoff, Olivier, Westermann, von zur Muhlen) Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany (Schneider) Institut fur Herzinfarktforschung, Ludwigshafen am Rhein, Germany (Seiffert) Department of Cardiology and Angiology, BG University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (Mahfoud) Department of Cardiology, Biomedical Engineering and Biomedicine, University Heart Center, University Hospital Basel, Basel, Switzerland (Sossalla) Department of Cardiology, Campus Kerckhoff of the Justus-Liebig-University Giessen, Kerckhoff-Klinik, Bad Nauheim, Germany (Sossalla) German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Bad Nauheim, Germany (Sossalla) Department of Cardiology and Angiology, Medical Clinic I, University Hospital Giessen, Justus-Liebig-University Giessen, Giessen, Germany (Hilgendorf) DZHK (German Centre for Cardiovascular Research), Berlin, Germany (Hilgendorf) Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite (DHZC), Campus Virchow Klinikum, Berlin, Germany Publisher Elsevier Inc. Abstract Transcatheter aortic valve implantation (TAVI) has become the standard treatment for patients with severe symptomatic aortic stenosis (AS) across most surgical risk categories. Despite its minimally invasive nature, transfemoral TAVI requires both a primary and a secondary arterial access site. While the femoral artery is most commonly used for secondary access, vascular and bleeding complications remain frequent and are associated with adverse outcomes. Observational evidence from TAVI cohorts suggests that radial secondary access may reduce such complications compared to femoral access. The RADIAL-TAVI trial is a prospective, randomized, controlled, multicenter, open-label study designed to compare radial versus femoral secondary access in patients undergoing transfemoral TAVI. A total of 434 patients will be randomized in a 1:1 ratio. The primary endpoint is the incidence of vascular and bleeding complications at the secondary access site within 30 days, adjudicated according to VARC-3 criteria. Secondary endpoints include early safety, cardiovascular mortality, major adverse cardiovascular and cerebrovascular events (MACCE), quality of life, and health economic aspects up to 30 days, as well as long-term mortality up to 12 months. The study is powered to detect a reduction in the primary endpoint from 8% with femoral to 2% with radial access. The RADIAL-TAVI trial will provide the first randomized evidence on the optimal secondary access strategy in transfemoral TAVI. If radial access proves superior, it has the potential to redefine standard practice, reduce complication rates, and improve patient safety and outcomes. Copyright © 2026 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <24> Accession Number 649571232 Title Effect of Pressure-Controlled Ventilation-Volume Guaranteed on Pulmonary Oxygenation Function in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting. Source Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae. 48(1) (pp 120-127), 2026. Date of Publication: 01 Feb 2026. Author Wei X.-Y.; Chen F.-H.; Li J.; Zhao N.; Qin R.; Yan R.; Ni X.-L. Institution (Wei, Li, Zhao, Qin, Yan, Ni) Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University, Yinchuan, China (Chen) Department of Otorhinolaryngology-Head and Neck Surgery, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China Abstract Objective To evaluate the effect of pressure-controlled ventilation-volume guaranteed(PCV-VG)on the perioperative pulmonary oxygenation function of the patients undergoing off-pump coronary artery bypass grafting(OPCABG). Methods Forty patients aged 40-65 years,of both sexes,with the American Society of Anesthesiologists physical status III or IV,preoperative cardiac function(NYHA)class II or III,scheduled for elective OPCABG were assigned via the random number table method into two groups(n=20):a volume-controlled ventilation(VCV)group(Group V)and a PCV-VG group(Group P).Other respiratory parameters of the anesthesia machine were set consistently in both groups.At the time of sawing the sternum(T0),when left internal mammary artery harvesting with the operating table tilted 10degree to the left(T1),when left anterior descending coronary artery bypass grafting with the operating table tilted 10degree to the right(T2),when right coronary artery bypass grafting with the operating table in a 30degree head-down and tilted 10degree to the right(T3),when circumflex coronary artery bypass grafting with the operating table in a 20degree head-down and tilted 15degree to the right(T4),and at the end of the surgery(T5),the peak airway pressure(Ppeak),mean airway pressure(Pmean),plateau airway pressure(Pplat),and pulmonary dynamic compliance(Cdyn)were recorded.The alveolar-arterial partial pressure difference of oxygen(PA-aDO2),oxygenation index(OI),and respiratory index(RI)were recorded at the aforementioned time points as well as on postoperative day 1(T6),day 3(T7),and day 7(T8).The dosages of intraoperative drugs(sufentanil,remifentanil,and rocuronium bromide),postoperative endotracheal tube indwelling time,the stay time in the cardiac surgery intensive care unit,and the occurrence of pulmonary complications within 7 days after the surgery were also recorded. Results Compared with Group V,Group P showed significant downward trends in Ppeak,Pmean,and Pplat during T3-T5,as well as in PA-aDO2 and RI during T3-T8(all P<0.05).Meanwhile,Group P exhibited significant upward trends in Cdyn during T3-T5 and in OI during T3-T8(all P <0.05).Compared with those in Group V,the postoperative endotracheal tube indwelling time and the stay time in the cardiac surgery intensive care unit were shortened in Group P(all P<0.05).There was no statistically significant difference in dosages of intraoperative drugs(sufentanil,remifentanil,and rocuronium bromide)or incidence of pulmonary complications within 7 days after the surgery between the two groups of patients(all P>0.05). Conclusion Compared with VCV,PCV-VG can improve the perioperative pulmonary oxygenation function of the patients undergoing OPCABG. <25> [Use Link to view the full text] Accession Number 649028983 Title Efficacy and safety of invasive versus noninvasive treatments in elderly patients with non-ST-segment myocardial infarction: a systematic review and meta-analysis. Source Coronary artery disease. 37(3) (pp 206-214), 2026. Date of Publication: 01 May 2026. Author Malik S.; Mufaddal Z.Q.; Koskina L.; Siddiqui O.M.; Mansour M.; Nusrat K.; Khan R.; Sohail M.U.; Farhan S.H.; Singh D.; Ali E.; Hameed I. Institution (Malik, Mufaddal, Siddiqui, Khan, Sohail, Farhan, Ali) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (Koskina, Mansour, Singh, Hameed) Department of Medicine, Medstar Health, Baltimore, MD, United States (Nusrat) Department of Medicine, University at Buffalo-Catholic Health System, Buffalo, NY, United States Abstract BACKGROUND: Historically, the elderly population was underrepresented in clinical trials evaluating the optimal treatment for non-ST-segment elevation myocardial infarction (NSTEMI). Therefore, we aimed to compare invasive versus noninvasive strategies for the management of NSTEMI in older adults. METHOD(S): PubMed, SCOPUS, and Cochrane Central Register of Controlled Trials were screened for studies evaluating medical therapy or invasive revascularization in elderly patients with NSTEMI. Following outcomes were extracted: all-cause mortality, cardiovascular death, fatal or nonfatal MI, repeat coronary revascularization, major adverse cardiovascular events (MACE), bleeding, stroke, noncardiovascular death, and repeat hospitalization for heart failure. Data were pooled using random-effects model to evaluate weighted mean differences and risk ratios with 95% confidence intervals (CIs). This study is registered with PROSPERO, CRD42024622236. RESULT(S): Seven studies ( n = 2997 patients) were included. Patients treated with medical versus invasive therapies showed no significant difference in all-cause mortality (risk ratio: 1.05, 95% CI: 0.94-1.18, P = 0.37); however, invasive therapies significantly decreased the risk of fatal or nonfatal MI (risk ratio: 0.75, 95% CI: 0.59-0.96, P = 0.02), repeat coronary revascularizations (risk ratio: 0.29, 95% CI: 0.21-0.40, P < 0.00001), and risk of MACE (risk ratio: 0.74, 95% CI: 0.61-0.89, P = 0.002). Lastly, invasive therapies were associated with increased risk of bleeding. CONCLUSION(S): Invasive therapy, in comparison to medical management, has reduced incidence of fatal or nonfatal MI, MACE, and the need for revascularization; however, no benefit was noted for all-cause and cardiovascular mortality. Age-specific guidelines must be established for the management of NSTEMI among older adults. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <26> Accession Number 2035395451 Title Clinical and economic consequences of medication nonadherence: a review of systematic reviews. Source Frontiers in Pharmacology. 16 (no pagination), 2025. Article Number: 1570359. Date of Publication: 2025. Author Achterbosch M.; Aksoy N.; Obeng G.D.; Ameyaw D.; Agh T.; van Boven J.F.M. Institution (Achterbosch, van Boven) Department of Clinical Pharmacy & Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands (Aksoy) Department of Clinical Pharmacy, School of Pharmacy, Altinbas University, Istanbul, Turkey (Obeng, Ameyaw, Agh) Syreon Research Institute, Budapest, Hungary (Obeng, Ameyaw) Syreon Research Africa, Accra, Ghana (Agh) Medication Adherence Research Group, Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pecs, Pecs, Hungary (van Boven) Department of Clinical Pharmacy & Pharmacology, Medication Adherence Expertise Center of the Northern Netherlands (MAECON), University Medical Center Groningen, University of Groningen, Groningen, Netherlands Publisher Frontiers Media SA Abstract Background: Medication efficacy observed in clinical trials may differ from its effectiveness during real-world usage. Medication nonadherence is one of the key factors being responsible for this efficacy-effectiveness gap. The World Health Organization estimated that only 50% of chronic medication users is adherent and nonadherence results in both negative health outcomes for the patient and higher societal costs. An overview of the consequences across disease groups may allow some comparison and could contribute to identification of priority clinical areas. Objective(s): We aimed to provide an overview the impact of nonadherence on clinical and economic outcomes. Method(s): We narratively reviewed systematic reviews published between 2014 and 2024 on the effect of medication nonadherence on clinical and economic outcomes. Result(s): Overall, 43 systematic reviews were identified, including over 410 original studies on clinical outcomes and 174 on economic outcomes, covering different clinical areas (e.g., organ transplantation, cardiovascular diseases, diabetes, depression and chronic lung diseases [asthma/COPD]). Beyond diminished treatment effects, medication nonadherence has been associated with elevated mortality, increased healthcare utilization (including hospital admissions), and higher direct (e.g., more healthcare provider visits) and indirect financial cost burden (e.g., work productivity losses due to absenteeism and presenteeism) for patients and society. Conclusion(s): Medication nonadherence is associated with poor clinical and economic outcomes across disease areas. Given the significant impact of nonadherence, raising awareness among healthcare professionals and policymakers, early stakeholder engagement in intervention design, and eventually implementation of cost-effective interventions on both health policy, system and individual patient level are urgently required. Copyright © 2025 Achterbosch, Aksoy, Obeng, Ameyaw, Agh and van Boven. <27> Accession Number 2044263191 Title Genetic Determinants of Coronary Artery Disease in Type 2 Diabetes Mellitus Among Asian Populations: A Meta-Analysis. Source Medical sciences. 14(1) (no pagination), 2026. Article Number: 52. Date of Publication: 01 Mar 2026. Author Kabibulatova A.; Mussina K.; Almazan J.; Sarria-Santamera A.; Salustri A.; Atageldiyeva K. Institution (Kabibulatova, Mussina, Sarria-Santamera) Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana, Kazakhstan (Almazan, Salustri, Atageldiyeva) Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan (Atageldiyeva) Department of Internal Medicine, Corporate Fund "University Medical Center", Astana, Kazakhstan Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Type 2 diabetes mellitus (T2DM) significantly elevates the risk of coronary artery disease (CAD), particularly in Asian populations where both conditions are epidemic. While shared genetic factors contribute to this comorbidity, evidence from Asian cohorts remains fragmented, with limited focus on population-specific variants. This meta-analysis synthesizes evidence on genetic variants associated with CAD risk in Asian patients with T2DM. Method(s): We systematically searched several databases according to the PRISMA statement and checklist. Pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated using random-effects models, with heterogeneity assessed via I2 and Cochran's Q, and publication bias via funnel plots and Egger's test. Result(s): In total, data on 11,268 subjects were reviewed, including 4668 cases and 6600 controls. Among 950 identified studies, 18 met eligibility criteria, and 14 studies provided sufficient data for the meta-analysis. The random-effects pooled estimate across all studied variants was not statistically significant (OR = 1.16 [95% CI: 0.68-2.00]; z = 0.56, p = 0.58). However, analysis of individual loci revealed gene-specific associations with CAD among this population: PCSK1 gene (OR = 2.12 [95% CI: 1.26-3.52]; p < 0.05; weight = 8.77%), GLP1R gene (OR = 2.25 [95% CI: 1.27-3.97]; p < 0.01; weight = 8.62%). ADIPOQ gene (OR = 8.00 [95% CI: 2.34-27.14]; p < 0.01; weight = 6.35%). Several genes were associated with an elevated risk of CAD: PCSK1 gene (OR = 2.12 [95% CI: 1.26-3.52]; p < 0.05; weight = 8.77%), GLP1R gene (OR = 2.25 [95% CI: 1.27-3.97]; p < 0.01; weight = 8.62%) and ADIPOQ gene (OR = 8.00 [95% CI: 2.34-27.14]; p < 0.01; weight = 6.35%). Several genes were associated with possible protective effects: ACE gene (OR = 0.41 [95% CI: 0.23-0.73]; p < 0.01; weight = 8.57%), Q192R gene (OR = 0.20 [95% CI: 0.08-0.52]; p < 0.001; weight = 7.41%). Heterogeneity was substantial (tau2 = 0.78; I2 = 81.95%; Q (13) = 64.67, p < 0.001). Conclusion(s): This first meta-analysis of genetic variants associated with CAD in Asian populations with T2DM identified specific locus-level associations implicating lipid metabolism, incretin signaling, and oxidative stress pathways. The lack of a significant pooled effect, alongside high heterogeneity, underscores the complexity and population-specific nature of this genetic architecture. These findings suggest that effective precision risk stratification may depend more on specific variants than on a broad polygenic signal, highlighting the need for further research in a larger, distinct sample size. Copyright © 2026 by the authors. <28> Accession Number 2043024225 Title Optimizing preoperative CTA protocols for TAVR: enhanced image quality and reduced radiation and contrast doses with dual-source Turbo Flash mode. Source Chinese Journal of Academic Radiology. 9(1) (pp 77-85), 2026. Date of Publication: 01 Mar 2026. Author Liu W.; Zheng Y.; Chen J.; Li J.; Du M.; Zeng J.; Chen X.; Chen W.; Li L. Institution (Liu, Zheng, Chen, Li, Du, Zeng, Chen, Li) First Affiliated Hospital of Army Medical University, Chongqing, China (Chen) University of Birmingham, Birmingham, United Kingdom Publisher Springer Abstract Purpose: This study aimed to investigate the feasibility of using the Turbo Flash mode for transcatheter aortic valve replacement (TAVR) computed tomography (CT) with a single contrast agent injection, aiming to reduce contrast agent volume and radiation dose while maintaining image quality. Method(s): Ninety patients were randomly assigned to either the Turbo Flash group, which received a single contrast agent injection and underwent the Turbo Flash scan without electrocardiogram synchronization, or the conventional group, which received two contrast agent bolus injections and underwent a standard scan. Result(s): Compared with the conventional group (110 mL contrast agent), the Turbo Flash group showed a 30% reduction in iodine usage (80 mL contrast agent). All examination image qualities met diagnostic requirements. No significant differences were noted between the two groups in terms of subjective and objective aortic root computed tomography angiography (CTA) scores. However, the Turbo Flash group had a significantly higher subjective score for aorta-femoral artery CTA compared with the conventional group (P < 0.001). The Turbo Flash group demonstrated lower radiation doses for aorto-femoral artery scanning (474.73 +/- 127.48 mGy cm) compared to the conventional group (661.97 +/- 172.91 mGy cm), a 28.3% reduction (P < 0.05). No significant difference in the radiation dose for aortic root scanning was observed between the two groups. Conclusion(s): Performing pre-TAVR CT with a single segmented contrast agent injection is feasible and effective. These images can meet clinical diagnostic needs while reducing contrast agent volume and radiation dose. Copyright © The Author(s) 2026. <29> Accession Number 2043822397 Title Arterial Branching Patterns Supplying the Left Upper Lobe of the Lung and Their Incidence: A Systematic Review. Source Journal of Clinical Medicine. 15(5) (no pagination), 2026. Article Number: 1724. Date of Publication: 01 Mar 2026. Author Dworski K.J.; Tulski M.; Wozniak S.; Anders M.; Kuo C.-A.; Tabola R. Institution (Dworski, Tulski, Wozniak, Anders, Kuo) Department of Anatomy, Wroclaw Medical University, Tytusa Chalubinskiego 6a, Wroclaw, Poland (Dworski, Tabola) Department of Thoracic Surgery, Wroclaw Medical University, Grabiszynska 105, Wroclaw, Poland (Tulski) Urology Center Student Scientific Club, Wroclaw Medical University, Wroclaw, Poland Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Objective: The arterial anatomy of the left upper lobe exhibits the greatest variability in branching patterns among all pulmonary lobes. This lobe is commonly described as having four segments: the fused apicoposterior segment (S1+2), the anterior segment (S3), and the lingular segments (S4 and S5). Each segment may contain subsegments with distinct vascular supplies. Although several studies have examined patterns and diversity of branching, a comprehensive assessment of the incidence of these variations has not yet been performed. Method(s): This systematic review was conducted in accordance with a protocol registered in PROSPERO (CRD42024546839). The search was performed between December 2023 and February 2024. A systematic search of databases was carried out to identify publications describing arterial branching patterns supplying the left upper lobe of the lung in adults. Furthermore, we collected and analyzed data on the relationship between the different origins of the lingular arteries and the corresponding bronchial and venous patterns. The AUQA tool was used to perform bias assessment. Data extraction included study characteristics, participant demographics (listed in AUQA), and anatomical variables based on the Yamashita classification of LUL arterial patterns and the number of branches supplying the left upper lobe. Result(s): In total, 15 publications were included (3313 cases). Lobar vasculature was firstly categorized more broadly, analyzing the number of branches from the left pulmonary artery, which supplies the left upper lobe, most commonly four branches. Then, analysis based on the Yamashita classification was performed, and Type A (A3, A(1+2) a+b, A(1+2) c) was established as the most common variant. Conclusion(s): The left upper lobe is most commonly supplied by four different arterial branches, followed by three and five. Differences in arterial branching patterns between Asian and Western populations may represent an important distinguishing factor. According to Yamashita's classification, Type A (A3, A1+2a+b, A1+2c) is the most frequently observed pattern. Further attention should be directed to the relationship between the presence of a common trunk and the origin of the lingular arteries. Detailed knowledge of this anatomy remains fundamental for segmental thoracic surgery. Copyright © 2026 by the authors. <30> Accession Number 2044190565 Title Avoidance of Hyperoxemia Versus Routine Hyperoxia During Cardiopulmonary Bypass in Children With Cyanotic Congenital Heart Disease-A Systematic Review and Meta-Analysis. Source Paediatric Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Fischer J.; Arobo A.; Almehandi A.; Leidens E.C.; Apostu E.B.; Passos F.S.; Kirov H.; Doenst T.; Kerst G.; Loukanov T.; Caldonazo T. Institution (Fischer, Leidens, Apostu, Kirov, Doenst, Caldonazo) Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Germany (Arobo) College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria (Almehandi) Department of Cardiovascular Science, University College London, London, United Kingdom (Passos) Department of Thoracic Surgery, MaterDei Hospital, Salvador, Brazil (Kerst) Clinic for Pediatric Cardiology and Congenital Heart Disease, Klinikum Stuttgart, Stuttgart, Germany (Loukanov) Division of Congenital Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany Publisher John Wiley and Sons Inc Abstract Background: Children with cyanotic congenital heart disease undergoing cardiac surgery with cardiopulmonary bypass (CPB) are exposed to varying oxygenation strategies, and the optimal oxygenation strategy and the impact of limiting hyperoxic exposure remain uncertain. This study aimed to compare oxygenation strategies designed to avoid hyperoxemia versus routine hyperoxic management in this population. Method(s): A systematic search was conducted in four databases. The primary outcome was postoperative intubation time. Secondary outcomes included intensive care unit (ICU) length of stay (LOS), hospital LOS, total operative duration, and epinephrine requirement. Standardized mean difference (SMD) and odds ratios (OR) with 95% confidence intervals (CI) were calculated for continuous and categorical outcomes, respectively. A random-effects model was applied to all outcomes. Result(s): Seven studies (six randomized controlled trials; one observational) met all the inclusion criteria. Strategies avoiding hyperoxemia did not significantly reduce postoperative intubation time compared with routine hyperoxia (SMD: -0.25; 95% CI: -0.52-0.03; p = 0.077; I2 = 15%). Also, no significant differences were observed for ICU LOS (SMD: -0.04; 95% CI: -0.46-0.38; p = 0.859; I2 = 64%), hospital LOS (SMD: 0.24; 95% CI: -0.01-0.50; p = 0.064; I2 = 0%), operative duration (SMD: -0.66; 95% CI: -1.90-0.58; p = 0.294; I2 = 84%), and epinephrine use (OR: 0.66; 95% CI: 0.28-1.57; p = 0.350; I2 = 0%). Conclusion(s): No significant differences in postoperative outcomes were observed between oxygenation strategies aimed at avoiding hyperoxemia and routine hyperoxic management during CPB. Copyright © 2026 John Wiley & Sons Ltd. <31> Accession Number 2043729147 Title Shexiang Baoxin pill in patients with stable coronary artery disease and reduced eGFR: Subgroup analysis of phase IV randomized trial. Source Phytomedicine. 