EPICORE Embase Updates

Total documents retrieved: 160 Results Generated From: Embase <1980 to 2026 Week 16> Embase Weekly Updates (updates since 2026-04-10) - (160 records) <1> Accession Number 2044609159 Title Comparative Outcomes of ICE Versus TEE/Fluoroscopy Guidance Transseptal Puncture in LA Procedures: A Systematic Review and Meta-Analysis. Source Annals of Noninvasive Electrocardiology. 31(3) (no pagination), 2026. Article Number: e70186. Date of Publication: 01 May 2026. Author Abdalla A.M.E.; Durga K.P.; Chukka A.; Kotte M.; Awais M.; Perveen A.; Malik J. Institution (Abdalla) Department of Anatomy, College of Medicine, King Khalid University, Abha, Saudi Arabia (Durga) Shri B M Patil Medical College and Research Center, Vijayapura, India (Chukka) Department of Internal Medicine, NRI Institute of Medical Sciences, Visakhapatnam, India (Kotte) Prime South GME, Consortium Knapp Medical Center, Weslaco, TX, United States (Awais) Department of Electrophysiology, Rawalpindi Institute of Cardiology (RIC), Rawalpindi, Pakistan (Perveen) Department of Medicine, Ibn e Seena Hospital, Kabul, Afghanistan (Malik) Department of Electrophysiology, Pakistan Air Force Hospital, Islamabad, Pakistan Publisher John Wiley and Sons Inc Abstract Objective: To evaluate the comparative efficacy, safety, and radiation exposure outcomes of intracardiac echocardiography (ICE)-guided versus TEE/fluoroscopy-guided trans-septal puncture (TSP) in left atrial procedures. Method(s): We conducted a systematic review and meta-analysis of randomized and observational studies comparing ICE-guided with TEE- or fluoroscopy-only-guided TSP. Eight studies encompassing over 9000 patients undergoing atrial fibrillation (AF) ablation or left atrial appendage occlusion (LAAO) were included. Primary endpoints were fluoroscopy time, radiation dose, first-pass success, puncture time, total procedure time, and major safety outcomes. Random-effects models were used to pool mean differences or hazard ratios with 95% confidence intervals (CIs). Risk of bias was assessed using validated tools, and funnel plots with sensitivity analyses evaluated robustness. Result(s): ICE guidance significantly reduced fluoroscopy time (MD -2.07 min, 95% CI -2.37 to -1.77; p < 0.001) and radiation dose (MD -2.30, 95% CI -3.27 to -1.27; p < 0.001). First-pass success and total procedure time were comparable between groups. Safety endpoints, including tamponade, pericardial effusion, and composite major adverse events, showed no significant increase with ICE. Funnel plots and leave-one-out analyses confirmed the stability of results. Conclusion(s): ICE-guided TSP reduces radiation exposure without compromising efficacy or safety, supporting its adoption as a valuable imaging modality in left atrial interventions. Copyright © 2026 The Author(s). Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC. <2> Accession Number 2043635049 Title Operating Room Extubation After Cardiac Surgery: A Promising Practice, or a Product of Selection Bias?. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(5) (pp 1390-1396), 2026. Date of Publication: 01 May 2026. Author Messinger C.J.; Hall E.; Smith M.R.; Mueller A.; Hou M.; Bloom J.; Mehaffey C.; Gibson L. Institution (Messinger, Hall, Smith, Mueller, Mehaffey, Gibson) Division of Cardiac Anesthesia, Department of Anesthesiology, Massachusetts General Hospital, Mass General Brigham, Boston, MA, United States (Hou, Bloom) Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Mass General Brigham, Boston, MA, United States Publisher W.B. Saunders Abstract Objectives: To evaluate the feasibility, safety, and early outcomes of a standardized operating room extubation (ORE) protocol implemented for elective cardiac surgery patients requiring cardiopulmonary bypass. Design(s): A prospective observational cohort study with systematic protocol implementation and data collection. Setting(s): A single academic medical center. Participant(s): Six hundred twenty-eight patients undergoing elective cardiac surgery with cardiopulmonary bypass between November 2024 and June 2025. Intervention(s): Implementation of a protocol requiring systematic consideration of ORE for all eligible patients, with 171 patients (27%) receiving ORE and 457 patients receiving conventional intensive care unit (ICU) extubation. Measurements and Main Results: Primary outcomes included unadjusted ORE utilization rates, reintubation rates, 30-day mortality, ICU length of stay, and hospital length of stay. On average 28% of eligible cases were extubated each month. Patients selected for ORE were relatively young (median age 62 years) with a low comorbidity burden. All ORE patients survived for 30 days. Reintubation occurred in 5 patients (2.9%). Median ICU stay was shorter for ORE patients compared with the overall cohort (26 v 38 hours), while median hospital stay was similar between groups (5 days). Conclusion(s): A standardized ORE protocol demonstrated feasibility and safety in selected cardiac surgery patients, with low reintubation rates, zero 30-day mortality, and reduced ICU length of stay. However, these encouraging outcomes likely reflect patient selection based on clinical judgment and cannot establish comparative efficacy relative to early ICU extubation. A multicenter randomized controlled trial is needed to determine efficacy and define optimal patient populations for ORE. Copyright © 2026 Elsevier Inc. <3> Accession Number 2044712980 Title Electronic tools to support medication adherence in patients undergoing solid organ transplantation: A systematic review. Source Medicina Clinica. 166(5) (no pagination), 2026. Article Number: 107434. Date of Publication: 01 May 2026. Author Guijarro-Martinez P.; Quesada-Munoz L.; Ciudad-Gutierrez P.; Molina-Mendoza M.D.; Delgado-Silveira E.; Alvarez-Diaz A.M. Institution (Guijarro-Martinez, Quesada-Munoz, Molina-Mendoza, Delgado-Silveira, Alvarez-Diaz) Servicio de Farmacia, Hospital Universitario Ramon y Cajal-IRYCIS, Madrid, Spain (Ciudad-Gutierrez) Servicio de Farmacia, Hospital Universitario Virgen del Rocio, Seville, Spain Publisher Ediciones Doyma, S.L. Abstract Background: Mobile digital health has expanded worldwide. Despite the high number of electronic tools developed, few of them are focused on improving medication adherence, particularly in patients undergoing solid organ transplantation.MethodsA systematic review of studies evaluating electronic tools supporting medication adherence in transplant patients. The review was registered in PROSPERO (CRD42024548913) and followed PRISMA guidelines. Searches were performed in PubMed, EMBASE, Cochrane Library, and Web of Science. Of 2032 records, eight studies met inclusion criteria.ResultsEight mobile apps designed for patients, caregivers and clinicians were identified. Users valued electronic medication monitoring systems and interactive reminders, although improvements in data confidentiality and navigation were suggested. Five tools demonstrated significant adherence improvements compared with non-use.ConclusionMost identified apps improved medication adherence, although methodological heterogeneity limits comparability. Further high-quality research is needed to determine the clinical impact of digital tools in solid organ transplantation. Copyright © 2026 Elsevier Espana, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <4> Accession Number 2044199181 Title LeAAPing Up From Down Under: Australia and Aotearoa New Zealand's Participation in the LeAAPS Trial. Source Heart Lung and Circulation. 35(4) (pp e59-e60), 2026. Date of Publication: 01 Apr 2026. Author DeBoard Z.M. Institution (DeBoard) Department of Cardiothoracic Surgery, Waikato Hospital, Hamilton, New Zealand (DeBoard) Faculty of Medical and Health Science, University of Auckland, New Zealand Publisher Elsevier Ltd <5> Accession Number 2043296956 Title TAVR in Bicuspid Aortic Valve Disease: A Meta-Analysis of Surgical Comparison and Anatomic Predictors. Source Heart Lung and Circulation. 35(4) (pp 503-516), 2026. Date of Publication: 01 Apr 2026. Author Lingamsetty S.S.P.; Thyagaturu H.; Jitta S.R.; Prajapati K.; Ajibade A.; Alruwaili W.; Muntazir H.; Zeb I. Institution (Lingamsetty) Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States (Thyagaturu, Zeb) Department of Cardiology, West Virginia University, Heart and Vascular Institute, Morgantown, WV, United States (Jitta) Department of Internal Medicine, Mercy Hospital, St. Louis, MO, United States (Prajapati) Department of Internal Medicine, Metropolitan Hospital Center, NYC Health + Hospitals, New York, NY, United States (Ajibade, Alruwaili) Department of Internal Medicine, West Virginia University, Morgantown, WV, United States (Muntazir) Binghamton University, State University of New York, Binghamton, NY, United States Publisher Elsevier Ltd Abstract Background: Despite the proven efficacy of transcatheter aortic valve replacement (TAVR) in treating tricuspid aortic valve stenosis, the bicuspid aortic valve (BAV) population has been excluded from most of the landmark trials. Aim(s): This study aimed to assess the outcomes of TAVR compared with those of surgical aortic valve replacement (SAVR) and examine the impact of BAV type, aortopathy, excess leaflet calcification, and raphe calcification on BAV TAVR outcomes. Method(s): We searched PubMed/MEDLINE, Embase, and Cochrane Library for studies that assessed the outcomes of TAVR in the BAV population. We also included studies of patients with BAV undergoing TAVR and SAVR, and those assessing anatomical predictors of TAVR outcomes. Random-effects models were used to calculate the pooled risk ratios, mean differences, and hazard ratios. Result(s): Patients with BAV who underwent TAVR showed significantly lower risks of major bleeding and acute kidney injury, and shorter hospital stays than those who underwent SAVR. However, BAV TAVR had a higher pacemaker implantation rate. Among the BAV types, Type 0 showed a higher risk of coronary obstruction, whereas Type 1 had a lower risk of pacemaker implantation following BAV TAVR. Additionally, BAV TAVR had a higher risk of long-term mortality in patients with aortopathy (ascending aortic diameter >4.5 cm) and excessive leaflet calcification. Conclusion(s): Compared with SAVR, TAVR in BAV is associated with favourable in-hospital outcomes. Anatomical features, such as BAV type, aortopathy, excess leaflet calcification, and calcified raphe, significantly influence the outcomes of TAVR in the BAV population. Copyright © 2025 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) <6> Accession Number 2044492149 Title Predictive Value of Machine Learning-Based Echocardiographic Myocardial Texture After Transcatheter Aortic Valve Replacement. Source Echocardiography. 43(4) (no pagination), 2026. Article Number: e70439. Date of Publication: 01 Apr 2026. Author Zheng L.; Zhang S.; Yin H.; Chen H.; Liang G.; Deng Y. Institution (Zheng, Yin, Chen) Department of Medical Ultrasonics, First People's Hospital of Yulin, YuLin, China (Zhang) Pubei County No. 1 Vocational Technical School, Qinzhou, China (Liang, Deng) Department of Medical Ultrasonics, First Affiliated Hospital of Guangxi Medical University, Nanning, China Publisher John Wiley and Sons Inc Abstract Objectives: Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure for treating severe aortic valve stenosis. This study aimed to develop an interpretable machine learning (ML) model based on echocardiographic myocardial texture for predicting 1-year clinical endpoints following TAVR via the femoral artery. Method(s): We retrospectively studied 121 patients who underwent transfemoral TAVR between January 2019 and October 2023, and data from external validation centers were collected between January 2019 and October 2023 to validate and evaluate the model externally. The composite outcome of all-cause mortality and heart failure events was used as the clinical endpoint. Based on echocardiographic imaging of myocardial texture analysis, nine widely used ML algorithms were used to construct models. Three predictive models were then constructed based on the best machine mode, with Shapley additive explanations for the interpretation of the model and the assessment of the contributions of the different characteristics. Result(s): Among the nine ML models, the Extra Tree (ET) model had the best discriminative ability. An explainable final ET model was established with two features. The final model accurately predicted the clinical endpoint 1 year after transfemoral TAVR in both internal and external validations, and the results in the COX multifactorial regression analysis showed that LVEF <50% was an independent predictor of the clinical endpoint 1 year after transfemoral TAVR. In addition, Kaplan-Meier survival curves showed that patients with high Rad-Score values had lower survival rates than those with low Rad-Score values. Conclusion(s): This novel method based on echocardiographic myocardial texture with ML may have the potential to be used for predicting clinical endpoints 1 year after transfemoral TAVR and may be used as a convenient tool to facilitate its utility in clinical settings. Copyright © 2026 Wiley Periodicals LLC. <7> Accession Number 2037932865 Title An adjustment of fraction of inspired oxygen using the oxygen reserve index during one-lung ventilation in pediatric patients: a prospective, randomized controlled trial. Source Korean Journal of Anesthesiology. 79(2) (pp 224-232), 2026. Date of Publication: 01 Apr 2026. Author Park J.-B.; Kang P.; Ji S.-H.; Jang Y.-E.; Kim E.-H.; Kim J.-T.; Kim H.-S.; Lee J.-H. Institution (Park, Ji, Jang, Kim, Kim, Kim, Lee) Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine (Kang) Department of Anesthesiology and Pain Medicine, Korea University Hospital, Seoul, South Korea Publisher Korean Society of Anesthesiologists Abstract Background: One-lung ventilation (OLV) during thoracic surgery frequently requires ap-proximately 100% oxygen, imposing the risk of hyperoxemia. This study aimed to assess whether oxygen reserve index (ORI)-guided fraction of inspired oxygen (FiO<inf>2</inf>) adjustment can reduce the incidence of hyperoxemia in children undergoing lung resection. Method(s): This prospective, randomized controlled trial enrolled children aged < 7 years scheduled for thoracoscopic lung resection. The participants were randomly assigned to either a conventional group (FiO<inf>2</inf> adjusted based on arterial blood gas analysis [ABGA]) or an ORI group (FiO<inf>2</inf> titrated to maintain an ORI target of 0.15). ABGA was performed 10 and 30 min after the start of OLV (T1 and T2). The primary outcome was the incidence of hyperoxemia 30 min after OLV (T2). Result(s): Data from 64 children (31 conventional, 33 ORI groups) were analyzed. The incidence rate of hyperoxemia at T2 was similar between the conventional and ORI groups (54.8% vs. 60.6%, P = 0.801). However, partial pressure of arterial oxygen at T1 was significantly lower in the ORI group than in the conventional group (214.6 +/- 65.5 mmHg vs. 268.8 +/- 92.7 mmHg, P = 0.014). The ORI group demonstrated a lower time-weighted av-erage FiO<inf>2</inf> during OLV (0.79 +/- 0.12 vs. 0.87 +/- 0.09, P = 0.004). The ORI group required more rescue interventions than the conventional group and experienced fewer episodes of hypoxia. Conclusion(s): ORI-guided FiO<inf>2</inf> adjustment does not significantly reduce the incidence of hyperoxemia in children undergoing OLV but reduces time-weighted FiO<inf>2</inf> and hypoxic events. Copyright © The Korean Society of Anesthesiologists, 2026. <8> Accession Number 2044600821 Title Prophylactic Dexmedetomidine Reduces Junctional Ectopic Tachycardia and Facilitates Postoperative Recovery in Pediatric Cardiac Surgery: A Systematic Review and Meta-Analysis of Prospective Trials. Source Paediatric Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Singh M.; Anilkumar A.; Vondivillu Srinivasan R.; Jabbar J.A.; Malaichamy N.; Jayaraman R. Institution (Singh, Anilkumar, Vondivillu Srinivasan, Jabbar, Malaichamy, Jayaraman) First Faculty of Medicine, Charles University, Prague, Czechia Publisher John Wiley and Sons Inc Abstract Objective: To evaluate the efficacy and safety of prophylactic dexmedetomidine in preventing Junctional Ectopic Tachycardia (JET) and its impact on postoperative recovery in pediatric congenital heart surgery, restricting analysis to prospective trials. Method(s): We systematically searched PubMed, Scopus, and CENTRAL through October 16, 2025, for prospective randomized and quasi-randomized trials. Retrospective cohorts were excluded. The primary outcome was postoperative JET incidence. Secondary outcomes included mechanical ventilation duration, ICU length of stay (LOS), Vasoactive-Inotropic Score (VIS), and safety. Data were synthesized using random-effects models and certainty of evidence was assessed using the GRADE framework. Result(s): Five prospective trials (n = 639) met the inclusion criteria. Prophylactic dexmedetomidine was associated with a significant reduction in postoperative JET incidence (OR 0.37; 95% CI 0.23-0.58; p < 0.0001; I2 = 0%), supported by moderate-certainty evidence. For secondary outcomes, pooled analyses suggested reductions in mechanical ventilation (MD -4.80 h) and ICU LOS (MD -19.83 h), but these were characterized by substantial clinical heterogeneity and low to very-low certainty of evidence. A significant reduction in VIS emerged only in the sensitivity analysis; these findings remain hypothesis-generating. No significant differences were observed for mortality or hypotension. Conclusion(s): In prospective pediatric cardiac surgery trials, prophylactic dexmedetomidine was associated with reduced postoperative JET, supported by moderate-certainty evidence. While dexmedetomidine may help facilitate earlier recovery, its impact on secondary outcomes remains suggestive rather than definitive due to low evidence certainty. Future large-scale, multicenter randomized trials are required to confirm if these potential benefits translate into consistent clinical improvements. Copyright © 2026 The Author(s). Pediatric Anesthesia published by John Wiley & Sons Ltd. <9> [Use Link to view the full text] Accession Number 2038239299 Title Regional Anesthesia With Fascial Plane Blocks for Pediatric Cardiac Surgery With Sternotomy: A Narrative Review. Source Anesthesia and Analgesia. 142(3) (pp 507-517), 2026. Date of Publication: 01 Mar 2026. Author Russell G.C.; Einhorn L.M. Institution (Russell) From the Department of Anesthesiology, Duke University School of Medicine, Durham, NC, United States (Einhorn) Department of Anesthesiology, Pediatric Division, Duke University School of Medicine, Durham, NC, United States Publisher Lippincott Williams and Wilkins Abstract Undertreated pain in children who undergo sternotomy for cardiac surgery can lead to cardiopulmonary complications, the development of chronic pain, and long-term maladaptive stress response. Opioids have dose-dependent side effects that may interfere with postoperative recovery. With the increasing availability of ultrasound, regional anesthesia is often included in multimodal analgesic approaches. Fascial plane blocks targeting the intercostal nerves or ventral rami are of particular interest for patients requiring full heparinization for cardiopulmonary bypass as they avoid manipulation of neuraxial and noncompressible paravertebral spaces. This narrative review summarizes the literature on fascial plane blocks for pediatric patients undergoing cardiac surgery via midline sternotomy and may serve as a guide for clinicians. Both prospective and retrospective studies are reviewed, as are prior review articles. We describe individual fascial plane block techniques including the transversus thoracic muscle plane, pectointercostal fascial plane, serratus anterior plane, and erector spinae plane blocks and provide clinical considerations for each block. Additionally, we provide an analysis of individual studies stratified by anterior or posterior approach and block type. The majority of described studies examine single-shot blocks; the existing catheter literature, which includes erector spinae plane block catheters, is also included. Our findings suggest that fascial plane blocks decrease intraoperative and postoperative opioid use, pain scores, time to extubation, and length of stay in the intensive care unit and hospital. Notably, prospective studies in this field are small, typically fewer than 100 patients, and overall include a homogenous patient population, focusing primarily on patients with acyanotic congenital heart defects. Nonetheless, despite the limitations of individual studies, there is substantial evidence to support the use of regional anesthesia, particularly for patients in whom early extubation is planned. There is a need for large, prospective multi-center studies to evaluate the effectiveness and safety of specific single-shot block types, optimal local anesthetic dosing strategies compared to active comparators, and generalizability of results across institutions. Future studies should also consider evaluating the role of regional block catheters for continuous local anesthetic infusion and the inclusion of additional surgical populations, including neonates, patients with cyanotic lesions, and those with longer postoperative mechanical ventilation courses. Copyright © 2025 <10> Accession Number 650428784 Title Effects of preconditioning with one-lung ventilation on perioperative oxygenation and oxidative stress in thoracoscopic surgery: a prospective single-center randomized controlled clinical trial. Source BMC anesthesiology. 26(1) (no pagination), 2026. Date of Publication: 28 Feb 2026. Author Lin J.; Du X.; Zhang W.; Wu C.; Zhao D.; Fang J. Institution (Lin) Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Du, Fang) Department of Anesthesiology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Zhang) Department of Anesthesiology, Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China (Wu) Department of Anesthesiology, Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China (Zhao) Department of Anesthesiology, Shenzhen People's Hospital, Second Clinical Medical College, Jinan University, First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China Abstract BACKGROUND: Hypoxemia is a common and clinically significant problem during one-lung ventilation (OLV). Prophylactic ventilation strategies to prevent OLV-associated hypoxemia and lung injury remain insufficiently defined. METHOD(S): Patients scheduled for elective video-assisted thoracoscopic lung lobectomy or segmentectomy were enrolled and randomly assigned into a preconditioning group or a control group. After anesthesia induction, a visual double-lumen endotracheal tube was inserted. The preconditioning group underwent three cycles of OLV preconditioning protocol before surgery: 2 min OLV -> 2 min two-lung ventilation (TLV) -> 4 min OLV -> 4 min TLV -> 6 min OLV -> 6 min TLV. The control group received conventional OLV only. Ventilation parameters: the tidal volume was set at 6 mL/kg during OLV and 8 mL/kg during TLV. Respiratory rate was adjusted to maintain an end-tidal carbon dioxide partial pressure of 35-45 mmHg. The primary outcome was the oxygenation index (arterial partial pressure of oxygen/fraction of inspired oxygen, PaO2/FiO2). Secondary outcomes included perioperative oxidative stress markers and the incidence of postoperative pulmonary complications (PPCs) within 7 days after surgery. RESULT(S): Seventy-four patients were included in the final analysis. The oxygenation index decreased in both groups after initiation of OLV, reaching its lowest value at 30 min. At this time point, the preconditioning group showed a significantly higher oxygenation index than the control group (209 +/- 64 vs. 145 +/- 43 mmHg, P < 0.001). No significant differences were observed between the two groups in perioperative superoxide dismutase (SOD) levels [168 +/- 16 vs. 160 +/- 21 U/mL, P = 0.302] or in the incidence of PPCs (10/38 vs. 16/36, P = 0.105). CONCLUSION(S): OLV preconditioning improved intraoperative oxygenation during thoracic surgery, but did not significantly affect perioperative oxidative stress or the incidence of PPCs. TRIAL REGISTRATION: The study was retrospectively registered in the Chinese Clinical Trial Registry on April 8, 2021, ( http://www.chictr.org.cn , ChiCTR2100045203). Copyright © 2026. The Author(s). <11> Accession Number 2042904029 Title Randomized evaluation of comparative effects of optimized static cold storage, hypothermic and normothermic machine perfusion, and colchicine pretreatment on ischemia-reperfusion injury in a porcine model. Source Journal of Heart and Lung Transplantation. 45(5) (pp 770-782), 2026. Date of Publication: 01 May 2026. Author Ughetto A.; Delmas C.; Benezech L.; Battistella P.; Gaudard P.; Molina A.; Andre G.; Maamar S.; Guihaire J.; Audo R.; Martinez M.C.; Guilbeau-Frugier C.; Roland D.; Herman F.; Lacampagne A.; Roubille F. Institution (Ughetto, Benezech, Battistella, Gaudard, Molina, Andre, Maamar, Audo, Martinez, Roland, Lacampagne, Roubille) PhyMedExp, University of Montpellier, CNRS, INSERM, CHU Montpellier, France (Ughetto, Gaudard, Andre) Department of Anesthesiology and Critical Care Medicine, Arnaud de Villeneuve Hospital, CHU Montpellier, University of Montpellier, Montpellier, France (Delmas, Benezech) Intensive Cardiac Care Unit, Cardiology department, Rangueil University Hospital, Toulouse, France / Toulouse University, Toulouse, France (Delmas) REICATRA (Recherche et Enseignement en Insuffisance Cardiaque Avancee Transplantation et Assistance), Institut Saint Jacques, CHU de Toulouse, France (Battistella, Roubille) Cardiology department, CHU de Montpellier, University of Montpellier, Montpellier, France (Molina, Maamar, Roland) Cardio-thoracic and Vascular Surgery department, CHU de Montpellier, University of Montpellier, Montpellier, France (Guihaire) Adult Cardiac Surgery and Transplantation, Marie Lanelongue Hospital, Paris Saclay University, France (Guilbeau-Frugier) INSERM U1297, Institute of Metabolic and Cardiovascular Diseases (I2MC), 31432, Toulouse, France (Herman) Clinical Research and Epidemiology Unit, La Colombiere University Hospital, Montpellier, France Publisher Elsevier Inc. Abstract Background Heart transplantation remains limited by ischemia-reperfusion injury (IRI). Optimizing graft preservation and modulating inflammation may improve early graft quality. We compared optimized static cold storage (SCS), hypothermic machine perfusion (HMP), and normothermic machine perfusion (NMP), and evaluated colchicine pretreatment as an adjunct anti-inflammatory strategy. Methods Thirty-six pigs were randomized to colchicine or placebo (n=18 each) and subsequently assigned to SCS, HMP, or NMP (n=12 per group). After 4 h of preservation, all hearts underwent 1 h of normothermic reperfusion. Myocardial injury, lactate extraction, systemic cytokines, and histological assessments were performed. Mixed-effects models accounting for repeated measures and treatment-preservation interactions were used for all longitudinal analyses. Results HMP was associated with lower H-FABP levels than SCS (beta -92.6; 95% CI -183 to -2.6; p=0.04), while NMP showed no difference. Troponin I release was significantly higher in NMP versus SCS (beta 97.9; 95% CI 63.4-132; p<0.001). Lactate extraction was greater with HMP compared with SCS (beta 10.2; 95% CI -0.2 to 20.6; p=0.05), with no difference for NMP. Preservation modality strongly influenced inflammation: IL-6 (beta 3.72; p<0.001) and TNF-alpha (beta 0.25; p=0.003) were markedly increased in NMP, whereas IL-10 was reduced in HMP versus SCS (beta -0.38; p<0.001). Colchicine had no significant effect on any biomarker. Oxidative stress proteins, apoptosis markers, and histological injury scores did not differ across preservation modalities or treatment groups. Conclusions In this randomized large-animal model, hypothermic preservation (SCS, HMP) provides superior metabolic and inflammatory profiles compared with NMP. Colchicine did not confer additional benefit under these conditions. Copyright © 2026 International Society for the Heart and Lung Transplantation. <12> Accession Number 2039571015 Title Navigating the silence: reconsidering treatment paradigms in asymptomatic severe aortic stenosis. Source Hellenic Journal of Cardiology. 87 (pp 101-120), 2026. Date of Publication: 01 Jan 2026. Author Karampinos K.; Ktenopoulos N.; Apostolos A.; Koliastasis L.; Kachrimanidis I.; Vlachakis P.; Katsaros O.; Tsalamandris S.; Karanasos A.; Drakopoulou M.; Synetos A.; Latsios G.; Tsioufis K.; Toutouzas K. Institution (Karampinos, Ktenopoulos, Apostolos, Koliastasis, Kachrimanidis, Vlachakis, Katsaros, Tsalamandris, Drakopoulou, Synetos, Latsios, Tsioufis, Toutouzas) First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, Athens, Greece (Karanasos) Department of Cardiology, Patras University Hospital, Patras, Greece Publisher Hellenic Cardiological Society Abstract Aortic stenosis (AS) remains the leading valvular heart disease worldwide, affecting up to 5% of older adults and posing a significant risk if left untreated. The evolution of transcatheter aortic valve replacement (TAVR) and its expanding indications for symptomatic patients with severe AS, coupled with the evolving understanding of the pathophysiology and natural history of AS, have heightened the focus on asymptomatic patients with severe AS. Although current clinical practice guidelines recommend aortic valve replacement (AVR) therapy in asymptomatic severe aortic stenosis (ASAS) only in specific clinical settings, recent studies have challenged traditional treatment paradigms, advocating for a more individualized strategy, particularly for patients exhibiting high-risk characteristics. In this review, we provide an in-depth analysis of ASAS, focusing on the intricacies of its clinical management, novel risk-stratification modalities, and predictors of symptom onset and disease progression. We also determine the role of echocardiography in assessing AS severity, highlighting inconsistencies in diagnostic criteria and the need for supplementary testing. Evolving and recently published randomized controlled trials-namely EARLY-TAVR, EVoLVeD, and TAVR-UNLOAD-randomizing asymptomatic patients to early intervention or a watchful waiting strategy provide significant evidence that has the potential to change treatment paradigms, lower the threshold for intervention, and pave the way for more individualized management strategies in ASAS. Copyright © 2025 Hellenic Society of Cardiology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/ <13> Accession Number 2042712394 Title Pericardial effusion and tamponade as a rare cardiac toxicity of covalent BTK inhibitors in CLL-a multi-modality study. Source Leukemia and Lymphoma. 67(4) (pp 860-867), 2026. Date of Publication: 2026. Author Hofstetter L.; Shimony S.; Sherban A.; Raanani P.; Itchaki G. Institution (Hofstetter, Sherban, Raanani) Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah- Tikva, Israel (Hofstetter, Sherban, Raanani, Itchaki) The Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel (Shimony) Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States (Itchaki) Institute of Hematology, Meir Medical center, Kfar-Saba, Israel Publisher Taylor and Francis Ltd. Abstract Bruton tyrosine kinase inhibitors (BTKi) have a unique cardiovascular toxicity profile. We investigated pericardial effusion and tamponade (PE/T) as a potential cardiac complication associated with BTKi therapy. We employed a multi-modal approach: (1) a case series (2) a prevalence analysis using institutional and National Health Oragnization Maintanance (HMO) registry data; and (3) a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing BTKi- and non-BTKi-based regimens in CLL. We identified 15 cases of PE/T during BTKi therapy. In our institutional cohort (n = 750), PE/T prevalence was 2.6% among BTKi-treated patients vs. 0.17% in non-BTKi-treated patients (RR 15.48; p = 0.0072). In the HMO registry (n = 5917), BTKi-associated PE/T prevalence was 0.78%, with an RR of 3.09 (p = 0.029). The meta-analysis showed a significantly increased risk of PE/T with BTKi therapy (OR 3.25; 95% CI 1.02-10.35; p = 0.01; I2=0%). These results suggest that PE/T may represent a rare but clinically meaningful cardiac toxicity of BTKi therapy. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <14> Accession Number 2044178859 Title Aspirin Dosing in Secondary Prevention of Atherosclerotic Cardiovascular Disease. Source Current Cardiology Reports. 28(1) (no pagination), 2026. Article Number: 41. Date of Publication: 01 Dec 2026. Author Porter K.; Acquah I.; Walker A.; Hogan S.E. Institution (Porter, Acquah, Walker) Department of Internal Medicine, Division of Cardiology, University of Colorado, Aurora, CO, United States (Hogan) Denver Health, 777 Bannock Street, Mail Code 0960, Denver, CO, United States (Hogan) University of Colorado School of Medicine, Aurora, CO, United States (Hogan) CPC Clinical Research, Aurora, CO, United States Publisher Springer Abstract Purpose of Review: To compile research evaluating low- versus high-dose aspirin efficacy and safety in patients with known cardiovascular disease. Recent Findings: The ADAPTABLE randomized controlled trial of ~ 1,500 participants with cardiovascular disease found similar ischemic efficacy and bleeding safety of low- versus high-dose aspirin at a median follow-up of 26 months. Summary: High-dose aspirin does not have improved efficacy and increases bleeding risk in secondary cardiovascular disease prevention. As such, patients with cardiovascular disease should be maintained on low-dose aspirin. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <15> Accession Number 2044691458 Title Diastolic dysfunction in the patients with failing Fontan circulation: New insights and future directions. Source Progress in Pediatric Cardiology. 81 (no pagination), 2026. Article Number: 101914. Date of Publication: 01 Mar 2026. Author Shah A.H. Institution (Shah) Section of Cardiology, Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada Publisher Elsevier Ireland Ltd <16> Accession Number 2044613283 Title Comfort-Focused Assessment and Patient-Reported Experience After Regional versus General Anaesthesia: Post Hoc Analysis of a Cluster-Randomised Trial. Source Anaesthesia Critical Care and Pain Medicine. 45(2) (no pagination), 2026. Article Number: 101660. Date of Publication: 01 Apr 2026. Author Maurice-Szamburski A.; Rozier R.; Fusco N.; Meuret L.; Loundou A.; Auquier P.; Beloeil H. Institution (Maurice-Szamburski) Department of Anesthesiology and Intensive Care Medicine, Pasteur Nice University Hospital, Nice, France (Rozier) Department of Anesthesiology and Intensive Care Medicine, L'Archet Nice University Hospital, Nice, France (Fusco) CHU Rennes, Anesthesia and Intensive Care Department, Rennes, France (Fusco) Private Hospital, Anesthesia Department, Saint-Gregoire, France (Fusco) Hypnosis Institute, Emergences Campus, Rennes, France (Meuret) CHU Rennes, Anesthesia and Intensive Care Department, Rennes, France (Loundou, Auquier) Laboratoire de Sante Publique, 264 rue Saint Pierre, Marseille, France (Beloeil) University of Rennes, CHU Rennes, Anesthesia and Intensive Care Department, Inserm, OSS1242, CIC 1414, Rennes, France Publisher Elsevier Masson s.r.l. Abstract IntroductionPostoperative pain management typically relies on numerical (NRS) or analogue rating scales. However, exclusive focus on nociception may overlook broader aspects of patient experience, especially under regional anaesthesia (RA). This post hoc analysis of the COMFORT trial (NCT05234216) examined whether replacing the NRS with a comfort-focused scale affects patient-reported experience, opioid use, and related outcomes.MethodsWe analysed data from a cluster-randomised trial in 29 French centres. Adults undergoing elective non-cardiac surgery managed in the post-anaesthesia care unit (PACU) were included. The intervention (comfort scale) and comparator (pain NRS) were applied in the PACU. Patient-reported experience was measured with the EVAN-G/LR scales, self-completed on the ward/day-care unit >=4 h postoperatively. Participants were divided into RA and general anaesthesia subgroups.ResultsOf 885 randomised patients, 786 had evaluable EVAN data. After regional anaesthesia (RA; n = 305), comfort-focused assessment was associated with higher EVAN Pain (median 88 [IQR 75-94] vs. 75 [69-88]; p = 0.034), Waiting (100 [75-100] vs. 75 [50-100]; p = 0.012), and Global Index (81 [72-91] vs. 77 [68-90]; p = 0.044). After general anaesthesia (GA; n = 481), EVAN scores were similar between groups. Nefopam use was lower with the comfort approach in RA (7% vs. 18%; p = 0.005). Antiemetic use was lower with the comfort approach in GA.ConclusionReplacing the NRS with a comfort-focused approach did not improve global patient experience after surgery. In patients receiving regional anaesthesia, however, using a comfort scale was associated with better patient-reported experience in the EVAN "Pain" dimension, while no benefit was observed after general anaesthesia. 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/ <17> Accession Number 2043176524 Title Pulmonary Valve Replacement: Update on Timing and Ventricular Remodelling. Source Journal of Clinical Medicine. 15(3) (no pagination), 2026. Article Number: 1295. Date of Publication: 01 Feb 2026. Author Ortiz-Garrido A.; Rozewicz Juraszek M.; Gabbert D.D.; Jussli-Melchers J.; Voges I. Institution (Ortiz-Garrido) Section of Paediatric Cardiology, Hospital Materno Infantil, Regional Universitario de Malaga, Malaga, Spain (Ortiz-Garrido) Faculty of Medicine, University of Malaga, Malaga, Spain (Rozewicz Juraszek, Gabbert, Voges) Department of Congenital Heart Disease and Paediatric Cardiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany (Gabbert, Voges) German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lubeck, Kiel, Germany (Jussli-Melchers) Department of Cardiac Surgery, Universitatsklinikum Schleswig-Holstein, Kiel, Germany Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Chronic pulmonary regurgitation (PR) after the repair of tetralogy of Fallot (TOF) and other right ventricular outflow tract (RVOT) interventions leads to progressive right ventricular (RV) dilatation, altered ventricular-ventricular interaction, and an increased risk of arrhythmia and heart failure. Pulmonary valve replacement (PVR), whether surgical or transcatheter, effectively eliminates or reduces PR and is associated with short- and mid-term improvement in RV size, symptoms, and electrocardiographic markers. However, the optimal timing of intervention remains unresolved: operating late can result in irreversible myocardial damage and arrhythmogenic substrates, whereas operating early can lead to repeated reinterventions, the impact of which on hard outcomes is uncertain. This review summarizes contemporary evidence on ventricular remodelling after PVR, focusing on cardiovascular magnetic resonance (CMR) and echocardiographic markers, and critically appraises proposed criteria for timing PVR. Classic CMR-derived thresholds (RV end-diastolic volume index [RVEDVi] 150-170 mL/m2, RV end-systolic volume index [RVESVi] 80-90 mL/m2) and QRS duration cut-offs are discussed alongside emerging markers of risk, including the RV mass-to-volume ratio, diffuse myocardial fibrosis (extracellular volume fraction), strain imaging, and diastolic dysfunction. Meta-analyses show consistent reverse remodelling and symptomatic benefit after PVR, but no conclusive survival benefit has been demonstrated, and data on arrhythmic outcomes remain conflicting. Key gaps include (i) the lack of prospective randomized or carefully matched comparative studies of "early" versus "deferred" PVR; (ii) limited understanding of how myocardial fibrosis, RV hypertrophy, and diastolic dysfunction interact with volume load and timing to influence long-term outcomes; (iii) under-representation of adult and older adult TOF cohorts; and (iv) insufficient integration of multiparametric risk scores and machine-learning approaches into clinical decision-making. Future research should prioritize multicentre longitudinal cohorts with standardized imaging, electrophysiological and clinical endpoints, incorporate advanced imaging techniques (e.g., strain, 3D late gadolinium enhancement, and T1 mapping), and explore precision-medicine strategies to individualize PVR timing. Copyright © 2026 by the authors. <18> Accession Number 2042916134 Title Hemodynamic monitoring strategies in cardiac surgery: an update systematic review. Source Journal of Clinical Monitoring and Computing. 40(1) (pp 7-20), 2026. Date of Publication: 01 Feb 2026. Author Melo R.; Galindo V.; Gioli-Pereira L.; Joelsons D.; Assuncao M.; Alves B.; Souza G.; Bravim B.; Passos R. Institution (Melo, Gioli-Pereira) Hospital Municipal Gilson de Cassia Marques de Carvalho, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/701, SP, Sao Paulo, Brazil (Galindo, Joelsons, Assuncao, Alves, Bravim, Passos) Department of Critical Care, Hospital Israelita Albert Einstein, SP, Sao Paulo, Brazil (Souza) Hospital Ortopedico Do Estado da Bahia, Hospital Israelita Albert Einstein, BA, Salvador, Brazil Publisher Springer Science and Business Media B.V. Abstract Hemodynamic monitoring is a cornerstone of perioperative care in cardiac surgery, where patients are at high risk of cardiovascular instability and organ hypoperfusion. In recent years, goal-directed therapy (GDT) protocols have increasingly incorporated advanced monitoring technologies to optimize perfusion and improve outcomes. This systematic review aims to critically appraise contemporary hemodynamic monitoring strategies and their integration into GDT protocols in adult patients undergoing cardiac surgery. A systematic review of studies published between January 2015 and May 2025 was conducted using PubMed, Embase, Scopus, and the Cochrane Library. The last search was conducted on 17 May 2025 in all databases. Eligible studies included adult cardiac surgical patients managed with perioperative hemodynamic monitoring strategies that incorporated cardiac output assessment and structured GDT protocols. A qualitative synthesis of monitoring modalities, targeted hemodynamic endpoints, and reported clinical outcomes was performed. Our analysis included 15 studies comprising 4,224 patients. Monitoring strategies ranged from pulmonary artery catheters to minimally invasive and noninvasive tools such as FloTrac/EV1000 and esophageal Doppler. Cardiac index and stroke volume variation were the most frequently targeted parameters, often in combination with perfusion markers such as mean arterial pressure or central venous oxygen saturation. GDT protocols were associated with reductions in AKI, duration of mechanical ventilation, and ICU/hospital stay. Mortality benefits were inconsistently reported and not predefined in most studies. Current evidence supports the physiological rationale for GDT guided by advanced hemodynamic monitoring in cardiac surgery. Nonetheless, substantial heterogeneity in strategies and outcomes highlights the need for standardized protocols and high-quality multicenter trials to determine the most effective, patient-centered approaches. Trial registration: PROSPERO registration number: CRD420251102582, retrospectively registered on 11 July 2025. Copyright © The Author(s) 2026. <19> Accession Number 2044021994 Title Trial of Edaravone for severe hypoxic ischemic encephalopathy in adults: a double-blind placebo-controlled study. Source Journal of Neurology. 273(3) (no pagination), 2026. Article Number: 207. Date of Publication: 01 Mar 2026. Author Razmeh S.; Karimi A.A.; Dashti A.M.; Vafapour F.; Mousavizadeh A. Institution (Razmeh) Neurology Department, Yasuj University of Medical Science, Yasuj, Iran, Islamic Republic of (Karimi, Dashti) Yasuj University of Medical Sciences, Shahid Motahari Blvd, Kohgiluyeh and Boyer-Ahmad Province, Yasuj, Iran, Islamic Republic of (Vafapour) Department of Internal Medicine, Yasuj University of Medical Science, Yasuj, Iran, Islamic Republic of (Mousavizadeh) Department of Biostatistics and Epidemiology, School of Health, Yasuj University of Medical Sciences, Yasuj, Iran, Islamic Republic of Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Hypoxic ischemic encephalopathy (HIE) is a severe brain injury that can lead to death and long-term disability. HIE can be treated with therapeutic hypothermia, and various adjuvant treatments (such as melatonin) are also utilized. Adjuvant therapies are not recommended outside clinical trials, and therapeutic hypothermia is not universally available. This study aimed to investigate the effects of Edaravone on improving levels of consciousness, hemodynamic stability, and short-term clinical outcomes of adult patients with severe HIE. To the best of our knowledge, this study is the first randomized clinical trial investigating the effects of Edaravone in adult patients with severe HIE. Method(s): A double-blind clinical trial enrolled 72 severe HIE patients (aged > 18) within 24 h of onset who were diagnosed clinically and radiologically. Patients were randomized to Edaravone group (n = 20) and non-Edaravone group (n = 52). Measured parameters included level of consciousness, vital signs, Barthel index, and patient outcome (death or discharge). Statistical analysis was performed using SPSS version 27, with a significance level of P < 0.05. Result(s): In short-term assessment of the patient's level of consciousness, the Edaravone group showed significant improvement in the Glasgow Coma Scale (GCS) post-intervention (p = 0.001). While the Edaravone group and non-Edaravone group showed no significant difference in outcome (p = 0.863) and Barthel score for discharged patients (P = 0.557). Vital signs showed significant differences between groups in temperature (P = 0.002). In the comparison of comorbidities between the Edaravone and non-Edaravone groups, only coronary artery bypass grafting was significantly different (P = 0.021). Conclusion(s): Edaravone improved the short-term level of consciousness in severe HIE adult patients, but there was no significant effect on outcome and level of independence in performing activities of daily living. Further investigation into Edaravone's effectiveness is warranted, particularly in patients with milder forms of HIE, as well as longer follow-up periods. Copyright © Springer-Verlag GmbH Germany, part of Springer Nature 2026. <20> Accession Number 2034823998 Title Coronary Artery Bypass Grafting With or Without Concomitant Surgical Ventricular Reconstruction in Ischemic Cardiomyopathy Patients. Source Cardiovascular Drugs and Therapy. 40(2) (pp 681-695), 2026. Date of Publication: 01 Apr 2026. Author Liao J.; Zhou Z.; Zhang Y.; Miao Z.; Li G.; Xiao H.; Ren Q.; Jian B.; Wu Z.; Liang M. Institution (Liao, Zhou, Zhang, Miao, Li, Xiao, Ren, Jian, Wu, Liang) Department of Cardiac Surgery, First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, China (Zhou) Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States Publisher Springer Abstract Purpose: The present study aims to compare the long-term outcomes of surgical ventricular reconstruction (SVR) combined with coronary artery bypass grafting (CABG) versus CABG alone in patients with ischemic cardiomyopathy (ICM). Method(s): A systematic literature search was conducted in PubMed, Embase, Scopus, Cochrane Library, and Web of Science until November 2024. Studies comparing SVR + CABG and CABG in patients with ischemic cardiomyopathy (left ventricular ejection fraction less than 40%) were included. The primary outcome included long-term mortality, and the secondary outcomes included hospital mortality, rehospitalization for cardiac causes, and other cardiac function indicators. Result(s): Twelve studies with a total of 3188 patients were included, with 1629 undergoing SVR + CABG and 1559 undergoing CABG. Patients who underwent SVR + CABG had a higher survival rate (HR 0.82; 95% CI, 0.69-0.96; I2 = 4%; P = 0.01) and a more significant postoperative left ventricular end-systolic volume index (ESVI) reduction (MD 15.53; 95% CI, 6.41-24.65; I2 = 93%; P = 0.01). In the subgroup analysis, the Dor (endoventricular circular patch plasty) surgery provided additional survival benefits compared with CABG (HR 0.83; 95% CI, 0.70-0.97; I2 = 9%; P = 0.02). The reconstructed Kaplan-Meier curves show that the survival rates in the SVR + CABG, Dor, Non-Dor, Mannequin-free, Mannequin, and CABG groups were 81.13%, 82.02%, 76.38%, 83.23%, 69.40%, and 71.42% at 60 months, respectively. Conclusion(s): Compared with CABG, SVR + CABG is associated with higher survival, a more significant reduction in ESVI, fewer rehospitalizations for cardiac causes, and more patients gaining postoperative New York Heart Association class improvement. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025. <21> Accession Number 2043417383 Title Direct oral anticoagulants versus vitamin K antagonists after heart valve bioprosthetic replacement or repair: A systematic review and meta-analysis. Source Archives of Cardiovascular Diseases. 119(4) (pp 302-308), 2026. Date of Publication: 01 Apr 2026. Author Bruno V.D.; Lester T.; Poletti E.; Celmeta B.; Viva T.; Bisogno A.; Miceli A.; Glauber M. Institution (Bruno, Celmeta, Viva, Bisogno, Miceli, Glauber) Department of Minimally Invasive Cardiac Surgery, IRCCS Galeazzi-Sant'Ambrogio Hospital, Milan, Italy (Lester) School of Medicine, University of Bristol, Bristol, United Kingdom (Poletti) Department of Cardiology, Hartcentrum Middelheim ZNA, Antwerp, Belgium Publisher Elsevier Masson s.r.l. Abstract Vitamin K antagonists are used as a temporary anticoagulation method after bioprosthetic valve replacement or repair. However, the novel direct oral anticoagulants may be a preferred method of anticoagulation because of their improved patient compliance. This meta-analysis aimed to evaluate the safety of direct oral anticoagulants versus vitamin K antagonists after biological valve replacement or repair. A systematic review and meta-analysis were performed for studies reporting the effect of direct oral anticoagulants versus vitamin K antagonists after biological valve replacement or repair. The inclusion criteria were studies of adults undergoing bioprosthetic mitral or aortic valve replacement or repair, comparing direct oral anticoagulants versus vitamin K antagonists in the early postoperative period. The main outcomes were thromboembolic and bleeding events, and short- and mid-term death rates. Six observational studies and one randomized controlled trial were included, with a total of 2994 direct oral anticoagulant recipients and 16,894 vitamin K antagonist recipients. There were no significant differences between the groups in terms of thromboembolic events (odds ratio: 0.82, 95% confidence interval: 0.45-1.49; P = 0.52) or bleeding events (odds ratio: 0.89, 95% confidence interval: 0.70-1.14, P = 0.36). Higher 30-day and mid-term death rates were observed in patients receiving direct oral anticoagulants, but this analysis was reported inconsistently, and was heavily influenced by a single study. In a mixed population of individuals undergoing bioprosthetic valve replacement or repair, there was no statistically significant difference between direct oral anticoagulants and vitamin K antagonists in terms of reducing thromboembolic or bleeding events. Further studies are needed to establish the optimal anticoagulation regimen in this context. Copyright © 2026 Elsevier Masson SAS. <22> Accession Number 2040496160 Title Efficacy of clopidogrel monotherapy versus aspirin monotherapy after percutaneous coronary intervention. Source Journal of Thrombosis and Thrombolysis. 59(2) (pp 286-296), 2026. Date of Publication: 01 Feb 2026. Author Waqas S.A.; Imran Z.; Bilal A.R.; Ahmed S.; Gaba H.; Chew N.W.S.; Greene S.J.; Khan M.S. Institution (Waqas, Imran) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (Bilal, Gaba) Department of Medicine, Ziauddin Medical College, Karachi, Pakistan (Ahmed) Department of Medicine, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan (Chew) Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore (Chew) Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore (Greene) Duke Clinical Research Institute, Durham, NC, United States (Greene) Division of Cardiology, Duke University School of Medicine, Durham, NC, United States (Khan) Baylor College of Medicine, Temple, TX, United States (Khan) Baylor Scott and White Heart Hospital, Plano, TX, United States (Khan) Baylor Scott and White Research Institute, Baylor Scott and White Health, Dallas, TX, United States Publisher Springer Abstract Following percutaneous coronary intervention (PCI), dual antiplatelet therapy (DAPT) is standard to reduce thrombotic complications. However, the optimal monotherapy after DAPT remains debated. Clopidogrel may offer better protection than aspirin. