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Total documents retrieved: 83 Results Generated From: Embase <1980 to 2026 Week 41> Embase Weekly Updates (updates since 2026-10-01) - (83 records) <1> Accession Number 2049253727 Title Redo-Transcatheter Aortic Valve Implantation Versus Surgical Explantation in Patients With Previous Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis. Source Journal of the American Heart Association. 15(17) (no pagination), 2026. Article Number: e048885. Date of Publication: 2026. Author Ktenopoulos N.; Apostolos A.; Terentes-Printzios D.; Drakopoulou M.; Synetos A.; Latsios G.; Xaplanteris P.; Panoulas V.; Baumbach A.; Tsioufis K.; Toutouzas K. Institution (Ktenopoulos, Apostolos, Terentes-Printzios, Drakopoulou, Synetos, Latsios, Tsioufis, Toutouzas) Department of Cardiology, Hippokration General Hospital of Athens, Greece (Ktenopoulos, Apostolos, Drakopoulou, Synetos, Latsios, Tsioufis, Toutouzas) Unit of Structural Heart Diseases, First Department of Cardiology, Medical School, Hippocration General Hospital of Athens, National and Kapodistrian University of Athens, Athens, Greece (Apostolos, Panoulas) Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Apostolos) Faculty of Medicine, Imperial College London, London, United Kingdom (Xaplanteris) Department of Cardiology, Centre Hospitalier Universitaire Saint-Pierre, Universite Libre de, Bruxelles, Brussels, Belgium (Panoulas) National Heart and Lung Institute, Imperial College London, London, United Kingdom (Baumbach) Center for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London and Barts Heart Center, London, United Kingdom (Baumbach) Cleveland Clinic, London, United Kingdom Publisher American Heart Association Inc. Abstract BACKGROUND: As transcatheter aortic valve implantation (TAVI) expands to younger and lower-risk populations, failed transcatheter heart valves are increasingly encountered, yet the optimal reintervention strategy remains uncertain. This meta-analysis aimed to compare the outcomes of redo-TAVI (TAVI-in-TAVI) versus surgical transcatheter heart valve explantation with surgical aortic valve replacement (TAVI-explantation) after transcatheter heart valve failure. METHOD(S): PubMed/Medline, Scopus and Cochrane Central Register of Controlled Trials were systematically searched from inception to September 10, 2025 for comparative studies. The primary outcome was all-cause mortality (in-hospital, 30-day, and 1-year). Secondary outcomes included cerebrovascular events, major adverse cardiac events, permanent pacemaker implantation, greater-than-mild paravalvular leak, major bleeding, length of stay, and 30-day readmission. As the primary analysis, reconstructed individual patient-level data were analyzed using Firth penalized logistic regression adjusting for study, and complementary random-effects meta-analyses were also used. RESULT(S): Eight observational studies including 6166 patients (3743 redo-TAVI; 2425 TAVI-explantation) were analyzed. Compared with TAVI-explantation, redo-TAVI was associated with lower in-hospital mortality (odds ratio [OR], 0.20 [95% CI, 0.11-0.35]; P<0.0001), 30-day mortality (OR, 0.28 [95% CI, 0.23-0.34]; P<0.0001), and 1-year mortality (OR, 0.70 [95% CI, 0.62-0.80]; P<0.0001). No significant differences were observed in cerebrovascular events or permanent pacemaker implantation rates. Redo-TAVI was associated with lower major bleeding (OR, 0.35 [95% CI, 0.24-0.50]; P<0.0001), fewer 30-day readmissions (OR, 0.53 [95% CI, 0.30-0.92]; P=0.023), and shorter hospitalization (Mean Difference -6.29days [95% CI, -8.66 to -3.93), but a higher risk of greater-than-mild paravalvular leak (OR, 80.12 [95% CI, 11.30-10153]; P<0.0001). CONCLUSION(S): Redo-TAVI was associated with lower early and 1-year mortality, reduced bleeding, and shorter hospitalization compared with TAVI-explantation, with similar cerebrovascular event and permanent pacemaker implantation rates but higher paravalvular leak risk. These findings support redo-TAVI as the preferred reintervention strategy in anatomically suitable patients, whereas randomized trials and longer-term follow-up are needed to refine lifetime management strategies after transcatheter heart valve failure. Copyright © 2026 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. JAHA is available at: www.ahajournals.org/journal/jaha <2> Accession Number 2049280243 Title Combined Antegrade-Retrograde Cardioplegia for Myocardial Protection During Coronary Artery Bypass Grafting in Patients with Left Main Coronary Artery Disease: The CARDIOPROTECT-LMCAD Randomised Trial. Source Medicina (Lithuania). 62(9) (no pagination), 2026. Article Number: 1799. Date of Publication: 01 Sep 2026. Author Lesanovic J.; Milojevic M.; Nikolic D.; Soldatovic I.; Unic-Stojanovic D.; Zivkovic I.; Milicic M.; Vukovic P.; Petrovic I.; Jagodic S.; Bojic M.; Micovic S. Institution (Lesanovic, Nikolic, Unic-Stojanovic, Jagodic) Department of Anesthesiology and Intensive Care, Institute for Cardiovascular Diseases Dedinje, Belgrade, Serbia (Lesanovic, Soldatovic, Unic-Stojanovic, Zivkovic, Milicic, Vukovic, Micovic) Faculty of Medicine, University of Belgrade, 11000, Belgrade, Serbia (Milojevic, Zivkovic, Milicic, Vukovic, Micovic) Department of Cardiac Surgery, Institute for Cardiovascular Diseases Dedinje, Milana Tepica 1, Belgrade, Serbia (Milojevic) Department of Cardiovascular Research, Institute for Cardiovascular Diseases Dedinje, Belgrade, Serbia (Milojevic) Department of Cardiac Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland (Soldatovic) Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia (Petrovic, Bojic) Department of Cardiology, Institute for Cardiovascular Diseases Dedinje, Belgrade, Serbia (Petrovic, Bojic) Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background and Objectives: Myocardial protection during on-pump coronary artery bypass grafting (CABG) limits ischaemic injury, particularly in patients with left main coronary artery disease (LMCAD), in whom severe proximal stenosis may compromise antegrade cardioplegia delivery. We investigated whether combined antegrade-retrograde blood cardioplegia reduces postoperative high-sensitivity cardiac troponin I (hs-cTnI) concentrations, a marker of perioperative myocardial injury. Material(s) and Method(s): We conducted a prospective, single-centre, randomised trial involving 60 adults undergoing elective isolated on-pump CABG for significant LMCAD. Patients were assigned (1:1) to antegrade-only or combined antegrade-retrograde blood cardioplegia. Cardiac biomarkers were measured after induction and at 4, 12, 24, and 48 h after ICU admission. The primary endpoint was peak hs-cTnI within 48 h; key secondary endpoints included the hs-cTnI area under the concentration-time curve, CK-MB, immediate myocardial electrical recovery and 30-day outcomes. Result(s): All patients received the assigned cardioplegia strategy, with no crossover. Peak hs-cTnI did not differ significantly between the antegrade-only and combined groups (median 529.1 [IQR 829.9] vs. 394.1 [503.4] ng/L; p = 0.21), nor did the hs-cTnI area under the concentration-time curve from 4 to 48 h (12,910.6 [23,127.4] vs. 8112.2 [11,686.2] ng.h/L; p = 0.16). Serial hs-cTnI, CK-MB, total creatine kinase, serum creatinine, immediate myocardial electrical recovery, and 30-day outcomes also did not differ significantly. No deaths, coronary sinus injuries, or other cardioplegia-related complications occurred. Conclusion(s): In patients undergoing isolated on-pump CABG for significant LMCAD, combined antegrade-retrograde blood cardioplegia did not significantly decrease peak hs-cTnI levels compared to the antegrade-only method. The combined approach was feasible with no cardioplegia-related complications, suggesting that an individualised strategy may be preferable to a routine one. Larger prospective studies are needed to determine whether higher-risk patients may derive greater benefit. Copyright © 2026 by the authors. <3> Accession Number 651708414 Title Inspiratory muscle training as part of multimodal prehabilitation improves maximal inspiratory pressure in elderly surgical patients: an exploratory secondary analysis of a randomised controlled trial. Source BMC geriatrics. 26(1) (no pagination), 2026. Date of Publication: 07 Jul 2026. Author Dueblin S.W.-S.; Wuethrich P.Y.; Engel D.; Eser P.; Beilstein C.M.; Wilhelm M.; Vetsch T. Institution (Dueblin) Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (Wuethrich, Engel, Beilstein, Vetsch) Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (Eser, Wilhelm, Vetsch) Centre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland Abstract BACKGROUND: Older adults awaiting major surgery often present with reduced physical fitness and respiratory muscle weakness, which are associated with increased postoperative complications. Prehabilitation may improve functional capacity, but evidence for its effect on inspiratory muscle strength in high-risk older adults remains limited. The main objective was to assess the change in maximal inspiratory pressure (MIP) in the preoperative period in high-risk patients receiving home-based tele-supervised prehabilitation compared to standard care. METHOD(S): This exploratory analysis included a subset of secondary outcome data from a prospective, two-arm, parallel-group randomised controlled trial conducted at a single university hospital in Switzerland. Patients aged >= 65 years awaiting elective cardiac or major non-cardiac surgery with a proven fitness deficit measured by cardiopulmonary exercise testing (CPET) were included. Participants randomized in the intervention arm received a multimodal, home-based tele-supervised prehabilitation programme over 2-4 weeks addressing deficits in physical fitness, nutrition, and anaemia, while controls received standard preoperative care. RESULT(S): Eighty eight participants were analysed (intervention n = 48; control n = 40). Patients in the intervention group showed improvement in MIP after the training period, whereas the control group demonstrated a decline (median change + 10.5 [0.00; 16.2] vs. - 3.00 [-8.00; 1.50] cmH2O; p < 0.001). After adjustment for baseline MIP, the estimated between-group difference was 13.39 cmH2O (95%CI 8.12-18.75; p < 0.001). CONCLUSION(S): Home-based tele-supervised IMT, delivered as part of a multimodal prehabilitation programme, improved maximal inspiratory pressure over the preoperative period in elderly high-risk surgical patients. The observed MIP decline in the control group suggests that the preoperative waiting period itself may carry a risk of functional deterioration in this population. Whether MIP improvements translate into reduced postoperative morbidity will be addressed by the primary outcome of the ongoing PREHABIL trial. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT04461301 (First Submitted: 02.07.2020, First Posted: 08.07.2020). Copyright © 2026. The Author(s). <4> Accession Number 2038497820 Title Effect of PCSK9 inhibitor usage on coronary endothelial dysfunction in patients with hypercholesterolemia after coronary stenting: The CuVIC-2 trial. Source Journal of Cardiology. 86(3) (pp 230-237), 2025. Date of Publication: 01 Sep 2025. Author Akiyama Y.; Katsuki S.; Koga Y.; Yamamoto M.; Hironaga K.; Suematsu N.; Miyata K.; Mukai Y.; Inoue S.; Nishi J.-I.; Tashiro H.; Nakano Y.; Funakoshi K.; Tagawa K.; Ichi I.; Tsutsui H.; Abe K.; Matoba T. Institution (Akiyama, Koga) Department of Cardiovascular Medicine, Oita Prefectural Hospital, Oita, Japan (Akiyama, Katsuki, Nakano, Abe, Matoba) Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (Yamamoto) Department of Cardiovascular Medicine, Harasanshin Hospital, Fukuoka, Japan (Hironaga) Department of Cardiovascular Medicine, Fukuoka City Hospital, Fukuoka, Japan (Suematsu) Department of Cardiovascular Medicine, Saiseikai Fukuoka General Hospital, Fukuoka, Japan (Miyata) Department of Cardiovascular Medicine, Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan (Mukai) Department of Cardiovascular Medicine, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan (Inoue) Department of Cardiovascular Medicine, National Hospital Organization Kyushu Medical Centre, Fukuoka, Japan (Nishi) Department of Cardiovascular Medicine, Iizuka Hospital, Fukuoka, Japan (Tashiro) Department of Cardiovascular Medicine, St. Mary's Hospital, Fukuoka, Japan (Funakoshi, Tagawa) Center for Clinical and Translational Research of Kyushu University Hospital, Fukuoka, Japan (Ichi) Graduate School of Humanities and Science, Ochanomizu University, Tokyo, Japan (Tsutsui) School of Medicine and Graduate School, International University of Health and Welfare, Fukuoka, Japan Publisher Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai) Abstract Background: The effects of evolocumab on coronary endothelial dysfunction (CED), a hallmark of atherogenesis, are unknown. The aim of this study was to investigate whether evolocumab, in combination with high-dose statins, could ameliorate CED in patients who underwent coronary stenting. Method(s): The CuVIC-2 trial was a multicenter randomized controlled trial. CED was defined as intracoronary acetylcholine (ACh)-induced contractile responses with signs of myocardial ischemia. We originally intended to enroll 160 participants but altered the study design due to the COVID-19 pandemic and then recruited 41 participants. The revised primary endpoint was the coronary contraction rate in response to ACh assessed in a core laboratory, ensuring a statistical power of over 80 % using the mixed model for repeated measures. Result(s): The evolocumab in combination with high-dose statins with or without ezetimibe (EV + S) group included 19 males and 4 females aged 62 +/- 13 years. The high-dose statins with or without ezetimibe (S) group included 13 males and 5 females aged 64 +/- 11 years. Compared with the S group, the EV + S group presented a significantly greater decrease in low-density lipoprotein cholesterol at 28 weeks; 83 +/- 17 to 20 +/- 16 mg/dL (-76 % from the baseline) in the EV + S group and 88 +/- 16 to 81 +/- 20 mg/dL (-7 % from the baseline) in the S group (p < 0.0001). At 28 weeks, there was no difference between the two groups in terms of the coronary artery constriction rate across all doses [mean difference: 4.8 % (95 % CI: -13.6 to 23.2); p = 0.6]. Conclusion(s): Amelioration of CED by evolocumab was not observed in this trial with several limitations. Copyright © 2025 The Authors <5> Accession Number 2048953952 Title HPS-4/TIMI 65/ORION-4: A double-blind randomized placebo-controlled trial assessing the effects of inclisiran on clinical outcomes among people with atherosclerotic cardiovascular disease: Trial design, recruitment, and baseline characteristics. Source American Heart Journal. 303 (no pagination), 2027. Article Number: 107546. Date of Publication: 01 Jan 2027. Author Mafham M.M.; Zayed M.G.; Collins R.; Sabatine M.S.; Armitage J.; Brittain D.; da Costa B.R.; Chen F.; Goonasekera M.A.; Hill M.; Hopewell J.C.; Landray M.J.; Lay M.D.; Lesogor A.; Maggioni A.P.; Morrow D.A.; Nunn M.; O'Donoghue M.L.; Ray K.K.; Rizkala A.; Schwartz G.G.; Stevens W.; Wallendszus K.; Wright R.S.; Wijesurendra R.; Wincott E.; Preiss D.; Bowman L. Institution (Mafham, Zayed, Collins, Armitage, da Costa, Chen, Goonasekera, Hill, Hopewell, Landray, Lay, Nunn, Stevens, Wallendszus, Wijesurendra, Wincott, Preiss, Bowman) Clinical Trial Service Unit and Epidemiological Studies Unit, Oxford Population Health, University of Oxford, Oxford, United Kingdom (Sabatine, Morrow, O'Donoghue) Division of Cardiovascular Medicine, Brigham and Women's Hospital, Thrombolysis in Myocardial Infarction (TIMI) Study Group, Boston, MA, United States (Brittain, Lesogor) Novartis Pharma AG, Basel, Switzerland (Maggioni) ANMCO Research Center, HCF Fondazione ANMCO per il Tuo cuore ETS, Florence, Italy (Ray) Imperial Centre for Cardiovascular Disease Prevention, Department of Primary Care and Public Health, Imperial College London, London, United Kingdom (Rizkala) Novartis, East Hanover, NJ, United States (Schwartz) Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, United States (Wright) Division of Preventive Cardiology, Department of Cardiology, Mayo Clinic, Rochester, MN, United States (Landray) Protas, Manchester, United Kingdom Publisher Elsevier Inc. Abstract Background Despite widespread statin use, atherosclerotic cardiovascular disease remains a leading cause of morbidity and mortality worldwide. Monoclonal antibodies targeting circulating proprotein convertase subtilisin-kexin type 9 (PCSK9) substantially reduce low-density lipoprotein cholesterol (LDL-C) levels and cardiovascular events. However, the requirement for self-administration every 2 to 4 weeks may limit adherence to treatment. Inclisiran, a first-in-class small interfering ribonucleic acid (siRNA) therapy targeting hepatic PCSK9 production, has several potential advantages over the anti-PCSK9 monoclonal antibodies, principally longer duration of action. To date, however, the efficacy and safety of inclisiran have not been proven in a cardiovascular outcomes trial. Methods The ORION-4 study is the first large-scale clinical outcomes trial of an siRNA therapy, aiming to assess the efficacy and safety of inclisiran among participants with pre-existing atherosclerotic cardiovascular disease. The primary assessment is an intention-to-treat comparison of the effect of inclisiran sodium 300 mg (equivalent to 284 mg inclisiran), given by subcutaneous injection at randomization, at approximately 3 months and then approximately every 6 months thereafter, on major adverse cardiovascular events (MACE), defined as the composite of coronary death, myocardial infarction, fatal or nonfatal ischemic stroke, or urgent coronary revascularization. Participants will be followed until the median time since randomization is at least 5 years and at least 1,700 participants have a recorded adjudicated MACE. With a planned sample size of ~15,000 participants, ORION-4 was designed to have >99% power to detect a relative reduction in the primary outcome of about 1 quarter, while also providing an opportunity to assess efficacy in different subgroups as well as on secondary outcomes of interest. Results Between 2019 and 2023 a total of 16,124 participants were randomized in the UK and the US. The mean (SD) age was 70 (8) years and 30% were female. At baseline, 78% had a history of coronary heart disease, 22% of ischemic stroke, 15% of revascularization for peripheral arterial disease, and 23% had diabetes mellitus. 85% were on statin therapy (53% high intensity statin, 29% moderate and 3% low intensity statins). Overall, baseline mean (SD) LDL-C was 96 (32) mg/dL, and was similar among participants on high- and moderate/low-intensity statin regimens (87 [27] mg/dL and 93 [26] mg/dL respectively), with higher levels in those receiving no statin therapy (133 [33] mg/dL). Follow-up will complete during 2026 and results will be available in early 2027. Interpretation Inclisiran potentially offers a scalable lipid-lowering treatment, either alone or in combination with other agents. ORION-4 will evaluate the clinical efficacy of inclisiran, and provide a robust assessment of the safety of prolonged use of an siRNA therapeutic. Trial Registration The trial is registered at ClinicalTrials.gov (NCT03705234) and the EU Clinical Trials Register (EudraCT Number: 2017-005066-22). Copyright © 2026 The Author(s). <6> Accession Number 2047890648 Title Treadmill Stress Test in Patients With Asymptomatic Severe Aortic Stenosis : A Prespecified Registry-Based Follow-Up of the EARLY TAVR Randomized Clinical Trial. Source JAMA Cardiology. 11(9) (pp 802-809), 2026. Date of Publication: 09 Sep 2026. Author Genereux P.; Schwartz A.; Lindman B.R.; Chhatriwalla A.; Ramee S.; Babaliaros V.; Schwartz R.; Sheth T.; Fearon W.F.; Sorajja P.; Beaver T.; Oldemeyer J.B.; Pop A.; Garcia S.; Southard J.; Bailey S.H.; Li W.; Cohen D.J.; Pibarot P.; Leon M.B. Institution (Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ, United States (Schwartz, Leon) NewYork Presbyterian Hospital, Columbia University Irving Medical Center, New York, United States (Lindman, Chhatriwalla) Structural Heart and Valve Center, Vanderbilt University Medical Center, Nashville, TN, United States (Ramee) Saint Luke's Mid America Heart Institute, Kansas City, MO, United States (Ramee) John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA, United States (Babaliaros) Emory University, Atlanta, GA, United States (Sheth) New York University Langone Hospital, Mineola, NY, United States (Schwartz) Hamilton Health Sciences, Hamilton, ON, Canada (Sheth) Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University, Stanford, CA, United States (Fearon) Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States (Sorajja) Minneapolis Heart Institute Foundation, Minneapolis, MN, United States (Beaver) Division of Cardiovascular Surgery, University of Florida, Gainesville, United States (Oldemeyer) UCHealth Northern, Colorado, United States (Pop) Ascension Alexian Brothers Hospital, Elk Grove Village, IL, United States (Garcia) The Christ Hospital, Cincinnati, OH, United States (Southard) University of California Davis Medical Center, Sacramento, United States (Bailey) Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA, United States (Li) Edwards Lifesciences, Irvine, CA, United States (Cohen) Cardiovascular Research Foundation, New York, NY, United States (Pibarot) St Francis Hospital and Heart Center, Roslyn, NY, United States (Leon) Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec, Canada Publisher American Medical Association Abstract IMPORTANCE In patients with asymptomatic severe aortic stenosis (AS), exercise stress testing is recommended to unmask symptoms and guide the timing of intervention, yet it is infrequently used in clinical practice. This registry-based follow-up of the Evaluation of TAVR Compared to Surveillance for Patients With Asymptomatic Severe Aortic Stenosis (EARLY TAVR) trial evaluates how treadmill stress testing (TST), used during screening for EARLY TAVR to confirm asymptomatic status, informed subsequent aortic valve replacement and clinical outcomes. OBJECTIVE To evaluate clinical outcomes in patients with asymptomatic severe AS and a positive TST result and to identify predictors of a positive TST result. DESIGN, SETTING, AND PARTICIPANTS This prespecified TST registry of the EARLY TAVR trial involved 75 clinical sites across the US. Between July 2017 and December 2021, apparently asymptomatic patients with severe AS underwent standardized TST. Those with normal TST results were randomized to transcatheter aortic valve replacement or clinical surveillance, whereas those with positive TST results were invited to enroll in a prospective registry and were followed up with through 2 years. Of 1250 patients screened, 962 met trial criteria. Of these, 816 (84.8%) had a normal TST result and 146 (15.2%) had a positive TST result. Of these, 105 consented to enroll in the EARLY TAVR Treadmill Registry. Data were analyzed from August 2025 to January 2026. EXPOSURE Positive TST result. MAIN OUTCOMES AND MEASURES TST-related safety, 2-year all-cause mortality, and rates of subsequent aortic valve replacement (AVR). Baseline predictors of a positive TST result were identified using multivariable logistic regression models. RESULTS Of the 105 patients included in the present analysis, the mean (SD) age was 76.1 (6.5) years, and 80 participants (76.2%) were male. TST was found to be safe, with no reported deaths, syncope, or cardioversions. Multivariable baseline predictors of a positive TST included higher peak velocity, lower ejection fraction, prior coronary artery bypass, and prior stroke. The 2-year Kaplan-Meier rate for all-cause mortality was 5.7%. Among patients with positive TST results, the rates of AVR at 1 and 2 years were 79.9% and 85.9%, respectively. Rates of mortality and AVR were similar for patients who had a class I indication for AVR (symptoms during testing) and those with a class IIa indication (drop in systolic blood pressure). CONCLUSIONS AND RELEVANCE In patients with asymptomatic severe AS, TST was found to be safe and identified symptoms and AVR indication in approximately 15% of patients. However, 20% of those patients remained untreated at 1 year, despite having an indication for prompt treatment. Copyright © 2026 American Medical Association. All rights reserved. <7> Accession Number 2049758593 Title Validating national registry data for randomized trials: comparison of registry-derived cardiovascular events with and without adjudication in the BETAMI-DANBLOCK trial. Source European Heart Journal - Quality of Care and Clinical Outcomes. 