154 (no pagination), 2026. Article Number: 157946. Date of Publication: 01 May 2026. Author Zhou J.; Chen Y.; Shi H.; Jin Y.; Li X.; Wu J.; Pan C.; Qian J.; Wu Y.; Wang X.; Wang Y.; Lu F.; Ge J. Institution (Zhou, Ge) Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China (Chen) Shanghai Innovative Engineering Technology Research Center for Traditional Chinese Medicine Solid Preparations, Shanghai, China (Shi) Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China (Jin) Department of Cardiology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China (Li) Department of Cardiology, Jiangsu Province Hospital, Nanjing, China (Wu) Department of Cardiology, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, China (Pan) Department of Cardiology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China (Qian) Department of Cardiology, Maanshan General Hospital of Ranger-duree Healthcare, Maanshan, China (Wu) Department of Cardiology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China (Wang) Department of Cardiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China (Wang) Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China (Lu) Department of Cardiology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China Publisher Elsevier GmbH Abstract Background : Shexiang Baoxin pill (MUSKARDIA) is a well-known traditional Chinese medicine that has demonstrated protective effects in coronary artery disease (CAD). Purpose : To evaluate MUSKARDIA in patients with stable CAD and reduced estimated glomerular filtration rate (eGFR). Study Design : This was a subgroup analysis of the multicenter, double-blind, placebo-controlled phase IV randomized clinical trial (MUST, ChiCTR-TRC-12,003,513). The MUST trial randomly assigned patients with stable CAD to MUSKARDIA or placebo group in a 1:1 ratio. The primary composite efficacy endpoint was the incidence of major adverse cardiovascular events. The secondary composite efficacy endpoint included all-cause mortality, non-fatal MI, non-fatal stroke, hospitalization for unstable angina or heart failure, and coronary revascularization. Methods This subgroup analysis included patients with reduced baseline eGFR (< 90 ml/min/1.73m2). Results : Among the 1354 participants with reduced baseline eGFR, there were numerical advantages with MUSKARDIA in improving the primary (hazard ratio=0.713; 95% CI: 0.379-1.342; p = 0.292) and secondary (hazard ratio=0.840; 95% CI: 0.608-1.161; p = 0.290) composite efficacy endpoints. Multivariable adjustment confirmed these benefits. The primary composite efficacy endpoint showed a trend toward a protective effect of MUSKARDIA after 12 months. MUSKARDIA significantly improved the secondary composite efficacy endpoint after 14 months. The profiles of adverse events were comparable between groups. There were no clinically meaningful differences in liver and kidney function indicators. Conclusion Long-term MUSKARDIA shows a protective trend against cardiovascular events in patients with stable CAD and reduced eGFR, and may be a consideration for clinical management. Copyright © 2026. Published by Elsevier GmbH. <32> [Use Link to view the full text] Accession Number 650012962 Title The Effect of Reflexology on Anxiety in Patients Undergoing Open Heart Surgery: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source The journal of nursing research : JNR. 34(2) (pp e451), 2026. Date of Publication: 01 Apr 2026. Author Dagcan Sahin N.; Gorucu S. Institution (Dagcan Sahin) Nursing Department, Faculty of Health Sciences, Kutahya Health Sciences University, Kutahya, Turkey (Gorucu) Nursing Department, Faculty of Health Science, Akdeniz University Kumluca, Antalya, Turkey Abstract BACKGROUND: Open-heart surgery is effective but may involve significant postoperative complications and long recovery times that can be exacerbated by patient anxiety. Nonpharmacological approaches such as reflexology have gained attention in the field of medicine for their ability to alleviate anxiety without significant side effects. PURPOSE: This systematic review and meta-analysis were designed to determine the effect of reflexology on anxiety in patients undergoing open-heart surgery. METHOD(S): The PubMed, EBSCO (including MEDLINE and CINAHL), OVID, Web of Science, and Cochrane databases were searched from May 15 to July 15, 2024. Randomized controlled trials that evaluated patients who had open-heart surgery were included in the analysis. Studies were appraised using the Critical Appraisal Checklists for Randomized Controlled Trials developed by the Joanna Briggs Institute (JBI). The meta-analysis was conducted using the Comprehensive Meta-Analysis Version 2, and heterogeneity between studies was assessed using the chi 2 test and I2 statistic. The results were reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. RESULT(S): Eight studies encompassing 485 patients were included in the meta-analysis. All of the included studies used common measurement times for anxiety and compared intervention groups with either standard care or a placebo. In the meta-analysis performed using a random-effects model, reflexology was found to significantly reduce anxiety ( g =-1.49, 95% confidence interval (CI)=[-2.35, -0.63], with a statistically significant difference observed between the intervention and control groups ( z =-3.41, p =.001). However, the findings of the meta-analysis should be interpreted with caution. CONCLUSION(S): Reflexology may be effective in reducing anxiety in patients undergoing open-heart surgery. However, the significant heterogeneity identified among the included studies indicates variability among study conditions. Therefore, their outcomes should be evaluated carefully. Reflexology may be used as an adjunct to standard patient care. Additional studies with more homogeneous methodologies are required to strengthen the evidence base for the efficacy of reflexology in reducing anxiety in this vulnerable patient population. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Taiwan Nurses Association. <33> Accession Number 2043995629 Title Valve-sparing root replacement versus Bentall procedure with bioprosthetic valves in patients with aortic insufficiency: a meta-analysis. Source General Thoracic and Cardiovascular Surgery. 74(4) (pp 340-348), 2026. Date of Publication: 01 Apr 2026. Author Yokoyama Y.; Shimoda T.M.; Kuno T.; Sa M.P.; Miyamoto Y.; Takagi H.; Fukuhara S.; Kaneko T. Institution (Yokoyama) Division of Cardiothoracic Surgery, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA, United States (Shimoda) Department of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Japan (Kuno) Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Sa) Department of Cardiac Surgery, Massachusets General Hospital, Harvard Medical School, Boston, MA, United States (Miyamoto) Department of Real-world Evidence, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan (Fukuhara) Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, United States (Kaneko) Division of Cardiothoracic Surgery, Washington University in St. Louis, St. Louis, MO, United States Publisher Springer Abstract Objective: The use of bioprosthetic valves in the Bentall procedure (bio-Bentall) has increased for its anticoagulant-free lifestyle benefits. Valve-sparing root replacement (VSRR) offers an alternative to the bio-Bentall with the preservation of native valves. However, comparative evidence between VSRR and bio-Bentall is scarce. This meta-analysis aims to address this knowledge gap. Method(s): A systematic review was conducted on databases from inception through December 2025. Studies reporting adjusted outcomes were included. The primary outcome was mid-term all-cause mortality and aortic valve reoperation. Secondary outcomes included perioperative mortality, stroke, reoperation for bleeding, new dialysis initiation, and permanent pacemaker implantation. Pooled analyses were performed using a random-effects model. Result(s): Four observational studies with 1,468 patients (VSRR = 771, bio-Bentall = 697) were included. Mean follow-up durations ranged from 2.3 to 9.8 years. Except for lower stroke rates in the VSRR group, no significant differences were found in perioperative outcomes between the two groups. VSRR was associated with favorable mid-term mortality compared with bio-Bentall (adjusted hazard ratio [aHR] [95% confidence interval [CI]] = 0.59 [0.42-0.85]), and reduced aortic valve reoperation rates (aHR [95% CI] = 0.41 [0.24-0.71]). Conclusion(s): VSRR was associated with comparable perioperative outcomes to bio-Bentall, with favorable mid-term mortality and aortic valve reoperation rates. Larger studies with longer follow-up are necessary to elucidate the potential benefits of VSRR in aortic root surgery. Copyright © The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery 2026. <34> Accession Number 2042694077 Title Comparison of perioperative outcomes of minimally invasive and conventional aortic root surgery in adult patients: a systematic review and meta-analysis. Source General Thoracic and Cardiovascular Surgery. 74(4) (pp 329-339), 2026. Date of Publication: 01 Apr 2026. Author Karadzha A.; Enginoev S.; Schaff H.V.; Suvorov A.; Mukharyaov M.; Babeshko S.; Chekhoeva A.; Kadyraliev B.; Bogachev-Prokophiev A. Institution (Karadzha, Schaff) Department of Cardiovascular Surgery, 200 1st St SW, Rochester, MN, United States (Enginoev) Federal State Budgetary Institution <<Federal Center for Cardiovascular Surgery>> of theMinistry of Health of the Russian Federation, Astrakhan, Russian Federation (Enginoev) Federal State Budgetary Educational Institution of Higher Education "Astrakhan State Medical University" of the Ministry of Health of the Russian Federation, Astrakhan, Russian Federation (Suvorov) Institute of Personalized Cardiology of the Center for Digital Biodesign and Personalized Healthcare, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation (Mukharyaov) University Clinic Jena, Thuringia, Germany (Mukharyaov) Kazan State Medical University, Kazan, Russian Federation (Babeshko) Region Hospital #1, Krasnodar Region, Russian Federation (Chekhoeva) Department of Cardiac Surgery, The University Hospital of Dusseldorf, Dusseldorf, Germany (Kadyraliev) S.G. Sukhanov Federal Center of Cardiovascular Surgery, E.A. Vagner Perm State Medical, Perm, Russian Federation (Bogachev-Prokophiev) Heart Valve Surgery Department, E. Meshalkin National Medical Research Centre, Novosibirsk, Russian Federation Publisher Springer Abstract Introduction: Minimally invasive approaches have become a gold standard for most cardiac surgery procedures, but their use in aortic root surgery remains limited. Previous analyses suggested potential benefits of minimally invasive aortic root surgery (MIARS) over conventional aortic root surgery (CARS). This study aims to provide updated insights into intraoperative and early postoperative outcomes between MIARS and CARS. Method(s):. This systematic review and meta-analysis followed PRISMA guidelines. Two-arm observational studies comparing MIARS and CARS were included. The literature search was conducted using a mix of keywords and standardized indexing terms in the eight sources up to December 16, 2024. The risk of bias was assessed using ROBINS-I. Result(s): Twenty-one studies comparing MIARS and CARS were included, resulting in 2908 MIARS and 3,456 CARS patients. Minimally invasive approaches were associated with shorter mechanical ventilation (-4.72 h; p <.001), ICU stay (-0.46 days; p <.001), hospital stay (-1.65 days; p <.001), reduced postoperative bleeding (-0.82 units; p <.001), blood transfusion (-0.50 units; p <.001) and atrial fibrillation rate (RR 0.73; p =.006). Safety outcomes, including the risk of mortality, stroke, and renal failure, as well as surgical procedure duration, reflected by aortic cross-clamp and cardiopulmonary bypass times, were comparable between MIARS and CARS. Conclusion(s): The use of minimally invasive approaches for aortic root procedures may offer benefits over median sternotomy, including shorter recovery times and reduced postoperative bleeding, without compromising safety. However, the certainty of the available evidence remains low. Copyright © The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery 2026. <35> Accession Number 2043873719 Title Proactive, short-term PCSK9 inhibition after PCI in patients with coronary artery disease at high residual risk: rationale and design of the randomized HANYANG-PICK trial. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1761093. Date of Publication: 2026. Author Kim W.; Park S.; Shin J.-H.; Kook H.; Lim Y.-H. Institution (Kim, Kook, Lim) Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea (Park) Division of Cardiology, Department of Internal Medicine, Hanyang University Seoul Hospital, Seoul, South Korea (Shin) Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, South Korea Publisher Frontiers Media SA Abstract Background: Despite advances in stent design and PCI optimization, stent failure remains clinically relevant in patients with coronary artery disease. This process is primarily driven by vascular injury and maladaptive healing, leading to neointimal hyperplasia, neoatherosclerosis, and recurrent ischemic events. A subset of patients remains vulnerable despite angiographically successful PCI, reflecting residual risk not fully captured by procedural assessment alone. Novel strategies to reduce this residual risk are therefore warranted. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, beyond potent LDL-C reduction, have demonstrated plaque-stabilizing effects. Preclinical data suggest that PCSK9 promotes proinflammatory cytokine release, vascular smooth muscle cell proliferation, and impaired endothelial repair-mechanisms implicated in adverse vascular responses after PCI. Aim(s): To determine whether proactive, short-term evolocumab improves outcomes in patients with coronary artery disease at high residual risk after PCI. Method(s): The HANYANG-PICK trial is a prospective, randomized, open-label, multicenter study enrolling patients with post-PCI <inf>max</inf>LCBI<inf>4mm</inf> >=200 on NIRS-IVUS. Participants will be randomized 1:1 to standard care or standard care plus evolocumab 140 mg subcutaneously within 24 h of PCI and at 2 weeks. The primary endpoint is the composite of all-cause death, myocardial infarction, stroke, or any clinically driven revascularization at 12 months. Ethics and dissemination: The protocol has been approved by the Institutional Review Board of all participating centers. Written informed consent will be obtained from all participants. Results will be disseminated in peer-reviewed journals and at scientific conferences. Conclusion(s): The HANYANG-PICK trial is an exploratory, hypothesis-generating randomized study designed to test whether proactive, short-term PCSK9 inhibition initiated during the early post-PCI period can reduce adverse outcomes in patients with high residual risk identified by post-PCI intravascular imaging. Clinical Trial Registration: https://clinicaltrials.gov/study/NCT07084259, Identifier NCT07084259. Copyright 2026 Kim, Park, Shin, Kook and Lim. <36> Accession Number 649834368 Title Complete revascularization timing in ST-segment elevation myocardial infarction and multivessel disease with heart failure: the OPTION-STEMI trial. Source European heart journal. 47(12) (pp 1435-1452), 2026. Date of Publication: 24 Mar 2026. Author Kim M.C.; Ahn J.H.; Hyun D.Y.; Lim Y.; Cho K.H.; Lee S.H.; Park S.; Oh S.; Sim D.S.; Hong Y.J.; Kim J.H.; Jeong M.H.; Cho J.H.; Lee S.-R.; Kang D.O.; Hwang J.-Y.; Youn Y.J.; Lee J.-H.; Jeong Y.-H.; Ahn J.-H.; Kim D.-B.; Choo E.H.; Kim C.J.; Kim W.; Rhew J.Y.; Park J.-I.; Yoo S.-Y.; Ahn Y. Institution (Kim, Ahn, Hyun, Lim, Cho, Lee, Park, Oh, Sim, Hong, Kim, Jeong, Ahn) Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, 42 Jebong-ro ,Dong-gu, Gwangju, South Korea (Park) Division of Cardiology, Department of Internal Medicine, Mokpo Hankook Hospital, Mokpo, South Korea (Jeong) Division of Cardiology, Department of Internal Medicine, Gwangju Veterans Hospital, Gwangju, South Korea (Cho) Division of Cardiology, Department of Internal Medicine, St Carollo General Hospital, Suncheon, South Korea (Lee) Division of Cardiology, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, South Korea (Kang) Cardiovascular Center, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea (Hwang) Division of Cardiology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, South Korea (Youn, Lee) Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea (Lee, Park) Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, South Korea (Jeong) CAU Thrombosis and Biomarker Center, Chung-Ang University Gwangmyeong Hospital, Department of Internal Medicine, Chung-Ang University College of Medicine, South Korea and Division of Cardiology, Seoul, South Korea (Jeong, Ahn) Division of Cardiology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, South Korea (Kim) Division of Cardiology, Department of Internal Medicine, Bucheon St. Mary's Hospital, Catholic University of Korea, Bucheon, South Korea (Choo) Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, South Korea (Kim) Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, Catholic University of Korea, South Korea (Kim) Division of Cardiology, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea (Rhew) Division of Cardiology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, South Korea (Yoo) Division of Cardiology, Department of Internal Medicine, Good Morning Hospital, Pyeongtaek, South Korea (Yoo) Division of Cardiology, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea Abstract BACKGROUND AND AIMS: The optimal timing of complete revascularization in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease complicated by heart failure remains uncertain. METHOD(S): The OPTION-STEMI (Optimal Timing of Fractional Flow Reserve-Guided Complete Revascularization for Non-Infarct-Related Artery in ST-segment Elevation Myocardial Infarction with Multivessel Disease) trial compared immediate vs staged complete revascularization during the index admission in patients with STEMI and multivessel disease. In the OPTION-STEMI trial, immediate complete revascularization was not found to be non-inferior for the primary endpoint compared with staged complete revascularization. Pre-specified subgroup analysis was performed according to heart failure at admission, defined as Killip class II or III. The primary endpoint was a composite of death from any cause, non-fatal myocardial infarction, or any unplanned revascularization at 1 year. RESULT(S): Among 994 randomized patients, 329 (33.1%) had heart failure at admission. These patients had a higher risk of primary endpoint than those without heart failure (18.2% vs 8.7%; adjusted HR 1.63; 95% CI 1.11-2.40; P = .013). At 1 year, immediate complete revascularization was associated with a higher incidence of the primary endpoint than staged complete revascularization in patients with heart failure (22.8% vs 13.3%; HR 1.79; 95% CI 1.05-3.04), but not in those without heart failure (8.0% vs 9.5%; HR 0.84; 95% CI .50-1.40). A significant interaction was observed between heart failure status and randomized strategy (P = .043). CONCLUSION(S): In the OPTION-STEMI trial, among patients with STEMI and multi-vessel disease who were not in cardiogenic shock, immediate complete revascularization was not non-inferior compared with staged complete revascularization. However, subgroup analysis suggests that the worse outcomes with immediate complete revascularization may be limited to patients with heart failure at admission. Further studies are required to demonstrate the non-inferiority of immediate complete revascularization compared with staged complete revascularization in patients without heart failure. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact <37> Accession Number 2023301965 Title Cost-effectiveness of Fibrinogen Concentrate vs Cryoprecipitate for Treating Acquired Hypofibrinogenemia in Bleeding Adult Cardiac Surgical Patients. Source JAMA Surgery. 158(3) (pp 245-253), 2023. Date of Publication: 08 Mar 2023. Author Abrahamyan L.; Tomlinson G.; Callum J.; Carcone S.; Grewal D.; Bartoszko J.; Krahn M.; Karkouti K. Institution (Abrahamyan, Tomlinson, Carcone, Krahn, Karkouti) Toronto General Hospital Research Institute, University Health Network, 10th Floor Eaton North, Room 237, 200 Elizabeth St, Toronto, ON, Canada (Abrahamyan, Carcone, Krahn) Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, ON, Canada (Abrahamyan, Tomlinson, Bartoszko, Krahn, Karkouti) Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada (Tomlinson) Biostatistics Research Unit, University Health Network, Toronto, ON, Canada (Callum) Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre, Queen's University, Kingston, ON, Canada (Grewal, Bartoszko, Karkouti) Department of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada (Bartoszko, Karkouti) Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada (Bartoszko, Karkouti) Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada Publisher American Medical Association Abstract Importance: Excessive bleeding requiring fibrinogen replacement is a serious complication of cardiac surgery. However, the relative cost-effectiveness of the 2 available therapies - fibrinogen concentrate and cryoprecipitate - is unknown. Objective(s): To determine cost-effectiveness of fibrinogen concentrate vs cryoprecipitate for managing active bleeding in adult patients who underwent cardiac surgery. Design, Setting, and Participant(s): A within-trial economic evaluation of the Fibrinogen Replenishment in Surgery (FIBERS) randomized clinical trial (February 2017 to November 2018) that took place at 4 hospitals based in Ontario, Canada, hospitals examined all in-hospital resource utilization costs and allogeneic blood product (ABP) transfusion costs incurred within 28 days of surgery. Participants included a subset of 495 adult patients from the FIBERS trial who underwent cardiac surgery and developed active bleeding and acquired hypofibrinogenemia requiring fibrinogen replacement. Intervention(s): Fibrinogen concentrate (4 g per dose) or cryoprecipitate (10 units per dose) randomized (1:1) up to 24 hours postcardiopulmonary bypass. Main Outcomes and Measures: Effectiveness outcomes included number of ABPs administered within 24 hours and 7 days of cardiopulmonary bypass. ABP transfusion (7-day) and in-hospital resource utilization (28-day) costs were evaluated and a multivariable net benefit regression model built for the full sample and predefined subgroups. Result(s): Patient level costs for 495 patients were evaluated (mean [SD] age 59.2 [15.4] years and 69.3% male.) Consistent with FIBERS, ABP transfusions and adverse events were similar in both treatment groups. Median (IQR) total 7-day ABP cost was CAD $2280 (US dollars [USD] $1697) (CAD $930 [USD $692]-CAD $4970 [USD $3701]) in the fibrinogen concentrate group and CAD $2770 (USD $1690) (IQR, CAD $1140 [USD $849]-CAD $5000 [USD $3723]) in the cryoprecipitate group. Median (interquartile range) total 28-day cost was CAD $38180 (USD $28431) $(IQR, CAD $26350 [USD $19622]-CAD $65080 [USD $48463]) in the fibrinogen concentrate group and CAD $38790 (USD $28886) (IQR, CAD $26180 [USD $19495]-CAD $70380 [USD $52409]) in the cryoprecipitate group. After exclusion of patients who were critically ill before surgery (11%) due to substantial variability in costs, the incremental net benefit of fibrinogen concentrate vs cryoprecipitate was positive (probability of being cost-effective 86% and 97% at $0 and CAD $2000 (USD $1489) willingness-to-pay, respectively). Net benefit was highly uncertain for nonelective and patients with critical illness. Conclusions and Relevance: Fibrinogen concentrate is cost-effective when compared with cryoprecipitate in most bleeding adult patients who underwent cardiac surgery with acquired hypofibrinogenemia requiring fibrinogen replacement. The generalizability of these findings outside the Canadian health system needs to be verified. Copyright © 2023 American Medical Association. All rights reserved. <38> Accession Number 2044126352 Title Prevalence of persistent left superior vena cava in the general population: a systematic review with meta-analysis. Source Anatomical Science International. (no pagination), 2026. Date of Publication: 2026. Author Gondorf D.; Triantafyllou G.; Paschopoulos I.; Arkoudis N.-A.; Prountzos S.; Samolis A.; Tsakotos G.; Piagkou M. Institution (Gondorf, Triantafyllou, Paschopoulos, Samolis, Tsakotos, Piagkou) Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str., Goudi, Athens, Greece (Triantafyllou, Piagkou) "VARIANTIS" Research Laboratory, Department of Clinical Anatomy, Masovian Academy in Plock, Plock, Poland (Arkoudis) Research Unit of Radiology and Medical Imaging, National and Kapodistrian University of Athens, Athens, Greece (Arkoudis, Prountzos) Second Department of Radiology, General University Hospital "Attikon", National and Kapodistrian University of Athens, Athens, Greece Publisher Springer Abstract Persistent left superior vena cava is a congenital variation of the thoracic venous system. Although it is often asymptomatic, its presence can complicate procedures such as central venous access, cardiac device implantation, and cardiothoracic surgery. Reported prevalence data are inconsistent and predominantly derived from populations with underlying cardiac pathology. This study seeks to provide a robust, evidence-based estimate of the prevalence of persistent left superior vena cava in populations not preselected for congenital heart disease. Additionally, it aims to quantify its principal anatomical configurations, including the laterality of the superior vena cava and the presence or absence of a bridging brachiocephalic vein. A systematic search was conducted using PubMed, Google Scholar, Scopus, and Web of Science. Studies documenting the prevalence of persistent left superior vena cava in populations not selected on the basis of congenital heart disease criteria were included. Statistical analysis was carried out using random-effects meta-analytic models. Eighteen studies (n = 169,835 individuals) were included. The pooled prevalence of persistent left superior vena cava was 0.61% (95% CI: 0.38-0.89), with substantial heterogeneity across studies. Subgroup analysis demonstrated higher detection rates in cadaveric investigations (2.08%) compared with interventional studies (0.38%), likely reflecting differences in detection sensitivity. Bilateral superior vena cava was observed in 0.32% of the population, whereas isolated persistent left superior vena cava occurred in 0.10%. A bridging brachiocephalic vein was present in approximately 0.11% of the total population. Although uncommon, persistent left superior vena cava is a reproducible component of thoracic venous morphology with embryological significance. Awareness of its anatomical configurations is important in diagnostic and procedural contexts, especially when a dilated coronary sinus is observed during imaging. Copyright © The Author(s) 2026. <39> Accession Number 2044221491 Title Ketamine as a Neuroprotective Intervention to Prevent Early Post-CABG Delirium: A Triple-Blind Randomized Clinical Trial. Source Journal of Cellular and Molecular Anesthesia. 