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing clopidogrel versus aspirin monotherapy after DAPT in PCI patients. Searches were performed in MEDLINE, Embase, Scopus, CENTRAL, and ClinicalTrials.gov up to April 12, 2025. Outcomes included stroke, myocardial infarction (MI), all-cause mortality, and cardiovascular (CV) death. Hazard ratios (HRs) were pooled using random-effects models. Four RCTs comprising 19,554 patients (clopidogrel: 9,846; aspirin: 9,708) were included. Clopidogrel was associated with a significantly lower risk of stroke (HR: 0.69; 95% CI: 0.51-0.94; p = 0.02; I2 = 28%) and MI (HR: 0.71; 95% CI: 0.51-0.99; p = 0.05; I2 = 48%) compared with aspirin. There was no significant difference between clopidogrel and aspirin in terms of all-cause mortality (HR: 0.99; 95% CI: 0.78-1.25; p = 0.92; I2 = 55%), CV death (HR: 0.87; 95% CI: 0.70-1.08; p = 0.22; I2 = 0%), coronary revascularization (HR: 0.95; 95% CI: 0.83-1.09; p = 0.44; I2 = 0%), major bleeding (HR: 0.97; 95% CI: 0.70-1.35; p = 0.87; I2 = 57%), or stent thrombosis (HR: 0.66; 95% CI: 0.38-1.15; p = 0.15; I2 = 0%). Clopidogrel monotherapy post-DAPT after PCI reduces stroke and MI risk compared to aspirin, without increasing mortality or bleeding. These findings support clopidogrel as a favorable alternative for monotherapy. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025. <23> [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. <24> Accession Number 2044326699 Title Myocardial Injury After Non-Cardiac Surgery in Otolaryngology: Evidence Gaps and a Systematic Review. Source Journal of Clinical Medicine. 15(6) (no pagination), 2026. Article Number: 2186. Date of Publication: 01 Mar 2026. Author Domka J.; Kasza R.; Zietek L.; Smyla-Gruca W.; Antkowiak M.; Koniewska A.; Gamrot-Wrzol M.; Kowalski D.; Misiolek H.; Misiolek M.; Bialka S. Institution (Domka) Clinical Department of Anaesthesiology and Intensive Care, University Clinical Hospital Fryderyk Chopin in Rzeszow, Rzeszow, Poland (Kasza, Zietek, Smyla-Gruca) Student Scientific Society of Anesthesiology and Intensive Care, Department of Anesthesiology and Intensive Care, Medical University of Silesia, Zabrze, Poland (Antkowiak, Koniewska, Gamrot-Wrzol, Misiolek) Department of Otorhinolaryngology and Laryngological Oncology in Zabrze, Medical University of Silesia, Zabrze, Poland (Kowalski, Misiolek, Bialka) Department of Anesthesiology and Intensive Care, Medical University of Silesia, Zabrze, Poland Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Myocardial injury after non-cardiac surgery (MINS) is a common and serious postoperative complication. Its largely asymptomatic course hampers early recognition, highlighting the importance of systematic biomarker monitoring. The aim of this review is to summarize current evidence on the diagnosis, risk factors, and management of MINS, with a focus on otolaryngology, where intraoperative hypotensive techniques may increase risk. Method(s): A basic science review was conducted using PubMed, Embase, and the Cochrane Library (2005-2025). From 2712 records, 30 studies met the inclusion criteria after removing duplicates, screening titles/abstracts, and full-text assessment. These studies formed the basis for the final analysis. Result(s): Observational studies and reviews identify perioperative troponin monitoring as the diagnostic gold standard. However, no evidence-based management guidelines exist, and otorhinolaryngology-specific data remain rare but not entirely absent. Troponin elevation in the early postoperative period reliably predicts adverse outcomes. While MINS is well documented in vascular and orthopedic surgery, evidence in otolaryngology is limited. Controlled hypotension in procedures such as functional endoscopic sinus surgery or head and neck tumor resection may further elevate risk. Conclusion(s): MINS is an underrecognized complication with major prognostic significance. The lack of standardized management and the absence of large otolaryngology cohorts underscore an urgent need for targeted research and specialty-specific guidelines and support the justification for integrating existing evidence into otolaryngologic practice. Copyright © 2026 by the authors. <25> Accession Number 2044127232 Title Risk factors for pituitary apoplexy: a meta-analysis and development of a clinical prediction nomogram. Source Frontiers in Neurology. 17 (no pagination), 2026. Article Number: 1772791. Date of Publication: 2026. Author Chen H.; Huang N.; Tang R.; Chen J.; Zhao G. Institution (Chen, Huang, Tang, Chen, Zhao) Department of Neurosurgery, The Second Affiliated Hospital of Chongqing, Medical University, Chongqing, China Publisher Frontiers Media SA Abstract Purpose: This study aimed to identify significant risk factors for pituitary apoplexy in patients with pituitary adenomas through a meta-analysis and to develop an individualized nomogram for clinical decision-making. Method(s): A two-part investigation was conducted. First, a meta-analysis of published studies identified risk factors for pituitary apoplexy and calculated pooled odds ratios (ORs) and 95% confidence intervals (CIs). Second, a retrospective cohort of 234 patients was used to construct and validate a nomogram based on multivariate logistic regression. Result(s): The meta-analysis included six studies, revealing that non-functioning pituitary adenomas (OR = 1.93, 95% CI: 1.38-2.70), male sex (OR = 2.57, 95% CI: 1.85-3.58), and hypertension (OR = 2.53, 95% CI: 1.54-4.15) were significantly associated with pituitary apoplexy. The nomogram demonstrated excellent predictive performance with AUCs of 0.86 in the training set and 0.83 in the validation set. Calibration curves showed good agreement between predicted and observed probabilities. The Hosmer-Lemeshow test yielded P values of 1 and 0.272 in the training and validation cohorts, respectively. Decision curve analysis demonstrated significant net clinical benefit in both cohorts. Conclusion(s): This study identified key predictors of pituitary apoplexy and developed a nomogram that may help stratify risk and guide preventive and therapeutic strategies. Copyright © 2026 Chen, Huang, Tang, Chen and Zhao. <26> Accession Number 2044281250 Title Oxidative Stress and the KEAP1/NRF2 Axis in Saphenous Vein: Implications for Graft Patency. Source Cells. 15(6) (no pagination), 2026. Article Number: 563. Date of Publication: 01 Mar 2026. Author Layton G.R.; Marston E.; Musa H.L.; Ladak S.; Copperwheat A.; Oluwanifemi A.; Antoun I.; Zakkar M. Institution (Layton, Marston, Musa, Ladak, Antoun, Zakkar) Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom (Layton, Copperwheat, Oluwanifemi, Zakkar) Department of Cardiac Surgery, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom (Layton, Marston, Ladak, Zakkar) Leicester British Heart Foundation Centre of Research Excellence, Leicester, United Kingdom (Antoun) Department of Cardiology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Vein graft disease remains a significant limitation to the long-term patency of venous conduits following coronary artery bypass grafting. Early oxidative stress, triggered by ischaemia-reperfusion injury and haemodynamic changes following the implantation of veins into the arterial circulation, disrupts endothelial integrity and initiates inflammation, apoptosis, and maladaptive remodelling. The KEAP1-NRF2 axis is a central regulator of cellular antioxidant responses; however, its role in the development of vein graft disease remains poorly defined. This narrative review aimed to summarise what is known about NRF2/KEAP1 signalling in modulating vein graft pathology. Method(s): A systematic search of PubMed was conducted to identify original research studies examining the NRF2/KEAP1 pathway in human saphenous vein tissue in vivo or ex vivo. Narrative synthesis was performed due to limited evidential availability and study heterogeneity. Result(s): Only one study has directly evaluated NRF2 pathway activation directly in human saphenous vein tissue, and it demonstrated that Protandim (a herbal dietary supplement) treatment increased antioxidant enzyme activity and reduced oxidative stress markers, including superoxide and 4-hydroxynonenal, both known activators of MAPK-dependent smooth muscle proliferation. Adjacent studies in other cells and tissues reveal that NRF2 intersects with multiple pathways central to vein graft pathology: it suppresses NFkappaB-mediated inflammation, modulates eNOS-NO signalling, inhibits NADPH oxidase expression, regulates MAPK activation, and influences angiogenic responses. However, context-dependent activation of NRF2 under arterial cyclic stretch can paradoxically drive proliferation through p62-mediated KEAP1 sequestration and enhanced glutathione synthesis. Conclusion(s): The NRF2/KEAP1 pathway serves as a central integrator of oxidative stress responses that directly intersect with established mechanisms of intimal hyperplasia and pathological angiogenesis. Post-translational KEAP1 inhibition may offer a targeted intervention point to limit these processes. Critical gaps remain regarding our understanding of the role of NRF2 in human saphenous vein under physiological arterial conditions and sex-specific pathway regulation. Mechanistic studies in vein-specific models are essential for advancing our understanding and any potential therapeutic translation. Copyright © 2026 by the authors. <27> Accession Number 2043483088 Title Benzodiazepine receptor agonists in hospitalised patients in the Netherlands: initiation, continuation and discontinuation-a retrospective observational analysis. Source BMJ Open. 16(2) (no pagination), 2026. Article Number: e112758. Date of Publication: 09 Feb 2026. Author De Gans C.J.; Van den Ende E.S.; Meewisse A.J.G.; Van Zuylen M.L.; Stenvers D.J.; Hermanides J.; Nanayakkara P.W.B. Institution (De Gans, Van den Ende, Nanayakkara) Department of Internal Medicine, Amsterdam University Medical Center, Section General Internal Medicine unit Acute Medicine, Amsterdam, Netherlands (De Gans, Van den Ende, Nanayakkara) Amsterdam Public Health Research Institute, Quality of Care, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, Netherlands (Meewisse, Van Zuylen, Hermanides) Amsterdam Public Health Research Institute, Quality of Care, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, Netherlands (Meewisse, Van Zuylen, Hermanides) Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, Netherlands (Van Zuylen) Department of Pediatric Intensive Care, Amsterdam University Medical Center, Amsterdam, Netherlands (Stenvers) Department of Endocrinology and Metabolism, Amsterdam University Medical Center, Amsterdam, Netherlands (Stenvers) Amsterdam Gastroenterology Endocrinology and Metabolism (AGEM), Amsterdam University Medical center, Amsterdam, Netherlands Publisher BMJ Publishing Group Abstract Objective To examine inpatient benzodiazepine receptor agonists prescribing patterns and assess how hospitalisation affects use at discharge. Design Subanalysis of the WEsleep trial, a cluster-randomised controlled single-centre study conducted at Amsterdam University Medical Center (Amsterdam UMC) (two locations) between July 2023 and March 2024. Twelve departments (six medical, six surgical) were matched and randomised to intervention or standard care. On intervention wards, multiple measures to improve sleep were implemented, including minimising nighttime disruptions. Setting Amsterdam UMC, across medical and surgical hospital departments. Patients Adult patients admitted for >=2 nights (medical) or undergoing elective non-cardiac surgery in a surgical department. Primary and secondary outcome measures Benzodiazepine use was classified as no use, pre-admission use or new in-hospital initiation. Prescribing patterns were summarised descriptively according to type, timing, indication and discharge status. Results Of 746 patients, 187 (25%) used benzodiazepines: 80 (43%) had pre-admission use, and 107 (57%) were newly initiated during their hospital stay. Among pre-admission users, two discontinued and five had adjustments at discharge. Among newly initiated users, 94 (88%) had their benzodiazepine discontinued at discharge. Approximately half of pre-admission prescriptions and one-third of in-hospital prescriptions lacked a documented indication. Conclusions Although most newly initiated benzodiazepine treatments were discontinued during hospitalisation, pre-existing use was rarely reassessed and nearly 10% of new users were discharged with a prescription. Structured deprescribing protocols, better documentation of indications and improved discharge planning are needed to promote safer and more rational benzodiazepine use. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group. <28> Accession Number 2044581952 Title Critical insights on "Off-pump versus on-pump coronary artery bypass grafting in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis". Source General Thoracic and Cardiovascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Hussain S.M.A.; Younas K. Institution (Hussain) Dow Medical College, Karachi, Pakistan (Younas) Bakhtawar Amin Medical and Dental College, Multan, Pakistan Publisher Springer <29> Accession Number 2044298651 Title Effect of Lemon Inhalation Aromatherapy on Postoperative Pain, Nausea and Vomiting, Delirium, and Inflammatory Markers After Coronary Artery Bypass Grafting: A Triple-Blind Randomized Trial. Source Iranian Journal of Pharmaceutical Research. 25(1) (no pagination), 2026. Article Number: e168770. Date of Publication: 01 Dec 2026. Author Sangi S.; Amouzegar Zavareh S.M.; Sahraei H.; Sepandi M.; Moradi A. Institution (Sangi) Student Research Center, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran, Islamic Republic of (Sangi) Department of Anesthesiology and Operation Room, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Amouzegar Zavareh) Atherosclerosis Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran, Islamic Republic of (Sahraei) Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran, Islamic Republic of (Sepandi) Department of Epidemiology and Biostatistics, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran, Islamic Republic of (Moradi) Student Research Committee, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran, Islamic Republic of Publisher Brieflands Abstract Background: Complementary and integrative medicine has gained increasing attention as a safe adjunct for improving postoperative outcomes, particularly in cardiac surgery where pain, postoperative nausea and vomiting (PONV), and delirium remain common and debilitating complications. Objective(s): This randomized clinical trial aimed to investigate the effect of lemon inhalation aromatherapy on postoperative pain, PONV, delirium, and inflammatory markers in patients undergoing coronary artery bypass grafting (CABG) surgery. Method(s): In this triple-blind, parallel-group randomized controlled trial, 104 adult patients scheduled for elective CABG surgery were randomly allocated to either lemon aromatherapy or an odorless placebo. Aromatherapy began the evening before surgery, was administered every two hours until anesthesia induction, and resumed continuously during mechanical ventilation and for 72 hours after extubation. Pain and PONV were assessed every 6 hours across eight postoperative shifts using a 0 - 10 Numeric Rating Scale. Delirium was evaluated at 24, 48, and 72 hours using the intensive care delirium screening checklist (ICDSC). Inflammatory markers [C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR)] were measured at baseline and 72 hours. Data were entered after double-checking into SPSS version 26. Continuous variables were tested for normality using the Shapiro-Wilk test; normally distributed variables were compared using independent t-tests, and non-normal variables with the Mann-Whitney U test. Categorical variables were analyzed using chi-square or Fisher's exact test. All analyses were two-tailed with a significance level of P < 0.05. Result(s): Of the 104 randomized patients, 103 completed the study (one patient in the intervention group was withdrawn due to postoperative cerebrovascular insult). The two groups were well-balanced at baseline with respect to demographic and clinical characteristics. Pain scores were significantly lower in the intervention group at all eight postoperative shifts (P < 0.001). Postoperative nausea and vomiting severity was significantly reduced across all shifts (P < 0.001), with fewer vomiting episodes and lower need for rescue antiemetic medications. The incidence of delirium was significantly lower in the intervention group at 24 hours (11.8% vs. 28.8%), 48 hours (15.7% vs. 34.6%), and 72 hours (7.8% vs. 23.1%) (all P < 0.05). Significant improvements were also observed in multiple ICDSC subscales, particularly inattention, disorientation, sleep-wake disturbances, and inappropriate speech/mood. At 72 hours, both CRP and NLR levels were significantly lower in the aromatherapy group, suggesting attenuation of the postoperative inflammatory response. No aromatherapy-related adverse events were observed. Conclusion(s): Lemon inhalation aromatherapy was effective in significantly reducing postoperative pain, PONV, delirium incidence, and inflammatory markers following CABG surgery. As a safe, low-cost, and non-invasive complementary intervention, lemon aromatherapy may enhance postoperative recovery and represents a promising adjunct to standard care in cardiac surgery. Copyright © 2026, Sangi et al. <30> Accession Number 2044196532 Title Effects of Transradial Catheterisation on Radial Artery Bypass Graft Patency: A Systematic Review and Meta-Analysis. Source Heart Lung and Circulation. 35(4) (pp 444-450), 2026. Date of Publication: 01 Apr 2026. Author Wang Y.; Sharma V.; Vu T.; Marasco S.F. Institution (Wang) School of Translational Medicine, Monash University, Melbourne, VIC, Australia (Wang, Marasco) Department of Surgery, Monash University, Melbourne, VIC, Australia (Sharma) Department of Cardiac Surgery, Austin Health, Heidelberg, VIC, Australia (Vu, Marasco) Department of Cardiothoracic Surgery and Transplantation, The Alfred, Melbourne, VIC, Australia Publisher Elsevier Ltd Abstract Background: Transradial catheterisation is the default approach of coronary angiography, and the radial artery (RA) is a popular conduit choice for coronary artery bypass grafting (CABG). Whether a previously catheterised RA (CRA) remains an optimal bypass conduit for CABG is uncertain. This systematic review and meta-analysis sought to evaluate the previous CRA bypass graft patency. Method(s): A systematic search is conducted in MEDLINE, Embase, and Scopus for comparative studies of CRA versus non-CRA (NCRA) grafts. The primary outcome of this study was RA graft patency. Random-effects models generated pooled effect sizes with heterogeneity assessed by I2; small-study effects were examined with funnel plot/Egger's test, and influence analyses were performed in the meta-analysis. Result(s): Of the 1,661 studies screened, four observational studies of 400 patients (175 CRA and 379 NCRA grafts) were included in the analysis. Across the included studies, the mean time from catheterisation to CABG was 27.4+/-16.0 days; the mean follow-up imaging was conducted at 2.06+/-1.88 years. CRA graft patency was lower than NCRA (73.2% vs 83.9%), and the pooled odds of graft failure were higher with CRA (odds ratio 1.82; 95% confidence interval 1.26-2.61; p=0.001; I2=33%). There were no significant small-study biases detected on planned assessments. Conclusion(s): Prior transradial catheterisation is associated with reduced patency of RA bypass grafts. Surgeons should exercise caution when selecting CRA for critical targets, and prospective controlled data are needed to define patient and procedural modifiers of risk. Copyright © 2025 <31> Accession Number 2040260187 Title The effectiveness and side effects of anti-coagulant drugs in pregnant women with mechanical or bio-prosthetic heart valves: A systematic review and meta-analysis study. Source Journal of Cardiology. 87(4) (pp 354-365), 2026. Date of Publication: 01 Apr 2026. Author Shishesaz M.I.; Eshraghi R.; Bahrami A.; Farzan M.; Hajibeygi R.; Fathi M.; Yaghoobpoor S.; Tavasol A.; Gorjizad M.; Dehghani M.; Akbari A.; Rafiei N.; Roostaie M.; Eslami S.; Taherkhani M.; Movahed M.R. Institution (Shishesaz) School of Medicine, Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Eshraghi) Social Determinants of Heath Research Center, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of (Bahrami) Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran, Islamic Republic of (Farzan, Farzan) Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran, Islamic Republic of (Farzan) Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran, Islamic Republic of (Hajibeygi) School of Medicine, Tehran University of Medical Science, Tehran, Iran, Islamic Republic of (Fathi, Yaghoobpoor, Tavasol, Gorjizad, Akbari) School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Dehghani, Rafiei) School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of (Roostaie) School of Medicine, Islamic Azad University Tehran Medical Branch, Tehran, Iran, Islamic Republic of (Eslami) Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Taherkhani) Clinical Research Development Unit (CRDU) of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Movahed) University of Arizona Sarver Heart Center, Tucson, AZ, United States (Movahed) University of Arizona College of Medicine, Phoenix, AZ, United States (Hajibeygi) Department of Radiology and Biomedical Imaging, Yale School of Medicine, CT, United States Publisher Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai) Abstract Background and objectives Patients with pregnancy and mechanical or bio-prosthetic heart valves (BHVs) need tailored antithrombotic therapy to prevent thromboembolism. The goal of this study was to evaluate the effects and complications of various anticoagulation strategies used during pregnancy in these patients using a meta-analysis. Method We searched PubMed, Google Scholar, Scopus, EMBASE, and Web of Science databases and discovered 24 articles. We also discarded some articles when evaluating them in detail due to inadequate information. Finally, 24 studies were included in the systematic review. We compared pregnancy outcomes in three groups of pregnant women: 1) Those taking warfarin; 2) Those taking LMWH (Low Molecular Weight Heparin) or UFH (Unfractionated Heparin); 3) Those on no anticoagulant therapy. The authors would like to thank the Clinical Research Development Unit (CRDU) of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran for their support, cooperation and assistance throughout the period of study. The ethic code is: IR.SBMU.RETECH.REC.1403.831. Results The incidence of maternal thromboembolic events was higher in the UFH or LMWH group, but fetal complications (FC) were lower in this group. Using warfarin during the first trimester was associated with a higher abortion rate, embryopathies, and FCs overall. Using '5 mg of warfarin daily to maintain their targeted INR had a lower risk of developing. Preterm labor and spontaneous abortion were observed in 0.09 (95 % CI = 0.04-0.14) and 0.08 (95 % CI = 0.01-0.14) of cases in the LMWH/UFH subgroup. In terms of maternal complications (MCs) in Warfarin subgroup, maternal hemorrhagic complications, maternal thromboembolic events, and valve thrombosis were respectively observed in 2.0 (95 % CI = 0-3), 0.01 (95 % CI = 0.00-0.03), 0.01 (95 % CI = 0.00-0.03); in LMWH subgroup the rates were 0.18 (95 % CI = 0.09-0.27), 0.03 (95 % CI = 0.00-0.06), and 0.28 (95 % CI = 0.15-0.71); and finally in those taking no anticoagulant therapy, the rates were 0.02 (95 % CI = 0.03-0.06), 0.07 (95 % CI = 0.06-0.19). Conclusions According to the results, preterm labor is a significant fatal complication in pregnant women on warfarin. Maternal hemorrhagic complications and thromboembolic events occur in the LMWH subgroup. There are no significant differences in other complications between the three subgroups. Copyright © 2025 Elsevier Ltd. <32> Accession Number 2044160624 Title Advances in acute normovolemic hemodilution: A narrative review. Source Current Problems in Surgery. 77 (no pagination), 2026. Article Number: 102014. Date of Publication: 01 Apr 2026. Author Wang R.; Zhang W. Institution (Wang) Department of Anesthesiology, Mianyang 404 Hospital, Sichuan, Mianyang, China (Zhang) Department of Anesthesiology, West China Hospital, Sichuan University, Sichuan, Chengdu, China Publisher Elsevier Inc. <33> 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. <34> 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. <35> Accession Number 2044299330 Title A Systematic Review of Inflatable Transcervical Mediastinoscopic Oesophagectomy and McKeown Oesophagectomy in Oesophageal Cancer. Source Journal of the College of Physicians and Surgeons Pakistan. 36(3) (pp 374-381), 2026. Date of Publication: 01 Mar 2026. Author Onyebuchi I.C.; Zhu S.; Qi Y.; Hou G. Institution (Onyebuchi, Zhu, Qi) Department of Thoracic Surgery, First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhu, China (Hou) Department of Thoracic Surgery, Henan Provincial People's Hospital, Henan, China Publisher College of Physicians and Surgeons Pakistan Abstract This study compared the clinical efficacy and practicality of inflatable transcervical mediastinoscopic oesophagectomy (TIME) versus minimally invasive 3-stage McKeown oesophagectomy (MIME) for oesophageal cancer. A comprehensive literature search from 2018 onwards was conducted in databases such as PubMed and Wiley Online Library, focusing on studies that detail these surgical methods. Primary outcomes assessed the feasibility and practicality of TIME and MIME, with secondary outcomes including post-surgical complications, using data from published sources. Results indicate that TIME is generally less invasive, associated with fewer pulmonary complications (6.43 vs. 15.42; p = 0.06, 95% CI: 3.71- 21.71) and shorter operative time (270.75 vs. 337.01 minutes; p = 0.60, 95% CI: 5,47-8.61) compared to MIME, making it preferable for patients with previous thoracic surgeries or elderly patients. TIME also shows advantages in terms of shorter hospital stays (15.37 vs. 24.28 days; p = 0.21, 95% CI: 5.90- 23.74), less operative bleeding (138.94 vs. 187.53 ml; p = 0.28, 95% CI: 4.65-12.2), and fewer postoperative complications. However, concerns remain regarding the capability of TIME for lymph node dissection (15.47 vs. 29.42; p = 0.05, 95% CI: 4.74-32.65) and the resection of large tumours, such as T3 and T4 tumours, where MIME is perceived to perform better. The mortality rate was insignificant for both surgical methods (0.50 vs. 0.20; p = 0.22, 95% CI: 1.11-5.61), demonstrating their safety for patients with oesophageal cancer. Nonetheless, both techniques are deemed safe and effective for treating oesophageal cancer, with TIME demonstrating capability in resecting T3 tumours with good post-surgical outcomes. Copyright © 2026 College of Physicians and Surgeons Pakistan. All rights reserved. <36> 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. <37> Accession Number 2043138636 Title Enhanced Detection and Prompt Diagnosis of Atrial Fibrillation Using Apple Watch. Source Journal of the American College of Cardiology. 87(14) (pp 1714-1728), 2026. Date of Publication: 14 Apr 2026. Author van Steijn N.J.; Blommestijn I.S.; Blok S.; Pepplinkhuizen S.; Somsen G.A.; Knops R.E.; Breukel L.; Tijssen J.G.P.; Tulevski I.I.; Croon P.M.; Winter M.M. Institution (van Steijn, Blommestijn, Pepplinkhuizen, Knops, Tijssen, Croon, Winter) Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, Netherlands (van Steijn, Blommestijn, Blok, Somsen, Tulevski, Winter) Cardiology Centers of the Netherlands, Utrecht, Netherlands (Breukel) Department of Cardiology, Spaarne Gasthuis, Haarlem, Netherlands (Croon) Section of cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States Publisher Elsevier Inc. Abstract Background Atrial fibrillation (AF), the most common cardiac arrhythmia, is a major cause of stroke and often remains undiagnosed due to its paroxysmal and frequently asymptomatic nature. Wearables provide a scalable, noninvasive screening tool.ObjectivesThis trial evaluated new onset AF detection in patients at elevated stroke risk using remote smartwatch-based screening.MethodsThis prospective multicenter randomized controlled trial included patients >=65 years with elevated stroke risk (CHA<inf>2</inf>DS<inf>2</inf>-VASc >=2 men, >=3 women) from 2 secondary care centers in the Netherlands. Patients were randomized to 6-month (180-day) monitoring with a smartwatch with photoplethysmography and single-lead electrocardiogram (ECG) functions, or standard care. ECGs were reviewed remotely by an independent eHealth team within 24 hours. The primary outcome was new onset AF, defined as a confirmed episode lasting >=30 seconds on single-lead ECG or standard ECG methods.ResultsBetween November 2022 and December 2023, 437 patients were randomized (219 intervention, 218 control); the median age was 75 years, 46.7% were female and the median CHA<inf>2</inf>DS<inf>2</inf>-VASc score was 3.0. New onset AF occurred in 21 (9.6%) patients of the intervention group and 5 (2.3%) patients of the control group (risk difference: 7.3 percentage points; 95% CI: 2.9-11.7 percentage points; P = 0.001; HR: 4.40; 95% CI: 1.66-11.66). Several asymptomatic AF episodes were detected only in the intervention group, while paroxysmal AF occurred in both groups.ConclusionsThis randomized controlled trial provides evidence that 6-month smartwatch-based AF screening enhances the detection rate of new onset AF compared with standard care in patients at elevated stroke risk. (Detection and Quantification of Atrial Fibrillation in High-risk Patients Using a Smartwatch Wearable [Apple Watch] [EQUAL]; NCT05686330) Copyright © 2026 by the American College of Cardiology Foundation. Published by Elsevier. <38> Accession Number 2044525048 Title Federated Meta-Analysis of HEART Score Performance for Emergency Department Chest Pain. Source Academic Emergency Medicine. 33(4) (no pagination), 2026. Article Number: e70284. Date of Publication: 01 Apr 2026. Author Wang H.; Chou E.; Robinson R.D.; Farzad A.; Saltarelli N.; Johnson G.; d'Etienne J.; Mahler S.A. Institution (Wang, Saltarelli, Johnson, d'Etienne) Department of Emergency Medicine, JPS Health Network, Integrative Emergency Services, Fort Worth, TX, United States (Chou, Farzad) Department of Emergency Medicine, Baylor Scott & White All Saints Hospital, Integrative Emergency Services, Fort Worth, TX, United States (Robinson) Department of Emergency Medicine, Baylor University Medical Center, Integrative Emergency Services, Dallas, TX, United States (Mahler) Department of Emergency Medicine, Wake Forest University, Medical Center Blvd, Winston Salem, NC, United States Publisher John Wiley and Sons Inc Abstract Objectives: Multicenter evaluation of emergency department (ED) risk stratification tools is often limited by barriers to patient-level data sharing. We used the HEART score as a clinical use case to evaluate whether a federated diagnostic meta-analytic approach yields performance estimates comparable to those obtained from centralized patient-level analysis for predicting 30-day major adverse cardiovascular events (MACE30). Method(s): We conducted a retrospective, multicenter observational study across six EDs between January 1, 2020, and December 31, 2023. Adult patients presenting with chest pain who had a documented HEART score were included. MACE30 was defined as acute myocardial infarction, coronary revascularization, or all-cause mortality. The diagnostic performance of the HEART score was evaluated using a federated bivariate random-effects meta-analysis based on site-level 2 x 2 tables, yielding pooled sensitivity, specificity, and hierarchical summary receiver operating characteristic (HSROC) estimates. These results were compared with performance metrics derived from centralized patient-level analysis. Result(s): Among 57,906 ED encounters with documented HEART scores, MACE30 occurred in 2.2%. In federated meta-analysis, the HEART score demonstrated high specificity and negative predictive value, consistent with its intended rule-out function, with modest between-site variability. The pooled HSROC area under the curve was 0.759 (95% CI, 0.646-0.831). Centralized patient-level analysis yielded similar discrimination (AUROC 0.785; 95% CI, 0.776-0.794). Differences between federated and centralized estimates were small and clinically modest, reflecting preservation of site-level heterogeneity and variation in outcome prevalence across EDs. Conclusion(s): Federated diagnostic meta-analysis produced HEART score performance estimates closely aligned with those obtained from centralized patient-level data. This approach enabled scalable, privacy-preserving multicenter evaluation of ED risk-stratification tools while accommodating heterogeneity across practice settings. Copyright © 2026 Society for Academic Emergency Medicine. <39> Accession Number 2044576418 Title Effect of Metabolic Bariatric Surgery on Cardiovascular Outcomes in People with Obesity and Pre-existing Cardiovascular Disease: A Systematic Review and Meta-Analysis. Source Obesity Surgery. (no pagination), 2026. Date of Publication: 2026. Author Qazi S.U.; Shuja M.H.; Shakil F.; Ansari H.U.H.; Khan L.A.; Aziz A.A.; Dang A.K.; Hassan O.U.; Farhan M.; Ahmed R.; Hall M.E. Institution (Qazi, Shuja, Shakil, Ansari) Dow University of Health Sciences, Karachi, Pakistan (Khan, Hall) University of Mississippi Medical Center, Jackson, United States (Aziz) INTEGRIS Baptist Medical Center, Oklahoma City, United States (Dang) University of California, Riverside, Riverside, United States (Hassan) AdventHealth, FL, United States (Farhan) Imperial College London, London, United Kingdom (Ahmed) Newcastle University, Newcastle upon Tyne, United Kingdom Publisher Springer Abstract Background: Metabolic bariatric surgery (MBS) effectively lowers the risk of cardiovascular (CV) events in individuals with obesity, however, its application in those with pre-existing CV disease has been limited due to concerns about perioperative outcomes. Objective(s): This study evaluates the effectiveness and safety of bariatric surgery in reducing CV risk in people with pre-existing CV disease. Method(s): We carried out an extensive search on PubMed, Google Scholar, Science Direct, and Clinicaltrial.gov from their inception until February 2025. Key outcomes included reductions in all-cause mortality (ACM), major adverse CV events (MACE), myocardial infarction (MI), and cerebrovascular events in people with and without prior CV disease undergoing bariatric surgery. Data were combined using a random-effects model and displayed as hazard ratios (HR) along with 95% confidence intervals (CI). Result(s): Three studies (n = 3,888) were included, with 1,523 patients getting Roux-en-Y gastric bypass and 442 receiving sleeve gastrectomy. Median age ranged from 52 to 56 years. Metabolic bariatric surgery was associated with a significant reduction in ACM (HR = 0.48, 95% CI: 0.38 to 0.61, p < 0.01) and MACE (HR = 0.55, 95% CI: 0.45 to 0.67, p < 0.01). However, no significant reduction was observed for MI (HR = 0.53, 95% CI: 0.24 to 1.18, p = 0.12) or cerebrovascular events (HR = 0.99, 95% CI: 0.64 to 1.54, p = 0.96). Conclusion(s): Metabolic bariatric surgery is associated with significantly lower ACM and MACE in people with obesity and prevalent CV disease. These results highlight the necessity for additional extensive trials to validate advantages in high-risk groups, specifically older individuals and those who have experienced prior MI or heart failure. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <40> Accession Number 650654396 Title Incidence and Outcomes of Intraluminal Frozen Elephant Trunk Stent Graft Thrombosis After Aortic Arch Surgery: Systematic Review and Meta-Analysis. Source Journal of the American Heart Association. 15(7) (pp e047425), 2026. Date of Publication: 07 Apr 2026. Author Sa M.P.; Consoli L.; Neves G.; Camarotti T.; Napoli F.; Brozzi N.A.; Navia J.L.; Polanco A. Institution (Sa, Napoli, Brozzi, Navia, Polanco) Department of Cardiovascular Surgery, Heart, Thoracic & Vascular Institute Cleveland Clinic Florida Weston FL USA (Consoli) School of Medicine of Universidade Federal da Bahia (UFBA) Salvador Brazil, Brazil (Neves) School of Medicine of Universidade Estadual do Para (UEPA) Belem Brazil (Camarotti) School of Medicine of Universidade de Pernambuco (UPE) Recife Brazil, Brazil Abstract BACKGROUND: Intraluminal thrombosis (ILT) has been observed in endografts in the thoracic aorta after frozen elephant trunk (FET) for aortic arch pathologies. This study aimed to evaluate the incidence and clinical outcomes associated with ILT. METHOD(S): Systematic review of studies reporting incidence of ILT after FET and comparing outcomes of patients with and without ILT. PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane databases (inception to September 2025) were searched. Single-arm meta-analysis was conducted to determine ILT incidence and 2-arm meta-analyses between groups with ILT and without with a random-effects model to assess patient-relevant outcomes. RESULT(S): Five observational studies, including 999 patients, met our eligibility criteria. Pooled incidence of ILT after FET was 9.24% (95% CI, 6.32-13.31). Although we did not find statistically significant associations between ILT and postoperative stroke (odds ratio [OR], 0.93 [95% CI, 0.46-1.88]; P=0.845), we found statistically significant associations with embolic events (OR, 6.94 [95% CI, 1.01-47.46]; P=0.048) and early mortality (OR, 3.59 [95% CI, 1.69-7.60]; P<0.001). We found positive correlations between proportion of female patients in the populations and incidence of ILT (coefficient, 0.08 [95% CI, 0.02-0.14]; P=0.011). Meta-regression coefficients were statistically significant for embolic events and female sex (coefficient, 0.12 [95% CI, 0.06-0.18]; P<0.001), aortic aneurysm (coefficient, 0.08 [95% CI, 0.04-0.13]; P<0.001), and mean age (coefficient, 0.66 [95% CI, 0.33-0.99]; P<0.001), which means that associations differ across populations with varying mean levels of these covariates. CONCLUSION(S): Because ILT after FET seems to be associated with embolic events and early mortality, close follow-up is warranted-especially for women, older people, and patients with aortic aneurysms-and anticoagulation should be considered. <41> 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. <42> Accession Number 2044634874 Title Association between different biomarkers and mortality in moderate or asymptomatic severe aortic stenosis: A systematic review. Source Medicina Clinica. 166(6) (no pagination), 2026. Article Number: 107408. Date of Publication: 01 Jun 2026. Author Carneiro J.A.; Costa A.R.; Araujo C. Institution (Carneiro) Faculdade de Medicina, Universidade do Porto, Porto, Portugal (Costa, Araujo) EPIUnit ITR, Instituto de Saude Publica da Universidade do Porto, Universidade do Porto, Porto, Portugal (Costa, Araujo) Departamento de Ciencias da Saude Publica e Forenses e Educacao Medica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal (Araujo) Unidade Local de Saude do Medio Ave, Santo Tirso, Portugal Publisher Ediciones Doyma, S.L. Abstract Circulating biomarkers may enhance risk stratification and guide treatment in diseases with heterogeneous prognosis, namely in moderate and asymptomatic severe aortic stenosis (AS). Therefore, this study aims to assess the association between biomarkers and mortality in patients with these diseases. MEDLINE, Web of Science, and Scopus were searched from inception up to January 2025. Cohort studies evaluating BNP, NT-proBNP, troponin, galectin-3 or ST2, before aortic valve replacement, and reporting mortality outcomes, were eligible. Two independent reviewers performed screening, data extraction and quality assessment. A total of ten studies were included: five focused on BNP and the other five on NT-proBNP. Despite methodological heterogeneity and a high risk of bias in most studies, a positive association was observed between high levels of these biomarkers and mortality. Further research should ascertain biomarkers' standardized thresholds, as well as the prognostic role of other biomarkers in this population. Copyright © 2026 Elsevier Espana, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <43> 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. <44> Accession Number 2043482685 Title Evaluation of a pharmacist-led patient-self-testing model for warfarin management in patients undergoing mechanical heart valve replacement in China: a multicentre, open-label, randomised, controlled trial. Source BMJ Open. 16(2) (no pagination), 2026. Article Number: e105575. Date of Publication: 09 Feb 2026. Author Wang C.; Luo J.; Zhou X.; Guo Y.; Cao W.; Zhang D.; Song L.; Tan S. Institution (Wang, Luo, Tan) Department of Pharmacy, The Second Xiangya Hospital of Central South University, Central South University, Hunan, Changsha, China (Zhou) Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China (Guo) Department of Pharmacy, Taoyuan People's Hospital, Hunan, Changde, China (Cao) Department of Pharmacy, Xiangtan Central Hospital, Hunan, Xiangtan, China Publisher BMJ Publishing Group Abstract Objectives Patient self-testing (PST) for warfarin management is well-established in developed countries but remains underused in developing regions. This study compared the safety and effectiveness of PST with usual care (UC) in China. Design A multicentre, open-label, randomised, controlled trial. Setting A total of five centres participated in this study, including one provincial tertiary hospital, two municipal tertiary hospitals and two primary hospitals. Participants Patients undergoing mechanical heart valve (MHV) replacement at five centres were prospectively enrolled. Patients were trained and stratified according to time on warfarin at enrolment and were randomly assigned to the PST or UC group. Interventions The PST group used a point-of-care testing device for at-home international normalised ratio (INR) monitoring with pharmacist-guided warfarin dosing, while the UC group attended outpatient clinics for INR monitoring and dosing. Primary and secondary outcome measures The primary outcome was the difference in time in therapeutic range (TTR). The secondary outcomes were incidences of major bleeding, thromboembolism and all-cause deaths in 12 months. Results From March 2021 to March 2023, a total of 556 patients were enrolled, with a mean age of 47.5 years, 45.1% being male. 342 were newly initiating warfarin therapy, while 214 had been on warfarin for over 6months. Baseline characteristics were similar between the PST and UC groups. The PST group showed significantly higher TTR (67.2% vs 55.1%, p<0.001) and lower incidences of major bleeding (0.7% vs 7.9%, p<0.001) and thromboembolism (0.4% vs 6.8%, p<0.001), with no difference in all-cause mortality (0.4% vs 1.8%, p=0.22). Logistic regression identified that using PST and younger age were independent factors associated with fewer warfarin-related adverse events. Conclusions A pharmacist-led PST intervention with ongoing education and counselling led to improved TTR and clinical outcomes in patients with MHV in China. 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. <45> [Use Link to view the full text] Accession Number 650664079 Title Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation. Source The New England journal of medicine. 394(13) (pp 1270-1280), 2026. Date of Publication: 02 Apr 2026. Author Landmesser U.; Skurk C.; Kirchhof P.; Lewalter T.; Hartung J.; Rroku A.; Pieske B.; Brachmann J.; Akin I.; Jacobshagen C.; Meder B.; Zeiher A.; Anker S.D.; Thiele H.; Blankenberg S.; Massberg S.; Schunkert H.; Frey N.; Joost A.; Bergmann M.; von Bardeleben R.S.; Friede T.; Placzek M.; Suling A.; Haeusler K.G.; Endres M.; Wegscheider K.; Boldt L.-H.; Eitel I. Institution (Landmesser, Skurk, Hartung, Rroku) Department of Cardiology, Angiology, Intensive Care Medicine, Campus Benjamin Franklin, Charite University Medicine Berlin, Berlin, Germany (Landmesser, Skurk, Hartung, Anker, Endres, Boldt) German Center for Cardiovascular Research (DZHK) Partner Site Berlin, Berlin, Germany (Landmesser) Friede Springer Cardiovascular Prevention Center, Berlin, Germany (Kirchhof, Blankenberg) Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany (Kirchhof, Blankenberg, Joost, Wegscheider, Eitel) DZHK Partner Site Hamburg-Kiel-Lubeck, Hamburg, Germany (Kirchhof) Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom (Lewalter) Department of Cardiology and Intensive Care Unit, Peter Osypka Heart Center, Hospital Munich South, Munich, Germany (Pieske) Division of Cardiology, Department of Internal Medicine, University Medicine Rostock, Rostock, Germany (Brachmann) Department of Cardiology, Klinikum Coburg, Coburg, Germany (Akin) Department of Cardiology, Hemostaseology, Medical Intensive Care, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany (Jacobshagen) Department of Cardiology, Intensive Care Medicine, Angiology, Vincentius-Diakonissen Hospital, Karlsruhe, Germany (Meder, Frey) Precision Digital Health, Department of Internal Medicine III, Cardiology, University Heidelberg, Heidelberg, Germany (Meder, Frey) DZHK Partner Site Heidelberg, Heidelberg, Germany (Zeiher) Department of Medicine III, Goethe University, Frankfurt am Main, Germany (Zeiher) DZHK Partner Site Rhein-Main, Frankfurt, Germany (Anker) Institute of Health Center for Regenerative Therapies, Charite University Medicine, Berlin, Germany (Thiele) Department of Internal Medicine-Cardiology, Heart Center at Leipzig University, Leipzig, Germany (Massberg) Department of Medicine I, LMU University Hospital, Ludwig Maximillian University of Munich, Munich, Germany (Massberg, Schunkert) DZHK Partner Site Munich, Munich Heart Alliance, Munich, Germany (Schunkert) Department of Cardiovascular Diseases, German Heart Center, School of Medicine and Health, TUM University Hospital, Technical University of Munich, Munich, Germany (Joost, Eitel) University Heart Center Lubeck, Lubeck, Germany (Bergmann) Department of Cardiology, Asklepios Klinik Altona, Hamburg, Germany (von Bardeleben) Department of Cardiology, University Medical Center, Mainz, Germany (Friede, Placzek) Department of Medical Statistics, University Medical Center Gottingen, Gottingen, Germany (Friede, Placzek) DZHK Partner Site Lower Saxony, Gottingen, Germany (Suling, Wegscheider) Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Haeusler) Department of Neurology, University Hospital Ulm, Ulm, Germany (Endres) Department of Neurology, Charite University Medicine Berlin, Berlin, Germany (Boldt) Department of Cardiology, Angiology, and Intensive Care Medicine, Deutsches Herzzentrum der Charite; Campus Virchow, Berlin Abstract BACKGROUND: Catheter-based closure of the left atrial appendage is an alternative to oral anticoagulation for stroke prevention in patients with atrial fibrillation. The effectiveness of this strategy, as compared with physician-directed best medical care, in patients at high risk for stroke and bleeding is unknown. METHOD(S): In this multicenter randomized trial conducted in Germany, we assigned patients with atrial fibrillation and a high risk of stroke and bleeding to undergo left atrial appendage closure or to receive physician-directed best medical care (including direct oral anticoagulants, if eligible). The primary end point, tested for noninferiority, was a composite of stroke (ischemic or hemorrhagic), systemic embolism, major bleeding, or cardiovascular or unexplained death, assessed in a time-to-event analysis. The noninferiority margin was a hazard ratio of 1.3. RESULT(S): A total of 912 adult patients underwent randomization. The primary end-point analysis included 446 patients who were assigned to undergo left atrial appendage closure (device group) and 442 who were assigned to physician-directed best medical care (medical-therapy group). The mean (+/-SD) age was 77.9+/-7.1 years; 38.6% of the patients were women, the mean CHA2DS2-VASc score was 5.2+/-1.5 (range, 0 to 9, with higher scores indicating a greater risk of stroke), and the mean HAS-BLED score was 3.0+/-0.9 (range, 0 to 9, with higher scores indicating higher risk of bleeding). After a median follow-up of 3 years (interquartile range, 1.7 to 4.7), a first primary end-point event had occurred in 155 patients (incidence per 100 patient-years, 16.8) in the device group and in 127 patients (incidence per 100 patient-years, 13.3) in the medical-therapy group (difference in restricted mean survival time, -0.36 years; 95% confidence interval, -0.70 to -0.01; P = 0.44 for noninferiority). Serious adverse events occurred in 368 patients (82.5%) in the device group and 342 (77.4%) in the medical-therapy group. CONCLUSION(S): Among patients with atrial fibrillation at high risk for stroke and bleeding, left atrial appendage closure was not noninferior to physician-directed best medical care with regard to a composite end point of stroke, systemic embolism, major bleeding, or cardiovascular or unexplained death. (Funded by the German Center for Cardiovascular Research; CLOSURE-AF ClinicalTrials.gov number, NCT03463317.). Copyright © 2026 Massachusetts Medical Society. <46> Accession Number 648520386 Title Effects of Progressive Muscle Relaxation on Pain and Sleep: Randomized Controlled Study. Source Pain management nursing : official journal of the American Society of Pain Management Nurses. 27(2) (pp 163-171), 2026. Date of Publication: 01 Apr 2026. Author Bolatturk G.; Kol E. Institution (Bolatturk) Fundamentals of Nursing Department, Suleyman Demirel University Nursing Departmant, Isparta, Turkey (Kol) Fundamentals of Nursing Department, Akdeniz University Nursing Faculty, Antalya, Turkey Abstract PURPOSE: This study aimed to evaluate the effectiveness of Progressive Muscle Relaxation (PMR) on postoperative pain level and sleep quality in patients undergoing open heart surgery. DESIGN: A single center, two-group, single-blind randomized controlled trial. METHOD(S): This study comprised 60 patients who were admitted to the cardiovascular surgery department and undergoing open heart surgery between January 2023 and April 2024. Patients were randomized into 30 in the experimental group and 30 in the control group. Data were collected using Patient Identification Form, Short-form of McGill's Pain Questionnaire (SF-MPQ) and Richard-Campbell Sleep Questionnaire (RCSQ). PMR were applied twice a day, morning and evening, on the post-operative days 1st, 2nd, and 3rd days to experimental group. Before and after PMR, the patients' pain level and sleep quality were evaluated. The control group received usual care and treatment. RESULT(S): In the experimental group, pain level decreased significantly from 9.36 points on the 1st day to 1.50 points on the 3rd day in the post-operative service (p < .001). In the control group, pain level decreased only to 6.13 points on the 3rd day. It was determined that sleep quality gradually increased in the experimental group and reached 545.83 points on the 3rd day in the post-operative service. In the control group, it increased only to 330.16 points. A significant difference was found pain level and sleep quality in all measurements between the experimental and control groups. CONCLUSION(S): In this study, it was suggested that progressive muscle relaxation reduces pain and improves sleep quality in patients undergoing open heart surgery. It is recommended that nurses include progressive muscle relaxation in postoperative pain control and sleep management in usual care. Copyright © 2025. Published by Elsevier Inc. <47> Accession Number 2041785355 Title Temporal trends and outcomes of long coronary chronic total occlusion interventions: the Japanese CTO-PCI expert registry. Source Cardiovascular Intervention and Therapeutics. 