12(6) (pp 903-911), 2026. Date of Publication: 01 Sep 2026. Author Holmager T.L.F.; Kristensen A.M.D.; Fagerland M.W.; Atar D.; Hecht Olsen M.; Bakken A.; Munkhaugen J.; Prescott E. Institution (Holmager, Kristensen, Prescott) Department of Cardiology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Nordre Fasanvej 57, Frederiksberg, Copenhagen, 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, Oslo, Norway (Atar) Faculty of Medicine, University of Oslo, Oslo, Norway (Hecht Olsen) Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark (Hecht Olsen) Department of Internal Medicine 1, Holbaek Hospital, Holbaek, Denmark (Munkhaugen) Department of Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway (Munkhaugen) Department of Behavioural Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway Publisher Oxford University Press Abstract Aims: Registry-based randomized 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. Methods and Results: In the BETAMI-DANBLOCK trial, 5574 patients with myocardial infarction (MI) and no heart failure were randomized to beta-blocker or no beta-blocker therapy. The primary endpoint events (all-cause mortality, MI, ischemic stroke, heart failure, unplanned coronary revascularization, 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 vs. controls. 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 vs. 4.43/100 person-years). The confirmation rate was lower during the first 6 months and varied by event type (from 92% for ischaemic stroke to 45% for unplanned coronary revascularizations 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 revascularization. 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. Trial registration number: BETAMI-DANBLOCK ClinicalTrials.gov numbers, NCT03646357 and NCT03778554 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 journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <8> Accession Number 2047139043 Title Preferred Glucagon-like Peptide-1 Receptor Agonists in Adults With Type 2 Diabetes and Established Cardiovascular Disease or High Cardiovascular Risk: A Network Meta-analysis of Randomized Trials. Source Canadian Journal of Diabetes. 50(6) (pp 429-439.e26), 2026. Date of Publication: 01 Aug 2026. Author Abomohsen M.; Rifai M.; Gadelmawla A.F.; Alghzawi H.M.; Elgendy M.S.; Bakr H.M.; Friedman A.; Idries I.Y. Institution (Abomohsen, Friedman, Idries) Cardiology Department, Brookdale University Hospital and Medical Center, Brooklyn, NY, United States (Rifai, Gadelmawla, Bakr) Faculty of Medicine, Menoufia University, Shibin al Kawm, Egypt (Alghzawi) School of Nursing, Tennessee State University, Nashville, TN, United States (Elgendy) Faculty of Medicine, Tanta University, Tanta, Egypt Publisher Elsevier B.V. Abstract The comparative cardiovascular (CV) efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with type 2 diabetes (T2D) and established cardiovascular disease (CVD) or high CV risk remain uncertain. PubMed, Embase, Web of Science, Scopus, and CENTRAL were searched from inception to December 20, 2025, for randomized controlled trials. We conducted a frequentist random-effects network meta-analysis and reported risk ratios (RRs) with 95% confidence intervals (CIs). Treatments were ranked using P-scores. Regimens were analyzed as individual agents, including albiglutide, dulaglutide, efpeglenatide, exenatide extended release, ITCA 650, liraglutide, lixisenatide, subcutaneous semaglutide, oral semaglutide, tirzepatide, and placebo. Eleven trials (n=83,215) were included. In the 3-point major adverse CV events (MACE) network (11 trials, 11 regimens), heterogeneity and inconsistency were absent (I2=0%, tau2=0). MACE rate was reduced with subcutaneous semaglutide (RR 0.74, 95% CI 0.58 to 0.94), efpeglenatide (RR 0.76, 95% CI 0.61 to 0.94), and albiglutide (RR 0.79, 95% CI 0.69 to 0.91); tirzepatide, oral semaglutide, liraglutide, and dulaglutide were also significantly reduced compared with placebo. Top ranked were subcutaneous semaglutide (P-score 0.87), efpeglenatide (0.84), and albiglutide (0.80). No regimen significantly reduced all-cause or CV death compared with placebo. Stroke was reduced with tirzepatide (RR 0.71, 95% CI 0.54 to 0.93) and dulaglutide (RR 0.77, 95% CI 0.63 to 0.95) vs placebo. Discontinuation and gastrointestinal discontinuation were higher with subcutaneous semaglutide, oral semaglutide, lixisenatide, and ITCA 650. Several GLP-1-based therapies reduced MACE vs placebo, with 3-point MACE emerging as the most consistent efficacy signal. Overall, these findings support guideline-based use of GLP-1 RAs in high-risk T2D while highlighting the need for individualized treatment selection. Copyright © 2026 Diabetes Canada <9> Accession Number 2050100865 Title Clinical significance of CT-detected hypoattenuated leaflet thickening after transcatheter aortic valve replacement: A systematic review and meta-analysis. Source Journal of Cardiovascular Computed Tomography. (no pagination), 2026. Date of Publication: 2026. Author Yasuda N.; Kato S.; Horita N.; Sawamura S.; Utsunomiya D. Institution (Yasuda, Kato, Sawamura, Utsunomiya) Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan (Horita) Chemotherapy Center, Yokohama City University Hospital, Yokohama, Japan Publisher Elsevier Inc. Abstract Background: Hypoattenuated leaflet thickening (HALT) is a CT-detected finding increasingly recognized after transcatheter aortic valve replacement (TAVR), but its predictors, association with valve platform and antithrombotic regimen, and clinical significance remain uncertain. Method(s): We performed a systematic review and meta-analysis of studies reporting HALT after TAVR. PubMed, Web of Science Core Collection, and the Cochrane Library were searched. Pairwise meta-analyses evaluated associations between HALT and patient characteristics, antithrombotic regimen, valve hemodynamics, and clinical outcomes. Network meta-analyses compared valve platform and valve size. Result(s): Fifty-nine studies including 16,269 patients were analyzed, with HALT observed in 1792 patients (11.0%). Most baseline patient characteristics were not associated with HALT. Compared with balloon-expandable valves, self-expanding supra-annular valves were associated with lower HALT risk, whereas self-expanding intra-annular and Lotus valves were associated with higher risk. Direct oral anticoagulants and warfarin did not differ in HALT risk, whereas oral anticoagulation was associated with lower risk than no oral anticoagulation. HALT was associated with a small increase in mean transvalvular gradient, but not with major clinical outcomes at short-term follow-up. Conclusion(s): HALT after TAVR was associated mainly with valve platform and antithrombotic regimen rather than baseline patient characteristics. Its hemodynamic and clinical impact appeared limited, supporting individualized interpretation of this CT-detected finding. Further long-term follow-up studies are warranted to clarify the clinical sequelae of HALT and its potential impact on valve durability. Copyright © 2026 Society of Cardiovascular Computed Tomography <10> Accession Number 2042143982 Title Cryopreserved vs Liquid-Stored Platelets for the Treatment of Surgical Bleeding: The CLIP-II Randomized Noninferiority Clinical Trial. Source JAMA. 335(7) (pp 600-608), 2026. Date of Publication: 17 Feb 2026. Author Reade M.C.; Marks D.C.; Howe B.D.; Bailey M.J.; Bannon P.G.; Eastwood G.M.; French C.J.; Gattas D.J.; Higgins A.M.; Holley A.D.; Hu R.T.; Irving D.O.; Johnson L.; Mcguinness S.P.; Mcquilten Z.K.; Royse A.G.; Smith J.A.; Weinberg L.; Wood E.M.; Buckland M.; Bedaton G.; Neylan A.; Robertshaw S.; Tran H.; Ueoka M.; Wallace S.; Bickerton T.; Kavadias P.; Macfarlane C.; Shackles J.; Veljanovski T.; Webb A.; Baulch S.; Bellomo R.; Claxton G.; Eastwood G.; Harris S.; Hu R.; Makar T.; Peck L.; Sidiropoulos S.; Young H.; Ambanloc S.; Banchi S.; Banks L.; Davies A.; Gao Y.; Gazelle R.; Hogan C.; Kannesan D.; Kelly S.; Kolar D.; Leong C.; Masuku P.; Napoles R.; Ng J.; Oldenburger C.; Rodrigues C.; Saberi M.; Tran K.; Uson M.; Wilkes A.-M.; McCullough J.; Gough M.; Houbert M.; Pitman J.; Tallott M.; Betts C.; McMahon S.; O'Loughlin Q.; Weng A.; Aneman A.; Coupland L.; Le T.; Miller J.; O'Regan W.; Pancholi A.; Shaw D.; Dhir V.; Matta L.; Moyo N.; Royse A.; Balcos P.; Boggett S.; Royse C.; Williams Z.; Wu J.; Bisignano M.; Haeusler M.; Neander E.; Nguyen V.; Pham N.; Smith K.; Snowdon M.; Gattas D.; Beattie L.; Buhr H.; Cartwright B.; Coles J.; Evangelisti O.; Liang Y.; Oostveen C.; Turner L.; Ackermann L.; Anwar Z.; Flinn H.; Lee R.; Pulanco C.; Skidmore J.; Teevan J.; Slater B.; Corcoran P.; Fernandez A.; Hall K.; Pappas P.; Scott D.; Cole-Sinclair M.; Crockett R.; Morris K.; Walter C.; Pearse B.; O'Brien D.; Amerio E.; Boyd M.; De Waard C.; Mehta A.; Vincent B.; Whiteside J.; Win A.; Baker-Pearson I.; Senthuran S.; Brown C.; Gofton C.; Kempshall L.; Lakh S.; McCormack S.; Marshall H.; Mills W.; Patane M.; Rice T.; Sawyer N.; Shucksmith M.; Smith J.; Hulley A.; Kim M.; Warwarek S.; Fossaert L.; Juliana J.; Hu S.; Koralegedara K.; Papasimeon V.; Reid S.; Santamaria M.; Singh H.; Sreng C.; Dieleman J.; Lei L.; Ali F.; Clark-Mackay E.; Cope J.; Hinks P.; Hussain S.; Crew J.M.; Medalla H.; Mungai T.N.; Pasalic L.; Shaktour T.; van de Vorstenbosch E.; Wentworth A.; Bailey M.; Paul E.; Tan S. Institution (Reade, Holley) Medical School, University of Queensland, Brisbane, QLD, Australia (Reade, Holley) Joint Health Command, Australian Defence Force, Canberra, ACT, Australia (Marks, Irving, Johnson, Tan) Australian Red Cross Lifeblood, Alexandria, NSW, Australia (Howe, Bailey, French, Higgins) Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (Bannon, Gattas) Royal Prince Alfred Hospital, Sydney, NSW, Australia (Bannon, Gattas) Sydney Medical School, Sydney, NSW, Australia (Eastwood, Hu, Weinberg) Austin Hospital, Melbourne, VIC, Australia (Eastwood, Hu, Royse, Weinberg) University of Melbourne, Melbourne, VIC, Australia (French) Western Hospital, Melbourne, VIC, Australia (Mcguinness) Cardiothoracic and Vascular Intensive Care, High Dependency Unit, Auckland, New Zealand (Mcquilten) School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (Royse) Royal Melbourne Hospital, Melbourne, VIC, Australia (Royse) Australian Army, Melbourne, VIC, Australia (Smith, Hulley, Kim, Warwarek, Fossaert, Juliana, Hu, Koralegedara, Papasimeon, Reid, Santamaria, Singh, Sreng) Victorian Heart Hospital, Melbourne, VIC, Australia (Smith) Monash University, Melbourne, VIC, Australia (Wood) Transfusion Research Unit, Monash University, Melbourne, VIC, Australia (Buckland, Bedaton, Neylan, Robertshaw, Tran, Ueoka, Wallace, Bickerton, Kavadias, Macfarlane, Shackles, Veljanovski, Webb) The Alfred Hospital, Melbourne, VIC, Australia (Weinberg, Baulch, Bellomo, Claxton, Eastwood, Harris, Hu, Makar, Peck, Sidiropoulos, Young, Ambanloc, Banchi, Banks, Davies, Gao, Gazelle, Hogan, Kannesan, Kelly, Kolar, Leong, Masuku, Napoles, Ng, Oldenburger, Rodrigues, Saberi, Tran, Uson, Wilkes) Austin Hospital, Heidelberg, VIC, Australia (McCullough, Gough, Houbert, Pitman, Tallott, Betts, McMahon, O'Loughlin, Weng) Gold Coast University Hospital, Southport, QLD, Australia (Aneman, Coupland, Le, Miller, O'Regan, Pancholi, Shaw, Dhir, Matta, Moyo) Liverpool Hospital, Liverpool, NSW, Australia (Royse, Balcos, Boggett, Royse, Williams, Wu, Bisignano, Haeusler, Neander, Nguyen, Pham, Smith, Snowdon) Royal Melbourne Hospital, Parkville, VIC, Australia (Gattas, Beattie, Buhr, Cartwright, Coles, Evangelisti, Liang, Oostveen, Turner, Ackermann, Anwar, Flinn, Lee, Pulanco, Skidmore, Teevan) Royal Prince Alfred Hospital, Camperdown, NSW, Australia (Slater, Corcoran, Fernandez, Hall, Pappas, Scott, Cole-Sinclair, Crockett, Morris, Walter, Pearse) St Vincent's Hospital Fitzroy, Melbourne, Australia (O'Brien, Amerio, Boyd, De Waard, Mehta, Vincent, Whiteside) Applied Science The Prince Charles Hospital, Chermside, QLD, Australia (Win, Baker-Pearson, Senthuran, Brown, Gofton, Kempshall, Lakh, McCormack, Marshall, Mills, Patane, Rice, Sawyer, Shucksmith, Smith) Townsville University Hospital, Douglas, QLD, Australia (Bailey, Paul) Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (Dieleman, Lei, Ali, Clark-Mackay, Cope, Hinks, Hussain, Crew, Medalla, Mungai, Pasalic, Shaktour, van de Vorstenbosch, Wentworth) Westmead Hospital, Westmead, NSW, Australia Publisher American Medical Association Abstract Importance: Liquid-stored platelets have a shelf-life of 5 to 7 days, limiting availability and resulting in wastage. Objective(s): To assess the effectiveness and safety of dimethyl sulfoxide-cryopreserved platelets, which have a shelf-life of 2 years, as a treatment for cardiac surgery bleeding. Design, Setting, and Participant(s): The Cryopreserved vs Liquid Platelets II (CLIP-II) trial was a multicenter, randomized, double-blind, parallel-group noninferiority trial, which enrolled patients between August 2021 and April 2024 at 11 Australian tertiary hospitals, with follow-up completed in July 2024. Patients at high risk of platelet transfusion were eligible. Patients were excluded if they had a history of deep vein thrombosis or pulmonary embolism, were coagulopathic, or were females aged 18 to 55 years who were rhesus D (RhD) negative or of unknown RhD status. Of 879 patients meeting inclusion criteria, 182 were excluded and 285 did not consent, leaving 412. Of these, 388 were randomized and 202 received study platelets. Intervention(s): Patients received up to 3 units of either group O cryopreserved platelets or conventional liquid-stored platelets, commencing intraoperatively or in the first 24 postoperative hours. Main Outcomes and Measures: The primary outcome was postsurgical chest drain bleeding within the first 24 hours following intensive care unit admission. Noninferiority was defined prospectively as less than 20% greater bleeding in this period. Five secondary and 42 tertiary outcomes were defined a priori. Result(s): Of the 202 transfused patients (mean [SD] age, 64.4 [13] years; 75.7% male), 61 (30.2%) underwent nonelective surgery. The primary outcome did not differ between groups (605 mL in cryopreserved platelet group vs 535 mL in liquid-stored platelet group; ratio of geometric means [cryopreserved to liquid ratio], 1.13 [95% CI, 0.96-1.34]; P =.07). As the confidence interval includes bleeding exceeding the noninferiority margin, noninferiority was not established. Cryopreserved platelet transfusion was associated with higher intraoperative and total perioperative blood loss (ratio of geometric means [cryopreserved to liquid ratio], 1.42 [95% CI, 1.12-1.80]; 1.31 [95% CI, 1.07-1.60], respectively), and increased red cell, plasma, and cryoprecipitate transfusion. While there were no differences in the incidence of prespecified adverse events, patients receiving cryopreserved platelets experienced longer times to extubation and intensive care unit/hospital discharge (median [IQR] duration of ventilation, 25.5 hours [16.1-77.3] vs 23.6 hours [13.1-52.8]; median [IQR] intensive care unit length of stay, 3.8 days [2.0-6.0] vs 3.0 days [1.9-4.9]; median hospital length of stay, 10.9 days [7.87-17.0] vs 9.1 [6.9-14.9]). Conclusions and Relevance: Cryopreserved platelets did not meet the predefined threshold for noninferiority in hemostatic effectiveness at 24 hours after ICU admission. Additional predefined end points consistently indicated diminished hemostatic effectiveness, although prespecified adverse events were comparable. Copyright © 2026 American Medical Association. <11> Accession Number 2049758282 Title Cardiovascular and renal outcomes of GLP-1 receptor agonists in type 2 diabetes mellitus: a systematic review and meta-analysis. Source European Heart Journal - Quality of Care and Clinical Outcomes. 12(6) (pp 980-994), 2026. Date of Publication: 01 Sep 2026. Author Ahmed M.; Hashmi T.M.; Shahzad M.; Zia R.; Ashraf H.; Ahmed R.; Rashid M.; Greene S.J.; Mentz R.J.; Fudim M.; Fonarow G.C.; Rana J.S. Institution (Ahmed, Hashmi, Zia, Ashraf) Department of Cardiology, Rawalpindi Medical University, Rawalpindi, Pakistan (Shahzad) Department of Cardiology, Dow University of Health Sciences, Karachi, Pakistan (Ahmed) Department of Cardiology, Royal Brompton Hospital, London, United Kingdom (Ahmed) National Heart and Lung Institute, Imperial College London, London, United Kingdom (Rashid) Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, David Weatherall building, University Road, Keele, United Kingdom (Greene, Mentz, Fudim) Division of Cardiology, Duke University Medical Center, 2301 Erwin Road, Durham, NC, United States (Greene, Mentz, Fudim) Division of Research, Duke Clinical Research Institute, 2301 Erwin Road, Durham, NC, United States (Fonarow) Ahmanson-UCLA Cardiomyopathy Center, Division of Cardiology, University of California Los Angeles, Los Angeles, CA, United States (Rana) Division of Cardiology, Kaiser Permanente Northern California, 1 Kaiser Plaza, Oakland, CA, United States (Rana) Division of Research, Kaiser Permanente Northern California, 1 Kaiser Plaza, Oakland, CA, United States Publisher Oxford University Press Abstract Aims: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as a foundational therapeutic option for type 2 diabetes mellitus (T2DM), offering glycaemic control and cardiovascular benefits. This systematic review and meta-analysis evaluate the impact of GLP-1RAs on cardiovascular outcomes in patients with T2DM. Methods and Results: We conducted a comprehensive search of PubMed, Embase, and Cochrane Library up to 31 March 2025, for randomized controlled trials (RCTs) comparing GLP-1RAs with placebo in T2DM patients. Risk ratios (RR) with 95% confidence intervals (CIs) were pooled using a random-effects model. Twenty RCTs involving 83 004 patients were included. GLP-1RAs significantly reduced the risk of major adverse cardiovascular events (RR 0.87, 95% CI 0.83-0.92), all-cause death (RR 0.89, 95% CI 0.84-0.93), cardiovascular death (RR 0.88, 95% CI 0.81-0.94), myocardial infarction (RR 0.87, 95% CI 0.79-0.96), stroke (RR 0.88, 95% CI 0.81-0.96) and composite renal outcome (RR 0.80, 95% CI 0.73-0.88) compared to placebo. In addition, a trend of reduction in heart failure hospitalizations (RR 0.93, 95% CI 0.85-1.01), and coronary revascularization (RR = 0.87, 95% CI 0.74 to 1.01) was observed with GLP-1 RAs without reaching statistical significance. Conclusion(s): GLP-1RAs are associated with improved cardiovascular outcomes in patients with T2DM. These findings support current guideline recommendations and highlight their cardioprotective benefits beyond glycaemic control in patients with T2DM. 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 journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <12> Accession Number 2042577030 Title Dexmedetomidine reduces acute kidney injury in high-risk but not low-risk patients after non-cardiac surgery: secondary analysis of a randomized controlled trial. Source Journal of Anesthesia. 40(5) (pp 726-736), 2026. Date of Publication: 01 Oct 2026. Author Liang X.-Q.; Li M.-L.; Li C.-J. Institution (Liang, Li, Li) Department of Anesthesiology, Peking University First Hospital, No. 8 Xishiku St., Xicheng District, Beijing, China Publisher Springer Abstract Purpose: Acute kidney injury (AKI) is a significant postoperative complication associated with poor long-term outcomes. Dexmedetomidine, a selective alpha2-adrenergic agonist with anti-inflammatory properties, may protect the kidney during non-cardiac surgery. This study examined whether intraoperative dexmedetomidine reduces AKI in both high-risk and low-risk patients. Method(s): This was a secondary analysis of a randomized double-blind placebo-controlled trial. Patients aged >= 60 years scheduled for elective non-cardiac surgery expected to last >= 2 h under general anesthesia were enrolled and classified as low-risk or high-risk using the General Surgery Acute Kidney Injury Risk Index. Participants were randomly allocated to receive intraoperative dexmedetomidine (loading dose 0.6 mug/kg over 10 min before induction, followed by 0.5 mug/kg/h until 1 h before surgery end) or normal saline. The primary endpoint was AKI incidence within 7 postoperative days. Result(s): Among high-risk patients, AKI occurred in 12.6% (13/103) of the dexmedetomidine group versus 23.4% (25/107) of controls (RR 0.54, 95% CI 0.29 to 1.00, P = 0.043); after multivariable adjustment, dexmedetomidine remained independently associated with lower AKI risk (OR 0.44, 95% CI 0.20 to 0.98, P = 0.045). In contrast, low-risk patients showed no significant difference with or without dexmedetomidine (7.9% vs 9.6%; RR 0.82, 95% CI 0.44 to 1.55, P = 0.543; adjusted OR 0.65, 95% CI 0.30 to 1.38, P = 0.260). Urological surgery was an independent predictor of AKI across the entire cohort. Conclusion(s): Intraoperative dexmedetomidine was associated with lower risk of AKI in high-risk but not in low-risk patients undergoing non-cardiac surgery. Copyright © The Author(s) 2026. <13> Accession Number 2049974938 Title Reply to the Letter to the Editor regarding "Comparing perioperative heparin bridging strategies in mechanical heart valve patients undergoing surgery: A systematic review and Bayesian meta-analysis". Source Thrombosis Research. 266 (no pagination), 2026. Article Number: 109843. Date of Publication: 01 Oct 2026. Author Batista P.G.; Montenegro M.V.; Gaelzer G.C.; Molinari M.E.; Malik M.; dos Santos Silva R.R.A.; de Lucena L.A.; Fischer Bacca C.O.; Giorgi J. Institution (Batista) Federal University of Paraiba, Paraiba, Joao Pessoa, Brazil (Montenegro) University of Pernambuco, Brazil (Gaelzer) Pontifical Catholic University of Parana, Brazil (Molinari, Fischer Bacca) University Center for the Development of Alto Vale, Brazil (Malik) Beth Israel Deaconess Medical Center, United States (dos Santos Silva) Federal University of Ceara, Brazil (de Lucena) Federal University of Rio Grande do Norte, Brazil (Giorgi) Hospital Sirio Libanes, Sao Paulo, Sao Paulo, Brazil (Giorgi) Albert Einstein Hospital, Sao Paulo, Sao Paulo, Brazil Publisher Elsevier Ltd <14> Accession Number 2048285030 Title Machine Learning for Predicting Mortality Following Transcatheter Aortic Valve Replacement: A Scoping Review of Current Literature. Source CJC Open. 8(10) (pp 1375-1385), 2026. Date of Publication: 01 Oct 2026. Author Elsherbini A.H.; Cherif I.A.; Ahmed A.; Haider A.; Alaraki A.; Gemae M.R.; Ansari F.; Harby A.A.; Chaudhary V.; Abu-Omar Y.; El-Diasty M. Institution (Elsherbini, Cherif, Ahmed, Haider) Faculty of Medicine, University of Toronto, Toronto, ON, Canada (Alaraki) Faculty of Health Sciences, Queen's University, Kingston, ON, Canada (Gemae) Department of Opthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada (Ansari) Department of Emergency Medicine, McMaster University, Hamilton, ON, Canada (Harby) The School of Computing, Queen's University, Kingston, ON, Canada (Chaudhary) Computer and Data Sciences, Case Western Reserve University, Cleveland, OH, United States (Abu-Omar, El-Diasty) Harrington Heart and Vascular Institute, Cardiac Surgery Department, University Hospitals, Cleveland, OH, United States Publisher Elsevier Inc. Abstract This scoping review aims to consolidate the current evidence on the use of machine learning (ML) algorithms to predict mortality following transcatheter aortic valve replacement (TAVR) procedures. This review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Electronic databases, including Medline, Embase, Cochrane, and ClinicalTrials.gov, were searched for studies assessing the use of ML models for the prediction of mortality in patients undergoing TAVR. A total of 1076 citations were screened, of which 21 studies underwent full-text review. Ultimately, 11 studies comprising 101,030 patients were included for data extraction. Study sample sizes ranged from 178 to 54,739 patients, with reported mortality intervals ranging from 30 days to 5 years after surgery. The parameters that were included in these ML models included demographic and clinical variables, electrocardiographic findings, laboratory results, computed tomography scans, and the type and size of the selected TAVR device. A total of 13 ML models were assessed across the included studies. Random Forest appeared to be the highest performing ML model in predicting 30-day and 1-year survival following TAVR, with reported area under the receiver operating characteristic (AUROC) scores ranging from 0.66 to 0.97. In addition, the gradient-boosted machine seemed to outperform the CoreValve and TAVI2-SCORE in predicting 1-year survival. ML models may allow for accurate prediction of mortality following TAVR and may offer advantages over traditional clinical risk scores. However, limited datasets and variability in algorithm metric scores remain the main limitations to the implementation of these models in clinical practice. Copyright © 2026 The Authors <15> Accession Number 2041816283 Title Updated evidence on peri-operative neutrophil-to-lymphocyte ratio in cardiac surgery: A dual analysis of prognostic and diagnostic value for post-operative atrial fibrillation. Source Heart Rhythm. 