11(1) (no pagination), 2026. Article Number: e168850. Date of Publication: 01 Mar 2026. Author Aligholizadeh M.; Kiaei M.M.; Dolatabadi M.R.M.; Moshki A.; Rajabzadeh R.; Ghorbanlo M.; Sangi S. Institution (Aligholizadeh, Sangi) Department of Anesthesia and Operating Room, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Kiaei, Moshki, Ghorbanlo) Department of Anesthesiology and Pain Medicine, Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Dolatabadi) Department of Anesthesiology and Pain Management, Health Management Research Institute, School of Medicine and Hospital Management, Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Rajabzadeh) Department of Community Medicine, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran, Islamic Republic of Publisher Brieflands Abstract Background: Postoperative delirium frequently occurs after coronary artery bypass graft (CABG) surgery, negatively impacting patient recovery and outcomes. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist with analgesic and anti-inflammatory effects, is considered a potential strategy for delirium prevention. Objective(s): This study examines the efficacy of intravenous ketamine administered during anesthesia induction in reducing postoperativee delirium among CABG patients. Method(s): A triple-blind, randomized, placebo-controlled clinical trial was performed on 92 patients scheduled for elective CABG surgery. Participants were randomly allocated to receive either ketamine (0.5 mg/kg, n = 46) or an equivalent placebo dose at anesthesia induction (n = 46). Delirium was assessed at 24 and 48 hours postoperatively using the Intensive Care Delirium Screening Checklist (ICDSC), covering the peak period of delirium incidence after CABG. Due to clinical workflow and resource constraints, long-term follow-up beyond 48 hours was not conducted. Statistical analyses included chi-square tests and t-tests, conducted using SPSS version 19, with a two-sided significance level of 0.05. Result(s): Baseline demographic and surgical characteristics were similar between groups. Delirium incidence at 24 hours was significantly lower in the ketamine group (2.2%) compared to the control group (17.4%) (P = 0.045). At 48 hours, the rates were 4.4% in the ketamine group versus 26.1% in controls (P = 0.038). These preliminary findings suggest a possible association between ketamine and reduced early delirium, though small event numbers and short follow-up limit definitive conclusions. Conclusion(s): Ketamine was associated with a lower incidence of early postoperative delirium; however, the small number of delirium events limits the strength of this conclusion. Larger trials with extended follow-up and comprehensive safety monitoring are essential before clinical implementation. Copyright © 2026, Aligholizadeh et al. <40> Accession Number 2043768409 Title Treatment of rheumatoid arthritis-associated interstitial lung disease: what is new since the 2022 SER-SEPAR recommendations?. Source Reumatologia Clinica. 22(4) (no pagination), 2026. Article Number: 502104. Date of Publication: 01 Apr 2026. Author Narvaez J.; Diaz del Campo Fontecha P.; Nieto M.A.; Villaverde Garcia V.; Candelas Rodriguez G.; Balsa A. Institution (Narvaez) Servicio de Reumatologia, Hospital Universitario de Bellvitge, Barcelona, Hospitalet de Llobregat, Spain (Diaz del Campo Fontecha) Unidad de Investigacion, Sociedad Espanola de Reumatologia, Madrid, Spain (Nieto) Servicio de Neumologia, Hospital Clinico San Carlos, Madrid, Spain (Villaverde Garcia) Servicio de Reumatologia, Hospital Universitario de Mostoles, Madrid, Mostoles, Spain (Candelas Rodriguez) Servicio de Reumatologia, Hospital Universitario Clinico San Carlos, Madrid, Spain (Balsa) Servicio de Reumatologia, Hospital Universitario La Paz, Madrid, Spain Publisher Ediciones Doyma, S.L. Abstract Objective: In 2020, the Spanish Society of Rheumatology (SER) and the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) published joint recommendations on the management of rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Since then, new evidence has emerged supporting an update focused on treatment. Method(s): A systematic literature review was conducted covering the period from October 2020 to October 2025. Result(s): IL-6 and JAK inhibitors (JAKi) show efficacy comparable to rituximab (RTX) and abatacept (ABA) in controlling joint disease, preserving pulmonary function, limiting radiological progression, and reducing RA-ILD-related mortality, without a significant increase in serious respiratory events. ABA has not demonstrated a lower risk of severe or opportunistic infections; therefore, these four options (ABA, RTX, anti-IL6, and JAKi) may be used interchangeably in RA-ILD patients requiring treatment intensification. In those with a progressive fibrosing phenotype and intolerance to nintedanib, pirfenidone may be considered. Conclusion(s): Recent evidence has expanded the therapeutic options available for RA-ILD. Copyright © 2026 Sociedad Espanola de Reumatologia (SER), Colegio Mexicano de Reumatologia (CMR) y Elsevier Espana, S.L.U. <41> Accession Number 2042947683 Title Comparative Effectiveness of Single-Dose Epidural Esketamine versus Hydromorphone in Thoracic and Upper Abdominal Surgery: A Randomized Trial. Source Drug Design, Development and Therapy. 20 (pp 1-10), 2026. Date of Publication: 2026. Author Song Y.; Wang C.; Huang N.; He H.; Hong W.; Wu J.; Yao M.; Miao C.; Liang C. Institution (Song, Wang, Huang, He, Hong, Wu, Yao, Miao, Liang) Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China Publisher Dove Medical Press Ltd Abstract Purpose: This study aimed to evaluate the effectiveness of a single epidural dose of esketamine versus hydromorphone in patients undergoing abdominal and thoracic surgeries. Patients and Methods: Patients undergoing elective abdominal and thoracic surgery were randomly assigned to receive either a single epidural injection of 15 mg esketamine (Group E) or 0.5 mg hydromorphone (Group H) at the end of surgery. All patients received intravenous patient-controlled analgesia postoperatively. The primary outcome was hydromorphone consumption within 48 hours after surgery. Secondary outcomes included time to first rescue analgesia, hydromorphone consumption within 0-24, 24-48, and 48-72 hours, numerical rating scale (NRS) pain scores, postoperative recovery scores, and complications. Result(s): In total, 205 patients were enrolled, with 186 randomly assigned to either group E (n = 93) or group H (n = 93). Hydromorphone consumption within 48 hours postoperatively was significantly higher in group E than in group H. The time to first rescue analgesia was significantly longer in group H compared to group E. Within the first 24 hours postoperatively, patients in group E required more hydromorphone than those in group H. No significant difference in hydromorphone consumption between the two groups at 24-48 and 48-72 hours postoperatively. The NRS scores during movement were significantly higher in group E than in group H at 3 and 6 hours postoperatively. Conclusion(s): Single-dose epidural esketamine for postoperative analgesia resulted in higher hydromorphone consumption and a shorter time to first rescue analgesia compared to hydromorphone. Copyright © 2026 Song et al. <42> Accession Number 2044460259 Title Effect of vitamin D on postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting: a systematic review and meta-analysis. Source Minerva Cardiology and Angiology. 74(1) (pp 75-82), 2026. Date of Publication: 01 Feb 2026. Author Nisa F.; Nauman H.M.; Lal P.K.; Assad A.A.; Arain M.; Ali R.; Saleem H.M.; Shafiq F.; Farooq A.U.; Zeb M.A.; Ijaz H.; Laeeq F.; Ibrahim M.; Arshad M.S. Institution (Nisa) Department of Medicine, Fatima Jinnah Medical University, Lahore, Pakistan (Nauman) Department of Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan Medical and Dental College, Lahore, Pakistan (Lal) Department of Medicine, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan (Assad, Saleem) Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan (Arain, Arshad) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (Ali) Department of Medicine, People University of Medical and Health Sciences SBA, Nawabshah, Pakistan (Shafiq) Department of Medicine, Karachi Medical and Dental College, Karachi, Pakistan (Farooq, Ijaz) Department of Medicine, King Edward Medical University, Lahore, Pakistan (Zeb) Department of Medicine, Swat Medical College, Khyber Pakhtunkhwa, Pakistan (Laeeq) Department of Medicine, Shalamar Medical and Dental College, Lahore, Pakistan (Ibrahim) Department of Medicine, Ziauddin University, Karachi, Pakistan Publisher Edizioni Minerva Medica Abstract INTRODUCTION: The aim of this paper was to determine whether vitamin D supplementation reduces the incidence of postoperative atrial fibrillation (POAF) in patients undergoing coronary artery bypass grafting (CABG). EVIDENCE ACQUISITION: PubMed and Cochrane Central Register of Controlled Trials were systematically searched from inception through May 2023 for randomized controlled trials (RCTs) assessing the effectiveness of Vitamin D in preventing atrial fibrillation among postoperative patients after CABG. EVIDENCE SYNTHESIS: The primary outcome extracted was the incidence of atrial fibrillation after Vitamin D in CABG patients. Secondary outcome included the length of hospital stay. Data were pooled using a random-effect model. A total of 4 RCTs, involving 694 patients, were included in the final analysis. The results showed that Vitamin D supplementation significantly reduced the incidence of POAF in CABG patients (RR: 0.55; 95% CI: 0.40 to 0.76; P=0.0003; I2=1%). However, administration of Vitamin D did not lead to significant reduction in the length of hospital stay (WMD: -0.14; 95% CI: -0.82 to 0.53; P=0.68; I2=34%). CONCLUSION(S): Our updated pooled analysis concludes that vitamin D reduces the incidence of POAF in CABG patients. Future large-scale studies should focus on more diverse patient populations and explore a broader range of outcomes to better understand the full impact of Vitamin D supplementation in this context. Copyright © 2025 EDIZIONI MINERVA MEDICA. <43> Accession Number 650776271 Title Computed Tomography in Preoperative Planning of Minimally Invasive Valvular Heart Surgery: A Systematic Review of Mixed Evidence and Clinical Application. Source European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. (no pagination), 2026. Date of Publication: 28 Mar 2026. Author Bejand E.A.; Suwita B.M.; Akowuah E.; Deshpande R.; Zacharias J.; Iyengar S.; Rajiah P.; Bahrami T.; Mirsadraee S. Institution (Bejand, Mirsadraee) National Heart and Lung Institute, School of Medicine, Imperial College London, London, United Kingdom (Suwita, Mirsadraee) Department of Radiology, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Akowuah) School of Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (Deshpande) Department of Cardiothoracic Surgery, King's College Hospital, London, United Kingdom (Zacharias) Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom (Iyengar) Department of Radiology, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, United Kingdom (Rajiah) Department of Radiology, Mayo Clinic, Rochester, MN, United States (Bahrami) Department of Cardiac Surgery, Royal Brompton and Harefield Hospitals, Guy's and St, Thomas' NHS Foundation Trust, London, United Kingdom Abstract OBJECTIVES: Minimally invasive cardiac surgery (MICS) offers significant advantages over conventional sternotomy, including reduced trauma and faster recovery. Preoperative planning is crucial, with computed tomography (CT) emerging as an essential imaging tool. This systematic review aims to evaluate CT's role in MICS planning, focusing on imaging protocols, surgical guidance, and patient outcomes. METHOD(S): This study included studies published between January 2003 and January 2025 that examined the role of CT imaging in planning minimally invasive valvular heart surgery. A comprehensive search was conducted in MEDLINE, CINAHL, and EMBASE using predefined keywords and MeSH terms related to CT imaging, angiography, minimally invasive surgery, robotic surgery, aortic valve surgery, and mitral valve surgery. RESULT(S): Initial search found 378 studies, and 17 studies were included in the review. The studies highlight CT's value in assessing surgical feasibility, vascular access, and risk stratification. CT aids in selecting arterial cannulation sites, guiding aortic occlusion strategies, and optimising port placement. It also identifies contraindications, such as extensive atherosclerosis and anatomical abnormalities that may necessitate sternotomy. CONCLUSION(S): Current evidence underscores CT's critical role in optimising MICS planning and enhancing patient safety. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further informat <44> [Use Link to view the full text] Accession Number 2043261676 Title Neurologic Complications of Cardiac Disease and Cardiac Procedures. Source CONTINUUM Lifelong Learning in Neurology. 32(1) (pp 23-56), 2026. Date of Publication: 01 Feb 2026. Author Jones L.K.; Das A.S.; Feske S.K. Publisher Lippincott Williams and Wilkins Abstract ABSTRACT - OBJECTIVE - This article reviews the neurologic complications of common cardiac conditions and cardiac procedures.LATEST DEVELOPMENTS - During the past two decades, there has been an expansion of pharmacologic and procedural strategies to reduce stroke risk in patients with atrial fibrillation (eg, direct oral anticoagulants, left atrial appendage occlusion, and catheter ablation), patent foramen ovale (ie, percutaneous closure in selected patients), and those undergoing cardiac surgery (eg, embolic protection devices).ESSENTIAL POINTS - Because stroke is the most common neurologic complication associated with cardiac disease, most newer pharmacologic agents and interventions have been designed to reduce the risk of cardioembolism, particularly from atrial fibrillation, the most prevalent cardiac arrhythmia. Common cardiac procedures such as coronary artery bypass grafting and valve replacement surgery can result in stroke and cognitive decline. Neurologists must be aware of the evolving evidence and tools to mitigate neurologic risks in these patients. Copyright © 2026 Lippincott Williams & Wilkins <45> Accession Number 650777117 Title Impact of FloTrac/EV1000-guided intraoperative hemodynamic optimization on postoperative outcomes in cardiac valve surgery: a randomized controlled trial. Source Scientific reports. (no pagination), 2026. Date of Publication: 29 Mar 2026. Author Tribuddharat S.; Ratanasuwan P.; Sathitkarnmanee T.; Chaimala N.; Polsena L.; Mantruad P. Institution (Tribuddharat, Ratanasuwan, Sathitkarnmanee) Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (Chaimala, Polsena) Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand (Mantruad) Queen Sirikit Heart Center of the Northeast, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand <46> [Use Link to view the full text] Accession Number 650778599 Title Discontinuation of Beta-Blocker Therapy after Myocardial Infarction. Source The New England journal of medicine. (no pagination), 2026. Date of Publication: 30 Mar 2026. Author Choi K.H.; Kang D.; Kim W.; Doh J.-H.; Park Y.H.; Ahn S.G.; Park J.P.; Kim S.M.; Cho B.R.; Nam C.-W.; Cho J.H.; Joo S.-J.; Suh J.; Jeong J.-O.; Jang W.J.; Goh C.W.; Yoon C.-H.; Hwang J.-Y.; Lim S.-H.; Lee S.R.; Shin E.-S.; Kim B.J.; Yu C.W.; Her S.-H.; Kim H.K.; Park K.T.; Kim J.; Park T.K.; Lee J.M.; Cho J.; Yang J.H.; Song Y.B.; Choi S.-H.; Gwon H.-C.; Guallar E.; Hahn J.-Y. Institution (Choi, Kim, Kim, Park, Lee, Yang, Song, Choi, Gwon, Hahn) Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Kang, Cho) Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea (Kim) Kyung Hee University Hospital, Seoul, South Korea (Doh) Inje University Ilsan Paik Hospital, Goyang, South Korea (Kim) Chonnam National University Hospital, Gwangju, South Korea (Park) Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea (Ahn) Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, South Korea (Park) Presbyterian Medical Center, Jeonju, South Korea (Kim) Chungbuk National University Hospital, Cheongju, South Korea (Cho) Kangwon National University Hospital, Chuncheon, South Korea (Nam) Keimyung University Dongsan Hospital, Daegu, South Korea (Cho) St. Carollo Hospital, Suncheon, South Korea (Joo) Jeju National University Hospital, South Korea (Suh) Soonchunhyang University Hospital, Bucheon, South Korea (Jeong) Chungnam National University Hospital, Daejeon, South Korea (Jang) Chung-Ang University Hospital, Seoul, South Korea (Goh) Ewha Woman's University Seoul Hospital, Seoul, South Korea (Yoon) Seoul National University Bundang Hospital, Seongnam, South Korea (Hwang) Gyeongsang National University Hospital, Jinju, South Korea (Lim) Dankook University Hospital, Cheonan, South Korea (Lee) Jeonbuk National University Hospital, Jeonju, South Korea (Shin) Ulsan University Hospital, Ulsan, South Korea (Kim) Kangbuk Samsung Hospital, Seoul, South Korea (Yu) Korea University Anam Hospital, Seoul, South Korea (Her) Catholic University of Korea, Seoul, South Korea (Kim) Chosun University Hospital, Gwangju, South Korea (Park) Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon, South Korea (Guallar) Department of Epidemiology, School of Global Public Health, New York University, NY, United States Abstract BACKGROUND: The role of long-term beta-blocker therapy after a myocardial infarction in patients without left ventricular systolic dysfunction or heart failure is unclear in the era of contemporary coronary-artery reperfusion and secondary prevention interventions. METHOD(S): We conducted an open-label, randomized, noninferiority trial at 25 centers in South Korea. Patients whose condition remained stable after a myocardial infarction, who had a left ventricular ejection fraction of at least 40% and no heart failure, and who had received beta-blocker therapy for at least 1 year after the myocardial infarction were randomly assigned in a 1:1 ratio to discontinue or to continue beta-blocker therapy. The primary end point was a composite of death from any cause, recurrent myocardial infarction, or hospitalization for heart failure. The prespecified noninferiority margin was an upper limit of the 95% confidence interval for the hazard ratio of 1.4. RESULT(S): A total of 2540 patients underwent randomization; 1246 were assigned to beta-blocker discontinuation and 1294 to beta-blocker continuation. The mean age of the patients was 63.2 years, and 12.8% were women. At a median follow-up of 3.1 years (interquartile range, 2.5 to 3.5), a primary end-point event had occurred in 58 patients (4-year Kaplan-Meier estimate, 7.2%) in the discontinuation group and in 74 patients (4-year Kaplan-Meier estimate, 9.0%) in the continuation group (hazard ratio, 0.80; 95% confidence interval, 0.57 to 1.13; P = 0.001 for noninferiority). The incidence of serious adverse events was similar in the two groups. CONCLUSION(S): Among patients who received beta-blocker therapy beyond the first year after a myocardial infarction, discontinuation of beta-blocker therapy was noninferior to continuation with respect to a composite of death from any cause, recurrent myocardial infarction, or hospitalization for heart failure. (Funded by Patient-Centered Clinical Research Coordinating Center in the Ministry of Health and Welfare, South Korea; SMART-DECISION ClinicalTrials.gov number, NCT04769362.). Copyright © 2026 Massachusetts Medical Society. <47> [Use Link to view the full text] Accession Number 650779070 Title Left Atrial Appendage Closure or Anticoagulation for Atrial Fibrillation. Source The New England journal of medicine. (no pagination), 2026. Date of Publication: 28 Mar 2026. Author Doshi S.K.; Kar S.; Nair D.G.; Waggoner T.; Agarwal H.; Moussavian M.; Kashani A.; Oza S.; Feldman L.; Sadhu A.; DeLurgio D.; Alli O.; Nielsen-Kudsk J.E.; Yamamoto M.; Alkhouli M.; Camm A.J.; Coylewright M.; Gibson C.M.; Granger C.B.; Gurol M.E.; Huber K.C.; Mansour M.; Natale A.; Pocock S.J.; Reddy V.Y.; Saliba W.I.; Asch F.M.; Wehrenberg S.; Frost K.; Christen T.; Sutton B.S.; Stein K.M.; Leon M.B.; Ellenbogen K.A. Institution (Doshi) Los AngelesMexico (Doshi) Pacific Heart Institute, Santa Monica, CA, United States (Kar) Los Robles Hospital and Medical Center, Thousand Oaks, CA, United States (Nair) Arrhythmia Research Group, Jonesboro, AR, United States (Waggoner) U.S. Heart and Vascular, Tucson, AZ, United States (Agarwal) Bergan Cardiology, Omaha, NE, United States (Moussavian) Cardiovascular Institute of San Diego, Chula Vista, CA, United States (Kashani) Memorial Hermann Memorial City Medical Center, Houston, United States (Oza) Ascension St. Vincent's, Jacksonville, FL, Puerto Rico (Feldman) Eisenhower Medical Center, Rancho Mirage, CA, United States (Sadhu) Phoenix Cardiovascular Research Group, Phoenix, AZ, United States (DeLurgio) Emory University Hospital, Atlanta, United States (Alli) Novant Health Presbyterian Medical Center, Charlotte, NC (Nielsen-Kudsk) Aarhus University Hospital, Aarhus, Denmark (Yamamoto) Toyohashi Heart Center, Toyohashi, Japan (Alkhouli) Mayo Clinic Foundation, Rochester, MN, United States (Camm) Cardiology Clinical Academic Group, Molecular and Clinical Sciences Institute, City St. George's University of London, London, United Kingdom (Coylewright) Heart and Vascular Center, Essentia Health-St. Mary's Medical Center, Duluth, MN, United States (Gibson) Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States (Granger) Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, United States (Gurol, Mansour) Massachusetts General Hospital, Boston, United States (Huber) Division of Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, MO, United States (Natale) Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, United States (Natale) Department of Biomedicine and Prevention, Division of Cardiology, University of Tor Vergata, Rome, United States (Pocock) Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom (Reddy) Helmsley Trust Electrophysiology Center, Icahn School of Medicine at Mount Sinai, NY, United States (Saliba) Cleveland Clinic Foundation, Cleveland, United States (Asch) MedStar Health Research Institute, MedStar Washington Hospital Center, WA, United States (Wehrenberg, Frost, Christen, Sutton, Stein) Boston Scientific, Marlborough, MA (Leon) Columbia University Medical Center, NY, United States (Ellenbogen) Division of Cardiology, Virginia Commonwealth University School of Medicine, Richmond, United Kingdom Abstract BACKGROUND: For patients with atrial fibrillation, the use of oral anticoagulant therapy to prevent stroke is limited by the risk of bleeding. Left atrial appendage closure is considered for patients who are unsuitable candidates for long-term anticoagulation, but its role in patients who are eligible for anticoagulants has not been established. METHOD(S): In this ongoing, prospective, international, randomized trial involving patients with atrial fibrillation who were suitable candidates for anticoagulation, we randomly assigned patients in a 1:1 ratio to receive either device-based left atrial appendage closure (device group) or non-vitamin K antagonist oral anticoagulant (NOAC) therapy (anticoagulation group). The primary efficacy end point - a composite of death from cardiovascular causes, stroke, or systemic embolism - was tested for noninferiority (noninferiority margin, 4.8 percentage points) after 3 years of follow-up. The primary safety end point, non-procedure-related bleeding, was tested for superiority. RESULT(S): Of the 3000 patients who underwent randomization, 1499 were assigned to the device group and 1501 to the anticoagulation group. The mean (+/-SD) age of the patients was 71.7+/-7.5 years, 31.9% of the patients were women, and the mean CHA2DS2-VASc score was 3.5+/-1.3. At 3 years, a primary efficacy end-point event had occurred in 81 patients (Kaplan-Meier estimate, 5.7%) in the device group and in 65 patients (Kaplan-Meier estimate, 4.8%) in the anticoagulation group (difference, 0.9 percentage points; 95% confidence interval [CI], -0.8 to 2.6; P<0.001 for noninferiority). Non-procedure-related bleeding occurred in 154 patients (Kaplan-Meier estimate, 10.9%) in the device group and in 260 patients (Kaplan-Meier estimate, 19.0%) in the anticoagulation group (hazard ratio, 0.55; 95% CI, 0.45 to 0.67; P<0.001 for superiority). CONCLUSION(S): Among patients with atrial fibrillation who were candidates for anticoagulation, device-based left atrial appendage closure was noninferior to NOAC therapy with respect to a composite of death from cardiovascular causes, stroke, or systemic embolism and was superior to NOAC therapy for non-procedure-related bleeding at 3 years. (Funded by Boston Scientific; CHAMPION-AF ClinicalTrials.gov number, NCT04394546.). Copyright © 2026 Massachusetts Medical Society. <48> Accession Number 2044504152 Title A comparison of two different management plans for patients requiring both carotid endarterectomy and coronary artery bypass grafting. Source Cardiovascular Journal of Africa. 