41(2) (pp 351-361), 2026. Date of Publication: 01 Apr 2026. Author Tanaka H.; Tsuchikane E.; Ito Y.; Sumitsuji S.; Kishi K.; Okada H.; Oikawa Y.; Yoshikawa R.; Kawasaki T.; Katoh O. Institution (Tanaka) Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Okayama, Kurashiki, Japan (Tsuchikane) Toyohashi Heart Center, Aichi, Japan (Ito) Saiseikai Yokohama-city Eastern Hospital, Kanagawa, Japan (Sumitsuji) Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan (Kishi) Tokushima Red Cross Hospital, Tokushima, Japan (Okada) Seirei Hamamatsu General Hospital, Shizuoka, Japan (Oikawa) The Cardiovascular Institute, Tokyo, Japan (Yoshikawa) Sanda City Hospital, Hyogo, Japan (Kawasaki) Shin-Koga Hospital, Fukuoka, Japan (Katoh) Kusatsu Heart Center, Shiga, Japan Publisher Springer Abstract Data on percutaneous coronary intervention (PCI) for long chronic total occlusions (CTOs) are limited. We sought to identify temporal trends in PCI for long CTOs. We studied patients undergoing CTO-PCI between January 2015 and December 2022. Long CTO was defined as an occlusion length of >= 20 mm. The study population consisted of 10,302 patients, of whom 5,627 (54.6%) had a long CTO. Of these, 1,937 CTOs (34.4%) underwent primary retrograde approach and 1,486 CTOs (26.4%) underwent reverse controlled antegrade and retrograde tracking (CART). Reverse CART had a higher technical success rate than retrograde wiring and intravascular ultrasound (IVUS)-guided wiring after antegrade wiring (94.7%, 91.0%, and 81.6%, respectively), a longer guidewire crossing time (124, 92, and 85 min, respectively), and a higher incidence of coronary perforation (8.5%, 4.9%, and 6.3%, respectively) (P < 0.01 for all). For long CTOs with good distal landing without side branches, the use of primary retrograde approach and reverse CART decreased over time from 39.9% to 27.3% and from 36.3% to 20.1%, respectively, whereas the use of antegrade wiring and IVUS-guided wiring after antegrade wiring increased from 46.6% to 58.7% and from 1.0% to 8.7%, respectively (P for trend < 0.01 for all). In PCI for long CTOs, reverse CART was the most commonly used re-entry technique. For long CTOs with good distal landing without side branches, the use of primary retrograde approach and reverse CART decreased, whereas the use of antegrade wiring and IVUS-guided wiring after antegrade wiring increased. Copyright © The Author(s) under exclusive licence to Japanese Association of Cardiovascular Intervention and Therapeutics 2025. <48> 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. <49> Accession Number 649733925 Title Effect of Early Nutritional Support Nursing Intervention on Postoperative Recovery in Patients With Critical Cardiac Surgery: A Systematic Review and Meta-analysis. Source Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses. 41(2) (pp 492-502), 2026. Date of Publication: 01 Apr 2026. Author Li Z.; Wei L.; Jing Y.; Zhang S. Institution (Li) Department of Cardiovascular and Macrovascular, Shandong Provincial Third Hospital, Jinan, Shandong, China (Wei) Department of Cardiovascular and Macrovascular, Shandong Provincial Third Hospital, Jinan, Shandong, China (Jing) Department of Cardiovascular and Macrovascular, Shandong Provincial Third Hospital, Jinan, Shandong, China (Zhang) Department of Cardiovascular and Macrovascular, Shandong Provincial Third Hospital, Jinan, Shandong, China Abstract PURPOSE: The purpose of this review was to evaluate the impact of early nutritional support on mortality, cardiopulmonary bypass times, aortic cross-clamp time, duration of mechanical ventilation, length of intensive care unit stay, and hospital stay. DESIGN: Systematic Review and Meta-Analysis. METHOD(S): A comprehensive search was conducted in PubMed, EMBASE, Web of Science, CINAHL, and Cochrane Library to identify 21 studies comprising 1,846 participants for final inclusion. Random-effects models using the DerSimonian-Laird method were applied to estimate pooled effect sizes, with heterogeneity assessed using I2 statistic. Publication bias was evaluated through funnel plots and Egger's test, and sensitivity analyses were conducted to ensure robustness of findings. FINDINGS: The intervention showed no significant effect on mortality (odds ratio: 0.694, 95% confidence intervals [CI]: 0.367 to 1.310) or procedural times, including cardiopulmonary bypass (standardized mean differences [SMD]: -0.011, 95% CI: -0.287 to 0.264) and aortic cross-clamp (SMD: 0.521, 95% CI: -0.140 to 1.183). However, significant reductions were observed in duration of mechanical ventilation (SMD: -0.306, 95% CI: -0.499 to -0.114, P = .002) and hospital length of stay (SMD: -0.462, 95% CI: -0.739 to -0.185, P = .001). Intensive care unit length of stay showed no significant effect. Moderate-to-substantial heterogeneity was noted for most outcomes. CONCLUSION(S): Early nutritional support nursing interventions can significantly reduce mechanical ventilation duration and hospital length of stay, supporting their role in enhancing recovery following cardiac surgery. Further research is needed to standardize protocols and identify optimal patient populations for these interventions. Copyright © 2026 The American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved. <50> Accession Number 2039378011 Title Intracardiac versus transesophageal echocardiographic guidance for left atrial appendage occlusion: Design and rationale of the ICE-TEE trial. Source Cardiovascular Revascularization Medicine. 84 (pp 82-87), 2026. Date of Publication: 01 Mar 2026. Author Al-Azizi K.; Thomas S.; Hajar M.B.A.; Pickering T.; McCullough K.; Dorton C.; Moubarak G.; Ma T.-W.; Banwait J.; Hale S.; Gupta S.; DiMaio J.M.; Szerlip M.; Matar R.; Aqtash O.; Baig I.; Trehan S.; Potluri S. Institution (Al-Azizi, Thomas, Szerlip, Matar, Aqtash, Baig, Trehan, Potluri) Department of Cardiology, Baylor Scott and White The Heart Hospital, Plano, TX, United States (Hajar, Pickering, McCullough, Dorton, Moubarak, Ma, Banwait, Hale, Gupta, DiMaio) Baylor Scott & White Research Institute, Plano, TX, United States (Moubarak) Department of Internal Medicine, Baylor University Medical Center, TX, United States Publisher Elsevier Inc. Abstract Left atrial appendage occlusion (LAAO) has emerged as an alternative to long-term anticoagulation for stroke prevention in patients with non-valvular atrial fibrillation deemed high risk for bleeding. LAAO is performed via a transseptal approach with the placement of an occlusion device in the left atrial appendage (LAA) to seal it. Intraoperative imaging with echocardiography is needed to guide and complete the procedure. Historically, Transesophageal echocardiography (TEE) has been the most frequently used modality for intraprocedural guidance. Recently, there has been a growing interest in the use of intracardiac echocardiography (ICE) as an adjunct to, or even an alternative to, transesophageal echocardiography (TEE), with several unique advantages and potential challenges. Several publications have highlighted the safety and feasibility of ICE in LAAO (Hemam et al., 2019; Morcos et al., 2022; Zhang et al., 2023 [2, 5, 7]). The most recent SCAI/HRS consensus statement recommends using TEE or ICE in procedural guidance (Saw et al., 2023 [8]). To date, no prospective randomized controlled trials have addressed the safety and feasibility of ICE-guided LAAO, compared to TEE guidance . The ICE TEE trial is a single-center, prospective, randomized, parallel-controlled, open-label clinical trial that will assess the efficacy and safety of ICE-guided LAAO compared to traditional TEE-guided LAAO. Patients are randomized in a 1:1 fashion. The primary endpoint of the study is the procedural success of LAAO device implantation, defined as the appropriate device implantation as per the IFU, without device-related complications, and no peri-device leaks >5 mm on color Doppler, according to the Munich consensus. Secondary endpoints include periprocedural complications, procedural characteristics, and cost of hospitalization. Patients will be assessed at 45 days with a TEE to evaluate for any peri-device leak (PDL). The trial aims to assess the efficacy and potential complications of using ICE to guide the implantation of percutaneous left atrial appendage occlusion (LAAO) devices compared to the traditional transesophageal echocardiography (TEE)- guided LAAO. Copyright © 2025 Elsevier Inc. <51> Accession Number 2042447186 Title Long-term outcome of patients undergoing pacemaker implantation after transcatheter aortic valve implantation: a systematic review and meta-analysis. Source Cardiovascular Intervention and Therapeutics. 41(2) (pp 425-433), 2026. Date of Publication: 01 Apr 2026. Author Veraar C.; Lamm G.; Merl L.; Fischer-Hammerschmied A.; Granner M.; Will M.; Schwarz K.; Kammerlander A.; Mascherbauer J. Institution (Veraar, Lamm, Merl, Granner, Will, Schwarz, Mascherbauer) Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Strase 30, Krems, Austria (Veraar, Lamm, Merl, Granner, Will, Schwarz, Mascherbauer) Division of Internal Medicine 3, University Hospital St. Polten, Dunant- Platz 1, St. Polten, Austria (Fischer-Hammerschmied) Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria (Kammerlander) Department of Cardiology, Medical University of Vienna, Vienna, Austria Publisher Springer Abstract The long-term prognostic relevance of permanent pacemaker (PM) implantation after transcatheter aortic valve implantation (TAVI) remains uncertain. We performed a meta-analysis to evaluate its association with all-cause mortality beyond five years. Following MOOSE recommendations, PubMed and Embase were searched through September 2025 for studies reporting long-term outcomes after TAVI, including hazard ratios (HRs) comparing patients with and without new PM implantation. Pooled HRs were calculated using random-effects models with restricted maximum likelihood estimation and Hartung-Knapp adjustment. Heterogeneity was quantified using I2, and robustness was tested by leave-one-out procedures and alternative model estimators. Random-effects meta-regression examined whether study-level covariates modified the association. Seven observational studies comprising 59 635 patients were included, of whom 11 325 (19%) received a new PM within 30 days after TAVI. Follow-up ranged from 60 to 120 months. PM implantation was associated with higher long-term all-cause mortality {pooled HR 1.13 (95% CI 1.07-1.19); I2 = 0%}. Leave-one-out analyses confirmed stability (HR 1.11-1.13), and funnel-plot inspection revealed no asymmetry. None of the examined covariates-female sex, diabetes, atrial fibrillation, conduction disturbances, coronary artery disease, or left-ventricular ejection fraction-significantly affected the association (beta range - 0.018 to + 0.024; exp(beta) 0.98-1.02; all p > 0.10). Across seven contemporary registries, PM implantation after TAVI was consistently linked to a modest increase in long-term mortality, independent of baseline comorbidities, emphasizing the need for conduction-preserving implantation and physiologic pacing strategies. Copyright © The Author(s) 2026. <52> Accession Number 2043473075 Title Efficacy and Harms of Opioid Analgesics for Acute Pain: Overview of Systematic Reviews and Meta-analyses. Source Drugs. 86(4) (pp 533-550), 2026. Date of Publication: 01 Apr 2026. Author Mathieson S.; Zadro J.R.; Narayan S.W.; McLachlan A.J.; Ballantyne J.C.; Blyth F.M.; Day R.O.; Maher C.G.; McLachlan H.; Lin C.-W.C.; Kamper S.J.; Abdel Shaheed C. Institution (Mathieson, Zadro, Blyth, Maher, McLachlan, Lin, Abdel Shaheed) Sydney School of Public Health, University of Sydney, Edward Ford Building, A27 Fisher Rd, Camperdown, NSW, Australia (Mathieson, McLachlan) Sydney School of Pharmacy, University of Sydney, A15, Science Rd, Camperdown, NSW, Australia (Zadro, Narayan, Maher, McLachlan, Lin, Abdel Shaheed) Institute for Musculoskeletal Health, Royal Prince Alfred Hospital (C39), Sydney Local Health District, Level 10N, King George V Building, Camperdown, NSW, Australia (Ballantyne) University of Washington Medical Centre, University of Washington, 1959 NE Pacific Street, Seattle, WA, United States (Day) St Vincent's Clinical Campus, School of Medicine, St Vincent's Hospital, University of New South Wales, Level 5, de Lacy Building, Darlinghurst, NSW, Australia (Kamper) Sydney School of Health Sciences, University of Sydney, Susan Wakil Health Building, Western Ave, Camperdown, NSW, Australia (Kamper) Nepean Blue Mountains Local Health District, 62 Derby St, Kingswood, NSW, Australia Publisher Adis Abstract Background: Opioids are commonly prescribed for acute pain. However, there is no overarching synthesis on their efficacy. Aim(s): We set out to conduct an overview review of the efficacy and harms of opioid analgesics for acute pain. Method(s): Electronic databases were searched until 4 March 2025 without restriction for systematic reviews of randomised trials comparing opioids to placebo/no active treatment for any acute, non-malignant pain condition published since 2010. Screening, extraction and quality assessment were conducted independently by two authors. The primary outcome was pain. Secondary outcomes were adverse events. Data timepoints were immediate (<= 3 h after administration-primary timepoint), short (> 3 to <= 6 h), intermediate (> 6 to <= 48 h) and long term (> 48 h). Random effect meta-analyses were conducted. AMSTAR 2 described review quality. Grading of Recommendations Assessment, Development and Evaluation determined evidence certainty. Result(s): We included 59 reviews. There was high certainty some opioids (morphine, oxycodone, tramadol, papaveretum) reduced acute abdominal pain at immediate term (mean difference [MD] - 18.4, 95% CI - 31.9 to - 5.0) compared with placebo. However, there were no harms data. At immediate term, there was moderate certainty opioids reduced pain including dental surgery (MD - 19.5, 95% CI - 25.0 to - 14.0), and myringotomy (MD - 15.0, 95% CI - 19.6 to - 10.4). However, harms data were only available for dental surgery, finding no increased risk of adverse events. Oral opioids provided only very small pain relief for acute musculoskeletal pain at intermediate term (MD - 8.9, 95% CI - 13.5 to - 4.3; moderate certainty) but increased the risk of adverse events (risk difference [RD] 0.1, 95% CI 0.0 to 0.2; moderate certainty). Limitation(s): Some opioids are not consistently efficacious across timepoints. Conclusion(s): Opioid analgesics are efficacious in reducing pain in some acute conditions. Registration: ROSPERO CRD42018109733. Copyright © The Author(s) 2026. <53> Accession Number 2044368887 Title Saphenous vein graft longevity: Novel approaches. Source Cardiovascular Revascularization Medicine. (no pagination), 2026. Date of Publication: 2026. Author Abusnina W.; Al Qaraghuli A.K.; Chitturi K.R.; Chaturvedi A.; Verma B.R.; Galo J.; Case B.C.; Ben-Dor I.; Hashim H.D.; Mintz G.S.; Waksman R. Institution (Abusnina, Chitturi, Chaturvedi, Verma, Galo, Case, Ben-Dor, Hashim, Mintz, Waksman) Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States (Al Qaraghuli) MedStar Washington Hospital Center, Washington, DC, United States Publisher Elsevier Inc. Abstract The saphenous vein remains the most commonly used conduit for coronary artery bypass grafting despite its low long-term patency rate. This has prompted extensive research focused on understanding the pathophysiology of graft failure and improving both short- and long-term patency. Several mechanisms of venous graft failure have been discussed in the literature, and different methods have been proposed to prevent and slow this pathological process, with the goal of improving the longevity of grafts. This review aims to provide a comprehensive overview of the novel therapies, techniques, and strategies to improve saphenous vein graft longevity after coronary artery bypass grafting. Copyright © 2026. Published by Elsevier Inc. <54> 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. 16(1) (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 <55> Accession Number 2033486442 Title Impact of Chronic Inflammatory Diseases on Clinical Outcomes in Patients undergoing Aortic Valve Replacement: A Systematic Review and Meta-analysis. Source Angiology. 77(5) (pp 545-553), 2026. Date of Publication: 01 May 2026. Author Theodoropoulou T.; Apostolos A.; Ktenopoulos N.; Koliastasis L.; Tsalamandris S.; Mourouzis I.; Pantos C.; Tsioufis K.; Toutouzas K. Institution (Theodoropoulou, Apostolos, Ktenopoulos, Koliastasis, Tsalamandris, Tsioufis, Toutouzas) Unit for Structural Heart Diseases and Valvulopathies, First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, Greece (Mourouzis, Pantos) Department of Pharmacology, National and Kapodistrian University of Athens, Athens, Greece Publisher SAGE Publications Inc. Abstract Patients with autoimmune chronic inflammatory disease (CID) are at an increased risk of valvular heart disease, including aortic valve stenosis, insufficiency, or both. The impact of CID on the prognosis of surgical or transcatheter aortic valve replacement (AVR) remains unclear. This meta-analysis aims to evaluate the impact of CID on major clinical outcomes in this population. A comprehensive literature search of PubMed, Cochrane, and Embase databases was conducted to identify relevant studies. The primary endpoint was 30-day all-cause mortality between patients with CID and controls. Secondary endpoints included, long-term all-cause mortality, stroke and in-hospital infection. Statistical analysis included Risk Ratio (RR) with 95% confidence interval (CI) using the random-effects model. Five studies involving 572,351 patients were included in the meta-analysis. Patients with CID had a greater 30-day mortality (RR = 1.17, 95% CI: 1.09, 1.27; P < .001) and a higher rate of in-hospital infection (RR = 2.13, 95% CI: 1.03, 4.41; P < .001). No differences were observed in the other secondary endpoints. Patients with CID are at an increased risk of short-term all-cause mortality and in-hospital infections after AVR. Further studies are required to validate our results and define the optimal management of these patients. Copyright © The Author(s) 2025 <56> Accession Number 2033951823 Title Clinical Outcomes of PCI in Hospitals With or Without Surgical Backup: A Meta-analysis. Source Angiology. 77(5) (pp 554-562), 2026. Date of Publication: 01 May 2026. Author Haddad T.A.; Toubasi A.A.; Fahmawi A.; Zaid A. Institution (Haddad, Toubasi, Zaid) Faculty of Medicine, University of Jordan, Amman, Jordan (Fahmawi) Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan Publisher SAGE Publications Inc. Abstract Percutaneous coronary interventions (PCIs) have seen a steady rise. Recent guidelines have established that PCIs conducted at non-surgical on-site (NSOS) facilities have low complication rates and outcomes comparable to surgical on-site (SOS) centers. However, differing perspectives in the growing literature continue to sustain controversy. A thorough literature review was performed across four databases, including PubMed, Cochrane Library, Scopus, and Web of Science, to identify studies comparing outcomes between hospitals. The primary endpoints were: 30-day mortality, myocardial infarction (MI), cerebral vascular accident (CVA), emergency coronary artery bypass surgery (eCABG), rePCI, and target vessel revascularization (TVR). The final search yielded 22 studies, including a total of 2,181,897 patients. The majority of patients (71.9%) underwent PCI in SOS hospitals. There was a significant association of increased eCABG (OR = 1.99; 95% CI: 1.08-3.67) and rePCI (OR = 1.62; 95% CI: 1.37-1.91) rates in SOS hospitals. However, 30-day mortality (OR = 0.91; 95% CI: 0.53-1.54), MI (OR = 1.08; 95% CI: 0.91-1.28), CVA (OR = 1.13; 95% CI: 0.69-1.86), and TVR (OR = 1.06; 95% CI: 0.92-1.21) showed no significant difference between hospitals. Subgroup analyses among clinical trials and ST-segment elevation myocardial infarction (STEMI) patients found no significant associations. Conclusively, this meta-analysis provides updated insight into the impact of SOS on PCI outcomes, having no difference except for eCABG and rePCI rates. Copyright © The Author(s) 2025 <57> Accession Number 2043477236 Title Cardiac damage and outcome in transcatheter aortic valve replacement patients-a COMPARE-TAVI 1 trial sub-study. Source European Heart Journal Cardiovascular Imaging. 27(2) (pp 293-301), 2026. Date of Publication: 01 Feb 2026. Author Carter-Storch R.; Terkelsen C.J.; Nissen H.; Pedersen A.L.D.; Andersen K.J.; Frederiksen C.A.; Haujir A.; Ulrikkaholm E.; Vase H.; Thim T.; Freeman P.; Uttenthal F.; Christiansen U.; Christiansen E.H.; Dahl J.S. Institution (Carter-Storch, Nissen, Haujir, Ulrikkaholm, Dahl) Department of Cardiology, Odense University Hospital, Sdr Boulevard 29, Odense C, Denmark (Terkelsen, Pedersen, Andersen, Frederiksen, Vase, Thim, Christiansen) Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (Terkelsen) Department of Clinical Medicine, Aarhus University Hospital, Aarhus University, Aarhus, Denmark (Freeman, Uttenthal, Christiansen) Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark (Dahl) Department of Clinical Research, University of Southern Denmark, Odense, Denmark (Dahl) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States Publisher Oxford University Press Abstract Aims This study aims to investigate the prognostic role of Stage 3 and 4 cardiac damage (CD) after transcatheter aortic valve intervention (TAVI), dependent on whether comorbidities contributing to right heart dysfunction were present. Methods and results Patients with severe aortic stenosis (AS) undergoing TAVI were included. Patients were divided into three groups: Stage 0-2 CD; Stage 3-4 CD, isolated AS (Stage 3-4 CD without significant concomitant chronic obstructive pulmonary disease, mitral annular calcification, mitral stenosis, mitral regurgitation, previous coronary artery bypass graft surgery, or cardiac amyloidosis); Stage 3-4 CD, AS with comorbidities (Stage 3-4 CD with >= 1 of these comorbidities). Futility was defined as death or Stage 3-4 New York Heart Association class dyspnoea 1 year after TAVI. Of 985 included patients, 822 (83%) had Stage 1-2 CD; 101 (10%) had Stage 3-4 CD, isolated AS; and 62 (6%) had Stage 3-4 CD, AS with comorbidities. Futility was not more common in Stage 3-4 CD groups (Stage 1-2 CD, 10%; Stage 3-4 CD, isolated AS, 17%; Stage 3-4 CD, AS with comorbidities, 15%, P = 0.09). Baseline and 1-year NYHA class were higher in Stage 3-4 CD compared with Stage 1-2 CD (P < 0.01). The 6 min walking test distance increased similarly in all groups at 1 year. Conclusion Potential comorbidities contributing to right heart dysfunction were common among patients in Stage 3-4 CD undergoing TAVI. Stage 3-4 CD was not associated with a significantly higher risk of futility, irrespective of comorbidities, and they experienced a similar functional improvement after TAVI. Copyright © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. <58> Accession Number 2041658013 Title Effects of intraoperative higher versus lower positive end-expiratory pressure during one-lung ventilation for thoracic surgery on postoperative pulmonary complications (PROTHOR): a multicentre, international, randomised, controlled, phase 3 trial. Source The Lancet Respiratory Medicine. 14(1) (pp 17-28), 2025. Date of Publication: 01 Jan 2025. Author Serpa Neto A.; Cohen E.; El Tahan M.R.; Gregoretti C.; Hachenberg T.; Nandor M.; Nisnevitch-Savarese Z.; Rossaint R.; Severgnini P.; Szegedi L.L.; Tamas V.; Vazquez de Anda G.F.; Waheedullah K.; Schultz M.J.; Abbenhuis J.; Abdulmomen A.; Abdyli A.; Abu Elyazed M.M.; Aguirre Puig P.; Akbudak I.H.; Aksu C.; Alagoz A.; Alhamdi M.; Almadhati S.; Altorki N.K.; Aragon Alvarez S.; Arun O.; Azizoglu M.; Baar W.; Balde D.; Balla B.; Balli Seker M.; Basheer M.; Bauer W.O.; Bence J.; Bernardi M.H.; Bigatello L.M.; Bignami E.; Bluth T.; Bonney I.; Bouhemad B.; Bradic N.; Brescianini L.; Bruthans J.; Bulte C.S.E.; Cadar G.; Cakmak G.; Cali P.; Cantatore L.P.; Chai X.; Chang Y.-T.; Chen J.; Christofaki M.; Cinnella G.; Coelho Sanches L.; Constantin A.; Contreras V.; Corsi L.; da Silva E.; Defosse J.; Deluca R.; Diaper J.; Didden L.; Dimitriou E.; do Nascimento Junior P.; Domi R.; Dorfinger L.; dos Reis Falcao L.F.; Douradinho C.; Drnovsek Globokar M.; Duran F.M.; Eldawlatly A.; El-Gendy H.M.; Elmazny M.I.; Elsherif S.-E.I.; Emara M.M.; Enriquez de los Santos S.T.; Farnell-Ward S.; Ferrufino R.; Gama de Abreu M.; Gao L.; Geyik D.; Gnezda D.; Goeden S.; Gorjup K.; Granell Gil M.; Guido Guerra R.E.; Guimaraes de Castro Pereira M.; Guinot P.-G.; Guven A.; Hager H.; Han L.; Hatipoglu Z.; Hayashi M.; Hell J.; Hofland J.; Hollmann M.W.; Hu J.; Hudacek K.; Huti G.; Ilic M.; Jankovic R.J.; Jegarl A.; Jimenez Andujar M.-J.; Jin D.; Kammerer T.; Karadza V.; Kawagoe I.; Kiran Paudel S.I.; Kiss T.; Koch T.; Kolaric N.; Koning N.J.; Kostopanagiotou K.; Kostroglou A.; Kovac P.; Kramer T.; Krassler J.; Kreft T.; Kumrular Y.; Kuut M.; Lan L.; Li P.-C.; Li X.-F.; Li L.-T.; Licker M.; Liu Y.; Longo F.; Loop T.; Lopez-Baamonde M.; Luise S.; Luo W.; Lv H.; Macias Jimenez M.D.L.A.; Magalhaes D.D.; Martuscelli M.; Mavko A.; Meco B.C.; Mermer H.A.; Miao C.; Michalek P.; Mills G.H.; Minana Aragon E.; Mirabella L.; Molyneux M.; Montrano L.; Mosqueira L.; Mourisse J.; Murrell M.T.; Navarro-Ripoll R.; Negru F.; Neskovic V.; Nikolic M.; Norberto de la Vega J.A.; Noto A.; Nyktari V.; Orhan Sungur M.; Ozdemir L.; Ozolina A.; Ozturk T.; Pace M.C.; Pagnussatt Neto E.; Paloczi B.; Papaioannou A.; Papamichail K.; Patroniti N.; Pektas Y.; Pereira Matalobos D.; Persec J.; Petrovic S.; Pirc D.; Plismanis G.; Prata Amendola C.; Prazetina M.; Radovic N.; Rauseo M.; Richter T.; Rivera Vallejo L.; Rodriguez Ruiz J.J.; Rondovic G.; Rosser J.; Sanchez Garcia F.J.; Sansone P.; Saracoglu A.; Saracoglu K.T.; Sazak H.; Scharffenberg M.; Schiavoni L.; Schilling T.; Sediq A.; Semmelmann A.; Senturk N.M.; Sertac Bingul E.; Sertcakacilar G.; Sfika E.; Shelley B.; Shin S.H.; Sidiropoulou T.; Silva-Jr J.M.; Socci L.; Socorro T.; Soulioti E.; Spadaro S.; Spicek-Macan J.; Spray D.; Stamenkovic D.; Stefanakis G.; Stoica R.; Stojanovic M.; Stopora P.; Sungur Z.; Svareniece-Karjaka E.; Szamos K.; Tanase N.-V.; Tanriverdi C.; Tempel F.; Terwindt L.E.; Theilen R.; Tipura D.; Tire Y.; Tomaselli E.; Tsuguie Onari N.; Tunc M.; Turhan O.; Turktan M.; Ugliola D.; Ulugol H.; Vegh T.; Vetrugno L.; Vitali C.; Volta C.A.; von Dossow V.; Voyagis G.; Vukovic R.; Vukovic A.Z.; Waeschle R.M.; Wall D.; Wang H.; Wang D.; Winroth D.; Wittenstein J.; Wu Q.; Xu P.; Yaldir O.; Yamansavci Sirzai E.; Yang X.; Yapici D.; Yildirim O.; Yildirim Guclu C.; Yu H.; Yuksel Tanriverdi S.; Zarbock A.; Zeba S.; Zhang Y.; Zhang X.; Zhang Z.; Zhang J.; Zhang G.-W.; Zhong J.; Ziemann S. Institution (Wittenstein, Kiss, Gama de Abreu) Department of Anesthesiology and Intensive Care Medicine, Pulmonary Engineering Group, Faculty of Medicine and University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany (Senturk) Department of Anesthesiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey (Senturk) Department of Anesthesiology and Reanimation, School of Medicine, Acibadem University, Istanbul, Turkey (Kiss) Department of Anesthesiology, Intensive-,Pain- and Palliative Care Medicine, Radebeul Hospital, Academic hospital of the Technische Universitat Dresden, Germany (Schultz) Department of Intensive Care, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands (Serpa Neto) Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia (Serpa Neto) Department of Critical Care, Melbourne Medical School, University of Melbourne, Austin Hospital, Melbourne, VIC, Australia (Serpa Neto) Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil (Gama de Abreu) Division of Intensive Care and Resuscitation, Department of Anesthesiology, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, OH, United States (Gama de Abreu) Outcomes Research Consortium, Department of Anesthesiology, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, OH, United States Publisher Elsevier Ltd Abstract Background: The effect of higher positive end-expiratory pressure (PEEP) and recruitment manoeuvres aimed at lung expansion as compared with lower PEEP without recruitment manoeuvres aimed at permissive atelectasis on postoperative pulmonary complications (PPCs) in patients undergoing one-lung ventilation (OLV) during thoracic surgery is unclear. We aimed to determine the contribution of an intraoperative lung expansion strategy to preventing PPCs. Method(s): In this multicentre, randomised, controlled, international phase 3 trial (PROTHOR) conducted at 74 sites in 28 countries, we enrolled adult patients (aged >=18 years) with a BMI of less than 35 kg/m2 who were scheduled for open thoracic or video-assisted thoracoscopic surgery under general anaesthesia requiring one-lung ventilation with a double-lumen tube, with a planned operative time of more than 60 min, and an expected duration of one-lung ventilation longer than that of two-lung ventilation. Patients were randomly assigned (1:1), using permuted blocks of random size (4, 6, and 8) and stratified by study site, to receive one-lung ventilation with either a higher PEEP of 10 cm H<inf>2</inf>O and periodic lung recruitment manoeuvres (high PEEP group) or a lower PEEP of 5 cm H<inf>2</inf>O without routine recruitment manoeuvres (low PEEP group). All patients received protective tidal volumes of 5 mL/kg predicted body weight during one-lung ventilation and 7 mL/kg predicted body weight during two-lung ventilation. Postoperative assessors were masked to treatment allocation. The primary outcome was a composite of PPCs during the first 5 postoperative days, including aspiration pneumonia, moderate or severe respiratory failure, acute respiratory distress syndrome (ARDS), pulmonary infection, atelectasis, cardiopulmonary oedema, pleural effusion, non-operative pneumothorax, pulmonary infiltrates, prolonged air leak, purulent pleuritis, pulmonary embolism, and pulmonary haemorrhage. A modified intention-to-treat analysis was performed, with patients analysed according to their assigned treatment group, except in cases of withdrawal of informed consent, cancellation of surgery, and or loss to follow-up. This trial is registered with ClinicalTrials.gov (NCT02963025) and is completed. Finding(s): Between Jan 3, 2017, and Feb 12, 2024, 2200 patients were randomly allocated: 1099 to the high PEEP group and 1101 to the low PEEP group. 43 patients in the high PEEP group and 33 in the low PEEP group were excluded from the modified intention-to-treat analysis after randomisation. The primary outcome occurred in 555 (53.6%) of 1036 patients in the high PEEP group and 592 (56.4%) of 1049 patients in the low PEEP group (absolute risk difference -2.68 percentage points [95% CI -6.36 to 1.01]; p=0.155). Intraoperative complications occurred in 484 (49.8%) of 972 patients in the high PEEP group and in 305 (31.3%) of 974 patients in the low PEEP group (absolute risk difference 18.09 percentage points [95% CI 14.41-21.77]), among which hypotension (360 [37.3%] of 966 patients in the high PEEP group vs 140 [14.3%] of 978 in the low PEEP group) and new arrhythmias (89 [9.9%] of 899 vs 37 [3.9%] of 956) were more frequent in the high PEEP group, while hypoxaemia rescue manoeuvres were more frequent in the low PEEP group (29 [3.3%] of 888 vs 86 [8.8%] of 982). The proportions of patients with extrapulmonary postoperative complications (110 [10.6%] of 1036 vs 107 [10.2%] of 1049 patients), and the numbers of adverse events (209 vs 204 events), did not differ between groups. Interpretation(s): In patients with a BMI of less than 35 kg/m2 undergoing thoracic surgery, one-lung ventilation using higher PEEP with recruitment manoeuvres, compared with lower PEEP without recruitment manoeuvres, did not reduce PPCs. The choice for intraoperative lung expansion or permissive atelectasis should take the individual gas-exchange and haemodynamic conditions into account, which might vary during the intraoperative period. Funding(s): Clinical Trials Network of the European Society of Anaesthesiology and Intensive Care; Department of Anaesthesiology and Intensive Care, University Hospital Carl Gustav Carus, Technische Universitat Dresden (Dresden, Germany); Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (Brasilia, Brazil); and the Association of Anaesthetists of GB and Ireland. Copyright © 2025 Elsevier Ltd <59> Accession Number 2044038182 Title Salvage surgery in non-small cell lung cancer: a three-decade bibliometric and clinical appraisal of the most influential studies. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 8. Date of Publication: 01 Dec 2026. Author Ozturk O.; Akcay O.; Acar T.; Gursoy S. Institution (Ozturk, Akcay, Acar, Gursoy) Department of Thoracic Surgery, Bakircay University Cigli Training and Research Hospital, Yeni Mahalle, Murat Karayalcin Bulvari No. 18, Cigli/Izmir, Turkey Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: This study aims to provide a comprehensive bibliometric evaluation of the most influential publications on salvage surgery for non-small cell lung cancer from 1991 to 2023, highlighting scientific trends, geographic contributions, journal impact, and major clinical themes. A systematic search was conducted in the Web of Science Core Collection using the terms "salvage surgery" and "non-small cell lung cancer." Only English, SCI-Expanded research articles reporting surgical intervention were included. Among 302 records, the 20 most cited studies were selected. Publication year, country, journal, citation count, clinical characteristics, surgical details, and oncologic outcomes were extracted and analyzed. Despite increasing clinical interest, no prior study has systematically synthesized both bibliometric trends and clinical outcomes in salvage surgery for NSCLC. Result(s): The included studies received a total of 508 citations, with Japan contributing the highest number (45%). Seventy-five percent of publications were produced in the last decade, reflecting rising academic interest. The most prominent journals were The Annals of Thoracic Surgery and The Journal of Thoracic and Cardiovascular Surgery. Clinical cohorts were small and typically composed of advanced-stage non-small cell lung cancer patients. Lobectomy was the predominant procedure, while morbidity ranged from 19 to 70% and mortality remained low. Achieving R0 resection, pathological N0 status, and lower disease stage were consistently associated with improved survival. Conclusion(s): This bibliometric assessment demonstrates that salvage surgery is a feasible and oncologically valuable option for selected non-small cell lung cancer patients following definitive chemoradiotherapy or other non-operative treatments. Despite high morbidity, perioperative mortality is acceptable, and complete resection remains the strongest predictor of long-term survival. Future prospective, multicenter, and standardized studies are required to strengthen the evidence base and refine patient selection. Copyright © The Author(s) 2026. <60> Accession Number 2043345414 Title Axillary Versus Sternotomy Access in Minimally Invasive Mitral Valve Surgery: A Systematic Review and Meta-Analysis. Source Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. 21(1) (pp 28-36), 2026. Date of Publication: 01 Jan 2026. Author Almehandi A.; Ramadhan M.; Ali Y.; Almhanedi A.; Al-Naseem A.O.; Gonnah A.; Awad A.; Fischer J.; Kirov H.; Doenst T.; Nazer R.I.; Caldonazo T. Institution (Almehandi) Department of Cardiovascular Science, University College London, United Kingdom (Ramadhan, Almhanedi, Al-Naseem) Department of Surgery, Jaber Al Ahmad Al Jaber Al Sabah Hospital, Surra, Al Asimah Governorate, Kuwait (Ali) Faculty of Life Science and Medicine, Kings College London, United Kingdom (Gonnah) Imperial College Healthcare NHS Trust, London, United Kingdom (Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt (Fischer, Kirov, Doenst, Caldonazo) Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Germany (Nazer) Department of Cardiac Science, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia (Caldonazo) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United States Publisher SAGE Publications Ltd Abstract Objective: Minimally invasive cardiac surgery for mitral valve (MV) disease is a rising strategy. Axillary access is linked to reduced pain and faster recovery, but its efficacy and safety compared with median sternotomy for MV surgery (MVS) remain unclear. We conducted a meta-analysis comparing the clinical outcomes of MVS via axillary access and median sternotomy. Method(s): Four databases were analyzed. The primary endpoint was perioperative mortality. Secondary endpoints included cardiopulmonary bypass (CPB) and cross-clamp times, rethoracotomy, wound complications, mechanical ventilation duration, stroke, hospital and intensive care unit (ICU) stay, and residual moderate mitral regurgitation. A random-effects model was used. Result(s): We included 2,129 patients from 4 studies, with 1,135 (53.3%) undergoing axillary access. Perioperative mortality was comparable between approaches (odds ratio [OR] = 0.34, 95% confidence interval [CI]: 0.09 to 1.23, P = 0.10). Axillary access was associated with longer CPB times (mean difference [MD] = 16.38, 95% CI: 6.42 to 26.34, P = 0.001), fewer wound complications (OR = 0.41, 95% CI: 0.21 to 0.80, P = 0.009), shorter ventilation time (MD = -4.93, 95% CI: -8.79 to -1.08, P < 0.01), and shorter hospital (MD = -0.78, 95% CI: -1.41 to -0.14, P = 0.02) and ICU stays (MD = -10.84, 95% CI: -19.54 to -2.14, P = 0.01). No difference was found in cross-clamp time, rethoracotomy, stroke, or residual mitral regurgitation. Conclusion(s): Axillary access for MVS shows comparable mortality to median sternotomy, with benefits in wound complications, ventilation, and recovery but longer CPB times. Further research is needed to confirm long-term safety and efficacy. Copyright © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). <61> Accession Number 2042004146 Title The effect of personalized perioperative blood pressure management on intraoperative cerebral oxygen saturation, burst suppression ratio and postoperative neurological outcomes in patients having major non-cardiac surgery: an observational substudy of the IMPROVE-pilot randomized controlled trial. Source Journal of Clinical Monitoring and Computing. 40(2) (pp 363-373), 2026. Date of Publication: 01 Apr 2026. Author Khader W.; Hein M.; Kouz K.; Bergholz A.; Saugel B.; Wallqvist J.; Goldmann S.; Grafe K.; Larmann J.; Grusser L. Institution (Khader, Hein, Wallqvist, Goldmann, Grafe, Larmann, Gruser) Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany (Kouz, Bergholz, Saugel) Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Wallqvist) Alexianer Center for Mental Health, Aachen, Germany Publisher Springer Science and Business Media B.V. Abstract Abstract: It is not clear whether adopting personalized intraoperative blood pressure management could lead to better intraoperative regional cerebral saturation (rSO2), lower burst suppression ratio (BSR) or better neurological outcomes. Therefore, we performed this prespecified exploratory substudy of the IMPROVE-pilot trial to investigate the effects of personalized compared to routine intraoperative blood pressure management on the intraoperative rSO2. We also explored the effect of personalized intraoperative blood pressure management on BSR and the incidence of postoperative delirium (POD) and delayed neurocognitive recovery (dNCR). We included patients aged >= 45 years with American Society of Anesthesiologists (ASA) physical status II-IV who were scheduled for elective major surgery. Preoperative automated nighttime blood pressure measurements were performed. Patients were randomized to personalized blood pressure management maintaining intraoperative mean arterial pressure (MAP) at least at the preoperative mean nighttime MAP or to routine blood pressure management with a lower MAP intervention threshold of 65 mmHg. Intraoperative measurements of MAP, rSO2 on both hemispheres, and BSR were performed. POD was assessed daily on the first 3 postoperative days using the 3D-confusion assessment method or the confusion assessment method for the intensive care unit. We screened for dNCR using the telephone-Montreal Cognitive Assessment on postoperative days 3, 7, and 30. We enrolled 55 patients and randomized 50 patients. 49 patients were included in the final analysis. The median areas under the baseline rSO2 and BSR were similar between the two groups. One patient assigned to personalized blood pressure management and none of the patients assigned to routine blood pressure management had POD. There was no meaningful difference in the incidence of dNCR between the groups. In this substudy of the IMPROVE-pilot trial, we observed no evidence of difference in intraoperative area under baseline rSO2 between patients who received personalized compared to routine perioperative blood pressure management. Trial registration: This substudy was registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien DRKS00025762, on December 3, 2021). Copyright © The Author(s) 2025. <62> Accession Number 2042075652 Title Updates in Radial Access for Neurointervention: Feasibility, Innovations, and Future Directions. Source Seminars in Interventional Radiology. 42(6) (pp 646-654), 2025. Date of Publication: 01 Dec 2025. Author Nedelcu S.; Suroop M.; Puri A.S. Institution (Nedelcu) Department of Neurology, Brigham and Women's Hospital, Boston, MA, United States (Suroop) Northeastern University, Boston, MA, United States (Puri) University of Massachusetts Chan Medical School, Worcester, MA, United States Publisher Thieme Medical Publishers, Inc. Abstract Radial access has rapidly gained popularity in the neurointervention world, building on its proven success in cardiovascular procedures. Radial access is currently used for a variety of neurointervention procedures, such as diagnostic cerebral angiography, aneurysm embolization, and mechanical thrombectomy due to a proven strong safety profile, patient-preferred alternative to traditional femoral access, faster ambulation, and fewer access-site complications. Additionally, the radial approach has proven effective for navigating particularly challenging arches not suitable for the femoral approach, posterior circulation interventions, and select acute ischemic stroke thrombectomy cases. Advances in the radial access technique, such as the distal radial access approach in the anatomical snuffbox, development of specialized access catheters, long radial sheaths to mitigate spasm, and refined hemostasis techniques have improved its feasibility, broadened its applicability to be routinely used in neurointervention procedures, and increased its utilization in cases with challenging aortic arch anatomy. Meta-analyses have reported high technical success (around 97%) with low crossover (approximately 5%) and minimal complications. This review highlights the latest evidence on radial access in neurointervention, focusing on technical tips, appropriate patient selection, clinical applications, as well as complication management. Copyright © 2025. Thieme. All rights reserved. <63> 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. <64> Accession Number 2044119275 Title Stress hyperglycemia ratio in coronary artery disease: a systematic review and meta-analysis of severity and prognosis. Source Cardiovascular Diabetology. 25(1) (no pagination), 2026. Article Number: 91. Date of Publication: 01 Dec 2026. Author Wang C.; Liang S.; Zhang J.; Lang Q.; Huang X.; Liu L.; Liu J.; Yi Y.; Tian L.; Yu X. Institution (Wang, Huang, Liu, Liu, Yi, Tian, Yu) Laboratory of Endocrinology and Metabolism, Department of Endocrinology and Metabolism, Rare Disease Center, West China Hospital, Sichuan University, No. 37 GuoXue Alley, Chengdu, China (Liang, Zhang) Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Zhang) West China School of Nursing, Sichuan University, Chengdu, China (Lang) Department of Cardiovascular Surgery, Cardiovascular Surgery Research Laboratory, West China Hospital, Sichuan University, Sichuan, Chengdu, China Publisher BioMed Central Ltd Abstract Background: The stress hyperglycemia ratio (SHR), calculated as the ratio of admission blood glucose to estimated average glucose derived from glycated hemoglobin, quantifies the degree of relative hyperglycemia during acute physiological stress. This systematic review and meta-analysis aimed to synthesize the current evidence on the association between SHR and the anatomical severity and clinical prognosis of coronary artery disease (CAD). Method(s): PubMed, EMBASE, Web of Science, and the Cochrane Library were systematically searched for studies published from inception to January 24, 2026. Cross-sectional, retrospective, and prospective cohort studies involving patients with CAD were included. Outcomes related to CAD severity comprised large thrombus burden, multi-vessel disease, non-target lesion progression, and in-stent restenosis. The primary outcome for CAD prognosis was major adverse cardiovascular events (MACE). Data were pooled using random-effects models to estimate hazard ratios (HRs) or odds ratios (ORs) and their 95% confidence intervals (CIs). CAD is classified into acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). Result(s): Nine studies evaluating CAD severity and thirty-one studies assessing CAD prognosis met the inclusion criteria. SHR was significantly associated with multiple markers of increased CAD severity. In the ACS subgroup, pooled analysis indicated that the highest SHR levels were significantly associated with an increased risk of MACE (HR: 1.60, 95% CI 1.41-1.81, P < 0.00001; OR: 1.58, 95% CI 1.19-2.11, P = 0.002). This prognostic value was confirmed in continuous variable analyses (HR: 1.59, 95% CI 1.27-2.00; OR: 3.50, 95% CI 1.47-8.32 per unit increment). Similarly, in the CCS subgroup, patients in the highest SHR category exhibited a higher risk of MACE (HR: 1.95, 95% CI 1.50-2.52; P < 0.00001), a finding consistent across continuous analyses (HR: 1.87, 95% CI 1.64-2.12, P < 0.00001 per unit increment). Consistently significant associations were observed across various secondary endpoints and additional subgroups. Conclusion(s): The current evidence suggests that SHR can reflect the anatomical complexity of CAD patients and serves as a valuable, easily accessible tool for risk stratification in this population. Copyright © The Author(s) 2026. <65> Accession Number 2041913817 Title Impact of P2Y12 Inhibitors Pretreatment on Stent Thrombosis in Patients Undergoing Percutaneous Coronary Intervention: Insight France PCI Registry. Source Canadian Journal of Cardiology. 42(4) (pp 689-698), 2026. Date of Publication: 01 Apr 2026. Author Range G.; Cayla G.; Angoulvant D.; Morelle J.-F.; Chanseaume S.; Baron-Rochette G.; Veugeois A.; Jeanneteau J.; Monsegu J.; Durel N.; Rias S.; Py A.; Genty G.G.; Gommeaux A.; Cuisset T.; Adjedj J.; Honton B.; Lhermussier T.; Afif Y.; Mouillet G.; Tarragano F.; Chassaing S.; Commeau P.; Benamer H.; Motreff P.; Koning R.; Van Belle E.; Zeitouni M.; Puymirat E.; Lambert C.; Amabile N. Institution (Range) Cardiology Department, Les Hopitaux de Chartres, Chartres, France (Cayla) Cardiology Department, Nimes University Hospital, Montpellier University, ACTION Group, Nimes, France (Angoulvant) Cardiology Department, Centre Hospitalier Universitaire de Tours, Tours, France (Morelle) Cardiology Department, Hopital Prive Saint Martin, Caen, France (Chanseaume) Cardiology Department, Centre Hospitalier de Montlucon, Montlucon, France (Baron-Rochette) Cardiology Department Centre Hospitalier Universitaire de Grenoble, Grenoble, France (Veugeois) Cardiology Department, Institut Mutualiste Montsouris, France (Jeanneteau) Cardiology Department, Clinique Saint Joseph, Trelaze, Trelaze, France (Monsegu, Afif) Cardiology Department, Groupe Hospitalier Mutualiste de Grenoble, Grenoble, France (Durel) Cardiology Department, Pole saint Republique, Clermont Ferrand, France (Rias) Cardiology Department, Centre Hospitalier Metropole Savoie, Chambery, France (Py) Cardiology Department, Centre de Cardiologie du Pole des Cliniques, Amiens, France (Genty) Cardiology Department, Centre Hospitalier de Versailles, Le Chesnay, France (Gommeaux) Cardiology Department, Hopital Prive de Bois-Bernard, Bois-Bernard, France (Cuisset) Cardiology Department, APHM hopital la Timone, Marseille, France (Adjedj) Cardiology Department, Arnault Tzanck Institute, Saint-Laurent-du-Var, France (Honton) Cardiology Department, Clinique Pasteur, Toulouse, France (Lhermussier) Cardiology Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France (Afif) Cardiology Department, Centre Hospitalier de Carcassonne, Carcassonne, France (Mouillet) Cardiology Department, Polyclinique de Saint Laurent, Rennes, France (Tarragano) Cardiology Department, Hopital Americain de Neuilly sur Seine, Neuilly sur Seine, France (Chassaing) Cardiology Department, Nouvelle Clinique Tourangelle, Saint-Cyr-sur-Loire, France (Commeau) Cardiology Department, Polyclinique Les Fleurs, Groupe ELSAN, Ollioules, France (Benamer) Cardiology Department, ICVGVM La Roseraie, Aubervilliers, France (Motreff) Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France (Koning) Cardiology Department, Clinique Saint-Hilaire, Rouen, France (Van Belle) Cardiology Department, Institut Coeur-Poumon-CHU Lille and INSERM U1011, Lille, France (Zeitouni) Cardiology Department, AP-HP Hopital Universitaire Pitie Salpetriere, Paris, France (Puymirat) Cardiology Department Hopital Europeen Georges-Pompidou, Paris, France (Lambert) Biostatistics Unit, DRCI, CHU Clermont-Ferrand, Clermont-Ferrand, France (Amabile) Department of Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France Publisher Elsevier Inc. Abstract Background The optimal timing for initiating P2Y12 inhibitor therapy in patients undergoing percutaneous coronary intervention (PCI) remains controversial. In this study we analyzed the impact of dual antiplatelet therapy (DAPT) pretreatment on premature stent thrombosis in patients with chronic coronary syndrome and non-ST-elevation myocardial infarction treated by PCI. Methods We analyzed data from 53,898 PCI procedures (44,412 patients) in the "France PCI" registry between 2014 and 2020. Patients were divided into P2Y12 inhibitor pretreatment (83.2%) and no-pretreatment (16.8%) groups. The primary endpoint was incidence of in-hospital definite stent thrombosis. Results Pretreatment was associated with a significantly lower incidence of in-hospital stent thrombosis (0.1% vs 0.4%; odds ratio [OR] 0.35, 95% confidence interval [CI] 0.22-0.57). At 1 year, the pretreatment group showed lower rates of major adverse cardiovascular events (6.6% vs 7.8%; OR 0.83, 95% CI 0.74-0.92) and all-cause mortality (4.6% vs 6.0%; OR 0.71, 95% CI 0.63-0.80). Notably, there was no significant increase in major bleeding events in the pretreatment group. Conclusions In this large, real-world cohort, P2Y12 inhibitor pretreatment was associated with a significant reduction in in-hospital stent thrombosis and improved 1-year clinical outcomes without increased major bleeding risk. Our findings suggest that selective use of antiplatelet pretreatment may still play a crucial role in improving ischemic outcomes for patients undergoing PCI. Copyright © 2025 Canadian Cardiovascular Society. <66> Accession Number 2044404698 Title Warfarin Patient Self-Management in the US Health Care System: A Nonrandomized Clinical Trial. Source JAMA Network Open. 9(3) (no pagination), 2026. Article Number: e262627. Date of Publication: 19 Mar 2026. Author Witt D.M.; Hong H.; Wilson A.S.; Jones A.E.; Vazquez S.R.; Gilbert S.J.; Malone D.C.; Chaiyakunapruk N.; King J.B.; Barnes G.D.; Sylvester K.W.; Chan L.; Delate T. Institution (Witt, Hong, Wilson, Jones, Vazquez, Gilbert, Malone, Chaiyakunapruk) University of Utah, College of Pharmacy, Salt Lake City, United States (Witt, Hong, Jones, Vazquez, Gilbert) Health Thrombosis Service, University of Utah, Salt Lake City, United States (Chaiyakunapruk) IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, United States (King) Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, United States (King) University of Michigan, Ann Arbor, United States (Barnes) Brigham and Women's Hospital, Boston, MA, United States (Sylvester) Kaiser Permanente National Pharmacy, Aurora, CO, United States Publisher American Medical Association Abstract Importance Warfarin patient self-management (PSM) has consistently demonstrated superior efficacy to clinic-based management and is recommended by evidence-based guidelines, but it is virtually unused in the US health care system. Objective To implement and evaluate warfarin PSM in the US health care system using strategies developed to overcome previously identified barriers associated with PSM underutilization. Design, Setting, and Participants This was a single-group implementation open-label trial conducted between March 2023 and January 2024 at 4 specialized anticoagulation management services facilities in the US. Patients who participated had been taking warfarin for at least 9 months and were using home international normalized ratio monitors. The follow-up period was 6 months. Data were analyzed between July and December 2025. Intervention Transition to warfarin PSM using an implementation toolkit developed to address barriers specific to the US health care system. Main Outcomes and Measures Implementation and clinical outcomes were assessed using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and included the proportion of participants successfully transitioned to PSM, time in the therapeutic international normalized ratio range, bleeding and thromboembolic events, and proportion of international normalized ratios managed independently by participants. Results Of the 255 patients invited to participate in the trial, 138 (54.0%) consented (mean [SD] age, 63.2 [13.2] years; 80 male [58.0%]; 117 White [84.8%]; 123 non-Hispanic or Latino [89.1%]); 127 participants (92.0%) had been receiving warfarin therapy for 2 or more years. Among participants, 120 (87.0%) successfully transitioned to PSM and completed 6 months of follow-up. Compared with baseline, time in therapeutic range during PSM improved from 77.1% (95% CI, 73.7%-80.6%) to 81.3% (95% CI, 78.1%-84.4%). During the PSM phase, 5 bleeding events and no thromboembolic events or deaths occurred. Differences in adverse events in the 6 months before and after PSM initiation were not statistically significant. Most (83.0%) warfarin dosing decisions were made independently by participants and rarely required intervention from clinicians due to safety concerns. At the conclusion of the study, 98 participants (84.4%) expressed a preference for continuing PSM and clinicians expressed comfort with 109 participants (94.0%) continuing PSM. Conclusions and Relevance In this single-group implementation trial, warfarin PSM was safely and effectively implemented. These results provide critically needed evidence to facilitate and accelerate PSM implementation in the US health care system. Copyright © 2026 Witt DM et al. <67> Accession Number 2043622569 Title Contemporary approaches to perioperative anticoagulant management in surgical patients: a literature review. Source Current Medical Research and Opinion. 