23(9) (pp 1865-1881), 2026. Date of Publication: 01 Sep 2026. Author Awad M.K.A.; Ali A.E.; Mazroua M.S.; Ali K.; Awad R.K.; Mohamed T.R.; Abdelmaksoud M.; Hashim M.A.; Nikollari R.; Vardas P.N.; Abu-Daya H. Institution (Awad, Mohamed, Abdelmaksoud) Division of Critical Care, Department of Anesthesia and Critical Care, Faculty of Medicine, Ain Shams University, Cairo, Egypt (Ali) Department of Internal Medicine, Crestwood Medical Center, Huntsville, AL, United States (Mazroua) Department of Surgery, University of Pittsburgh, Pittsburgh, PA, United States (Ali) Department of Medicine, Hennepin Healthcare, Minneapolis, MN, United States (Awad) Department of Critical Care, Cairo University, Cairo, Egypt (Hashim) Department of Internal Medicine, Mercy St. Vincent Medical Center, Toledo, OH, United States (Nikollari) Department of Internal Medicine, St. Barnabas Hospital Health System, Bronx, NY, United States (Vardas) Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL, United States (Abu-Daya) Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL, United States Publisher Elsevier B.V. Abstract Background Post-operative atrial fibrillation (POAF) is a frequent complication after cardiac surgery, increasing morbidity. The neutrophil-to-lymphocyte ratio (NLR), a simple marker of systemic inflammation, has been studied as a predictor. Objective We aimed to assess the association between NLR and new-onset POAF. Methods We systematically searched PubMed, Scopus, Web of Science, and Embase through June 2025 for studies reporting pre-operative or post-operative NLR and incidence of POAF in adult cardiac surgery patients. Diagnostic test accuracy (DTA) was assessed to evaluate the predictive performance of pre-operative NLR for POAF, using pooled sensitivity, specificity, and likelihood ratios. Subgroup analyses and meta-regression were conducted to explore sources of heterogeneity. Results 32 studies (20,056 patients) were included. In 27 studies excluding pre-operative atrial fibrillation (13,630 patients), POAF was associated with significantly higher pre-operative NLR (standardized mean difference [SMD] = 0.51; 95% confidence interval [CI]: 0.34-0.67; P <.001; I2 = 94.0%). Post-operative NLR was also elevated in POAF patients (SMD = 0.30; 95% CI: 0.13-0.47; P <.001; I2 = 70.7%). Among 4 studies including patients with prior atrial fibrillation (6364 patients), no significant association was observed (SMD = 0.04; P =.21). DTA analysis of 12 studies showed pooled sensitivity of 0.52, specificity of 0.71, and diagnostic odds ratio of 3.74 (area under the curve [AUC] = 0.713), indicating moderate diagnostic accuracy. Conclusion Elevated NLR is associated with increased risk of POAF. Distinguishing new-onset POAF and accounting for surgical type are essential when evaluating NLR as a predictive biomarker. Copyright © 2025 Heart Rhythm Society. <16> Accession Number 2049422245 Title Biophysical rationale and emerging clinical perspectives of surfactants in thoracic surgery: a translational review. Source Langenbeck's Archives of Surgery. 411(1) (no pagination), 2026. Article Number: 252. Date of Publication: 01 Dec 2026. Author Yibulayin X.; Arkin E.; Yang G.; Kalverkamp S.; Spillner J.W.; Greven J. Institution (Yibulayin, Arkin, Yang, Kalverkamp, Spillner, Greven) Department of Thoracic Surgery, University Clinic RWTH Aachen, Pauwelsstrase 30, Aachen, Germany Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Pulmonary surfactants are essential for alveolar stability and gas exchange. While their clinical use is well established in neonatal care, their potential in thoracic surgery remains underexplored. Objective(s): To review the current and emerging applications of surfactants in thoracic surgical practice, and to assess their role in perioperative lung protection. Method(s): We reviewed recent literature on surfactant biology, perioperative administration strategies, and novel formulations, including bio-derived and responsive surfactants. Result(s): Exogenous surfactants may improve lung compliance, preventing atelectasis, and mitigating postoperative respiratory complications. In thoracic surgery, surfactants may also serve as drug delivery vehicles or anti-inflammatory agents. However, clinical use remains limited, and further studies are needed to define optimal dosing, timing, and patient selection. Conclusion(s): Surfactants represent a versatile and evolving tool in thoracic surgery. With continued innovation and clinical validation, they may become an effective adjunct for enhancing perioperative respiratory outcomes. Copyright © The Author(s) 2026. <17> Accession Number 2046444662 Title A Critical Systematic Review of Modelling Approaches and Methodologies used in Hyperlipidaemia Economic Evaluations. Source PharmacoEconomics. 44(9) (pp 1019-1041), 2026. Date of Publication: 01 Sep 2026. Author Vivoda K.; Koh H.; Abebe T.B.; Rodda S.; Bain C.; Ademi Z. Institution (Vivoda, Koh, Abebe, Rodda, Ademi) Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia (Koh, Ademi) School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia (Bain) Faculty of IT, Monash University, Clayton, Australia (Ademi) Faculty of Medicine, University of Prishtina, Prishtina, Kosovo (Ademi) School of Pharmacy, University of Eastern Finland, Kuopio, Finland Publisher Adis Abstract Background and Objectives: Health economic modelling integrates evidence from multiple sources and relies on transparency to support reimbursement decisions. Hyperlipidaemia is a major contributor to cardiovascular disease and is routinely evaluated within health technology assessment frameworks. This systematic review examines health economic models of hyperlipidaemia, evaluates the methodological approaches used in the model development and identifies opportunities to improve model quality and transparency. Method(s): A systematic literature search was conducted in MEDLINE and Embase between 1987 and 2025 to identify hyperlipidaemia health economic models. Screening, data extraction and quality assessment were performed manually, and artificial intelligence (AI) software was used for additional checking, this was followed by conflict resolution. Findings are presented through narrative synthesis. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD420251043922). The review assessed key aspects of model structure including model type, type of hyperlipidaemia, population, hyperlipidaemia-related events, model outcomes, time horizon, software used and discounting approach. We assessed methodological quality through the Philips checklist, with a focus on model structure, data usage, the way in which studies addressed uncertainty through sensitivity analysis and model validation. Result(s): A total of 154 unique model-based economic evaluations were identified, comprising 132 Markov models, 9 microsimulation models and 1 discrete event simulation. Most economic evaluations explored general hypercholesterolaemia in 138 studies, followed by familial hypercholesterolaemia in 23 studies, while lipoprotein(a) was investigated in two studies. Primary prevention was examined in 89 models, secondary prevention in 50 models and a combination of both in 15 evaluations. Overall methodological quality was assessed as high for models' structure and data usage; however, it was moderate for model consistency. Conclusion(s): Hyperlipidaemia models generally had transparent assumptions and a justified structure. However, current models often lack systematic data-selection practices to identify the most appropriate evidence for evaluation. Extensive uncertainty analysis and model validation were frequently absent in the assessed models. To support decision-making, model results should be displayed in an open-source format with publicly available code. Furthermore, patient values are rarely incorporated in current modelling practices, representing missed opportunities for patient-centred care. Copyright © The Author(s) 2026. <18> Accession Number 2049235159 Title 2026 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Source Journal of the American College of Cardiology. 88(13) (pp 1543-1643), 2026. Date of Publication: 29 Sep 2026. Author Thompson A.; Fleischmann K.E.; Smilowitz N.R.; de las Fuentes L.; Mukherjee D.; Aggarwal N.R.; Ahmad F.S.; Allen R.B.; Altin S.E.; Auerbach A.; Berger J.S.; Chow B.; Dakik H.A.; Eisenstein E.L.; Gerhard-Herman M.; Ghadimi K.; Kachulis B.; Leclerc J.; Lee C.S.; Macaulay T.E.; Mates G.; Merli G.J.; Parwani P.; Poole J.E.; Rich M.W.; Ruetzler K.; Stain S.C.; Sweitzer B.J.; Talbot A.W.; Vallabhajosyula S.; Whittle J.; Williams K.A. Publisher Elsevier Inc. Abstract Aim: The "2026 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery" provides recommendations to guide clinicians in the perioperative cardiovascular evaluation and management of adult patients undergoing noncardiac surgery. Method(s): A comprehensive literature search was conducted from August 2022 to March 2023 to identify clinical studies, reviews, and other evidence conducted on human subjects that were published in English from MEDLINE (through PubMed), EMBASE, the Cochrane Library, the Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. Structure: Recommendations from the "2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery" have been updated with new evidence consolidated to guide clinicians; clinicians should be advised this guideline supersedes the previously published 2014 guideline. In addition, evidence-based management strategies, including pharmacological therapies, perioperative monitoring, and devices, for cardiovascular disease and associated medical conditions, have been developed. Copyright © 2026 by the American College of Cardiology Foundation <19> Accession Number 2047638636 Title Beyond procedure-specific protocols: a systematic review identifying a universal anaesthesiological core across Enhanced Recovery After Surgery Society guidelines. Source British Journal of Anaesthesia. 137(3) (pp 796-807), 2026. Date of Publication: 01 Sep 2026. Author Bornemann-Cimenti H.; Furtmuller J.M.; Labenbacher S.; Niederer M.; Bader M.; Lang-Illievich K.; Tamussino K.; Hammer S. Institution (Bornemann-Cimenti, Furtmuller, Labenbacher, Niederer, Bader, Lang-Illievich, Hammer) Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria (Lang-Illievich) Department of Anaesthesiology and Intensive Care Medicine, Klinikum Gussing, Gussing, Austria (Tamussino) Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria Publisher Elsevier Ltd Abstract Background: Enhanced Recovery After Surgery (ERAS) Society guidelines provide procedure-specific, evidence-based recommendations for perioperative care. Many interventions fall within anaesthesiology, yet the extent to which they reflect cross-speciality principles remains unclear. The objective of this systematic review was to identify a universal anaesthesiological core across ERAS guidelines. Method(s): All ERAS Society guidelines were screened for eligibility. Guidelines were excluded if they had no practical anaesthesiological recommendations, had been superseded, or were not intended for standard hospital settings. A classification of 45 anaesthesiological umbrella terms was developed through pilot extraction and Delphi consensus. Two reviewers independently extracted recommendations and their strength. Methodological quality was assessed using Appraisal of Guidelines for Research and Evaluation II (AGREE II). Umbrella terms were classified as consistent (>80%), mostly consistent (60-80%), mixed (20-60%), or sparse (<=20%). Result(s): Of 39 publications, 24 guidelines (2013-2025) were included. Anaesthesiological involvement was identifiable in 23 out of 24 guidelines. Of the 45 umbrella terms, eight were consistent, 10 mostly consistent, 16 mixed, and 11 sparse. The consistent domains were: multimodal analgesia, fasting, thromboprophylaxis, antimicrobial prophylaxis, nutrition, temperature and fluid management, and surgery-specific recommendations. The mean AGREE II score was 76%, highest for scope and purpose and clarity of presentation and lowest for stakeholder involvement. Conclusion(s): Despite procedural heterogeneity, a consistent anaesthesiological core is identifiable within the ERAS guidelines. Cross-guideline consistency identifies the priority domains for cross-speciality implementation, whereas recommendation strength independently indicates the confidence with which guidance transposes onto local practice; high-frequency, mixed-strength domains, notably fluid management, preoperative carbohydrate administration and preanaesthetic medication, warrant structured local appraisal. Registration: The study protocol: Open Science Framework (DOI: 10.17605/OSF.IO/CBWDT) Copyright © 2026 The Author(s). Published by Elsevier Ltd on behalf of British Journal of Anaesthesia. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <20> Accession Number 2048832068 Title Dynamic parameter-guided goal-directed fluid therapy and postoperative acute kidney injury in non-cardiac surgery: a meta-analysis of 11 randomized controlled trials. Source Journal of Anesthesia. 40(5) (pp 838-847), 2026. Date of Publication: 01 Oct 2026. Author Sun X.; Liu Y.; Ren W. Institution (Sun, Liu, Ren) Department of Anesthesiology, Tianjin Hospital, No. 406, Jiefang South Road, Hexi District, Tianjin, China Publisher Springer Abstract The efficacy of goal-directed fluid therapy (GDFT) in preventing postoperative acute kidney injury (AKI) remains controversial. This meta-analysis specifically examined dynamic parameter-guided GDFT using fluid challenges alone in non-cardiac, non-transplant surgery. We systematically searched PubMed, Embase, and the Cochrane Library from inception to December 25, 2025. Randomized controlled trials comparing dynamic index-guided GDFT (SVV, PPV, or PVI) with conventional fluid management in adults undergoing major non-cardiac surgery were included. The primary outcome was postoperative AKI. Subgroup analyses by surgical site and monitoring device invasiveness were pre-specified. The GRADE framework was used to assess evidence certainty. Eleven RCTs comprising 1698 patients were included. Overall, GDFT did not significantly reduce postoperative AKI compared with conventional management (OR 0.93; 95%CI 0.59-1.45; low certainty evidence). No significant differences were observed in 180-day mortality (OR 1.30; 95%CI 0.28-5.99; very low certainty evidence) or ICU length of stay (MD -0.20 days; 95%CI -1.72 to 1.31; very low certainty evidence). GDFT was associated with significantly higher intraoperative colloid administration (MD 167.51 mL; 95% CI 36.02-299.01; very low certainty evidence), though with substantial heterogeneity. Subgroup analysis by surgical site showed no significant differences between groups. A pre-specified subgroup analysis by monitoring device invasiveness showed a significant interaction: invasive devices showed no benefit (OR 1.10; 95%CI 0.78-1.55; very low certainty evidence), while minimally invasive/non-invasive devices were associated with reduced AKI risk (OR 0.13; 95%CI 0.02-0.79; very low certainty evidence), though based on only two small studies. In this meta-analysis, dynamic parameter-guided GDFT did not significantly reduce postoperative AKI in non-cardiac, non-transplant surgery compared with conventional management (low certainty evidence). The substantial heterogeneity in colloid administration highlights variability in GDFT protocols across studies. Trial Registration: PROSPERO Registration, CRD420251274571. Copyright © The Author(s), under exclusive licence to Japanese Society of Anesthesiologists 2026. <21> Accession Number 2050025273 Title Efficacy of Noninvasive Ventilatory Therapies Through Different Interfaces in the Postoperative Care of Cardiac Surgery Patients: A Randomized Controlled Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Okubo B.M.R.; Filho J.G.L.; Filho H.G.L.; Junior A.B.V.; Nogueira A.D.N.C. Institution (Okubo) Physiotherapy Department, Hospital Regional Unimed, Ceara, Fortaleza, Brazil (Okubo, Filho, Filho, Nogueira) Postgraduate Program in Medical-Surgical Sciences, Universidade Federal do Ceara, Ceara, Fortaleza, Brazil (Filho, Filho) Department of Surgery, Faculdade de Medicina, Universidade Federal do Ceara, Ceara, Fortaleza, Brazil (Junior) Clinical Research Unit, Nucleo de Apoio ao Pesquisador, Complexo de Hospitais Universitarios da UFC/EBSERH, Ceara, Fortaleza, Brazil (Nogueira) Instituto Dr. Jose Frota/Complexo Hospitalar da Universidade Federal do Ceara (CH-UFC/EBSERH), Ceara, Fortaleza, Brazil Publisher W.B. Saunders Abstract Objectives: To compare the clinical efficacy of 5 noninvasive ventilatory strategies-delivered via a conventional oronasal mask, a conventional full-face mask, the Wolf Mask full-face interface, the ELMO helmet (continuous positive airway pressure), and high-flow nasal cannula-against conventional physiotherapy without active ventilatory support in patients following elective cardiac surgery. Design(s): Prospective, randomized, controlled trial. Setting(s): High-complexity intensive care unit (ICU) of a tertiary care hospital from July 2023 to May 2026. Participant(s): In total, 172 patients undergoing elective coronary artery bypass grafting or valve surgery, randomized into 6 groups (G-FA, G-FULL, G-WOLF, G-ELMO, G-TAF, and G-CONTR). Intervention(s): Three daily 60-minute sessions of the assigned ventilatory modality integrated into standard physiotherapy care, from ICU admission to discharge. Measurements and Main Results: The primary outcomes were interface comfort and mobilization progression, with postoperative pulmonary complications as a secondary outcome. The Wolf Mask achieved the highest comfort score (9.41 +/- 0.68 on a 0-10 visual analog scale) and required the lowest inspiratory pressure support (5.62 +/- 2.08 cmH2O) to reach the target tidal volume (6 mL/kg ideal body weight), suggesting superior mechanical efficiency. It was the only interface with no recorded cases of bibasal atelectasis and showed the lowest overall pulmonary complication rate. The conventional full-face mask yielded the second-best performance in comfort, arterial oxygenation, and pulmonary protection. High-flow nasal cannula proved safe but offered no advantage over full-face interfaces in pulmonary or functional outcomes. The ELMO helmet was hemodynamically safe and produced no hypercapnia but registered comfort scores among the lowest, statistically comparable to those of the conventional oronasal mask, along with the poorest oxygenation values. The control group had the highest complication rate, the lowest mobilization levels, and the smallest proportion of patients reaching mobilization level 3 at ICU discharge (18% v 73%-74% in the full-face groups). Interface comfort was identified as an independent positive predictor of mobilization progression by linear mixed-effects modeling (p = 0.004). Conclusion(s): In this trial, full-face interfaces, and the Wolf Mask in particular, were associated with the highest comfort and the lowest inspiratory pressure support, and interface comfort was an independent predictor of mobilization progression. The pulmonary and oxygenation findings were exploratory and hypothesis-generating. These results support the deliberate selection of well-tolerated full-face interfaces in postoperative cardiac surgery care and warrant confirmation in multicenter trials with longer follow-up. Copyright © 2026 Elsevier Inc. <22> Accession Number 2049587514 Title Efficacy and safety of intravenous methadone for pain management in cardiac surgery: a systematic review and meta-analysis. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1785811. Date of Publication: 10 Aug 2026. Author Li W.; Ye Y.; Zhou J.; Ji Y.; Gong Z. Institution (Li) School of Basic Medical Sciences & School of Nursing, Chengdu University, Chengdu, China (Ye) Anesthesia Surgery Center, Affiliated Hospital of Chengdu University, Chengdu, China (Zhou, Ji, Gong) Department of Pain Medicine, Clinical Medical College and Affiliated Hospital of Chengdu University, Chengdu, China Publisher Frontiers Media SA Abstract Objectives - To evaluate the analgesic efficacy and safety of intraoperative intravenous methadone compared with conventional opioid-based analgesic regimens in adult patients undergoing cardiac surgery, using data derived from randomized controlled trials and retrospective cohort studies. Methods - A comprehensive retrieval of scholarly literature was implemented in Embase, MEDLINE, PubMed, Web of Science, and the Cochrane Library until November 28, 2025. Randomized controlled trials and retrospective cohort studies comparing intraoperative methadone with other opioid analgesics for pain management in patients undergoing cardiac surgical procedures were eligible for inclusion in this meta-analysis. Quality of included studies was independently evaluated by two reviewers, with randomized controlled trials assessed using the Cochrane Risk of Bias tool (version 2.0) and cohort studies appraised using the Newcastle-Ottawa Scale. The primary outcome was postoperative pain intensity at 24 h. Secondary outcomes included postoperative 24-h opioid consumption, time to first rescue morphine administration, time to extubation, ICU length of stay, hospital length of stay, and reported adverse outcomes, including postoperative nausea, vomiting, and postoperative reintubation. Results - Eight studies, including 4 randomized controlled trials and 4 retrospective cohort studies, involving 10, 203 patients were included. Compared with conventional opioid analgesics, intraoperative methadone was associated with lower postoperative 24-h pain intensity (SMD, -0.44; 95% CI-0.71 to -0.17; p =0.001, I2 =77%). Methadone was also associated with lower postoperative 24-h opioid consumption in the primary analysis (SMD, -0.72; 95% CI, -1.35 to -0.23; p =0.02; I2 =97%), No statistically significant differences were observed for overall time to first rescue morphine administration, time to extubation, ICU length of stay, or hospital length of stay. In randomized controlled trials, methadone was not associated with significant differences in postoperative nausea or vomiting, whereas reintubation was less frequent in the methadone group (RR, 0.75; 95% CI, 0.58 to 0.96; p =0.02). In retrospective cohort studies, postoperative nausea and vomiting were slightly less frequent with methadone (RR, 0.96; 95% CI, 0.93 to 1.00; p =0.04), but the magnitude of this association was small. Conclusion - In adult patients undergoing cardiac surgery, intraoperative intravenous methadone may be associated with lower pain intensity and reduced opioid consumption during the first 24 h after surgery. However, substantial heterogeneity, inconsistent findings between randomized and retrospective studies, and incomplete reporting of key safety outcomes limit the certainty of the evidence. These findings should be interpreted cautiously, and further adequately powered randomized trials with standardized analgesic protocols and safety monitoring are needed. Systematic review registration - https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251237093, identifier (CRD420251237093). Copyright © 2026 Li, Ye, Zhou, Ji and Gong. <23> Accession Number 2049340381 Title Comparing Transcatheter Mitral Valve Replacement to Transcatheter Edge-to-Edge Repair in Mitral Regurgitation: A Systematic Review. Source Cardiovascular Therapeutics. 