32(3) (pp 129-132), 2021. Date of Publication: 01 May 2021. Author Ecevit A.N.; Karaca O.G.; Kalender M.; Bekmezci M.; Ali Sungur M.; Darcin O.T. Institution (Ecevit) Bilkent City Hospital, Yuksek Ihtisas Cardiovascular Surgery Hospital, Ankara, Turkey (Karaca) Department of Cardiovascular Surgery, Medical Faculty, Duzce University, Duzce, Turkey (Kalender) Department of Cardiovascular Surgery, Derince Traning and Research Hospital, Kocaeli, Turkey (Bekmezci) Dr Ali Kemal Belviranli Obstetric and Gynecology Hospital, Konya, Turkey (Ali Sungur) Department of Biostatistics and Medical Informatics, Medical Faculty, Duzce University, Duzce, Turkey (Darcin) Department of Cardiovascular Surgery, Antalya Traning and Research Hospital, Antalya, Turkey Publisher Clinics Cardive Publishing (PTY)Ltd Abstract Background: Carotid endarterectomy (CEA) is a prophylactic operation that is used to mitigate the risk of stroke caused by embolism of atherosclerotic plaques in the carotid bifurcation. Previously, the large, multicentre, randomised, controlled GALA study found no significant differences in clinical outcomes between patients treated using general or local anaesthesia. While this study provided important insights into disease outcomes based on treatment modalities, it did not answer questions regarding the safety of CEA under local anaesthesia in patients at high risk for cardiovascular complications. Here, we examined the use of two different management plans in patients requiring both carotid endarterectomy and coronary artery bypass grafting (CABG), in terms of their effects on hospital mortality. Method(s): Thirty-four patients consecutively operated on in our cardiovascular department were included in this analysis. The patients were divided into two groups based on the anaesthetic management plan. The first group consisted of patients who underwent CEA and CABG under general anaesthesia in the same session (GA group); the second group consisted of patients who initially underwent CEA under cervical block anaesthesia followed by CABG under general anaesthesia in a separate session (CB-GA group). These two groups were compared in terms of postoperative complications and hospital mortality. Result(s): The incidence of postoperative myocardial infarction was higher in the CB-GA group, with four patients experiencing postoperative myocardial infarction, compared to no patients in the GA group. Conclusion(s): For patients requiring CEA and CABG, performing both operations under general anaesthesia in the same session was safer than initially performing CEA under cervical block anaesthesia followed by CABG under general anaesthesia. Copyright © 2021 Clinics Cardive Publishing (PTY)Ltd. All rights reserved. <49> Accession Number 650785472 Title Effectiveness of non-pharmacological and pharmacological interventions in preventing delirium in older adults: a systematic review and meta-analysis of randomised controlled trials. Source Age and ageing. 55(3) (no pagination), 2026. Date of Publication: 16 Mar 2026. Author Sanchez A.; Sawant-Uttekar P.; Heinen D.; Pribadi A.N.; Thomas C.; von Arnim C.; Kuhnle J.; Kreisel S.H.; Hewer W.; Fath B.; Sadlonova M.; Rapp M.; Deeken F. Institution (Sanchez, Heinen, Pribadi, Rapp, Deeken) Department of Social and Preventive Medicine, University of Potsdam, Potsdam, Brandenburg, Germany (Sawant-Uttekar) Marien Hospital Stuttgart, Klinik fur Geriatrie, Baden-Wurttemberg, Stuttgart, Germany (Thomas) Department of Old Age Psychiatry and Psychotherapy, Klinikum Stuttgart, Baden-Wurttemberg, Stuttgart, Germany (Thomas) Department of Neurology and Neurophysiology, Medical Center, University of Freiburg, Baden-Wurttemberg, Freiburg, Germany (Thomas) Department of Anaesthesiology, Klinikum Stuttgart, Baden-Wurttemberg, Stuttgart, Germany (von Arnim, Kuhnle, Sadlonova) Department of Geriatrics, University Medical Center Gottingen, Gottingen, Lower Saxony, Germany (Kuhnle, Fath) Department of Geriatric Psychiatry and Psychotherapy, Klinikum Stuttgart, Baden-Wurttemberg, Stuttgart, Germany (Kuhnle, Sadlonova) German Center for Cardiovascular Research (DZHK), Gottingen, Lower Saxony, Germany (Kreisel) Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy Bethel, Evangelisches Krankenhaus Bielefeld, North Rhine-Westphalia, Bielefeld, Germany (Hewer, Fath) Clinic for Geriatric Psychiatry, Klinikum Christophsbad, Goppingen, Baden-Wurttemberg, Germany (Sadlonova) Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Goettingen, Goettingen, Lower Saxony, Germany (Sadlonova) Department of Cardiac, Thoracic and Vascular Surgery, University Medical Center Goettingen, Lower Saxony, Germany (Sadlonova) Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States (Rapp) German Center for Mental Health (DZPG), Germany, Potsdam, Brandenburg, Germany Abstract BACKGROUND: Delirium is a serious neuropsychiatric condition common among older adults, associated with prolonged hospital stays, increased morbidity and mortality. Although guidelines emphasise prevention, identifying most effective measures is crucial. OBJECTIVE(S): To evaluate the efficacy of non-pharmacological and pharmacological interventions in preventing delirium in older adults (>=65 years). METHOD(S): We conducted a systematic review and meta-analysis of randomised controlled trials across settings, excluding ICU-only studies. MEDLINE, Cochrane, Web of Science and PsycINFO were searched through October 2024. Comparators included standard care, placebo, or other drugs. Random-effects models estimated pooled risk ratios. Risk of bias was assessed using RoB 2.0. Subgroup analyses were performed by setting and drug type. PROSPERO: CRD42024500387. RESULT(S): Eighty-seven trials (19,289 randomised patients) were included. Non-pharmacological multicomponent interventions (k = 17) significantly reduced delirium occurrence (risk ratio [RR] = 0.56, 95% CI 0.45-0.72; I2 = 63%) versus usual care, although certainty of evidence was very low. Effects were significant in non-cardiovascular surgical and medical patients. Single-component non-pharmacological interventions (k = 9) showed mixed or inconclusive findings. Among pharmacological trials (k = 53), dexmedetomidine reduced delirium risk (RR = 0.49; 95% CI 0.43-0.57; low-certainty) in non-cardiovascular surgical patients. Corticosteroids and intranasal insulin showed significant effects (high-certainty), based on a small number of trials. Mixed strategies, such as haemodynamic or cerebral oxygen-guided approaches, suggested potential benefit but were heterogeneous. CONCLUSION(S): Non-pharmacological multicomponent interventions reduce delirium occurrence and should be prioritised. Dexmedetomidine showed benefit in non-cardiac surgical populations, while evidence for other drugs remains inconclusive. Overall, certainty was low to very low, highlighting the need for further high-quality randomised trials to ensure generalisability. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact jou <50> Accession Number 2044599607 Title Short-term outcomes of commercial transcatheter tricuspid valve intervention: a systematic review and meta-analysis. Source Annals of Cardiothoracic Surgery. 15(2) (no pagination), 2026. Article Number: 17. Date of Publication: 01 Mar 2026. Author Ng D.K.Y.; Downes D.; Gupta R.; Droungas Y.; Nguyen K.; Wilson-Smith A.R. Institution (Ng, Gupta) Department of Cardiothoracic Surgery, Westmead Hospital, Sydney, Australia (Downes) School of Medicine, University of New England, Armidale, Australia (Droungas) School of Medicine, Deakin University, Geelong, Australia (Nguyen) Department of Cardiology, Liverpool Hospital, Sydney, Australia (Wilson-Smith) School of Medicine, Macquarie University, Sydney, Australia Publisher AME Publishing Company Abstract Background: Severe tricuspid regurgitation (TR) is associated with increased all-cause mortality and morbidity. Isolated tricuspid valve surgery is uncommon due to high perioperative mortality and typically co-morbid patients. Transcatheter tricuspid interventions are an increasingly common therapeutic option becoming available for this high-risk patient cohort. This systematic review and meta-analysis sought to determine the short-term outcomes of these patients. Method(s): Four databases were searched from their inception to August 2025. All studies reporting 1-year mortality and New York Heart Association (NYHA) class pre- and post-intervention were identified. Studies utilizing non-commercially available devices were excluded. Relevant data were extracted, and meta-analysis was conducted using a random-effects model. Result(s): Thirteen studies were included, encompassing a total of 1,589 patients. The aggregate mean age was 78.0 years. Thirty-day mortality was 1.8%, with 1-year mortality and heart failure hospitalization rates at 9.9% and 20.1%, respectively. At 1-year, TR was moderate or less in 66.5% of patients, and 81.1% of patients reported NYHA I or II status. Conclusion(s): Transcatheter tricuspid interventions provide sustained symptomatic benefit and reduction in TR at one year. Copyright © AME Publishing Company. <51> [Use Link to view the full text] Accession Number 650778282 Title Angiography-Based Physiology to Guide Coronary Revascularization. Source The New England journal of medicine. (no pagination), 2026. Date of Publication: 29 Mar 2026. Author Daemen J.; van der Eijk J.A.; Barbierato M.; Byrne R.A.; Canova P.; De Maria G.L.; Van Belle E.; Amat-Santos I.; Mangieri A.; Hovasse T.; Sabate M.; Margey R.; Biscaglia S.; Rivero F.; D'Amario D.; Abdelwahed Y.S.; Oemrawsingh R.M.; Moreno R.; Cockburn J.; Testa L.; de Vries T.; Landmesser U.; Banning A.P.; Tijssen J.G.P.; Spitzer E. Institution (Daemen, van der Eijk) Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, Netherlands (Barbierato) Department of Cardiology, Ospedale dell'Angelo-ULSS 3 Serenissima, Mestre, Italy (Byrne) Department of Cardiology, Mater Private Network, Dublin, United States (Byrne) Cardiovascular Research Institute Dublin, Mater Private Network, Dublin, United States (Byrne) School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, United States (Canova) Department of Cardiology, Ospedale Papa Giovanni XXIII, Bergamo, Italy (De Maria, Banning) Oxford Heart Centre, John Radcliffe, Oxford University Hospitals, National Health Service Foundation Trust, Oxford, United Kingdom (Van Belle) Department of Cardiology, Centre Hospitalier Universitaire Lille, Lille, France (Van Belle) Department of Interventional Cardiology for Coronary Valves and Structural Heart Diseases, INSERM, Institut Pasteur de Lille, European Genomic Institute for Diabetes, Universite de Lille, Lille, France (Amat-Santos) Department of Cardiology, Hospital Clinico Universitario Valladolid, Valladolid, Spain (Mangieri) Department of Cardiology, IRCCS Humanitas Research Hospital, Milan, United States (Hovasse) Department of Cardiology, Institut Cardiovasculaire Paris Sud, Hopital Jacques Cartier, Massy, France (Sabate) Cardiology Department, Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer, University of Barcelona, Centro de Investigacion Biomedica en Red Enfermedades Cardiovaculares (CIBER-CV), Barcelona, Philippines (Margey) Department of Cardiology, Mater Private Cork, Cork, Ireland (Biscaglia) Department of Cardiology, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy (Rivero) Department of Cardiology, Instituto de Investigacion Sanitaria Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, Madrid, Spain (D'Amario) Dipartimento di Medicina Translazionale, Universita del Piemonte Orientale, Novara, Italy (D'Amario) Department of Cardiology, Ospedale Maggiore della Carita, Novara, Italy (Abdelwahed, Landmesser) Department of Cardiology, Angiology, Intensive Care Medicine, Charite-Universitatsmedizin Berlin, Berlin, Germany (Abdelwahed) Deutsches Zentrum fur Herz-Kreislauf-Forschung, Partner Site Berlin, Berlin, Germany (Oemrawsingh) Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, Netherlands (Moreno) Department of Cardiology, La Paz Hospital, Madrid, Spain (Cockburn) Department of Cardiology, Royal Sussex County Hospital, Brighton, United Kingdom (Testa) Coronary Revascularization Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy (de Vries, Spitzer) Cardialysis, Rotterdam, Netherlands (Banning) National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, United Kingdom (Tijssen) Amsterdam University Medical Centers, Department of Cardiology, Amsterdam, United States (Spitzer) European Cardiovascular Research Institute, Rotterdam, Netherlands Abstract BACKGROUND: Current society guidelines recommend physiological assessment of intermediate coronary lesions to guide revascularization. Data regarding revascularization guided by vessel fractional flow reserve (vFFR), derived from three-dimensional quantitative coronary angiography without the need for a pressure wire or hyperemic agent, as compared with pressure-wire-based fractional flow reserve (FFR), are lacking. METHOD(S): We conducted an international, open-label, randomized, noninferiority trial at 37 sites in Europe. Patients with intermediate coronary-artery lesions (diameter stenosis of 30 to 80%) who presented with chronic or acute coronary syndromes were randomly assigned in a 1:1 ratio to undergo either vFFR-guided or FFR-guided revascularization of the intermediate coronary-artery lesions. The primary end point was a composite of death from any cause, any myocardial infarction, or any revascularization at 1 year. The noninferiority margin was 3.0 percentage points. RESULT(S): The primary end point was assessed in 1116 patients in the vFFR group and 1095 in the FFR group. The mean age of the patients was 67 years, 24.3% were women, 18.7% presented with an acute coronary syndrome, and 26.6% had diabetes mellitus. At 1 year, a primary end-point event had occurred in 80 patients (Kaplan-Meier estimate, 7.5%) in the vFFR group and in 79 patients (Kaplan-Meier estimate, 7.5%) in the FFR group (risk difference, -0.02 percentage points; 95% confidence interval, -2.25 to 2.21; P = 0.004 for noninferiority). The incidence of serious adverse events appeared to be similar in the two groups. CONCLUSION(S): Among patients with intermediate coronary lesions, vFFR-guided revascularization was noninferior to FFR-guided revascularization with respect to a composite of death, myocardial infarction, or revascularization at 1 year. (Funded by Pie Medical Imaging and Siemens Healthineers; FAST III ClinicalTrials.gov number, NCT04931771.). Copyright © 2026 Massachusetts Medical Society. <52> Accession Number 2044463130 Title Prognostic value of blood pressure variability in patients with heart failure: a systematic review and meta-analysis. Source Journal of Human Hypertension. (no pagination), 2026. Date of Publication: 2026. Author Nurhafizah A.; Huang W.; Frederich A.; Khairunnisa A.R.; Zahrani R.A.F.; Atmojo S.; Siswanto B.B. Institution (Nurhafizah, Huang, Frederich, Khairunnisa, Zahrani) Faculty of Medicine, University of Padjadjaran, Sumedang, Indonesia (Nurhafizah, Huang, Khairunnisa, Atmojo, Siswanto) National Cardiovascular Center Harapan Kita, Jakarta, Indonesia (Siswanto) Department of Cardiology and Vascular Medicine, Universitas Indonesia, Depok, Indonesia Publisher Springer Nature Abstract Blood pressure variability (BPV) has been associated with increased morbidity and mortality across various cardiovascular conditions, but its prognostic significance in heart failure (HF) remains insufficiently established. This review aims to assess the potential utility of BPV as a prognostic marker in the HF population. We conducted a systematic review and meta-analysis of 15 studies including 33,022 patients (mean age 66.2 +/- 10.5 years). Composite endpoints included all-cause mortality, cardiovascular mortality, HF rehospitalization, nonfatal stroke, nonfatal myocardial infarction, and heart transplantation. Pooled hazard ratios were calculated using a generic inverse variance approach under a random-effects model. Higher long-term BPV was significantly associated with increased risk of composite outcomes (HR 1.20, 95% CI 1.01-1.43; I2 = 89%, p = 0.03) and all-cause mortality (HR 1.15, 95% CI 1.05-1.25; I2 = 49%, p = 0.001). Daytime short-term BPV showed an inverse association (OR 0.96, 95% CI 0.92-0.99; I2 = 0%, p = 0.01), while a U-shaped relationship between long-term BPV and risk of composite outcomes and cardiovascular mortality was observed. These findings suggest that BPV may serve as a prognostic factor for secondary risk stratification in patients with HF. Copyright © The Author(s), under exclusive licence to Springer Nature Limited 2026. <53> Accession Number 650776636 Title Clinical applicability of anti-Xa measurements to monitor unfractionated heparin activity during arterial procedures: a scoping review. Source Journal of thrombosis and haemostasis : JTH. (no pagination), 2026. Date of Publication: 27 Mar 2026. Author Hoebink M.; Steunenberg T.A.H.; Smit S.; Hamer H.M.; Wiersema A.M.; Yeung K.K.; Jongkind V. Institution (Hoebink, Wiersema, Jongkind) Amsterdam UMC location Vrije Universiteit, department of Vascular Surgery, De Boelelaan 1117, Amsterdam, the Netherlands; Dijklander Ziekenhuis, department of Vascular Surgery, Maelsonstraat 3, Hoorn, the Netherlands; Amsterdam Cardiovascular Sciences, Atherosclerosis and Aortic Diseases, Amsterdam, the Netherlands (Steunenberg) Amsterdam UMC location Vrije Universiteit, department of Vascular Surgery, De Boelelaan 1117, Amsterdam, the Netherlands; Dijklander Ziekenhuis, department of Vascular Surgery, Maelsonstraat 3, Hoorn, the Netherlands; Amsterdam UMC, location AMC, Laboratory Specialized Diagnostics & Research, department of Laboratory Medicine, Meibergdreef 9, Amsterdam, the Netherlands (Smit) Amsterdam UMC location Vrije Universiteit, department of Vascular Surgery, De Boelelaan 1117, Amsterdam, Netherlands (Hamer) location AMC, Laboratory Specialized Diagnostics & Research, department of Laboratory Medicine, Meibergdreef 9, Amsterdam, Netherlands (Yeung) Amsterdam UMC location Vrije Universiteit, department of Vascular Surgery, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences, Atherosclerosis and Aortic Diseases, Amsterdam, the Netherlands Abstract The anti-Xa test is regarded as the standard assay to measure unfractionated heparin activity in a laboratory setting, but its use during arterial procedures has not been established. The objectives of this systematic review, designed as a scoping review, were to structure the existing body of evidence, identify possible research gaps, and provide guidance for future research on the applicability of anti-Xa to measure the heparin activity during arterial procedures. Literature search resulted in 55 included reports (cardiac procedures: 44 reports, non-cardiac procedures: nine reports, cardiac and non-cardiac procedures: two reports). During arterial procedures, anti-Xa is widely used as reference laboratory test to validate heparin point-of-care assays, compare different heparinization strategies, and measure residual heparin activity at the end of the procedure or after heparin reversal using protamine. There is considerable heterogeneity among included reports, which hampers the ability to draw firm conclusions. The available literature is insufficient to define optimal periprocedural heparin activity measured by anti-Xa. Currently, anti-Xa is not used as a primary heparin monitoring assay during arterial procedures. The impact of alterations in periprocedural anti-Xa activity on clinical outcomes has been rarely investigated. Anti-Xa measurements appear to be reproducible compared to point-of-care heparin activity essays but require standardization. In conclusion, anti-Xa is useful as a reference test to evaluate point-of-care heparin testing and compare heparin strategies during arterial procedures, but there is a high need for studies to investigate correlation of anti-Xa levels with clinical outcomes and to determine optimal anti-Xa levels for arterial procedures. Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved. <54> Accession Number 2044460211 Title Association between lipoprotein levels and outcomes after coronary artery bypass grafting surgery: a systematic review and meta-analysis. Source Minerva Cardiology and Angiology. 74(1) (pp 128-134), 2026. Date of Publication: 01 Feb 2026. Author Cancelli G.; Harik L.; Ibrahim M.; Hameed I.; Rossi C.; Caldonazo T.; Dell'Aquila M.; Soletti G.J.; An K.R.; Leith J.; Demetres M.; Dimagli A.; Gaudino M.F. Institution (Cancelli, Harik, Rossi, Caldonazo, Dell'Aquila, Soletti, An, Leith, Dimagli, Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United States (Ibrahim) Department of General Surgery, Maimonides Medical Center, Brooklyn, NY, United States (Hameed) Department of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, CT, United States (Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, NY, United States Publisher Edizioni Minerva Medica Abstract INTRODUCTION: Lipoprotein(a) (Lp[a]) is a variant of low-density lipoprotein (LDL) and has been associated with increased risk of vascular inflammation and thrombosis. Coronary artery bypass grafting (CABG) has been associated with local inflammation of the myocardium. It is plausible, therefore, that patients with elevated baseline Lp(a) may be prone to unfavorable clinical outcomes following CABG. We evaluate differences in outcomes between CABG patients with high and low serum Lp(a) in this meta-analysis. EVIDENCE ACQUISITION: A comprehensive literature search was performed to identify studies reporting outcomes in CABG patients stratified by preoperative Lp(a) level. When possible, the outcomes were pooled in a meta-analysis. We assessed post-operative mortality, major cardiovascular events, stroke occurrence and saphenous graft occlusion. EVIDENCE SYNTHESIS: Eight studies involving 8681 patients were included. Articles used varying cut-offs for high versus low Lp(a), and outcomes varied. In the three studies evaluating mortality, two showed no statistically significant difference between groups while one reported increased mortality associated with high Lp(a) level. Both studies investigating major adverse cardiovascular events reported higher risk in patients with high Lp(a). A study-level meta-analysis of four studies reporting saphenous vein graft occlusion incidence after CABG was performed. High (>=30 mg/dL) preoperative Lp(a) was not associated with an increased risk of graft occlusion compared with low (<30 mg/dL) preoperative Lp(a) (OR=1.88, 95% CI: 0.66-5.36; P=0.15). CONCLUSION(S): Studies evaluating the impact of Lp(a) on outcomes in CABG patients are few, with heterogenous cutoffs and outcomes In the limited ublished studies L (a) level was not associated with raft occlusion Copyright © 2024 EDIZIONI MINERVA MEDICA. <55> Accession Number 2043262086 Title Impact of Sternal Precautions on Clinical and Patient-Reported Outcomes in Patients Undergoing Cardiac Surgery via Sternotomy: A SCOPING REVIEW. Source Journal of Cardiopulmonary Rehabilitation and Prevention. Publish Ahead of Print (no pagination), 2026. Date of Publication: 02 Feb 2026. Author Blakoe M.; Gottlieb R.; Hojskov I.E.; Olsen D.B.; Damgaard S.; Christensen J. Institution (Blakoe, Hojskov) Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Blakoe) Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark (Gottlieb, Christensen) Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Olsen, Damgaard) Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Christensen) Department of Public Health, Section of Social Medicine, Copenhagen University, Copenhagen, Denmark Publisher Lippincott Williams and Wilkins Abstract Purpose: - Patients undergoing cardiac surgery via sternotomy are typically advised to follow sternal precautions for 8 to 12 weeks post-operatively. These precautions vary across surgical centers, and current recommendations are primarily based on heterogeneous studies and expert opinion. This scoping review aimed to map the impact of upper body movement and sternal precaution strategies on clinical and patient-reported outcomes within 1 year post-operatively in adult patients undergoing cardiac surgery via sternotomy. Review methods: - The review was reported based on the PRISMA-ScR (Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Eligible studies included randomized controlled trials; nonrandomized controlled trials; quasi-experimental, prospective, and retrospective cohort studies; mixed methods studies; case studies; case-control studies; and cross-sectional studies. Studies were considered eligible if they included patients >=18 years undergoing cardiac surgery via sternotomy and examined the relationship between sternal precautions or upper body movement strategies within 12 weeks post-operatively and any clinical or patient-reported outcomes within 1 year post-operatively. The systematic literature search was conducted in March 2025 in 6 databases. Summary: - Of 16 464 unique records screened, 12 studies involving 2853 patients were included. These studies found that neither weighted upper body movement strategies nor less restrictive sternal precautions negatively affect sternal wound infections, sternal stability, pain, length of hospital stay, readmissions, or health-related quality of life. Positive improvements were found in functional status and discharge disposition in patients following a less restrictive sternal regimen. The body of evidence indicates that weighted upper body movement strategies and less restrictive sternal precautions do not negatively affect the investigated clinical or patient-reported outcomes post-sternotomy. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <56> [Use Link to view the full text] Accession Number 650778873 Title Angiography-Derived Fractional Flow Reserve to Guide PCI. Source The New England journal of medicine. (no pagination), 2026. Date of Publication: 29 Mar 2026. Author Fearon W.F.; Jeremias A.; Witberg G.; Al-Lamee R.; Cohen D.J.; Kaki A.; Sharma R.P.; Yeh R.W.; Chehab B.M.; Kim M.C.; Otake H.; Tayal R.; Matsuo H.; McEntegart M.; Patel A.K.; Sandoval Y.; Al-Azizi K.M.; Dan K.; Razzouk L.; Fournier S.; Popma A.; Popma J.J.; Zhao D.; Redfors B.; Madhavan M.V.; Kornowski R.; Leon M.B.; Kirtane A.J. Institution (Fearon, Sharma) Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford, CA, United States (Fearon) Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States (Jeremias, Cohen, Popma, Popma, Zhao, Redfors, Madhavan, Leon, Kirtane) Cardiovascular Research Foundation, NY, United States (Jeremias, Cohen) Department of Cardiology, St. Francis Hospital and Heart Center, Roslyn, NY, United States (Witberg, Kornowski) Department of Cardiology, Rabin Medical Center ,Petah Tikva, Israel (Witberg, Kornowski) Gray School of Medicine, Tel Aviv University, Tel Aviv, Israel (Al-Lamee) National Heart and Lung Institute, Imperial College London, London, United Kingdom (Al-Lamee) Imperial College Healthcare NHS Trust, London, United Kingdom (Kaki) Interventional Cardiology Department, Ascension St. John Hospital and Center, Detroit, United States (Yeh, Popma) Division of Cardiovascular Medicine, Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States (Chehab) University of Kansas, Ascension Via Christi Hospital, Wichita, United States (Kim) Lenox Hill Hospital, Northwell Health, NY, United States (Otake) Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan (Tayal) Valley Health Hospital, Paramus, NJ, United States (Matsuo) Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan (McEntegart, Madhavan, Leon, Kirtane) Columbia University Irving Medical Center of the NewYork-Presbyterian Hospital, NY, United States (Patel) Hackensack Meridian School of Medicine, Hackensack Meridian Mountainside Medical Center, Montclair, NJ, United States (Sandoval) Allina Health Minneapolis Heart Institute, Abbott Northwestern Hospital and Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation Minneapolis (Al-Azizi) PlanoTXUnited States (Dan) Ichinomiyanishi Hospital, Aichi, Japan (Razzouk) NYU Langone Health and NYU School of Medicine, Department of Medicine, Division of Cardiology, NY, United States (Fournier) Lausanne University Center Hospital, Lausanne, Switzerland (Redfors) Department of Population Health Sciences, Weill Cornell Medicine, NY, United States (Redfors) Department of Molecular and Clinical Medicine, Gothenburg University, Gothenburg, Sweden (Redfors) Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden (Kornowski) Tel Aviv University, Tel Aviv, Israel Abstract BACKGROUND: Assessing intermediate coronary lesions with an intracoronary pressure wire improves clinical outcomes in patients undergoing cardiac catheterization and percutaneous coronary intervention (PCI). However, clinical use of pressure-wire-based physiological assessment remains low. Measurement of fractional flow reserve (FFR) derived from coronary angiographic images alone correlates well with pressure-wire-based FFR measurements and may simplify procedures, but its effect on clinical outcomes is unknown. METHOD(S): In this international noninferiority trial, we randomly assigned patients undergoing coronary angiography who were found to have at least one intermediate coronary stenosis to physiological assessment with measurements derived from angiographic images (FFRangio) or with pressure-wire-based measurements. The primary end point was a composite of death, myocardial infarction, or unplanned, clinically indicated coronary revascularization at 1 year. The noninferiority margin was 3.5 percentage points. RESULT(S): A total of 1930 patients were randomly assigned to physiological assessment with FFRangio (FFRangio group; 965 patients) or a pressure-wire-based approach (pressure-wire group; 965 patients). The mean age of the patients was 68.4 years, and 25.0% of the patients were women. At 1 year, a primary end-point event had occurred in 64 patients (Kaplan-Meier estimate, 6.9%) in the FFRangio group and 65 patients (Kaplan-Meier estimate, 7.1%) in the pressure-wire group (hazard ratio, 0.98; 95% confidence interval, 0.70 to 1.39; difference, -0.2 percentage points; upper boundary of the one-sided 97.5% confidence interval, 2.1 percentage points; P<0.001 for noninferiority). There were no apparent differences between the groups with respect to the incidence of bleeding, acute kidney injury, or procedure-related adverse events. CONCLUSION(S): Among patients with intermediate coronary-artery lesions undergoing physiological assessment in the cardiac catheterization laboratory, an angiography-guided strategy involving FFRangio was noninferior to a pressure-wire-guided strategy with respect to a composite end point of death, myocardial infarction, or unplanned clinically indicated coronary revascularization at 1 year. (Funded by CathWorks; ALL-RISE ClinicalTrials.gov number, NCT05893498.). Copyright © 2026 Massachusetts Medical Society. <57> Accession Number 2044434702 Title Design and rationale of the prospective, randomized, controlled trial to assess the management of moderate aortic stenosis by clinical surveillance or transcatheter aortic valve replacement: The PROGRESS Trial. Source American Heart Journal. 297 (no pagination), 2026. Article Number: 107433. Date of Publication: 01 Jul 2026. Author Genereux P.; Makkar R.R.; Bax J.J.; Pibarot P.; Lindman B.R.; Prince H.; Park B.; Cohen D.J.; Mack M.J.; Leon M.B. Institution (Genereux) Morristown Medical Center, Gagnon Cardiovascular Institute, Morristown, NJ, United States (Makkar) Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, United States (Bax) Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands (Pibarot) Quebec Heart & Lung Institute, Laval University, Quebec City, QC, Canada (Lindman) Cardiovascular Medicine Division, Structural Heart and Valve Center, Vanderbilt University Medical Center, Nashville, TN, United States (Prince, Park) Edwards Lifesciences, Irvine, CA, United States (Cohen) St. Francis Hospital and Heart Center, Roslyn, NY, United States (Cohen, Leon) Cardiovascular Research Foundation, New York, NY, United States (Mack) Department of Cardiothoracic Surgery, Baylor Research Institute, Baylor Scott and White the Heart Hospital Plano, Plano, TX, United States (Leon) Division of Cardiology, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, NY, United States Publisher Elsevier Inc. Abstract Background For patients with moderate aortic stenosis (AS), current US guidelines recommend clinical surveillance every 1 to 2 years. However, moderate AS has been associated with increased morbidity and mortality in multiple observational studies, suggesting a possible role for earlier treatment with transcatheter aortic valve replacement (TAVR). To date, no large, randomized trial has examined whether an early intervention with TAVR will improve outcomes among these patients. Study Design and Objectives The PROGRESS trial is a prospective, open-label, randomized, controlled, multicenter trial that includes up to 750 patients with moderate AS and at-risk features randomized 1:1 to either clinical surveillance or transfemoral TAVR with the SAPIEN 3/SAPIEN 3 Ultra/SAPIEN 3 Ultra RESILIA transcatheter heart valve (Edwards Lifesciences, Irvine, CA). Patients are stratified by site, left ventricular ejection fraction, and peak jet velocity. The primary effectiveness endpoint is the composite of death or heart failure event with or without hospitalization at 2 years. The primary safety endpoint (evaluated in the TAVR arm only) is a composite of death, stroke, life threatening or fatal bleeding, acute kidney injury stage 4, hospitalization due to device- or procedure-related complications, or valve dysfunction requiring reintervention at 30 days. Patients will be followed annually through 10 years. Conclusions The PROGRESS trial is the first large, randomized trial assessing the role of early intervention among patients with moderate AS with at-risk features compared to clinical surveillance. Trial Registration Number ClinicalTrials.gov identifier: NCT04889872 Copyright © 2026 The Authors. <58> Accession Number 2044253736 Title Left Atrium and Mitral Valve Hemodynamics in Patients With Mitral Stenosis Pre and Post-Percutaneous Balloon Mitral Valvuloplasty: A Systematic Review and Meta-Analysis. Source Catheterization and Cardiovascular Interventions. (no pagination), 2026. Date of Publication: 2026. Author Zaied M.A.; Shahzaib M.; Mukhlis M.; Latif J.; Fatima N.; Brohi F.; Alam U.; Singh P. Institution (Zaied) Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Shahzaib) King Edward Medical University, Lahore, Pakistan (Mukhlis) Ayub Medical College, Abbottabad, Pakistan (Latif) Allama Iqbal Medical College, Lahore, Pakistan (Fatima) Gomal Medical College, Dera Ismail Khan, Pakistan (Brohi) Peoples University of Medical and Health Sciences for Women, Nawabshah, Pakistan (Alam) Khyber Medical College, Peshawar, Pakistan (Singh) Kirori Mal College, Delhi University, Delhi, India Publisher John Wiley and Sons Inc Abstract Mitral stenosis (MS) is still a significant cause of cardiovascular morbidity and mortality in low- and middle-income countries, despite being nearly eradicated in the developed world. Percutaneous balloon mitral valvuloplasty (PBMV) is the treatment of choice for appropriate patients with MS, but traditional predictors such as mitral valve area and regurgitation grade fail to fully reflect long-term prognosis. This review aims to analyze pre- and post-PBMV hemodynamic changes in the left atrium and determine their prognostic significance in predicting clinical outcomes in patients with MS. This meta-analysis followed PRISMA guidelines and was registered in PROSPERO (CRD420251017356). PubMed, Scopus, and Web of Science were searched on March 23, 2025, for studies on adults >= 18 years with isolated MS undergoing PBMV. Eligible studies reported both pre- and post-procedure valve and hemodynamic parameters. Primary outcomes included mitral valve area, mean gradient, and left atrial indices. Pooled analyses were conducted in R (v 4.5.1). This meta-analysis included the outcomes of PBMV by comparing pre- and post-procedural data from 30 studies consisting of 2239 participants. Post-PBMV outcomes revealed a significant increase in mitral valve area (MD 0.8834, 95% CI: 0.80; 0.96, p < 0.0001), cardiac output (MD 0.70, 95% CI: 0.58; 0.81, p < 0.0001), and alongside significant reductions in left atrial diameter (MD -4.47; 95% CI: -6.23 to -2.71, p < 0.0001), left atrial pressure (MD -9.51, 95% CI: -11.19; -7.84, p < 0.0001), mitral valve pressure (MD -8.58, 95% CI: -9.41; -7.74, p < 0.0001), and systolic pulmonary pressure (MD -17.96, 95% CI: -21.48; -14.45, p < 0.0001). Out of 2239 patients, 71, 37, and 32 had valve replacement, PBMV repetition, and experienced death, respectively. PBMV showed promising effectiveness and safety in treating patients with MS with a significant increase in cardiac output and MV area and a significant decrease in LA diameter, LA pressure, MV pressure, and systolic pulmonary pressure post-PBMV, while observing low adverse events. Copyright © 2026 Wiley Periodicals LLC. <59> Accession Number 2044432664 Title Percutaneous coronary intervention versus coronary artery bypass grafting for unprotected left main stenosis: 10-year final results from the randomised, open-label, non-inferiority NOBLE trial. Source The Lancet. 407(10536) (pp 1374-1382), 2026. Date of Publication: 04 Apr 2026. Author Holck E.N.; Holm N.R.; Hildick-Smith D.; Lindsay M.M.; Spence M.S.; Erglis A.; Menown I.B.A.; Steigen T.; Hune Mogensen L.J.; Modrau I.S.; Niemela M.; Lassen J.F.; Oldroyd K.; Stradins P.; Walsh S.J.; Endresen P.C.; Trovik T.; Frobert O.; Graham A.N.J.; Anttila V.; Trivedi U.; Thuesen L.; Christiansen E.H. Institution (Holck, Holm, Hune Mogensen, Christiansen) Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (Modrau) Department of Cardio-Thoracic Surgery, Aarhus University Hospital, Aarhus, Denmark (Holck, Hune Mogensen, Modrau, Frobert, Christiansen) Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Hildick-Smith) Sussex Cardiac Centre, University Hospitals Sussex, Brighton, United Kingdom (Lindsay, Oldroyd) Heart, Lung, and Diagnostic Division, Golden Jubilee University National Hospital, Clydebank, United Kingdom (Spence, Walsh) Department of Cardiology, Royal Victoria Hospital, Belfast, United Kingdom (Erglis) Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, Riga, Latvia (Stradins) Cardiac Sugery Centre, Pauls Stradins Clinical University Hospital, Riga, Latvia (Menown) Craigavon Cardiac Centre, Southern Health and Social Care Trust, Portadown, United Kingdom (Steigen) Department of Cardiology, University Hospital of Northern Norway, Troms, Norway (Niemela) Medical Research Center, University of Oulu, Oulu University Hospital, Oulu, Finland (Lassen) Department of Cardiology, Odense University Hospital, Odense, Denmark (Endresen) Department of Thoracic and Vascular Surgery, University Hospital of Northern Norway, Troms, Norway (Trovik) Department of Cardiology, Nordland Hospital Trust, Bod, Norway (Frobert) Department of Cadiology, Orebro University Hospital, Orebro, Sweden (Graham) Department of Cardiac Surgery, Royal Victoria Hospital, Belfast, United Kingdom (Anttila) Heart Center, Turku University Hospital, University of Turku, Turku, Finland (Trivedi) Royal Sussex County Hospital, Brighton, United Kingdom (Thuesen) Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark Publisher Elsevier B.V. Abstract Background Coronary artery bypass grafting (CABG) is recommended over percutaneous coronary intervention (PCI) for patients with significant unprotected left main coronary artery disease. We aim to provide long-term outcome data comparing PCI with newer generation drug-eluting stents and CABG, which are scarce. Methods This previously published, prospective, randomised, open-label, non-inferiority trial enrolled patients with unprotected left main coronary artery stenosis at 36 hospitals in Denmark, Estonia, Finland, Germany, Latvia, Lithuania, Norway, Sweden, and the UK. Eligibility was determined by a multidisciplinary heart team and defined by clinical criteria (chronic or acute coronary syndrome and a life expectancy of >1 year) and angiographic criteria (left main coronary artery diameter stenosis >=50% or fractional flow reserve <=0.80 in the left main ostium, mid-shaft, or bifurcation). Patients with ST elevation myocardial infarction within 24 h or considered at too high risk for CABG or PCI were excluded. Patients with angiographically confirmed significant left main coronary artery disease were randomly assigned (1:1) to PCI or CABG using an online system and stratified by site, sex, distal left main coronary artery bifurcation lesions, and diabetes. The primary outcome was the difference in 10-year all-cause mortality in the intention-to-treat (ITT) population, which was analysed using Kaplan-Meier estimates and unadjusted Cox regression. Patients were censored at the date of death, emigration, withdrawal, or loss to follow-up. Variation in all-cause mortality was assessed in prespecified subgroups. The trial is registered with ClinicalTrials.gov, NCT01496651 (active, not recruiting). Findings From Dec 9, 2008, to Jan 21, 2015, 1201 patients were randomly assigned to PCI (n=598) or CABG (n=603). 17 patients were lost to follow-up before 1 year. 592 patients in each group were included in the ITT population. Mean age was 66.2 years (SD 9.9) in the PCI group and 66.2 years (9.4) in the CABG group. 256 (22%) of 1184 participants were female and 928 (78%) were male. There was no difference in all-cause mortality at 10 years (136 [23%] of 592 in the PCI group and 145 [25%] of 592 in the CABG group; hazard ratio 0.93 [95% CI 0.74-1.18]; p=0.56). No significant difference in all-cause mortality with SYNTAX score was identified. Interpretation There was no significant difference in all-cause mortality at 10 years between PCI and CABG for patients with unprotected left main coronary artery disease and no additional complex lesions, indicating that PCI is equally as safe as CABG in patients eligible for both treatments. These results will aid heart teams in developing an individualised patient-centred strategy. Funding Biosensors and Aarhus University Hospital. Copyright © 2026 Elsevier Ltd. <60> Accession Number 650749539 Title Maternal, Valvular, and Foetal Outcomes of Pregnancy following Aortic Valve Replacement. Source European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. (no pagination), 2026. Date of Publication: 26 Mar 2026. Author Khargi S.D.M.; Grashuis P.; Veen K.M.; Kluin J.; Cornette J.M.J.; Johnson M.R.; Roos-Hesselink J.W.; Takkenberg J.J.M.; Mokhles M.M. Institution (Khargi, Grashuis, Veen, Kluin, Takkenberg) Department of Cardiothoracic Surgery, Erasmus Medical Centre, Rotterdam, Netherlands (Cornette) Department of Obstetrics and Gynaecology, Erasmus Medical Centre, Rotterdam, Netherlands (Cornette) Department of Obstetrics and Gynaecology, University of Antwerp, Antwerp, Belgium (Johnson) Department of Obstetric Medicine, Imperial College London, Kensington, London, United Kingdom (Roos-Hesselink) Department of Cardiology, Erasmus Medical Centre, Rotterdam, Netherlands (Mokhles) Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Utrecht, Netherlands Abstract OBJECTIVES: To investigate the optimal valve substitute for young women requiring aortic valve replacement (AVR), allowing improved future valve-related outcomes for mother and foetus during pregnancy. METHOD(S): A systematic search was performed for publications between 1998-2025 reporting women experiencing pregnancy after AVR with a pulmonary autograft (Ross-procedure), homograft, bioprosthesis (xenograft) or mechanical valve. Pooled proportions were calculated to determine maternal, valvular and foetal outcomes during pregnancy using generalized linear mixed models. RESULT(S): Thirteen studies reporting 356 pregnancies in 251 women(pooled mean age at pregnancy 29.1 +/- 4.8 years) after AVR with a pulmonary autograft (70 women, 119 pregnancies), homograft (73 women, 99 pregnancies), bioprosthesis (37 women, 50 pregnancies), or mechanical valve (71 women, 88 pregnancies) were included. During pregnancy, valve-related reintervention in women with a bioprosthesis was 2.7%(95% CI : 0.4-16.9) at 5.1 +/- 2.5 years after AVR. This was not observed in women with pulmonary autografts (7.7 +/- 4.2 years after AVR) and homografts(4.1 +/- 3.3 years after AVR). Reintervention for valve thrombosis(4.9%(95% CI : 1.6-14.0)) and maternal death(1.1%(95% CI : 0.2-7.6)) occurred only in women with mechanical valves(8.1 +/- 4.5 years after AVR). Pooled probability of liveborn delivery was 71.7%(95% CI : 59.2-81.6) in women with a mechanical valve, compared to 90.6%(95% CI: 72.4-97.3), 92.3%(95% CI : 56.0-99.1) and 82.9%(95% CI : 53.3-95.4) in women with an autograft, homograft or bioprosthesis respectively. CONCLUSION(S): Maternal mortality and valve thrombosis during pregnancy occurred only in women with mechanical valves. Although no statistical comparisons were made, pregnancies in women with pulmonary autograft, homograft or bioprosthesis showed acceptable maternal and foetal outcomes. These descriptive findings provide foundations for further investigation of tissue-valve function before, during and after pregnancy, aiming for more support of current guidelines. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further informat <61> Accession Number 2037899168 Title Levosimendan vs. Intra-Aortic Balloon Pump in Coronary Artery Bypass Grafting: A Meta-Analysis. Source Brazilian Journal of Cardiovascular Surgery. 41(3) (no pagination), 2026. Article Number: e20250057. Date of Publication: 2026. Author Wang Y.; Qu J.; Sheng D.; Sun X.; Zhong L.; Wu Y.; Liang H. Institution (Wang, Sheng, Zhong, Wu, Liang) Institute of Traditional Chinese Medicine Diagnostics, Hunan University of Chinese Medicine, Hunan, Changsha, China (Qu) School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Hunan, Changsha, China (Sun) Cardiology Department, Changsha Hospital of Traditional Chinese Medicine, Hunan, Changsha, China Publisher Sociedade Brasileira de Cirurgia Cardiovascular Abstract Objective: To compare the clinical efficacy and safety of intra-aortic balloon pump (IABP) and levosimendan in coronary artery bypass grafting (CABG). Method(s): A systematic search of PubMed, Embase, Cochrane Library, and Google Scholar was conducted through July 2024. Outcomes analyzed included atrial fibrillation, postoperative mediastinitis, the requirement for inotropic support, in-hospital mortality, postoperative intensive care unit (ICU) stay, postoperative length of stay, ventilation time, and mean arterial pressure (MAP) levels. Result(s): The analysis included nine studies with 681 patients. Levosimendan presented advantage over IABP in CABG patients in terms of postoperative ICU stay, postoperative length of stay, and reduction in MAP levels, with effect sizes: mean difference (MD) =-0.83, 95% confidence interval (CI)-0.97 to-0.68, P < 0.00001, MD =-1.14, 95% CI:-1.33 to-0.95, P < 0.00001, and MD =-4.55, 95% CI:-6.14 to-2.96, P < 0.00001, respectively. Levosimendan had an advantage on subgroup analyses in terms of postoperative ICU stay and postoperative length of stay, with effect sizes: MD =-0.83, 95% CI:-0.93 to-0.72, P < 0.00001 and MD =-1.14, 95% CI:-1.28 to-1.01, P < 0.00001, respectively. However, the incidence of postoperative mediastinitis was higher in the levosimendan group (relative risk = 1.45, 95% CI: 0.88 to 2.38), though not statistically significant. Conclusion(s): Levosimendan may improve recovery and hemodynamic outcomes in high-risk CABG patients compared to IABP but may be associated with a higher, though non-significant, risk of mediastinitis. Further high-quality studies are warranted. Copyright © 2026, Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved. <62> Accession Number 2044468390 Title Leadless or Transvenous pacemakers following TAVR: A systematic review and meta-analysis. Source Cardiovascular Revascularization Medicine. (no pagination), 2026. Date of Publication: 2026. Author Suruagy-Motta R.F.O.; Nogueira C.F.S.C.; Dexheimer da Silva L.; Bertoli E.D.; Barbosa G.L.V.; Pinto E.L.O.; Brigido A.R.D.; de Moraes S.R.R.; Rosa Filho A.A.M.; de Carvalho G.D.; Pileggi B.; Filho E.M.; Stone G.W.; Cavalcante J.L. Institution (Suruagy-Motta, Nogueira) Department of Medicine, Cesmac University Center, AL, Maceio, Brazil (Dexheimer da Silva) Department of Medicine, University of Sao Paulo, Brazil (Bertoli) Department of Internal Medicine, Hospital and Maternity Marieta Konder Bornhausen, Itajai, Brazil (Barbosa) Department of Medicine, Federal University of Ceara, Brazil (Pinto) Department of Medicine, University of Center Belo Horizonte, Minas Gerais, Brazil (Brigido) Department of Electrophysiology, Heart Institute of the Hospital das Clinicas, Brazil (de Moraes) Department of Cardiology, Cesmac University Center, AL, Maceio, Brazil (Rosa Filho, de Carvalho) Department of Electrophysiology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil (Pileggi) Department of Interventional Cardiology, Heart Institute of the Hospital das Clinicas, Brazil (Filho) Department of Interventional Cardiology, Santa Casa de Misericordia de Maceio, Brazil (Stone) Icahn School of Medicine at Mount Sinai, New York City, NY, United States (Cavalcante) Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, MN, United States Publisher Elsevier Inc. Abstract Introduction Transcatheter aortic valve replacement (TAVR) is frequently associated with conduction disturbances and arrhythmias, often requiring permanent pacemaker (PPM) implantation in an elderly, high-bleeding-risk population. Leadless pacemakers (LPMs) reduce pocket and lead-related complications and have demonstrated noninferior safety compared with transvenous pacemakers (TVP) in non-TAVR populations. However, comparative data in the post-TAVR setting are lacking. Methods We systematically searched Pubmed, Cochrane, Embase, Web of Sciences and Scopus for studies comparing LPM vs. TVP following TAVR. Random effects models were used to calculate risk ratios (RRs) with 95% confidence intervals (CIs) for all-cause mortality, device-related complications, re-hospitalization and vascular access site complications. Statistical analysis was performed with R software, version 4.2.3. Results Six retrospective studies comprising 10,681 patients were included, of whom 874 (7.56%) underwent LPM implantation. Compared with TVP, LPM was associated with a significant reduction in device related complications (RR 0.46; 95% 