42(1) (pp 179-189), 2026. Date of Publication: 2026. Author Budiarto R.M.; Luthfah N.; Saputra P.B.T.; Widiarti W.; Aufazhafarin N.T.; Qolbina F.F.; Arba I.F.; Faizah N.N.; Alkaff F.F. Institution (Budiarto, Luthfah, Saputra, Qolbina) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia (Budiarto, Luthfah, Saputra, Qolbina) Department of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia (Widiarti, Aufazhafarin) Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia (Arba) National Heart and Lung Institute, Imperial College London, London, United Kingdom (Faizah) Division of Cardiovascular Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan (Alkaff) Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands (Alkaff) Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia Publisher Taylor and Francis Ltd. Abstract Perioperative anticoagulation management requires balancing thromboembolic prevention with bleeding risk. With the growing use of oral anticoagulants, this review synthesizes current evidence and guideline recommendations to support safe decision-making. A systematic search of scientific databases up to 28 May 2025 identified studies on perioperative anticoagulation. Review articles, animal studies, and non-English publications were excluded. Methodological quality was assessed using The Scale for the Assessment of Narrative Review Articles (SANRA). Oral anticoagulants fall into two main groups: vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs). DOACs, with predictable kinetics and short half-lives, allow brief interruption and rarely require bridging. VKAs, by contrast, have variable pharmacodynamics, often necessitating prolonged discontinuation and bridging with low-molecular-weight or unfractionated heparin. DOACs have simplified management, but high-risk procedures and vulnerable populations still require tailored planning, reversal protocols, and occasional bridging. High-bleeding-risk procedures typically necessitate temporary interruption, whereas many low-risk procedures can proceed without cessation. In emergencies, both targeted and non-specific reversal agents provide therapeutic options. Risk stratification tools such as CHADS-VASc and HAS-BLED further guide individualized decisions. Optimal perioperative anticoagulation requires integration of patient-specific thromboembolic risk, procedural bleeding risk, and drug properties. Multidisciplinary collaboration and adherence to evidence-based guidelines remain essential for safe outcomes. Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <68> Accession Number 2044601943 Title Cardiac Surgery 2025 Reviewed. Source Thoracic and Cardiovascular Surgeon. (no pagination), 2026. Date of Publication: 2026. Author Kirov H.; Caldonazo T.; Mukharyamov M.; Runkel A.; Fleckenstein P.; Freiburger S.; Siemeni T.; Doenst T. Institution (Kirov, Caldonazo, Mukharyamov, Runkel, Fleckenstein, Freiburger, Siemeni, Doenst) Department of Cardiothoracic Surgery, Friedrich-Schiller-University of Jena, University Hospital Jena, Jena, Germany Publisher Georg Thieme Verlag Abstract For the 12th consecutive time, we systematically reviewed the cardio-surgical literature for the past year, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach for a results-oriented summary. In 2025, the discussion on the value of randomized and observational evidence continued, showing converging results in the treatment of coronary artery disease and further diverging results in the field of invasive aortic valve therapies. Across randomized trials, meta-analyses, and registries, coronary artery bypass grafting (CABG) consistently provides superior long-term outcomes compared with percutaneous coronary intervention in complex coronary artery disease, driven primarily by sustained reductions in future myocardial infarctions. In addition, atrial fibrillation after CABG was shown to be more frequent than expected, but its long-term burden was negligible, while prolonged dual antiplatelet therapy after CABG for acute coronary syndrome offered no benefit but increased bleeding risk. The "valve treatment arena" in 2025 was heavily affected by the new guidelines, which clarified many aspects in mitral and tricuspid valve treatment but generated great controversy for aortic stenosis treatment. The latter was based on a reduction of the age cut-off for transcatheter aortic valve implantation to 70 years (unsupported by new data) and the selective reliance on only randomized studies (despite contradictory risk-adjusted registry evidence). Across mitral and tricuspid valve disease, publications showed improvements in symptoms and quality of life without survival benefits with transcatheter therapies and the most consistent long-term outcomes with surgery, particularly when appropriately timed and performed in experienced centers. This article summarizes publications perceived as important by us. It cannot be complete nor free of individual interpretation, but it provides up-to-date information for patient-specific decision-making. Copyright © 2026. Thieme. All rights reserved. <69> Accession Number 2044602920 Title Effect of preoperative oral iron supplementation on postoperative outcomes in children with acyanotic congenital heart disease undergoing cardiac surgery: a pragmatic randomised clinical trial. Source Cardiology in the Young. (no pagination), 2026. Date of Publication: 2026. Author Murugaiyan A.; Jha A.K.; Parida S.; Rajeswari Thangaswamy C.; Munuswamy H. Institution (Murugaiyan, Jha, Parida, Rajeswari Thangaswamy) Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India (Munuswamy) Cardiothoracic and Vascular surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India Publisher Cambridge University Press Abstract Background: Studies assessing the effect of preoperative iron supplementation in paediatric cardiac surgery are limited and yield conflicting data. Objective(s): The study aimed to evaluate the effect of preoperative oral iron supplementation on allogeneic blood transfusion after cardiac surgery for acyanotic CHD. Method(s): This was a prospective, open-label, outcome assessor-blinded, randomised clinical trial performed in a large tertiary care centre in India. Children (haemoglobin <13 gm/dl) with acyanotic CHD were recruited for the study. Children in the intervention arm received colloidal iron (3 mg/kg), folic acid, and cyanocobalamin according to body weight for at least 7 days before cardiac surgery. The primary outcome was the amount of allogeneic blood transfusion, while secondary outcome measures were the duration of mechanical ventilation and ICU stay. Result(s): A total of eighty-six children (43 in each arm) completed the trials. A total of 43 children received iron supplementation for a minimum of 1 month. The haemoglobin level improved by 1.3 gm/dl immediately before the cardiac surgery in the intervention arm. The allogeneic blood transfusions (ml/kg) median (IQR) were significantly lower in the intervention group (5 (0-8) vs 10 (8-12); p < 0.01). Furthermore, total cumulative allogeneic blood transfusion was also significantly lower in the intervention arm (60 ml; (0-100) vs 100 ml; (70-140); p < 0.001). The duration of mechanical ventilation, ICU stay, and hospital stay was significantly lower in the intervention arm. Conclusion(s): Preoperative oral iron supplementation significantly reduces the need for allogeneic blood transfusion in children undergoing cardiac surgery for acyanotic heart disease. Copyright © The Author(s), 2026. Published by Cambridge University Press. <70> Accession Number 2039207887 Title Meta-analysis of transcatheter edge-to-edge repair vs surgery for secondary mitral regurgitation. Source Cardiovascular Revascularization Medicine. 84 (pp 90-95), 2026. Date of Publication: 01 Mar 2026. Author Singh S.; Shabbir M.A.; Tiwari N.; Bliden K.; Tantry U.S.; Gurbel P.A.; Kanjwal M.Y.; Lundgren S.W. Institution (Singh) Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD, United States (Shabbir, Tiwari, Lundgren) Division of Cardiology, University of Nebraska Medical Center, Omaha, NE, United States (Bliden, Tantry) Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, MD, United States (Gurbel, Kanjwal) Division of Cardiology, Sinai Hospital of Baltimore, Baltimore, MD, United States Publisher Elsevier Inc. Abstract Background Transcatheter edge-to-edge repair (TEER) in patients with secondary mitral regurgitation (MR) has shown variable outcomes in clinical studies when compared with mitral valve surgery. We conducted a meta-analysis to reconcile the data. Methods Online databases were searched for studies assessing TEER vs surgery for secondary MR. The outcomes of interest were length of hospital stay, all deaths, heart failure (HF) rehospitalization, mitral valve reintervention, implantation of left ventricular assist device (LVAD), stroke and recurrence of grade 3 or 4 MR. Pooled odds ratios (OR) and standardized mean difference (SMD), with 95 % confidence intervals (CI) were calculated. Results Eight studies (1 randomized and 7 observational) with a total of 1436 patients (TEER n = 826, surgery n = 610) were included. Length of hospital stay was shorter in the TEER group (SMD -2.50, 95 % CI -4.65 to -0.35, p = 0.02). No significant differences were found between the two groups with respect to all deaths ( p = 0.80), HF rehospitalization, mitral valve reintervention, implantation of LVAD and stroke. Recurrence of grade 3 or 4 MR was higher in the TEER group (OR 5.33, 95 % CI 2.57 to 11.03, p < 0.00001). Conclusions In patients with secondary MR, TEER and surgery have comparable outcomes such as mortality, except for the lower recurrence of grade 3 or 4 MR in the surgical group. Thus, TEER may be the first approach in such patients, except in low surgical risk cases who need other concomitant cardiac surgeries. Copyright © 2025 Elsevier Inc. <71> Accession Number 2035937041 Title The impact of heated humidified circuits on arterial oxygenation during one-lung ventilation in thoracic surgery: a randomized controlled trial. Source Journal of Anesthesia. 40(2) (pp 201-209), 2026. Date of Publication: 01 Apr 2026. Author Park S.-K.; Lee J.; Kim M.H.; Park J.; Kim H.-C. Institution (Park, Lee, Kim, Kim) Department of Anesthesiology and Pain Medicine and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea (Park) Department of Anesthesiology and Pain Medicine, Keimyung University College of Medicine, Seoul, South Korea Publisher Springer Abstract Purpose: One-lung ventilation (OLV) during thoracic surgery often disturbs systemic oxygenation. Hypoxic pulmonary vasoconstriction is influenced by body temperature; however, the effect of heated humidified circuits on hypoxic pulmonary vasoconstriction and arterial oxygenation during OLV remains unclear. This study aimed to investigate the impact of heated humidified circuits on arterial oxygenation during OLV for thoracic surgery, compared with conventional non-heated circuits. Method(s): Patients undergoing video-assisted thoracic surgery were randomly assigned to the heated humidified circuit or conventional breathing circuit group. During two-lung ventilation, tidal volume was set at 8 ml/kg with a fraction of inspired oxygen (FiO<inf>2</inf>) of 0.5, and during OLV, it was adjusted to 6 ml/kg with a FiO<inf>2</inf> of 1.0. Arterial blood gas measurements were obtained preoperatively, during two-lung ventilation, at 15, 30, 45, and 60 min after initiating OLV. The primary outcome was the partial pressure of oxygen in the arterial blood (PaO<inf>2</inf>) at 30 min after initiating OLV. Result(s): Ninety-seven patients were included in the final analysis. The heated humidified circuit group had significantly higher PaO2 at 30 min after initiating OLV than the control group (estimated mean [standard error], 211.3 [13.4] vs. 146.2 [13.2] mmHg; P = 0.004). The mean PaO<inf>2</inf> at 15 and 45 min was significantly higher in the heated humidified circuit group. Conclusion(s): Using heated humidified circuits significantly improves PaO<inf>2</inf> during OLV in patients undergoing thoracic surgery compared to conventional circuits. These findings suggest that heated humidified circuits can be considered as an option when hypoxemia persists despite other interventions. Copyright © The Author(s) under exclusive licence to Japanese Society of Anesthesiologists 2025. <72> Accession Number 2043704729 Title The efficacy and safety of cerebral embolic protection devices in patients undergoing transcatheter aortic valve replacement: a systematic review and meta-analysis with trial sequential analysis of randomized controlled trials. Source Expert Review of Cardiovascular Therapy. 24(3) (pp 253-271), 2026. Date of Publication: 2026. Author Elazab A.; Hageen A.W.; Elbataa A.; Labeeb E.E.; Najah Q.; Elbahloul M.A.; Elnady M.I.; Abdelsatar S.M.; Mansour A.; Elkasaby M.H.; Odat R.M.; Rhabneh L.; Nassar M.; Turkmani M.; Hakim D. Institution (Elazab) Faculty of Medicine, South Valley University, Qena, Egypt (Hageen) Faculty of Medicine, Tanta University, Tanta, Egypt (Elbataa, Mansour, Labeeb, Mansour, Elkasaby) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Najah) Faculty of Medicine, Elmergib University, Alkhums, Libyan Arab Jamahiriya (Elbahloul, Elnady) Faculty of Medicine, Kafr El Sheik University, Kafr El Sheikh, Egypt (Abdelsatar) Faculty of Nursing, Beni-Suef National University, Beni-Suef, Egypt (Odat) Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Rhabneh) Department of Internal Medicine, HMH Ocean University Medical Center, Brick, NJ, United States (Nassar) Division of Endocrinology and Diabetes, Larner College of Medicine, University of Vermont, Burlington, VT, United States (Turkmani) Faculty of Medicine, Michigan State University, East Lansing, MI, United States (Turkmani) Department of Pulmonary and Critical Care, University of Toledo, Toledo, OH, United States (Hakim) Brigham & Women's Hospital/Harvard Medical School, Boston, MA, United States Publisher Taylor and Francis Ltd. Abstract Introduction: Transcatheter aortic valve replacement (TAVR) is an established treatment for severe aortic stenosis but carries a risk of stroke and cerebral embolism. Cerebral embolic protection devices (CEPD), including filter-based and deflection-based systems (Sentinel and TriGUARD), aim to reduce embolic complications; however, their clinical benefit remains uncertain. This study evaluated the efficacy and safety of CEPD during TAVR using trial sequential analysis (TSA) and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. Method(s): Randomized controlled trials (RCTs) comparing TAVR with and without CEPD were identified through four electronic databases from inception to April 2025. Primary outcomes were all-cause mortality, major adverse cardiovascular and cerebrovascular events (MACCE), stroke, and disabling stroke. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated. TSA was conducted with a 5% type I error and 80% power. Result(s): Nine RCTs including 11,876 patients were analyzed. CEPD use showed no significant reduction in mortality, MACCE, stroke, or disabling stroke. Secondary and subgroup analyses yielded consistent findings. TSA demonstrated that the accrued evidence was insufficient to confirm a clinical benefit. Conclusion(s): Current evidence does not support the routine use of CEPD during TAVR, given the lack of significant benefit in key clinical outcomes. Registration: The protocol of this study was registered at Prospero CRD420251036308. Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <73> Accession Number 2043855469 Title The Exercise aNd hEArt Transplant (ENEA) Trial: A Randomized Controlled Trial of Cardiac Rehabilitation After Heart Transplantation. Source Journal of Clinical Medicine. 15(5) (no pagination), 2026. Article Number: 1832. Date of Publication: 01 Mar 2026. Author Pedersini P.; Villaschi A.; Toccafondi A.; Antolini L.; Grati P.; Cusmano I.; Mapelli L.; Gonella M.; Di Lauro S.; Gonella R.; Masciocco G.; Garascia A.; Morici N. Institution (Pedersini, Villaschi, Toccafondi, Antolini, Grati, Cusmano, Mapelli, Gonella, Di Lauro, Gonella, Morici) IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy (Pedersini) Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy (Villaschi) Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy (Masciocco, Garascia) De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Heart transplantation (HTx) remains the gold-standard therapy for patients with end-stage heart failure. Cardiac rehabilitation (CR) is a multidisciplinary intervention that improves cardiovascular prognosis and quality of life. The aim of this randomized controlled trial was to evaluate the impact of cardiac telerehabilitation on cardiovascular events after HTx. Method(s): Forty patients who had undergone HTx were recruited at a single Italian institution and randomly allocated 1:1 to an experimental group (on-site CR followed by 12 weeks of telerehabilitation) or a control group (on-site CR followed by standard homecare and an exercise program). The primary outcome was a 6-month composite of major cardiovascular events, including acute allograft rejection, heart failure hospitalization, coronary allograft vasculopathy, stroke, and all-cause mortality. Secondary outcomes included return to work within 6 months, physical and functional activity levels and treatment adherence. Result(s): Forty patients were equally allocated to control and experimental groups, with well-balanced baseline demographic, clinical, and functional characteristics. At 6 months, the primary composite endpoint occurred in 35% of patients in both groups, with no significant between-group differences. Return to work was observed in 72.2% of the controls and 64.3% of intervention patients. Physical activity levels were comparable between groups, with most patients classified as sufficiently active. Adherence to the cardiac telerehabilitation program was complete in only 50% of the patients. Conclusion(s): In this randomized trial on HTx patients, a hybrid telerehabilitation program was as safe as standard care regarding major cardiovascular events at 6 months. The low adherence observed suggests that future digital interventions must focus on enhancing patient engagement. Copyright © 2026 by the authors. <74> 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. <75> Accession Number 2041918030 Title The Limit of Detection in the Emergency Department Trial (LEGEND): A Stepped-Wedge Cluster Randomized Trial to Rule Out Acute Myocardial Infarction and Reduce Hospital Length of Stay for Patients Presenting to the Emergency Department. Source Annals of Emergency Medicine. 87(4) (pp 424-434), 2026. Date of Publication: 01 Apr 2026. Author Parsons R.; Greenslade J.; Parsonage W.; Stephensen L.; Perez S.; Starmer K.; Starmer G.; Gaikwad N.; McPhail S.M.; Hall E.; Brownlee E.; McCormick E.; Bonnin R.; Brain D.; Campbell V.; Charters B.; Chew D.; Figtree G.; Funk V.; Fincher G.; Hamilton-Craig C.; Rigney J.; Stone R.; Cullen L. Institution (Greenslade, Stephensen, Brownlee, McCormick, Cullen, Greenslade, Parsonage, Stephensen, Perez, Starmer, Starmer, Gaikwad, McPhail, Hall, Brownlee, McCormick, Bonnin, Brain, Campbell, Charters, Chew, Figtree, Funk, Fincher, Hamilton-Craig, Rigney, Stone, Cullen) Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia (Greenslade, Parsonage, Stephensen, Parsons, McPhail, Cullen, Greenslade, Parsonage, Stephensen, Perez, Starmer, Starmer, Gaikwad, McPhail, Hall, Brownlee, McCormick, Bonnin, Brain, Campbell, Charters, Chew, Figtree, Funk, Fincher, Hamilton-Craig, Rigney, Stone, Cullen) Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia (Parsonage, Greenslade, Parsonage, Stephensen, Perez, Starmer, Starmer, Gaikwad, McPhail, Hall, Brownlee, McCormick, Bonnin, Brain, Campbell, Charters, Chew, Figtree, Funk, Fincher, Hamilton-Craig, Rigney, Stone, Cullen) Department of Cardiology, Royal Brisbane and Women's Hospital, Brisbane, Australia (Perez, Greenslade, Parsonage, Stephensen, Perez, Starmer, Starmer, Gaikwad, McPhail, Hall, Brownlee, McCormick, Bonnin, Brain, Campbell, Charters, Chew, Figtree, Funk, Fincher, Hamilton-Craig, Rigney, Stone, Cullen) Emergency Department, Logan Hospital, Brisbane, Australia (Starmer, Greenslade, Parsonage, Stephensen, Perez, Starmer, Starmer, Gaikwad, McPhail, Hall, Brownlee, McCormick, Bonnin, Brain, Campbell, Charters, Chew, Figtree, Funk, Fincher, Hamilton-Craig, Rigney, Stone, Cullen) Emergency Department, Cairns Hospital, Cairns, Australia (Starmer, Greenslade, Parsonage, Stephensen, Perez, Starmer, Starmer, Gaikwad, McPhail, Hall, Brownlee, McCormick, Bonnin, Brain, Campbell, Charters, Chew, Figtree, Funk, Fincher, Hamilton-Craig, Rigney, Stone, Cullen) Department of Cardiology, Cairns Hospital, Cairns, Australia (Gaikwad, Greenslade, Parsonage, Stephensen, Perez, Starmer, Starmer, Gaikwad, McPhail, Hall, Brownlee, McCormick, Bonnin, Brain, Campbell, Charters, Chew, Figtree, Funk, Fincher, Hamilton-Craig, Rigney, Stone, Cullen) Department of Cardiology, the Prince Charles Hospital, Brisbane, Australia (Gaikwad, Greenslade, Parsonage, Stephensen, Perez, Starmer, Starmer, Gaikwad, McPhail, Hall, Brownlee, McCormick, Bonnin, Brain, Campbell, Charters, Chew, Figtree, Funk, Fincher, Hamilton-Craig, Rigney, Stone, Cullen) Faculty of Medicine, the University of Queensland, Brisbane, Australia (Hall, Greenslade, Parsonage, Stephensen, Perez, Starmer, Starmer, Gaikwad, McPhail, Hall, Brownlee, McCormick, Bonnin, Brain, Campbell, Charters, Chew, Figtree, Funk, Fincher, Hamilton-Craig, Rigney, Stone, Cullen) Emergency Department, the Prince Charles Hospital, Brisbane, Australia (Hall, Greenslade, Parsonage, Stephensen, Perez, Starmer, Starmer, Gaikwad, McPhail, Hall, Brownlee, McCormick, Bonnin, Brain, Campbell, Charters, Chew, Figtree, Funk, Fincher, Hamilton-Craig, Rigney, Stone, Cullen) Emergency Department, Gold Coast University Hospital, Gold Coast, Australia Publisher Elsevier Inc. Abstract Study objectives The Limit of Detection in the Emergency Department (LEGEND) rule-out strategy integrates high-sensitivity cardiac troponin assay concentrations with shared decision making to rapidly assess emergency patients with suspected acute coronary syndrome (ACS). We hypothesized that the LEGEND rule-out strategy would reduce length of stay (LOS), increase the proportion of patients safely discharged within 4 hours, reduce cardiac testing, and decrease hospital representations, while maintaining patient safety. Methods We conducted a stepped-wedge cluster randomized controlled trial in 4 Australian emergency departments from August 2019 to July 2020. We included adult patients presenting with suspected ACS. We randomized sites to implement the LEGEND strategy. The primary outcome was LOS. Secondary outcomes included discharge from hospital within 4 hours, cardiovascular tests, representations, index, and 30-day events. Results The study included 9,944 patients, 5,347 in the standard care and 4,597 in the intervention arm. For patients in the LEGEND cohort (presentation troponin <=2 ng/L), the mean LOS was 3.6 hours shorter in the intervention arm than the standard care arm (95% confidence interval [CI] 2.5 to 4.6 hours). The proportion of patients safely discharged within 4 hours increased by 22.9% (95% CI 19.5% to 26.3%), and cardiac testing decreased by 7.8% (95% CI 4.6% to 11.1%). There were no differences in representations, index events, or 30-day events. Conclusion The LEGEND rule-out strategy safely ruled out acute myocardial infarction, reduced hospital LOS, increased the proportion of patients discharged within 4 hours, and reduced cardiac testing. Copyright © 2025 American College of Emergency Physicians. <76> Accession Number 2044357345 Title The additive value of preprocedural cardiac computed tomography angiography (CCTA) planning in percutaneous left atrial appendage occlusion: a systematic review and meta-analysis. Source Journal of Interventional Cardiac Electrophysiology. (no pagination), 2026. Date of Publication: 2026. Author Balbaa E.; Rakab M.S.; Gadelmawla A.F.; Amin A.M.; Tawfik A.M.; Elgendy A.; AL-Ihribat A.R.; Turkmani M.; Altobaishat O.; Elgendy M.S.; Shubietah A.; Abuelazm M. Institution (Balbaa, Tawfik) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Rakab, Amin, Elgendy) Faculty of Medicine, Mansoura University, Mansoura, Egypt (Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt (AL-Ihribat) Faculty of Medicine, Palestine Polytechnic University, Hebron, Palestine (Turkmani) Faculty of Medicine, Michigan State University, East Lansing, MI, United States (Turkmani) Division of Pulmonary and Critical Care, University of Toledo, Toledo, OH, United States (Altobaishat) Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Elgendy, Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt (Shubietah) Department of Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, United States Publisher Springer Abstract Background: Cardiac computed tomography angiography (CCTA) is increasingly used to guide left atrial appendage occlusion (LAAO) by providing a detailed anatomical assessment. However, its incremental value over conventional planning methods, such as transesophageal echocardiography or fluoroscopy, remains uncertain. This study evaluated the additive value of CCTA-guided planning in percutaneous LAAO. Method(s): A systematic review and meta-analysis conducted using PubMed, Embase, CENTRAL, Scopus, and Web of Science, up to September 2024 (updated in July 2025). Dichotomous outcomes were pooled as risk ratios (RR), while continuous outcomes were pooled as mean differences (MD) along the corresponding 95% confidence intervals (CI). PROSPERO ID: CRD42024600363. Result(s): Six studies comprising 978 patients with follow-up periods of up to 90 days were included. The CCTA-guided group had significant higher device implantation success [RR: 1.06; 95% CI (1.01, 1.11), P = 0.028], a lower device resizing [RR: 0.42; 95% CI (0.26, 0.66), P = 0.0002], and a lower procedure time [MD: -13.29 min; 95% CI (-23.72, -2.86), P = 0.01]. There was no significant difference between the two groups in device-related embolization [P = 0.38], peri-device leakage [P = 0.16], radiation dose [P = 0.84], and contrast utilization [P = 0.96]. Conclusion(s): Adding CCTA to preoperative planning for LAAO as a complementary modality can increase implantation success rate, improve device selection accuracy, and shorten procedure time without increasing adverse events or contrast use with substantial heterogeneity and divergent subgroups. However, limited follow-up restricts long-term safety conclusions. Further large-scale, long-term randomized trials are needed to validate these findings. Copyright © The Author(s) 2026. <77> Accession Number 2040212305 Title Safety of cardioversion without anticoagulation in patients' status post left atrial appendage occlusion: A systematic review and meta-analysis. Source Cardiovascular Revascularization Medicine. 84 (pp 105-109), 2026. Date of Publication: 01 Mar 2026. Author Sawalha K.; Alakchar M.; Mamas M.A.; Johnson D.; Bhan A.; Goldsweig A.M. Institution (Sawalha, Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center and Division of Cardiovascular Medicine, University of Massachusetts Baystate, Springfield, MA, United States (Alakchar) Department of Cardiovascular Medicine, Southern Illinois University, Springfield, IL, United States (Mamas) Keele Cardiovascular Research Group, Keele University, Stoke on Trent, United Kingdom (Johnson) Department of Cardiology, University of Illinois at Chicago, Chicago, IL, United States (Bhan) Department of Cardiology, Heart Vascular Institute, Advocate Christ Medical Center, Oak Lawn, IL, United States Publisher Elsevier Inc. Abstract Background Direct current cardioversion (DCCV) is commonly used for rhythm control in atrial fibrillation (AF). Left atrial appendage occlusion (LAAO) provides stroke prevention in patients with contraindications to oral anticoagulation (OAC), but the safety of DCCV without periprocedural anticoagulation in this group remains uncertain. Objective To evaluate the safety of performing DCCV without systemic anticoagulation in patients with prior LAAO. Methods We conducted a systematic review and meta-analysis following PRISMA guidelines. PubMed, ScienceDirect, and the Cochrane Library were searched (January 2010-April 2025). Studies comparing outcomes of patients undergoing DCCV after LAAO, with versus without subsequent anticoagulation, were included. Primary outcomes were thromboembolic events and clinically significant bleeding. Odds ratios (ORs) were calculated using random-effects modeling, with heterogeneity assessed via I2 statistic. Results Five observational studies (1697 DCCV procedures; 965 patients receiving post-DCCV anticoagulation) met inclusion criteria. Thromboembolic events occurred in 3.8 % of patients without OAC versus 1.6 % with OAC, with no statistically significant difference (OR 0.48; 95 % CI 0.16-1.43; p = 0.19; I2 = 17 %). Clinically significant bleeding occurred in 4.1 % without OAC and 4.0 % with OAC, also without significant difference (OR 1.22; 95 % CI 0.75-2.00; p = 0.42; I2 = 0 %). Pre-DCCV imaging protocols varied widely among studies. Conclusions In selected patients post-LAAO with no device-related thrombus or significant peri-device leak, DCCV without subsequent anticoagulation demonstrated low thromboembolic and bleeding risks. These findings, derived from limited observational data, require confirmation by randomized controlled trials. Copyright © 2025 Elsevier Inc. <78> Accession Number 2044357089 Title Angio-Seal plug-based versus dual ProGlide for transfemoral hemostasis in transcatheter aortic valve replacement: a systematic review and meta-analysis. Source Journal of Thrombosis and Thrombolysis. (no pagination), 2026. Date of Publication: 2026. Author Alnomani Y.R.; Algazar M.; Omar M.M.; Aldemerdash M.A.; Henes K.; Arafa A.; Rageh B.M.; Abdelaziz A. Institution (Alnomani) Faculty of Medicine, Benha University, Benha, Egypt (Algazar) Faculty of Medicine, Al-Azhar University, Asyut, Egypt (Omar) Faculty of Medicine, Cairo University, Cairo, Egypt (Aldemerdash) Faculty of Medicine, Sohag university, Sohag, Egypt (Henes) Department of Cardiology, El-Mabarra Health Insurance Hospital, Asyut, Egypt (Arafa) Department of Nephrology, Alexandria University, Alexandria, Egypt (Rageh) Department of Physiology, Sana'a University, Sana'a, Yemen (Abdelaziz) Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, United States (Algazar, Omar, Aldemerdash, Henes, Rageh, Abdelaziz) Medical Research group of Egypt (MRGE), Cairo, Egypt Publisher Springer Abstract Transcatheter aortic valve replacement (TAVR) carries risks of vascular and bleeding complications. We aimed to study the effectiveness of Angio-Seal combined with Perclose ProGlide versus dual Perclose ProGlide following transfemoral TAVR. We searched PubMed, Cochrane Library, Scopus, and WOS from inception until November 2024 for studies comparing Parclose ProGlide with Angio-Seal versus dual Parclose ProGlide in transfemoral TAVR. The primary outcome was major vascular complications, while other secondary outcomes were bleeding complications, the need for additional vascular closure device (VCD), minor vascular complications, unplanned surgical intervention, mortality, hematoma, pseudoaneurysm, and dissection. Dichotomous outcomes were pooled and analyzed using odds ratio (OR) with 95% confidence interval (CI) via the DerSimonian-Laird random-effect model. Seven studies (two RCTs and five observational studies) comprising 1,766 patients were included. In RCT-only analyses, single Perclose ProGlide combined with Angio-Seal showed no significant difference compared with dual Perclose ProGlide in major vascular complications (OR = 0.54, 95% CI [0.28-1.04], P = 0.07) or major/life-threatening bleeding (OR = 0.66, 95% CI [0.25-1.74], P = 0.40). However, it significantly reduced the need for additional vascular closure devices (OR = 0.11, 95% CI [0.05-0.24], P < 0.01) and minor vascular complications (OR = 0.52, 95% CI [0.38-0.72], P < 0.01). For dual Perclose ProGlide combined with Angio-Seal, no RCTs were available; observational evidence suggested a reduction in major/life-threatening bleeding compared to dual Perclose ProGlide (OR = 0.43, 95% CI [0.21 to0.92], p = 0.03), while there was no significant difference between the two groups upon excluding Costa et al. (EuroIntervention, 17:728-735, 2021) (OR = 0.56, 95% CI [0.26 to 1.21], p = 0.14). Based on the available RCTs, the combination of single Perclose ProGlide with Angio-Seal during transfemoral TAVR significantly reduces the need for additional vascular closure devices. It may also reduce minor vascular complications, but this effect is not consistently robust. The pooled analysis of observational studies suggests a potential benefit of dual Perclose ProGlide combined with Angio-Seal for major/life-threatening bleeding. However, this finding was not robust in sensitivity analyses and no RCTs have evaluated this strategy. Copyright © The Author(s) 2026. <79> Accession Number 2043907468 Title Efficacy and safety of transcatheter aortic valve replacement for the treatment of pure severe native aortic valve regurgitation: a single-arm meta-analysis. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1735206. Date of Publication: 2026. Author Zhu F.; Zhai G.; He S.; Liu Z.; He Z. Institution (Zhu, Zhai, He, Liu, He) Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, China Publisher Frontiers Media SA Abstract Objective: Numerous studies have reported the efficacy and safety of transcatheter aortic valve replacement (TAVR) for pure severe native aortic valve regurgitation (psNAVR) in recent years; however, these studies show considerable variability in outcomes such as success rate and mortality. Therefore, this meta-analysis was conducted to evaluate the efficacy and safety of TAVR in patients with psNAVR based on the latest research evidence. Method(s): Relevant studies were searched in four databases-PubMed, Embase, Web of Science, and the Cochrane Library-up to August 27, 2025. The primary outcomes were device success, all-cause mortality, and cardiovascular mortality during the perioperative period. Secondary outcomes included perioperative and 1-year post-operative adverse events, such as stroke, acute kidney injury (AKI), new-onset myocardial infarction, major vascular complications, major bleeding events, readmission due to heart failure (HF), and new permanent pacemaker (PPM) implantation. Statistical analyses were performed using Stata 14.0 software. Result(s): A total of 29 articles involving 2,773 patients with psNAVR undergoing TAVR were included in the meta-analysis. The device success rate was 87.5% [95% confidence interval (CI): 83.3%-91.2%]. Perioperative all-cause mortality was 3.1% (95% CI: 1.6%-5.1%), and perioperative cardiovascular mortality was 1.4% (95% CI: 0.2%-3.5%). During the perioperative period, the incidence of adverse events was as follows: stroke, 0.7%; AKI, 4.5%; new-onset myocardial infarction, 0.0%; major vascular complications, 3.3%; major bleeding events, 4.4%; and new PPM implantation, 11.4%. At 1 year, the incidence rates were 9.3% for all-cause mortality, 4.3% for cardiovascular mortality, 2.6% for stroke, 9.1% for AKI, 0.0% for new-onset myocardial infarction, 1.6% for major bleeding events, 19.0% for readmission due to HF, and 10.0% for new PPM implantation. Subgroup analysis indicated that geographic location, surgical risk, valve type, and procedural approach influenced the incidence of post-operative adverse events. Conclusion(s): TAVR is a valuable therapeutic option for patients with psNAVR at high surgical risk. However, geographic location, surgical risk, valve type, and procedural approach appear to influence the incidence of adverse events after TAVR. Copyright © 2026 Zhu, Zhai, He, Liu and He. <80> Accession Number 2043911553 Title Natural products targeting the gut-brain axis for the treatment of post-cardiac procedures anxiety or depression. Source Phytomedicine. 155 (no pagination), 2026. Article Number: 158061. Date of Publication: 01 Jun 2026. Author Ning B.; Wei Y.; Luo C.; Yang L.; Zheng Z.; Fang P.; Ge T.; Wang C.; Hu J.; Zhao Q.; Bo J.; Dong Y.; Lei Y.; He L.; Zhang Z.; Zhao M.; Peng J.; Zou R.; Fan X. Institution (Ning, Yang, Zheng, Ge, Wang, Hu, Zhao, Bo, Zou, Fan) The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China (Wei) The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China (Luo) The Clinical Medical College of Chengdu University of Traditional Chinese Medicine, Chengdu, China (Fang) The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China (Wang, Peng, Zou, Fan) Guangdong Provincial Hospital of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China (Dong) The First Clinical Medical College of Yunnan University of Chinese Medicine, Kunming, China (Lei, He, Zhang) The First Clinical Medical College of Shaanxi University of Chinese Medicine, Xianyang, China (Zhao) Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China (Zou, Fan) State Key Laboratory of Traditional Chinese Medicine Syndrome, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangdong Provincial Key Laboratory of TCM Emergency Research, Guangzhou, China Publisher Elsevier GmbH Abstract Background Post-cardiac surgery anxiety or depression (PCPAD) is a common neuropsychiatric complication following cardiovascular interventional procedures, which significantly increases the risk of adverse cardiovascular events and long-term mortality. Existing treatment strategies have limitations, and clinical needs remain unmet. The gut-brain axis (GBA) serves as a core network regulating neuroimmune and endocrine responses, and its imbalance involves key links such as intestinal flora dysbiosis and neuroimmune crosstalk disorders. It is closely related to the pathogenesis of this complication, providing a novel perspective for targeted interventions. Objective This review aims to systematically clarify the mechanism of GBA in PCPAD, comprehensively explore therapeutic strategies targeting this axis, and focus on the intervention value and application potential of natural products. Methods The study was designed and conducted in strict accordance with the PRISMA 2020 guidelines. Relevant literatures were searched from PubMed, Web of Science Core Collection, ScienceDirect, Embase, Cochrane Library, and CNKI databases from their inception to December 2025. Literatures focusing on GBA-related mechanisms of PCPAD or investigating the mechanisms and clinical applications of natural products targeting GBA for PCPAD treatment were included. Conference abstracts, case reports, duplicate publications, and other ineligible literatures were excluded. Through quality control strategies including double independent screening and verification, priority inclusion of high-credibility evidence, and data cross-validation, 168 eligible literatures were finally included. The composition and functions of GBA, its imbalance mechanisms, and the basic and clinical evidence of natural product-based interventions were systematically analyzed. Results Studies have shown that GBA imbalance is the core pathogenesis of PCPAD, among which the inflammatory cascade initiated by intestinal flora dysbiosis, abnormal activation of the neuroendocrine axis, disorder of immune-nerve crosstalk, and abnormal gene and epigenetic regulation are key pathological links. In summary, GBA imbalance, especially gut microbiota dysbiosis and neuroimmune interactions, plays a critical role in the pathogenesis of PCPAD. Natural products (including traditional Chinese medicine (TCM) monomers, TCM compound prescriptions, patented TCM drugs, and natural products from other plant sources worldwide) can exert therapeutic effects by synergistically regulating GBA homeostasis through multiple targets. Specifically, they include increasing the abundance of beneficial bacteria such as Bifidobacterium and Lactobacillus, promoting the production of anti-inflammatory metabolites such as short-chain fatty acids, repairing intestinal barrier function, inhibiting pro-inflammatory pathways such as NF-kappaB and NLRP3 inflammasome, and regulating the levels of neurotransmitters and neurotrophic factors such as 5-HT and BDNF. Basic and clinical studies have confirmed that these natural products have high biocompatibility and low toxic side effects, and are compatible with the safe medication needs of patients during the organ function recovery period after cardiac surgery. Several natural products have been proven to modulate GBA dysfunction, with potential for clinical therapeutic application. Conclusions This review systematically elucidates a new paradigm of precise intervention for PCPAD via natural products that regulate GBA through multiple targets, addressing the limitation of traditional single-target therapies and providing a low-cost, easily promotable solution for clinical translation. Additionally, natural product-based interventions offer a novel approach for treating post-cardiac surgery complications. In the future, it is necessary to further conduct large-sample, multicenter clinical trials to clarify their mechanisms of action and standardized dosage regimens, strengthen toxicological research, facilitate the translation from basic research to clinical practice, and provide more precise therapeutic strategies for patients. Copyright © 2026 Elsevier GmbH. <81> 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. <82> Accession Number 2044266655 Title Meta-Analysis: Prevalence and Incidence of Gastroparesis Following Lung or Heart Transplantation. Source Alimentary Pharmacology and Therapeutics. (no pagination), 2026. Date of Publication: 2026. Author Eldesouki M.H.; Marey M.M.; Ali M.A.; Genidy A.M.; Gamal M.H.; Othman A.M.; Mohamed A.N.; Al Qady A.; Amaris M.A.; Sharma A. Institution (Eldesouki) Department of Internal Medicine, New York Medical College, St Michael Medical Center, Newark, NJ, United States (Marey) Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt (Ali) Qena Faculty of Medicine, Qena University, Qena, Egypt (Genidy, Gamal) Faculty of medicine, Tanta University, Tanta, Egypt (Othman) Department of Internal Medicine, Faculty of Medicine, Kafr El-Sheik University, Kafr El-Sheik, Egypt (Mohamed) Division of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, OH, United States (Al Qady, Amaris) Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Florida, Gainesville, FL, United States (Sharma) Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, United States Publisher John Wiley and Sons Inc Abstract Background: Gastroparesis is a recognized complication after thoracic organ transplantation that impairs nutrition, medication absorption, and graft outcomes. Aim(s): This study aimed to quantify the risk of gastroparesis following lung (LT) and combined heart-lung transplantation (HLT). Method(s): A systematic search of PubMed, Embase, Scopus, and Web of Science from inception to January 2025 identified studies reporting gastroparesis after LT or HLT in adult cohorts with objective diagnostic testing. Random-effects meta-analysis was used to pool prevalence and incidence, with subgroup analyses by transplant type, and diagnostic modality, and meta-regression asessing the effects of age and sex. Result(s): Twenty-one studies, including 2888 patients, met the inclusion criteria. The pooled prevalence of gastroparesis was 31.87% (95% CI: 19.88-46.87). Subgroup analysis revealed a higher prevalence of gastroparesis in combined HLT recipients (44.89%, 95% CI: 17.05-76.35) compared to LT only (26.95%, 95% CI: 15.46-42.68), though this difference was not statistically significant (p = 0.31). The overall incidence was 25.67% (95% CI: 15.07-40.41), with HLT recipients showing a higher incidence (35.79%, 95% CI: 20.73-54.29) than LT only (19.38%, 95% CI: 8.3-38.9). Conclusion(s): Gastroparesis affects nearly one-third of thoracic transplant recipients, with a numerically higher burden after HLT transplantation. There was no association between age and gender and the prevalence of post-transplant gastroparesis. Copyright © 2026 The Author(s). Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd. <83> Accession Number 2042493009 Title Extremity Function After Transfemoral Transcatheter Aortic Valve Implantation: A TAVI XS Sub-Study. Source Catheterization and Cardiovascular Interventions. 107(5) (pp 1293-1302), 2026. Date of Publication: 01 Apr 2026. Author Versteeg G.A.A.; Rooijakkers M.J.P.; Hemelrijk K.I.; Vlaar P.J.; Overduin D.C.; van Wely M.H.; Aarts H.M.; van Ginkel D.-J.; Stens N.A.; van Nunen L.X.; van Geuns R.J.; van Garsse L.A.F.M.; Geuzebroek G.S.C.; Verkroost M.W.A.; Cetinyurek-Yavuz A.; Heijmen R.H.; Thijssen D.H.J.; ten Berg J.M.; Tonino P.A.L.; Delewi R.; van Royen N. Institution (Versteeg, Rooijakkers, van Wely, Stens, van Nunen, van Geuns, van Royen) Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands (Hemelrijk, Aarts, Delewi) Department of Cardiology, Amsterdam UMC, Amsterdam, Netherlands (Vlaar, Tonino) Department of Cardiology, Catharina Hospital, Eindhoven, Netherlands (Overduin, van Ginkel, ten Berg) Department of Cardiology, St. Antonius Hospital, Nieuwegein, Netherlands (Stens, Thijssen) Department of Medical Biosciences, Radboud University Medical Center, Nijmegen, Netherlands (van Garsse, Geuzebroek, Verkroost, Heijmen) Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, Netherlands (Cetinyurek-Yavuz) Department of IQ Health, Section Biostatistics, Radboud University Medical Center, Nijmegen, Netherlands (Thijssen) Liverpool Centre for Cardiovascular Science, Liverpool John Moores University and Liverpool Heart & Chest Hospital, University of Liverpool, Liverpool, United Kingdom (ten Berg) Cardiovascular Research Institute Maastricht (CARIM), Maastricht, Netherlands Publisher John Wiley and Sons Inc Abstract Background: Physical decline after transcatheter aortic valve implantation (TAVI) is associated with worse outcomes. However, data on post-TAVI extremity function are limited. This sub-study of the TAVI XS trial aimed to assess extremity function after transfemoral TAVI, evaluate functional decline, compare outcomes between upper-and lower-extremity secondary access approaches and identify predictors of functional decline after TAVI. Method(s): The TAVI XS was a randomized clinical trial comparing upper- and lower-extremity secondary access during TAVI. Patients were assessed for extremity function at baseline and at 30 days using the Lower Extremity Function Scale (higher score indicating better function) and the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (higher score indicating worse function). Result(s): Lower-extremity (45.0 [IQR 35.0-57.0] to 52.0 [39.0-63.0]; p < 0.001), and upper-extremity function (11.4 [2.3-25.0] to 6.8 [0-22.7]; p = 0.003) improved after TAVI. Relevant decline in lower-extremity function occurred in 20 (8.4%) patients, and in upper-extremity function in 19 (8.0%) patients. No differences in post-TAVI function were observed between upper- or lower-extremity secondary access (lower-extremity: 10.1% vs. 6.7%; p = 0.35, upper-extremity: 7.6% vs. 8.4%; p = 0.81). Predictors (OR [95% CI]) of clinically relevant decline were baseline use of dual antiplatelet therapy/oral anticoagulants (4.17 [1.39-12.49]; p = 0.01) for lower-extremity function and multiple punctures (4.05 [1.46-11.24]; p = 0.007) for upper-extremity function. Age inversely affected lower- (0.92 [0.85-0.99/year]; p = 0.02) and upper-extremity function (0.93 [0.86-0.99/year]; p = 0.04). Conclusion(s): The incidence of clinically relevant decline in extremity function after TAVI is low. No differences in reported extremity function were observed between the upper- and lower-extremity secondary access approach. Predictors of decline were antithrombotic therapy and multiple punctures. Trial Registration: ClinicalTrials.gov identifier: NCT05672823. Copyright © 2026 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. <84> Accession Number 2043477422 Title The role of CMR in the timing of aortic valve interventions and risk stratification in aortic regurgitation: a systematic review and meta-analysis. Source European Heart Journal Cardiovascular Imaging. 27(2) (pp 162-173), 2026. Date of Publication: 01 Feb 2026. Author Bali T.; Gall A.; Bana A.; Pavon A.G.; Ricci F.; Matthews G.; Shah D.J.; Cavalcante J.L.; Naik G.; Garg P. Institution (Bali, Gall, Bana, Matthews, Garg) Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom (Pavon) Division of Cardiology, Ente Ospedaliero Cantonale, Cardiocentro Ticino Institute, Via Tesserete, 48, Lugano, Switzerland (Ricci) Gabriele D'Annunzio University of Chieti and Pescara, Chieti Scalo, Italy (Matthews, Garg) Cardiology Department, Norfolk and Norwich University Teaching Hospitals, Norwich, United Kingdom (Shah) Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, United States (Cavalcante) Department of Cardiology, Minneapolis Heart Institute, Minneapolis, MN, United States (Naik) Cardiology Department, Indraprastha Apollo Hospitals, New Delhi, India Publisher Oxford University Press Abstract Aims Aortic regurgitation (AR) is a prevalent valvular disease. Cardiovascular magnetic resonance (CMR) imaging is emerging as an accurate and precise method for assessing AR. However, its role in guiding interventions and risk stratification for outcomes remains to be fully defined. Objective This systematic review and meta-analysis evaluate the predictive utility of CMR-derived AR fraction (ARF) in determining intervention timing and clinical outcomes. Methods and results A systematic search identified observational studies assessing CMR-derived ARF in AR prognostication. Hazard ratios (HRs) for intervention timing, mortality, and heart failure were pooled using a random-effects model. Study heterogeneity (I2 statistic) was assessed, and publication bias was evaluated using a funnel plot. A total of 1235 studies were screened, with 12 meeting the inclusion criteria. Eight studies (n = 1996 patients) were included in the meta-analysis. ARF severity thresholds ranged from 30 to 43% (mean 33.7%). Follow-up ranged from 2 to 5.1 years. The pooled HR for clinic outcomes with an ARF > 33% was 4.12 (95% CI: 2.31-7.34, P value < 0.01). The highest reported HR was 24.59, while the lowest was 1.04. Studies demonstrated that a higher ARF correlates with an increased risk of adverse outcomes, supporting CMR as a key tool for risk stratification and intervention timing. Conclusion CMR-derived ARF is strongly predictive of clinical outcomes. ARF > 33% is associated with significantly increased risk, warranting its integration into clinical decision-making frameworks. Copyright © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. <85> Accession Number 2042855681 Title Contemporary outcomes of lower extremity vein bypass for chronic limb-threatening ischemia based on a post hoc comparison of the BEST-CLI and PREVENT III multicenter prospective randomized controlled trials. Source Journal of Vascular Surgery. 83(4) (pp 1171-1180), 2026. Date of Publication: 01 Apr 2026. Author Hussain M.A.; Khan A.A.; Menard M.T.; Conte M.S.; Vouyouka A.G.; Doros G.; Strong M.B.; Kalish J.A.; Chew D.; Gasper W.J.; Tan T.