2026(1) (no pagination), 2026. Article Number: 7522199. Date of Publication: 2026. Author Safadi R.A.; Esmail A.D.A.; DeProfio L.E.; Elsayed A.A.R.; Basson M.D. Institution (Safadi, Esmail, DeProfio, Elsayed, Basson) College of Medicine, Northeast Ohio Medical University, Rootstown, OH, United States (Elsayed, Basson) Department of Surgery, Northeast Ohio Medical University, Rootstown, OH, United States (Elsayed, Basson) Department of Biomedical Sciences, Northeast Ohio Medical University, Rootstown, OH, United States Publisher John Wiley and Sons Inc Abstract Background: Mitral regurgitation affects 2% of the population globally, with a widely increasing prevalence. Although mitral regurgitation is most commonly corrected by open surgery, there has been a recent shift toward less invasive transcatheter approaches, including both transcatheter edge-to-edge repair (TEER) and transcatheter mitral valve replacement (TMVR). Method(s): A comprehensive literature search was conducted using four databases: PubMed, Cochrane Library, Virtual Health Library (VHL), and Web of Science (WOS), following the PRISMA guidelines. Relevant observational studies were assessed for reporting using STROBE guidelines, whereas case reports were assessed using CARE guidelines. Independent reviewers evaluated studies based on eligibility criteria and analyzed relevant studies. Result(s): Postoperative complications observed in patients undergoing either technique (TMVR or TEER) included acute kidney injury, stroke, access site complications, and postoperative bleeding. These complications were generally more frequent in patients after TMVR. Myocardial infarction, prosthesis malposition, and valve migration were reported exclusively after TMVR, whereas ischemic cardiomyopathy was associated with TEER. Regarding hemodynamic outcomes, TMVR patients were associated with greater MR reduction to <= 1, frequently observed complete MR resolution, near-laminar blood flow, and marked improvement in left ventricular function (assessed using LVEDVI and LVESVI). TMVR was associated with significantly higher 30-day mortality, whereas pooled 1-year mortality did not differ significantly between TMVR and TEER. Conclusion(s): Although TEER remains the safer option in appropriately selected patients, TMVR offers greater efficacy in MR resolution at the cost of higher procedural risk. However, findings should be interpreted with caution, given that patient selection between TMVR and TEER patients may influence observed outcomes. Copyright © 2026 Rama A. Safadi et al. Cardiovascular Therapeutics published by John Wiley & Sons Ltd. <24> Accession Number 2049977257 Title Effectiveness of elastic therapeutic taping in pain management after median sternotomy: A randomized controlled trial. Source PLOS One. 21(9 September) (no pagination), 2026. Article Number: e0359282. Date of Publication: 01 Sep 2026. Author Ozel A.; Ugras U.A.; Uysal M.F.; Ucaroglu E.R. Institution (Ozel, Uysal) Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey (Ugras, Ucaroglu) Department of Cardiovascular Surgery, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey Publisher Public Library of Science Abstract : To evaluate the effectiveness of elastic therapeutic taping on postoperative pain, functional mobility, sleep quality, analgesic consumption, and length of hospital stay in patients undergoing coronary artery bypass grafting (CABG) via median sternotomy. In this prospective, randomized, double-blind, placebo- and sham-controlled trial, 195 patients undergoing elective CABG were randomly assigned to elastic therapeutic taping (n = 65), placebo taping without tension (n = 65), or sham taping to a non-related region (n = 65). Elastic therapeutic taping was applied after patients were transferred from the intensive care unit to the cardiovascular surgery ward. Pain at rest and during coughing was assessed using the Visual Analog Scale (VAS) at baseline and 12, 24, and 48 hours. Secondary outcomes were Timed Up and Go (TUG), sleep quality, total analgesic use, and length of hospital stay. Data were analyzed using a prespecified two-way mixed ANOVA with Bonferroni-adjusted post hoc comparisons for the primary pain outcome. Nonparametric secondary outcomes were analyzed using Kruskal-Wallis or Friedman tests, as appropriate. At 48 hours, resting pain was lower in the elastic therapeutic taping group (19.0 +/- 10.2) than placebo taping without tension group (37.5 +/- 13.7) and sham taping group (41.2 +/- 16.2; p = 0.001). The observed between-group reduction in pain exceeded the reported minimal clinically important difference (MCID) of 9.9 mm for acute postoperative pain, indicating a clinically meaningful treatment effect. Coughing pain was also reduced (39.2 +/- 17.0 vs. 56.3 +/- 17.2 and 59.4 +/- 16.8; p = 0.001). Tramadol use was lower with elastic therapeutic taping (50 +/- 50 mg vs. 100 +/- 50 mg; p = 0.038). Elastic therapeutic taping was associated with a shorter length of hospital stay (4 [3-5] vs. 5 [4-7] days; p = 0.042). Functional mobility (TUG, p = 0.002) and sleep quality (p = 0.001) were also significantly improved in the elastic therapeutic taping group compared with the placebo and sham groups. Elastic therapeutic taping was associated with reduced pain, lower opioid use, improved early recovery, and a shorter length of hospital stay after median sternotomy. Trial registration: ClinicalTrials.gov NCT06910215 Copyright © 2026, Ozel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. <25> Accession Number 2045589949 Title Lymphadenectomy and Upstaging in Thoracic Oncology: A Narrative Review. Source European Journal of Cardio-thoracic Surgery. 68 (pp i41-i49), 2026. Date of Publication: 01 Apr 2026. Author Ceccarelli I.; Durand M.; Seguin Givelet A. Institution (Ceccarelli) Minimally Invasive and Robotic Thoracic Surgery-Department of Surgical, Medical, Molecular and Critical Care Pathology, University of Pisa, Pisa, Italy (Ceccarelli) Thoracic Surgery Department, Groupe Hospitalier Prive Ambroise Pare Hartmann, 48 Ter Bd Victor Hugo, Neuilly-sur-Seine, France (Durand) Thoracic Surgery Department, Groupe Hospitalier Prive Ambroise Pare Hartmann, 48 Ter Bd Victor Hugo, Neuilly-sur-Seine, France (Seguin Givelet) Thoracic Surgery Department, Groupe Hospitalier Prive Ambroise Pare Hartmann, 48 Ter Bd Victor Hugo, Neuilly-sur-Seine, France Publisher European Association for Cardio-Thoracic Surgery Abstract Objectives: To review the historical evolution, current evidence, and future perspectives regarding lymphadenectomy in non-small-cell lung cancer (NSCLC), with a particular focus on its role in accurate staging, nodal upstaging, and therapeutic decision-making. Method(s): This narrative review was conducted through a literature search of PubMed and Scopus from 1950 to March 2025, using the terms non-small-cell lung cancer, lymphadenectomy, nodal upstaging, and mediastinal dissection. Reference lists of relevant studies and guidelines were also screened. Both randomized controlled trials and large observational studies were included, together with international guidelines and recent conference abstracts (Asia-Pacific Innovative Thoracic Surgery Symposium [APITS] 2025). Result(s): Evidence consistently demonstrates that systematic mediastinal lymphadenectomy enhances staging accuracy, increases the detection of occult nodal disease, and improves prognostic stratification. Pathologic upstaging is a frequent and clinically relevant phenomenon in clinically node-negative patients, directly influencing indications for adjuvant systemic therapy. Guideline-based nodal dissection remains a cornerstone of curative-intent surgery, with at least 3 mediastinal stations and 1 hilar station recommended. Comparative studies show that when a station-based approach is rigorously applied, minimally invasive and robotic techniques achieve staging outcomes equivalent to open surgery. Recent technological innovations, including radiomics, deep learning, and artificial intelligence applied to positron emission tomography/computed tomography (PET/CT) and endobronchial ultrasound, hold promise for refining preoperative risk prediction but remain adjuncts to systematic surgical clearance. Conclusion(s): Lymphadenectomy is central to the surgical management of NSCLC. Beyond its role in accurate staging and prognostic assessment, it guides multimodality treatment and underpins long-term outcomes. Future advances are likely to derive not from platform choice but from integrating technology to ensure that systematic, station-based lymphadenectomy is performed safely, consistently, and comprehensively. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <26> Accession Number 2048830219 Title A narrative review of PCSK9 inhibitors: from evolocumab to novel discoveries. Source Frontiers in Pharmacology. 17 (no pagination), 2026. Article Number: 1800502. Date of Publication: 2026. Author Liu H.-H.; Li S.; Li J.-J. Institution (Liu) State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Heart Failure Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Li, Li) State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Cardiometabolic Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China Publisher Frontiers Media SA Abstract The application of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors represents a crucial milestone in the field of lipid-lowering therapy. As the first PCSK9 inhibitor to be approved globally, evolocumab has not only offered an entirely novel therapeutic option for patients with familial hypercholesterolemia but also established a paradigm for the development of subsequent anti-PCSK9 monoclonal antibodies. This narrative review provides an overview of the discovery of PCSK9 and its role in low-density lipoprotein cholesterol metabolism, detailing the developmental trajectory and key clinical trials of evolocumab, and underscoring its central importance and transformative impact on lipid-lowering therapeutics. On this basis, we conduct a comparative analysis of the differences in mechanism of action, clinical efficacy and safety among the marketed PCSK9 inhibitors, and dissect the limitations and unmet needs in current clinical practice. Furthermore, this review explores the pleiotropic effects of PCSK9 beyond lipid metabolism, and comments on its potential application value and latest research advances in diseases such as infection, liver disease, and malignancy. Finally, we prospect the future development directions of PCSK9-targeted therapy, aiming to provide an integrated reference perspective for basic research and clinical practice in this field. Copyright © 2026 Liu, Li and Li. <27> Accession Number 2045590016 Title Multiport Versus Single-Port Video-Assisted Thoracic Surgery for Pulmonary Resection. Source European Journal of Cardio-thoracic Surgery. 68 (pp i12-i18), 2026. Date of Publication: 01 Apr 2026. Author Sihoe A.D.L. Institution (Sihoe) CUHK Medical Centre, Hong Kong (Sihoe) Gleneagles Hong Kong Hospital, Hong Kong Publisher European Association for Cardio-Thoracic Surgery Abstract Objectives: There have been many attempts to compare Uniportal Video-Assisted Thoracic Surgery (UVATS) with Multiportal VATS (MVATS) for anatomic lung resection. A review is warranted to appreciate: what has been learnt about the relative benefits of the 2 approaches; what lessons have been learned by the process of comparing approaches; and whether such comparisons should influence surgical practice. Method(s): A narrative review and qualitative analysis of the literature pertaining to UVATS and especially to comparisons between UVATS and MVATS was conducted. Result(s): The balance of currently published evidence suggests that UVATS offers the following when compared to MVATS: equivalent safety; similar or slightly better post-operative outcomes (especially in reducing pain); equivalent treatment outcomes for lung cancer (measured by lymph node yields and medium-term survival); and broadly similar learning curves. There has been a general trend for studies comparing UVATS with MVATS in recent years to exhibit greater scientific rigor and to investigate a broader range of clinically relevant outcome measures. Conclusion(s): Over a decade's worth of comparisons between UVATS and MVATS have validated UVATS as a mainstream approach for minimally invasive pulmonary resections. The direct comparisons have generally suggested non-inferiority vis-a-vis MVATS. However, the true value of the ongoing process of comparison lies in its elevation of good clinical research practices and increasing awareness of those outcome measures most pertinent to patients. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <28> Accession Number 2049259757 Title Expectation-related effects of fascial plane blocks in cardiac surgery: A hypothesis-generating network meta-analysis of randomized controlled trials. Source Journal of Clinical Anesthesia. 115 (no pagination), 2026. Article Number: 112328. Date of Publication: 01 Nov 2026. Author De Cassai A.; Karapinar Y.E.; Turunc E.; Boscolo A.; Dost B. Institution (De Cassai, Boscolo) Department of Medicine (DIMED), University of Padua, Padua, Italy (De Cassai, Boscolo) Institute of Anesthesia and Intensive Care Unit, University Hospital of Padua, Padua, Italy (Karapinar) Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey (Turunc, Dost) Department of Anesthesiology and Reanimation, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey Publisher Elsevier Inc. <29> Accession Number 2049911946 Title Prevention of radial artery occlusion with rivaroxaban after interventional coronary interventions using transradial access: Results of a single-center randomized clinical trial. Source Journal of Vascular Access. (no pagination), 2026. Date of Publication: 2026. Author Korotkikh A.; Babunashvili A. Institution (Korotkikh) Cardiac Surgery Clinic, Amur State Medical Academy, Blagoveshchensk, Russian Federation (Babunashvili) Department of Interventional Cardioangiology, Sechenov University, Moscow, Russian Federation Publisher SAGE Publications Ltd Abstract Background: Transradial access is the preferred approach for coronary angiography and percutaneous coronary intervention; however, radial artery occlusion (RAO) remains the most common vascular complication and may preclude repeat radial access, radiocephalic arteriovenous fistula creation, and use of the radial artery as a coronary bypass conduit. Most preventive strategies target procedural factors, whereas extended pharmacologic prophylaxis remains insufficiently studied. Objective(s): To evaluate the efficacy of rivaroxaban 2.5 mg twice daily for 3 months in preventing RAO after transradial coronary procedures and to assess bleeding events during follow-up. Method(s): This prospective, single-center, open-label randomized controlled trial enrolled 300 patients with chronic coronary syndrome undergoing coronary angiography or percutaneous coronary intervention via conventional transradial access. Patients were randomized (1:1) to rivaroxaban 2.5 mg twice daily for 3 months or standard therapy without additional anticoagulation. Duplex ultrasound, performed by a blinded assessor at 7 days, 1 month, and 3 months, evaluated the primary endpoint of complete RAO. Bleeding was classified according to Bleeding Academic Research Consortium criteria. Adjusted associations were assessed using Firth penalized logistic regression. Result(s): Rivaroxaban significantly reduced RAO at 7 days (0.7% vs 12.7%; p < 0.001), 1 month (3.3% vs 14.7%; p < 0.001), and 3 months (4.0% vs 13.3%; p = 0.004). At 3 months, the absolute risk reduction was 9.3%, corresponding to a number needed to treat of approximately 11. After adjustment for chronic kidney disease, radial artery diameter, and procedure duration, rivaroxaban remained independently associated with lower RAO (adjusted OR 0.22, 95% CI 0.08-0.61; p = 0.003). No BARC type 3-5 bleeding occurred; four BARC type 1 events were observed. Conclusion(s): In this selected single-center population, prolonged low-dose rivaroxaban was associated with a substantial reduction in ultrasound-detected RAO after transradial coronary procedures. These findings support further multicenter placebo-controlled trials but do not justify routine prophylactic use pending additional safety, cost-effectiveness, and comparative-effectiveness data. Copyright © The Author(s) 2026 <30> Accession Number 2038669030 Title Guarding the Threshold: Depth-of-Anesthesia Monitoring and its Impact on the Neuroendocrine-Inflammatory Stress Response: A Systematic Review. Source Natural Resources for Human Health. 6(12S) (pp 39-47), 2026. Date of Publication: 08 Sep 2026. Author Hemaidah E.G.S.; Omar A. Institution (Hemaidah) Department of Anesthesia, Intensive Care, and Pain Management, Faculty of Medicine For girls, Al-Azhar University, Cairo, Egypt (Omar) Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt Publisher Visagaa Publishing House Abstract Background: Intraoperative depth-of-anesthesia (DoA) monitoring using processed-EEG indices (Bispectral Index [BIS], Entropy, Narcotrend) was developed to prevent intraoperative awareness, but a growing body of evidence suggests it may also modulate the neuroendocrine-inflammatory response to surgical stress. This review frames the anesthetic titration strategy itself as the primary exposure and neuroendocrine/inflammatory biomarkers as the outcome, a pairing not addressed by prior reviews in this space. Method(s): MEDLINE/PubMed and general web search (search-engine mediated; institutional access to Embase, Scopus, Web of Science, and Cochrane CENTRAL was not available for this review) were searched for randomized controlled trials and comparative cohort studies evaluating processed-EEG-guided anesthesia against standard or alternative-depth anesthesia, reporting at least one neuroendocrine (cortisol, ACTH, glucose) or inflammatory (IL-6, TNF-alpha, CRP, IL-1beta, IL-10) biomarker. Reference lists of included studies were hand-searched. One identified study was excluded after discovery that it had been formally retracted. Given cross-study heterogeneity, findings were synthesized by vote-counting direction of effect rather than pooled meta-analysis. Result(s): Seven studies (plus one retrospective cohort retained for mechanistic context only) met inclusion criteria, spanning cardiac (CABG/OPCAB), thoracic (VATS lobectomy), and abdominal/gastrointestinal surgery in adult and elderly populations. Monitoring modalities included BIS, Spectral/State Entropy, and Narcotrend. Deeper or monitor-titrated anesthesia favored attenuated TNF-alpha in 3 of 4 studies, lower CRP in 2 of 2 studies, lower IL-1beta in 2 of 2 studies, and lower IL-6 in 2 of 3 studies reporting each marker; no study reported a biomarker moving in the direction of harm under monitor-guided titration for these markers. Conclusion(s): Across a modest but consistent evidence base, anesthetic depth-titration strategy shows a directionally consistent association with attenuated postoperative inflammatory cytokine release, without evidence of harm. The evidence base remains limited in size and heterogeneous in monitoring modality and biomarker timing; a fully resourced multi-database systematic search with formal meta-analysis is needed before these findings can inform practice guidance. Copyright © 2026, Visagaa Publishing House. All rights reserved. <31> Accession Number 651242638 Title Cost-effectiveness of catheter ablation in end-stage heart failure with atrial fibrillation: Insights from CASTLE-HTx. Source Heart rhythm. 23(10) (pp 2184-2194), 2026. Date of Publication: 01 Oct 2026. Author Boettger P.; Moersdorf M.; Sommer P.; Marrouche N.F.; Costard-Jaeckle A.; Crijns H.J.G.M.; Bergau L.; Fox H.; Hindricks G.; Dagres N.; Schramm R.; Fink T.; Khalaph M.; Sciacca V.; Didenko M.; Konietschke F.; Rudolph V.; Gummert J.; Tijssen J.G.P.; Sossalla S.; Sohns C. Institution (Boettger) Department of Cardiology, Angiology and Critical Care Medicine, Justus Liebig University of Giessen, Giessen, Germany; Department of Health Policy, London School of Economics and Political Science, London, United Kingdom (Moersdorf) Department of Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany; Cardiology Department, Tulane University School of Medicine, New Orleans, Louisiana (Sommer, Bergau, Fink, Khalaph, Sciacca, Didenko, Sohns) Department of Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany (Marrouche, Gummert) Cardiology Department, Tulane University School of Medicine, New Orleans, LA, United States (Costard-Jaeckle, Fox, Schramm) Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Med. Fakultat OWL (Universitat Bielefeld), Bad Oeynhausen, Germany; Heart Failure Department, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Med. Fakultat OWL (Universitat Bielefeld), Bad Oeynhausen, Germany (Crijns) Department of Cardiology and CARIM, Maastricht University, Cardiovascular Research Institute Maastricht, Maastricht, Netherlands (Hindricks, Dagres) Department of Cardiology, Angiology and Intensive Care Medicine, German Heart Center of the Charite-University Medicine Berlin, Charite Campus Mitte, Germany (Konietschke) Institute of Biometry and Clinical Epidemiology, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany (Rudolph) Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany (Tijssen) Department of Cardiology, University of Amsterdam, Amsterdam, Netherlands (Sossalla) Department of Cardiology, Angiology and Critical Care Medicine, University of Giessen & Kerckhoff Heart Center, Germany Abstract BACKGROUND: The CASTLE-HTx (Catheter Ablation for Atrial Fibrillation in patientS With End-sTage Heart Failure and Eligibility for Heart Transplantation; ClinicalTrials.gov identifier NCT04649801) trial showed that the combination of catheter ablation and guideline-directed medical therapy (GDMT) was associated with a lower likelihood of a composite of death from any cause, implantation of a left ventricular assist device, or heart transplantation (HTx) in patients with end-stage heart failure (HF) and atrial fibrillation (AF). OBJECTIVE(S): This analysis evaluates the cost-effectiveness of catheter ablation plus GDMT vs medical therapy alone in patients with end-stage HF and AF referred for HTx evaluation. METHOD(S): In CASTLE-HTx, we randomized 194 patients in end-stage HF and AF to receive catheter ablation and GDMT (n = 97) or medical therapy alone (n = 97). Details of study design, outcome definitions, and results have been published. A cohort-based Markov model projected lifetime costs, life-years (LYs), and quality-adjusted life-years (QALYs) from the perspective of the German statutory health insurance system using 3-year outcomes from CASTLE-HTx. RESULT(S): In lifetime projections, the combination of AF ablation and GDMT was associated with a mean survival gain of ~1.7 LYs per patient at an incremental cost of ~12,000, yielding an incremental cost-effectiveness ratio of ~7300 per LY gained. The incremental cost-effectiveness ratios per QALY in lifetime projections (8600) and at 36 months (30,400) were below 50,000 per QALY, indicating cost-effectiveness at contemporary thresholds. Within 36 months, this survival benefit resulted in a gain of 0.34 LYs, reflecting prevention of death and worsening HF. The long-term benefit emerged early and remained consistent across sensitivity analyses. CONCLUSION(S): The combination of catheter ablation and GDMT is cost-effective and economically favorable in patients with end-stage HF and AF who are referred for HTx evaluation. Copyright © 2026 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. <32> Accession Number 2048907359 Title Effect of programmed intermittent paravertebral analgesia on postoperative neurocognitive disorders in elderly patients undergoing video-assisted thoracoscopic surgery: a randomized controlled trial. Source European Journal of Medical Research. 