0.25-0.83; p < 0.011) and vascular access site complications (RR 0.15; 95% CI 0.03-0.68; p = 0.011). There was no significant difference in re-hospitalization (RR 0.82; 95% CI 0.23-3.12; p = 0.76). LPM was associated with a higher risk of all-cause mortality (RR 1.61; 95% CI 1.01-2.57; p = 0.047). Conclusions Among these six retrospective studies, LPM use following TAVR was associated with fewer device-related and vascular access complications compared with TVP, albeit with a higher risk of all-cause mortality at 2 years. However, this finding likely reflects a selection bias in non-adjusted baseline characteristics rather than device inferiority. No significant differences were observed in re-hospitalization between the two strategies. Prospective studies are required to confirm or refute these findings. Copyright © 2026 Elsevier Inc. <63> Accession Number 2044461435 Title Safety and efficacy of ultralow-dose fluoroscopy in left atrial appendage occlusion. Source Heart Rhythm O2. (no pagination), 2026. Date of Publication: 2026. Author Demian J.; Younis A.; El Hajjar A.H.; Kanj M.; Saliba W.I.; Santangeli P.; Tabaja C.; Baranowski B.; Taigen T.L.; Bhargava M.; Wazni O.M.; Hussein A.A. Institution (Demian, Younis, El Hajjar, Kanj, Saliba, Santangeli, Tabaja, Baranowski, Taigen, Bhargava, Wazni, Hussein) Cardiac Electrophysiology Section, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States Publisher Elsevier B.V. Abstract Background Minimizing radiation exposure has become a growing priority in electrophysiology, with increasing adoption of zero- or minimal-fluoroscopy techniques. Little is known about left atrial appendage occlusion (LAAO) using ultralow-dose fluoroscopy. Objective This study aimed to assess the safety and efficacy of an ultralow-dose fluoroscopy strategy for LAAO. Methods In a prospectively maintained registry at our center, 46 patients underwent LAAO with ultralow-dose fluoroscopy using Watchman FLX devices (Boston Scientific, Minneapolis, MN). The ultralow-dose strategy was a priori planned for these patients with the goal of minimizing radiation exposure (total radiation exposure <10 mGy), while relying on transesophageal echocardiography guidance for device placement. The ultralow-dose fluoroscopy group was compared using propensity score matching with patients treated with standard fluoroscopy guidance (1:3 matching; n = 46 vs 138). Baseline characteristics, procedural metrics, and clinical outcomes were compared between groups. Results Procedural success was 100% in both groups, with significantly shorter procedural duration in the ultralow-dose group (42 vs 60 minutes; P < .001). Periprocedural adverse events were infrequent and did not differ significantly (none in ultralow dose vs 3 cases [2.2%] in standard dose; P = .6). Closure success at 45 days was high in both groups (97.8% vs 100%; P = .3). Device-related thrombus occurred in 1 ultralow-dose patient (2.2%)-with none in the standard group ( P = .3)-and resolved without sequelae with anticoagulation. The 1-year rate of ischemic stroke or systemic embolism was similarly low between groups, with 2 (4.3%) vs 3 events (2.2%), respectively ( P = .4). Conclusion Ultralow-dose fluoroscopy is a safe and effective, radiation-sparing strategy for LAAO. Copyright © 2026 Heart Rhythm Society. <64> Accession Number 2044612875 Title Cost-utility of point-of-care viscoelastic hemostatic assays in the management of bleeding during cardiac surgery: A single-blinded prospective multicenter stepped wedge cluster randomized trial in French context. Source Anaesthesia Critical Care and Pain Medicine. (no pagination), 2026. Article Number: 101704. Date of Publication: 2026. Author Vourc'h M.; Boissier E.; Lakhal K.; Grosjean S.; Labaste F.; Robin E.; Bougle A.; Mattei M.; Morel J.; Wurtz V.; Mertes P.-M.; Zlotnik D.; Lagier D.; Beurton A.; Rineau E.; Fischer M.-O.; May M.-A.; Medard A.; Guimbretiere G.; Durand-Zaleski I.; Pere M.; Rozec B.; Rigal J.-C. Institution (Vourc'h, Lakhal, Rozec, Rigal) Anesthesie et reanimation chirurgicale, Hopital Laennec, Centre Hospitalier Universitaire de Nantes, Nantes Universite, Nantes, France (Vourc'h) INSERM CIC 0004 Immunologie et infectiologie, Nantes Universite, France (Boissier) Laboratoire d'hematologie, Hopital Laennec, Centre Hospitalier Universitaire de Nantes, Nantes Universite, Nantes, France (Grosjean) Departement d'Anesthesie-Reanimation, Centre Hospitalier Universitaire de Dijon, LNC UMR1231, Universite Bourgogne Franche Comte, Dijon, France (Labaste) Anesthesiology and Intensive Care Department, Centre Hospitalier Universitaire de Toulouse; Inserm U1048, I2MC-Institut des Maladies Metaboliques & Cardiovasculaires, Universite Paul Sabatier, Toulouse, France (Robin) Department of Anesthesia and Reanimation, Centre Hospitalier Universitaire de Lille, Bd du Pr Jules Leclercq, Lille, France (Bougle) Department of Anesthesiology and Critical Care, DMU DREAM, Hopital La Pitie-Salpetriere, APHP 75013 Paris, France. GRC 29 - Groupe de Recherche Clinique en Anesthesie Reanimation medecine Perioperatoire, ARPE, Sorbonne Universite, Paris, France (Mattei) Anesthesie et Reanimation de Chirurgie Cardiaque, Centre Hospitalier Universitaire de Nancy, Nancy, France (Morel) Departement d'anesthesie reanimation, CHU St Etienne, 25 boulevard Pasteur, Saint Etienne, France (Wurtz) Departement d'Anesthesie-Reanimation, Hopital Charles Nicolle, Centre Hospitalier Universitaire de Rouen, Rouen, France (Mertes) Service d'Anesthesie Reanimation, UMR_S 1255, Nouvel Hopital Civil - Centre Hospitalier Universitaire de Strasbourg, 83 rue Himmerich, Strasbourg, France (Zlotnik) Department of Anesthesiology and Intensive Care, Hopital Europeen Georges Pompidou, AP-HP 75015, Paris, France. INSERM UMR-S1140 "Innovations Therapeutiques en Hemostase", Universite Paris Cite, Paris, France (Lagier) Service d'Anesthesie Reanimation - CHU La Timone - APHM, UR 4264 - Centre Europeen de Recherche en Imagerie Medicale - Aix-Marseille Universite, Marseille, France (Beurton) Department of Cardiovascular Anesthesia and Critical Care, Centre Hospitalier Universitaire de Bordeaux, INSERM, UMR 1034, Biology of Cardiovascular Diseases, Universite de Bordeaux, Pessac, France (Rineau) Department of anesthesiology and critical care, Angers University Hospital, Angers, France; Univ Angers, MITOVASC INSERM U1083 - CNRS 6015, Team CARME, Angers, France (Fischer) Institut Aquitain du Coeur, Clinique Saint Augustin, ELSAN 33074 Bordeaux, France. Pole Reanimations Anesthesie, Centre Hospitalier Universitaire de Caen, Caen, France (May) Anesthesie - Reanimation Chirurgicale, Centre Hospitalier Universitaire de Tours, Tours, France (Medard) Pole Anesthesie Reanimation, Chirurgie Cardio-vasculaire, Hopital Gabriel Montpied, Centre Hospitalier Universitaire de Clermont Ferrand, Clermont Ferrand, France (Guimbretiere) Department of thoracic and cardiovascular Surgery, l'Institut du Thorax, Hopital Laennec, Centre Hospitalier Universitaire de Nantes, Nantes Universite, Nantes, France (Durand-Zaleski) Service d'epidemiologie clinique, URC-Eco AP-HP, Hotel Dieu. CRESS, Inserm, INRAE, universite Paris Cite, 75004 Paris, France; Sante Publique hopital Henri-Mondor, Universite Paris Est Creteil, Creteil, France (Pere) Plateforme de Methodologie et Biostatistique, Direction de la Recherche et de l'Innovation, Centre Hospitalier Universitaire, Nantes, France (Rozec) Nantes Universite, CNRS, INSERM, l'institut du thorax, Nantes, France Publisher Elsevier Masson s.r.l. Abstract BackgroundThe IMOTEC study aims to determine whether a point-of-care viscoelastic hemostatic assay (VHA)-guided algorithm is cost-effective for the management of ongoing bleeding.MethodsStepped wedge cluster randomized trial, patient blinded, conducted at 16 French academic cardiac surgery centers from 01/2017 to 02/2020. Adults undergoing elective or urgent cardiac surgery with ongoing bleeding were enrolled during 2 successive inclusion periods: 1) transfusion guided on standard hemostasis tests (control period), and 2) transfusion using a VHA-guided algorithm. The primary objective was to estimate the efficiency of VHA based on the 1-year incremental cost-utility ratio (ICUR, primary outcome). Secondary outcomes included transfusion, postoperative complications, duration of stay in-hospital, reintervention, and mortality.Results1095 patients were randomized, and 1044 (95.3%) were analyzed. The mean utility was 0.60 (+/-0.30) in the VHA vs. 0.61 (+/-0.30) in the control period, adjusted difference, -0.01 [95% CI, -0.09 to 0.07]. The ICUR did not suggest that the VHA-guided algorithm was cost-effective. One-year mortality was 12.0% for VHA and 10.9% for control, Hazard Ratio, 1.69 [95% CI, 0.98-2.89], P = .06. The frequency of plasma and platelet transfusions was significantly lower in the VHA compared to the control period (respectively, 48.8% vs. 72.4%, P < 0.0001 and 52.3% vs. 74.1%, P = .0002), whereas fibrinogen administration was more frequent in the VHA period (58.4% vs. 47.0%, P = .002). The median in-hospital length of stay was significantly shorter in the VHA vs. control period: 11.0 days (8.0-18.0) vs. 14.0 (9.0-22.0), P = .02.ConclusionsThe ICUR did not suggest that VHA was cost-effective in cardiac surgery patients with ongoing bleeding, compared with standard tests.Trial registrationClinical trial submission: November 2, 2016Registry name: Cost-Utility Analysis of Management of Peri Operative Hemorrhage Following Cardiac Surgery With Cardiopulmonary Bypass (IMOTEC)ClinicalTrials.gov Identifier: NCT02972684URL registry: https://clinicaltrials.gov/study/NCT02972684 Copyright © 2025 The Author(s). Published by Elsevier Masson SAS on behalf of Societe Francaise d'Anesthesie et de Reanimation (SFAR). This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <65> Accession Number 650746702 Title Long-Term Mortality After PCI or CABG for Left Main Stem Disease: Updated Meta-Analysis of Randomized Trials Using Reconstructed Individual-Participant Survival Data. Source Journal of the American College of Cardiology. (no pagination), 2026. Date of Publication: 17 Mar 2026. Author Koeckerling D.; Reddy R.K.; Howard J.P.; Bansal R.; Bernstein H.; Lehmann L.; Frey N.; Buszman P.P.; Buszman P.E.; Christiansen E.H.; Park S.-J.; Serruys P.W.; Stone G.W.; Ahmad Y. Institution (Koeckerling, Lehmann, Frey) Department of Cardiology, Angiology and Respiratory Medicine, Heidelberg University Hospital, Heidelberg, Germany (Reddy, Howard) National Heart and Lung Institute, Imperial College London, London, United Kingdom (Bansal) Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom (Bernstein, Ahmad) Division of Cardiology, University of California-San Francisco, San Francisco, CA, United States (Buszman) Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland (Buszman) Jan Dlugosz University, Czestochowa, Poland (Christiansen) Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (Park) Division of Cardiology, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul Republic of Korea, South Korea (Serruys) CORRIB Research Centre for Advanced Imaging and Core Laboratory, University of Galway, Galway, Ireland; Department of Cardiology, School of Medicine, University of Galway, Galway, Ireland (Stone) Icahn School of Medicine at Mount Sinai, NY, United States <66> [Use Link to view the full text] Accession Number 650733099 Title Perioperative management of adults with heart valve disease having noncardiac surgery: a narrative review. Source Current opinion in anaesthesiology. (no pagination), 2026. Date of Publication: 19 Mar 2026. Author Eichlseder M.; Schreiber N.; Flick M.; Sartori S. Institution (Eichlseder) Division of Anaesthesiology and Intensive Care Medicine 1 (Schreiber, Sartori) Division of Anaesthesiology and Intensive Care Medicine 2, Medical University of Graz, Graz, Austria (Flick) Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Abstract PURPOSE OF REVIEW: This article reviews the perioperative management of adults with heart valve disease undergoing noncardiac surgery. It focuses on aortic and mitral valve disease, as well as prosthetic heart valves, in the context of the substantial hemodynamic challenges imposed by anesthesia during major surgery. We aim to integrate guideline-based recommendations for preoperative evaluation and risk stratification with pathophysiological principles to support individualized intraoperative hemodynamic and anesthetic management. RECENT FINDINGS: Current literature and guidelines converge on symptom status and echocardiographic severity as key determinants of perioperative risk. For stenotic lesions, maintaining sinus rhythm, avoiding tachycardia, preserving preload, and preventing abrupt afterload reduction are central intraoperative goals. For regurgitant lesions, strategies that support forward flow by avoiding bradycardia and excessive afterload are emphasized. In prosthetic valves, perioperative management is driven by valve type/position and thromboembolic risk, guiding anticoagulation interruption and bridging, while endocarditis prophylaxis is reserved for selected high-risk dental procedures. SUMMARY: A practical approach integrates surgical urgency, valve severity, symptoms, ventricular function, and pulmonary pressures to determine whether to proceed with surgery, optimize medically, or to perform valve intervention first, and to tailor intraoperative monitoring and anticoagulation plans. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <67> Accession Number 650733363 Title Perioperative outcomes and graft patency in coronary artery bypass grafting (CABG) after no-touch saphenous vein harvesting: A single-center exploratory study. Source Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia. (no pagination), 2026. Date of Publication: 24 Mar 2026. Author Konecny J.; Troubil M.; Svitek V.; Barshatskyi A.; Sabacky D.; Simek M. Institution (Konecny, Troubil, Svitek, Barshatskyi, Sabacky, Simek) Department of Cardiovascular and Transplant Surgery, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czechia Abstract BACKGROUND: The no-touch (NT) technique for saphenous vein harvesting aims to preserve vascular integrity and improve graft performance in coronary artery bypass grafting (CABG). However, concerns remain regarding wound healing disorders and local complications at the graft harvest site. METHOD(S): This prospective observational comparative study included 60 consecutive patients undergoing CABG, allocated to conventional saphenous vein harvesting (CONV, n=30) or the NT technique (NT, n=30). Group allocation was based on routine clinical practice and surgeon preference, without formal randomization. The primary outcome was the incidence of wound healing disorders and local complications at the harvest site. Secondary outcomes included perioperative parameters, major adverse cardiovascular events (MACE), and venous graft patency assessed by computed tomography coronary angiography one year after surgery. RESULT(S): Operative time and aortic cross-clamp time were comparable between groups. Shorter graft harvesting time was observed in the NT group (35 +/- 7.5 min vs. 43 +/- 9.1 min; P=0.001), along with significantly reduced perioperative blood loss (15 +/- 7 mL vs. 40 +/- 12.1 mL; P<0.0001). The incidence of subcutaneous hematoma on postoperative day 7 was significantly lower in the NT group (20% vs. 60%; P=0.003). No statistically significant differences were found between groups in wound infection rates, MACE, or venous graft patency at one-year follow-up. CONCLUSION(S): The NT technique for saphenous vein harvesting offers relevant perioperative advantages, including shorter harvesting time, reduced blood loss, and fewer early local complications, without adversely affecting operative time, major adverse cardiac events, wound infection, or one-year graft patency. <68> Accession Number 2044187644 Title Thoracic corpectomy and vertebral body reconstruction (TCVBR): a systematic review and meta-analysis. Source European Spine Journal. (no pagination), 2026. Date of Publication: 2026. Author Badary A.; Aziz El-Ramly T.; Kertam A.; Y. Salama E.; Sanker V.; E. Abomera N.; De la Garza Ramos R.; Atallah O.; Hernandez-Hernandez A.; Khalil Al-Barbarawi M.; Hong B.; Heesen P.; Catic S.; Desai A.; A Zaazoue M.; Shiban E. Institution (Badary, Hong, Shiban) Department of Neurosurgery, Carl-Thiem-Klinikum Cottbus, Cottbus, Germany (Aziz El-Ramly) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Kertam) Tu Lab for Diagnostic Research, Yale University, New Haven, United States (Y. Salama) Faculty of Medicine, Benha University, Banha, Egypt (Sanker, Desai) Department of Neurosurgery, Stanford University, Stanford, United States (E. Abomera) Faculty of Medicine, Menoufia University, Shibin al Kawm, Egypt (De la Garza Ramos) Department of Neurological Surgery, Albert Einstein College of Medicine, The Bronx, United States (Atallah) Department of Neurosurgery, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany (Hernandez-Hernandez) Spine surgery department, Instituto Nacional de Neurologia y Neurocirugia, Mexico City, Mexico (Khalil Al-Barbarawi) Department of Neurosurgery, King Hussein Cancer Center, Amman, Jordan (Heesen) Faculty of Medicine, University of Zurich, Zurich, Switzerland (Catic) Faculty of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina (A Zaazoue) Department of Neurological Surgery, University of Wisconsin-Madison, Madison, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Introduction: Thoracic corpectomy (TCo) and vertebral body reconstruction (TCVBR = Thoracic corpectomy and vertebral body reconstruction) is a critical surgical procedure addressing severe thoracic spinal pathologies stemming from trauma, infection, tumor, or degenerative disease. Its primary goals are to restore spinal alignment, decompress neural elements, and ensure mechanical stability. This meta-analysis systematically evaluates the clinical presentation, etiologies, and outcomes of TCVBR. Method(s): A comprehensive literature search was conducted across PubMed, Google Scholar, Scopus, Web of Science, and Embase, encompassing publications from 1995 to March 2025. Studies including adult patients undergoing thoracic corpectomy with TCVBR were eligible if they reported outcomes such as kyphotic angle correction, neurological status, pain scores, or complication rates. Data from cohort studies were analyzed using random-effects models, while case reports/series were descriptively analyzed. Result(s): This meta-analysis included 17 studies (1995-2023), comprising a pooled cohort of 649 patients (359 male, 289 female). The mean patient age was 54.97 years, with a mean follow-up of 19.88 months. Etiologies included malignancy (58%), infection (26%), trauma (11%), and spinal deformity (7%). Preoperatively, median VAS pain was 8, and the mean kyphotic angle was 27.6 degree. Postoperatively, median VAS improved to 2, and the mean kyphotic angle to 18.7 degree. Significant neurological improvement was observed in 49.2% of patients. Surgical approaches were predominantly posterior (77%), with over 90% of procedures being single-stage. The overall complication rate was 23%, with dural tears (8%), implant-related screw complications (7%), and surgical site infections (6%) being notable. The reoperation rate was 6%. Conclusion(s): TCVBR is a highly effective and transformative procedure, providing significant pain relief, substantial kyphotic deformity correction, and crucial neurological recovery for patients with severe thoracic spinal pathologies, primarily malignancy and infection. While associated with a notable complication rate, detailed insights into specific complications and reoperation rates are crucial for refining surgical strategies and optimizing patient outcomes in this complex yet vital intervention. Copyright © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2026. <69> Accession Number 2044326672 Title Effects of Continuous Postoperative Pericardial FLUshing with Investigational Device on Postoperative Re-Explorations for Bleeding (FLUID)-Randomized Clinical Trial. Source Journal of Clinical Medicine. 15(6) (no pagination), 2026. Article Number: 2151. Date of Publication: 01 Mar 2026. Author Molenaar M.A.; Koolbergen D.R.; Vegter M.; Lam K.; Hofman F.N.; van Dinter S.R.; van 't Loo A.; de Weger A.; Janson J.A.; Bulte C.S.E.; Eberl S.; Lagrand W.K.; Vonk A.; Lucas F.R.M.; Klautz R.J.M.; Schultz M.J. Institution (Molenaar, Lagrand, Lucas, Schultz) Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, Netherlands (Molenaar, Koolbergen, Vegter, Vonk, Klautz) Department of Cardiothoracic Surgery, Amsterdam University Medical Centers, Amsterdam, Netherlands (Koolbergen, Vegter, de Weger, Klautz) Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands (Lam) Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, Netherlands (Hofman, van Dinter, van 't Loo) Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, Netherlands (Janson) Department of Intensive Care, Leiden University Medical Center, Leiden, Netherlands (Bulte, Eberl) Department of Anesthesiology, Amsterdam University Medical Centers, Amsterdam, Netherlands Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Objectives: Continuous postoperative pericardial flushing (CPPF) may prevent postoperative re-explorations for tamponade or excessive postoperative bleeding due to a non-surgical cause in cardiac surgery patients. Method(s): An investigator-initiated, national, multicenter, randomized clinical superiority trial was performed in four hospitals in the Netherlands between November 2021 and April 2023. Patients undergoing general cardiac surgery involving cardiopulmonary bypass were randomly assigned to receive CPPF or standard care. The primary endpoint was the number of surgical re-explorations for either cardiac tamponade or excessive postoperative bleeding due to a non-surgical cause in the first postoperative week. Result(s): The study was stopped after randomization of 164 patients, of which 79 were allocated to CPPF and 85 served as controls. The number of surgical re-explorations for either cardiac tamponade or excessive postoperative bleeding due to a non-surgical cause in the first postoperative week was not different between CPPF patients and control patients (3.8% vs. 2.4%; relative risk 1.61 [0.28-9.41]; p = 0.67). There were no safety issues related to use of the investigational device. Conclusion(s): In this prematurely stopped study, CPPF did not reduce the number of postoperative re-explorations for cardiac tamponade or excessive bleeding due to a non-surgical cause in cardiac surgery patients. Additional well-powered studies remain needed to determine whether CPPF has any beneficial effect on outcome. Copyright © 2026 by the authors. <70> Accession Number 650745822 Title Neutrophil gelatinase-associated lipocalin in contrast-induced acute kidney injury post cardiac procedure: a systematic review. Source Clinica chimica acta; international journal of clinical chemistry. (pp 120977), 2026. Date of Publication: 24 Mar 2026. Author Al-Harazi S.M.; Azzani M.; Shirin L.; Kabir M.S.; Haza'a Abdulhameed T.; Anbazhagan D.; Islam T. Institution (Al-Harazi) Early clinical exposure and Professional personal development, Faculty of Medicine, MAHSA University, Bandar Saujana Putra, Malaysia (Azzani) Department of Public Health Medicine, Faculty of Medicine, Sungai Buloh Campus, Sungai Buloh, Universiti Teknologi MARA, Selangor, Malaysia (Shirin) Anatomy Department, Faculty of Medicine, Sungai Buloh Campus, Sungai Buloh, Universiti Teknologi MARA, Selangor, Malaysia (Kabir) Department of Internal Medicine, International Medical School, Management and Science University, Shah Alam, Selangor, Malaysia (Haza'a Abdulhameed) Department of Internal medicine, Kuwait University Hospital, Yemen (Anbazhagan) Department of Microbiology, International Medical School, Management and Science University, Shah Alam, Selangor, Malaysia (Islam) Department of Surgery, Universiti Malaya ,Lembah Pantai, Kuala Lumpur, Malaysia Abstract BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker for the early diagnosis of contrast-induced acute kidney injury (CI-AKI) after coronary angiography (CAG) or percutaneous coronary intervention (PCI), but its diagnostic performance varies widely. NGAL may also predict adverse outcomes such the need for renal replacement therapy (RRT), the length of the hospital stays, and mortality. OBJECTIVE(S): This systematic review assessed the diagnostic performance of NGAL versus serum creatinine for early diagnosis of CI-AKI in adults undergoing CAG/PCI and evaluated its prognostic value for clinical outcomes. METHOD(S): Following a registered protocol (PROSPERO: CRD42023475660), databases were searched until November 1, 2023. Twenty studies were included. Diagnostic data were narratively synthesised; prognostic outcomes were not due to insufficient data. RESULT(S): In 20 studies (n = 4172 patients, 3882 with NGAL measurements), 433 developed CI-AKI (11.2%). Diagnostic accuracy varied by protocol: serum/plasma NGAL 2-6 h post-contrast had higher specificity, while urinary NGAL 6-24 h post-contrast showed greater sensitivity. Dynamic measurements such as DELTAuNGAL (0-6 h >= 121 ng/mL; AUC 0.93) and a >= 49% increase in serum NGAL at 24 h (AUC 0.899) were crucial for accuracy in chronic kidney disease (CKD) patients. NGAL consistently demonstrated excellent negative predictive values (90-100%), supporting its rule-out utility. The prognostic value of NGAL was reported inconsistently, which precluded the synthesis of associations with the need for RRT, the length of the hospital stays, and mortality. CONCLUSION(S): NGAL is a clinically useful, protocol-dependent biomarker for ruling out CI-AKI. Standardisation of matrix, timing, and dynamic measurement, especially in CKD, is essential for reliable implementation. Future multicentre prospective studies employing standardised NGAL protocols and consistent definitions of CI-AKI are essential to validate its diagnostic utility. Copyright © 2026. Published by Elsevier B.V. <71> Accession Number 650737118 Title APCU USM 2025. Source Open Heart. Conference: 16th Asia Pacific Cardiology Update at USM 2025. Kota Bharu Malaysia. 