-W.; Darling R.C.; LaMuraglia G.; Rosenfield K.; Farber A.; Schanzer A. Institution (Hussain, Menard, Strong) Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States (Hussain) Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, United States (Khan) Warren Alpert Medical School of Brown University, Providence, RI, United States (Conte, Gasper) Division of Vascular & Endovascular Surgery, University of California, San Francisco, CA, United States (Vouyouka) Division of Vascular Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY, United States (Doros) Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States (Kalish, Farber) Division of Vascular & Endovascular Surgery, Department of Surgery, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, MA, United States (Chew) Division of Vascular Surgery, Iowa Heart Center, West Des Moines, IA, United States (Tan) Department of Vascular Surgery, University of Southern California, Los Angeles, CA, United States (Darling) Division of Vascular Surgery, Albany Medical Center Hospital, Albany, NY, United States (LaMuraglia, Rosenfield) Division of Vascular & Endovascular Surgery, Massachusetts General Hospital, Boston, MA, United States (Schanzer) Division of Vascular Surgery, UMass Chan Medical School, Boston, MA, United States Publisher Elsevier Inc. Abstract Background: BEST-CLI (Best Endovascular vs Best Surgical Therapy in Patients with Chronic Limb-Threatening Ischemia [CLTI]) demonstrated the superiority of single-segment great saphenous vein bypass over endovascular treatment for patients with CLTI who were candidates for both treatment strategies. However, with the rise of endovascular techniques and the subsequent decrease in the number of vein bypass procedures being performed, concerns have emerged regarding the continued ability to perform surgical bypass safely and effectively. This study aimed to evaluate whether outcomes after lower extremity infrainguinal vein bypass for CLTI have changed over the past two decades by comparing data from two major randomized controlled trials: BEST-CLI and PREVENT III (Project or Ex-Vivo vein graft Engineering via Transfection III). Method(s): This post hoc comparative analysis included patients with CLTI who underwent lower extremity infrainguinal vein bypass in the multicenter, prospective BEST-CLI (2014-2019) and PREVENT III (2001-2003) trials. The primary outcome was a composite of major adverse limb event (MALE) or death at 1 year. Secondary outcomes included perioperative (30-day) rates of major adverse cardiovascular event (MACE) and MALE. Multivariable Cox and logistic regression models were used for 1-year and 30-day outcomes, respectively, to compare outcomes between the two cohorts; confirmatory analyses were conducted using propensity score methods. Result(s): In total, 2114 patients underwent infrainguinal vein bypass for CLTI (710 BEST-CLI and 1404 PREVENT III). The mean patient age was 67.9 +/- 11.0 years; 32.8% were female. Patients in BEST-CLI had higher use rates of aspirin, statins, and single segment great saphenous vein conduit. The primary end point of 1-year MALE or death was lower in BEST-CLI (21.0%) compared with PREVENT III (37.8%) (adjusted hazard ratio [HR], 0.50; 95% confidence interval [CI], 0.40-0.62; P < .0001)-this observation was consistent across predefined subgroups and in confirmatory analyses using propensity score methods. Major reinterventions (new bypass, surgical revision, thrombectomy, or endovascular intervention for graft occlusion) at 1 year were also lower in BEST-CLI (7.2% vs 18.4%; adjusted HR, 0.40; 95% CI, 0.28-0.57; P < .0001), although rates of any reinterventions were similar (25.8% vs 29.3%; adjusted HR, 0.90; 95% CI, 0.72-1.14; P = .39). Perioperative major cardiovascular and limb events were significantly lower in BEST-CLI: MACE (4.1% vs 7.8%; adjusted OR 0.47; 95% CI, 0.28-0.79; P = .005) and MALE (2.7% vs 6.3%; adjusted OR 0.44; 95% CI, 0.24-0.82; P = .009). Conclusion(s): Over the past two decades, outcomes after lower extremity infrainguinal vein bypass for CLTI have improved significantly. These advances likely reflect a combination of broad improvements in cardiovascular risk management, surgical techniques, and postoperative care for CLTI patients. Copyright © 2025 Society for Vascular Surgery <86> Accession Number 2043855456 Title Rupture of Caseous Calcification of the Mitral Annulus: Pathophysiology, Diagnosis and Treatment. Source Diagnostics. 16(5) (no pagination), 2026. Article Number: 778. Date of Publication: 01 Mar 2026. Author Ruggio A.; Belmusto A.; Locorotondo G.; Ruscio E.; Graziani F.; Lombardo A.; Lanza G.A.; Burzotta F. Institution (Ruggio, Belmusto, Locorotondo, Ruscio, Graziani, Lombardo, Lanza, Burzotta) Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A.Gemelli, IRCCS, Rome, Italy (Lombardo, Lanza, Burzotta) Department of Cardiovascular Sciences-CUORE, Catholic University of the Sacred Heart, Rome, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Caseous calcification of the mitral annulus (CCMA) is a liquefactive necrosis of mitral annular calcification (MAC). CCMA is rare and usually asymptomatic, has a benign course, and, when incidentally found, can be misdiagnosed as a thrombus, abscess, cardiac tumor or vegetation. Although rarely, CCMA may complicate with rupture, which can lead to ventricular-atrial fistulization, pseudoaneurysm, severe mitral regurgitation (with possible heart failure and atrial fibrillation) and systemic embolism of caseous material (with cerebral ischemic events). A significant increase in CCMA dimensions and an infectious involvement of liquefactive necrosis make CCMA prone to rupture. To date, only case reports and some case series have been published on CCMA, without focusing on the pathophysiological mechanisms responsible for rupture, nor recommendations for prevention and management. However, despite general concerns about surgical treatment of CCMA because of high perioperative risks, most published cases actually underwent successful cardiac surgery. In the present review, we conducted a systematic review of the studies published in the medical literature up to March 2025, reporting cases of CCMA and its complications, as identified through the PubMed database. We analyzed clinical and biological risk factors for CCMA rupture and its diagnostic criteria, focusing on imaging features differentiating mitral annular calcification from uncomplicated CCMA and ruptured CCMA. To this regard, we focused on the key role of multimodality imaging in the achievement of the correct diagnosis. Finally, we propose a management strategy for CCMA, with the aim to fill a gap in this field in the current literature. 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. <88> Accession Number 2044443433 Title A systematic review of the relationship between race and health-related quality of life outcomes in patients with advanced heart failure who undergo heart transplantation or mechanical circulatory support. Source Quality of Life Research. 35(5) (no pagination), 2026. Article Number: 106. Date of Publication: 01 May 2026. Author Dixon-Evans J.; Briley A.; Way J.S.; Clay S.; Mazurek K.; Wafford Q.E.; Vela A.M.; Grady K.L. Institution (Dixon-Evans, Vela, Grady) Department of Surgery, Division of Cardiac Surgery, Northwestern University, Feinberg School of Medicine, 676 North Saint Clair Street, Arkes Pavilion, Suite 730, Chicago, IL, United States (Briley, Clay, Mazurek) College of Health and Human Sciences, Northern Illinois University, Wirtz Hall, 323, DeKalb, IL, United States (Way) Department of Physical Therapy and Health Science, Bradley University, Campustown 170, 1501 W. Bradley Ave., Peoria, IL, United States (Wafford) Feinberg School of Medicine, Northwestern University, 320 E. Superior Street, Chicago, IL, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Purpose: Health inequalities may disproportionately affect health-related quality of life (HRQOL) in patients with heart failure who identify as a racial or ethnic minority and undergo advanced surgical therapies. Objectives of this systematic review were to determine the impact of race on HRQOL of adults who undergo heart transplantation (HT) or durable mechanical circulatory support (MCS), while awaiting HT or long-term, and whether race is a risk factor for worse HRQOL. Method(s): A synthesis framework was used following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Medical Subject Headings was applied to search engines. Peer reviewed articles (English) published prior to 1/5/25, examining associations between race & HRQOL of adults who underwent HT and/or MCS, were included. Excluded were systematic reviews, editorials/opinions, case series/reports, grey literature, qualitative research, and case-control studies. Risk of bias was assessed using Joanna Briggs Institute checklists and the Cochrane Risk-of-Bias tool. Result(s): Among 2,902 identified records, eight studies met inclusion criteria (HT: n = 4; MCS: n = 3; and HT and MCS: n = 1). Participants' mean age = 57 years; the majority were White (80%) and male (78%). Risk of bias varied by study. Race did not impact HRQOL in 50% of HT studies. HRQOL improved with MCS in all studies; however, compared to White patients, Black patients experienced less improvement in HRQOL. Conclusion(s): HRQOL measures were not comparable. Thus, a meta-analysis was not performed which is a study limitation. Racial differences in HRQOL may exist among adults who undergo HT and/or MCS; more research is needed. Copyright © The Author(s) 2026. <89> Accession Number 650858325 Title Effect of preoperative prehabilitation in adults undergoing cardiac surgery on physical status and perioperative complications: a systematic review and meta-analysis. Source Minerva anestesiologica. (no pagination), 2026. Date of Publication: 09 Apr 2026. Author Gil-Casado C.; Fernandez-Vazquez U.; Luna-Rojas P.; Diaz-Vidal P.; Diz-Ferreira E.; Diz J.C. Institution (Gil-Casado, Fernandez-Vazquez, Luna-Rojas, Diaz-Vidal) School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain (Diz-Ferreira) Well-Move Research Group, School of Medicine, University of Vigo, Vigo, Spain (Diz) Department of Anesthesia and Postoperative Critical Care, Alvaro Cunqueiro Hospital, Vigo, Spain (Diz) Department of Functional Biology and Health Sciences, Well-Move Research Group, University of Vigo, Vigo, Spain Abstract INTRODUCTION: Many patients scheduled for cardiac surgery have low cardiorespiratory fitness, which is associated with increased perioperative morbidity and mortality. There is limited evidence to suggest that prehabilitation can reduce perioperative complications. The objective was to evaluate the impact of prehabilitation comprising physical exercise on the cardiorespiratory fitness of cardiac patients, and on quality of life, hospital stay, postoperative complications and mortality. EVIDENCE ACQUISITION: A systematic review and meta-analysis, following the PRISMA statement, encompassing randomized controlled trials on prehabilitation for adult patients undergoing cardiac surgery. The protocol was pre-registered on Open Science Framework. EVIDENCE SYNTHESIS: We included eight studies comprising 894 patients. The prehabilitation group exhibited a greater improvement in preoperative six-minute walk test than the control group (MD 36.65 m; 95% CI 1.72, 71.58; P=0.04). The number of patients demonstrating a clinically relevant improvement was not significantly different between the groups (OR 1.86; 95% CI 0.82, 4.21). The prehabilitation group exhibited a shorter hospital stay (MD -1.01 days; 95% CI -2, -0.02; P=0.04). No differences were observed in other outcomes. Overall, the certainty of the evidence was low. CONCLUSION(S): Our findings suggest an association between prehabilitation and preoperative enhancement in cardiorespiratory fitness. However, the effect size is modest and may have marginal clinical significance. It remains unclear whether prehabilitation can improve clinical outcomes beyond the reduction of hospital length of stay. Further research is required to provide evidence of the efficacy of these programs. <90> [Use Link to view the full text] Accession Number 650858160 Title Randomized Controlled Trial of the Psychological and Clinical Outcomes of Reiki Plus Manual Therapy After Open Heart Surgery. Source The Journal of cardiovascular nursing. (no pagination), 2026. Date of Publication: 09 Apr 2026. Author Zampino S.; Hosler R.; Brown K.; Hamm A.; Deran B.; Bena J.F.; Morrison S.L.; Murray T.; Vandenbossche R.; Bakaeen F.; Albert N.M. Institution (Zampino) Sandra Zampino, BSN, Heart, Vascular and Thoracic Institute, Nursing Institute, Cleveland Clinic, RN, OH, United States (Hosler) BSN, Healing Solutions Coordinator, Quality and Patient Safety Institute, Cleveland Clinic Hillcrest Hospital, Mayfield Heights, RN, OH, United States (Brown) BSN, Clinical Nurse, Cardiothoracic Surgery Stepdown, Nursing Institute, Cleveland Clinic, RN, OH, United States (Hamm) BSN, Healing Solutions Coordinator, Quality and Patient Safety Institute, Cleveland Clinic, RN, OH, United States (Deran) BSN, Clinical Nurse, Cardiovascular Surgery Intensive Care Unit, Nursing Institute, Cleveland Clinic, RN, OH, United States (Bena) James F. Bena, MS, Biostatistician, Quantitative Health Sciences, Cleveland Clinic, Ohio (Morrison) Shannon L. Morrison, MS, Statistical Programmer, Quantitative Health Sciences, Cleveland Clinic, Ohio (Murray) MSN, Chief Nursing Officer, Nursing Institute, Cleveland Clinic South Pointe Hospital, RN, OH, United States (Vandenbossche) Rosslyn Vandenbossche, MBA, Heart, Vascular and Thoracic Institute, Nursing Institute, Cleveland Clinic, RN, OH, United States (Bakaeen) Faisal Bakaeen, MD, Cardiothoracic Surgeon, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Ohio (Albert) Nancy M. Albert, CCNS, CCRN, FAAN, Executive Director/Associate Chief Nursing Officer-Research and Innovation, Nursing Institute, Cleveland Clinic Health System, FAHA, OH, United States Abstract BACKGROUND: Reiki plus manual therapy are utilized to improve relaxation, sleep, emotional state, and pain. Evidence within hospital settings was limited, and previous studies had weak designs. OBJECTIVE(S): The purpose of this study was to examine the effects of Reiki plus manual therapy on depression, anxiety, sleep, postoperative pain, atrial fibrillation, hospital length of stay, and 30-day rehospitalization after open heart surgery. METHOD(S): Using a 2-group randomized controlled trial design, patients were randomized to 20 minutes of nurse-delivered Reiki to 5 body areas plus manual therapy to the head and feet or quiet time for 3 consecutive days. Analyses included analysis of covariance, Poisson regression and logistic regression models. RESULT(S): Among 272 patients (136/group), the mean (SD) age was 62.2 (12.2) years, and 75.4% were male. After adjusting for having a coronary artery bypass graft procedure, there were no between-group differences in change in depression, anxiety, or sleep (P = .21; P = .13; or P = .20, respectively), mean postoperative pain (P = .91), hospital length of stay (P = .92), intensive care length of stay (P = .67), and new onset atrial fibrillation (P = .59). There was no difference in the odds (95% confidence interval) of 30-day rehospitalization after Reiki plus manual therapy compared with usual care (0.31 [0.10, 1.01], P = .051); however, adjusted probabilities were low in both groups: Reiki plus manual therapy: 0.02 (95% confidence interval [CI]: 0.01-0.06) and usual care: 0.06 (95% CI: 0.03-0.13). CONCLUSION(S): When compared with 20 minutes of quiet time, postoperative Reiki plus manual therapy did not change clinical outcomes. Future research with different intervention steps and methods is needed to understand Reiki plus manual therapy effects on postoperative depression, anxiety, pain, and other clinical outcomes. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <91> Accession Number 2044843502 Title Best evidence summary for exercise adherence management in outpatient rehabilitation following coronary artery bypass graft surgery. Source Heart and Lung. 78 (no pagination), 2026. Article Number: 102787. Date of Publication: 01 Jul 2026. Author Xiu M.; Wang H.; Zhang M.; Yang F.; Wang C.; Zhang W. Institution (Xiu, Wang, Yang, Wang) Tongji University School of Medicine, Shanghai, China (Xiu, Wang, Zhang, Yang, Wang, Zhang) Department of Nursing, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China (Zhang) School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China Publisher Elsevier Inc. Abstract Background: Coronary artery bypass grafting (CABG) is a common procedure for treating coronary artery disease. Exercise rehabilitation is essential for secondary prevention, but patient adherence remains low. High-quality evidence is needed to guide effective adherence management strategies. Objective(s): To evaluate and summarize the existing evidence on adherence management in phase II exercise rehabilitation following CABG, providing a foundation for the development of evidence-based clinical practice. Method(s): Following the 6S pyramid model, a comprehensive top-down search was conducted to retrieve evidence related to adherence management in phase II exercise rehabilitation following CABG. The literature types included clinical decisions, guidelines, expert consensus, systematic reviews, evidence summaries, and the latest randomized controlled trials. The search period ranged from July 2015 to July 2025. Two researchers trained in evidence-based nursing graded the evidence according to the Joanna Briggs Institute evidence pre-classification and evidence recommendation level system (2014 version). Result(s): A total of 19 high-quality studies were included, from which 26 pieces of evidence were summarized. These pieces of evidence covered five aspects: overall approach, exercise plan, patient education, feedback and supervision, and management of special populations. Key strategies consistently highlighted included establishing a multidisciplinary rehabilitation team and a structured follow-up pathway, delivering individualized and progressive exercise prescriptions, providing multimodal education to enhance patients' understanding and self-efficacy, and strengthening monitoring/feedback mechanisms to support sustained self-management. Collectively, these strategies may facilitate long-term exercise adherence during phase II rehabilitation and improve the continuity and safety of post-discharge care. Conclusion(s): Evidence supports a comprehensive, integrated phase II exercise adherence-management approach for post-CABG patients, emphasizing multidisciplinary collaboration, individualized progressive exercise prescription, multimodal education, and monitoring/feedback to promote sustained self-management and adherence. Strategies should be adapted to local resources and vulnerable groups. Future research should validate these strategies in CABG-specific populations and evaluate implementation feasibility and cost-effectiveness using standardized adherence outcomes. Protocol Registration: http://ebn.nursing.fudan.edu.cn/registerResources, identifier ES20246232. Copyright © 2026 <92> Accession Number 650857004 Title From fast track to ultrafast track extubation in cardiac surgery: a systematic review. Source Minerva anestesiologica. (no pagination), 2026. Date of Publication: 09 Apr 2026. Author Silvetti S.; Fresilli S.; Abelardo D.; Ajello V.; Aloisio T.; Capuano P.; Guarracino F.; Labanca R.; Landoni G.; Lobdell K.W.; Meani P.; Pieri M.; Ranucci M.; Sepolvere G.; Toscano A.; Scolletta S.; Stoppe C.; Weltert L.; Zarbock A.; Paternoster G. Institution (Silvetti) Department of Cardioanesthesia and Intensive Care, Cardiovascular Network, IRCCS Ospedale Policlinico San Martino, Genoa, Italy (Fresilli, Labanca, Landoni, Pieri) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Abelardo) Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy (Ajello) Department of Cardiac Anesthesia, Tor Vergata University Hospital, Rome, Italy (Aloisio, Ranucci) Department of Cardio-Thoraco-Vascular Anesthesia and Intensive Therapy, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (Capuano) IRCCS ISMETT, Palermo, Italy (Capuano) UPMC Italy, Palermo, Italy (Guarracino) Department of Medical, Oral and Biotechnological Sciences "Gabriele d'Annunzio" University, Chieti, Italy (Landoni, Pieri) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Lobdell) Sanger Heart and Vascular Institute, Advocate Health, Charlotte, NC, USA (Meani) Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands (Sepolvere) Intensive Care Unit, Department of Anesthesia and Cardiac Surgery, San Michele Hospital, Caserta, Italy (Toscano) Department of Anesthesia and Intensive Care, ASL TO4, Ivrea Hospital, Ivrea, Turin, Italy (Scolletta) Department of Medicine, Surgery and Neurosciences, Anesthesia and Intensive Care Unit, University Hospital of Siena, Siena, Italy (Stoppe) Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital, Wurzburg, Germany (Stoppe) Department of Cardiac Anesthesiology and Intensive Care Medicine, Berlin, Germany (Stoppe, Zarbock) UTHealth, Center for Outcomes Research and Department of Anesthesiology, Houston, TX, United States (Weltert) Saint Camillus International University for Health Science, Rome, Italy (Zarbock) Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Munster, Munster, Germany (Paternoster) Department of Health Science, Anesthesia and Intensive Care Unit, San Carlo Hospital, University of Basilicata Potenza, Italy Abstract INTRODUCTION: This study aimed to evaluate interventions that facilitate rapid extubation in adult cardiac surgery patients, defined as extubation within six hours, three hours, or one hour post-surgery. Early extubation is a critical component of enhanced recovery pathways in cardiac surgery and plays an essential role in improving patient outcomes. Several strategies have been investigated, including the use of locoregional anesthesia techniques, dexmedetomidine, and adaptive support ventilation. EVIDENCE ACQUISITION: A systematic review of randomized controlled trials (RCTs) was conducted, searching the Medline, Central, and Embase databases from January 2015 to May 2025. Studies were included if they compared interventions for rapid extubation and achieved extubation within at least one study group for more than 75% of patients. Fifty-seven trials were included in the review. EVIDENCE SYNTHESIS: Out of the 57 trials, 42 studies reported extubation within six to three hours post-surgery. These results were predominantly associated with locoregional anesthesia techniques, particularly fascial blocks, as well as dexmedetomidine use and adaptive support ventilation. Eleven studies reported extubation within three hours and one hour, with the majority of these trials also involving fascial blocks. Among the 57 studies, four focused specifically on ultrafast track strategies. Notably, only one study assessing the erector spinae plane block achieved extubation within one hour in over 75% of patients, with a median extubation time of 10 minutes (range 10-120 minutes), compared to 60 minutes (range 10-225 minutes) in the control group (P=0.06). CONCLUSION(S): While ultrafast extubation is currently limited to select patients, it appears to be safe and effective when carefully applied. The study supports the use of various interventions for facilitating rapid extubation and highlights the importance of individualized patient selection. Further high-quality trials are needed to identify the most effective combinations of these interventions and to standardize protocols for broader clinical practice. <93> Accession Number 2044831315 Title Free Versus In situ Right Internal Mammary Artery as a Conduit in Coronary Artery Bypass Surgery: A Meta-Analysis. Source Interdisciplinary Cardiovascular and Thoracic Surgery. 41(4) (no pagination), 2026. Date of Publication: 01 Apr 2026. Author Kikuchi Y.; Sakata T.; Shimoda T.; Fukuhara S.; Shimamura J.; Hibino M.; Kaneko T.; Takayama H.; Takagi H.; Sa M.P.; Kuno T. Institution (Kikuchi) Department of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, United States (Sakata) Department of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, United States (Shimoda) United States Naval Hospital Yokosuka, Kanagawa, Yokosuka, Japan (Fukuhara) Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, United States (Shimamura) Division of Cardiothoracic Surgery, Westchester Medical Center, Valhalla, NY, United States (Hibino) Division of Cardiothoracic Surgery, Westchester Medical Center, Valhalla, NY, United States (Kaneko) Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO, United States (Takayama) Division of Cardiothoracic and Vascular Surgery, Columbia University Irving Medical Center, New York, NY, United States (Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center, Japan (Sa) Department of Cardiothoracic Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic Florida, Weston, FL, United States (Kuno) Cardiology Division, Massachusetts General Hospital Harvard Medical School, Boston, MA, United States (Kuno) Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States Publisher Oxford University Press Abstract Abstract Objectives There is debate regarding the optimal choice for a second conduit in coronary artery bypass grafting. The right internal mammary artery (RIMA) is commonly employed as a second conduit; however, it is unclear whether the free (fRIMA) or in situ (isRIMA) configuration yields superior outcomes. We performed a systematic review and meta-analysis to compare clinical outcomes between fRIMA and isRIMA as the second conduit. Methods A comprehensive search of PubMed (MEDLINE), EMBASE, and CENTRAL was performed through May 2025 to identify studies comparing outcomes in patients undergoing coronary artery bypass grafting with either fRIMA or isRIMA as a second conduit. The outcomes of interest were overall mortality, graft occlusion, major adverse cardiac events (MACE), and repeat revascularization. Data with 95% confidence intervals (CIs) were extracted. Pooled analysis was performed using a random-effects model. Results A total of 13 studies with 9899 patients were included (fRIMA, n = 3095; isRIMA, n = 6804). The median study follow-up duration ranged from 1 to 20 years across the studies. No statistically significant differences were observed in overall mortality (hazard ratio [95% CI] = 1.16 [0.79-1.69]), graft occlusion (1.04 [0.90-1.21]), MACE (0.87 [0.62-1.21]), and repeat revascularization (1.34 [0.68-2.66]). Conclusions In this meta-analysis, no statistically significant differences were observed between fRIMA and isRIMA configurations across the evaluated clinical outcomes. These findings suggest that, within the limitations of available evidence, the choice between fRIMA and isRIMA may be guided by clinical context, surgeon preference, patient anatomy, and target vessel characteristics rather than expected differences in major clinical outcomes. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. <94> Accession Number 2044662847 Title The effect of adding a second multimodal analgesic component to anesthesia regimens on acute postoperative pain outcomes: a systematic review and meta-analysis. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 225. Date of Publication: 01 Dec 2026. Author van Eijk L.T.; van den Heuvel S.A.S.; van Boekel R.L.M.; van der Meer R.; Bruhn J.; Wever K.E. Institution (van Eijk, van den Heuvel, van Boekel, van der Meer, Bruhn, Wever) Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, P.O. box 9101, Geert Grooteplein Zuid 10, Nijmegen, Netherlands Publisher BioMed Central Ltd Abstract Background: Postoperative pain remains a common clinical challenge, affecting patient recovery, satisfaction, and risk of chronic pain. Conventional analgesics often inadequately address the multifactorial nature of postoperative pain, while opioids carry risks of adverse effects and dependence. Multimodal analgesia, combining agents with complementary mechanisms, aims to improve pain control and reduce opioid consumption, but the incremental benefit of adding a second component is unclear. Objective(s): To evaluate whether adding a second multimodal analgesic component to conventional regimens improves postoperative pain control and reduces opioid consumption in adult patients undergoing non-cardiac surgery. Method(s): We performed a systematic review and meta-analysis of randomized controlled trials. PubMed and EMBASE (via Ovid) were searched for eligible studies up to August 2, 2024, using search terms related to surgical patients, pain, multimodal analgesia, and ten common multimodal components. We included RCTs in adults (>= 18 years) undergoing non-cardiac surgery under general anesthesia, comparing standard care plus two multimodal components versus one component, with postoperative opioid consumption measured and pain measured by numeric rating scale (NRS) or visual analog scale (VAS). Result(s): Twenty-seven trials were included. Meta-analysis of 17 trials (24 comparisons) showed that a second multimodal component reduces 24-hour opioid consumption by 5.2 mg oral morphine equivalents (95% CI[-7.7, -2.7]; p < 0.01; I2 = 99%). Nineteen trials (29 comparisons) reported reduced pain scores at 4 h postoperatively by -0.5 points (95% CI[-0.8, -0.2]; I2 = 94%). However, heterogeneity was very high. Subgroup analyses did not reveal a superior multimodal component. Adverse events were generally comparable, with some reductions in postoperative nausea and vomiting. Data on long-term outcomes and quality of recovery were limited. Conclusion(s): Adding a second multimodal analgesic component may modestly improve acute postoperative pain control and may reduce opioid consumption. Further research is needed to determine optimal combinations for specific surgical settings, to systematically evaluate associated adverse effects and to assess long-term outcomes including chronic pain prevention. Copyright © The Author(s) 2026. <95> Accession Number 650857030 Title From Caging to Uncaging With Bioadaptors: A Novel Paradigm in Coronary Revascularization. Source Journal of the American Heart Association. (pp e041843), 2026. Date of Publication: 09 Apr 2026. Author Mazzone P.M.; Spagnolo M.; Finocchiaro S.; Mauro M.S.; Di Leo G.; Capodanno D. Institution (Mazzone, Spagnolo, Finocchiaro, Mauro, Di Leo, Capodanno) Division of Cardiology Azienda Ospedaliero-Universitaria Policlinico "G. Rodolico - San Marco" University of Catania Catania Italy, Italy Abstract The evolution of percutaneous coronary intervention has improved the outcomes of patients with coronary artery disease, but conventional drug-eluting stents remain limited by late adverse events, reduced vessel compliance, and the inability to restore physiological function. The DynamX coronary bioadaptor aims to address these issues by combining the mechanical performance of drug-eluting stents with a bioadaptive mechanism that restores natural vessel motion. The device features a cobalt-chromium scaffold connected by bioresorbable polymer elements that degrade 6 months after implantation. This process unlocks helical strands, enabling vessel pulsatility, compliance, and adaptive remodeling while maintaining lumen integrity. Preclinical studies demonstrated reduced vessel stress and restored physiological rotational motion. In the DYNAMIX (12-Month Clinical and Imaging Outcomes of the Uncaging Coronary DynamX Bioadaptor System) study, patients exhibited increased vessel area without lumen loss, optimal strut apposition, and complete neointimal coverage at 12 months. The small BIOADAPTOR-RCT (Randomized Controlled Trial of Sirolimus-Eluting Bioadaptor Versus Zotarolimus-Eluting Drug-Eluting Stent) showed noninferiority to drug-eluting stents with superior late lumen preservation and reduced neointimal hyperplasia. The larger INFINITY-SWEDEHEART (Percutaneous Coronary Intervention With a Bioadaptor Compared to a Contemporary Drug-Eluting Stent) trial confirmed low target-lesion failure rates and a plateauing of adverse events after 6 months, highlighting the benefits of vessel motion restoration. The DynamX coronary bioadaptor may represent a significant advancement in percutaneous coronary intervention by providing early mechanical support and restoring vessel function. Further studies on complex anatomy and long-term outcomes are needed to further define its role in interventional cardiology. <96> Accession Number 2044442814 Title Quality of life during electronic patient-reported outcome (ePRO) monitoring in thoracic surgery patients: a pilot randomized controlled trial. Source Quality of Life Research. 35(5) (no pagination), 2026. Article Number: 118. Date of Publication: 01 May 2026. Author Cox C.E.; Deal A.M.; Wang M.; Williams B.; Gentry A.L.; Hoch C.; Schlusser C.; Shrestha S.; Boisson-Walsh A.; Kurz C.; Happ M.; Bright A.; Hill L.; Coleman J.; Long J.; Haithcock B.; Bennett A.V.; Basch E.; Mody G.N. Institution (Cox, Gentry, Kurz, Happ, Hill, Coleman, Long, Haithcock, Mody) Department of Cardiothoracic Surgery, University of North Carolina, Burnett-Womack Building Suite 3041 Campus Box 7065, Chapel Hill, NC, United States (Deal, Wang, Bennett, Basch, Mody) Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States (Williams) Department of Cardiothoracic Surgery, Emory University, Atlanta, GA, United States (Hoch, Bennett) Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States (Schlusser) GlaxoSmithKline, Durham, NC, United States (Shrestha) Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States (Boisson-Walsh) Division of Infectious Diseases, Center for Emerging Pathogens, New Jersey Medical School, Rutgers University, Newark, NJ, United States (Bright) University of North Carolina School of Medicine, Chapel Hill, NC, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Purpose: Patients undergoing thoracic surgery experience high symptom burden and negative impacts on postoperative health-related quality of life (HRQOL). Remote symptom monitoring using electronic patient-reported outcomes (ePROs) in other patient populations improves HRQOL but may increase workload for surgical providers. We evaluated the feasibility of ePRO use by thoracic surgery patients and providers as well as its impact on HRQOL. Method(s): In this single center randomized controlled trial, thoracic surgery patients were assigned to either ePROs with alerts to their providers for severe symptoms or ePROs for measurement only, for 90 days after hospital discharge. Primary outcomes were feasibility (measured by patient survey completion) and change in postoperative HRQOL, assessed using the EORTC QLQ-C30 and LC-13 instruments. We also assessed symptom burden, health care utilization during ePRO use, and provider management of alerts. Result(s): A total of 113 patients planned for thoracic surgery were randomized to ePROs with alerts (n = 56) vs. ePRO measurement (n = 57) only. Of these, 99 participants were discharged from the hospital using postoperative ePROs. More surveys were completed in the alerting arm (61.9% vs. 52.8%, p<0.001, h=0.18). HRQOL at 2 months (social and role function, summary score) was improved in the ePRO with alerts arm, and emotional function at 12 months was improved in the ePRO measurement only arm. Conclusion(s): Remote symptom monitoring using ePROs with alerts is feasible for thoracic surgery patients and providers. Short-term HRQOL may be improved with ePROs with alerts. The downstream impact of ePRO use on long-term HRQOL and other outcomes requires further study. Trial registration: https://Clinicaltrials.gov NCT04342260. Copyright © The Author(s) 2026. <97> [Use Link to view the full text] Accession Number 2043620788 Title Artificial intelligence in cardiothoracic monitoring and echocardiography. Source Current Opinion in Anaesthesiology. Publish Ahead of Print (no pagination), 2025. Date of Publication: 03 Dec 2025. Author Bryant J.M.; Jelly C.A.; Kertai M.D. Institution (Bryant, Jelly, Kertai) Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, United States Publisher Lippincott Williams and Wilkins Abstract Purpose of review - This review describes the recent advancements of artificial intelligence (AI) in cardiothoracic anesthesia monitoring. Recent findings - The application of AI in cardiothoracic anesthesia monitoring has potential to affect all phases of perioperative care - from preoperative testing and risk stratification to postoperative evaluation and advances in echocardiography image acquisition and interpretation. While these developments are promising, they remain in the early stages of clinical integration and validation. Summary - Advances in machine learning and natural language processing are expected to play an increasingly significant role in the monitoring and management of cardiothoracic surgery patients. As these technologies evolve, they hold the potential to enhance the precision, efficiency, and personalization of care. However, as AI becomes more integrated into clinical decision-making, it is imperative that care models remain grounded in the core principles of patient-centeredness and safety. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <98> [Use Link to view the full text] Accession Number 2043620841 Title Will prothrombin complex concentrate replace plasma in cardiac surgical bleeding in North America?. Source Current Opinion in Anaesthesiology. Publish Ahead of Print (no pagination), 2025. Date of Publication: 04 Dec 2025. Author Bartoszko J.; Gabarin N.; Tanaka K.; Callum J. Institution (Bartoszko) Department of Anesthesia and Pain Management, University Health Network, Sinai Health, Women's College Hospital, University of Toronto, Canada (Bartoszko) Peter Munk Cardiac Centre and Toronto General Hospital Research Institute, University Health Network, Canada (Bartoszko) Departments of Anesthesiology and Pain Medicine, Canada (Gabarin) Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada (Tanaka) Department of Anesthesiology, University of Oklahoma Health, Oklahoma City, OK, United States (Callum) Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre and Queen's University, Kingston, ON, Canada Publisher Lippincott Williams and Wilkins Abstract Purpose of review - There is increasing interest in four-factor prothrombin complex concentrate (4F-PCC) for treatment of acquired coagulopathic bleeding in cardiac surgery. Plasma, traditionally the treatment of choice, has a different composition compared with 4F-PCC. This review summarizes the current evidence. Recent findings - Because of its rapid reconstitution at the bedside and small administration volume, the use of 4F-PCC over plasma is rising - particularly with new clinical trial evidence suggesting 4F-PCC has efficacy and safety advantages. This is reinforced by mechanistic evidence supporting the role of 4F-PCC in normalizing or improving thrombin generation, an important aspect of secondary hemostasis often impacted in cardiac surgery. Four randomized controlled trials contribute to the human evidence base for the use of 4F-PCC in cardiac surgery. FARES-II, the largest study to date, demonstrated that 4F-PCC has improved hemostatic efficacy and a superior safety profile compared with plasma. Three additional studies are underway to confirm these findings. Summary - The use of 4F-PCC for the treatment of coagulopathic bleeding in cardiac surgery is supported by high-quality clinical evidence. Several unanswered questions remain regarding sex- and race-specific efficacy, the mechanism through which 4F-PCC may reduce serious adverse events, and its use in procedures that were under-represented in existing clinical trials. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <99> Accession Number 2037918095 Title Zero-Balance Ultrafiltration Reduces Postoperative Delirium After Cardiac Surgery with Cardiopulmonary Bypass: A Randomized Controlled Trial. Source Therapeutics and Clinical Risk Management. 21 (pp 1807-1819), 2025. Date of Publication: 2025. Author Lan X.; Tang S.; Lu J.; Tang G.; Shao Y.; Zhu Z.; Zhou K.; Xiong X.; Chen D.; Shi J. Institution (Lan, Tang, Lu, Tang, Shao, Zhu, Zhou, Xiong, Shi) Department of Anesthesiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China (Lan) Department of Anesthesiology, The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China (Chen) Department of Anesthesiology, West China Second Hospital, Chengdu, China (Chen) Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China Publisher Dove Medical Press Ltd Abstract Purpose: To assess the effects of conventional ultrafiltration and conventional plus zero-balanced ultrafiltration on delirium and cognition in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Method(s): A total of 116 adults who were scheduled for cardiac surgery with CPB were randomly assigned to the conventional ultrafiltration group or the conventional plus zero-balanced ultrafiltration group. CPB was managed with standard protocols. In the conventional ultrafiltration group, ultrafiltration began during the rewarming phase and was performed until the CPB was terminated. In another group, perfusionists conducted zero-balance ultrafiltration after aortic cross-clamping and began conventional ultrafiltration during the rewarming phase. The primary outcome was the incidence of postoperative delirium (POD) within 7 days; the secondary outcome was postoperative cognitive dysfunction (POCD) at 1 and 3 months. In addition, the patients' vital signs and postoperative complications at different points during the operation were also recorded. Result(s): During the first 7 postoperative days, POD was observed in 12 patients in the zero-balance ultrafiltration group and 27 patients in the conventional ultrafiltration group (12/53 [22.64%] vs 27/53 [50.94%]; RR 0.45, 95% CI 0.25 to 0.78; P = 0.005). At 1 month after surgery, POCD occurred in 12 patients in the zero-balance ultrafiltration group versus 18 patients in the conventional ultrafiltration group (12/53 [22.64%] vs 18/53 [33.96%]; RR = 0.67; 95% CI 0.36-1.24; P = 0.281). By 3 months postoperatively, postoperative cognitive dysfunction occurred in 4 patients in the zero-balance ultrafiltration group and 7 patients in the conventional ultrafiltration group (4/53 [7.55%] vs 7/53 [13.21%]; RR = 0.57; 95% CI 0.18-1.84; P = 0.524). Conclusion(s): In patients who underwent cardiac surgery with CPB, zero-balance ultrafiltration significantly reduced the incidence of delirium compared with conventional ultrafiltration alone within the first 7 postoperative days. In contrast, the incidence of cognitive dysfunction did not differ significantly between the two groups at 1 or 3 months postoperatively. Copyright © 2025 Lan et al. This work is published and licensed by Dove Medical Press Limited. <100> Accession Number 2044616828 Title "Real-world prognostic performance of different severe and advanced heart failure definitions: Data from the Swedish Heart Failure Registry". Source Journal of Heart and Lung Transplantation. (no pagination), 2026. Date of Publication: 2026. Author Guidetti F.; Lund L.H.; Benson L.; Hage C.; Lindberg F.; Basile C.; Villaschi A.; Musella F.; Stolfo D.; Scorza R.; Baudry G.; Ljungman C.; Braun O.; Valente V.; Bozkurt B.; Metra M.; Savarese G. Institution (Guidetti, Benson, Lindberg, Basile, Villaschi, Musella, Stolfo, Scorza, Valente, Savarese) Department of Clinical Science and Education, Sodersjukhuset; Karolinska Institute, Stockholm, Sweden (Guidetti) Department of Cardiology, University Cardiovascular Center, Bern University Hospital, Inselspital, Bern, Switzerland (Lund, Benson, Hage) Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden (Villaschi) Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy (Musella) Cardiology Department, Santa Maria delle Grazie Hospital, Naples, Italy (Stolfo) Division of Cardiology, Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy (Baudry) Universite de Lorraine, INSERM, Centre d'Investigations Cliniques Plurithematique, INSERM 1433, CHRU de Nancy, Institut Lorrain du Coeur et des Vaisseaux, Nancy, France (Baudry) REICATRA, Universite de Lorraine, Vandoeuvre-les-Nancy, France (Ljungman) Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (Braun) Department of Clinical Sciences, Lund University and Skane University Hospital, Lund, Sweden (Bozkurt) Winters Center for Heart Failure Research, Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, United States (Metra) Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy Publisher Elsevier Inc. Abstract Background A valid definition of severe heart failure (HF) is essential for earlier identification, timely referral for advanced therapies, and to optimize clinical trial design. Objectives To assess the prevalence, prognostic performance, and 1-year outcomes associated with different definitions of severe and advanced HF (AdvHF) in patients with heart failure with reduced ejection fraction (HFrEF). Methods We included 15,153 patients with EF '40%, HF duration '6 months, and no prior left ventricular assist device or heart transplant, from the Swedish Heart Failure Registry. Several definitions of severe/AdvHF were evaluated: a simplified Heart Failure Association (HFA) definition (NYHA III-IV, EF '30%, >=2 HF hospitalizations in 12 months), the GALACTIC-Severe-definition (NYHA III-IV, EF '30%, >=1 hospitalization in 6 months), and variations adding/removing criteria such as NT-proBNP levels and diuretic dose to the HFA-AdvHF definition. Predictive performance and 1-year outcomes were analyzed. Results The HFA-definition identified 6.4% of patients, with a 1-year cardiovascular death/HF hospitalization risk of 70% and all-cause mortality of 45% (AUC = 0.72). The GALACTIC-Severe definition identified 12.6% of patients with slightly lower but still substantial event rates (59% and 38%, respectively; AUC = 0.73). Definitions incorporating NT-proBNP >=2000 pg/ml had the highest prognostic accuracy (AUC = 0.75). Conclusions The HFA-AdvHF definition selected a smaller, high-risk group, while the GALACTIC-Severe criteria identified a broader population, with a lower, but still high risk. NT-proBNP, HF hospitalization history, and diuretic dose might represent valuable enrichment tools for future trials. Copyright © 2026 The Authors. <101> Accession Number 650843846 Title High-Flow Nasal Oxygen Therapy After Cardiac Surgery: A Randomized Clinical Trial. Source JAMA network open. 9(4) (pp e265447), 2026. Date of Publication: 01 Apr 2026. Author Litton E.; Parke R.L.; McGuinness S.P.; Dawson S.N.; Villar S.S.; Shetty S.S.; Fox-Rushby J.A.; Coombes J.; Norman R.; Murphy G.J.; Affandi J.S.; Ahmed A.B.; Bottrill F.E.; Chiu Y.-D.; Churchill L.J.; Dash S.K.; Delaney A.P.; Duckworth M.J.P.; Earwaker M.J.; Evans C.R.; Hoppington A.J.; Kunst G.; Maiorana A.J.; Martinez G.; McDonald A.; Mohammed A.A.; Orford N.R.; Pilcher D.V.; Ramanan M.; Reid C.M.; Senthuran S.; Shaw M.W.; Shelley B.G.; Singh H.; Steele C.J.M.; Temple E.B.; Veltman-Grisenthwaite M.W.M.; Yadav S.; Zimbler N.; Zochios V.; Klein A.A. Institution (Litton) Intensive Care Unit, Fiona Stanley Hospital, Perth, Australia (Litton, Norman, Affandi, Reid) Curtin School of Population Health, Curtin University, Perth, Australia (Parke, McGuinness) Cardiothoracic and Vascular Intensive Care Unit, Auckland, New Zealand (Parke) School of Nursing, University of Auckland, Auckland, New Zealand (Dawson, Villar, Shetty, Fox-Rushby, Bottrill, Chiu, Duckworth, Earwaker, Mohammed, Steele, Temple) Papworth Trials Unit Collaboration, Royal Papworth Hospital NHS (National Health Service) Foundation Trust, Cambridge, United Kingdom (Dawson, Villar) MRC (Medical Research Council) Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom (Shetty, Fox-Rushby) Department of Population Health Sciences, King's College London, London, United Kingdom (Coombes) George Institute for Global Health, Sydney, Australia (Murphy) College of Life Sciences, University of Leicester, Glenfield Hospital Leicester, Leicester, United Kingdom (Ahmed, Zochios) Department of Anaesthesia & Critical Care, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, United Kingdom (Churchill, Zochios) Intensive Care Unit and Critical Care Research Group, Prince Charles Hospital, Metro North Hospital and Health Services, Brisbane, Australia (Dash, Ramanan) Intensive Care Unit, Townsville University Hospital, Townsville, Australia (Delaney, Senthuran) Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia (Delaney) Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Evans) Department of Anaesthetics, University Hospital of Wales, Cardiff, United Kingdom (Hoppington) Patient representative, United Kingdom (Kunst) Department of Anaesthetics and Pain Therapy, King's College Hospital NHS FT, London, United Kingdom (Kunst) School of Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, United Kingdom (Maiorana) Curtin School of Allied Health, Curtin University, Perth, Australia (Martinez, Klein) Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, United Kingdom (McDonald) Cardiothoracic Unit, James Cook Hospital, Middlesbrough, United Kingdom (Orford) Intensive Care Unit, University Hospital Geelong, Geelong, Australia (Orford) Deakin University School of Medicine, Geelong, Australia (Pilcher) Department of Intensive Care, Alfred Hospital, Melbourne, Australia (Pilcher) Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia (Reid) School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia (Shaw) Department of Anaesthetics, Guy's and St Thomas' Hospitals, London, United Kingdom (Shelley) West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (Shelley) Academic Unit of Anaesthesia, Pain and Critical Care, University of Glasgow, Glasgow, United Kingdom (Singh) Department of Anaesthesia, Queen Elizabeth Hospital, Birmingham, United Kingdom (Veltman-Grisenthwaite) Cambridge Cancer Research Hospital, Cambridge Institute, University of Cambridge, Cambridge, United Kingdom (Yadav) Department of Cardiothoracic Surgery, Mater Private Hospital Townsville, Townsville, Australia (Zimbler) Department of Anaesthesia, Royal Brompton Hospital, London, United Kingdom (Zochios) Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom Abstract Importance: High-flow nasal oxygen therapy (HFNOT) is used for noninvasive respiratory support following cardiac surgery despite uncertainty about its clinical effectiveness or associated costs. Objective(s): To determine whether prophylactic HFNOT in patients at increased risk of respiratory complications following cardiac surgery has clinical benefits compared with standard oxygen therapy (SOT). Design, Setting, and Participant(s): This adaptive, parallel group, randomized clinical trial collected and analyzed data from 17 cardiac surgery centers in 3 countries between October 7, 2020, and June 19, 2024. Eligible participants included adults undergoing nonemergent cardiac surgery with any of the following risk factors for pulmonary complications: chronic obstructive pulmonary disease, asthma, lower respiratory tract infection in the last 4 weeks, a body mass index of 35 or greater, or currently or recently smoking for longer than 10 pack-years. Outcome assessors were blinded. A preplanned sample size re-estimation was conducted after 300 participants completed the 90-day follow-up. Intervention(s): Participants were randomized at a 1:1 ratio with concealed allocation to HFNOT or SOT administered for at least 16 hours immediately after postoperative extubation. Main Outcomes and Measures: The primary effectiveness outcome was days alive and at home (DAH) without increased support compared with baseline in the first 90 days (DAH90). Any day of increased support, including at home, would provide a value of 0 for that day. Secondary outcomes included DAH90 without considering the additional support component. Result(s): A total of 1280 patients were recruited (mean [SD] age, 62.9 [10.5] years; 892 [69.7%] men; 640 in each group), of whom 1224 (95.6%) had complete DAH90 data. The primary outcome of median DAH90 was 0 (IQR, 0-79) for the HFNOT group and 0 (IQR, 0-87) for the SOT group (median difference, 0 [95% CI, 0-0]; P = .75). Secondary clinical outcomes, including DAH90 without considering whether additional support was required, were similar between groups. Conclusions and Relevance: In this randomized clinical trial of HFNOT in patients at increased risk of postoperative pulmonary complications after nonemergent cardiac surgery, HFNOT did not improve DAH90 without increased support. These findings do not support the implementation of routine prophylactic HFNOT after cardiac surgery. Trial Registration: isrctn.org Identifier: ISRCTN14092678. <102> Accession Number 2044773260 Title The influence of staged intervention based on Meleis transition theory on the knowledge, attitude, practice and anticoagulation effect of warfarin in patients undergoing cardiac valve surgery. Source Chinese Journal of Practical Nursing. 