31(1) (no pagination), 2026. Article Number: 1219. Date of Publication: 01 Dec 2026. Author Wang L.; Sun Y.; Wang F.; Gao G.; Chen B.; Liu T.; Liu W. Institution (Wang, Sun, Wang, Gao, Chen, Liu, Liu) Department of Anesthesiology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institution, Capital Medical University, No. 97 Ma Chang, Tongzhou District, Beijing, China Publisher BioMed Central Ltd Abstract Background: Perioperative neurocognitive disorders (PND) refer to neurocognitive abnormalities detected during the perioperative periods and can significantly impede patient recovery. Thoracic surgery is a highly invasive procedure and is linked to an increased risk of PND. Although paravertebral block (PVB) is effective in providing postoperative analgesia following thoracic procedures, robust evidence linking PVB to lower PND risk remains limited. Objective(s): This study aimed to evaluate the efficacy of programmed intermittent paravertebral analgesia (PIPA) on delayed neurocognitive recovery (dNCR) at postoperative 3 days in elderly patients undergoing video-assisted thoracoscopic surgery (VATS). Method(s): This prospective, randomized controlled trial enrolled 228 elderly patients scheduled for elective VATS of the lungs. Patients were randomly assigned to one of two postoperative analgesia groups: the paravertebral block group (Group P), which received paravertebral infusion of 0.2% ropivacaine hydrochloride at 300 mL, or the intravenous patient-controlled analgesia group (Group I), which received sufentanil (2 mug/kg, diluted to 100 mL). Result(s): A total of 190 patients were included in the primary complete-case analysis. The incidence of delayed neurocognitive recovery (dNCR) at 72 h postoperatively was significantly lower in the Group P compared to the Group I (33.3% vs. 55.3%, RR = 0.404 [0.224, 0.727], p = 0.002). The sensitivity analysis incorporating all 228 randomized patients with 72-h cognitive data confirmed this finding (Group P 32.5% vs. Group I 52.6%, p = 0.003), and the effect remained robust after adjustment for age and baseline MoCA score (adjusted OR = 0.43, 95% CI 0.25-0.76, p = 0.004). Furthermore, the incidence of dNCR at 30 days (12.5% vs. 25.5%, p = 0.022) and postoperative neurocognitive disorder at 3 months (5.2% vs. 19.1%, p = 0.003) postoperatively showed statistically significant differences between the Group P and the Group I. Regarding acute pain, both active (3 [2, 4] vs. 3 [2, 5], p = 0.037) and coughing (4 [3, 5] vs. 4 [4, 5], p = 0.015), Numeric Rating Scale (NRS) scores at 24 h postoperatively were significantly lower in the Group P than Group I. At 3 months postoperatively, resting NRS scores remained significantly lower in the Group P (1 [0, 2] vs. 2 [0, 2], p = 0.033). Additionally, the incidence of neuropathic pain (20.2% vs 34.0%, p = 0.03) and chronic postsurgical pain (3.2% vs. 11.7%, p = 0.025) at 3 months was significantly reduced in the Group P compared to the Group I. Conclusion(s): In elderly patients undergoing VATS, PIPA was associated with a lower incidence of MoCA-defined dNCR and postoperative neurocognitive disorder, as well as lower incidences of chronic postsurgical pain and neuropathic pain, compared with conventional opioid-based intravenous analgesia. Trial registration: The study was registered in the Chinese Clinical Trial Registry on June 30, 2022 (ChiCTR2200061670). Copyright © The Author(s) 2026. <33> Accession Number 2048964035 Title TAVR Explant in the Era of Lifetime Valve Management: Indications, Operative Challenges, and Contemporary Outcomes. Source Current Cardiology Reports. 28(1) (no pagination), 2026. Article Number: 91. Date of Publication: 01 Dec 2026. Author Lopez-Trevino M.G.; Szekely M.; Ramirez-Del Val F.; Reardon M.J. Institution (Lopez-Trevino, Szekely, Ramirez-Del Val, Reardon) Department of Cardiovascular Surgery, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, 6565 Fannin Street, Houston, TX, United States Publisher Springer Abstract Purpose of review: This review summarizes contemporary evidence on transcatheter aortic valve replacement (TAVR) explantation, emphasizing epidemiology, indications, operative challenges, outcomes, risk prediction, and implications for lifetime valve management. Recent findings: As TAVR expands to younger and lower-risk patients, explantation is becoming an increasingly relevant component of lifetime valve care. Recent systematic reviews, registries, national databases, and center experiences show that TAVR explant is technically complex, frequently requires concomitant procedures, and carries early mortality that exceeds conventional risk predictions. TAVR-in-TAVR is feasible in selected patients with structural valve degeneration but may be limited by infection, small annulus, coronary obstruction risk, or impaired future coronary access. Summary: TAVR explant should be considered during index valve selection. Heart Team planning should incorporate durability, coronary access, annular size, redo-TAVR feasibility, and surgical explant complexity, particularly in younger patients. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <34> Accession Number 2044393185 Title A history that matters: a systematic review and meta-analysis on prior heart failure hospitalization and outcomes after transcatheter aortic valve implantation. Source Journal of Echocardiography. 24(3) (pp 149-161), 2026. Date of Publication: 01 Sep 2026. Author Ahmed M.; Kumar A.; Ridham F.N.U.; Azad I.F.; Lohana R.R.; Qadir Z.; Kumari M.; Moosani F.; Saleh S.; Shaikh A.S.; Dito A.; Alam M. Institution (Ahmed, Kumar, Ridham, Azad, Qadir, Kumari, Moosani, Saleh, Shaikh, Dito) Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, Pakistan (Lohana) Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan (Alam) Department of Cardiology, The Texas Heart Institute, Baylor College of Medicine, Houston, TX, United States Publisher Springer Abstract Aortic stenosis in older adults often requires valve replacement and transcatheter aortic valve implantation (TAVI) is an option with good outcomes. However, recent hospitalizations due to heart failure (HF) may worsen results. This systematic review and meta-analysis adhering to PRISMA guidelines. We systematically searched PubMed, Cochrane Library and Scopus from database inception until July 2025. Data were analyzed by Review Manager using Risk Ratio (RRs) and 95% confidence interval (95% CIs) were used, and result was considered significant when the p-value is less than 0.05. Our primary outcome was 30-day mortality. Secondary outcomes included long-term mortality, major vascular complication, stroke, bleeding complications, pacemaker implantation, acute kidney injury (AKI) and long-term hospitalization. We included six studies, consisting of a population of 3,800 in the group with recent HF hospitalization and 12,949 in the group without recent HF hospitalization. Our pooled estimate shows a significantly higher rate of mortality in 30-day in the patients with group with recent HF hospitalization compared to the patients without recent HF hospitalization (RR: 2.28; 95% CI: [1.84-3.61]; p = 0.00001; I2 = 40%). Among the secondary outcomes, long-term mortality (RR = 1.75; 95% CI: [1.53-2.01]; p < 0.00001, I2 = 43%), stroke (RR = 1.30; 95% CI: [1.01-1.68]; p = 0.04, I2 = 0%), bleeding complications (RR = 1.36; 95% CI: [1.18-1.56]; p = 0.00001, I2 = 0%), AKI (RR = 1.42; 95% CI: [1.117-1.74]; p = 0.0005, I2 = 23%) and long-term hospitalization (RR = 1.39; 95% CI: [1.09-1.78]; p = 0.007, I2 = 93%) were associated with higher risk in the patients with recent HF hospitalization as compared to the patients without prior HF hospitalization. While major vascular complication and pacemaker implantation were statistically insignificant. Patients with recent HF hospitalization had significantly higher 30-day mortality, long-term mortality, stroke, bleeding complications, AKI and long-term hospitalization than those without recent hospitalization. Copyright © Japanese Society of Echocardiography 2026. <35> Accession Number 2049894338 Title Beyond catecholamine escalation: Receptor desensitization and endogenous vasopressor failure, and extracorporeal circuit biocompatibility after cardiopulmonary bypass-A narrative review. Source Vascular Pharmacology. 165 (no pagination), 2026. Article Number: 107707. Date of Publication: 01 Dec 2026. Author Condello I.; Dell'Aquila M.; Condello S.; Totaro A.; El Dsouki Y.; Prapas S.; Katsavrias K.; D'Onofrio A.; Newman J.; Patel N.; Kalimi R.; Gaudino M.; Calafiore A.M. Institution (Condello) School of Medicine and Surgery, University of Insubria, Varese, Italy (Dell'Aquila, Newman, Patel, Kalimi) Northwell Health, Cardiovascular Institute, New York, NY, United States (Condello) Neuromotor Rehabilitation Unit, Istituti Clinici Scientifici, Maugeri SPA, Ribera, Italy (Totaro) Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy (El Dsouki) Faculty of Health, Medicine and Life Sciences, CARIM, Maastricht University, Maastricht, Netherlands (Prapas, Katsavrias) 1st Division of Cardiac Surgery, Henry Dunant Hospital, Athens, Greece (D'Onofrio, Calafiore) Division of Cardiac Surgery, University of Rome "Tor Vergata", Rome, Italy (Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United States Publisher Elsevier Inc. Abstract Background: Vasoplegic syndrome following cardiopulmonary bypass (CPB) is a major cause of postoperative circulatory failure in cardiac surgery and is associated with increased morbidity and mortality. Traditionally, vasoplegia has been attributed to systemic inflammation, endothelial dysfunction, excessive nitric oxide production, and pathological vasodilation. However, these mechanisms alone do not fully explain the marked variability in vasopressor responsiveness observed in clinical practice. Increasing evidence suggests that vasoplegia may result not only from depletion of endogenous vasopressors, but also from receptor desensitization and impaired intracellular signaling involving catecholamines, arginine vasopressin (AVP), and angiotensin II (Ang II). Evidence Synthesis: A narrative literature review was conducted using PubMed/MEDLINE, Scopus, and Web of Science, supplemented by citation tracking and manual cross-referencing. Literature was selected qualitatively according to its relevance to endogenous vasopressor physiology, GPCR signaling and desensitization, endothelial and glycocalyx dysfunction, extracorporeal circuit biocompatibility, and vasoplegic syndrome after cardiac surgery. Fifty-one publications representing the key clinical, experimental, translational, and physiological evidence informing these themes were included in the final narrative synthesis; this number represents the literature selected for qualitative discussion rather than the yield of a systematic-review screening process. Result(s): The available evidence suggests that CPB profoundly alters endogenous vasopressor pathways through systemic inflammation, oxidative stress, endothelial activation, ischemia-reperfusion injury, and prolonged adrenergic stimulation. These mechanisms may contribute to depletion of endogenous vasopressors as well as receptor downregulation, desensitization, and uncoupling of intracellular signaling pathways. Alterations involving vasopressin V1/V2 receptors, beta-adrenergic receptors, and the renin-angiotensin system may all participate in vasopressor refractoriness. Increased activation of the ACE2/Ang-(1-7) counter-regulatory axis may further promote vasodilatory pathways, particularly in patients with obesity, diabetes mellitus, and heart failure. Emerging evidence also suggests that multimodal vasopressor strategies, including vasopressin and Ang II supplementation, may be more effective than isolated catecholamine escalation in refractory vasoplegia. In severe cases, non-conventional therapies such as Methylene Blue may restore vascular tone independently of classic vasopressor receptor pathways. Conclusion(s): Vasoplegia after CPB may represent a complex endocrine and receptor-mediated disorder rather than a purely vasodilatory state. The interaction between endogenous vasopressor depletion, receptor dysfunction, and altered intracellular signaling may explain the development of catecholamine-refractory shock after cardiac surgery. A better understanding of these mechanisms could support more individualized and physiologically guided vasopressor strategies aimed at preventing receptor exhaustion and improving hemodynamic management in cardiac surgical patients. Copyright © 2026 Elsevier Inc. <36> Accession Number 2049188323 Title Prehabilitation for patients with mild to moderate frailty undergoing coronary artery and valve surgery: a pilot randomized controlled trial. Source European Journal of Cardiovascular Nursing. 25(6) (pp 1197-1206), 2026. Date of Publication: 01 Sep 2026. Author Li P.W.C.; Yu D.S.F.; Chan D.T.L.; Ho C.K.L.; Lam S.C.C.; Chiu P.K.C.; Wan S.H.Y.; Lam L.; Hung N. Institution (Li, Yu) School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 5/F., 3 Sassoon Road, Pokfulam, Hong Kong (Chan, Ho, Wan) Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong Kong (Lam, Chiu) Department of Medicine, Queen Mary Hospital, Hong Kong (Lam, Hung) Physiotherapy Department, Queen Mary Hospital, Hong Kong Publisher Oxford University Press Abstract Aims: Although prehabilitation is increasingly studied to address preoperative frailty in cardiac surgery candidates, most interventions overlook recommended exercise principles for frailty. This study evaluated the feasibility and effects of a frailty-specific prehabilitation programme on health outcomes in frail patients undergoing cardiac surgery. Methods and Results: Adult patients with mild to moderate frailty scheduled for elective coronary or valve surgery were randomized to prehabilitation (n = 26) or usual care (n = 25). The programme combined education, nutritional optimization, stress management, and individualized resistance-focused exercise training via centre-based, home-based, and online sessions over at least 4 weeks. Primary outcome was functional capacity. The prehabilitation group showed significant improvements in functional capacity measured by the Short Physical Performance Battery at 1 day before surgery (beta = 0.99; 95% confidence interval [CI] = 0.08-1.90; P = 0.032) and 3-month post-intervention (beta = 1.04; 95% CI = 0.05-2.03; P = 0.040). Frailty level measured by Fried criteria showed significant reductions at 1 day before surgery (P = 0.005) and at 3-month follow-up (P = 0.043), with large effect sizes (Hedges' g = 0.92-1.18). Health-related quality of life measured by the MacNew Questionnaire improved significantly at 1-month (P = 0.006) and 3-month post-intervention (P = 0.007), with large effect sizes (Hedges' g = -0.89 to -0.96). The programme demonstrated high feasibility (89% adherence) and safety (minimal adverse events). No significant differences were found in biomarkers or clinical events, unplanned readmission, or length of stay. Conclusion(s): This frailty-specific prehabilitation programme is feasible and safe for cardiac surgical patients, demonstrating improvements in functional capacity, frailty, and quality of life. A full-scale trial is warranted to confirm its efficacy and guide clinical implementation. Registration: ClinicalTrials.gov Identifier: NCT06323317 Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. 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 journals.permissions@oup.com. <37> Accession Number 2047862291 Title Sex-Related Differences in Outcomes and Thresholds for Intervention in Primary Mitral Regurgitation: A Systematic Review and Meta-Analysis. Source JACC: Cardiovascular Imaging. 19(10) (pp 1204-1218), 2026. Date of Publication: 01 Oct 2026. Author Long E.; Hahn R.T.; Gulati M.; Demetrescu C.; Shah B.N.; Bhattacharya S.; Moorjani N.; Lucchese G.; Bilkhu R.; Bosco P.; Patterson T.; Redwood S.; Pibarot P.; Prendergast B.; Rajani R.; Androshchuk V. Institution (Long, Lucchese, Redwood, Rajani, Androshchuk) Faculty of Life Sciences and Medicine, King's College London, United Kingdom (Long, Demetrescu, Lucchese, Bilkhu, Bosco, Patterson, Redwood, Rajani, Androshchuk) Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Hahn) Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States (Gulati) Department of Cardiology, The Davis Women's Heart Center, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States (Shah) Department of Cardiology, Wessex Cardiac Centre, Southampton General Hospital, Southampton, United Kingdom (Bhattacharya) Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (Bhattacharya, Prendergast) Cleveland Clinic London, London, United Kingdom (Moorjani) Department of Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, United Kingdom (Pibarot) Department of Medicine, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada Publisher Elsevier Inc. Abstract Background: Evidence on sex differences in outcomes after interventions for primary mitral regurgitation (PMR) remains conflicting. The authors performed a dedicated meta-analysis to examine whether guideline-recommended thresholds for intervention may contribute to these discrepancies. Method(s): Electronic databases were searched for studies reporting long-term outcomes of patients undergoing surgical or transcatheter interventions for PMR, stratified by sex. The primary endpoint was all-cause mortality, and the secondary endpoint was major adverse cardiovascular events. Reconstructed time-to-event individual patient data were used to derive frailty-adjusted Cox models and restricted mean survival time. To investigate whether sex-based differences in baseline characteristics had a modulating effect on differences in all-cause mortality, meta-regression was performed on individual patient data-derived HRs using a linear mixed-effects model. Result(s): Across 17 studies (N = 25,690), women comprised the minority (n = 9,632, 37.5%) and were significantly older (mean difference: 3.2 years, 95% CI: 2.2-4.3) with a greater proportion of heart failure symptoms (OR: 1.8; 95% CI: 1.6-2.1). At 15.7 years of follow-up, women had significantly greater risk of all-cause mortality compared with men (HR: 1.15; 95% CI: 1.07-1.24), corresponding to a survival deficit of 5.8 months (95% CI: 3.7-7.7). Similar results were observed in sensitivity analyses restricted to surgical intervention studies (HR: 1.18; 95% CI: 1.10-1.27). Female sex was also associated with significantly increased major adverse cardiovascular events (n = 2,775) (HR: 1.37; 95% CI: 1.11-1.70; DELTA restricted mean survival time: 8.5 months, 95% CI: 2.4-14.5). Age, >= moderate tricuspid regurgitation (TR), and concomitant tricuspid valve repair (TVr) emerged as significant moderators of sex differences in mortality after intervention for PMR (P < 0.001, P = 0.03, and P < 0.001, respectively). A greater proportion of >= moderate TR and TVr in women conferred increased mortality relative to men. Neither left ventricular nor left atrial parameters significantly moderated sex differences in all-cause mortality (all P > 0.05). Conclusion(s): At the time of PMR intervention, women are older, have more symptoms, and worse long-term outcomes compared with men. Older female age alongside higher prevalence of >= moderate TR and TVr explained a significant proportion of this heterogeneity in sex-related all-cause mortality, whereas differences in left ventricular and left atrial parameters had no significant influence. A careful appraisal of current guidelines to ensure equality of health care outcomes between sexes is warranted. Copyright © 2026 The Authors <38> [Use Link to view the full text] Accession Number 2049570386 Title Proteomics analysis of empagliflozin in patients without diabetes or overt heart failure from empagliflozin and cardiac remodeling in people without diabetes CardioLink-7 randomized clinical trial. Source Cardiovascular Endocrinology and Metabolism. 15(2) (pp 1-9), 2026. Article Number: e00358. Date of Publication: 01 Jan 2026. Author Chen W.-S.; Yang N.-I.; Verma S.; Liu M.-H.; Chien K.-Y.; Chen C.-W.; Quan A.; Teoh H.; Yan A.T.; Connelly K.A.; Juan Y.-H.; Chang C.-W.; Mazer C.D.; Wang C.-H. Institution (Chen, Yang, Liu, Wang) Division of Cardiology, Department of Internal Medicine, Heart Failure Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan (Republic of China) (Verma, Quan, Teoh) Division of Cardiac Surgery, Li Ka Shing Knowledge Institute, St Michael's Hospital of Unity Health Toronto, Taiwan (Republic of China) (Verma) Department of Surgery, St Michael's Hospital, Taiwan (Republic of China) (Verma, Mazer) Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada (Liu) Department of Nursing, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan (Republic of China) (Chien) Department of Biochemistry and Molecular Biology, Chang Gung University, Taiwan (Republic of China) (Chen) Clinical Proteomics Core Laboratory, LinKou Chang Gung Memorial Hospital, Taoyuan, Taiwan (Republic of China) (Teoh) Division of Endocrinology and Metabolism, St Michael's Hospital, Taiwan (Republic of China) (Yan, Connelly) Division of Cardiology, Li Ka Shing Knowledge Institute, St Michael's Hospital of Unity Health Toronto, Taiwan (Republic of China) (Yan, Connelly) Department of Medicine, University of Toronto, Taiwan (Republic of China) (Yan) Department of Medical Imaging, Li Ka Shing Knowledge Institute, St Michael's Hospital of Unity Health Toronto, Taiwan (Republic of China) (Connelly, Mazer) Department of Physiologyd, University of Toronto, Toronto, Ontario, Canada (Juan) Institute for Radiological Research, Chang Gung University, Keelung, United States (Juan) Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan (Republic of China) (Chang) Department of Diagnostic Radiology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan (Republic of China) (Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute, St Michael's Hospital of Unity Health Toronto, Taiwan (Republic of China) (Mazer) Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada (Wang) School of Medicine, Chang Gung University, Taoyuan, Taiwan (Republic of China) Publisher Lippincott Williams and Wilkins Abstract Background - Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce cardiovascular and cardiorenal events in people across the spectrum of heart failure. Using proteomics analysis, this study investigated the potential benefits of SGLT2 inhibitors in primary prevention at a protein level in patients without diabetes or heart failure. Methods - This is a sub-study of the EMPA-HEART 2 CardioLink-7 trial, which randomized people without diabetes or clinically overt heart failure but with risk factors for adverse cardiac remodeling to empagliflozin (10 mg/day) or placebo for 6 months. Blood samples were collected during the randomization visit and at the 6-month follow-up visit for proteomics analysis. Our investigation involved two phases of approach: discovery and verification. Results - Samples from individuals assigned to empagliflozin (n = 21) and placebo (n = 22) (median baseline N-terminal pro-B-type natriuretic peptide levels: 33.9 and 78.4 pg/ml, respectively) were analyzed. In the discovery phase, 28 of 1622 proteins fulfilled our threshold for being differentially expressed at 6 months. Ten proteins were verified, including calmodulin-like protein 5, desmoplakin, hornerin, peroxiredoxin-2, macrophage colony-stimulating factor 1 receptor, endosialin, high-temperature requirement serine protease A1, immunoglobulin epsilon heavy chain, proteasome subunit beta type-5, and cerebellin-4. Compared to the placebo group, the expression of these proteins from baseline to 6 months was all significantly decreased in the empagliflozin group. Their functions involved ion channel signaling, fibrosis, oxidative stress, inflammation, apoptosis, immune response, proteolysis, and neuromodulation. Conclusion - Empagliflozin modified multiple biologically relevant pathways in the nondiabetes and non-heart failure setting. These findings should be considered hypothesis-generating and warrant validation in larger, adequately powered studies. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. <39> Accession Number 2048126316 Title Uncovering the evidence frontier beyond the lipid-lowering effects of PCSK9 inhibitors in heart transplantation. Source American Journal of the Medical Sciences. 372(4) (pp 297-301), 2026. Date of Publication: 01 Oct 2026. Author Yazdanpanah F.; Ramirez G. Institution (Yazdanpanah) Department of General Preventive Medicine and Public Health, The University of Texas Health Science Center at Tyler, TX, United States (Ramirez) Division of Population Health Leadership and Analytics, The University of Texas Health Science Center at Tyler, TX, United States Publisher Elsevier B.V. Abstract Cardiac allograft vasculopathy (CAV) is a major cause of long-term complications in heart transplant (HTx) recipients, with dyslipidemia playing a key role in its development. While statins are the standard therapy, their effectiveness can be limited by side effects, insufficient lipid-lowering response, or drug interactions. This scoping review examines the emerging role of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) as an alternative strategy, emphasizing their positive effects on lipid profiles, especially low-density lipoprotein cholesterol (LDL-c), in slowing CAV progression. Recent preclinical studies using a heterotopic murine heart transplant model have identified a novel finding: the PCSK9i "alirocumab" may protect against transplant rejection through mechanisms independent of lipid-lowering, possibly by modulating hepatic immune responses. These findings reveal a significant evidence frontier and highlight the need for clinical research to further explore the immunomodulatory properties of PCSK9i in the context of heart transplantation. Copyright © 2026 Southern Society for Clinical Investigation <40> Accession Number 2049138028 Title ESC quality indicators for post-myocardial infarction care: transition and chronic coronary syndrome phases: Developed in collaboration with the European Association of preventive cardiology of the ESC. Source European Journal of Preventive Cardiology. 