13(Supplement 1) (no pagination), 2026. Date of Publication: 01 Feb 2026. Author Anonymous Publisher BMJ Publishing Group Abstract The proceedings contain 72 papers. The topics discussed include: Hospital Pakar Universiti Sains Malaysia TAVI Registry; clinical outcome of electrical cardioversion for atrial fibrillation without transesophageal echocardiography: retrospective study; development of surevalves calculator to calculate operative survival and mortality probability using timely manner and echocardiography parameters for patients underwent heart valve surgery; bridging the gap between evidence and practice: real-world insights from a cardiovascular risk reduction clinic in Malaysia; diastolic function in patients with trastuzumab-based chemotherapy regimen: a systematic review and meta-analysis; and atherogenic combined indices, sex differences, and cardiometabolic risk factors correlate to predictor of atherosclerosis among large population of police officers in East Java, Indonesia. <72> Accession Number 2044337840 Title The journey of retained epicardial pacing wires: a systematic review of migration site and mechanisms. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 13. Date of Publication: 01 Dec 2026. Author Akele O.; Osuji E.; Parisapogu A.; Varma R.; Shahani R. Institution (Akele, Parisapogu) Department of Medicine, University of Connecticut School of Medicine, UConn Health, Farmington, CT, United States (Osuji) Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, United States (Varma) Department of Medicine, Cook County Hospital, Chicago, IL, United States (Shahani) Department of Cardiothoracic Surgery, Staten Island University Hospital, Staten Island, NY, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Temporary epicardial pacing wires are routinely placed during cardiac surgery and are typically removed before discharge. When resistance is encountered, wires are clipped and left in place. Although long considered benign, retained wires have increasingly been linked to delayed migration into vascular, thoracic, and abdominal structures. The patterns, timing, clinical consequences, and mechanisms of these events remain poorly defined. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta Analyses 2020 guidelines and was registered with the International Prospective Register of Systematic Reviews CRD420251103727. Main body: Twenty-two studies describing 23 patients with migration of retained temporary epicardial pacing wires were included. Ages ranged from 14 months to 89 years. Migration occurred between 12 days and 17 years after surgery, with a median interval of approximately 1 year. Cardiovascular migration was reported in 15 patients and involved the aorta, aortic arch, carotid artery, coronary artery, pulmonary artery, or cardiac chambers. Extracardiac migration was reported in 8 patients and involved the lung, bronchial tree, transverse colon, neck, jaw, and subcutaneous tissues. Migration location corresponded to the reported origin of the pacing wire. Atrial wires were described in cases involving systemic arterial structures, whereas ventricular wires were described in cases involving the right heart or pulmonary circulation. Fourteen patients were symptomatic at diagnosis, presenting with chest pain, respiratory symptoms, hemoptysis, abdominal pain, neurologic deficits, or localized inflammation. Infectious complications were reported in 8 patients, including several cases in which more than 1 wire had been retained. Computed tomography identified migration in 13 patients and was the most frequently reported diagnostic modality. Echocardiography detected intracardiac migration in 6 patients. Percutaneous extraction was reported as successful in all attempted cases. Surgical extraction was performed in 3 patients, and 2 patients were managed conservatively. Conclusion(s): Migration of retained temporary epicardial pacing wires has been reported months to years after cardiac surgery and has involved both cardiovascular and extracardiac structures. Reported cases describe migration across multiple anatomic pathways and a range of clinical presentations. Computed tomography was commonly used to identify migration, and percutaneous retrieval was reported as successful in several cases. These findings describe the reported spectrum of migration patterns, presentations, and management strategies among published cases of retained temporary epicardial pacing wire migration. Copyright © The Author(s) 2026. <73> Accession Number 2044511199 Title Multicentre, adaptive, double-blind, three-arm, placebo-controlled, non-inferiority trial examining antimicrobial prophylaxis duration in cardiac surgery (CALIPSO): trial protocol. Source BMJ Open. 16(3) (no pagination), 2026. Date of Publication: 01 Mar 2026. Author Stewardson A.J.; Peleg A.Y.; Myles P.S.; Peel T.; Stewardson A.; Myles P.; McGiffin D.; Smith J.; Marasco S.; Pilcher D.; Peleg A.; Forbes A.; Petrie D.; Wisniewski J.; Forster S.; Roney J.; Druce P.; Astbury S.; Berkovic D.; McCracken P. Institution (Peel) Infectious Diseases, Monash University, Melbourne, VIC, Australia (Peel, Stewardson, Roney) Infectious Diseases, Alfred Hospital, Melbourne, VIC, Australia (McGiffin) Cardiothoracic Surgery, Monash University Faculty of Medicine Nursing and Health Sciences, Melbourne, VIC, Australia (McGiffin, Wisniewski) Alfred Hospital, Melbourne, VIC, Australia (Smith) Cardiothoracic Surgery, Monash Medical Centre Clayton, Clayton, VIC, Australia (Smith) Department of Surgery, School of Clinical Sciences, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, VIC, Australia (Forbes) School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia (Marasco) Cardiothoracic Surgery, Alfred Hospital, Melbourne, VIC, Australia (Pilcher) Australian and New Zealand Intensive Care Society Centre for Outcomes and Resource Evaluation, Melbourne, VIC, Australia (Stewardson, Peleg) Centre to Impact AMR, Monash University, Melbourne, VIC, Australia (Petrie) Centre for Health Economics, Monash University, Melbourne, VIC, Australia (Peleg, Astbury) Department of Infectious Diseases, Monash University, Clayton, VIC, Australia (Peleg) Monash University Monash Biomedicine Discovery Institute, Clayton, VIC, Australia (Forster) Hudson Institute of Medical Research, Clayton, VIC, Australia (Druce, Myles) Anaesthesiology and Perioperative Medicine, Monash University, Melbourne, VIC, Australia (Druce) Anaesthesiology and Perioperative Medicine, Alfred Health, Melbourne, VIC, Australia (Berkovic) Monash University, Clayton, VIC, Australia (Mccracken) Bayside Health, Melbourne, VIC, Australia (Mccracken) Monash University, Melbourne, VIC, Australia (Myles) Anaesthesiology and Perioperative Medicine, Alfred Hospital, Melbourne, VIC, Australia Publisher BMJ Publishing Group Abstract IntroductionAdministration of antibiotics before incising the skin ('surgical antimicrobial prophylaxis') is a critical infection prevention strategy in surgery. Extending doses of prophylaxis into the postoperative period is a common practice in cardiac surgery; however, the benefit has not been clearly established and may lead to emergence of antimicrobial resistance and patient harm. We present the protocol for a large international multicentre, adaptive, pragmatic, double-blind, three-arm, placebo-controlled, randomised, non-inferiority clinical trial to compare the incidence of surgical site infection after three different durations of postoperative surgical antimicrobial prophylaxis in patients undergoing cardiac surgery.Methods and analysisThis adaptive, multi-arm multistage non-inferiority trial will compare intraoperative only (Arm A), to intraoperative and 24 hours (Arm B) and, to intraoperative and 48 hours (Arm C) of intravenous cefazolin and placebo as surgical antimicrobial prophylaxis in 9180 patients undergoing cardiac surgery. The adaptive design allows for potential dropping of any of the three arms if clear inferiority is indicated at any of the scheduled interim analyses. The trial will evaluate the clinical and cost-effectiveness of the three different antibiotic prophylaxis durations.Ethics and disseminationEthics approval will be obtained at all participating sites. Results of the study will be submitted for publication in peer-reviewed journals and the key findings presented at national and international conferences. Patients and members of the public will also be involved in the dissemination and translation of the trial results.Trial registration numberNCT05447559. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. <74> Accession Number 2044510602 Title Efficacy of low-dose nalmefene on recovery from general anaesthesia in adult patients: a multicentre randomised controlled study. Source BMJ Open. 16(3) (no pagination), 2026. Date of Publication: 01 Mar 2026. Author Ma X.; Liu J.; Zhang Y.; Li L.; Zhang G.; Xing L.; Huai X.; Tang Y.; Xie Y.; Su D. Institution (Ma, Liu) Department of Anesthesiology, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China (Zhang, Huai) Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China (Li) The First Affiliated Hospital of Guangxi Medical University, Guangxi, Nanning, China (Zhang) Department of Anesthesiology, Shanghai Tongren Hospital, Shanghai, Shanghai, China (Xing) The First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou, China (Tang) Department of Anaesthesiology, Shanghai Jiaotong University, Shanghai, China (Xie) Department of Anesthesiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China School of Medicine, Sichuan, Chengdu, China (Su) Anesthesiology, Zhejiang University School of Medicine First Affiliated Hospital, Zhejiang, Hangzhou, China Publisher BMJ Publishing Group Abstract ObjectivesThis randomised controlled trial aims to evaluate the impact of low-dose intravenous nalmefene on anaesthesia recovery in adult patients aged 18-65 undergoing surgery under general anaesthesia.DesignThis was a multicentre, randomised, double-blind trial with two parallel arms clinical study.SettingFour hospitals from ChinaParticipantsA total of 514 patients aged 18-65 who underwent elective orthopaedic, urologic and thoracic surgeries.InterventionsOn completion of skin suturing, the intervention group received a single intravenous dose of nalmefene (0.25 microg/kg). The control group received an equivalent volume of normal saline at the same time point.Primary and secondary outcome measuresThe primary outcome was the interval time between the end of anaesthesia and the Aldrete score >=9 being achieved in the postanaesthesia care unit (PACU). The secondary endpoints included the time interval from the end of operation to extubation; Richmond Agitation Sedation Scale (RASS) score at extubation; the time at Montreal Cognitive Assessment Scale (MoCA) orientation score >=5; visual analogue scale (VAS) score in PACU and 24 hours postoperatively.Results514 patients were included in the Intention-to-Treat (ITT) analysis. The time interval between the end of anaesthesia and Aldrete score reached >=9 in PACU was significantly shorter in the intervention group than in the control group (mean (SD) 24.8 (11.8) min vs 33.8 (12.5) min; 95% CI -8.8 (-10.8 to -6.7); p<0.001). Furthermore, the time interval from the end of surgery to extubation was shorter in the intervention than in the control group (mean (SD) 20.0 (9.9)min vs 27.6 (11.6) min; 95% CI -7.6 (-9.43 to -5.7), p<0.001). The time at Montreal cognitive assessment score >=5 was also shorter in the control than in the intervention group (mean (SD) 20.0 (15.9) min vs 27.0 (20.5) min; 95% CI -7.0 (-10.2 to -3.8); p<0.001). Compared with the control group, the intervention group had better analgesic effect at the recovery endpoint (P Aldrete score >=A was achieved as well as lower 24 hours points postoperatively (p<0.05)).ConclusionsIn patients aged 18-65 who underwent elective orthopaedic, urologic and thoracic surgeries, low-dose nalmefene administered at the end of surgery can accelerate postanaesthesia recovery without compromising analgesic effects.Trial registration numberNCT04713358. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <75> Accession Number 650741817 Title Incidence, Predictors, Management, and Clinical Impact of Major Bleeding Following Left Atrial Appendage Occlusion: The Amulet IDE Randomized Clinical Trial. Source JAMA cardiology. (no pagination), 2026. Date of Publication: 25 Mar 2026. Author Schmidt B.; Windecker S.; Thaler D.; Ellis C.R.; Nielsen-Kudsk J.E.; Freixa X.; Aminian A.; Anderson J.A.; Gage R.; Alkhouli M.; Lakkireddy D. Institution (Schmidt) Cardioangiologisches Centrum Bethanien, Frankfurt, Germany (Windecker) Inselspital, University of Bern, Bern, Switzerland (Thaler) Tufts Medical Center, Boston, MA, United States (Ellis) Vanderbilt Heart Institute, Nashville, TN, United States (Nielsen-Kudsk) Aarhus University Hospital, Aarhus N, Denmark (Freixa) Hospital Clinic of Barcelona, Barcelona, Spain (Aminian) Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium (Anderson, Gage) Abbott Structural Heart, Plymouth, MN, United States (Alkhouli) Mayo Clinic, Rochester, MN, United States (Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation, Overland Park, KS, United States Abstract Importance: Left atrial appendage occlusion (LAAO) is used in patients with contraindications to oral anticoagulation, who are at increased risk for major bleeding (MB). Objective(s): To evaluate the incidence, predictors, management, and clinical outcomes of MB after LAAO in the Amulet IDE trial. Design, Setting, and Participant(s): The randomized clinical Amulet IDE trial enrolled patients from 2016 through 2019 with 5-year follow-up. Procedures were performed at specialized LAAO centers. Of 1878 randomized patients (1:1 Amulet vs Watchman), 1833 underwent attempted LAAO implantation. These data were analyzed from May 2025 through November 2025. Main Outcomes and Measures: Pooled (Amulet and Watchman) patients with vs without MB (Bleeding Academic Research Consortium [BARC] score >=3: overt bleeding with transfusion and >=3 g/dL hemoglobin drop) were compared. Result(s): This study included a total of 1833 patients (57.7% male and 42.3% female; mean [SD] age, 75.8 [7.5] years). MB occurred in 331 patients (18.1%) over 5 years (annualized rate 5.9% per year). Patients with MB were older (76.8 vs 74.7 years) and had higher CHA2DS2-VASc (4.8 vs 4.6) and HAS-BLED (3.4 vs 3.2) scores, as well as greater prevalence of diabetes (38.7% vs 34.1%), prior MB (45.3% vs 28.0%), and kidney disease (9.4% vs 4.5%). MB risk was highest in the first 6 months after LAAO (20.5% per year), then decreased to 3.9% per year through 5 years. Most MB events were nonprocedural (88.8%) with gastrointestinal bleeding accounting for 252 of 438 events. Independent predictors of MB included increasing age (hazard ratio [HR], 1.04; 95% CI, 1.02-1.06), female sex (HR, 1.25; 95% CI, 1.01-1.56), diabetes (HR, 1.26; 95% CI, 1.01-1.58), prior MB (HR, 1.93; 95% CI, 1.55-2.40), and kidney disease (HR, 2.15; 95% CI, 1.48, 3.12). At first MB event, 47.1% of patients were not receiving antithrombotic therapy and 92 patients had recurrent events. Patients with MB had significantly higher rates of the composite of stroke, systemic embolism, or cardiovascular death (32.5% vs 18.0%; P < .001), driven by higher stroke (14.7% vs 6.6%) and cardiovascular death (24.4% vs 12.9%) rates. All-cause mortality was also higher (49.2% vs 25.4%; P < .001). MB was fatal (BARC score of 5) in 25 patients (1.4%). Conclusions and Relevance: In this study, MB was common in this high-risk population and largely related to underlying patient factors. Early MB risk was highest 6 months post-LAAO, then dropped considerably. Most events were gastrointestinal and occurred even in patients on minimal or no antithrombotic therapy. MB after LAAO was strongly associated with increased stroke and mortality. Trial Registration: ClinicalTrials.gov Identifier: NCT02879448. <76> [Use Link to view the full text] Accession Number 650731317 Title The effect of intravenous sodium ferric gluconate complex (Ferrlecit) on outcomes of patients undergoing transcatheter aortic valve implantation: a prospective randomized controlled trial. Source Journal of cardiovascular medicine (Hagerstown, Md.). (no pagination), 2026. Date of Publication: 17 Mar 2026. Author Bar O.; Zukerman R.; Halhal B.; Marcusohn E. Institution (Bar, Zukerman, Halhal, Marcusohn) Department of Cardiology, Rambam Healthcare Campus (Zukerman, Marcusohn) Technion Israel Institute of Technology, Haifa, Israel Abstract AIMS: The aim of this trial was to evaluate whether intravenous sodium ferric gluconate could provide benefit beyond transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis. METHODS AND RESULTS: Between 1 October 2020 and 1 July 2023, we conducted an investigator-initiated, single-center, randomized, single-blind, placebo-controlled trial enrolling patients electively admitted for TAVI due to severe symptomatic aortic stenosis. Patients were randomly assigned to receive intravenous sodium ferric gluconate or a placebo before the procedure and were followed for up to 3 months. After screening, 44 patients were included: 20 patients randomized to intravenous sodium ferric gluconate complex treatment and 24 patients to placebo. There was no difference in the baseline-adjusted 6-min walk distance between the two treatment arms (P = 0.215). Quality-of-life measures such as Kansas City Cardiomyopathy Questionnaire score and New York Heart Association class did not differ between the treatment arms. CONCLUSION(S): Treatment with intravenous sodium ferric gluconate did not provide clinical benefit beyond TAVI in patients with severe aortic stenosis.Clinical Trial Registration: ClinicalTrials.gov NCT04797832. Copyright © 2026 Italian Federation of Cardiology - I.F.C. All rights reserved. <77> [Use Link to view the full text] Accession Number 650748003 Title Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis at 10 Years. Source The New England journal of medicine. 394(12) (pp 1167-1174), 2026. Date of Publication: 26 Mar 2026. Author Kang D.-H.; Park S.-J.; Kim G.Y.; Lee S.; Sun B.J.; Kim J.B.; Jung S.-H.; Kim H.-K.; Yun S.-C.; Hong G.-R.; Song J.-M.; Chung C.-H. Institution (Kang, Kim, Lee, Sun, Song) Division of Cardiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea (Park) Division of Cardiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Kim, Jung, Chung) Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea (Kim) Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea (Yun) Department of Biostatistics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea (Hong) Division of Cardiology, Severance Hospital, Seoul, South Korea Abstract BACKGROUND: Among asymptomatic patients with severe aortic stenosis, a previous analysis showed that the risk of a composite of death during surgery or within 30 days after surgery (called operative mortality) or death from cardiovascular causes was significantly lower with early surgery than with conservative care. However, the long-term survival benefit of early surgery, as compared with conservative care, remains unclear. METHOD(S): We randomly assigned asymptomatic patients with very severe aortic stenosis (defined as an aortic-valve area of <=0.75 cm2 with a peak aortic jet velocity of >=4.5 m per second) in a 1:1 ratio to undergo early surgery or receive conservative care. The primary end point was a composite of operative mortality or death from cardiovascular causes during the 10-year follow-up period. RESULT(S): A total of 145 patients underwent randomization. In an intention-to-treat analysis, a primary end-point event occurred in 2 of 73 patients (3%) in the early-surgery group and in 17 of 72 (24%) in the conservative-care group (hazard ratio, 0.10; 95% confidence interval [CI], 0.02 to 0.43; P = 0.002). At 10 years, the cumulative incidence of operative mortality or death from cardiovascular causes was 1% in the early-surgery group and 19% in the conservative-care group. Death from any cause occurred in 11 patients (15%) in the early-surgery group and in 23 (32%) in the conservative-care group (hazard ratio, 0.42; 95% CI, 0.21 to 0.86). CONCLUSION(S): Among asymptomatic patients with very severe aortic stenosis, early surgery led to a lower risk of a composite of operative mortality or death from cardiovascular causes than conservative care at 10 years. (Funded by the Korean Institute of Medicine; RECOVERY ClinicalTrials.gov number, NCT01161732.). Copyright © 2026 Massachusetts Medical Society. <78> Accession Number 2044510139 Title Efficacy of perioperative intravenous lidocaine infusion on postoperative recovery and analgesia in patients undergoing video-assisted thoracoscopic surgery: study protocol for a randomised, double-blind, placebo-controlled trial. Source BMJ Open. 16(3) (no pagination), 2026. Date of Publication: 01 Mar 2026. Author Omindo W.W.; Xiao Z.; Wang X.; Fu L.; Wang J.; Zhang R.; Ping W.; Zhou B.; Zhang N. Institution (Omindo, Xiao, Wang, Fu, Wang, Zhang, Ping, Zhang) Department of Thoracic Surgery, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Hubei, Wuhan, China (Zhou) Department of Anesthesiology, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Hubei, Wuhan, China Publisher BMJ Publishing Group Abstract IntroductionDespite the minimally invasive nature of video-assisted thoracoscopic surgery (VATS), moderate-to-severe postoperative pain remains frequent and impairs recovery. Intravenous lidocaine possesses multimodal analgesic, antihyperalgesic and anti-inflammatory properties that may improve pain control and functional outcomes, but robust evidence in thoracic surgery is lacking. Moreover, its potential to attenuate neuropathic pain, a key component of chronic post-thoracic pain syndromes, has not been adequately investigated. This trial will determine whether continuous perioperative intravenous lidocaine infusion improves recovery, reduces acute pain intensity and prevents the development of neuropathic pain after VATS.Methods and analysisThis single-centre, randomised, double-blind, placebo-controlled trial will enrol 84 adult patients undergoing elective VATS. Participants will be randomised (1:1) to receive either intravenous lidocaine (bolus 1 mg/kg at induction followed by continuous infusion at 1.5 mg/kg/hour intraoperatively and postoperatively for 24 hours) or matched normal saline postoperatively, with identical intraoperative management in both groups. The primary outcome is the incidence of moderate-to-severe movement-evoked pain at 24 hours postoperatively. Secondary outcomes include pain at 48 and 72 hours, opioid consumption, pulmonary complications, sleep quality, quality of recovery, neurocognitive outcomes and chronic neuropathic pain at 3 months. Analyses will follow the intention-to-treat principle.Ethics and disseminationThe study protocol was approved by the Institutional Review Board of Tongji Hospital (Reference No. TJ-IRB202509102) and registered in the Chinese Clinical Trial Registry (ChiCTR2500111163). Written informed consent will be obtained from all participants. Results will be submitted to peer-reviewed journals and academic conferences.Trial registration numberChiCTR2500111163. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <79> [Use Link to view the full text] Accession Number 2044138474 Title Do Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Reflect Coronary Artery Disease Severity Assessed by SYNTAX Score?: A Meta-Analysis. Source Cardiology in Review. Publish Ahead of Print (no pagination), 2026. Date of Publication: 2026. Author Assayed A.; Aburumman S.; Abunemr I.; Salih A.R.F.; Gruhonjic H.; Minasyan A.; Fabian D.; Ledonio C.; Prashad R. Institution (Assayed, Gruhonjic, Minasyan, Fabian) From the Department of Cardiology, University of Central Florida, Orlando, FL, United States (Assayed, Gruhonjic, Minasyan, Fabian, Ledonio, Prashad) Cardiology Department, Cardiology Fellowship Program, HCA Florida Ocala Hospital, Ocala, FL, United States (Aburumman, Abunemr, Salih) Department of Internal Medicine, University of Jordan Queen Rania Street, Amman, Jordan (Prashad) Professor UCF College of Medicine, University of Central Florida, Orlando, FL, United States Publisher Lippincott Williams and Wilkins Abstract Coronary artery disease is a major global cause of morbidity and mortality, with systemic inflammation playing a central role in its pathophysiology. The SYNTAX (Synergy Between percutaneous coronary intervention With Taxus and Cardiac Surgery) score is widely used to quantify the anatomical complexity of coronary lesions, but its invasiveness and cost limit routine application. Hematologic inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been proposed as simple, inexpensive biomarkers that may reflect the presence and severity of coronary disease. This meta-analysis evaluated the association between NLR and PLR and angiographic complexity measured by the SYNTAX score. A systematic search of PubMed, MEDLINE, Cochrane, and CINAHL through May 2024 identified studies reporting correlations between NLR and/or PLR and SYNTAX scores in adults with coronary artery disease. Random-effects models using Fisher's z-transformation were applied to pool correlation coefficients. Heterogeneity was assessed using Cochran's Q, I2, and tau2. Subgroup analyses examined the effects of country, study design, and publication year, and meta-regression explored the influence of mean age and sex distribution. Publication bias was evaluated with funnel plots and Egger's regression. Fifteen studies involving 17, 348 participants were included. NLR showed a significant positive correlation with SYNTAX score (r = 0.37; 95% CI, 0.28-0.45). PLR demonstrated a similar association (r = 0.38; 95% CI, 0.23-0.51). Heterogeneity was substantial for both indices. Stronger correlations were observed in Turkish cohorts, and increasing mean age was associated with larger effect sizes. No significant publication bias was detected. Both NLR and PLR correlate moderately with coronary lesion complexity and may provide accessible adjunctive markers for preprocedural risk stratification. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <80> Accession Number 2044404714 Title Transradial vs Transfemoral Access for Cerebral Angiography: A Randomized Noninferiority Clinical Trial. Source JAMA Network Open. 9(3) (no pagination), 2026. Article Number: e261929. Date of Publication: 19 Mar 2026. Author Ni W.; Yang H.; Su J.; Peng Y.; Lin Z.; Sun J.; Li Y.; Wang J.; Wan S.; Ye X.; Zhang Q.; Wang D.; Gao C.; Jiang H.; Gao X.; Zhang Y.; Han B.; Cao J.; Zhu X.; Zhou S.; Zeng Y.; Chen F.; Lin Y.; Ba H.; Chen X.; Liu X.; Hao J.; Sun Z.; Li M.; Wang M.; Xie D.; Zhuang Z.; Shi L.; Zhou L.; Tang H.; Chen D.; Anderson C.S.; Kang D.; Gu Y. Institution (Ni, Yang, Su, Gao, Jiang, Gao, Gu) Department of Neurosurgery, Department of Neurosurgery, Huashan Hospital, Fudan University, Huashan Hospital, Fudan University, Fudan University, Shanghai, China (Peng, Cao, Zhu) Department of Neurosurgery, First People's Hospital of Changzhou, Changzhou, China (Wang, Chen, Lin, Kang) Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China (Lin, Zhou, Zeng) Department of Neurosurgery, The First Affiliated Hospital of Ningbo University, Ningbo, China (Sun, Ba, Chen) Department of Neurosurgery, Panvascular Disease Management Center, Wenzhou Central Hospital, Wenzhou, China (Chen, Liu) Department of Neurosurgery, Affiliated Zhongshan Hospital of Fudan University, Qingpu Branch, Shanghai, China (Wang, Hao) Department of Neurosurgery, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Shanghai, China (Li, Sun) Department of Neurosurgery, Southern Central Hospital of Yunnan Province, Honghe, China (Wang, Li) Department of Neurosurgery, Zhejiang Hospital, Hangzhou, China (Wan, Wang) Department of Neurosurgery, Sir Run Run Shaw Hospital, Hangzhou, China (Ye, Xie) Nanjing University, Department of Neurosurgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing, China (Zhang, Zhuang) Department of Neurosurgery, Qilu Hospital of Shandong University Dezhou Hospital, Shandong University, Dezhou, China (Wang, Shi) Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China (Zhang) Caidya (formerly dMed Biopharmaceutical Co Ltd), dMed Biopharmaceutical Co Ltd, Shanghai, China (Han) Institute for Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China (Zhou, Tang, Chen) The George Institute for Global Health, University of New South Wales, Sydney, Australia (Anderson) Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (Anderson) Department of Neurosurgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China Publisher American Medical Association Abstract Importance Transradial access (TRA) has emerged as a promising alternative to standard transfemoral access (TFA) for interventional cardiac procedures, but its application for examination of the cerebral circulation has not been tested in a clinical trial. Objective To compare the efficacy and safety of TRA with TFA for diagnostic cerebral angiography. Design, Setting, and Participants This investigator-initiated, multicenter, open-label, noninferiority randomized clinical trial with a blinded outcome assessment was conducted at 13 sites in China. Patients eligible for cerebral angiography were randomized between September 15, 2023, and November 4, 2024, with final follow-up performed on November 27, 2024. The primary analysis was performed in the intention-to-treat population; secondary analyses were performed in the per-protocol population. Interventions Patients were randomly allocated to TRA (n = 431) or TFA (n = 430) for diagnostic cerebral angiography. Main Outcomes and Measures The primary outcome was the success of diagnostic cerebral angiography. Secondary outcomes were success in achieving an accurate diagnosis, duration of angiography and fluoroscopy, time in bed, and patient-reported satisfaction on an 11-point visual analog scale for pain (ranging from 0 [none] to 10 [worst possible]) within 24 hours after the procedure. The noninferiority margin was an absolute difference of 5% in success of angiographic diagnosis and success of accurate diagnosis. Results A total of 858 patients (median age, 58.4 [IQR, 52.0-67.0] years; 479 [55.8%] male) completed the trial. Success of diagnostic cerebral angiography in the TRA group was lower than that in the TFA group (392 of 431 [91.0%] vs 409 of 427 [95.8%]; difference, -4.8 percentage points [pp] [95% CI, -8.1 to -1.5 pp]; relative risk [RR], 0.95 [95% CI, 0.92-0.98]; P =.46 for noninferiority test). The success rate of accurate diagnosis was 78.9% in the TRA group vs 91.1% in the TFA group (difference, -12.2 pp [95% CI, -16.9 to -7.5 pp]; RR, 0.87 [95% CI, 0.82-0.92]; P =.99 for noninferiority test). Compared with the TFA group, the TRA group had longer median times for angiography (33.7 [IQR, 23.0-40.0] vs 38.7 [IQR, 26.0-47.0] minutes; P <.001) and fluoroscopy (10.6 [IQR, 5.6-12.9] vs 11.8 [IQR, 6.2-15.0] minutes; P =.02); the TRA group had significantly shorter median time in bed (188.4 [IQR, 3.0-180.0] vs 1079.0 [IQR, 842.0-1366.0] minutes; P <.001) and lower median pain scores (0.5 [IQR, 0.0-1.0] vs 0.7 [IQR, 0.0-1.0]; P <.001). Overall angiography complications were comparable between the groups (19 of 445 [4.3%] vs 25 of 413 [6.1%]; P =.28), but TRA had more radial artery puncture failures than TFA. Conclusions and Relevance In this randomized clinical trial of patients undergoing diagnostic cerebral angiography, TRA was not shown to be noninferior to TFA with regard to the success rate of diagnostic cerebral angiography. Additional research, including superiority trials, is needed to clearly define the comparative benefits of TRA and TFA. Copyright © 2026 Ni W et al. <81> Accession Number 650732071 Title Catheter-based Foetal Cardiac Interventions (FCI) - Literature Review. Source Fetal diagnosis and therapy. (pp 1-35), 2026. Date of Publication: 23 Mar 2026. Author Chow P.-C. Abstract BACKGROUND: Fetal cardiac interventions (FCI) represent a groundbreaking advancement in maternal-fetal medicine, offering therapeutic strategies to address congenital heart defects (CHDs) in utero. SUMMARY: The indications, techniques, complications, and outcomes of the three most reported foetal cardiac interventions, namely foetal aortic valvuloplasty, foetal pulmonary valvuloplasty, and foetal atrial septal intervention, were systematically reviewed based on the published literature. The challenges and future directions of this field was also highlighted. KEY MESSAGES: Foetal cardiac interventions open the therapeutic opportunity of several severe congenital heart diseases. However, the selection of cases for best outcome is yet to be refined due to lack of randomized controlled trial. Copyright S. Karger AG, Basel. <82> Accession Number 2044321832 Title Interactions Between the Human Microbiome and Surgical Practice. Source Hygiene. 6(1) (no pagination), 2026. Article Number: 10. Date of Publication: 01 Mar 2026. Author Kalinowski J.; Nasr N.; Colamarino A.; Esposito M.M. Institution (Kalinowski, Nasr, Colamarino, Esposito) Department of Biology, College of Staten Island, City University of New York, 2800 Victory Blvd., New York, NY, United States (Kalinowski, Nasr, Colamarino, Esposito) Macaulay Honors College, City University of New York, New York, NY, United States (Esposito) PhD Program in Biology, The Graduate Center, City University of New York, New York, NY, United States Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract The human microbiome has emerged as a critical factor influencing surgical outcomes across a broad number of specialties. This paper explores the evolving interactions between the body's microbiome and surgical practice, especially focusing on wound healing, post-operative recovery, and infection risk. We analyze current evidence from multiple surgical disciplines, including transplantation, reconstructive, bariatric, orthopedic, cardiothoracic, and oral surgery. Recognizing different microbial communities and their influence on surgical success opens doors to personalized medicine and targeted preventions. The studies discussed in this review provide valuable interdisciplinary insights that could ultimately uncover the microbiome's fullest potential in optimizing future surgical protocols. Copyright © 2026 by the authors. <83> [Use Link to view the full text] Accession Number 2044150216 Title Extracorporeal Membrane Oxygenation Following Acute Type A Aortic Dissection Repair: A Systematic Review and Meta-Analysis. Source ASAIO Journal. 72(3) (pp 233-241), 2026. Date of Publication: 01 Mar 2026. Author Papakonstantinou N.A.; Antonopoulos C.N. Institution (Papakonstantinou) 2nd Cardiac Surgery Department, Onassis Cardiac Surgery Center, Athens, Greece (Antonopoulos) 1st Department of Vascular Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece Publisher Lippincott Williams and Wilkins Abstract Acute type A aortic dissection (ATAAD) is a life-threatening cardiovascular emergency. Despite the well-established role of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) after postcardiotomy cardiogenic shock in cardiac surgery patients, its application in the context of ATAAD has been controversial. The goal of this study is to evaluate the role of postcardiotomy ECMO subsequent to ATAAD repair. A meta-analysis of nine retrospective studies approaching this topic was conducted. Finally, a total of 318 patients were analyzed. Despite a successful weaning from ECMO rate of 48.3% (95% confidence interval [CI]: 30.6-66.2), not all of them finally survived, resulting in a higher overall in-hospital mortality of 72.4% (95% CI: 61.9-81.9). Acute kidney injury requiring continuous renal replacement therapy rate was 60.5% (95% CI: 43.9-76.0), neurologic complications rate as a consequence of stroke was 24.4% (95% CI: 13.9-36.3), limb ischemia rate was 7.6% (95% CI: 1.7-16.2) and bleeding requiring reoperation rate was 29.2% (95% CI: 10.3-52.2). We estimated a pooled 6.04 days mean duration on ECMO support (95% CI: 3.88-8.20) and a pooled 24.26 days mean length of stay (95% CI: 18.81-29.71). Concerning medium-term outcomes, a pooled incidence rate of late mortality of 5.8% per 100 person-years (95% CI: 0.8-13.4) was recorded. Despite high mortality and complication rates, postcardiotomy ECMO after ATAAD repair may be reasonable, but it depends on further multicenter research to determine which patients could benefit. Copyright © ASAIO 2025 The Authors. <84> Accession Number 2044513841 Title Cost-saving strategies for sustainable surgical care: a scoping review of efficiency models and potential approaches for low-income and middle-income countries. Source BMJ Global Health. 11 (no pagination), 2026. Date of Publication: 01 Mar 2026. Author Alayande B.T.; Ngutete Mukundwa P.; Ojomo O.; Garcia Fuentes M.J.; Gemechu N.B.; Olatunji B.T.; Kabba M.S.; Shaibu I.E.; Hyman G.Y.; Roy N.; Park K.B.; Ntihumbya J.B. Institution (Alayande, Ngutete Mukundwa, Ojomo, Gemechu) Centre for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda (Garcia Fuentes) Corporacion Latinoamericana para la Salud, Quito, Ecuador (Gemechu) Pan-African Surgical Healthcare Forum Secretariat, University of Global Health Equity, Kigali, Rwanda (Olatunji) Johns Hopkins Global Alliance for Perioperative Professionals, The Johns Hopkins University School of Medicine, Baltimore, MD, United States (Kabba) Office of the Deputy Chief Medical Officer-Clinical Services, Ministry of Health and Sanitation, Freetown, Sierra Leone (Kabba) Department of Surgery, Connaught Hospital, Freetown, Sierra Leone (Shaibu) Emmab Complete Solutions Concept, Jos, Nigeria (Hyman, Park) Harvard Medical School Department of Global Health & Social Medicine, Boston, MA, United States (Roy) University of Global Health Equity, Kigali, Rwanda (Ntihumbya) Directorate of Health Quality Services Standards and Regulation, Republic of Rwanda Ministry of Health, Kigali, Rwanda Publisher BMJ Publishing Group Abstract IntroductionWhile philanthropy, multilateral support and innovative internal funding approaches remain important to address surgical healthcare needs, there is increasing demand for efficiency models that maximise the impact of available resources. Cost-saving strategies are attractive to governments. We sought to answer the scoping review question: 'What are documented and transferable system-level cost-saving strategies in the provision of surgical healthcare services applicable in limited-resource settings?'MethodsThe scoping review was guided by the Arksey and O'Malley framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines; 642 studies were screened from PubMed, EMBASE, Global Index Medicus, Africa Journals Online and Google Scholar (2015-2024), without language or article type restrictions. Following title, abstract and full-text screening by 2 independent reviewers, we identified 63 records that met inclusion criteria: documented cost-saving strategies in surgical systems from community to national levels. Strategies were extracted into a theoretical framework adapted from the Procter and Gamble's cost optimisation model and the Triple Aim Framework using Jabareen's eight-step method.ResultsMost literature on cost savings for surgical healthcare was from high-income countries (81%), at national levels (48%), and focused on orthopaedic/cardiothoracic/vascular surgery. Most (25%) were retrospective observational studies or economic modelling (21%). We synthesised 125 distinct cost-saving strategies into 32 transferable strategies across five thematic areas, prioritised using a sustainability and scalability lens-preventative healthcare management (9%), surgical healthcare guidelines and pathways (31%), payment model transformation (19%), lean principles (25%) and technology adoption (16%). Strategies focused on governance, standardisation and process redesign were more likely to be sustainable and scalable with minimal resources, whereas interventions requiring coordinated delivery models or advanced digital infrastructure were more scale-dependentConclusionsWe identified an integrated portfolio of contextualisable surgical cost-saving strategies that eliminate system waste, improve efficiency and result in savings. Policymakers and health system stakeholders in low-income and middle-income countries can use this structured evidence to prioritise, implement and scale cost-saving strategies. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <85> Accession Number 2044461931 Title Clinical benefits of right-lumen fiberoptic bronchoscope-guided double-lumen tube placement in thoracic surgery: a randomized controlled trial. Source Journal of Thoracic Disease. 18(3) (no pagination), 2026. Article Number: 213. Date of Publication: 31 Mar 2026. Author Bao Q.; Song Z.; Zhu M.; Huang S.; Cai J.; Zhou Y.; Wang L.; Tan J. Institution (Bao, Song, Zhou, Wang, Tan) Department of Anesthesiology, Jiangsu Cancer Hospital, Nanjing, China (Bao, Zhu, Huang, Cai, Wang, Tan) Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China Publisher AME Publishing Company Abstract Background: Single-lung ventilation is frequently required in thoracic surgery, with double-lumen tubes (DLTs) serving as the standard device for lung isolation. However, DLT placement and accurate positioning remain technically challenging, and may cause airway trauma and postoperative discomfort that affect patient satisfaction. This study aims to compare the clinical efficacy of a novel fiberoptic bronchoscope (FOB)-guided intubation technique via the right lumen of left-sided DLTs with conventional blind intubation and left-lumen FOB-guided placement. Method(s): This prospective study enrolled 120 patients [aged 18-79 years, American Society of Anesthesiologists (ASA) physical status II-III] undergoing elective thoracic surgery requiring right one-lung ventilation. Participants were randomized into Group C (n=40) undergoing conventional blind intubation, Group R (n=40) receiving FOB-guided placement through the right lumen of left-sided DLTs (L-DLTs) and Group L (n=40) receiving FOB-guided placement via the left lumen of DLTs. The primary outcome of this study was the total DLT placement time (T-total), defined as the interval from insertion of the DLT through the lips to confirmation of correct anatomical positioning by fiberoptic bronchoscopy. Secondary efficacy outcomes included the final positioning time (T3), the other procedural time components (T1 and T2), and the first-attempt success rate of DLT placement. Safety outcomes comprised peri-intubation hemodynamic changes and airway mucosal injury assessed bronchoscopically, while patient-reported outcomes included postoperative throat symptoms (hoarseness, postoperative pharyngalgia, and odynophagia) and patient satisfaction. Result(s): The primary outcome, total DLT placement time (T-total), was significantly shorter in Group R than in Groups L and C (P<0.05). Group R also showed a significantly reduced T3 compared with the other two groups (P<0.05). No significant differences were observed among the three groups for T1 and T2. The tracheal injury score and the severity of airway mucosal injury in Group R were markedly lower than those in Group C (P<0.05). On postoperative day 1, both the incidence and severity of postoperative pharyngalgia in Group R were significantly reduced compared to Group C (P<0.05). Additionally, Group R exhibited a statistically significant decrease in the incidence and severity of postoperative pharyngalgia compared with Group C, and patients in Group R also reported the highest satisfaction scores among the three groups (P<0.01). Conclusion(s): Compared to conventional blind intubation and FOB-guided placement through the left lumen of L-DLTs, the right-lumen FOB-guided DLT positioning technique not only simplified the intubation process and significantly reduced the total DLT placement time, but also decreased patient-reported postoperative discomfort (postoperative pharyngalgia and hoarseness), minimized airway mucosal injury, and enhanced overall recovery experience. These findings suggest that the right-lumen technique may be considered a feasible alternative in selected clinical settings when performed by experienced anesthesiologists. However, further multicenter studies are required to validate these results and to determine their generalizability to broader patient populations and routine clinical practice. Copyright © AME Publishing Company. <86> Accession Number 2044327019 Title Transcatheter Valve Replacement for Mitral Stenosis: A State of the Art Review. Source Journal of Clinical Medicine. 15(6) (no pagination), 2026. Article Number: 2373. Date of Publication: 01 Mar 2026. Author Comis A.; Sanfilippo C.; Imme S.; Tamburino C.I.; Ferrarotto L.; Rubino A.S.; Tamburino C. Institution (Comis, Sanfilippo, Imme, Tamburino, Ferrarotto, Rubino, Tamburino) Cardiology Unit, Policlinico Centro Cuore Morgagni, Pedara, Italy (Rubino) Faculty of Medicine and Surgery, Kore University of Enna, Enna, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Degenerative mitral stenosis (MS) secondary to extensive mitral annular calcification (MAC) represents a growing clinical challenge in an aging population. These patients are often elderly, frail, and harbor a significant burden of comorbidities, rendering conventional mitral valve surgery prohibitively high-risk. While transcatheter mitral valve replacement (TMVR) has emerged as a potential alternative, the current evidence is only derived from single-arm observational registries. Therefore, the transition toward randomized controlled trials to define optimal patient selection and long-term prosthetic durability is necessary. This review examines the current landscape of TMVR for degenerative MS, focusing on the role of multimodal pre-procedural planning, procedural technique, and prevention of the principal complications. The integration of echocardiography and multi-slice computed tomography (MSCT) is essential for evaluating anatomical feasibility, particularly in predicting neo left ventricle outflow tract (neo-LVOT) obstruction, the primary determinant of procedural mortality. However, it is limited due to the absence of standardized protocol. We are showing the outcomes of off-label balloon-expandable aortic prostheses and dedicated TMVR system, which are the only two devices which data in patients with MS are available. Despite high technical success rates in specialized centers, complications, including paravalvular leak, valve thrombosis, and device migration, remain more prevalent than in aortic interventions. We present some tips and tricks to prevent and manage adverse events. TMVR represents a transformative frontier for inoperable patients with severe MAC. However, its routine clinical adoption requires further refinement of dedicated technologies and standardized imaging protocols to improve safety and bridge the gap between palliative medical therapy and definitive intervention. Copyright © 2026 by the authors. <87> Accession Number 2044528346 Title Effect of Subcutaneous Versus Topical Nitroglycerin on the Radial Artery Dimensions in Pediatric Patients Undergoing Surgery: A Randomized Non-inferiority Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Verma C.; Mahajan V.; Ganesan R.; Biswas I.; Mathew P.J.; Mandal B. Institution (Verma, Mahajan, Ganesan, Biswas, Mathew, Mandal) Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India Publisher W.B. Saunders Abstract Objectives: To compare the changes in radial artery dimensions produced by subcutaneous nitroglycerin (NTG) versus a topical NTG patch in pediatric patients. Design(s): Randomized controlled non-inferiority trial. Setting(s): Pediatric and cardiac operating rooms at a tertiary care hospital. Participant(s): Forty-five children aged 2 to 8 years undergoing surgery requiring radial arterial catheterization for hemodynamic monitoring or blood gas sampling. Intervention(s): Patients were randomized to receive either subcutaneous NTG (5 microg/kg diluted in 0.5 mL of saline solution, administered under ultrasound guidance) or a topical NTG patch (Releasing approximately 200 microg/h) applied over the radial artery 30 minutes before induction. Radial artery dimensions were measured ultrasonographically at baseline and after NTG administration. Measurements and Main Results: The increase in post-intervention vertical diameter in the topical NTG group met the predefined criterion for non-inferiority when compared with the subcutaneous NTG group (non-inferiority margin, -0.3 mm). Compared with subcutaneous NTG, topical NTG produced a significantly greater percentage increase in vertical diameter (0.45% +/- 11.76% v 15.6% +/- 16.18%, p = 0.002), horizontal diameter (3.53% +/- 16.01% v 19.72% +/- 16.42%, p = 0.001), and cross-sectional area (3.6% +/- 18.02% v 38.29% +/- 26.65%, p < 0.001). Subcutaneous NTG resulted in a markedly greater increase in radial artery depth when compared with topical NTG (84.35% +/- 47.09% v -0.37% +/- 15.8%, p < 0.001). The first-attempt cannulation success rate was lower in the subcutaneous NTG group (81.8% v 100%, p = 0.049). No NTG-related adverse events or significant hemodynamic changes were observed in either group. Conclusion(s): Topical NTG was statistically non-inferior to subcutaneous NTG in increasing the radial artery vertical diameter. Although the absolute post-intervention dimensions were similar between groups-likely influenced by the slightly smaller baseline arterial dimensions in the topical NTG group-the topical application produced larger percentage increases from baseline and did not cause the depth increase observed with subcutaneous NTG. Copyright © 2026 Elsevier Inc.

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