42(10) (pp 761-767), 2026. Date of Publication: 01 Apr 2026. Author Xing A.; Chen C.; Wu Y.; Bao T.; Hu X. Institution (Xing, Chen, Wu, Bao, Hu) Department of Cardiac Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China Publisher Chinese Medical Journals Publishing House Co.Ltd Abstract Objective To explore the influence of nursing intervention based on Meleis transformation theory on the knowledge, attitude, practice and anticoagulation effect of warfarin in patients after cardiac valve surgery, in order to provide reference for the postoperative management of such patients in clinical practice. Methods A randomized controlled study was conducted. Patients who met the inclusion and exclusion criteria after cardiac valve surgery and were admitted to the First Affiliated Hospital of Wenzhou Medical University from January to October 2024 were selected as the research subjects by convenience sampling. They were divided into the control group and the experimental group using a random number table. The control group received conventional warfarin medication guidance after the operation, while the patients in the experimental group received nursing intervention based on the Meleis transformation theory on the basis of the control group. The effects were evaluated at 1 month and 6 months after the operation by using the self-designed general information questionnaire, warfarin knowledge, attitude and Practice questionnaire, and the compliance rate of the International normalized ratio (INR). Results A total of 90 cases were finally included in the control group, including 42 males and 48 females, with an age of (55.2 +/- 15.6) years. There were 89 cases in the experimental group, including 44 males and 45 females, with an age of (56.1 +/- 16.3) years. The scores of warfarin knowledge dimension, attitude dimension, behavior dimension and total score of the patients in the experimental group one month after the operation were (7.0 +/- 1.2), (31.9 +/- 6.1), (21.5 +/- 5.9) and (60.4 +/- 13.5) respectively. Compared with the scores of (6.4 +/- 1.4), (27.2 +/- 7.3), (18.6 +/- 6.0), and (52.2 +/- 14.9) of the control group, the differences were statistically significant (t values ranged from 3.15 to 4.78, all P<0.05). The scores of warfarin knowledge dimension, attitude dimension, behavior dimension and total score of the patients in the experimental group 6 months after the operation were (8.6 +/- 1.8), (35.6 +/- 8.1), (27.5 +/- 6.7) and (71.7 +/- 16.6) points respectively. Compared with the scores of (7.5 +/- 1.6), (29.8 +/- 6.3), (22.9 +/- 5.8), and (60.2 +/- 13.7) in the control group, the differences were statistically significant (t values ranged from 3.17 to 5.82, all P<0.05). The rates of reaching the INR standard within 6 months after surgery in the experimental group and the control group were (77.8 +/- 12.9) % and (70.4 +/- 14.5) %, respectively. There was a statistically significant difference between the two groups (t=3.67, P<0.05). Conclusions The nursing intervention based on the Meleis transformation theory can improve the knowledge, attitude and practice level of warfarin in patients after cardiac valve surgery, enhance the anticoagulation effect of warfarin, and is worthy of promotion and application in the postoperative nursing of cardiac valves. Copyright 2026, Chinese Medical Association <103> Accession Number 650844523 Title Tip Egitiminde Yapay Zeka: Lisans ve Uzmanlik Egitimi Boyunca Mufredat Tasarimi, Degerlendirme Modelleri ve Egitim Altyapisi - Anlati Derlemesi, Artificial Intelligence in Medical Education: Curriculum Design, Assessment Models, and Educational Infrastructure Across Undergraduate and Residency Training - A Narrative Review. Source Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir. (no pagination), 2026. Date of Publication: 08 Apr 2026. Author Gocer H.; Durukan A.B.; Ozyuksel A. Institution (Gocer) Department of Cardiology, Private Umit Hospital, Eskisehir, Turkey (Durukan) Department of Cardiovascular Surgery, Liv Ankara Hospital, Ankara, Turkiye; Department of Cardiovascular Surgery, Istinye University School of Medicine, Istanbul, Turkiye (Ozyuksel) Department of Cardiovascular Surgery, Istanbul Health and Technology University, School of Medicine, Istanbul, Turkey <104> [Use Link to view the full text] Accession Number 650830397 Title Association Between Acute Gastrointestinal Injury and Mortality Risk in Critically Ill Patients: A Systematic Review and Meta-Analysis. Source Clinical and translational gastroenterology. (no pagination), 2026. Date of Publication: 07 Apr 2026. Author Gao T.; Liu J.; Du Y.; Yang J.; Sheng G.; Zhou L.; Qiu Y.; Zhang Q.; Duan M. Institution (Gao, Duan) Department of Anesthesiology, Jinling Hospital, Nanjing University of Chinese Medicine, NO.305 Zhongshan East Road ,Xuanwu District, Nanjing, Jiangsu, China (Liu) Endocrinology Department, Liuzhou Traditional Chinese Medical Hospital, Guangxi Zhuang Autonomous Region, No.6 Honghu Road ,East Ring Road Extension, China (Liu, Du, Yang, Sheng, Zhou) Third Affiliated Medical College of Guangxi University of Chinese Medicine, Guangxi Zhuang Autonomous Region, China (Du, Yang) Department of Critical Care Medicine, Liuzhou Traditional Chinese Medical Hospital, Guangxi Zhuang Autonomous Region, No.6 Honghu Road ,East Ring Road Extension, China (Sheng) Liuzhou Traditional Chinese Medical Hospital, Guangxi Zhuang Autonomous Region, No.6 Honghu Road ,East Ring Road Extension, China (Zhou) Rehabilitation Department, Liuzhou Traditional Chinese Medical Hospital, Guangxi Zhuang Autonomous Region, No.6 Honghu Road ,East Ring Road Extension, China (Qiu) Guangxi University of Chinese Medicine, Guangxi Zhuang Autonomous Region, China (Zhang) Endocrinology Department, People's Hospital of Chongqing Banan District, Longzhouwan Street ,Banan District, Chongqing, China Abstract OBJECTIVE: To systematically evaluate the association between severe AGI/GI dysfunction score (GIDS) and mortality risk in adult ICU patients. METHOD(S): We conducted a systematic review and meta-analysis. We searched the MEDLINE, Embase, Web of Science and Cochrane Central Register of Controlled Trials databases for articles published between January 2016 and January 2025. Observational cohort studies reporting mortality outcomes in ICU patients with AGI (grades III-IV vs 0-II) or GIDS (scores 2-4 vs 0-1) were included. Studies focusing on specific subpopulations such as patients following cardiac surgery or with COVID-19 were excluded to maintain population homogeneity. The primary outcome was short-term all-cause mortality. Random-effects meta-analysis using inverse-variance weighting was performed using odds ratios (ORs) with 95% confidence intervals (CIs). RESULT(S): Eight studies involving 2,786 critically ill patients were included. The pooled analysis demonstrated that severe GI dysfunction (AGI III-IV or GIDS 2-4) was significantly associated with increased mortality risk (OR 2.78, 95% CI 2.19-3.52, I2=42.5%). Subgroup analyses by outcome type (28-day/ICU mortality: OR 2.70, 95% CI 2.04-3.58; in-hospital mortality: OR 4.27, 95% CI 1.63-11.18) and scoring system (AGI: OR 2.75, 95% CI 2.07-3.67; GIDS: OR 3.18, 95% CI 1.43-7.07) showed consistent results. The addition of a large-scale prospective Chinese study (Wang 2024, n=1,102) and a multicentre European cohort (Reintam Blaser 2021, n=540) strengthened the findings and broadened generalisability. CONCLUSION(S): Severe AGI is strongly associated with increased mortality in critically ill patients. Early recognition and assessment of GI dysfunction using standardised grading systems may facilitate risk stratification and guide clinical management. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology. <105> Accession Number 2044477837 Title Workflow-based Framework to Aid with High-Definition Intravascular Ultrasound-Optimised Coronary Stenting: Introducing IVUS 123 Essentials. Source Revista Espanola de Nutricion Humana y Dietetica. 28(3) (pp 1-6), 2026. Date of Publication: 28 Mar 2026. Author Walsh S.J.; Cavalcante R.; Croce K.; Hanratty C.G.; Hashim H.; Joshi F.; Kalra S.; Kirtane A.; Maehara A.; McEntegart M.; Riley R.F.; Spratt J.C. Institution (Walsh) Cardiology Department, Belfast Health and Social Care Trust, Royal Victoria Hospital, Northern Ireland, Belfast, United Kingdom (Cavalcante) Boston Scientific, Maple Grove, MN, United States (Cavalcante) Cardiology Department, Hospital Sao Camilo, Sao Paulo, Brazil (Croce) Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, United States (Hanratty) Cardiology Department, Mater Private Hospital, Dublin, Ireland (Hashim) Cardiology Department, MedStar Washington Hospital Center, Washington, DC, United States (Joshi) Cardiology Department, Golden Jubilee National Hospital, Glasgow, United Kingdom (Kalra) Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, ON, Canada (Kirtane, Maehara, McEntegart) Cardiology Department, Cardiovascular Research Foundation, New York, NY, United States (Riley) Cardiology Department, Overlake Medical Center, Bellevue, WA, United States (Spratt) Cardiology Department, St George's Hospital, University of London, London, United Kingdom Publisher Asociacion Espanola de Dietistas-Nutricionistas Abstract Intravascular ultrasound (IVUS) has been in clinical use for more than three decades. Despite evidence that supports the application of the technology from multiple registries, randomised trials and meta-analyses, adoption remains low. Potential barriers to the adoption of IVUS are a lack of understanding as to how to accurately interpret images and how to incorporate it into clinical workflow. To address this, this paper summarises evidence-based protocols for the application of IVUS during percutaneous coronary intervention (PCI) into an easily understood workflow. Standardisation of approaches and wider adoption of IVUS-optimised PCI should improve patient outcomes and PCI durability. Copyright © (2026), (Asociacion Espanola de Dietistas-Nutricionistas). All right reserved. <106> Accession Number 2037944315 Title Ischaemic and bleeding events after complex versus non-complex PCI: a systematic review and meta-analysis. Source EuroIntervention. 22(7) (pp e402-e414), 2026. Date of Publication: 06 Apr 2026. Author Piccolo R.; Vitale A.P.; Laino A.; Franzone A.; Cirillo P.; Di Serafino L.; Bardi L.; Spaccarotella C.A.M.; Esposito G. Institution (Piccolo, Vitale, Laino, Franzone, Cirillo, Di Serafino, Bardi, Spaccarotella, Esposito) Department of Advanced Biomedical Sciences, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy Publisher Europa Group Abstract BACKGROUND: Complex percutaneous coronary intervention (PCI) is increasingly performed among patients undergoing myocardial revascularisation. AIMS: We conducted a systematic review and meta-analysis to evaluate the association between complex PCI and the risk of ischaemic and bleeding outcomes. METHOD(S): Hazard ratios (HRs) were pooled using a random-effects model within a Bayesian framework. The primary analysis was restricted to studies providing adjusted risk estimates, whereas the secondary analysis included unadjusted risk estimates. The primary outcomes were myocardial infarction and major bleeding. The secondary outcomes were all-cause death, stent thrombosis, cardiovascular death, target lesion or vessel revascularisation, and stroke. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework for prognostic studies was used to determine the level of certainty in the association between complex PCI and the risk of events. RESULT(S): We included 290,039 patients, of whom 94,633 (33%) underwent complex PCI. Compared with non-complex PCI, patients undergoing complex PCI had a higher risk of myocardial infarction (adjusted HR 1.71, 95% credible interval [CrI]: 1.49-1.96), major bleeding (adjusted HR 1.24, 95% CrI: 1.14-1.35), all-cause death (adjusted HR 1.21, 95% CrI: 1.12-1.32), cardiovascular death (adjusted HR 1.29, 95% CrI: 1.15-1.46), stent thrombosis (adjusted HR 1.76, 95% CrI: 1.49-2.14), target lesion or vessel revascularisation (adjusted HR 1.99, 95% CrI: 1.58-2.50), and stroke (adjusted HR 1.21, 95% CrI: 1.03-1.42). The posterior probability of a higher risk associated with complex versus non-complex PCI was >99% for all study outcomes. Except for stroke (which was low certainty), the certainty of evidence was moderate to high for all other outcomes. Secondary analysis, including unadjusted risk estimates, provided consistent results. CONCLUSION(S): Patients undergoing complex PCI have an increased risk of both ischaemic and bleeding events compared with patients undergoing non-complex PCI (PROSPERO: CRD420250656254). Copyright © Europa Group 2026. All rights reserved. <107> [Use Link to view the full text] Accession Number 650827805 Title Effect of Family Intervention on Postoperative Delirium in Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis. Source The Journal of cardiovascular nursing. (no pagination), 2026. Date of Publication: 07 Apr 2026. Author Yue Y.; Liu S.; Martin-Payo R.; Zhang F.; Xie X. Institution (Yue) BSN, West China Hospital/West China School of Nursing, Sichuan University, MSN Candidate, Chengdu, China (Liu) MSN, Vice General Head Nurse, Department of Urology, Institute of Urology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China (Martin-Payo) Ruben Martin-Payo, PhD, Associate Professor, Department of Medicine, University of Oviedo, Spain; and Precam Research Group, Instituto de Investigacion Sanitaria del Principado de Asturias, Oviedo, Spain (Zhang) West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China (Xie) Xiaofeng Xie, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China Abstract BACKGROUND: Postoperative delirium (POD) is a common and serious complication after cardiac surgery. Although family involvement is considered a promising nonpharmacological strategy, its efficacy specifically in patients undergoing cardiac surgery remains inadequately supported by systematic evidence. OBJECTIVE(S): Our aim was to evaluate the effectiveness of family interventions in preventing POD among patients undergoing cardiac surgery. METHOD(S): We systematically searched multiple databases from inception to July 2025 for randomized controlled trials (RCTs) assessing family intervention for POD in patients undergoing cardiac surgery. Study selection, quality assessment, and data extraction were performed independently by 2 reviewers. We conducted a meta-analysis using RevMan 5.4 and Stata 18.0, with effects expressed as risk ratios or standard mean differences and 95% confidence intervals (CIs). We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework to evaluate evidence quality. The protocol was registered on PROSPERO (CRD42024627097). RESULT(S): A total of 6 RCTs with 508 patients were included in the analysis. Family intervention significantly reduced the incidence of POD (risk ratio = 0.38, 95% CI: 0.25-0.58, P < .001) and shortened hospital length of stay (standard mean difference = -1.07, 95% CI: -1.91 to -0.24, P < .05). Our subgroup analysis revealed no significant differences in outcomes based on family involvement level, age, or sample size. Additionally, interventions improved psychological well-being and increased caregiver satisfaction (P < .05). CONCLUSION(S): Family intervention reduces POD incidence and hospital stay and enhances psychological outcomes for patients and caregivers. However, due to small sample sizes, further large-scale high-quality RCTs are warranted. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <108> Accession Number 2044414927 Title Benefits of nitric oxide administration during cardiopulmonary bypass on postoperative outcomes in adult patients: a meta-analysis and systematic review. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 206. Date of Publication: 01 Dec 2026. Author Zhang Y.; Wang M.; Chen G.; Zhou Y. Institution (Zhang, Wang, Chen, Zhou) Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Qingchun East Road No. 3, Hangzhou, China (Wang) Department of Anesthesiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China Publisher BioMed Central Ltd Abstract Background: Nitric oxide (NO) is reported to play several protective roles in the inflammatory response and ischemia/reperfusion injury. This study evaluated the effect of nitric oxide (NO) on postoperative outcomes in adults undergoing cardiac surgery with cardiopulmonary bypass (CPB). Method(s): We systematically searched PubMed, Web of Science, and EMBASE (inception-April 2025) for relevant RCTs. Two reviewers independently screened studies, extracted data, and assessed risk of bias (Cochrane RoB 1) and evidence certainty (GRADE). Meta-analysis was performed using random-effects models. Result(s): Eight RCTs involving 774 patients were finally included. The use of NO did not reduce the postoperative mortality (RR 0.71, 95% CI 0.36 to 1.42), the duration of postoperative ventilation (MD -0.23 h, 95% CI -1.18 to 0.71), the length of stay in hospital (MD -0.07 days, 95% CI -0.55 to 0.42) or in intensive care unit (MD -4.17 h, 95% CI -8.74 to 0.4). This study demonstrated that NO administration significantly reduced serum levels of creatine kinase-MB at both 24 h (MD -19.36 ng/ml, 95% CI -28.72 to -10.00) and 48 h (MD -17.47 ng/ml, 95% CI -19.53 to -15.41) postoperatively, though it did not affect troponin levels. Concurrently, NO was associated with a significantly lower incidence of postoperative acute kidney injury (RR 0.78, 95% CI 0.64 to 0.93), but not with a reduced need for renal replacement therapy (RR 0.88, 95% CI 0.45 to 1.72). Conclusion(s): This meta-analysis of RCTs did not demonstrate a clear benefit of nitric oxide administered via cardiopulmonary bypass on mortality, duration of mechanical ventilation, or length of stay in adult cardiac surgery. Although suggestive renal and cardioprotective signals were observed, these findings are preliminary and require confirmation in larger, methodologically rigorous trials before definitive conclusions can be drawn. Trial registration: INPLASY2022120002. Copyright © The Author(s) 2026. <109> Accession Number 2044429047 Title Right lateral decubitus as a strategy to improve left bronchial blocker placement in thoracic operations: a randomized clinical trial. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 201. Date of Publication: 01 Dec 2026. Author Chen S.; Deng Z.; He Y.; Luo J.; Li Y.; Liu Q.; Wu H.; Huang B.; Wang H.; Luo T. Institution (Chen, Deng, Luo, Li, Liu, Wu, Wang, Luo) Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Guizhou, Zunyi, China (He, Wang, Luo) Key Laboratory of Anesthesia and Organ Protection of Ministry of Education (In Cultivation), Zunyi Medical University, Guizhou, Zunyi, China (He) Department of Radiology, The Third Hospital of Zunyi Medical University, The First People's Hospital of Zunyi), Guizhou, Zunyi, China (Huang) Department of bioengineering, Imperial College London, London, United Kingdom Publisher BioMed Central Ltd Abstract Background: Left-sided bronchial blocker (BB) placement can sometimes be challenging and time-consuming, often requiring multiple fiberoptic bronchoscopic examinations. This study evaluated whether right lateral decubitus positioning improves placement compared to the supine position. Method(s): In this prospective, single-center randomized controlled trial, 90 adult patients scheduled for elective thoracic surgery with right one-lung ventilation were randomized to receive BB placement in either the right lateral decubitus or supine position. The primary outcome was ease of placement, defined as first-attempt success or successful placement under bronchoscopic guidance within 120 s. Secondary outcomes included placement time, malposition rate, intraoperative hemodynamic and blood gas changes, and postoperative recovery. Additionally, nine patients had chest CT scans in both positions to assess tracheobronchial alignment. Result(s): Right lateral positioning significantly improved placement compared to supine, with higher ease of placement (87% vs. 27%), greater first-attempt success (29% vs. 11%), shorter median time to placement (97 s vs. 201 s), and lower malposition rate (11% vs. 29%). In the supine group, all patients required bronchoscopic verification after lateral repositioning, and 11.1% needed repositioning; no additional verification was needed in the lateral group. CT analysis revealed that right lateral positioning increased the left main bronchus angle (148.3degreevs 142.9degree), aligning the BB more directly with the opening of the left main bronchus. Conclusion(s): Right lateral decubitus enhances left BB placement by increasing first-attempt success, reducing procedural time, and decreasing malposition. CT imaging confirms anatomical realignment facilitating insertion. Copyright © The Author(s) 2026. <110> Accession Number 2044494698 Title Medical therapies to prevent the development and progression of calcific aortic valve stenosis: a contemporary review. Source Expert Review of Cardiovascular Therapy. (no pagination), 2026. Date of Publication: 2026. Author Courtney W.A.; Walker J.; Dorai-Raj A.; Arnous S.; O'Connor C.T.; Playford D.; Ihdayhid A.; Schultz C.J.; Hillis G.S.; Kiernan T.J. Institution (Courtney, Schultz, Hillis) Medical School, University of Western Australia, Crawley, WA, Australia (Courtney, Walker, Dorai-Raj, Schultz, Hillis) Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia (Courtney, Arnous, O'Connor, Kiernan) Department of Cardiology, University Hospital Limerick, Limerick, Ireland (Playford) School of Medicine, University of Notre Dame, Fremantle, WA, Australia (Ihdayhid) Harry Perkins Institute of Medical Research, Fiona Stanley Hospital, Perth, Australia (Ihdayhid) Department of Cardiology, Fiona Stanley Hospital, Perth, Australia (Ihdayhid) Medical School, Curtin University, Bentley, WA, Australia (Kiernan) School of Medicine, University of Limerick, Castletroy, Ireland Publisher Taylor and Francis Ltd. Abstract Introduction: Aortic stenosis (AS), the leading cause of valvular heart disease related mortality, affects 12% of individuals over 75 years and is set to expand as the population ages. Once symptoms develop, severe symptomatic AS carries an average survival of approximately two years. The only management currently available is aortic valve replacement (AVR), either surgically or via transcatheter aortic valve implantation, but this addresses only the end stage of the disease process which is often associated with irreversible myocardial remodeling. There are currently no pharmacotherapies proven to treat AS. The development of this condition is an active pathophysiological process which involves complex metabolic signaling cascades providing myriad potential therapeutic targets. Areas covered: This review looks at recent and ongoing clinical trials of novel pharmacotherapies for AS, including lipid lowering therapy, nitrous oxide pathway targeting, vitamin K supplementation, renin-angiotensin-aldosterone system blockade, repurposing diabetic pharmacotherapies, colchicine, and transthyretin stabilizers. Expert opinion: AS is an active, pathological disease which should be amenable to pharmacological modulation. A wide spectrum of pharmacotherapeutic agents are currently being investigated and the authors of this review are optimistic that we might be on the cusp of a breakthrough. Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <111> Accession Number 2044821674 Title Comparing right ventricle to pulmonary artery conduit with modified Blalock-Taussig shunt in hypoplastic left heart syndrome undergoing Norwood procedure: A meta-analysis. Source Asian Journal of Surgery. (no pagination), 2026. Date of Publication: 2026. Author Yasa K.P.; Pertiwi P.F.K.; Sudarma I.W.; Harta I.K.A.P.; Bhaskara N.S.S. Institution (Yasa, Sudarma, Harta) Cardiothoracic and Vascular Surgery Division, Department of Surgery, Faculty of Medicine, Udayana University, Bali, Denpasar, Indonesia (Yasa, Sudarma, Harta) Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Denpasar, Indonesia (Pertiwi, Bhaskara) Faculty of Medicine, Udayana University, Prof. dr. I.G.N.G Ngoerah General Hospital, Bali, Denpasar, Indonesia Publisher Elsevier (Singapore) Pte Ltd Abstract The Norwood procedure is the first palliative surgery for Hypoplastic Left Heart Syndrome (HLHS). Traditionally, pulmonary circulation was supplied via a modified Blalock-Taussig (mBT) shunt, but the right ventricle-to-pulmonary artery (RV-PA) conduit has recently been introduced. A systematic review and meta-analysis identified 13 studies with 905 patients comparing RV-PA and mBT outcomes. RV-PA was associated with significantly lower short-term mortality (RR: 0.62 [0.45-0.85], p = 0.003) and interstage mortality (RR: 0.18 [0.05-0.63], p = 0.008). Before the hemi-Fontan procedure, RV-PA showed better late hemodynamic outcomes, including a lower pulmonary-to-systemic (Qp/Qs) ratio (MD: 0.25 [-0.43 to -0.07], p = 0.007), higher aortic diastolic pressure (MD: 5.22 [2.56-7.87], p < 0.001), and higher Nakata index (MD: 30.54 [3.34-57.75], p = 0.03). RV-PA had no significant impact on right ventricular compliance, as indicated by similar RV end-diastolic pressure (RVEDP; MD: 0.44 [-0.52 to 1.40], p = 0.37). Although RV-PA had a higher but non-significant incidence of shunt stenosis (RR: 4.68 [0.21-105.18], p = 0.33), its advantages outweighed this limitation. Kaplan-Meier analysis showed superior 3-year survival for RV-PA (72% vs. 61% for mBT, p = 0.005). These findings support RV-PA as the preferred shunt for improving survival, hemodynamic outcomes, and perioperative success in HLHS patients undergoing the Norwood procedure. Copyright © 2026 Asian Surgical Association and Taiwan Society of Coloproctology. Publishing services by Elsevier B.V. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <112> Accession Number 2044624085 Title Comment on"Left ventricular systolic recovery after TAVI in severe aortic stenosis: A systematic review and meta-analysis". Source International Journal of Cardiology: Cardiovascular Risk and Prevention. (no pagination), 2026. Article Number: 200630. Date of Publication: 2026. Author Cao B.; Ouyang M. Institution (Cao) Department of Cardiology, The Central Hospital of Yongzhou, Yongzhou, China (Cao) Department of Cardiology, Yongzhou Hospital Affiliated to University of South China, Yongzhou, China (Ouyang) The First Affiliated Hospital of Jishou University, Jishou, China Publisher Elsevier B.V. <113> Accession Number 2044817508 Title Comparison between two different strategies of pre- and post-dilation during TAVI implantation. Clinical relevance. Source Cirugia Cardiovascular. (no pagination), 2026. Date of Publication: 2026. Author Candela-Navarro G.P.; Montesino-Villafranca J.J.; Meseguer-Oller J.; Bernabeu-Sanchez E.; Garcia-Valentin A.J.; Campos-Carot E.; Solbes Molto A.I.; Hurle-Gonzalez A.; Daroca-Martinez T.; Gomez-Vidal M.A. Institution (Candela-Navarro, Montesino-Villafranca, Meseguer-Oller, Bernabeu-Sanchez, Garcia-Valentin, Campos-Carot, Solbes Molto, Hurle-Gonzalez, Daroca-Martinez, Gomez-Vidal) Servicio de Cirugia Cardiovascular, Hospital General Universitario Doctor Balmis, Alicante, Spain (Candela-Navarro, Montesino-Villafranca, Meseguer-Oller, Bernabeu-Sanchez, Garcia-Valentin, Campos-Carot, Solbes Molto, Hurle-Gonzalez, Daroca-Martinez, Gomez-Vidal) Instituto de Investigacion Sanitaria y Biomedica de Alicante (ISABIAL), Alicante, Spain Publisher Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE) Abstract The implantation of transcatheter aortic valves (TAVI) has revolutionized the treatment of aortic stenosis (AS). The review of simplified techniques (direct TAVI) becomes relevant due to the increased heterogeneity of the subgroups of patients who need to be treated. In this review, we aim at determining the clinical results of different implantation strategies (with or without pre/post-dilation) with the object of adapting the best treatment to each individual patient.Pre-dilation carries a higher risk of haemodynamic instability. Direct-TAVI (without pre-dilation) entails higher perivalvular regurgitation rates, which are associated with an increased need of post-ballooning (when implanting self-expandable devices). There are no statistically significant differences in terms of acute kidney injury, rhythm disturbances or stroke when both techniques are compared.Post-dilatation is associated with a greater risk of annulus rupture and TAVI embolization, without differences regarding conduction disorders, stroke or prosthetic damage. Post-ballooning also corrects the perivalvular regurgitation, thus improving mid and long-term results.Conclusively, the pre and/or post-dilation strategies must be undertaken selectively, bearing in mind clinical and anatomic parameters, as well as the prosthetic type to be implanted, and only when a benefit is expected. Copyright © 2026 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/ <114> Accession Number 2044832617 Title Impact of immunosuppressive therapy on non-melanoma skin cancer after solid organ transplantation: A critical systematic review. Source Transplant Immunology. 96 (no pagination), 2026. Article Number: 102384. Date of Publication: 01 Jun 2026. Author Abulail J.A.; Abu Husein S.; Al-Tamimia M.; Jaradat M.; Alhawamdeh S.; Elkhalili Z.; Esaid R.; Saleh T.; Al Shboul S. Institution (Abulail) Department of Surgery, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Abulail, Abu Husein, Al-Tamimia, Alhawamdeh, Elkhalili, Esaid, Saleh, Al Shboul) Department of Pharmacology and Public Health, Faculty of Medicine, The Hashemite University, Zarqa, Jordan (Jaradat) Plastic surgery department, Royal rehabilitation center, Royal medical services, Amman, Jordan (Saleh) Department of Pharmacology & Therapeutics, College of Medicine & Health Sciences, Arabian Gulf University, Manama, Bahrain Publisher Elsevier B.V. Abstract Recent advancements in immunosuppressive therapy have markedly reduced graft rejection rates post-transplantation and improved the life expectancy of solid organ transplant recipients. However, these improved long-term outcomes are accompanied by an increased risk of complications, of which skin malignancies remain significantly challenging. Unlike prior reviews that analyzed solid organ transplant recipients as a pooled population, we focused on examining the association between immunosuppressive therapy and the potential risk of non-melanoma skin cancer (NMSC) within organ-specific cohorts. This review provides a distinct perspective by emphasizing the role of induction and maintenance immunosuppressive therapy in the development of NMSC in individual transplant settings, particularly kidney, liver, lung, and heart transplantation, with brief reference to pancreas transplantation. Across organs, basiliximab was generally associated with a lower reported incidence of NMSC than T-cell depleting agents, although the strength and consistency of this association varied among organ types. In addition, calcineurin inhibitors were consistently associated with a higher incidence of NMSC across multiple organ-specific cohorts, whereas sirolimus and mycophenolate-based regimens were associated with a lower reported incidence in some cohorts. However, current data do not support routine modification of immunosuppression regimens solely for transplant recipients with NMSC. Greater emphasis should instead be placed on preventive strategies, including regular structured skin examinations and a dedicated post-transplant dermatology clinics for high-risk populations. Copyright © 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <115> Accession Number 2044628236 Title Streamlining postprocedural care after transcatheter edge-to-edge repair. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 295. Date of Publication: 01 Dec 2026. Author Voran J.C.; Baucks J.; Catania V.; Bramlage P.; Frank D.; Kreidel F. Institution (Voran, Baucks, Frank, Kreidel) Department of Internal Medicine III, Cardiology and Critical Care, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3, Kiel, Germany (Voran, Baucks, Kreidel) DZHK (German Centre for Cardiovascular Research), Partner site Hamburg/Kiel/Lubeck, Potsdamer Strasse 58, Berlin, Germany (Catania, Bramlage) Institute for Pharmacology and Preventive Medicine, Bahnhofstrasse 20, Cloppenburg, Germany Publisher BioMed Central Ltd Abstract Background: Patients undergoing transcatheter edge-to-edge repair (TEER) of the mitral or tricuspid valve are predominantly elderly and exhibit high rates of frailty. The procedure regularly involves general anaesthesia, necessitating the monitoring of patients on an intensive or intermediate care unit (ICU/ImCU). This study aimed to investigate the outcome of patients being admitted to a general ward as opposed to an ICU/ImCU for postprocedural care after TEER. Method(s): This is a retrospective study analysing the course of 209 patients that underwent TEER at a university hospital centre in Germany from January 2022 to February 2024. Patients were assigned to either intended postprocedural care at ICU/ImCU (n = 113) or streamlined care (n = 95) based on a cut-off date unrelated to this study. Result(s): In comparison to the ICU/ImCU group, patients in the streamlined group exhibited a significantly reduced total hospital stay (median 4 [IQR 3, 9] vs. 3 [IQR 3, 5] days, p = 0.009) and a reduced postprocedural length of stay without an elevated rate of unplanned ICU/ImCU admissions. Postprocedural care in the streamlined group was not associated with a higher rate of complications nor a higher mortality rate at 30 days (0.9% vs. 2.2%, p = 0.6), six months (10.1% vs. 4.7%, p = 0.2) or 12 months (16.0% vs. 12.0%, p = 0.4). Conclusion(s): The transition of postprocedural care from the ICU/ImCU to a general ward was found to be safe, reduced length of hospital stay and spared the utilization of ICU/ImCU resources. This encourages for randomised clinical trials to further advance the streamlined care of these patients. Copyright © The Author(s) 2026. <116> Accession Number 650821533 Title Validating National Registry Data for Randomised Trials: Comparison of registry-derived cardiovascular events with and without adjudication in the BETAMI-DANBLOCK trial. Source European heart journal. Quality of care & clinical outcomes. (no pagination), 2026. Date of Publication: 04 Apr 2026. Author Holmager T.L.F.; Kristensen A.M.D.; Fagerland M.W.; Atar D.; Olsen M.H.; Bakken A.; Munkhaugen J.; Prescott E. Institution (Holmager, Kristensen, Prescott) Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark (Fagerland) Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway (Atar, Bakken) Department of Cardiology, Oslo University Hospital Ullevaal, Norway (Atar) Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway (Olsen) Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark (Olsen) Department of Internal Medicine 1, Holbaek Hospital, Denmark (Munkhaugen) Department of Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Norway (Munkhaugen) Department of Behavioural Medicine, Faculty of Medicine, University of Oslo, Norway Abstract BACKGROUND: Registry-based randomised clinical trials are increasingly applied in clinical research, providing advantages in feasibility and data capture. However, registry-based data may introduce bias through misclassification or missing information. METHOD(S): In the BETAMI-DANBLOCK trial, 5,574 patients with myocardial infarction (MI) and no heart failure were randomised to beta-blocker or no beta-blocker therapy. The primary endpoint events (all-cause mortality, MI, ischemic stroke, heart failure, unplanned coronary revascularisation, and malignant ventricular arrhythmias) were identified from the Danish/Norwegian national patient registries, self-reported questionnaires, and medical records. All registry-identified events, except all-cause mortality, underwent blinded adjudication. We compared non-adjudicated and adjudicated events by calculating incidence rates and hazard ratios (HRs) for beta-blocker therapy versus controls. RESULT(S): National registries captured 99.7% of primary endpoint events registered by self-report and medical records. Of the primary endpoint events identified through the registries, 75% were confirmed by adjudication (incidence rate 6.23 versus 4.43/100 person-years). The confirmation rate was lower during the first six months and varied by event type (from 92% for ischemic stroke to 45% for unplanned coronary revascularisations and heart failure). Estimated treatment effects were consistent for the primary endpoint with non-adjudicated and adjudicated events (HR 0.88, 95% confidence interval (CI): 0.78-0.98 and HR 0.85, 95% CI: 0.75-0.98, respectively), with no apparent differences across event types except for heart failure and revascularisation. CONCLUSION(S): Registry data provided effect estimates of beta-blockers comparable to adjudicated data. However, adjudication substantially reduced the number of cardiovascular endpoint events and event-specific misclassification appeared, particularly during the first months after the index-event. 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 <117> Accession Number 650818325 Title Silent Brain Infarcts Post-Interventional Cardiac Catheterization: Insights from High-Resolution DW-MRI in a Randomized Study. Source Insights into Imaging. Conference: ECR 2025. Vienna Austria. 16(Supplement 1) (pp 132-133), 2025. Date of Publication: 01 Jul 2025. Author Tan N.; Zhou X. Institution (Tan, Zhou) KunmingChina Publisher Springer Science and Business Media Deutschland GmbH Abstract Purpose or Learning Objective: To analyze the incidence and anatomic distribution of acute cerebral embolism and identify associated risk factors in patients undergoing interventional cardiac catheterization. Methods or Background: We conducted a prospective study of patients from two cohorts between January 2023 and April 2024. Diffusion-weighted magnetic resonance imaging (DW-MRI) was used to detect silent brain infarcts (SBIs) preoperatively and within 48 hours postoperatively. For transcatheter aortic valve implantation (TAVI) patients, a cerebral embolic protection device (CEPD, model CEP016F) was randomly employed to minimize the risk of small emboli entering the cerebral vasculature. In atrial fibrillation ablation procedures, some patients underwent Vein of Marshall Ethanol Infusion (VOMEt) to decrease the recurrence of atrial fibrillation and prevent the formation of new embolic events. Independent risk factors were identified through multivariate logistic regression analysis. Results or Findings: Silent brain infarcts were detected in 34 of 48 patients (70.8%) within 48 hours postoperatively. Among the patients who used CEPDs (n = 12), 7 (56.8%) found SBIs. Patients who used CEPDs showed a trend toward smaller infarct volumes ( 5.32 cm3 vs. 8.11 cm3; P = 0.07). In patients who underwent VOMEt procedures (n = 20), 13 (65.0%) developed SBIs; however, neither the incidence nor the volume of SBIs showed significant differences compared to those who did not undergo VOMEt. Multivariate logistic regression analysis identified operation time as an independent positive predictor of SBIs (odds ratios, 6.190 and 13.564; both P < .001). Conclusion(s): Silent brain infarcts were detected in 70.8% of patients undergoing interventional cardiac catheterization, predominantly affecting the parietal lobes. These findings highlight the importance of procedural optimization to reduce cerebral embolic risk. <118> [Use Link to view the full text] Accession Number 2044262704 Title Efficacy and Safety of Very Low Achieved LDL Cholesterol in Patients With Previous Ischemic Stroke. Source Circulation. 153(2) (pp 86-93), 2026. Date of Publication: 13 Jan 2026. Author Monguillon V.; Kelly P.J.; O'Donoghue M.L.; Park J.-G.; Bohula E.A.; Saver J.L.; Atar D.; Keech A.C.; Sever P.S.; Wang H.; Paiva da Silva Lima G.; Sabatine M.S.; Giugliano R.P. Institution (Monguillon, O'Donoghue, Park, Bohula, Sabatine, Giugliano) Thrombolysis in Myocardial Infarction Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, United States (Kelly) Mater Misericordiae University Hospital, Dublin, Ireland (Kelly) School of Medicine, University College Dublin, Ireland (Kelly) Health Research Board Stroke Clinical Trials Network Ireland, Dublin, Ireland (Saver) Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California-Los Angeles (Atar) Department of Cardiology, Oslo University Hospital Ulleval, Norway (Atar) Institute of Clinical Medicine, University of Oslo, Norway (Keech) Sydney Medical School, National Health and Medical Research Council Clinical Trials Centre, Australia (Sever) National Heart and Lung Institute, Imperial College London, United Kingdom (Wang, Paiva da Silva Lima) Global Development, Amgen, Thousand Oaks, CA, United States Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Patients with previous ischemic stroke are at high risk for recurrent stroke and other major adverse cardiovascular events. The benefits of achieving very low levels of low-density lipoprotein cholesterol (LDL-C) in such patients is unclear. METHOD(S): - We analyzed patients with previous ischemic stroke enrolled in FOURIER (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk), a randomized placebo-controlled trial studying evolocumab in patients with stable atherosclerotic cardiovascular disease (median follow-up, 2.2 years), and through the open-label extension (FOURIER-OLE) period (additional median follow-up, 5 years), to examine the relationship between achieved LDL-C and the long-term incidence of the primary end point (cardiovascular death, myocardial infarction, stroke, or hospitalization for unstable angina or coronary revascularization) and stroke-related end points. RESULT(S): - The analysis included 5291 patients with previous ischemic stroke (>4 weeks). Of these, 666 (12.6%), 1410 (26.6%), 586 (11.1%), 508 (9.6%), and 2121 (40.1%) patients achieved LDL-C values of <20, 20 to <40, 40 to <55, 55 to <70, and >=70 mg/dL, respectively. The incidence of the primary end point, all stroke, and ischemic stroke each decreased in a monotonic fashion with lower achieved LDL-C levels on a continuous scale (P<inf>trend</inf><0.001, 0.002, and 0.002, respectively). Compared with patients with LDL-C >=70 mg/dL, those who achieved levels <40 mg/dL had incidence rate ratios of 0.69 (95% CI, 0.57-0.84), 0.73 (95% CI, 0.53-0.99), and 0.75 (95% CI, 0.54-1.05) for the outcomes of the primary end point, all stroke, and ischemic stroke, respectively. Hemorrhagic strokes were infrequent and unrelated to achieved LDL-C (P<inf>trend</inf>=0.85). CONCLUSION(S): - In patients with previous ischemic stroke, it appeared that the lower the LDL-C, down to levels <40 mg/dL, the lower the risk of major adverse cardiovascular events, including recurrent stroke, without a clear increase in risk of hemorrhagic stroke. These findings support the concept that more intensive LDL-C lowering in patients with previous ischemic stroke may be warranted. REGISTRATION: - URL: https://www.clinicaltrials.gov; Unique identifier: NCT01764633/NCT01764633. Copyright © 2025 American Heart Association, Inc. <119> Accession Number 2044537056 Title Magnesium for Preventing Postoperative Atrial Fibrillation After Cardiac Surgery: A Systematic Review and Meta-analysis. Source Indian Journal of Clinical Biochemistry. (no pagination), 2026. Date of Publication: 2026. Author Batra A.; Pandeya A.; Batra J.; Kumar A. Institution (Batra, Kumar) Department of Medicine, Santosh Deemed to be University, Ghaziabad, India (Pandeya, Batra) Central Research Facility, Santosh Deemed to be University, Ghaziabad, India Publisher Springer Abstract Postoperative atrial fibrillation (POAF) is a frequent complication after cardiac surgery, associated with increased mortality and healthcare costs. While beta-blockers are the recommended prophylaxis, their use may be limited by hemodynamic effects. Magnesium has been proposed as an alternative due to its membrane-stabilizing properties mediated through modulation of calcium handling and suppression of early after-depolarizations. However, its clinical efficacy remains uncertain. This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD420261282792). We searched MEDLINE, Cochrane Central, Scopus, and ClinicalTrials.gov from inception to January 2026 for randomized controlled trials comparing perioperative magnesium with placebo in patients undergoing cardiac surgery. Risk of bias was assessed using RoB 2.0. Random-effects meta-analyses were performed using RevMan 5.4. Certainty of evidence was evaluated using the GRADE framework. Twenty-four randomized trials with a total of 3385 patients were included. Magnesium significantly reduced the incidence of POAF compared with placebo (RR 0.58, 95% CI 0.46-0.74; I2 = 62%; low-certainty evidence). Magnesium also reduced the need for pharmacological cardioversion (RR 0.33, 95% CI 0.19-0.59; I2 = 60%; low-certainty evidence) and was associated with shorter ICU stay (MD - 0.34 days, 95% CI - 0.59 to - 0.10; I2 = 96%; moderate-certainty evidence) and hospital stay (MD - 0.67 days, 95% CI - 1.27 to - 0.06; I2 = 86%; low-certainty evidence). No significant differences were observed in all-cause mortality, bradycardia, pacemaker dependence, or duration of intubation (low-to-moderate certainty). Perioperative magnesium supplementation was associated with a reduced incidence of POAF and modest reductions in ICU and hospital length of stay without an increased risk of adverse events. However, substantial heterogeneity and evidence of small-study effects warrant cautious interpretation of effect magnitude. Further trials are needed to define optimal dosing strategies and confirm clinical benefit. Copyright © The Author(s), under exclusive licence to Association of Clinical Biochemists of India 2026. <120> Accession Number 2044304073 Title MIDCAB vs. DES in Isolated Proximal LAD Lesions: A Comprehensive Meta-Analysis. Source Turkish Journal of Health and Sport. 6(3) (pp 115-123), 2026. Date of Publication: 01 Jan 2026. Author Zengin O.; Celik Y.; Tigen M.K. Institution (Zengin) Marmara Universitesi Saglik Bilimleri Fakultesi Saglik Ekonomisi Ana bilim Dali, Turkey (Celik) Acibadem Mehmet Ali Aydinlar Universitesi Saglik Yonetimi Bolumu, Turkey (Tigen) Marmara Universitesi Tip Fakultesi Kardiyoloji Anabilim Dali, Turkey Publisher Hasan Basri Savas Abstract The comparison of stent implantation and minimally invasive coronary artery bypass grafting (MIDCAB) in patients with coronary artery disease is a clinically important topic aimed at improving patient outcomes by reducing surgical trauma. This comparison includes an evaluation of the efficacy, safety, and long-term outcomes of these two methods, which are widely used in lesions of the left anterior descending artery (LAD). In addition to patient outcomes such as mortality, myocardial infarction, target vessel revascularization, and quality of life, this study also provides important data from a health economics perspective, including hospital stay duration, need for reintervention, and utilization of healthcare resources. The aim of this study is to compare the data from different studies on the two revascularization methods (PCI and MIDCAB) used in patients with LAD stenosis in an objective and statistically significant manner. One of the main limitations of this study is the lack of sufficient studies and cases for statistical analysis in some subgroups. This study was reported in accordance with the PRISMA 2020 guidelines. The findings indicate that the MIDCAB method provides a significant advantage in terms of the need for target vessel revascularization (RR = 0.30, 95% CI [0.19-0.47]). Similarly, a significant reduction in the overall risk of major cardiac and cerebrovascular events (MACE) was observed in favor of MIDCAB (RR = 0.65, 95% CI [0.43-0.99]). However, no statistically significant difference was found between the two methods in terms of mortality, myocardial infarction (MI), and stroke (RR = 0.88, RR = 0.76, RR = 0.74, respectively). Copyright © (2026), (Hasan Basri Savas), All Rights Reserved. <121> Accession Number 650822259 Title Effects of prehabilitation programmes on postoperative outcomes in older adults undergoing major abdominal, cardiac or vascular surgery: a systematic review. Source Aging clinical and experimental research. (no pagination), 2026. Date of Publication: 04 Apr 2026. Author Buckinx F.; Rousseau A.-F.; Louis E.; De Roover A.; Detry O.; Durieux R.; Gillain S.; Kaba A.; Kaux J.-F.; Tchana-Sato V.; Bruyere O. Institution (Buckinx, Bruyere) Research Unit in public health, epidemiology and health economics, University of Liege, Liege, Belgium (Rousseau) Intensive Care Department, University Hospital of Liege, Liege, Belgium (Rousseau) Research Unit for a Life-Course Perspective on Health & Education (RUCHE), University of Liege, Liege, Belgium (Louis) Hepato-Gastroenterology and Digestive Oncology Department, University Hospital of Liege, Liege, Belgium (De Roover, Detry) Department of Abdominal Surgery and Transplantation, University Hospital of Liege, Liege, Belgium (Durieux, Tchana-Sato) Division of Cardiovascular and Thoracic Surgery, University Hospital of Liege, Liege, Belgium (Gillain) Geriatric Department, University Hospital of Liege, Liege, Belgium (Kaba) Department of Anaesthesiology, University Hospital of Liege, Service of Abdominal Surgery, Liege, Belgium (Kaux, Bruyere) Department of Physical Activity and Rehabilitation Sciences, University of Liege, Liege, Belgium (Kaux) Department of Physical Medicine, Rehabilitation and Sports Traumatology FIMS Collaborative Centre of Sports Medicine, FIFA Medical Centre of Excellence, Liege, Belgium <122> Accession Number 650825490 Title Effect of HA380 hemoadsorption on postoperative delirium in elderly cardiac surgery patients: a randomized controlled trial. Source Scientific reports. (no pagination), 2026. Date of Publication: 05 Apr 2026. Author Wu Y.; Zou S.; Chen M.; Liu Q.; Lei L. Institution (Chen, Wu, Zou, Chen, Liu, Lei) Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China Abstract To investigate the efficacy of HA380 hemoadsorption during cardiopulmonary bypass (CPB) in reducing postoperative delirium (POD) and improving clinical outcomes in elderly cardiac surgery patients. A prospective, single-center, evaluator-blinded, randomized controlled trial. Single institution, tertiary university hospital. 130 patients were randomized (HA380 n = 65; control n = 65), with 128 included in the complete-case primary analysis (64 per group). Eligible patients were aged >= 65 years and scheduled for cardiac surgery under CPB with anticipated duration > 2 h. The intervention group received HA380 hemoadsorption integrated into the CPB circuit; the control group underwent standard CPB. Outcome assessors remained blinded to group allocation. The primary endpoint was POD incidence within 7 days postoperatively, assessed using the confusion assessment method. Secondary outcomes included inflammatory biomarkers (TNF-alpha, IL-6, IL-10), liver function markers (ALT, AST, CRP), renal function (creatinine, procalcitonin), and postoperative complications. The primary unadjusted analysis showed a significantly lower incidence of delirium in the HA380 group versus controls (28.1% [18/64] vs 51.6% [33/64]; unadjusted OR 0.38, 95% CI 0.18-0.81; P = 0.012). Multivariable adjustment (primary analysis per locked SAP v1.0 Model I: age and hypertension) yielded an adjusted OR of 0.42 (95% CI 0.19-0.91; P = 0.028), with consistent results in sensitivity analysis additionally adjusting for coronary artery disease (OR 0.41, 95% CI 0.18-0.89; P = 0.025). Results were robust in random-forest multiple-imputation sensitivity analyses. HA380 significantly attenuated inflammatory markers (permutation P < 0.01 for IL-6, IL-10, and TNF-alpha at surgery-end/24 h) and significantly reduced ALT levels (permutation P = 0.015). However, no significant differences were observed for AST, CRP, creatinine, procalcitonin, mechanical ventilation duration, ICU length of stay, total hospital stay, or postoperative complications. Exploratory analyses suggested shorter delirium duration among patients who developed POD in the HA380 group (median 3 [2-3] vs 4 [3-5] days, P = 0.021). In this single-center, preliminary efficacy trial, HA380 hemoadsorption during CPB significantly reduced POD incidence in elderly cardiac surgery patients. These findings require confirmation in larger, multicenter, adequately powered trials with pre-specified secondary hierarchies and long-term cognitive follow-up. Copyright © 2026. The Author(s). <123> Accession Number 650818826 Title CAD-Man EXTEND: Long-term clinical results of a single centre randomised controlled trial comparing CT with ICA. Source Insights into Imaging. Conference: ECR 2025. Vienna Austria. 16(Supplement 1) (pp 289), 2025. Date of Publication: 01 Jul 2025. Author Stantien A.-M.; Biavati F.; Stahl A.-C.; Chimed S.; Mohamed M.; Serna Higuita L.M.; Bosserdt M.; Dewey M. Institution (Stantien, Biavati, Stahl, Chimed, Mohamed, Bosserdt, Dewey) BerlinGermany (Serna Higuita) TubingenGermany Publisher Springer Science and Business Media Deutschland GmbH Abstract Purpose or Learning Objective: To investigate major adverse cardiovascular events (MACE) after 10 years of follow-up in patients with an intermediate probability of coronary artery disease (CAD) undergoing computed tomography (CT) or invasive coronary angiography (ICA). Methods or Background: This is the 10-year long-term clinical follow-up of the single centre randomised CAD-Man (Coronary Artery Disease Management) trial comparing CT with ICA in patients with atypical angina or chest pain clinically referred for ICA. Clinical follow-up was done by interviewing patients using questionnaires asking about MACE (myocardial infarction, stroke, unstable angina, (surgical) re-/revascularization, cardiac death) in the past 10 years. Additionally, every patient was offered a cardiac CT scan and blood samples were taken. The association between randomisation group and MACE was assessed using a multivariate Cox proportional hazards model. Results or Findings: Out of 329 patients included in CAD-Man 106 patients completed the clinical long-term follow-up resulting in a total median follow-up of 4.9 years. Additional 18 MACE cases occurred, 7/49 (14%) of which in the CT group and 11/57 (19%) in the ICA group. There was no statistically significant difference in MACE between the two randomisation arms. The HR was 0.86 (95% CI 0.42-1.74) in the CT group. Conclusion(s): After 10 years of follow-up, the survival and the occurrence of MACE was similar in the CT group compared to the ICA group for patients referred for ICA because of atypical angina or stable chest pain and an intermediate pretest probability of CAD. <124> Accession Number 650817610 Title Liposomal bupivacaine for parasternal blocks in cardiac surgery: a promising addition to the peri-operative toolbox?. Source Anaesthesia. Conference: Winter Scientific Meeting 2024. London United Kingdom. 