33(11) (pp 1940-1949), 2026. Date of Publication: 01 Aug 2026. Author Gencer B.; Follonier C.; Abdelrahman A.; Rossello X.; Sionis A.; Wilhelm M.; Koskinas K.C.; Moholdt T.; Panagiotakos D.; Dendale P.; Biondi-Zoccai G.; Ahrens I.; Krychtiuk K.A.; Salzwedel A.; Cavarretta E.; Vrints C.; Andreotti F.; Gale C.P.; Pedretti R.F.E.; Davos C.H.; Aktaa S. Institution (Gencer) Preventive Cardiology Unit, Service of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, Lausanne, Switzerland (Follonier) Service of General Internal Medicine and Service of Cardiology, Geneva University Hospitals, Geneva, Switzerland (Abdelrahman) Interventional Cardiology, University Hospital of Wales, Leeds, United Kingdom (Rossello) Cardiology Department, University Hospital of Son Espases, Institut D'Investigacio Sanitaria Illes Balears (IDISBA), Universitat de les Illes Balears (UIB), Palma de Mallorca, Spain (Sionis) Acute and Intensive Cardiac Care Unit, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain (Wilhelm) Centre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (Koskinas) Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland (Moholdt) Department of Circulation and Medical Imaging, Norwegian University if Science and Technology, Trondheim, Norway (Panagiotakos) School of Health Sciences & Education, Harokopio University of Athens, Athens, Greece (Dendale) Department of Cardiology, Jessa Hospital and Hasselt University Faculty of Medicine and Life Sciences, Hasselt, Belgium (Biondi-Zoccai, Cavarretta) Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (Biondi-Zoccai) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (Ahrens) Department of Cardiology and Medical Intensive Care, Hospital of Cologne, Cologne, Germany (Krychtiuk) Department of Internal Medicine II-Division of Cardiology, Medical University of Vienna, Vienna, Austria (Salzwedel) Department of Rehabilitation Medicine, University of Postdam, Postdam, Germany (Cavarretta) Advanced Cardiovascular Therapies, Bambino Gesu Children Hospital, IRCCS, Rome, Italy (Vrints) Department of Cardiology, Antwerp University Hospital, Edegem, Belgium (Vrints) Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp, Belgium (Andreotti) Cardiovascular Science Department, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy (Andreotti) CardioThoracic Department, Catholic University Medical School, Rome, Italy (Gale) Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom (Pedretti) School of Medicine and Surgery, University of Milan Bicocca, Milan, Italy (Pedretti) Cardiology Unit, Hospital of Erba, CO, Erba, Italy (Davos) Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece (Aktaa) Centre for Heart Valve Innovation, St Paul's Hospital, Vancouver, BC, Canada Publisher Oxford University Press Abstract Aims: We aimed to develop the European Society of Cardiology (ESC) quality indicators (QIs) for myocardial infarction (MI), from 1 year after hospital discharge, corresponding to transition to the chronic coronary syndrome phases. Methods and Results: We collaborated with the European Association of Preventive Cardiology (EAPC) and developed QIs for the long-term management of patients following MI. We applied the ESC methodology for QI development by (i) determining key domains of post-MI care; (ii) developing candidate QIs by performing a systematic review of the literature, and (iii) selecting the final set of QIs using a modified Delphi approach. In total, 18 QIs were identified across seven domains of care including (i) structural framework, (ii) risk assessment and follow-up, (iii) pharmacological management, (iv) rehabilitation, behavioural, and preventive interventions, (v) coronary revascularization, (vi) clinical outcomes, and (vii) patient-reported outcomes. Conclusion(s): We present the ESC QIs from 1 year after hospitalization for MI, to standardize and address gaps in care for this high-risk group. These QIs are supported by evidence from contemporary literature, endorsed by expert consensus, and aligned with the 2024 ESC guidelines on the management of chronic coronary syndromes. Lay summary: Measures to evaluate and improve the long-term management of patients following a heart attack are needed. In this paper, we identified key aspects of care that can help clinicians, decision-makers and patients improve the quality of care, from one year after a heart attack onwards, and help address inequalities and variations in clinical practice. Copyright © The European Society of Cardiology 2025. 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 journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <41> Accession Number 2042248452 Title Prognostic value of right ventricular free-wall longitudinal strain compared to conventional echocardiographic parameters in tricuspid regurgitation: a systematic review and meta-analysis. Source Journal of Echocardiography. 24(3) (pp 170-178), 2026. Date of Publication: 01 Sep 2026. Author Yamaguchi M.; Nabeshima Y.; Takeuchi M.; Node K. Institution (Yamaguchi) Department of Cardiovascular Medicine, National Hospital Organization Ureshino Medical Center, Ureshino, Japan (Nabeshima, Node) Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan (Takeuchi) Department of Cardiology, Tobata General Hospital, Kitakyushu, Japan Publisher Springer Abstract Background: Hemodynamically significant tricuspid regurgitation (TR) often leads to right ventricular (RV) dysfunction, which is associated with poor outcome. Estimation of RV function is difficult using conventional echocardiographic parameters. We aimed to compare the association of right ventricular free-wall longitudinal strain (RVfwLS) with outcome to that of conventional RV function parameters in TR. Method(s): A systematic review and meta-analysis were conducted per PRISMA guidelines. PubMed and Scopus databases were searched for studies reporting the association of RVfwLS with adverse outcomes such as all-cause mortality and cardiopulmonary events. Studies that reported hazard ratios (HRs) of RVfwLS, tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RVFAC), systolic pulmonary arterial pressure (sPAP), and left ventricular ejection fraction (LVEF) were also collected. HRs were pooled using a random-effects model, and ratio of HR per 1 standard deviation change between RVfwLS and other parameters were calculated for direct comparison. Result(s): Of 4,288 publications, 11 studies involving 12 patient cohorts were included for analysis. Mean age was 71 years, with follow-up periods ranging from 18 to 60 months. RVfwLS was associated with outcome (HR: 1.09, 95% confidence interval: 1.07 - 1.12). RVfwLS provided greater prognostic value than sPAP, RVFAC, and LVEF. Conclusion(s): RVfwLS is a more accurate predictor of adverse outcomes than conventional parameters in patients with TR, suggesting its potential role in managing patients. Copyright © Japanese Society of Echocardiography 2025. <42> Accession Number 2049280250 Title Endocardial Left Atrial Appendage Occlusion in Atrial Fibrillation: Device Design, Clinical Evidence, and Postprocedural Antithrombotic Management. Source Medicina (Lithuania). 62(9) (no pagination), 2026. Article Number: 1644. Date of Publication: 01 Sep 2026. Author Matvienko G.; Rimkiene M.A.; Bajoras V.; Drasutiene A.; Masiuliene R.; Gabartaite D.; Salaseviciene M.; Mataciunas M.; Sudaviciene D.; Marinskis G.; Aidietis A.; Rackauskas G. Institution (Matvienko, Rimkiene, Bajoras, Drasutiene, Salaseviciene, Sudaviciene, Marinskis, Aidietis, Rackauskas) Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania (Masiuliene, Gabartaite) Center of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania (Mataciunas) Department of Radiology, Nuclear Medicine and Medical Physics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background and Objectives: Atrial fibrillation is a major cause of ischemic stroke, and in patients with non-valvular atrial fibrillation the left atrial appendage is the predominant site of thrombus formation. Although oral anticoagulation remains the standard strategy for stroke prevention, long-term therapy may be limited by bleeding risk, prior major bleeding, contraindications, intolerance, or difficulty maintaining stable anticoagulation. Endocardial left atrial appendage occlusion (LAAO) has therefore emerged as an alternative strategy in selected patients. Its role continues to evolve with expanding device technologies, contemporary direct oral anticoagulant therapy, and ongoing randomized evidence. Material(s) and Method(s): This narrative literature review summarizes current evidence on endocardial LAAO, focusing on device design, anatomical considerations, clinical outcomes, postprocedural antithrombotic therapy, and ongoing research directions. Result(s): Available devices differ substantially in sealing mechanism, fixation strategy, conformability, surface properties, and suitability for complex appendage anatomy. The Watchman and Amulet platforms remain the most extensively studied systems, whereas several CE-marked and investigational devices aim to improve anatomical adaptability, reduce peri-device leak and device-related thrombus, and simplify implantation. Randomized evidence supports LAAO as a non-inferior alternative to oral anticoagulation in selected populations, with potential reduction in late bleeding but persistent concerns regarding procedural risk, frailty, comorbidity burden, and patient selection. The optimal postprocedural antithrombotic regimen remains uncertain, with increasing interest in individualized strategies and short-term direct oral anticoagulant therapy when feasible. Current research is shifting toward next-generation devices, combined ablation-closure strategies, simplified imaging guidance, and evaluation of LAAO as both an alternative and an adjunct to oral anticoagulation. Conclusion(s): LAAO should currently be considered a selective rather than a universal strategy, requiring individualized assessment of thromboembolic risk, bleeding risk, anatomy, procedural safety, and comorbidity burden. Copyright © 2026 by the authors. <43> Accession Number 2048544427 Title Machine Learning Models for Warfarin Dose Prediction: A Systematic Review of Performance and Clinical Utility. Source Journal of Applied Pharmaceutical Science. 16(9) (pp 941-952), 2026. Date of Publication: 01 Sep 2026. Author Noviyani R.; Nguyen H.N.; Duong K.L.T.; Ngo T.V.; Ngo N.T.N.; Wijayakusuma I.G.N.L.; Widhiartini I.A.A.; Duong K.N.C. Institution (Noviyani) Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Udayana University, Bali, Denpasar, Indonesia (Nguyen, Ngo, Duong) Department of Economic, Social, and Administrative Pharmacy, Faculty of Pharmacy, University of Health Sciences, Vietnam National University Ho Chi Minh City, Ho Chi Minh City, Vietnam (Duong) Department of Computer Science, University of Information Technology, Vietnam National University Ho Chi Minh City, Vietnam (Ngo) Mahidol University Health Technology Assessment (MUHTA) Program, Mahidol University, Bangkok, Thailand (Wijayakusuma) Department of Mathematics, Faculty of Mathematics and Natural Sciences, Udayana University, Bali, Denpasar, Indonesia (Widhiartini) Department of Pharmacology and Therapy, Faculty of Medicine, Udayana University, Bali, Denpasar, Indonesia Publisher SAGE Publications Ltd Abstract Warfarin therapy is complicated by its narrow therapeutic index and significant inter-individual variability. This study aimed to systematically review the performance of machine learning (ML) for predicting warfarin doses in clinical settings, compared with conventional methods, and to assess the quality of evidence. We searched PubMed, Embase, and Web of Science until December, 2024, and included studies developing ML models for warfarin dosing in clinical settings. The performance metrics of ML models were evaluated using predictive accuracy, model fit, and clinical utility. Risks of bias were assessed using the Prediction Model Risk of Bias Assessment Tool. Thirty-five studies were included. In terms of ML models, the majority of included studies evaluated artificial neural networks (n = 24), followed by ensemble models (n = 19), and support vector machines (n = 18). Regarding performance, ML models demonstrated superiority across all three metrics: predictive accuracy (16 of 18 studies), model fit (5 of 7 studies), and INR-related clinical utility (all 4 studies). A high risk of bias was identified in 94% of studies, mainly due to analysis-domain limitations, including missing-data handling, insufficient events per predictor, unclear predictor selection, and limited external validation. In conclusion, ML-based approaches may improve warfarin dose prediction compared with conventional methods, but the current evidence should be interpreted cautiously. Future studies should prioritize transparent reporting, robust model development, external validation, and clinically relevant outcomes before these models can be recommended for routine clinical implementation. Copyright © 2026 The Author(s). 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). <44> Accession Number 2049094432 Title Effect of phenylephrine versus ephedrine on the incidence of postoperative delirium in elderly patients undergoing non-cardiac and non-neurosurgical procedures: protocol for a multicentre, double-blind, randomized, controlled trial. Source Annals of Medicine. 58(1) (no pagination), 2026. Article Number: 2732555. Date of Publication: 2026. Author Xu X.; Wang G.; Li X.; Peng K.; Liu H.; Ji F.; Shan X.; Wang Y. Institution (Xu, Wang, Li, Peng, Ji, Shan, Wang) Department of Anesthesiology, First Affiliated Hospital of Soochow University, Jiangsu, Suzhou, China (Xu, Wang, Li, Peng, Ji, Shan, Wang) Institute of Anesthesiology, Soochow University, Jiangsu, Suzhou, China (Xu) Department of Anesthesiology, The Fifth People's Hospital of Huai'an, Huai'an, Jiangsu, China (Liu) Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA, United States Publisher Taylor and Francis Ltd. Abstract Background: Whether ephedrine, when used to maintain intraoperative blood pressure, is superior to phenylephrine in reducing postoperative delirium remains uncertain. This study aims to determine whether the intraoperative management of hypotension with ephedrine, compared with phenylephrine, reduces the incidence of postoperative delirium in elderly patients undergoing major non-cardiac, non-neurosurgical surgery. Method(s): This multicentre, randomized, double-blind, controlled trial will enrol 1,084 elderly patients scheduled for elective non-cardiac and non-neurosurgical major surgeries under general anaesthesia at seven hospitals in China. Participants will be randomized in a 1:1 ratio, stratified by study centre, to receive continuous intravenous infusion of either phenylephrine or ephedrine to maintain mean arterial pressure within 20% of the baseline value. The primary outcome is the incidence of postoperative delirium within 7 days after surgery. Secondary outcomes include severity of postoperative delirium, numeric rating scale pain scores at rest and during activity at 24, 48 and 72 h postoperatively, intensive care unit (ICU) admission rate and length of ICU stay, length of postoperative hospital stay, incidence of in-hospital major adverse cardiovascular and cerebrovascular events (myocardial infarction, arrhythmia, heart failure, and stroke), and 30-day all-cause mortality. Discussion(s): We hypothesize that ephedrine, when used to maintain intraoperative blood pressure, is superior to phenylephrine in reducing postoperative delirium in elderly patients undergoing major non-cardiac, non-neurosurgical surgery. The findings of this study may provide high-quality evidence for optimizing the management of intraoperative hypotension in this vulnerable population. Trial registration: Chinese Clinical Trial Registry (ChiCTR2500115385). Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <45> Accession Number 2049718881 Title Health Status Outcomes 7 Years After Transcatheter or Surgical Aortic Valve Replacement in Low-Surgical Risk Patients With Aortic Stenosis. Source Journal of the American College of Cardiology. 88(14) (pp 1690-1700), 2026. Date of Publication: 06 Oct 2026. Author Brener M.I.; Cohen D.J.; Kodali S.K.; Hahn R.T.; Thourani V.H.; Makkar R.R.; Pibarot P.; Yu X.; Lubich B.; Mack M.J.; Leon M.B.; Arnold S.V. Institution (Brener, Kodali, Hahn, Leon) Division of Cardiology, Columbia University Medical Center, New York, NY, United States (Cohen, Leon) Cardiovascular Research Foundation, New York, NY, United States (Cohen) St. Francis Hospital, Roslyn, NY, United States (Thourani) Division of Cardiothoracic Surgery, Piedmont Heart, Atlanta, GA, United States (Makkar) Cedars-Sinai Heart Institute, Los Angeles, CA, United States (Pibarot) Quebec Heart and Lung Institute, Laval University, Quebec, QC, Canada (Yu, Lubich) Edwards Lifesciences, Irvine, CA, United States (Mack) Division of Cardiac Surgery, Baylor Scott and White Health, Plano, TX, United States (Arnold) Division of Cardiology, Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City, Kansas City, MO, United States Publisher Elsevier Inc. Abstract Background: Transcatheter aortic valve replacement (TAVR) results in early improvements in health status outcomes relative to surgical aortic valve replacement (SAVR) in low-surgical risk patients with symptomatic severe aortic stenosis. However, long-term data comparing the detailed health status outcomes of these 2 treatments are lacking. Objective(s): The purpose of this study was to compare long-term health status outcomes between TAVR and SAVR in low-risk patients and explore heterogeneity of treatment effect. Method(s): The PARTNER 3 (Placement of Aortic Transcatheter Valves) trial randomized patients with severe aortic stenosis and low surgical risk 1:1 to TAVR with a balloon-expandable valve vs SAVR. Health status was evaluated with the Kansas City Cardiomyopathy Questionnaire (KCCQ) and Short Form-36 Heath Survey at baseline and 1 month, 6 months, and annually from years 1 to 7. Between treatment group differences in health status scores over time were examined with mixed effects models for repeated measures adjusted for baseline. Result(s): The analytic cohort included 943 patients enrolled in the PARTNER 3 trial who had baseline KCCQ assessments and underwent their assigned procedure (494 TAVR, 449 SAVR; mean age: 73.5 +/- 5.9 years; 69.2% men; mean Society of Thoracic Surgeons-Predicted Risk of Mortality: 1.9% +/- 0.6%; mean KCCQ-overall summary [KCCQ-OS] score: 70.9 +/- 20.5). TAVR and SAVR both resulted in significant improvements in KCCQ and Short Form-36 Heath Survey summary scores relative to baseline through 7-year follow-up. KCCQ-OS scores were substantially higher at 1 month after TAVR vs SAVR (mean treatment difference: +16.2 points; 95% CI: 14.3-18.1) and remained modestly higher through 2 years of follow-up (mean difference at 2 years: +1.9 points; 95% CI: 0.2-3.7), but there were no significant between-group differences in years 3-7. At 7 years, ~60% of patients in both treatment groups had an excellent outcome (alive, KCCQ-OS >=75; no KCCQ-OS decline >=10 from baseline). Conclusion(s): Patients with severe aortic stenosis at low surgical risk had substantial improvement in patient-reported health status with either TAVR or SAVR that was sustained through 7 years. Patients had earlier recovery with TAVR, but health status outcomes after 2 years were similar between treatment groups. (PARTNER 3 Trial: Safety and Effectiveness of the SAPIEN 3 Transcatheter Heart Valve in Low Risk Patients With Aortic Stenosis; NCT02675114) Copyright © 2026 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/ <46> Accession Number 2049239224 Title Computational modeling of thrombosis after transcatheter aortic valve implantation: A systematic review of hemodynamic and mechanical risk metrics. Source Computer Methods and Programs in Biomedicine. 287 (no pagination), 2026. Article Number: 109644. Date of Publication: 01 Dec 2026. Author Erina Y.; Kuchumov A.G. Institution (Erina, Kuchumov) Scientific Center of Genetics and Life Sciences, Sirius University of Science and Technology, Olympic Avenue 1, Sirius, Russian Federation (Kuchumov) Biofluids Laboratory, Perm National Research Polytechnic University, Professor Pozdeev Street 11, Perm, Russian Federation Publisher Elsevier Ireland Ltd Abstract Background and objective Although transcatheter aortic valve implantation (TAVI) generally provides favorable procedural outcomes, thrombotic complications remain an important concern for the long-term performance and durability of transcatheter heart valves. A subset of patients develops hypo-attenuated leaflet thickening (HALT), reduced leaflet mobility, or late thrombotic complications, often in the absence of overt clinical manifestations. This has motivated the use of computational modeling to investigate post-TAVI hemodynamics and valve mechanics and to identify flow- and device-related factors associated with thrombus formation. Methods In this review, we systematically analyze 68 computational studies focused on post-TAVI hemodynamics and thrombosis. The literature is organized into three categories based on their relevance to thrombogenic risk modeling: Peripheral (31 studies), Intermediate (21 studies), and Core (16 studies). This classification reflects the presence of hemodynamic modeling, the use of dedicated proxy metrics of thrombogenicity, and the extent to which thrombosis constitutes the primary focus of the investigation. We further examine the methodological spectrum of existing approaches, including computational fluid dynamics, fluid-structure interaction, and finite element analysis; the use of patient-specific versus idealized geometries; and the application of thrombogenicity-related metrics, such as residence time and washout indices, wall shear stress-based measures, and stress-history-based indicators of mechanical platelet activation. Results Our study shows that while direct simulation of thrombus formation is still mostly lacking, most published studies use indirect hemodynamic and mechanical proxies to evaluate thrombogenic risk. The existence and geometry of paravalvular leaks, valve implantation depth, asymmetric stent expansion, and patient-specific characteristics of aortic root architecture are the risk factors that are most frequently reported across studies. Notably, research in the Core category shows a distinct move away from descriptive flow analyzes and toward a more mechanistic understanding of thrombogenic risk, connecting the cumulative mechanical exposure of blood constituents, unstable neo-sinus hemodynamics, and implantation parameters. Conclusions Overall, this analysis shows that modern in silico methods already make it possible to compare implantation techniques and valve design elements quantitatively in terms of thrombogenic risk. Simultaneously, a shift from exclusively proxy-based evaluations to hybrid and multiscale modeling frameworks that incorporate geometry, hemodynamics, and a minimally adequate description of the biological mechanisms behind thrombus formation will be necessary for future advancements in the field. Copyright © 2026 Elsevier B.V. <47> Accession Number 2048960392 Title Does weight-adjusted dosing improve outcomes over fixed-volume bupivacaine in transversus thoracic muscle plane block for cardiac surgery? A prospective randomised controlled trial. Source Indian Journal of Anaesthesia. 70(8) (pp 954-957), 2026. Date of Publication: 01 Aug 2026. Author Singh A.; Kapoor D.; Garg S.; Khanna S. Institution (Singh, Kapoor) Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, Punjab, India (Garg) Department of Cardiothoracic and Vascular Surgery, Neelam Hospital, Rajpura, Punjab, India (Khanna) Department of General Surgery, Government Medical College and Hospital, Chandigarh, Punjab, India Publisher Wolters Kluwer Medknow Publications <48> Accession Number 2047863042 Title Artificial intelligence technology in aortic valve disease: a decade of scientometric and narrative review. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1843658. Date of Publication: 2026. Author Hei P.; Ren H.; Ma W.; Fang W.; Li Y. Institution (Hei, Ren, Ma, Fang, Li) Department of Cardiology, Tangdu Hospital, The Fourth Military Medical University, Shaanxi, Xi'an, China (Hei) Cardiac Rehabilitation Center, Department of Cardiology, Tangdu Hospital, The Fourth Military Medical University, Shaanxi, Xi'an, China Publisher Frontiers Media SA Abstract Background - Aortic valve disease, particularly aortic stenosis, poses a growing global health burden with aging populations. Artificial intelligence technology offers promising tools for diagnosis, risk stratification, and prognosis prediction, yet the knowledge structure of this interdisciplinary field remains unsystematically characterized. Objective - This study aims to conduct a scientometric analysis to delineate the research landscape, identify hotspots, and trace evolutionary trends of AI technology applications in aortic valve disease over the past decade. Methods - We retrieved relevant literature published between January 2016 and January 2026 from the Web of Science Core Collection and Scopus databases. After screening, 270 eligible articles were included. CiteSpace and VOSviewer were employed to perform visualization analyses of authors, institutions, countries, journals, keywords, and co-citation networks. Results - Annual publications increased steadily, with the United States leading in both output and influence. The Mayo Clinic emerged as the most prolific institution. Research hotspots focused on AI-assisted diagnosis, risk stratification, and prognosis prediction for aortic stenosis, primarily using deep learning and machine learning techniques. Keyword clustering revealed themes spanning disease diagnosis, therapeutic technologies, AI-enabled applications, and clinical outcomes. Co-citation analysis highlighted key studies on AI-enhanced electrocardiography and echocardiography for valve disease detection. Conclusions - AI technology research in aortic valve disease is advancing rapidly. Based on the keyword clustering and timeline analysis, we propose a conceptual mapping of AI techniques onto clinical phases. Future efforts should prioritize developing multimodal models, facilitating clinical integration, and enhancing patient lifecycle management. Copyright © 2026 Hei, Ren, Ma, Fang and Li. <49> Accession Number 2049695187 Title Spironolactone, early acute eGFR changes, and clinical outcomes in patients with heart failure with preserved ejection fraction: insights from TOPCAT Americas. Source European Journal of Heart Failure. 28(3) (pp 538-545), 2026. Date of Publication: 01 Mar 2026. Author Beldhuis I.E.; Claggett B.L.; Neuen B.L.; Chatur S.; Mc Causland F.R.; Voors A.A.; Desai A.S.; Lewis E.F.; Pitt B.; Pfeffer M.A.; Solomon S.D.; Vaduganathan M. Institution (Beldhuis, Claggett, Neuen, Chatur, Mc Causland, Desai, Pfeffer, Solomon, Vaduganathan) Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, United States (Beldhuis, Voors) Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands (Neuen) The George Institute for Global Health, UNSW Sydney, Sydney, Australia (Mc Causland) Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States (Lewis) Division of Cardiovascular Medicine, Stanford University School of Medicine, Palo Alto, CA, United States (Pitt) University of Michigan School of Medicine, Ann Arbor, United States Publisher Oxford University Press Abstract Aims: Early acute changes in estimated glomerular filtration rate (eGFR) have been well described with renin-angiotensin system inhibitors and sodium-glucose cotransporter-2 inhibitors, but less is known about the frequency, prognostic relevance, and implications of these changes after mineralocorticoid receptor antagonist (MRA) initiation in patients with heart failure with preserved ejection fraction (HFpEF). Method(s): We performed a post-hoc analysis of 1648 patients enrolled in the TOPCAT trial (Americas regional subgroup), defining an early eGFR dip as a >=15% decrease in eGFR between baseline and week 4. Landmark analyses assessed the association of eGFR changes, treatment, and the primary composite endpoint (cardiovascular death, HF hospitalization, or aborted cardiac arrest). Result(s): Within 4 weeks of treatment initiation, 431 (26%) patients experienced acute eGFR decrease with a higher proportion of patients assigned to spironolactone [269 (33%)] compared with placebo [162 (20%)] (odds ratio 1.97; 95% confidence interval 1.58-2.47). An acute eGFR decrease was independently associated with higher risk of subsequent cardiovascular outcomes, irrespective of treatment arm. However, treatment with spironolactone appeared beneficial in reducing the primary cardiovascular outcome irrespective of the presence [hazard ratio 0.75 (0.53-1.08)] or absence [0.80 (0.64-1.00)] of early eGFR decrease (P<inf>interaction</inf> = .81). At any given magnitude of eGFR decline, risk of the primary endpoint was consistently lower with spironolactone compared with placebo (P<inf>interaction</inf> = .64). Conclusion(s): Early acute eGFR changes were common and adversely prognostic in patients with HFpEF. Spironolactone treatment was beneficial in improving cardiovascular outcomes, despite a modest increase in the likelihood of acute eGFR decrease. An acute eGFR decrease early after MRA initiation should not automatically prompt treatment discontinuation. Trial Registration: ClinicalTrials.gov NCT00094302. 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 journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <50> Accession Number 2049276241 Title Rethinking Transfusion Strategies in CABG: Acute Normovolaemic Haemodilution versus Conventional Transfusion: A Systematic Review. Source Journal of the College of Physicians and Surgeons Pakistan. 36(9) (pp 1181-1186), 2026. Date of Publication: 01 Sep 2026. Author Muhammad D.; Ali T.A.; Khan M.A.; Khan A.; Shah S.; Iqbal I. Institution (Muhammad, Ali, Iqbal) Department of Cardiac Surgery, National Institute of Cardiovascular Diseases, Karachi, Pakistan (Khan) Department of Biochemistry, Khyber Medical College, Peshawar, Pakistan (Khan) Department of Internal Medicine, Aneurin Bevan University Health Board, Newport, United Kingdom (Shah) Department of Internal Medicine, DHQ Teaching Hospital, Kohat, Pakistan Publisher College of Physicians and Surgeons Pakistan Abstract Coronary artery bypass grafting (CABG) is among the most commonly performed cardiac surgical procedures worldwide and frequently requires perioperative blood transfusion. Acute normovolaemic haemodilution (ANH) is a simple and economical strategy that aims to reduce the need for allogeneic blood transfusion. A systematic review was conducted between October 2024 and August 2025 and analysed randomised controlled trials comparing ANH with conventional transfusion practices in patients undergoing coronary bypass surgery. Eighteen studies were evaluated for outcomes such as transfusion rates, blood loss, coagulation profiles, myocardial protection, postoperative complications, and cost-effectiveness. ANH reduced the need for allogeneic blood transfusion without affecting haemodynamic stability or postoperative recovery. Moderate improvements were observed in coagulation preservation and myocardial protection, although the certainty of evidence varied across outcomes. Further large-scale trials are required to establish standardised ANH protocols and clarify long-term clinical outcomes. Copyright © 2026 College of Physicians and Surgeons Pakistan. All rights reserved. <51> Accession Number 2048853787 Title Virtual reality for reducing pain, anxiety, and distress in children, adolescents, and young adults with cancer: a systematic review and meta-analysis of randomized controlled trials. Source Frontiers in Psychiatry. 17 (no pagination), 2026. Article Number: 1852113. Date of Publication: 2026. Author Yi S.; Fan Y.; Ren J.; Zheng Z.; Wang T.; Bai J. Institution (Yi, Bai) Department of Radiation Oncology, The People's Hospital of Huantai, Shandong, Zibo, China (Fan) Department of Psychiatry, The People's Hospital of Huantai, Shandong, Zibo, China (Ren, Zheng, Wang) Department of Pediatrics, The People's Hospital of Huantai, Shandong, Zibo, China Publisher Frontiers Media SA Abstract Background - Needle-related procedures are a significant source of pain, anxiety, and distress for children with cancer. This systematic review and meta-analysis aimed to evaluate the effectiveness of virtual reality (VR) as a distraction intervention for reducing these outcomes in pediatric oncology patients undergoing needle-related procedures. Methods - A systematic search of PubMed, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and CINAHL was conducted from database inception to March 23, 2026. We included randomized controlled trials (RCTs) evaluating the effect of VR (immersive or non-immersive) compared to standard care or active distraction in pediatric oncology patients (aged <=21 years) undergoing needle-related procedures. The primary outcome was self-reported pain. Secondary outcomes included parent-reported pain, nurse-reported pain, self-reported fear, parent-reported fear, nurse-reported fear, self-reported anxiety, parent-reported anxiety, distress, procedure duration, and heart rate. Meta-analyses were performed using random-effects models. Risk of bias was assessed using the Cochrane RoB 2.0 tool. Results - Ten RCTs enrolling 536 participants were included. VR significantly reduced self-reported pain (Standardized Mean Difference [SMD] = -0.99, 95% Confidence Interval [CI]: -1.37 to -0.61, p = 0.001, I2 = 71.7%), parent-reported pain (SMD = -1.10, 95% CI: -1.66 to -0.54, p < 0.001, I2 = 83.6%), and nurse-reported pain (SMD = -1.00, 95% CI: -1.92 to -0.08, p = 0.025, I2 = 80.0%). Significant reductions were also observed in self-reported fear (Weighted Mean Difference [WMD] = -1.10, 95% CI: -1.50 to -0.70, p < 0.001, I2 = 58.0%), parent-reported fear (WMD = -1.31, 95% CI: -1.58 to -1.03, p < 0.001, I2 = 7.1%), nurse-reported fear (WMD = -1.15, 95% CI: -1.55 to -0.75, p < 0.001, I2 = 0.0%), self-reported anxiety (SMD = -1.06, 95% CI: -1.63 to -0.49, p = 0.002, I2 = 79.9%), parent-reported anxiety (SMD = -1.59, 95% CI: -2.24 to -0.95, p < 0.001, I2 = 51.5%), and distress (SMD = -0.35, 95% CI: -0.67 to -0.03, p = 0.032, I2 = 19.6%). VR also significantly shortened procedure duration (WMD = -0.76 minutes, 95% CI: -1.34 to -0.19, p = 0.009, I2 = 0.0%) but had no significant effect on heart rate (WMD = 1.57, 95% CI: -3.51 to 6.64, p = 0.544, I2 = 80.3%). The overall risk of bias was low risk for five studies, some concerns for four studies, and high risk for one study. Conclusion - The available evidence suggests that VR may reduce pain, fear, anxiety, and distress and may shorten procedure duration in pediatric oncology patients undergoing needle-related procedures. These findings should be interpreted cautiously because several outcomes were based on few small trials and substantial heterogeneity was present. Larger multicenter RCTs are needed before routine implementation can be recommended. Systematic review registration - https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42026134853. Copyright © 2026 Yi, Fan, Ren, Zheng, Wang and Bai. <52> Accession Number 2048906066 Title Non-inferiority trial of remimazolam versus propofol for fast-track anesthesia in children undergoing percutaneous closure of atrial septal defect. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 547. Date of Publication: 01 Dec 2026. Author Qin P.; Jing H.; Shen X.; Zhang H.; Qiu L.; Song S.; Lin H. Institution (Qin, Jing, Shen, Zhang, Qiu, Song, Lin) Department of Anesthesia and Perioperative Medicine, Fuwai Central China Cardiovascular Hospital, Zhengzhou University Central China Fuwai Hospital, Zhengzhou Key Laboratory of Transesophageal Echocardiography, Henan Province Clinical Medical Research Center for Cardiovascular Disease, Zhengzhou, China Publisher BioMed Central Ltd Abstract Background and objective: Remimazolam, a new member of the benzodiazepine class, has been used as an alternative to propofol during anesthesia induction. In this study, we aimed to examine the effectiveness and safety of remimazolam compared with propofol for both the induction and maintenance of fast-track general anesthesia in children undergoing percutaneous closure of an atrial septal defect (ASD). Method(s): We carried out a single-center, prospective, randomized controlled, observer-blinded, non-inferiority trial among 101 children, of whom 57 received remimazolam and 44 received propofol. All children underwent percutaneous closure of an atrial septal defect and had an American Society of Anesthesiologists (ASA) physical status of II before surgery. The primary outcome was the time to laryngeal mask airway (LMA) removal, measured in minutes. Result(s): We included all 101 patients in the final analysis. Children in the remimazolam group had a significantly shorter time to LMA removal (mean difference [MD]: -7.97 min; 95% CI: -8.91 to -7.02; p < 0.001) and a shorter duration of hospitalization (median 5 vs. 7 days; p < 0.001) than the propofol group. The Pediatric Anesthesia Emergence Delirium (PAED) score was also lower in the remimazolam group (median 3 vs. 6; p < 0.001), indicating a reduced occurrence of postoperative emergence delirium. Fewer children in the remimazolam group required a vasopressor (26% vs. 64%). Mean arterial pressure and heart rate each showed a significant intervention-by-time interaction (their trajectories over time differed between groups), without a significant overall between-group difference in either. Conclusion(s): This study suggests that remimazolam offers advantages over propofol for fast-track anesthesia in children undergoing percutaneous ASD closure, including faster LMA removal, shorter hospitalization, and a lower incidence of postoperative emergence delirium, with a differing intraoperative mean arterial pressure trajectory and comparable overall hemodynamic stability. Trial registration number: ChiCTR2500109737, Registration date: 24 Sep. 2025. Retrospectively registered. Copyright © The Author(s) 2026. <53> Accession Number 2048906920 Title Effect of the orexin receptor antagonist, suvorexant, on sleep architecture in the early postoperative period following cardiac surgery: a randomized controlled trial. Source Critical Care. 30(1) (no pagination), 2026. Article Number: 459. Date of Publication: 01 Dec 2026. Author Wongtangman K.; reddy Janga S.; Azimaraghi O.; Khandaker R.; Khera T.; Leff J.; Forest S.J.; Suleiman A.; Tam C.; Spindel S.; DeYoung P.N.; Malhotra A.; Subramaniam B.; Eikermann M. Institution (Wongtangman, Azimaraghi, Khandaker, Leff, Suleiman, Tam, Eikermann) Department of Anesthesiology, Montefiore Medical Center and Albert Einstein College of Medicine, 111 East 210th St, Bronx, NY, United States (Wongtangman) Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand (reddy Janga, Khera, Subramaniam) Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, MA, Boston, Israel (Forest, Spindel) Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, United States (DeYoung, Malhotra) Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, University of California San Diego, La Jolla, CA, United States (Eikermann) Klinik fur Anasthesiologie und Intensivmedizin, Universitat Duisburg- Essen, Essen, Germany Publisher BioMed Central Ltd Abstract Background: Patients recovering from cardiac surgery in the intensive care unit (ICU) do not sleep well. Commonly used sedative-hypnotic medications can disrupt sleep architecture and increase the risk of delirium in critically ill patients after surgery. The orexin receptor antagonist suvorexant, improves sleep onset and duration in patients with chronic insomnia. We hypothesized that suvorexant improves sleep onset and duration while also reducing the incidence of delirium after cardiac surgery. Method(s): This multicentric, double-blind, randomized controlled trial was conducted at two university-based cardiac ICUs. One hundred adult patients were enrolled after admission to the ICU following cardiac surgery. Enrollment occurred between March 2020 and February 2025. Participants were randomized to receive either a once daily oral dose of suvorexant 20 mg or placebo. Treatment began on the first night after extubation and continued until hospital discharge or for a maximum of seven days, whichever occurred first. Sleep was recorded using an electroencephalography (EEG) monitor (SedLine, Masimo Corp., California, USA) on the first night after extubation and was scored blindly by an experienced registered polysomnographic technologist. The primary outcome was wakefulness after persistent sleep onset (WASO). Sleep onset was defined as the first 30-second epoch classified by rapid eye movement (REM) or non-REM stages 1, 2, 3 after lights off. Wakefulness was defined as an awake period of 30s or longer. Sleep questionnaires were administered and delirium screenings were conducted every morning until hospital discharge. Result(s): One hundred patients were randomized to receive suvorexant (n = 49) or placebo (n = 51). EEG analysis indicated that neither the median [inter-quartile range] nighttime WASO (200.7 [112.1, 328.4] minutes vs. 184.2 [80.4, 304.2] minutes; p = 0.33) nor total sleep time (224.0 [112.0, 379.0] minutes vs. 253.0 [68.0, 420.0] minutes; p = 0.92) differed significantly between the groups. There was no significant difference in rescue medication (melatonin, dexmedetomidine, benzodiazepine) utilization between the groups. Subjective sleep quality, incidence of delirium, and delirium-free days did not differ between the two groups. Trial registration number: Clinical Trials Registry no. NCT04092894, Registration Date 09/17/2019. Conclusion(s): Among patients recovering in the ICU who underwent cardiac surgery with cardiopulmonary bypass, the suvorexant treatment did not affect wakefulness after sleep onset or post-operative delirium. Copyright © The Author(s) 2026. <54> Accession Number 2048940564 Title Pulmonary artery catheters or central venous catheters for cardiac surgery: the PUMA Pilot randomised clinical trial. Source Anaesthesia. 81(10) (pp 1358-1366), 2026. Date of Publication: 01 Oct 2026. Author Perry L.A.; Segal R.; Larobina M.; Bellomo R.; Smith J.A.; Sin J.; Danial K.; McLean A.R.D.; Rong L.Q.; Gaudino M.; Schwann T.; Palumbo M.; O'Halloran L.; Chee B.; Patel J.; Silvers A.; Bennetts J.; Marasco S.; Coulson T.G.; Royse A.; See E.; Miles L.F. Institution (Perry, Sin, Danial, Chee, Patel) Victorian Cardiac Anaesthesia Research Laboratory, Department of Surgery, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia (Perry, Sin, Danial, Palumbo, O'Halloran, Chee, Patel, Silvers) Department of Anaesthesia and Perioperative Medicine, Victorian Heart Hospital, Melbourne, VIC, Australia (Perry, Coulson, See, Miles) Department of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia (Segal) Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, VIC, Australia (Larobina, Smith, Bennetts) Department of Cardiothoracic Surgery, Victorian Heart Hospital, Monash Health, Melbourne, VIC, Australia (Smith, Marasco) Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia (McLean) Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia (McLean) MISCH (Methods and Implementation Support for Clinical Health) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia (Rong) Department of Anesthesiology, Weill Cornell Medicine, New York, NY, United States (Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United States (Schwann) Department of Cardiovascular Surgery, Corewell Health, Royal Oak, MI, United States (Marasco) Cardiothoracic Unit, The Alfred, Melbourne, VIC, Australia (Coulson) Department of Anaesthesiology and Perioperative Medicine, Alfred Health, Melbourne, VIC, Australia (Royse) Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Melbourne, VIC, Australia (Royse) Department of Surgery, The University of Melbourne, Melbourne, VIC, Australia (See) Departments of Intensive Care and Nephrology, The Royal Melbourne Hospital, Melbourne, VIC, Australia (Miles) Department of Anaesthesia, Austin Health, Melbourne, VIC, Australia Publisher John Wiley and Sons Inc Abstract Introduction: Pulmonary artery catheters are used widely in cardiac surgery despite observed associations with worse outcomes and guidelines that recommend against their routine use. No adequately powered randomised trials are available. Method(s): The PUMA Pilot was a multicentre, randomised, parallel assignment, open-label, pilot and feasibility trial conducted at three tertiary cardiac surgery centres. Eligible patients were adults undergoing coronary artery bypass grafting, aortic valve replacement or surgery on the aortic root or ascending aorta with or without aortic valve replacement, with a predicted surgical mortality of < 2%. Patients were allocated randomly to receive a pulmonary artery catheter or a central venous catheter inserted immediately before surgery. The primary feasibility outcome was protocol compliance, defined as receiving the assigned intervention without crossover. Secondary feasibility outcomes were eligibility rate; recruitment proportion and rate; data completeness; and rate of clinician refusal. Result(s): We screened 480 patients and 206 (43%) were eligible; 150/203 (74%) approached provided informed consent. Three of 206 (1%) eligible patients were not included due to clinician refusal. Of 149 patients who were randomised, 76 were assigned to the pulmonary artery catheter group and 73 to the central venous catheter group. For the primary feasibility outcome, 147 patients (99%) received the allocated intervention. Data were complete for 144 (97%) patients. Median (IQR [range]) days alive and at home at 30 days was 23.7 (21.9-24.7 [7.0-26.0]) in the pulmonary artery catheter group and 22.9 (20.8-23.9 [8.6-25.8]) in the central venous catheter group. Acute kidney injury occurred in 26/76 (34%) patients in the pulmonary artery catheter group and 14/73 (19%) in the central venous catheter group. Discussion(s): A randomised trial of pulmonary artery catheters compared with central venous catheters in low-risk cardiac surgery is feasible. Such a trial would address significant practice variability and inform international guidelines. Copyright © 2026 The Author(s). Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. <55> Accession Number 2045496576 Title Short-Term, Weight-Adjusted Colchicine to Prevent Post-CABG Arrhythmias: A Randomized, Double-Blind, Controlled Trial. Source PACE - Pacing and Clinical Electrophysiology. 49(9) (pp 1425-1433), 2026. Date of Publication: 01 Sep 2026. Author Farzaneh A.H.; Abbaspour H.; Habibi V.; Sadraei S.J.; Darayi M.; Moradi S.; Nataj A.H. Institution (Farzaneh, Abbaspour) Department of Clinical Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of (Habibi, Sadraei, Darayi) Department of Cardiac Surgery, Fatemeh Zahra Hospital, Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of (Moradi) Education Development Center, Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of (Nataj) Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of Publisher John Wiley and Sons Inc Abstract Background: Postoperative arrhythmias are common after coronary artery bypass graft (CABG) surgery and are linked to adverse outcomes. Colchicine, an anti-inflammatory agent, has shown inconsistent results in prior studies, possibly due to dosing and timing variations. Objective(s): To evaluate the efficacy and safety of short-term, weight-adjusted colchicine initiated preoperatively for preventing postoperative arrhythmias after CABG. Method(s): In this randomized, double-blind, placebo-controlled trial, 172 adults scheduled for on-pump CABG received colchicine or placebo. The regimen included a preoperative loading dose (1 mg twice daily) followed by a weight-based maintenance dose (0.5 mg daily if <70 kg; 1 mg daily if >=70 kg) for 14 days. The primary outcome was incidence of postoperative atrial fibrillation (POAF). Secondary outcomes included early (<=48 h) and late (>48 h) POAF, other arrhythmias, inflammatory markers (CRP, ESR), length of stay, and adverse events. Result(s): Of 163 analyzed patients (81 colchicine, 82 placebo), POAF incidence was significantly lower in the colchicine group (17.3% vs. 46.3%; RR 0.37, 95% CI 0.21-0.66; p < 0.001), with an absolute risk reduction of 29.0% and number needed to treat (NNT) of 4. Colchicine reduced both early and late POAF (p < 0.001 and p = 0.002). No significant reduction was seen in other arrhythmias. Gastrointestinal events, primarily diarrhea, were more common with colchicine (25.9% vs. 8.5%, p = 0.003), but were manageable and without serious adverse events. Conclusion(s): Short-term perioperative weight-adjusted colchicine is effective and safe for preventing POAF after CABG, with a low NNT and manageable side effects, though it did not significantly affect other arrhythmias. Trial Registration: Iranian Registry of Clinical Trials, IRCT20200328046886N6. Copyright © 2026 Wiley Periodicals LLC. <56> Accession Number 652288639 Title Incidence and Predictors of Complications After Transcatheter Aortic Valve Implantation According to VARC-3 Criteria: A Systematic Review and Meta-Analysis. Source Journal of the American Heart Association. (pp e045455), 2026. Date of Publication: 29 Sep 2026. Author Giacobbe F.; Bruno F.; Brero M.; Meynet P.; Solano A.; Capoccia S.; Pilia R.; D'Ascenzo F.; Conrotto F.; Tarantini G.; la Torre M.; Kim W.