73(Supplement 1) (pp 8), 2024. Date of Publication: 01 Jan 2024. Author Ashe M.; Bhawnani A.; Keogh T.; Shankar S. Institution (Ashe, Bhawnani, Keogh) Liverpool Heart and Chest Hospital NHS Foundation Trust, United Kingdom (Shankar) Liverpool University Hospitals NHS Foundation Trust, United Kingdom Publisher John Wiley and Sons Inc Abstract Acute pain after cardiac surgery is common and related to poorer outcomes, and parasternal blocks are a useful adjunct as part of multimodal analgesia [1, 2]; however, pain persists beyond the duration of a single-shot block, so our institution began using liposomal bupivacaine, a multi-vesicular drug system that releases bupivacaine over 96 h. Comparing outcomes in patients receiving common practice within the Trust (no block) with those receiving parasternal block with liposomal bupivacaine allowed us to review the impact of this change. Methods Postoperative opioid consumption over 5 days was compared in 25 patients having cardiac surgery with an ultrasound guided pre-incision parasternal block (mix of 20 ml liposomal bupivacaine and 20 ml 0.25% levobupivacaine across four injection sites), with 24 patients having no block (matched to surgical procedure). Secondary outcomes included intra-operative opioid use, use of adjuncts, requirement for advanced respiratory support postoperatively, re-admission to critical care, length of intensive care unit (ICU) and hospital stay, and bowel opening. Results Euroscore and demographic variables were not significantly different between the groups. As seen in Discussion These results show that liposomal bupivacaine parasternal blocks are a safe and potentially useful addition to peri-operative care in cardiac surgery. The block does not cover drain or donor sites, which might explain an ongoing requirement for strong opioids, but promising secondary outcomes suggest a potential reduction of respiratory complications, which could be related to less pain-related restriction of breathing. The numbers involved were small and we would like to undertake further study such as a randomised controlled trial to ascertain the significance of these early indications. <125> Accession Number 650799282 Title Deferral of percutaneous coronary intervention in patients undergoing transcatheter aortic valve implantation (PRO-TAVI): an investigator-initiated, multicentre, open-label, non-inferiority, randomised controlled trial. Source Lancet (London, England). (no pagination), 2026. Date of Publication: 29 Mar 2026. Author Delewi R.; Aarts H.M.; Broeze G.M.; Hemelrijk K.I.; van Ginkel D.J.; Versteeg G.A.A.; Grundeken M.J.; Claessen B.E.P.M.; Tonino P.A.L.; Schotborgh C.E.; Meuwissen M.; van Houwelingen G.K.; Wykrzykowska J.J.; Amoroso G.; Vossenberg T.N.; Vriesendorp P.A.; van Royen N.; Ten Berg J.M.; Tijssen J.G.P.; Voskuil M. Institution (Delewi, Broeze, Hemelrijk, Grundeken, Claessen, Tijssen) Department of Cardiology, Amsterdam University Medical Centres, Amsterdam, Netherlands (Aarts) Department of Cardiology, Amsterdam University Medical Centres, Amsterdam, Netherlands; Department of Cardiology, University Medical Centre Utrecht, Utrecht, Netherlands (van Ginkel) Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands (Versteeg, van Royen) Department of Cardiology, Radboud University Medical Centre, Nijmegen, Netherlands (Tonino) Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, Netherlands; Department of Biomedical Engineering, Technical University Eindhoven, Eindhoven, Netherlands (Schotborgh) Department of Cardiology, Haga Hospital, The Hague, Netherlands (Meuwissen) Department of Cardiology, Amphia Hospital, Breda, Netherlands (van Houwelingen) Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, Netherlands (Wykrzykowska) Department of Cardiology, Groningen UMC, Groningen, Netherlands (Amoroso) Department of Cardiology, OLVG, Amsterdam, Netherlands (Vossenberg) Department of Cardiology, Medical Centre Leeuwarden, Leeuwarden, Netherlands (Vriesendorp) Department of Cardiology, Maastricht University Medical Centre, Maastricht, Netherlands (Ten Berg) Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands; Cardiovascular Research Institute Maastricht, Maastricht, Netherlands (Voskuil) Department of Cardiology, University Medical Centre Utrecht, Utrecht, Netherlands Abstract BACKGROUND: Coronary artery disease is common in patients undergoing transcatheter aortic valve implantation (TAVI). We aimed to assess whether deferral of percutaneous coronary intervention (PCI) is non-inferior to routine PCI before TAVI in patients with coronary artery disease. METHOD(S): In this investigator-initiated, open-label, randomised controlled trial, done at 12 hospitals in the Netherlands, TAVI patients with coronary artery disease were randomly assigned in a 1:1 ratio to deferral of PCI or PCI before TAVI. Randomisation was done by use of a web-based system with random block sizes of 2 and 4, and stratification by presence of coronary artery disease involving proximal left anterior descending artery. The primary endpoint was a composite of all-cause mortality, myocardial infarction, stroke, and major bleeding at 1 year. Non-inferiority testing was done in the intention-to-treat population against the prespecified margin of 11 percentage points. The study is registered with ClinicalTrials.gov (NCT05078619) and long-term follow-up is ongoing. FINDINGS: Between Oct 7, 2021, and Nov 19, 2024, 466 patients were enrolled: 233 were assigned to deferral of PCI and 233 to PCI before TAVI. Median age was 81 years (IQR 78-84), and 166 (36%) of 466 patients were female. The primary endpoint occurred in 56 (24%) of 233 patients in the deferral group as compared with 60 (26%) of 233 patients in the PCI group (rate difference -1.7% [95% CI -9.5 to 6.2]; hazard ratio 0.89 [95% CI 0.62-1.28]; p=0.0008 for non-inferiority; p=0.68 for superiority). INTERPRETATION: In patients with coronary artery disease undergoing TAVI, deferral of PCI was non-inferior to PCI before TAVI for the 1-year composite of all-cause mortality, myocardial infarction, stroke, and major bleeding. These findings suggest that an initial conservative strategy can be appropriate in selected patients, although patient-tailored treatment decisions remain essential.ZonMw. Copyright © 2026 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies. <126> Accession Number 2044703542 Title European Uncomplicated Type B Aortic Repair Pretrial Setup: Paradox and Analysis. Source Journal of Vascular Surgery. Conference: Journal of Vascular Surgery. Boston United States. 83(5 Supplement) (pp S55), 2026. Date of Publication: 01 May 2026. Author Bashir M.; Jubouri M. Institution (Bashir) Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, United Kingdom (Jubouri) Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom Publisher Elsevier Inc. Abstract Objective: The European Uncomplicated Type B Aortic Repair (EU-TBAR) trial is being developed to compare preemptive thoracic endovascular aortic repair (TEVAR) with optimal medical management. The pretrial setup involves three pillars: (1) a European multicenter assessment of volume and activity, (2) multicenter reporting of uncomplicated type B aortic dissection (uTBAD) outcomes, and (3) understanding the cost-benefit analysis of preemptive TEVAR across the participating European centers. Method(s): Pillar 1 included a cross-sectional survey of 37 vascular centers across 14 European countries that examined uTBAD case volumes, intervention preferences, risk assessment, and governance. Pillar 2 focused on the analysis of 263 patients undergoing TEVAR across participating centers, assessing demographics, operative details, complications, reinterventions, aortic remodeling, and survival. Multivariable logistic regression identified predictors of mortality, reintervention, and remodeling. Result(s): Pillar 1 demonstrated variation in practice: 43.2% favor preemptive TEVAR (median, 50% of uTBAD cases), favoring subacute timing, with rapid aortic enlargement identified as the primary high-risk marker. Governance frameworks were available in most centers, though transfer protocols were inconsistent. In the Pillar 2 outcome-reporting cohort, the mean age was 61.4 +/- 13.4 years; 79.5% were male. In-hospital mortality was 9.9%, with 14.1% dying during follow-up (median follow-up of approximately 1 year). Independent predictors of mortality included postoperative AKI (odds ratio [OR], 9.93; P < .0001), AKI at presentation (OR, 4.24; P = .012), syncope (OR, 3.15; P < .0001), and prolonged ventilation (OR, 2.69; P = .024); higher hemoglobin and glomerular filtration rate were protective factors. Reinterventions were performed in 18.3% of patients, most often due to endoleak or TEVAR extension; discharge endoleak increased reintervention odds threefold. Positive aortic remodeling was associated with beta-blocker use, previous thoracic aortic surgery, and targeted branch stenting. Female sex independently predicted false lumen thrombosis at follow-up (OR, 11.53; P = .022). Conclusion(s): The pretrial setup and analysis successfully confirm the feasibility and methodological foundation for the definitive EU-TBAR randomized controlled trial. There is a clinical equipoise across European centers, with significant practice variation justifying a randomized trial comparing preemptive TEVAR versus medical management for uTBAD. Key mortality predictors provide objective criteria for patient selection, while the reintervention rate establishes important trial end points. Copyright © 2025 <127> Accession Number 650800594 Title Landiolol for the prevention of postoperative atrial fibrillation after cardiac surgery: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials. Source Anaesthesia, critical care & pain medicine. (pp 101842), 2026. Date of Publication: 30 Mar 2026. Author Elbahloul M.A.; Badran A.S.; Shawky A.; Akoum A.; Awad A.K.; Medhat A.; El-Diasty M. Institution (Elbahloul) Faculty of Medicine, Kafr El-Shaikh University, Egypt (Badran) Faculty of Medicine, Ain-Shams University, Cairo, Egypt (Shawky) Faculty of Medicine, Benha University, Qalyubia, Egypt (Akoum) Department of Medicine, Hennepin Healthcare, Minneapolis MN, United States (Awad) Faculty of Medicine, Galala University, Suez, Egypt (Medhat) Faculty of Medicine for Men in Asyut, Al-Azhar University, Egypt (El-Diasty) Division of Cardiac Surgery, Harrington Heart and Vascular Institute, Cleveland Medical Center, University Hospitals, Cleveland, OH, United States Abstract BACKGROUND: Postoperative atrial fibrillation (POAF) occurs in up to 30% of patients undergoing cardiac surgery. Landiolol is an ultrashort-acting, highly beta1-selective intravenous beta blocker. We aimed to investigate the effect of landiolol in the prevention of POAF. METHOD(S): Electronic databases were searched for randomized clinical trials (RCTs) evaluating landiolol for the prevention of POAF. Dichotomous outcomes were reported as odds ratios (ORs) and continuous outcomes as mean differences (MDs), each with 95% confidence intervals. The primary outcome was the incidence of POAF. RESULT(S): A total of 11 RCTs, including 1,264 patients, were analyzed. Landiolol was associated with a significantly lower incidence of POAF compared with the control group (OR: 0.35, 95% CI: 0.23-0.53, p < 0.01). There were no significant differences between landiolol and the control group in terms of hospital mortality, length of hospital stay, heart failure, or major complications. CONCLUSION(S): Landiolol appears to be an effective agent for the prevention of POAF in patients undergoing cardiac surgeries. Large-scale, multi-ethnic RCTs are needed to confirm these findings. Copyright © 2026. Published by Elsevier Masson SAS. <128> Accession Number 650795406 Title Effects of Preprocedural Acupressure on Pain, Anxiety, and Vital Signs in Patients Undergoing Transradial Coronary Angiography: A Randomized Controlled Trial. Source Pain management nursing : official journal of the American Society of Pain Management Nurses. (no pagination), 2026. Date of Publication: 30 Mar 2026. Author Ozen S.; Aydin D.; Sinmaz T. Institution (Ozen) Angiography Unit, Kocaeli City Hospital, Kocaeli, Turkey (Aydin, Sinmaz) Faculty of Health Sciences, Bandirma Onyedi Eylul University, Balikesir, Turkey Abstract AIM: To evaluate the effects of pre-procedural acupressure on pain, anxiety, and vital signs among patients undergoing transradial coronary angiography. DESIGN: A single-blind, three-arm randomized controlled trial was conducted. METHOD(S): Ninety-three eligible participants were randomly allocated to acupressure, sham, or control groups. The acupressure intervention was applied for 20 minutes to the HT7, LI4, and PC6 acupoints prior to the procedure. Pain, anxiety, and vital signs were assessed at five time points: twice before transradial coronary angiography and at 0, 2, and 4 hours postprocedure. RESULT(S): Pain, anxiety, and systolic blood pressure were significantly lower in the acupressure group than in the sham and control groups. No significant differences were observed in diastolic blood pressure, heart rate, respiratory rate, or oxygen saturation. CONCLUSION(S): Preprocedural acupressure effectively reduces pain and anxiety and contributes to hemodynamic stability in patients undergoing transradial coronary angiography. CLINICAL IMPLICATIONS: Acupressure may be considered a simple and low-cost complementary nursing intervention that could support symptom management in patients undergoing cardiovascular procedures. Copyright © 2026 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved. <129> Accession Number 650804160 Title Perioperative outcomes and safety of Uniportal Robotic-Assisted Thoracic Surgery (U-RATS) for anatomic lung resection: a systematic review and meta-analysis. Source Journal of robotic surgery. 20(1) (no pagination), 2026. Date of Publication: 02 Apr 2026. Author Kaaki S.; Barnawi A.B.; Robaidi H.A.; Maghrabi A.A.; Almaymuni A.D.; Alzahim A.; Almahmoud A.; Alsalem K.A.; Alshehri Y.M.; Alsharari H.S.; Hajjar W.M. Institution (Kaaki, Hajjar) Department of Surgery, Division of Thoracic Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia (Barnawi, Almahmoud, Alsalem, Alshehri) College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia (Robaidi) College of Medicine, Alfaisal University, Riyadh, Saudi Arabia (Maghrabi) Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (Almaymuni) Department of Surgery, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (Alzahim) King Saud University Medical City, Riyadh, Saudi Arabia (Alsharari) College of Medicine, AlMaarefa University, Riyadh Region, Riyadh, SA, Saudi Arabia <130> [Use Link to view the full text] Accession Number 650812418 Title Post-Catheter Ablation Long-Term Antithrombotic Strategies in Atrial Fibrillation: A Network Meta-Analysis of Randomized Controlled Trials. Source Circulation. Arrhythmia and electrophysiology. (pp e014692), 2026. Date of Publication: 03 Apr 2026. Author Rodriguez-Riascos J.F.; Navale D.; Somappa A.; Estrada Mendizabal R.; Scott L.R.; Shen W.-K.; Srivathsan K. Institution (Rodriguez-Riascos, Navale, Somappa, Scott, Shen, Srivathsan) Department of Cardiovascular Diseases, Mayo Clinic, Phoenix, AZ (J.F.R.-R., D.N., A.S., L.R.S., W.-K.S., K.S.) (Estrada Mendizabal) Department of Medicine, NYC Health and Hospitals/Elmhurst, Icahn School of Medicine at Mount Sinai, Elmhurst, United States Abstract BACKGROUND: Catheter ablation for atrial fibrillation is a widely used rhythm-control strategy, yet its role in reducing thromboembolic risk and enabling oral anticoagulation (OAC) discontinuation remains uncertain. This meta-analysis aims to comprehensively synthesize and evaluate randomized controlled trial evidence supporting long-term antithrombotic strategies in patients with atrial fibrillation undergoing catheter ablation. METHOD(S): A systematic literature search was performed in MEDLINE/PubMed, Embase, and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials evaluating antithrombotic strategies after catheter ablation for atrial fibrillation. The primary outcome was ischemic stroke. A frequentist network meta-analysis comparing reported treatment arms, along with a pooled incidence meta-analysis for outcomes of interest, was conducted. RESULT(S): Four randomized controlled trials, including 3924 patients, met the inclusion criteria. Three trials compared long-term OAC continuation versus OAC discontinuation, and 1 compared OAC continuation with left atrial appendage occlusion after catheter ablation. No significant differences in stroke incidence were observed when comparing OAC or left atrial appendage occlusion with no antithrombotic therapy (incidence rate ratio, 0.90 [95% CI, 0.02-33.85]; P=0.95; incidence rate ratio, 0.79 [95% CI, 0.00-241.01]; P=0.94, respectively). Among patients who discontinued antithrombotic therapy without undergoing left atrial appendage occlusion (n=1161), with 2864 cumulative person-years of follow-up, the pooled incidence of stroke was 0.23 events per 100 person-years (95% CI, 0.02-2.43; I2=0%). CONCLUSION(S): This analysis reinforces that, across randomized data, the incidence of thromboembolic events in patients who discontinued OAC after successful ablation remained low. However, the evaluation of net clinical benefit is limited by the low number of events across all treatment arms, underscoring the need for larger studies with prolonged follow-up to further validate the safety of this strategy, particularly in higher-risk populations. <131> Accession Number 2044435760 Title Safety and efficacy of ticagrelor plus aspirin vs. aspirin monotherapy in patients undergoing coronary artery bypass grafting: A meta-analysis with trial sequential analysis. Source Journal of Thrombosis and Thrombolysis. (no pagination), 2026. Date of Publication: 2026. Author Hammadeh B.M.; Hussein A.M.; Alhamwi N.; Odat R.M.; Naseem M.; Asawaeer M. Institution (Hammadeh, Hussein) Al-Balqa' Applied University, As-Salt, Jordan (Alhamwi) The University of Jordan, Amman, Jordan (Odat) Jordan University of Science and Technology, Irbid, Jordan (Naseem) Department of Internal Medicine, LSU HEALTH Shreveport, Shreveport, LA, United States (Asawaeer) Burnett School of Medicine, Texas Christian University, Fort Worth, TX, United States (Asawaeer) Division Chief of Cardiology, Texas Health Harris Methodist Hospital Fort Worth, Fort Worth, TX, United States Publisher Springer Abstract Optimal antiplatelet therapy after coronary artery bypass grafting (CABG) remains debated. While aspirin is standard, the benefit of adding ticagrelor, a P2Y12 inhibitor with distinct pharmacological properties, is unclear. We compared the efficacy and safety of ticagrelor plus aspirin versus aspirin alone in patients undergoing CABG. We systematically searched major databases for randomized controlled trials and observational studies comparing ticagrelor plus aspirin with aspirin alone in post-CABG patients. The primary efficacy endpoint was trial-defined MACE. Secondary efficacy endpoints included all-cause mortality, cardiovascular death, stroke, MI, revascularization, and saphenous vein graft failure. The primary safety endpoint was major bleeding. A total of seven studies (five randomized controlled trials (RCTs) and one observational study) were included, enrolling 11,893 patients post-CABG, primarily for acute coronary syndrome or stable angina. The majority of studies had a follow-up duration of one year. Ticagrelor plus aspirin significantly reduced the risk of trial-defined MACE (RR 0.61, 95% CI 0.45-0.84; I2 = 0%) and stroke (RR 0.49, 95% CI 0.29-0.82; I2 = 11.5%), but did not reduce all-cause mortality, myocardial infarction, or cardiovascular death. However, it significantly increased the risk of major bleeding (RR 1.70, 95% CI 1.06-2.71; I2 = 42%), while minor bleeding showed no difference (RR 2.38, 95% CI 0.88, 6.43; I2 = 39%). In a sensitivity analysis restricted to RCTs alone (n = 4,905), the reduction in trial-defined MACE remained significant (RR 0.61, 95% CI 0.45-0.84), while the reduction in stroke (RR 0.74, 95% CI 0.35-1.56) and the increase in major bleeding (RR 1.82, 95% CI 0.77-4.34) were no longer statistically significant. In patients undergoing CABG, the addition of ticagrelor to aspirin reduces trial-defined MACE and stroke compared with aspirin alone, but increases the risk of major bleeding without a mortality benefit. These findings support a personalized, risk-stratified approach to antiplatelet therapy, though they are limited by the number and heterogeneity of available studies. Further trials are warranted to define the optimal antiplatelet regimen in this population. Clinical Trial Registration Number: Not applicable. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <132> Accession Number 2044614954 Title Transcatheter aortic valve implantation in centers without a cardiac surgery department: a meta-analysis of contemporary evidence. Source Postepy w Kardiologii Interwencyjnej. 22(1) (pp 58-69), 2026. Date of Publication: 2026. Author de Almeida A.R.; Viana R.; Fernandes R.; Bento A.; Bras D.; Congo K.; Patricio L. Institution (de Almeida, Viana, Fernandes, Bento, Bras, Congo, Patricio) Hospital Espirito Santo de Evora, Portugal Publisher Termedia Publishing House Ltd. Abstract Introduction: The prevalence of aortic stenosis (AS) is increasing, resulting in a growing demand for aortic valve interventions. Current guidelines recommend transcatheter aortic valve implantation (TAVI) only in centers with on-site cardiac surgery (CS) backup. However, procedural advancements have reduced the need for emergent cardiac surgery (ECS), prompting a debate about the necessity of backup for this procedure. This meta-analysis evaluated the safety of TAVI performed in centers without CS backup. Material(s) and Method(s): The study was conducted in accordance with the MOOSE guidelines. The protocol was registered at PROSPERO (CRD420251044095). PubMed, CENTRAL, and Scopus were systematically searched up to November 2025. Studies comparing outcomes of TAVI performed with and without on-site CS or reporting outcomes of TAVI in non-CS centers were included. The outcomes were in-hospital mortality, 30-day death, need for ECS, and stroke. Meta-analyses of comparative studies and pooled proportions were performed using random-effects models. Risk of bias was evaluated using the ROBINS-I tool. Result(s): Eight observational studies were analyzed, including 22,203 patients (19,373 with and 2830 without on-site CS). No significant difference in in-hospital mortality was observed between groups (relative risk [RR] = 1.1, 95% CI: 0.6-1.9, p = 0.8). Thirty-day mortality was also similar (RR = 1.2, 95% CI: 0.5-2.6, p = 0.72). ECS did not occur (0%; 95% CI: 0-1), with an RR of 0.8 (95% CI: 0.2-2.4, p = 0.7). Stroke rates did not differ (RR = 1.1, 95% CI: 0.8-1.5). Pooled in-hospital mortality in non-surgical centers was 3% (95% CI: 1-4%), and 30-day mortality was 4% (95% CI: 2-6%). Sensitivity analyses in propensity score-matched populations confirmed findings with reduced heterogeneity and consistent results. Conclusion(s): TAVI performed in centers without on-site cardiac surgery demonstrated comparable outcomes to those with surgical backup, suggesting that selected programs may safely operate under this model. These findings support reconsidering current guideline restrictions to enhance access and equity in TAVI delivery. Copyright © Termedia Sp. z o. o. <133> Accession Number 2037935254 Title Ultrasound-guided in-plane and Out-of-plane Techniques Versus Landmark Technique for Internal Jugular Vein Catheterization in Adult Cardiac Surgery Patients. Source Kathmandu University Medical Journal. 23(4) (pp 458-463), 2025. Date of Publication: 01 Oct 2025. Author Amatya A.; Pudasaini A.; Bhusal S.; Bajracharya S.M.; Shrestha B.K.; Pandey P.; Shrestha B.M. Institution (Amatya, Pudasaini, Bhusal, Bajracharya, Shrestha, Pandey, Shrestha) Department of Anesthesia, Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Nepal Publisher Kathmandu University Abstract Background Internal jugular vein (IJV) catheterization is routinely performed in cardiac surgical patients. Ultrasound (US) guidance has been shown to increase success rates and reduce complications compared to landmark (LM) techniques; however, access to ultrasound machines and operator skill remain limitations in several centers. Objective To compare two different real-time 2-dimensional ultrasound-guided short axis/out-off-plane (SAX OOP) and long axis/in-plane (LAX IP) approaches and to determine whether ultrasound guidance could improve the success rate and decrease the complication rate of internal jugular vein catheterization compared with the landmark approach (LM). Method This Prospective, randomized comparative study evaluated three techniques for internal jugular vein cannulation in adult elective cardiac surgery patients (n=90): (1) real-time short-axis/out-of-plane ultrasound guidance (SAX-OOP), (2) real-time long-axis/in-plane ultrasound guidance (LAX-IP), and (3) landmark technique (LM). Primary outcomes included number of attempts and procedure duration. Secondary outcomes included mechanical complications. Chi-square for categorical variables and one-way ANOVA for continuous variables were applied to find out the associations. Result First-attempt success was highest in LAX-IP (100%), followed by SAX-OOP (96.7%) and LM (83.3%) (p=0.024). All complications (n=7) occurred in the LM group (p=0.001). Mean cannulation time was significantly longer in the LM group (90.83+/-13.23 seconds) versus SAX-OOP (60.47+/-10.96 seconds) and LAX-IP (70.47+/-23.10 seconds) (p<0.001). Conclusion Real-time ultrasound guidance, particularly the in-plane technique, significantly improves success rates, reduces complications, and shortens cannulation time compared with the landmark technique. Ultrasound guidance should be preferred for internal jugular vein cannulation in cardiac anesthesia settings. Copyright © 2025, Kathmandu University. All rights reserved. <134> Accession Number 2044425697 Title Key considerations in a meta-analysis of physiology-guided percutaneous vs surgical revascularization in multivessel coronary artery disease. Source World Journal of Cardiology. 18(3) (no pagination), 2026. Article Number: 115153. Date of Publication: 01 Jan 2026. Author Tsai T.Y.; Garg S.; Serruys P.W. Institution (Tsai, Serruys) CORRIB Research Centre for Advanced Imaging and Core Laboratory, University of Galway, Galway, Ireland (Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn, United Kingdom (Garg) School of Medicine, University of Lancashire, Preston, United Kingdom Publisher Baishideng Publishing Group Inc Abstract We read the meta-analysis by Kataveni et al with great interest; however, we have identified two major methodological errors. First, the population from the Fractional Flow Reserve Versus Angiography for Multivessel Evaluation 3 (FAME 3) trial appears to have been double-counted through inclusion of both Fearon et al (primary FAME 3 trial) and Dillen et al (a FAME 3 bifurcation substudy), likely violating the independence assumptions required for meta-analytic pooling. Second, the study by Di Gioia et al (2020) has been misclassified as a randomized controlled trial, whereas it is a registry-based, non-randomized study. Because the authors' conclusions rely on the inclusion of "three randomized controlled trials" with minimal heterogeneity, these errors may overstate the certainty of the evidence and introduce bias into the pooled estimates. We request that the authors address these concerns, perform a re-analysis as required, and revise the manuscript accordingly. Ultimately, these issues reflect the general paucity of high-quality randomized data in this field. Copyright © (2026), (Baishideng Publishing Group Inc). All rights reserved. <135> [Use Link to view the full text] Accession Number 2044139603 Title Comparison of Fasting and Nonfasting Regimens Outcomes Before Catheterization Laboratory Procedures: A Systematic Review and Meta-Analysis. Source Critical Pathways in Cardiology. 25(1) (pp e0402), 2026. Date of Publication: 01 Mar 2026. Author Shojaei S.; Mousavi A.; Radkhah H.; Mahalleh M.; Rahmati S.; Soltani P.; Farooqi M.A.; Ashrafi M.M.; Bozorgi S.J.; Moradi A.; Askari M.K.; Nasir K.; Almandoz J.P.; Hakim D.; Kuno T.; Hosseini K. Institution (Shojaei, Mousavi, Mahalleh, Rahmati, Soltani, Ashrafi, Bozorgi, Hosseini) Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Shojaei, Mousavi, Mahalleh, Rahmati, Soltani, Ashrafi, Bozorgi, Hosseini) Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Radkhah) Internal Medicine Department, School of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Farooqi) Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, MI, United States (Moradi) Blake Hospital, HCA Healthcare, University of South Florida, Morsani College of Medicine, Bradenton, Florida, United States (Askari) Department of Medicine, Assistant Professor Clerkship Director Internal Medicine, University of Toledo, OH, United States (Nasir) Division Cardiovascular and Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States (Almandoz) Division of Endocrinology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States (Hakim) Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States (Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, NY, United States Publisher Lippincott Williams and Wilkins Abstract Guidelines recommend fasting before catheterization laboratory (cath lab) procedures. However, recent studies question the necessity of fasting, suggesting that fasting may not provide significant clinical benefits. This study aims to evaluate the existing evidence between outcomes for patients with fasting and nonfasting regimens. We conducted a comprehensive search for randomized controlled trials comparing fasting and nonfasting protocols before cath lab procedures. Outcomes included hypoglycemia, aspiration pneumonia, contrast nephropathy, all-cause mortality, and cardiovascular mortality. A random effects meta-analysis was performed to derive odds ratios (ORs) and 95% confidence intervals (CIs). The meta-analysis included 8 randomized controlled trials with a total of 3068 participants: 1544 in the fasting group and 1524 in the nonfasting group. Compared with fasting, nonfasting was not associated with significant differences in hypoglycemia (OR = 0.77, 95% CI, 0.44-1.34), aspiration pneumonia (OR = 1.33, 95% CI, 0.38-4.72), contrast nephropathy (OR = 1.82, 95% CI, 0.88-3.75), all-cause mortality (OR = 1.29, 95% CI, 0.51-3.28), or cardiovascular mortality (OR = 0.94, 95% CI, 0.22-4.05). Nonfasting regimens show no significant differences in safety outcomes compared with fasting, suggesting it may be implemented to improve patient experience without compromising safety. Larger trials are needed to confirm the safety of nonfasting regimens. Summary of outcomes (CEID, cardiac implantable electronic device; PCI, percutaneous coronary intervention; TAVR, transcatheter aortic valve replacement). The design features graphical elements sourced from Servier Medical Art, which are provided by Servier under the Creative Commons Attribution 4.0 unported license. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <136> Accession Number 650814376 Title Comment on "Postoperative Sleep Interventions and Cardiac Surgery: A Systematic Review and Meta-Analysis". Source ANZ journal of surgery. (no pagination), 2026. Date of Publication: 03 Apr 2026. Author Cao B.; Ouyang M. Institution (Cao) Department of Cardiology, Central Hospital of Yongzhou, Yongzhou, China (Cao) Department of Cardiology, Yongzhou Hospital Affiliated to University of South China, Yongzhou, China (Ouyang) First Affiliated Hospital of Jishou University, China <137> Accession Number 650800219 Title Non-invasive vessel fractional flow reserve versus fractional flow reserve guidance to revascularize intermediate coronary stenosis (LIPSIA-STRATEGY) trial: study protocol for a randomized controlled trial. Source Trials. (no pagination), 2026. Date of Publication: 01 Apr 2026. Author Majunke N.; Desch S.; Kister T.; Buske M.; Poss J.; Feistritzer H.-J.; Erbs S.; Hosler N.; Wolff J.; Schneider S.; Ouarrak T.; Woitek F.; Lenk K.; Nef H.; Dorr O.; Sossalla S.; Achenbach S.; Marwan M.; Barlagiannis D.; Haude M.; Mahabadi A.A.; Rassaf T.; Thiele H. Institution (Majunke, Desch, Kister, Buske, Poss, Feistritzer, Erbs, Thiele) Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany (Hosler, Wolff) Leipzig Heart Science, Leipzig, Germany (Schneider, Ouarrak) Institut fur Herzinfarktforschung, Ludwigshafen am Rhein, Germany (Woitek) Heart Center Dresden - Technische Universitat Dresden, Dresden, Germany (Lenk) University Clinic Leipzig, Klinik und Poliklinik fur Kardiologie, Leipzig, Germany (Nef) Cardiology Department, Heart Center, Segeberger Kliniken GmbH, Bad Segeberg, Germany (Dorr) CCB Am Markuskrankenhaus, Med. Klinik III, Agaplesion Markuskrankenhaus, Frankfurt Am Main, Germany (Sossalla) Department of Internal Medicine/Cardiology, University Clinic Giessen, Giessen, Germany (Achenbach, Marwan) Department of Cardiology, Erlangen-Nurnberg, Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Germany (Barlagiannis, Haude) Medical Clinic I, Rheinland Klinikum Neuss GmbH, Lukaskrankenhaus, Neuss, Germany (Mahabadi, Rassaf) Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany Abstract BACKGROUND: Current guidelines on coronary revascularization support the use of wire-based coronary physiology measurements to guide decision making in patients with coronary artery stenoses. Nevertheless, the use of these techniques in clinical practice is variable and its application worldwide remains limited by its requirement for the use of an intracoronary pressure wire and prolonged procedure time. Recently, angiography-based wire-free techniques to estimate fractional flow reserve (FFR) values have been introduced. These developments may translate towards more physiology-guided intervention bearing the potential to improve clinical outcomes in patients with stable coronary artery disease (CAD). METHOD(S): The LIPSIA-STRATEGY trial is a randomized controlled, investigator-initiated, multicenter, open-label study. A total of 1054 eligible patients will be randomized 1:1 to coronary revascularization based on angiography-derived vessel fractional flow reserve (vFFR) or revascularization based on FFR obtained by pressure wire measurements. The major inclusion criterion is the presence of visually assessed intermediate coronary artery stenoses in one or more native major epicardial coronary arteries in the setting of stable angina or an acute coronary syndrome (ACS). In patients with an ACS, only non-culprit vessels will be considered for inclusion. The primary endpoint is the occurrence of major adverse cardiovascular events (MACE) during the first year after randomization. DISCUSSION(S): The LIPSIA-STRATEGY trial will be the first to compare angiography-derived vFFR with invasive FFR with respect to clinical outcomes in patients with intermediate coronary lesions. TRIAL REGISTRATION: ClinicalTrials.gov NCT03497637. Registered 2018-04-13. Copyright © 2026. The Author(s). <138> Accession Number 650786867 Title A systematic review of Comprehensive Geriatric Assessment (CGA), or interventions aimed at its components, in older patients undergoing Transcatheter Aortic Valve Implantation (TAVI). Source European Geriatric Medicine. Conference: 19th Congress of the European Geriatric Medicine Society. Helsinki Finland. 14(1 Supplement) (pp S134-S135), 2023. Date of Publication: 01 Dec 2023. Author Chin K.; Jones R.; Schiff R. Institution (Chin, Jones) Guy's and St Thomas' NHS Foundation Trust, United Kingdom (Schiff) King's College London, United Kingdom Publisher Springer Science and Business Media Deutschland GmbH Abstract Introduction: Older adults living with frailty who have severe aortic stenosis are often offered a TAVI, however increasing frailty is associated with worse outcomes post-procedure. This study evaluates the evidence to determine whether CGA, or interventions aimed at its component, may improve outcomes for this population. Method(s): EMBASE, MEDLINE, Cochrane, CINAHL, ClinicalTrial. gov and WHO Trials were searched on 09/01/23 for trials that evaluated CGA, or its components, in over 65-year-olds pre-or post-TAVI. The review was conducted using PRISMA guidelines and registered on PROSPERO (CRD42022299955). Two independent reviewers independently screened and assessed included papers for risk of bias using the Cochrane RoB and ROBINS-I tool. Result(s): Nineteen studies met the eligibility criteria. Of those, one observational study evaluated the effect of CGA in older adults undergoing TAVI. Eighteen studies evaluated an intervention targeting a domain of CGA. All studies had at least a moderate risk of bias, with the majority having a high risk of confounding due to lack of randomisation or adequate control groups. There was very lowquality evidence suggesting that CGA may improve functional independence and physical performance post-TAVI, but conflicting results regarding the impact of exercise-based programmes and multicomponent interventions. Conclusion(s): There is an absence of evidence to support CGA, or interventions targeting component domains, improving outcomes in older adults post-TAVI. The strong evidence base for CGA in perioperative care, paired with the results of this review, support the need for well-designed trials to determine whether CGA improves outcomes for older adults living with frailty undergoing TAVI. <139> [Use Link to view the full text] Accession Number 650810121 Title Postoperative Cognitive Dysfunction and Analgesic Outcomes in Cardiac Surgery: Evaluating the Role of Nerve Block Techniques. Source The Clinical journal of pain. (no pagination), 2026. Date of Publication: 03 Apr 2026. Author Yan M.; Wang K.; Yan H.; Yuan S. Institution (Yan) Department of Anesthesiology, Fuwai Hospital, National Center of Cardiovascular Diseases, No. 167 Beilishi Road, Xicheng District, Beijing, China Abstract OBJECTIVE: Cardiac surgery frequently induces moderate to severe postoperative pain, which impedes recovery and elevates the risk of opioid dependence and postoperative cognitive dysfunction. This review aims to outline peripheral nerve block approaches in cardiac surgery and examine their analgesic efficacy and potential relationship with postoperative cognitive dysfunction. MATERIALS AND METHODS: A comprehensive literature search was performed using the electronic databases PubMed, EMBASE, and Google Scholar for publications up to September 2025. Search terms included regional anesthesia, nerve block, pain management, delirium, cognitive dysfunction, and cardiac surgery. The retrieved literature, including clinical reviews, basic research, clinical trials, and guidelines, was screened and prioritized based on thematic relevance and the strength of clinical evidence. The available evidence was synthesized into a narrative review. RESULT(S): The evidence suggests that nerve blocks are an effective component of a multimodal analgesic strategy, significantly reducing postoperative opioid consumption and attenuating neuroinflammatory responses such as microglial activation. However, they have not been conclusively shown to reduce the incidence of postoperative cognitive dysfunction. Current implementation faces challenges including a lack of technique standardization and the need to adapt to heterogeneous surgical anatomies. DISCUSSION(S): Nerve blocks are valuable for opioid-sparing analgesia and may modulate neuroinflammation, but their role in preventing postoperative cognitive dysfunction remains unproven. Future efforts should focus on standardizing protocols and conducting mechanistic studies to clarify the relationship between nerve blocks, neuroinflammatory modulation, and long-term neurological outcomes. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. <140> Accession Number 2044614817 Title Guideline-directed medical therapy in Polish patients with chronic coronary syndrome and advanced chronic kidney disease: insights from the ISCHEMIA-CKD trial. Source Postepy w Kardiologii Interwencyjnej. 22(1) (pp 1-7), 2026. Date of Publication: 2026. Author Pracon R.; Anthopolos R.; Lu Y.; Demkow M.; Mazurek T.; Drozdz J.; Pruszczyk P.; Roik M.; Kryczka K.; Henzel J.; Kaczmarska-Dyrda E.; Malecki R.; Teresinska A.; Szwed H.; Ruzyllo W. Institution (Pracon, Demkow, Kryczka, Henzel, Kaczmarska-Dyrda) Coronary and Structural Heart Diseases Department, National Institute of Cardiology, Warsaw, Poland (Anthopolos, Lu) Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, New York, United States (Mazurek) Department of Cardiology, Medical University of Warsaw, Poland (Drozdz) Department of Cardiology, Medical University of Lodz, Poland (Pruszczyk, Roik) Department of Internal Medicine and Cardiology, Medical University of Warsaw, Poland (Malecki) Nephrology Department, Miedzyleski Szpital Specjalistyczny, Warsaw, Poland (Malecki) First Department of Internal Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University, Warsaw, Poland (Teresinska, Szwed, Ruzyllo) National Institute of Cardiology, Warsaw, Poland Publisher Termedia Publishing House Ltd. Abstract Introduction: The ISCHEMIA-CKD trial showed similar outcomes with an initial conservative vs invasive approach to chronic coronary syndrome in patients with advanced chronic kidney disease. Guideline-directed medical therapy (GDMT) was recommended regardless of the randomized strategy assignment. Aim(s): To describe GDMT attainment in ISCHEMIA-CKD participants in Poland compared to other world regions. Material(s) and Method(s): Among 777 trial participants, 105 were randomized in Poland. Patients were followed for a median of 2.2 years with the following GDMT recommendations: not smoking, systolic blood pressure (SBP) < 140/ diastolic blood pressure (DBP) < 90 mm Hg, high/moderate-intensity statin, antiplatelet/anticoagulant, angiotensin-converting-enzyme inhibitors (ACE-I)/ angiotensin receptor blockers (ARB) and beta-blocker therapy, glycated hemoglobin (HbA1c) < 8% when indicated. Result(s): Participants in Poland vs other regions of the world (age 67 [60, 76] vs. 63 [55, 70] years, p < 0.001, 32% vs. 31% females, p = 0.86) had higher incidence of prior myocardial infarction (25% vs. 16%, p = 0.04), peripheral vascular disease (12% vs. 5%, p = 0.009), atrial fibrillation (23% vs. 7%, p < 0.001), and less frequently diabetes (44% vs. 59%, p = 0.004). At baseline, Polish participants were more often on antiplatelets/anticoagulants (91% vs. 83%, p = 0.04), beta-blockers (95% vs. 72%, p < 0.001), and ACE-I/ARBs (62% vs. 45%, p = 0.002), with better attainment of SBP < 140 (73% vs. 53%, p < 0.001), and HbA1c < 8% (86% vs. 56%, p = 0.003) and similar smoking and high-/moderate-intensity statin treatment frequencies. This degree of GDMT goal attainment was maintained at the last follow-up visit. Conclusion(s): In Polish patients with advanced kidney disease, high GDMT goal attainment was observed and maintained until the last follow-up visit under trial-specific, strict medical surveillance. The impact of GDMT on long-term outcomes remains to be studied in this patient population. Copyright © Termedia Sp. z o. o. <141> Accession Number 2044491099 Title Effects of remimazolam and propofol on parasympathetic activity during general anesthesia induction in patients with severe aortic stenosis: a randomized controlled trial utilizing high-frequency variability index. Source Journal of Clinical Monitoring and Computing. (no pagination), 2026. Date of Publication: 2026. Author Kotani T.; Ida M.; Naito Y.; Tanaka N.; Kawaguchi M. Institution (Kotani, Ida, Naito, Tanaka, Kawaguchi) Department of Anesthesiology, Nara Medical University, 840 Shijo-cho, Nara, Kashihara, Japan Publisher Springer Science and Business Media B.V. Abstract In this study, we aimed to compare the effects of remimazolam and propofol on parasympathetic activity during general anesthesia induction in patients with severe aortic stenosis using heart rate variability (HRV) analysis. In this single-center randomized controlled trial, 28 patients scheduled for elective transcatheter aortic valve replacement were assigned to receive either remimazolam or propofol for anesthesia induction at a tertiary emergency medical facility. Parasympathetic activity was assessed using the high-frequency variability index (HFVI), derived from spectral analysis of HRV based on electrocardiographic R-R intervals. HFVI was recorded for 3 min before and after induction. Remimazolam or propofol was administered at 6 mg/kg/h or 2.0 microg/ml via target-controlled infusion, respectively. The primary outcome was the difference in mean HFVI values recorded between the 3-min period before and after induction. Hemodynamic parameters, including mean blood pressure, heart rate, cardiac output, stroke volume variation, pulse pressure variation, and dynamic arterial elastance, were also measured. Baseline HFVI values did not differ significantly between groups. After induction, HFVI decreased significantly more in the remimazolam group than in the propofol group (DELTAHFVI: 16 vs. 3, P = 0.010). Heart rate increased in the remimazolam group but decreased in the propofol group (P = 0.006). No significant intergroup differences were observed in other hemodynamic parameters. These findings suggest that remimazolam may be associated with distinct autonomic responses during anesthesia induction. Copyright © The Author(s) 2026. <142> Accession Number 2044514888 Title Percutaneous Coronary Intervention in Frail Patients Undergoing Transcatheter Aortic Valve Replacement. Source JACC: Cardiovascular Interventions. 19(7) (pp 828-839), 2026. Date of Publication: 13 Apr 2026. Author Ratcovich H.; Holmvang L.; Sadjadieh G.; Jabbari R.; Glinge C.; Sabbah M.; Veien K.T.; Niemela M.; Freeman P.; Linder R.; Sorensen R.; Ioanes D.; Terkelsen C.J.; Ellert-Gregersen J.; Christiansen E.; Eftekhari A.; Piuhola J.; Kajander O.; Koul S.; Savontaus M.; Karjalainen P.; Ruck A.; Angeras O.; Bieliauskas G.; Jorgensen T.H.; Sondergaard L.; De Backer O.; Engstrom T.; Lonborg J. Institution (Ratcovich, Holmvang, Sadjadieh, Jabbari, Glinge, Sabbah, Sorensen, Bieliauskas, Jorgensen, De Backer, Engstrom, Lonborg) Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark (Veien, Ellert-Gregersen) Department of Cardiology, Odense University Hospital, Odense, Denmark (Niemela, Piuhola) Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland (Freeman, Eftekhari) Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark (Linder, Ruck) Department of Medicine, Karolinska Institute, Stockholm, Sweden (Linder, Ruck) Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institute, Danderyd University Hospital, Stockholm, Sweden (Ioanes, Angeras) Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden (Terkelsen, Christiansen) Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (Terkelsen) The Danish Heart Foundation, Copenhagen, Denmark (Kajander) Heart Hospital, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland (Kajander) The Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland (Koul) Department of Cardiology, Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden (Savontaus) Heart Center, Turku University Hospital, Turku, Finland (Karjalainen) Heart and Lung Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland (Angeras) Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg University, Gothenburg, Sweden (Sondergaard) Abbott Cardiovascular, Santa Clara, CA, United States (De Backer) Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark Publisher Elsevier Inc. Abstract Background Frailty is an important predictor of outcomes in patients with coronary artery disease (CAD) and following transcatheter aortic valve replacement (TAVR). The NOTION-3 (Third Nordic Aortic Valve Intervention) trial demonstrated that performing percutaneous coronary intervention (PCI) in addition to TAVR reduced the risk for major adverse cardiac events (MACE). Whether this benefit applies to frail patients remains uncertain. Objectives The aim of this study was to evaluate efficacy and safety of PCI in frail TAVR patients with CAD. Methods NOTION-3 was an international, open-label, randomized superiority trial enrolling patients with CAD and severe aortic stenosis undergoing TAVR. Patients were randomized 1:1 to PCI or conservative treatment. Frailty was assessed post hoc using a calculated frailty score derived from baseline data on symptom-related limitations, daily function, and quality of life. Primary endpoint was a composite of all-cause mortality, myocardial infarction (MI), and urgent coronary revascularization. Safety endpoints included bleeding and acute kidney injury. Results Frailty data were available for 407 patients (90%), of whom 130 (32%) were frail. During median follow-up of 2 years (Q1-Q3: 1-4 years), PCI reduced MACE in nonfrail patients (15% vs 33%; HR: 0.42; 95% CI: 0.25-0.69; P < 0.001), as well as death of any cause (P = 0.019), MI (P = 0.004), and urgent revascularization (P = 0.005). No differences were observed in frail patients. In contrast, frail patients undergoing PCI had more bleeding events (HR: 2.51; 95% CI: 1.23-5.11; P = 0.011). Conclusions In nonfrail patients with CAD undergoing TAVR, PCI lowered the risk for MACE, all-cause mortality, and MI compared to conservative treatment. In frail patients, PCI increased bleeding without clinical benefit. These findings require confirmation in larger prospective studies. Copyright © 2026 American College of Cardiology Foundation. <143> Accession Number 2044510820 Title Neutrophil gelatinase-associated lipocalin in contrast-induced acute kidney injury post cardiac procedure: a systematic review. Source Clinica Chimica Acta. 588 (no pagination), 2026. Article Number: 120977. Date of Publication: 01 Jun 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, Selangor, Jenjarom, Malaysia (Azzani) Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Sungai Buloh, Malaysia (Shirin) Anatomy Department, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Sungai Buloh, Malaysia (Kabir) Department of Internal Medicine, International Medical School, Management and Science University, Selangor, Shah Alam, Malaysia (Haza'a Abdulhameed) Department of Internal medicine, Kuwait University Hospital, Sana'a, Yemen (Anbazhagan) Department of Microbiology, International Medical School, Management and Science University, Selangor, Shah Alam, Malaysia (Islam) Department of Surgery, Universiti Malaya, Lembah Pantai, Kuala Lumpur, Malaysia Publisher Elsevier B.V. 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 as the need for renal replacement therapy (RRT), the length of hospital stay, and mortality. Objective 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. Methods 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 synthesised due to insufficient data. Results 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 NGAL is a clinically useful, protocol-dependent biomarker for ruling out CI-AKI. Standardisation of the 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. <144> Accession Number 650784613 Title IVUS or Angiography Guidance for Percutaneous Coronary Intervention in Complex Coronary Bifurcation Lesions: The DKCRUSH VIII Randomized Clinical Trial. Source Journal of the American College of Cardiology. (no pagination), 2026. Date of Publication: 30 Mar 2026. Author Gao X.; Kan J.; Chen Y.; Chen X.; Wang Y.; Zeng H.; Li Y.; Yan H.; Xie P.; Li F.; Mao Y.; Nie S.-P.; Wang L.; He Y.; Miao L.; Wen S.; Xue Y.; Tao J.; Pu J.; Han L.; Xue Q.; Wei L.; Zhang Z.; Yang Q.; Yuan Y.; Sun Y.; Yiu K.H.; Zhang J.; Chen S.-L. Institution (Gao, Kan, Zhang) Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (Chen) Department of Cardiology, Fuwai Henan Hospital, Zhengzhou, China (Chen, Wang) Department of Cardiology, Xiamen Heart Center, Xiamen University, Xiamen, China (Zeng) Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li) Department of Cardiology, first affiliated hospital of Harbin Medial University, Harbin, China (Yan) Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan, China (Xie) Department of Cardiology, Gansu Provincial Hospital, Lanzhou, China (Li) Department of Cardiology, Affiliated oriental general hospital, Anhui University of Science and Technology, Anhui, China (Mao, Miao) Department of Cardiology, First Hospital of Tsinghua Uinversity, Beijing, China (Nie) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (Wang) Department of Cardiology, Mudanjiang Cardiovascular Disease Hospital, HeilongJiang, China (He) Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun, China (Wen) Department of Cardiology, Fourth Central Hospital of Tianjin, Tianjin, China (Xue) Department of Cardiology, Liaocheng People's Hospital, Liaocheng, China (Tao) Department of Cardiology, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Sciences, Chengdu, China (Pu) Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Han) Department of Cardiology, Changshu No. 1 People's Hospital, Suzhou, China (Xue) Department of Cardiology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, China (Wei) Department of Cardiology, Harbin The First Hospital, Harbin, China (Zhang) Department of Cardiology, Shanghai General Hospital, Shanghai, China (Yang) Department of Cardiology, Tianjin General Hospital, Tianjin Medical University, Tianjin, China (Yuan) School of Medicine, Zhe Jiang University, Hangzhou, China (Sun) Department of Cardiology, Shanghai Fourth People's Hospital, Shanghai, China (Yiu) University of Hong Kong Shenzhen Hospital, Shenzhen, China (Chen) Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China Abstract BACKGROUND: Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) is associated with fewer clinical events than angiography-guided PCI. Whether the use of IVUS guidance improves the outcomes as compared with angiography guidance in patients with complex coronary bifurcation lesion undergoing double kissing (DK) crush is uncertain. OBJECTIVE(S): This study aimed to investigate the treatment effect of IVUS-guided PCI, as compared with angiography-guided PCI, in patients with complex bifurcation lesions. METHOD(S): We conducted a multicenter, randomized, open-label trial at 24 centers in China. Patients with clinical indications for PCI and a complex bifurcation lesion based on DEFINITION (Definitions and Impact of Complex Bifurcation Lesions on Clinical Outcomes After Percutaneous Coronary Intervention Using Drug-Eluting Stents) criteria (particularly side branch lesion length >=10 mm) from coronary angiography were randomly assigned in a 1:1 ratio to IVUS-guided PCI or angiography-guided PCI. The primary endpoint was a composite of target vessel failure, defined as cardiac death, target vessel myocardial infarction, or clinically driven target vessel revascularization at 1 year after randomization. RESULT(S): We assigned 555 patients to IVUS-guided PCI (n = 277) or angiography-guided PCI (n = 278). A total of 124 patients (44.8%) in the IVUS-guided PCI group and 122 (43.9%) in the angiography-guided PCI group had a bifurcation lesion involving the left main coronary artery. DK crush was used in 96.8% of patients. At 1 year, a primary endpoint event occurred in 17 patients (6.1%) in the IVUS-guided PCI group and in 41 patients (14.7%) in the angiography-guided PCI group (HR: 0.40; 95% CI: 0.23-0.71; P = 0.002), driven mainly by reductions in target vessel myocardial infarction or target vessel revascularization. CONCLUSION(S): In the present randomized trial comparing IVUS-guided vs angiography-guided PCI for complex coronary bifurcation lesions treated with the 2-stent DK crush technique, the benefits of IVUS-guided PCI at 1 year was achieved largely through achievement of IVUS-defined optimization targets rather than IVUS use alone. (IVUS-guided DK Crush Stenting Technique for Patients With Complex Bifurcation Lesions [DKCRUSH VIII]; NCT03770650). Copyright © 2026 American College of Cardiology Foundation. All rights reserved. <145> Accession Number 650797244 Title Comparing the Efficacy of Earplugs and Eye Masks on Pain and Sleep Quality in Cardiovascular Intensive Care Unit Patients: A Three-Arm Randomised Controlled Trial. Source Nursing in critical care. 31(3) (pp e70432), 2026. Date of Publication: 01 May 2026. Author Ozkan E.; Yaman Aktas Y.; Surmeli S. Institution (Ozkan, Yaman Aktas) Giresun University Faculty of Health Sciences, Department of Surgical Nursing, Giresun, Turkey (Surmeli) Giresun University Training and Research Hospital, Cardiovascular Surgery Intensive Care Unit, Giresun, Turkey Abstract BACKGROUND: Cardiovascular diseases are among the most common and leading causes of death worldwide. Surgical methods such as coronary artery bypass graft surgery (CABG) provide successful results in this process. Patients who are faced with these disturbing life-threatening experiences try to cope with many problems until the discharge process. The most common of these problems in the postoperative period is pain and insomnia. In the literature, there have been studies to determine the effect of eye mask and earplug on sleep and pain level; however, there are no studies examining the superiority of earplugs or eye masks over each other. AIM: To determine the superiority of earplugs and eye masks to each other and their efficacy in pain and sleep quality. STUDY DESIGN: The study was a three-arm randomised controlled trial. METHOD(S): After a baseline assessment, participants were randomly assigned to three groups. The random assignment was performed by using a computer program. Afterwards, participants were categorised into three groups. Group 3 patients in this group did not receive any treatment to improve pain and sleep quality during the study period. Routine postoperative care was applied in the clinic (n = 30). Group 2 was given the earplug (n = 30), whereas Group 1 was given the eye mask (n = 30). RESULT(S): Statistically significant differences were found between the three groups in terms of sleep depth, sleep onset latency, number of awakenings, sleep efficiency, sleep quality, total Richard-Campbell Sleep Questionnaire (RCSQ) score and visual analogue scale (VAS) scores (p = 0.000) in total 90 participants participated, 30 in each group. The group that used an eye mask (Group 1) and the group that used earplugs (Group 2) had higher mean values than the control group (Group 3) in terms of sleep depth, sleep onset latency, sleep efficiency, sleep quality and total RCSQ score. The mean total RCSQ scores were 61.4 +/- 3.7 in Group 1, 62.8 +/- 5.0 in Group 2 and 46.5 +/- 4.6 in Group 3. Accordingly, the mean difference was calculated as 14.9 points (95% CI: 12.8-17.0; p = 0.000) between Group 1 and Group 3 and 16.3 points (95% CI: 13.9-18.7; p = 0.000) between Group 2 and Group 3. Furthermore, VAS scores measured in the morning showed lower mean values in Group 1 (VAS: 4.4 +/- 0.7) and Group 2 (VAS: 4.2 +/- 0.8) compared to the control group (VAS: 6.3 +/- 1.0) (p = 0.000). No statistically significant difference was found between the eye mask and earplug groups in terms of RCSQ subscales, total RCSQ score and VAS scores (p > 0.05). CONCLUSION(S): Promoting sleep in intensive care unit (ICU) patients is crucial for recovery. Simple, non-pharmacological interventions like eye masks and earplugs improve sleep quality and comfort, especially after cardiac surgery. These cost-effective strategies reduce sleep disturbances and enhance patient well-being, highlighting the importance of prioritising restorative sleep in critical care. RELEVANCE TO CLINICAL PRACTICE: Improving sleep quality in ICU patients is essential for postoperative recovery. This study highlights that simple, cost-effective interventions like eye masks and earplugs can enhance sleep and comfort in patients undergoing cardiac surgery. Integrating these non-pharmacological strategies into routine nursing care can help reduce sleep disturbances, manage pain more effectively and promote overall patient well-being in critical care settings. TRIAL REGISTRATION: NCT07100002. Copyright © 2026 British Association of Critical Care Nurses. <146> Accession Number 650783375 Title Relationship Between Achieved LDL-C and Saphenous Vein Graft Patency: A Post Hoc Analysis of the NEWTON-CABG CardioLink-5 Study. Source European journal of preventive cardiology. (no pagination), 2026. Date of Publication: 31 Mar 2026. Author Szarek M.; Leiter L.A.; Teoh H.; Mancini G.B.J.; Quan A.; Elituv R.; Verma M.; Misner E.; Saha T.; Yanagawa B.; Juni P.; Koren M.J.; Nicholls S.J.; Bhatt D.L.; Mazer C.D.; Verma S. Institution (Szarek) Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, United States (Szarek) CPC Clinical Research, University of Colorado School of Medicine, Aurora, CO, United States (Szarek) State University of New York, Downstate Health Sciences University, Brooklyn, NY, United States (Szarek, Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA (Leiter, Teoh) Division of Endocrinology and Metabolism, St Michael's Hospital-Unity Health Toronto, Toronto, ON, Canada (Leiter) Department of Medicine, University of Toronto, Toronto, ON, Canada (Leiter) Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada (Teoh, Quan, Elituv, Misner, Yanagawa, Verma) Division of Cardiac Surgery, St Michael's Hospital-Unity Health Toronto, Toronto, ON, Canada (Mancini) Division of Cardiology, Centre for Cardiovascular Innovation, Dilawri Cardiovascular Institute, University of British Columbia, Vancouver, BC, Canada (Elituv) North York Diagnostic and Cardiac Centre, Toronto, ON, Canada (Verma) Royal College of Surgeons in Ireland, Dublin, Ireland (Saha) Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston, ON, Canada (Saha) Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada (Yanagawa, Verma) Department of Surgery, University of Toronto, Toronto, ON, Canada (Yanagawa, Mazer, Verma) Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada (Juni) Institute of Health Policy, Management, Evaluation, University of Toronto, Toronto, ON, Canada (Juni) Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, Oxfordshire, UK (Koren) Jacksonville Center for Clinical Research, Flourish Research Group, Jacksonville, FL, United States (Nicholls) Victorian Heart Institute, Monash University, Melbourne, VIC, Australia (Mazer) Department of Anesthesia, St Michael's Hospital-Unity Health Toronto, Toronto, ON, Canada (Mazer) Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada (Mazer) Department of Physiology, University of Toronto, Toronto, ON, Canada Abstract AIMS: In the NEWTON-CABG CardioLink-5 trial, treatment with the PCSK9 inhibitor evolocumab did not improve saphenous vein graft (SVG) patency relative to placebo in post-CABG patients. This post hoc analysis investigated whether achieved month 3 LDL-C levels were related to subsequent measures of SVG patency. METHOD(S): Adults (>=18 years) on moderate- to high-intensity statins and undergoing CABG surgery with >=2 SVGs were randomized 3-21 days postoperatively to subcutaneous evolocumab 140 mg or placebo every two weeks for 24 months. The primary endpoint was the proportion of SVGs with >=50% occlusion on coronary computed tomography angiography or clinically indicated invasive angiography at 24 months. Secondary efficacy outcomes included the proportion of totally occluded SVGs, proportion of participants with >=1 totally occluded SVG, and SVG total plaque volume. RESULT(S): A total of 1198 SVGs were assessed (499 evaluable participants). Mean LDL-C was 2.04 mmol/L and 1.03 mmol/L at baseline and month 3, respectively. Month 3 LDL-C (odds ratio [OR] = 0.74 per 1 mmol/L decrement; P = 0.005) and LDL-C change from baseline to month 3 (OR = 0.78 per 1 mmol/L decrease; P = 0.03) were related to the primary endpoint, with lower achieved levels or greater reductions associated with improved vein outcomes. These relationships did not depend on treatment assignment (Pinteraction = 0.79 and 0.84, respectively). CONCLUSION(S): LDL-C achieved over the range in this study was associated with SVG-related angiographic outcomes, suggesting LDL-C may have some role in SVG patency. These findings emphasize the importance of adhering to cholesterol guidelines after CABG. 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 <147> Accession Number 650784671 Title Regional analgesia techniques as adjuncts to general anesthesia in pediatric cardiac surgery: an updated systematic review and meta-analysis of randomized controlled trials. Source Regional anesthesia and pain medicine. (no pagination), 2026. Date of Publication: 30 Mar 2026. Author Wegner B.F.M.; Wegner G.R.M.; Gonzalez G.L.; Felippe V.A.; Marinho A.; Nascimento T.S.; Sharma A. Institution (Wegner) Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil (Wegner) Universidade Federal da Fronteira Sul Campus Passo Fundo Curso de Graduacao em Medicina, Passo Fundo, Brazil (Gonzalez) Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil (Felippe) Instituto Nacional de Cancer, Rio de Janeiro, Brazil (Marinho) Universidade Federal de Sao Paulo, Sao Paulo, Brazil (Nascimento, Sharma) University of Iowa Health Care, Iowa City, IA, United States Abstract BACKGROUND: Regional analgesia (RA) is increasingly used in pediatric cardiac surgery, but evidence supporting its benefit remains fragmented. This systematic review and meta-analysis aimed to determine the "class effect" of RA. METHOD(S): A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. Data sources included PubMed, Embase, Cochrane Library, and Web of Science, searched up to July 10, 2025. We included RCTs of pediatric patients undergoing cardiac surgery that compared any RA technique (neuraxial, peripheral nerve blocks, or local infiltration) against general anesthesia with systemic analgesia alone. RESULT(S): 31 RCTs (n=2245) were included. Adjunctive RA was associated with significant reductions in intraoperative fentanyl (MD -2.50 microg.kg-1; 95% CI -3.84 to -1.15; 95% PI -9.51 to 4.52; I2=97%), 24-hour intravenous morphine (MD -0.33 mg.kg-1; 95% CI -0.55 to -0.11; 95% PI -1.17 to 0.51; I2=96%), and improved recovery. Benefits included shorter time to tracheal extubation (MD -1.72 hours; 95% CI -2.93 to -0.52; 95% PI -7.78 to 4.34; I2=99%), reduced ICU stay (MD -0.25 days; 95% CI -0.34 to -0.16; 95% PI -0.61 to 0.11; I2=93%), and prolonged time to first analgesia (MD 2.95 hours; 95% CI 1.86 to 4.04; 95% PI -1.42 to 7.31; I2=97%). Subgroup analyses showed outcome-specific, inconsistent effects. CONCLUSION(S): There is very low to low certainty of evidence that adjunctive RA is associated with reduced opioid exposure and improved recovery in pediatric cardiac surgery. Substantial heterogeneity and imprecision markedly reduce confidence in the estimated effects, which should therefore be interpreted cautiously. REGISTRATION: PROSPERO CRD420251073543. Copyright © American Society of Regional Anesthesia & Pain Medicine 2026. No commercial re-use. See rights and permissions. Published by BMJ Group. <148> [Use Link to view the full text] Accession Number 650783211 Title Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Symptomatic Severe Aortic Stenosis and Prior Mediastinal Radiation: A Meta-Analysis of Short-Term and 1-Year Outcomes. Source Cardiology in review. (no pagination), 2026. Date of Publication: 31 Mar 2026. Author Elbenawi H.; Mostafa N.; Abdelgalil M.S.; Dahik B.; Mohamed Hamed B.; Botros M.M.; Eisa M.; Zreigh S.; Kalaiger A.M.; Almaadawy O.; Youssef M.; Zaaya M.; Stephens R.; Ghanim M.; Lin C.-J.; Elgendy I.Y.; Goldsweig A.M. Institution (Elbenawi) From the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Mostafa, Abdelgalil) Faculty of Medicine, Ain Shams University, Cairo, Egypt (Dahik, Zreigh) Faculty of Medicine, Ankara Yilidirim Beyazit University, Ankara, Turkey (Mohamed Hamed) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Botros) Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States (Eisa, Ghanim) Rochester General Hospital, Rochester, NY, United States (Kalaiger) Department of Internal Medicine, Montefiore Medical Center, Bronx, NY, United States (Almaadawy, Lin) Department of Cardiovascular Medicine, St. Louis University, St. Louis, MO, United States (Youssef) Division of Internal Medicine, Arkansas College of Osteopathic Medicine, Greenville, TX, United States (Zaaya) Cardiovascular Medicine Department, Maimonides Medical Center, Brooklyn, NY, United States (Stephens) Department of General Internal Medicine, Mayo Clinic, Rochester, MN, United States (Ghanim) Department of Cardiovascular Medicine, Morris Hospital & Health Care Centers, Morris, IL, United States (Elgendy) Department of Cardiovascular Medicine, Gill Heart and Vascular Institute, University of Kentucky, Lexington, KY; and (Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center and Division of Cardiovascular Medicine, University of Massachusetts-Baystate, Springfield, MA, United States Abstract Mediastinal radiation potentiates aortic stenosis and complicates its treatment. We compared the short and midterm-outcomes with transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in patients with prior mediastinal radiation. Electronic databases were searched from inception through December 2024. Dichotomous outcomes were pooled as risk ratios (RRs), and continuous outcomes were pooled as mean differences (MDs) with respective 95% confidence intervals (CIs). Six observational studies were identified, including 2458 TAVR patients and 1873 SAVR patients. In the short-term, TAVR was associated with lower rate of mortality (RR: 0.54; 95% CI: 0.34-0.88), atrial fibrillation (RR: 0.31; 95% CI: 0.15-0.65), acute kidney injury (RR: 0.75; 95% CI: 0.59-0.95), bleeding (RR: 0.37, 95% CI: 0.33-0.42), and shorter length of hospital stay (MD: -4.30; 95% CI: -5.45 to -3.15). One-year mortality was comparable between the 2 groups (RR: 1.04; 95% CI: 0.50-2.13). This meta-analysis of observational studies of patients with prior mediastinal radiation demonstrated that TAVR was associated with better short-term outcomes compared to SAVR. While 1-year mortality appeared similar between the 2 interventions, this finding should be interpreted with caution. However, randomized controlled trials are needed to validate these findings. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <149> [Use Link to view the full text] Accession Number 2044034336 Title Better in, better out: advancing transplant care through prehabilitation and rehabilitation: towards a multimodal continuum of care before and after solid organ transplantation. Source Current Opinion in Organ Transplantation. 31(2) (pp 53-59), 2026. Date of Publication: 01 Apr 2026. Author Van Criekinge H.; Leunis S.; Pol R.A.; Monbaliu D. Institution (Van Criekinge, Leunis, Monbaliu) Laboratory of Abdominal Transplantation, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium (Pol) Division of Transplant Surgery, Department of Surgery, University of Groningen, Groningen, Netherlands (Monbaliu) Transplantoux foundation, Leuven, Belgium Publisher Lippincott Williams and Wilkins Abstract Purpose of review - Solid organ transplantation is life-saving but imposes substantial physical and psychological demands across the pre, peri-, and posttransplant trajectory. Emerging evidence highlights the potential of prehabilitation and rehabilitation to enhance resilience before surgery, support recovery afterward, and reduce surgical and medical complications, ultimately improving long-term health after transplantation. Despite growing evidence of their benefits, these strategies remain underutilized in transplant care. This review aims to introduce multimodal continuum of care that integrates prehabilitation and rehabilitation into a unified pathway before and after transplantation to optimize outcomes in solid organ transplantation.Recent findings - Multimodal programs combining exercise, nutrition, and psychosocial support have demonstrated reductions in complications, shorter hospital stays, and improved survival and quality of life in surgical populations, with emerging evidence in transplantation. Consensus statements advocate individualized, adaptive interventions across the transplant continuum, delivered by interdisciplinary teams. Leveraging the same multidisciplinary team before and after transplantation fosters consistency, efficiency, and patient engagement-critical for adherence and empowerment.Summary - Although high-quality transplant-specific evidence remains limited, targeted, multimodal prehabilitation and rehabilitation represent promising strategies to enhance functional capacity and long-term health. We therefore propose "better in, better out" as a guiding principle for transplant care, calling for its adoption as a new standard supported by emerging evidence across kidney, liver, lung, and heart transplantation. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <150> Accession Number 650765212 Title Safety and efficacy of single versus dual arterial access in transfemoral transcatheter aortic valve implantation: a systematic review and meta-analysis of propensity-matched cohort. Source BMC cardiovascular disorders. (no pagination), 2026. Date of Publication: 28 Mar 2026. Author Adamu U.G.; Mashilo D.; Mutyaba A.; Patel A.; Farrel H.; Tsabedze N. Institution (Adamu, Mashilo, Mutyaba, Patel, Tsabedze) Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (Adamu) Division of Cardiology, Department of Internal Medicine, Faculty of Health Sciences, University of Witwatersrand, York Road ,Parktown, South Africa (Farrel) Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, South Africa (Farrel) Sunninghill Hospital, Johannesburg, South Africa <151> Accession Number 2044647075 Title Difference of Admission Neutrophil Gelatinase-Associated Lipocalin Concentration Between Patients Developing and Not Developing Acute Kidney Injury or Need for Acute Dialysis: An Ancillary Individual-Study Data Meta-Analysis (INDICATE-AKI). Source Kidney Medicine. 8(5) (no pagination), 2026. Article Number: 101280. Date of Publication: 01 May 2026. Author Albert A.; Blume L.; Di Somma S.; Hur M.; Bellomo R.; Devarajan P.; Breidthardt T.; Camou F.; Chocron S.; Cruz D.; de Geus H.R.; Doi K.; Endre Z.H.; Garcia-Alvarez M.; Haase M.; Haase-Fielitz A.; Hjortrup P.B.; Karaolanis G.; Kavalci C.; Kim H.; Lange S.; Lauten P.; Lentini P.; Liebetrau C.; Lipcsey M.; Martensson J.; Muller C.; Nanas S.; Nickolas T.L.; Pickering J.W.; Pipili C.; Ronco C.; Rosa-Diez G.; Ralib A.M.; Soto K.; Stieger P.; Zapf A.; Braun-Dullaeus R.C.; Albert C. Institution (Albert, Lange, Albert) Department of Nephrology, Central Clinic Bad Berka, Bad Berka, Germany (Blume, Stieger, Braun-Dullaeus, Albert) University Clinic for Cardiology and Angiology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany (Blume) Department of Neonatology, Charite University Medicine Berlin, Berlin, Germany (Di Somma) Postgraduate School of Emergency Medicine, Faculty of Medicine and Psychology, University La Sapienza of Rome, Rome, Italy (Hur, Kim) Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, South Korea (Bellomo) Department of Intensive Care, The Austin Hospital, Melbourne, Australia (Bellomo) Centre for Integrated Critical Care, The University of Melbourne, Melbourne, Australia (Devarajan) Division of Nephrology and Hypertension, Cincinnati Children's Hospital, University of Cincinnati, OH, United States (Breidthardt, Muller) Departments of Internal Medicine, Nephrology and Cardiology, University Hospital Basel, Basel, Switzerland (Camou) Service de reanimation medicale, Hopital Saint-Andre, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France (Chocron) Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besancon, France (Cruz) Division of Nephrology and Hypertension, University of California, San Diego, CA, United States (de Geus) Department of Intensive Care, Erasmus University Medical Center, Rotterdam, Netherlands (Doi) Department of Emergency and Critical Care Medicine, The University of Tokyo, Hongo, Tokyo, Bunkyo, Japan (Endre) Department of Nephrology, Prince of Wales Hospital and Clinical School, University of New South Wales, Randwick, Sydney, Australia (Garcia-Alvarez) Department of Anesthesiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (Haase) Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany (Haase) Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany (Haase-Fielitz) Department of Cardiology, Immanuel Diakonie Bernau, Heart Center Brandenburg, Brandenburg Medical School Theodor Fontane (MHB), Bernau, Germany (Haase-Fielitz) Institute of Social Medicine and Health Systems Research, Otto-von-Guericke University Magdeburg, Magdeburg, Germany (Hjortrup) Department of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark (Hjortrup) Department of Cardiothoracic Anaesthesia and Intensive Care, The Heart Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark (Karaolanis) Vascular Unit, First Department of Surgery, "Laiko" General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Kavalci) Emergency Department, Faculty of Medicine, Baskent University, Ankara, Turkey (Lauten) Department of Cardiology and Intensive Care Medicine, Central Clinic Bad Berka, Bad Berka, Germany (Lauten) Medical Faculty, Philipps University of Marburg, Marburg, Germany (Lentini) Department of Nephrology and Dialysis, San Bassiano Hospital, Bassano del Grappa, Italy (Liebetrau) Center for Cardiology and Angiology, Agaplesion Bethanien Krankenhaus, Frankfurt, Germany (Liebetrau) Department of Cardiology, Kerckhoff Clinic, Bad Nauheim, Germany (Lipcsey) CIRRUS, Hedenstierna laboratory, Anaesthesiology and Intensive care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (Martensson) Section of Anaesthesia and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (Nanas, Pipili) First Critical Care Department, 'Evangelismos' General Hospital, National and Kapodistrian University of Athens, Athens, Greece (Nickolas) Department of Medicine, Division of Nephrology, Columbia University, New York, NY, United States (Pickering) Department of Emergency Medicine, Christchurch Hospital, Christchurch, New Zealand (Pickering) Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand (Ronco) Medical Faculty, University of Padova and Department of Nephrology, Dialysis & Transplantation, International Renal Research Institute Vicenza (IRRIV), San Bortolo Hospital, Vicenza, Italy (Rosa-Diez) Department of Nephrology, Dialysis and Transplantation, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina (Ralib) Department of Anaesthesiology and Intensive Care, International Islamic University Malaysia, Pahang, Kuantan, Malaysia (Soto) Department of Nephrology, Hospital Fernando Fonseca, Lisbon, Portugal (Zapf) Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Publisher Elsevier Inc. Abstract Rationale & ObjectivePatients admitted to the emergency department, the intensive care unit (ICU), and after cardiac surgery are at increased risk of developing adverse kidney events. Assessment of neutrophil gelatinase-associated lipocalin (NGAL) may facilitate renal risk prediction. However, the difference in NGAL-concentrations at admission in patients developing and not developing adverse events is unclear.Study DesignAn ancillary meta-analysis to a previous systematic review and meta-analysis using reanalyzed individual study-data from prospective clinical studies to compare NGAL concentrations measured using clinical laboratory platforms at patient admission. The study followed the Preferred Reporting Items for a Systematic Review and Meta-analysis of Individual Participant Data guideline.Setting & Study PopulationsStudies of adults investigating acute kidney injury (AKI) of all stages, severe AKI (stage injury or failure), and acute initiation of renal replacement therapy (RRT) in the setting of cardiac surgery, emergency department, or intensive care unit using either urinary or plasma NGAL concentrations measured on clinical laboratory platforms.Selection Criteria for StudiesData inclusion was limited to the individual study-level data from the predecessor study.Data ExtractionThis study used individual study-level data acquired using the protocol of a previous study, which was accomplished by individual authors' reassessment of their study data.Analytical ApproachClassification of AKI was harmonized among studies. Prespecified data comparison was performed for urine and plasma specimens for the outcome measures AKI, severe AKI, and acute RRT-initiation. Random effects meta-analyses were performed using the inverse variance method and the DerSimonian and Laird heterogeneity estimator.ResultsIn total, 30 data sets from 26 studies were included. The estimated mean difference of urine NGAL concentrations was 125 (95% CI, 57.33-193.54) ng/mL for AKI, 317 (95% CI, 134.95-499.82) ng/mL for severe AKI, and 331 (95% CI, 71.36-592.06) ng/mL for RRT. For plasma NGAL concentrations, the estimated mean differences were 86.04 (95% CI, 51.74-120.34) ng/mL for AKI, 150.52 (95% CI, 80.27-220.76) ng/mL for severe AKI, and 129.83 (95% CI, 79.03-180.63) ng/mL for RRT. There were subgroup differences for the clinical setting, but not for the use of the urine output criterion. Multiple studies showed elevated NGAL concentrations in patients without serum creatinine concentration-based AKI, likely identifying patients with suspected AKI stage 1S (subclinical AKI).LimitationsImperfect harmonization of data across studies because of their original protocols.ConclusionsNGAL concentration differences may facilitate identification of patients at risk of AKI or with suspected AKI stage 1S at admission. Heterogeneity and variability across studies, specimen types, and settings emphasize the importance of interpreting NGAL values within the specific clinical context and patient population.Study RegistrationThe International Database of Prospectively Registered Systematic Reviews reg. no.: CRD42016042735. Version of Record 1.2.Plain-language SummaryPatients admitted to the intensive care unit, the emergency department, or following cardiac surgery are at increased risk of acute kidney injury (AKI). Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker that may help stratify AKI risk. This meta-analysis pooled and reanalyzed data from prospective studies measuring NGAL levels at patient admission and systematically compared them in those patients who developed AKI or required renal replacement therapy with those who did not. Higher NGAL levels were found to be associated with unfavorable outcomes. However, variability across studies and settings was observed. Interestingly, some patients showed elevated NGAL levels despite not being affected by serum creatinine-based AKI, suggesting NGAL levels may reflect subclinical AKI (stage 1S). These findings highlighted the need to interpret NGAL concentrations contextually within clinical settings. Copyright © 2026 The Authors. Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <152> Accession Number 2044632928 Title Pharmacology and clinical use of plasma expanders: a 2026 update. Source Anaesthesia and Intensive Care Medicine. (no pagination), 2026. Date of Publication: 2026. Author Teixeira J.P.; Wentowski C.C.; Nielsen N.D. Institution (Teixeira, Wentowski, Nielsen) University of New Mexico School of Medicine, Albuquerque, NM, United States (Teixeira, Wentowski, Nielsen) Rutgers University, New Brunswick, NJ, United States (Teixeira, Wentowski, Nielsen) University of New Mexico School of Medicine, Albuquerque, NM, United States Publisher Elsevier Ltd Abstract Plasma expanders are colloidal solutions that expand the circulating blood volume more than isotonic crystalloids. Though this physiologic effect is typically transient, colloids remain commonly though variably used in critical care and perioperative medicine worldwide. Our review of these agents begins by introducing the modified Starling model, which incorporates the fundamental physiologic role of the endothelial glycocalyx in transcapillary fluid movement. Next, we discuss each fluid's pharmacological properties and evidence base for use. Multiple trials suggest that albumin is a safe, albeit more expensive, alternative to crystalloids in intensive care, with secondary analyses suggesting harm in traumatic brain injury and possibly benefit in septic shock. Data to support the routine perioperative use of albumin are lacking, with recent trials in cardiac surgery showing no benefit or harm. Trials on hydroxyethyl starch in critical care demonstrate increased risk of kidney injury, coagulopathy, and possibly mortality. Recent trial data indicate that these harms may not equally apply to low-risk surgical patients, but, while an area of ongoing debate and study, no compelling evidence exists to support the routine perioperative use of hydroxyethyl starch. Finally, human trials on gelatins and dextrans are relatively scarce, making their use difficult to justify in most settings. Copyright A© 2026 Published by Elsevier Ltd. <153> Accession Number 650764953 Title Cardiorenal Outcomes With Tirzepatide Compared With Dulaglutide in Patients With Diabetes and Cardiovascular Disease: A Post Hoc Analysis of the SURPASS-CVOT Randomized Clinical Trial. Source JAMA cardiology. (no pagination), 2026. Date of Publication: 28 Mar 2026. Author Nissen S.E.; Wolski K.; D'Alessio D.; Weerakkody G.; Kiljanski J.; Wiese R.J.; Pavo I.; Cariou B.; Nicholls S.J. Institution (Nissen, Wolski) Cleveland Clinic Coordinating Center for Clinical Research (C5 Research), Cleveland Clinic, Cleveland, OH, United States (Nissen, Wolski) Department of Medicine, Cleveland Clinic, Cleveland, OH, United States (D'Alessio) Duke University Medical Center, Durham, NC, United States (Weerakkody, Kiljanski, Wiese, Pavo) Eli Lilly and Company, Indianapolis, IN, United States (Cariou) l'Institut du Thorax, Nantes Universite, CHU Nantes, CNRS, INSERM, Nantes, France (Nicholls) Victorian Heart Institute, Monash University, Melbourne, VIC, Australia Abstract Importance: The dual glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) agonist tirzepatide was noninferior to a GLP-1 agonist, dulaglutide, for effects on the composite outcome of cardiovascular death, myocardial infarction (MI), or stroke. However, comparison for a comprehensive range of major adverse cardiovascular and kidney outcomes has not been reported. Objective(s): To perform a post hoc analysis for an expanded range of adverse outcomes in a completed randomized clinical trial comparing the effects of tirzepatide and dulaglutide in patients with type 2 diabetes and cardiovascular disease. Design, Setting, and Participant(s): This parallel-design double-blind trial enrolled patients with diabetes and preexisting cardiovascular disease (from May 29, 2020, to June 27, 2022) at 640 centers in North and South America, Europe, Asia, and Oceania. Data were analyzed from July 2025 to February 2026. Intervention(s): Participants were randomized to receive subcutaneous tirzepatide up to 15 mg (n = 6586) or a fixed dose of dulaglutide, 1.5 mg (n = 6579), administered weekly. Main Outcomes and Measures: The primary efficacy measure was time from randomization to first occurrence of a 6-component composite of cardiorenal adverse outcomes, including all-cause mortality, MI, stroke, coronary revascularization, hospitalization for heart failure, and a composite of adverse kidney outcomes. Result(s): Among the 13 165 patients enrolled, the mean (SD) age was 64 (8.8) years; 9348 patients (71.0%) were male and 3817 were female (29.0%). The mean (SD) hemoglobin A1c was 8.4% (0.93). After a median (IQR) treatment duration of 46.9 (34.6-50.6) months, the primary cardiorenal end point occurred in 1559 tirzepatide-treated patients (23.7%) and 1803 dulaglutide-treated patients (27.4%; hazard ratio [HR], 0.84; 95% CI, 0.79-0.90; P < .001). Sensitivity analyses showed similar hazard ratios for a narrower 5-component end point (without the kidney composite outcomes: HR, 0.86; 95% CI, 0.80-0.93) and the 4-component composite (without either kidney or heart failure end points: HR, 0.86; 95% CI, 0.80-0.93). Gastrointestinal adverse events were more common with tirzepatide (2827 patients [42.5%]) than dulaglutide (2387 patients [35.9%]) treatment. Other adverse events were similar. Conclusion(s): In this post hoc analysis, the dual GLP-1 and GIP agonist tirzepatide, compared with the GLP-1 agonist dulaglutide, was associated with a lower incidence of a broad 6-component composite cardiovascular and kidney end point in patients with diabetes and established cardiovascular disease. Trial Registration: ClinicalTrials.gov Identifier: NCT04255433. <154> Accession Number 2044461695 Title Thoracic paravertebral block with liposomal bupivacaine versus ropivacaine for postoperative analgesia in thoracic surgery: a randomized controlled study. Source Journal of Thoracic Disease. 18(3) (no pagination), 2026. Article Number: 196. Date of Publication: 31 Mar 2026. Author Sun Y.; Chen B.; Liu T.; Wang L.; Gao G.; Kang W.; Liu W. Institution (Sun, Chen, Liu, Gao, Liu) Department of Anesthesiology, Beijing Tuberculosis and Thoracic Tumor Research Institution, Beijing, China (Sun, Chen, Liu, Gao, Liu) Department of Anesthesiology, Beijing Chest Hospital, Capital Medical University, Beijing, China (Wang) Department of Pharmacology, Beijing Chest Hospital, Capital Medical University, Beijing, China (Wang) Department of Pharmacology, Beijing Tuberculosis and Thoracic Tumor Research Institution, Beijing, China (Kang) Department of Disease Prevention and Control, Beijing Chest Hospital, Capital Medical University, Beijing, China (Kang) Department of Disease Prevention and Control, Beijing Tuberculosis and Thoracic Tumor Research Institution, Beijing, China Publisher AME Publishing Company Abstract Background: Paravertebral block is a highly effective regional analgesic technique for thoracic surgery. Liposomal bupivacaine (LB) significantly extends the duration of analgesia. However, the efficacy of LB for thoracic paravertebral block (TPVB) in patients undergoing video-assisted thoracic surgery (VATS) remains unclear. This trial aimed to evaluate the analgesic efficacy of TPVB with LB following VATS. Method(s): In this prospective, randomized controlled trial, patients scheduled for VATS were randomly assigned (1:1) to receive either LB or ropivacaine. All patients received a standardized multimodal analgesic regimen, which included a preoperative ultrasound-guided TPVB and patient-controlled intravenous analgesia. The primary outcome was the Numerical Rating Scale (NRS) score for pain during coughing at 24 hours postoperatively. Result(s): Among 100 patients undergoing VATS, paravertebral analgesia with LB provided superior pain control compared to ropivacaine. At 24 hours postoperatively, the LB group demonstrated significantly lower median cough NRS pain scores [median: 4 (IQR, 3, 6) vs. 6 (IQR, 5, 7); median difference: -2; P=0.001], as well as reduced resting [2 (IQR, 1, 3) vs. 4 (IQR, 2, 6); P=0.001] and active [3 (IQR, 1, 5) vs. 4.5 (IQR, 3.75, 6.00); P=0.002] NRS pain scores. These analgesic benefits persisted at 48 hours and 72 hours for cough pain (P=0.001 and P=0.02, respectively). The LB group also exhibited a lower incidence of vomiting (4% vs. 26%) and dizziness (14% vs. 36%), along with reduced vasopressor requirements (20% vs. 46%). Conclusion(s): Preoperative administration of LB for TPVB effectively reduced postoperative pain in patients undergoing VATS and was associated with a lower incidence of vomiting and dizziness. Copyright © AME Publishing Company. <155> 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 <156> Accession Number 650765187 Title Personalized hemodynamic management targeting preoperative baseline cardiac index in high-risk patients having major abdominal surgery: rationale and design of the international multicenter randomized PELICAN trial. Source Trials. (no pagination), 2026. Date of Publication: 28 Mar 2026. Author Flick M.; Aasvang E.K.; Eichlseder M.; Klimovic A.; Meidert A.S.; Meyhoff C.S.; Roth S.; Steinhaus M.; Sort R.; Vives M.; Vojnar B.; Ziemann S.; Krause L.; Vettorazzi E.; Zapf A.; Kouz K.; Saugel B. Institution (Flick, Kouz) Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Aasvang) Department of Anaesthesiology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen University, Copenhagen, Denmark (Eichlseder) Department of Anaesthesiology and Intensive Care, Medical University of Graz, Graz, Austria (Klimovic) Department of Anesthesiology, Resuscitation and Intensive Care, Faculty of Medicine in Pilsen, Charles University, Prague, Czechia (Meidert) Department of Anaesthesiology, LMU University Hospital, LMU Munich, Munich, Germany (Meyhoff) Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark (Roth) Department of Anesthesiology, University Hospital Dusseldorf, Heinrich Heine University Dusseldorf, Dusseldorf, Germany (Steinhaus) Department of Anesthesiology and Intensive Care, University of Lubeck and University Medical Center Schleswig-Holstein, Lubeck, Germany (Sort) Department of Anaesthesiology, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark (Vives) Department of Anesthesia & Critical Care, Clinica Universidad de Navarra, Pamplona, Spain (Vojnar) Department of Anesthesiology and Intensive Care Medicine, University Hospital Giessen and Marburg, Marburg, Campus Marburg and Philipps-University of Marburg, Germany (Ziemann) Department of Anaesthesiology, Medical Faculty, RWTH Aachen University Hospital, Aachen, Germany (Krause, Vettorazzi, Zapf) Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Kouz) OUTCOMES RESEARCH Consortium, Houston, TX, United States (Saugel) Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Saugel) OUTCOMES RESEARCH Consortium, Houston, TX, United States Abstract BACKGROUND: Intraoperative hemodynamic management is intended to ensure adequate tissue perfusion and oxygen delivery and eventually help avoid organ injury. However, the optimal strategy for intraoperative hemodynamic management in patients having non-cardiac surgery remains unclear. We here report the protocol of a trial designed to test the hypothesis that personalized intraoperative hemodynamic management targeting preoperative baseline cardiac index reduces the incidence of a composite outcome of major postoperative complications and death within 7 days after surgery compared to routine hemodynamic management in high-risk patients having elective major abdominal surgery. METHOD(S): The PELICAN trial is an international multicenter randomized trial in 1,128 high-risk patients having elective major abdominal surgery. The individual preoperative baseline cardiac index is determined with the patient being awake and resting in the supine position using noninvasive bioreactance. Patients are randomized to personalized hemodynamic management (intervention) or to routine hemodynamic management (control) during surgery. In patients assigned to personalized hemodynamic management, intraoperative cardiac index is maintained at least at the preoperative baseline cardiac index. In patients assigned to routine hemodynamic management, it is performed as per anesthesiologist preference (with blinded cardiac index monitoring). The primary outcome is the incidence of a composite outcome ("any event versus none") of acute kidney injury, acute myocardial injury (including myocardial infarction), non-fatal cardiac arrest, severe infectious complications, and death within 7 days after surgery. DISCUSSION(S): Our trial will determine whether personalized intraoperative hemodynamic management targeting preoperative baseline cardiac index reduces the incidence of major postoperative complications and death within 7 days in high-risk patients having elective major abdominal surgery compared to routine hemodynamic management. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT05648279. Registered on 5 December 2022. Copyright © 2026. The Author(s). <157> Accession Number 650764538 Title Design and rationale of the EMPagliflozin after Aortic Valve Replacement (EMPAVR) study: a randomized clinical trial. Source American heart journal. (pp 107432), 2026. Date of Publication: 26 Mar 2026. Author Sorensen L.M.; Reinert M.S.; Raja A.A.; de Backer O.; Bieliauskas G.; Schou M.; Jensen J.; Moller E.L.R.; Linde J.J.; Kofoed K.F.; Kuhl J.T.; Procida K.; Petersen J.K.; Havers-Borgersen E.; Kober L.; Fosbol E. Institution (Sorensen) Department of Cardiology, Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Reinert, Raja, Bieliauskas, Moller, Linde, Kuhl, Petersen, Havers-Borgersen) Department of Cardiology, Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (de Backer, Fosbol) Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Schou, Jensen) Department of Cardiology, Copenhagen University Hospital, Herlev-Gentofte, Denmark (Kofoed) Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Cardiology and Radiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Procida) Department of Cardiology, Zealand University Hospital - Roskilde, Roskilde, Denmark (Kober) Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Cardiology, Copenhagen University Hospital, Herlev-Gentofte, Hellerup, Denmark Abstract INTRODUCTION: Left ventricular (LV) hypertrophy and dysfunction secondary to aortic stenosis (AS) are key components of the disease's underlying pathophysiology. Previous trials suggest that up to 1/3 of patients do not benefit symptomatically after aortic valve replacement (AVR), which could be explained by insufficient LV remodeling. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are effective in heart failure (HF) and have been shown to improve LV remodeling (change in LV mass). METHOD(S): The EMPAVR study is an investigator-initiated, randomized, placebo-controlled, and double-blinded trial comparing the effect of empagliflozin to placebo in patients with severe and symptomatic AS undergoing transcatheter aortic valve implantation (TAVI). The primary outcome for the EMPAVR trial is the difference in LV mass indexed to body surface area (measured by cardiac CT) from pre-AVR to 6 months post-AVR. Patients are randomized in a 1:1 ratio to 180 days of treatment. DISCUSSION(S): To the best of our knowledge, the EMPAVR study is the first placebo-controlled trial investigating the effects of SGLT2 inhibition in patients following TAVI because of AS. The EMPAVR study has the potential to pave the way for treatment of the LV in valvular heart disease and may help patients worldwide and expand our understanding of aortic stenosis. TRIAL REGISTRATION: The EMPAVR study was registered in December 2024 (Clinical Trial Registration number: NCT06171802) before enrollment of the first patient. All patients will provide oral and written informed consent. The EMPAVR study is approved by the Regional Committee on Health Research Ethics and the Danish Medicines Agency. Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved. <158> Accession Number 650765061 Title Drug-Coated Balloons Versus Drug-Eluting Stents for Side Branch Lesions in Coronary Bifurcations: An Updated Comparative Meta-Analysis. Source The American journal of cardiology. (no pagination), 2026. Date of Publication: 26 Mar 2026. Author Quevedo-Candela F.; Cieza T.; Ruhl A.; Nolte C.; Bertrand O.F. Institution (Quevedo-Candela, Cieza, Ruhl, Bertrand) Interventional Cardiology - Institut Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ), Quebec City, Canada (Nolte) Interventional Cardiology - Instituto Nacional Cardiovascular (INCOR), Lima, Peru Abstract The management of side branch (SB) lesions in true coronary bifurcations remains controversial, particularly regarding long-term risks associated with metallic implants. Drug-coated balloons (DCB) have emerged as an alternative to drug-eluting stents (DES), offering a scaffold-free approach that may simplify percutaneous coronary intervention (PCI) and reduce adverse events. We performed a systematic review and meta-analysis of randomized and observational studies directly comparing placlitaxel DCB and limus-eluting DES for SB treatment. The primary endpoint was major adverse cardiac events (MACE) including cardiovascular death, target vessel myocardial infarction (TV-MI), and clinically driven target lesion revascularization (TLR); secondary endpoints included target lesion revascularization, binary restenosis, myocardial infarction, and all-cause or cardiovascular mortality. Risk of bias was assessed using RoB 2 and Newcastle-Ottawa tools. Five studies (n=898) were included. In pooled random-effects analyses, DCB use was associated with a significant reduction in MACE (odds ratio 0.48, 95% confidence interval 0.27-0.81; p=0.008) and target lesion revascularization (odds ratio 0.35, 95% confidence interval 0.19-0.68; p=0.001). Late lumen loss was significantly lower with DCB across studies. In conclusion, placlitaxel DCBs therefore appeared to be an effective alternative to DES for SB lesions in true bifurcations. Larger randomized trials are still required to confirm these findings and clarify their role in bifurcation (side branch) PCI.. Copyright © 2026. Published by Elsevier Inc. <159> Accession Number 2044640503 Title Side Branch Protection in Coronary Bifurcation Stenting: A Systematic Review and Meta-Analysis of Jailed Wire Versus Jailed Balloon Technique. Source American Journal of Cardiology. 267 (pp 58-67), 2026. Date of Publication: 15 May 2026. Author Lee J.V.; Emmanuela M.; Patricio A.; Theja D.A.; Lee J.B.; Fahendra N.A.; Wahjoepramono N.N.D. Institution (Lee, Emmanuela) Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia (Patricio, Theja, Lee, Fahendra) Faculty of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia (Wahjoepramono) Department of Cardiology and Vascular Medicine, Siloam Hospitals Lippo Village, Tangerang, Indonesia Publisher Elsevier Inc. Abstract Bifurcation percutaneous coronary intervention (PCI) remains technically challenging and is considered high risk to procedural complications, particularly side branch (SB) occlusion. The jailed wire technique (JWT) is commonly recommended for SB protection; however, it does not fully prevent the complication. The jailed balloon technique (JBT) was introduced to provide more active protection, but previous evidence has been inconsistent. This study aimed to provide updated evidence on the effectiveness of JBT versus JWT for SB protection during bifurcation PCI. PubMed, ScienceDirect, and the Cochrane Library were searched for randomized trials and cohort studies comparing JBT and JWT in patients undergoing bifurcation PCI. The primary end points were procedure-related adverse events, including SB occlusion, coronary dissection, and peri-procedural myocardial infarction. Secondary end points included all-cause mortality, cardiac death, target-lesion revascularization, and major adverse cardiovascular events (MACE). Odds ratios with 95% confidence intervals were calculated as a measure. Study quality was assessed using the Newcastle-Ottawa Scale and risk of bias 2.0 tool. Ten studies involving 2,329 patients were included (793 JBT and 1,536 JWT). The risk of SB occlusion was lower in JBT group compared to JWT group (odds ratio = 0.31, 95% confidence interval 0.20 to 0.48; p <0.00001). There were no significant differences between the 2 techniques in coronary dissection, peri-procedural myocardial infarction, all-cause mortality, cardiac death, target-lesion revascularization, or MACE. All studies were considered good quality. In conclusion, the use of JBT was associated with a reduced risk of SB occlusion during bifurcation PCI, while both techniques demonstrated comparable outcomes for other procedural and long-term clinical outcomes. Copyright © 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <160> Accession Number 2044590308 Title Heart Transplantation in Patients with Congenital Heart Disease: A Review of Long-term Outcomes. Source Indian Journal of Transplantation. 20(1) (pp 3-8), 2026. Date of Publication: 01 Jan 2026. Author Cicaric N. Institution (Cicaric) Clinic for Cardiology, University Clinical Centre Kragujevac, Kragujevac, Serbia (Cicaric) Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Publisher Wolters Kluwer Medknow Publications Abstract Congenital heart disease (CHD) represents the most prevalent form of birth defect worldwide and has emerged as a leading indication for pediatric heart transplantation. With significant advances in surgical palliation, a growing number of patients with complex CHD are surviving into adulthood, but many ultimately develop heart failure or experience failure of previous palliative surgeries, necessitating transplantation. Heart transplantation in CHD patients is uniquely challenging due to anatomic complexity, prior surgical scarring, and high rates of pretransplant sensitization, all of which contribute to higher perioperative risk and variable long-term outcomes compared to non-CHD recipients. In this review, we performed a comprehensive literature search using PubMed, Scopus, and Web of Science databases, focusing on studies published from 2000 to 2024, and included relevant international guidelines and registry data to synthesize the current knowledge on indications, surgical strategies, immunologic considerations, and posttransplant outcomes in CHD. Unlike prior reviews that have largely focused on Western cohorts, this review integrates the global data with a particular emphasis on low- and middle-income countries (LMICs) such as India, highlighting disparities in access, outcomes, and future directions for equitable care. There is an urgent need for strategies to improve the early identification and referral of candidates, personalized immunosuppression protocols, advanced surgical simulation tools, and robust data collection from LMIC to inform global practice and improve outcomes. Investing in capacity building and adapting international best practices to the local context could substantially enhance the survival and quality of life for CHD transplant recipients worldwide. Copyright © 2026 Indian Journal of Transplantation.

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