-K.; Buono A.; Blumenstein J.; Polzin A.; Gennari M.; Gmeiner J.M.D.; Piperata A.; Ruge H.; Li J.; Mascherbauer J.; Waksman R.; Barbash I.; Tang G.; Gasior T.; Webb J.; Hioki H.; Obaid D.; Mangieri A.; Crimi G.; Joner M.; Toggweiler S.; Mauri V.; Lin M.-S.; Haussig S.; Avvedimento M.; Nanayakkara S.; Serruys P.W.; Landolff Q.; Latib A.; Rodes-Cabau J.; De Ferrari G.M.; de Filippo O. Institution (Giacobbe, Bruno, Brero, Meynet, Solano, Capoccia, Pilia, D'Ascenzo, Conrotto, De Ferrari, de Filippo) Division of Cardiology, Cardiovascular and Thoracic Department Citta della Salute e della Scienza Turin Italy, Italy (Giacobbe, Brero, Meynet, Solano, Capoccia, Pilia, D'Ascenzo, De Ferrari) Division of Cardiology, Department of Medical Sciences University of Turin Italy, Italy (Giacobbe, Bruno) Royal Brompton and Harefield Hospitals Trust and Imperial College London UK (Tarantini) Cardiology Clinic, Department of Cardiac, Thoracic, Vascular Sciences and Public Health Padova University of Padua Italy, Italy (la Torre) Division of Cardiac Surgery, Cardiovascular and Thoracic Department Citta della Salute e della Scienza Turin Italy, Italy (Kim) Department of Cardiology Kerckhoff Heart and Thorax Center Bad Nauheim Germany, Germany (Buono) Interventional Cardiology Unit, Cardiovascular Department Fondazione Poliambulanza Brescia Italy, Italy (Blumenstein) Department of internal medicine St. Johannes hospital Dortmund Dortmund Germany, Germany (Blumenstein) Department of cardiology University Oldenburg Oldenburg Germany, Germany (Polzin) Department of Cardiology, Pulmonology, Vascular Medicine, University Hospital Dusseldorf Medical Faculty of the Heinrich Heine University Dusseldorf Dusseldorf Germany, Germany (Polzin) Cardiovascular Research Institute Dusseldorf (CARID) Dusseldorf Germany, Germany (Gennari) IRCCS Centro Cardiologico Monzino Valvular and Structural Invasive Cardiology Unit Milan Italy, Italy (Gmeiner) Medizinische Klinik und Poliklinik I LMU Klinikum Munchen Munich Germany, Germany (Piperata) Division of Cardiac Surgery IRCCS Azienda Ospedaliero-Universitaria di Bologna Italy, Italy (Ruge) Technical University of Munich, TUM School of Medicine and Health, Department of Cardiovascular Surgery TUM University Hospital German Heart Center Munich Germany, Germany (Li) Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou China, China (Mascherbauer) Universitatsklinikum St. Polten Karl Landsteiner Privatuniversitat fur Gesundheitswissenschaften Dunant-Platz St. Polten Austria, Austria (Waksman) Cardiovascular Research and Advanced Education, MedStar Heart and Vascular Institute MedStar Washington Hospital Center Washington DC USA (Barbash) Interventional Cardiology Unit, Sheba Medical Center, Ramat Gan Tel Aviv University Israel, Israel (Tang) Division of Cardiology, Mount Sinai Medical Center Icahn School of Medicine at Mount Sinai New York NY USA (Gasior) Collegium Medicum - Faculty of Medicine WSB University Dabrowa Gornicza Poland, Poland (Webb) St. Paul's Hospital University of British Columbia Vancouver Canada, Canada (Hioki) Department of Cardiology, Division of Minimal Invasive Treatment Center IMS Tokyo Katsushika General Hospital Katsushika City Tokyo Japan, Japan (Obaid) Morriston Regional Heart Centre Swansea University Medical School Swansea UK (Mangieri) IRCCS Humanitas Research Hospital Rozzano, Milan Italy, Italy (Crimi) Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV) IRCCS Ospedale Policlinico San Martino Genoa Italy, Italy (Joner) TUM University Hospital German Heart Center Technical University of Munich Germany, Germany (Joner) German Center for Cardiovascular Research (DZHK) Berlin Germany, Germany (Toggweiler) Heart Center Lucerne, Switzerland (Mauri) Faculty of Medicine and University Hospital Cologne, Clinic III for Internal Medicine University of Cologne Cologne Germany, Germany (Lin) National Taiwan University Hospital Taipei Taiwan, Taiwan (Republic of China) (Haussig) Herzzentrum Dresden, University Clinic, Department of Internal Medicine and Cardiology Technische Universitaet Dresden Dresden Germany, Germany (Avvedimento, Rodes-Cabau) Quebec Heart & Lung Institute Laval University Quebec City Quebec Canada, Canada (Nanayakkara) Department of Cardiology The Alfred Melbourne Australia, Australia (Nanayakkara) Monash Alfred Baker Centre for Cardiovascular Research, School of Translational Medicine Monash University Melbourne Australia, Australia (Nanayakkara) Heart Failure Research Group Baker Institute Melbourne Australia, Australia (Serruys) Department of Cardiology, School of Medicine University of Galway Ireland, Ireland (Landolff) Department of Cardiology Clinique Saint Hilaire Rouen France, France (Latib) Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center Albert Einstein College of Medicine Bronx NY USA Abstract BACKGROUND: Despite continuous advancements in devices and techniques, transcatheter aortic valve implantation remains associated with complications impacting outcomes. In 2021, the Valve Academic Research Consortium (VARC) introduced the VARC-3 criteria to better classify procedural complications. METHOD(S): We conducted a systematic review and meta-analysis of studies reporting transcatheter aortic valve implantation-related complications using VARC-3 definitions between 2021 and 2025. The primary end point was all-cause mortality at latest follow-up. Secondary end points included major VARC-3 complications and predictors of adverse events. RESULT(S): A total of 57 studies with 73 588 patients were included. The cohort had a mean age of 81.7 years, 51.7% were women, and most had preserved ejection fraction (55.5%) and low-to-moderate surgical risk (Society of Thoracic Surgeons [STS] predicted risk of mortality [PROM] 4.1%). Technical and 30-day device success rates were 95% and 90%, respectively; early safety rate at 30 days was 66%. At average 12 months follow-up, all-cause mortality was 10.2%. The most common complication was permanent pacemaker implantation (13%), followed by type 2 or greater bleeding (9.7%), acute kidney injury stage 3-4 (4.7%), major vascular events (4.3%), and stroke (3.0%). Moderate/severe paravalvular regurgitation and patient-prosthesis mismatch occurred in 4% and 8%, respectively. Study-level pooled predictor analyses showed that acute kidney injury, type 2 or greater bleeding, paravalvular regurgitation, non-structural valve dysfunction, and higher STS score were associated with higher mortality, while eccentric/severe aortic valve calcification was associated with significant paravalvular regurgitation. CONCLUSION(S): Transcatheter aortic valve implantation shows high procedural success but non-negligible complication rates under VARC-3 criteria. acute kidney injury, type 2 or greater bleeding, NSVD, periprocedural stroke and myocardial infarction after transcatheter aortic valve implantation were associated with higher mortality. <57> Accession Number 652301258 Title Quantification of Immediate Surgical Stress After Major and Minor Thoracic Surgeries Through HRV: A Secondary Post Hoc Analysis of a Randomized Controlled Trial. Source Pulmonary medicine. 2026(1) (pp e3752161), 2026. Date of Publication: 2026. Author Miri S.; Lahteenmaki S.; Mahrberg H.; Vehkaoja A.; Laurikka J.; Viik J. Institution (Miri, Lahteenmaki, Vehkaoja, Laurikka, Viik) Finnish Cardiovascular Research Center-Tampere, Tampere University, Tampere, Finland (Miri, Lahteenmaki, Vehkaoja, Laurikka, Viik) Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland (Lahteenmaki, Mahrberg, Laurikka) Tampere University Hospital Heart Center, Tampere, Finland Abstract PURPOSE: Heart rate variability (HRV) reflects autonomic nervous system activity and is sensitive to physiological stress induced by surgery. This study is a secondary, post hoc analysis of a randomized controlled trial aimed at evaluating changes in HRV following major and minor thoracic surgery, and investigating whether postoperative respiratory physiotherapy can modulate these changes. In a prospective, randomized design, two physiotherapy interventions, including positive expiratory pressure (PEP) and inspiratory muscle training (IMT), were compared to assess their effects on HRV. METHOD(S): Electrocardiogram recordings were analyzed from 75 patients undergoing either minor pulmonary (PM) or pulmonary resection (PR) surgery. HRV data were collected preoperatively and during the first two postoperative days, immediately following physiotherapy sessions. Patients were assigned to one of two intervention groups (PEP or IMT). Time-, frequency-, and nonlinear-domain HRV parameters were analyzed longitudinally and compared between surgical and intervention groups. RESULT(S): Most HRV parameters exhibited a postoperative reduction, with more pronounced changes observed in the PR surgery group. In particular, the root mean square of successive RR interval differences (RMSSD) and high-frequency (HF) power, which are commonly associated with parasympathetic modulation, showed marked decreases. Recovery toward baseline values varied across surgical groups, interventions, and HRV parameters; however, no clear signs of recovery were observed in the PR surgery group during the observation period. No statistically significant differences were detected between the PEP and IMT interventions (p >= 0.05), with the exception of short-term detrended fluctuation analysis (DFA alpha1) in the PM surgery group (p = 0.04). CONCLUSION(S): HRV parameters reflected surgery-induced autonomic alterations, with more pronounced and persistent changes observed in patients undergoing PR compared with PM surgery. No clear recovery toward baseline was detected during the 2-day postoperative follow-up, suggesting prolonged autonomic disturbances after thoracic surgery. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02931617. Copyright © 2026 Seyedsadra Miri et al. Pulmonary Medicine published by John Wiley & Sons Ltd. <58> Accession Number 2049254544 Title Residual Atherosclerotic Cardiovascular Disease Risk in Statin Users: A Systematic Review and Meta-Analysis. Source Journal of the American Heart Association. 15(17) (no pagination), 2026. Article Number: e044840. Date of Publication: 20 Aug 2026. Author Watanabe A.H.; Bash L.D.; Westley T.; Garcia A.; Aiello E.; Bradbury J.; Garg J.; Telukuntla V.; Nanna M.G. Institution (Watanabe, Bash) Merck & Co, Inc, Rahway, NJ, United States (Westley, Aiello, Bradbury) Lumanity, Sheffield, United Kingdom (Garcia) Lumanity, Utrecht, Netherlands (Garg, Telukuntla) Lumanity, Gurugram, India (Nanna) Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States Publisher American Heart Association Inc. Abstract BACKGROUND: Statins are the cornerstone of lipid-lowering therapy, reducing low-density lipoprotein cholesterol in adults. However, residual atherosclerotic cardiovascular disease (ASCVD) risk among statin users remains unclear. This study estimated residual ASCVD risk in statin users in practice. METHOD(S): We conducted a systematic literature review and meta-analyses following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, including observational studies published January 1, 2013, to August 1, 2023, that reported ASCVD risk in adult statin users. Five outcomes were assessed: composite risk (major adverse cardiovascular events or all-cause death), myocardial infarction, ischemic stroke, cardiovascular-related death, and coronary revascularization. Meta-analysis methods were used to synthesize individual study estimates. For each outcome, forest plots present study-level estimates and the pooled incidence rate per 1000 person-years (PPY). RESULT(S): The meta-analysis of residual composite risk (major adverse cardiovascular events or all-cause death) in the overall population was 12.3 PPY (range, 0.2-72.0). Rates were lower in adults at risk of ASCVD (6.4 PPY [range, 3.7-9.8 PPY]) and higher in adults with prior ASCVD (15.8 PPY [range, 0.2-72.0 PPY]). Meta-analysis for myocardial infarction showed 8.23 PPY (range, 1.1-88.82 PPY) in the overall patient population, and a lower rate of ischemic stroke with a rate of 6.0 PPY (range, 1.4-18.8 PPY). A rate of 4.3 PPY (range, 0.4-22.9 PPY) was estimated for cardiovascular-related death, and 7.4 PPY for coronary revascularization (range, 3.1-27.6 PPY). CONCLUSION(S): Despite substantial between-study variability, this real-world meta-analysis indicates meaningful residual ASCVD risk among statin users, underscoring persistent treatment gaps and need for comprehensive, optimized risk management. Copyright © (2026), The Authors and Merck Sharp & Dohme LLC. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. <59> Accession Number 2049972661 Title Racial Differences in the Incidence and Outcomes of Postoperative Atrial Fibrillation After Isolated Coronary Artery Bypass Grafting: A Systematic Review. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Fields A.; Vo J.; Elsherbini A.; Hasheminia A.; Barzegar N.S.; Rodriguez M.; Abu-Omar Y.; El-Diasty M. Institution (Fields, Vo) College of Arts & Sciences, Case Western Reserve University, Cleveland, OH, United States (Elsherbini) Temerty Faculty of Medicine, University of Toronto, Toronto, Canada (Hasheminia) McGill Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada (Barzegar) Faculty of Health Sciences, Queen's University, Kingston, Canada (Rodriguez) School of Applied Life Sciences, Keck Graduate Institute, Claremont, CA, United States (Abu-Omar, El-Diasty) Cardiac Surgery Department, University Hospitals Cleveland Medical Center, Cleveland, OH, United States Publisher W.B. Saunders Abstract Postoperative atrial fibrillation (POAF) is a common complication after coronary artery bypass grafting (CABG), with an estimated incidence of up to 20% to 40%. Existing evidence suggests that inequities in access to health care may impact clinical outcomes following POAF. This systematic review was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines across the Cochrane, MEDLINE, and Embase databases to retrieve potential studies. Studies reporting racial and/or socioeconomic differences in the incidence or outcomes of new-onset POAF after isolated CABG were included. Title and abstract screening and full-text review were performed using Covidence software for systematic reviews. The risk of bias was assessed using the JBI Critical Appraisal Tool. The search strategy retrieved 1,155 studies. After duplicate removal, 1,149 studies underwent the screening process. Eventually, 6 studies were included for data extraction. The results showed a higher reported incidence of POAF among White patients than among African American and other racial and ethnic groups. However, African American patients appear to have worse survival after developing POAF. Income, education, insurance status, and other socioeconomic or access-to-care variables were not consistently reported or adjusted for in the included studies. Racial differences can impact the incidence and clinical outcomes in patients who develop POAF after CABG. Future work could investigate the role of other socioeconomic factors. Copyright © 2026 Elsevier Inc. <60> Accession Number 652288381 Title Effects of Inspiratory Muscle Training on Pulmonary Recovery and Complications in Cardiothoracic Surgery: A Systematic Review and Meta-Analysis. Source AORN journal. 124(4) (pp 293-297), 2026. Date of Publication: 01 Oct 2026. Author Allen G. <61> Accession Number 2049998713 Title Recent Trials of Left Atrial Appendage Closure versus Oral Anticoagulants: An Optimistic View. Source Thrombosis and Haemostasis. (no pagination), 2026. Article Number: TH-26-08-0492. Date of Publication: 2026. Author Camm A.J. Institution (Camm) Division of Cardiac and Vascular Sciences, City St George's University of London, London, United Kingdom Publisher Georg Thieme Verlag Abstract Thrombus formation in atrial fibrillation mostly occurs in the left atrial appendage (LAA). LAA closure (LAAC) seems logical to reduce thrombo-embolic AF-related stroke. Early device trials, which predominantly compared LAAC against oral anticoagulant (OAC) with warfarin, showing after 5 years less bleeding and possibly similar ischemic stroke rates with LAAC. New trials (CHAMPION-AF, OPTION, CLUSTER-AF and ASAP TOO) comparing LAAC versus direct OACs, or standard of care for the OAC-intolerant, have reported apparently discordant results, most probably related to the patient phenotype than LAAC itself. Recent meta-analyses, which include new trials have shown that overall, LAAC is followed by less clinically-relevant bleeding but more ischemic but not total strokes. Longer follow-up offsetting penalties related to the implant procedure, more expert implantation and reduced device-related thrombosis should increase the comparative value of LAAC. Meanwhile, LAAC offers therapeutic relief for OAC-intolerant patients or for those wh, understand the outcomes of LAAC and prefer device rather than medical therapy. A change in guideline recommendations should now be considered. Copyright © 2026. Thieme. All rights reserved. <62> Accession Number 2050176147 Title Interventions to Promote Utilisation of Cardiac Rehabilitation: 2026 Cochrane Systematic Review and Meta-Analysis. Source Heart Lung and Circulation. (no pagination), 2026. Date of Publication: 2026. Author Long L.; Lin C.Z.; Davies P.; Wells V.; Grace S.L.; Taylor R.S. Institution (Long, Wells, Taylor) School of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom (Lin) School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom (Davies) Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom (Grace) School of Kinesiology and Health Science, York University, Toronto, ON, Canada (Grace) Toronto Rehabilitation Institute & Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada Publisher Elsevier Ltd Abstract Background: Despite strong evidence of benefit and guideline recommendation, access to cardiac rehabilitation remains low across global healthcare systems. We provide a 2026 analysis of our previous Cochrane review of randomised trial evidence for interventions designed to increase cardiac rehabilitation enrolment, adherence, and completion. Method(s): We searched CENTRAL, MEDLINE, Embase, CINAHL, CPCI-S, and trial registries up to 10 March 2025, without language restrictions. We included randomised controlled trials involving adults eligible for cardiac rehabilitation following myocardial infarction, angina, coronary revascularisation, or heart failure. Risk of bias was assessed using the Cochrane tool, and certainty of evidence assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Data on cardiac rehabilitation enrolment, adherence, and completion were pooled using random-effects meta-analysis. Result(s): A total of 47 trials involving 10,803 participants were included. Most common intervention strategies included: education, self-management training, or motivational interviewing; alternative delivery models (home-based, digital, or hybrid); invitation letters or messaging prompts; and peer support. Compared to control, interventions showed improvements in cardiac rehabilitation program enrolment (relative risk [RR]: 1.19, 95% confidence interval [CI]: 1.11 to 1.29; participants; 27 trials, 7,216 participants; low-certainty evidence), cardiac rehabilitation program adherence (standardised mean difference: 0.32, 95% CI: 0.15 to 0.49; 18 trials, 3,024 participants; moderate-certainty evidence), and cardiac rehabilitation completion (RR:1.22, 95% CI: 1.10 to 1.35; 19 trials, participants: 5,432; moderate-certainty evidence). Conclusion(s): To overcome the persistent challenge of suboptimal cardiac rehabilitation utilisation, global healthcare systems should consider a multifaceted approach to improving cardiac rehabilitation utilisation that combines patient- and system-level intervention strategies identified in this review. Further high-quality trials targeting underserved populations are needed in order to optimise equity in future cardiac rehabilitation access. Copyright © 2026 The Authors <63> Accession Number 2050094087 Title Artificial Intelligence and Machine Learning for Predicting 1-Year Mortality after Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis. Source International Journal of Angiology. (no pagination), 2026. Date of Publication: 2026. Author Senapati S.G.; Shetty U.S.A.; Trivedi Y.; Srivastava A.; Mohnani P.; Desai R.; Mukherjee D. Institution (Senapati) Department of Internal Medicine, Texas Tech University, Health Sciences Center, El Paso, TX, United States (Shetty) Department of Internal Medicine, Southern Regional Medical Center, Riverdale, GA, United States (Trivedi) Department of Internal Medicine, Nassau University, Medical Center, East Meadow, NY, United States (Srivastava) Department of Internal Medicine, Boston Medical Center, Brighton, MA, United States (Mohnani) Department of Internal Medicine, Parkview Health, Fort Wayne, IN, United States (Desai) Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, GA, United States (Mukherjee) Division of Cardiovascular Medicine, Department of Internal Medicine, Texas Tech University, Health Sciences Center, El Paso, TX, United States Publisher Thieme Medical Publishers, Inc. Abstract The prediction of mortality after transcatheter aortic valve replacement (TAVR) is important in risk stratification, selection of patients, and the joint decision-making process. Conventional surgical and TAVR-specific risk scores have poor predictive ability, while artificial intelligence (AI)/machine learning (ML) models can provide better performance in capturing the complex nature of interdependencies between variables. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 protocol. PubMed, Scopus, and Google Scholar were systematically searched from inception to September 2025 for papers describing AI/ML models used in predicting mortality at 1 year following TAVR. The eligible papers reported either area under the receiver operating characteristic curve (AUC)/C-statistics with 95% confidence intervals (95% CIs) or had enough data for calculation. Papers that lacked comparable outcome measures, did not report on discrimination, or did not employ AI/ML methods were excluded from further analysis. The pooled estimates were estimated using the random-effects model. The risk of bias and applicability assessment was performed using PROBAST criteria. Four retrospective studies comprising 1,732 patients who underwent TAVR were included. ML-based gradient boosting and clustering were used as methods. The overall pooled estimate of AUC for 1-year mortality prediction was 0.76 (95% CI: 0.71-0.81; p < 0.01) with considerable heterogeneity (I2 = 64.76%, p = 0.04). Sensitivity analysis with the leave-one-out method showed consistent results for pooled estimates. AI/ML models proved their ability in predicting 1-year mortality following TAVR with moderate discrimination ability. Future research requires larger sample sizes in prospective studies. Copyright © 2026. International College of Angiology. All rights reserved. <64> Accession Number 2050124021 Title The effect of surgical prehabilitation on autonomic nervous system regulation: Rationale and design of the TUNE trial. Source Contemporary Clinical Trials. 170 (no pagination), 2026. Article Number: 108486. Date of Publication: 01 Nov 2026. Author D'Amico F.; Misceo F.; Benato C.; Veneziano M.; Maj G.; Notarianni L.; Guarracino F.; Oliva F.M.; Valsecchi C.; De Piccoli N.; Pontillo D.; Turi S.; Fossati L.; Ghezzi M.; Tucci M.; Belhassen L.; Bove T.; Novellis P.; Gottin L.; Paternoster G.; Landoni G.; Donadello K.; Veronesi G.; Borello M.; Bruno S.; Chiodi B.; Fumagalli A.; Giardina G.; Kozhan P.; Lembo R.; Mongardini E.; Nakhnoukh C.; Muriana P.; Tambasco A.M.; Scala C.; Viscardi S.; Barletta F.; Briganti A.; Corti G.; Tettamanti A.; Anderloni M.; Fasan M.; Rama J.; Ridolfi C.; Villano M.; Cusumano G.; Colombo S.M.; Romano B.; Dinatale G.; Meda S.; Meroi F. Institution (Borello, Bruno, Chiodi, Fumagalli, Giardina, Kozhan, Lembo, Mongardini, Nakhnoukh) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Muriana, Tambasco, Scala, Viscardi) Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy (Barletta, Briganti) Unit of Urology, Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Milan, Italy (Barletta, Briganti) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Corti, Tettamanti) Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy (Anderloni, Fasan, Rama) Department of Surgery, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy (Anderloni) Anesthesia and Intensive Care Unit B, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy (Fasan, Rama) Cardio-Thoraco-Vascular Anesthesia and Intensive Care Unit, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy (Ridolfi) Mini-Invasive and Robotic Thoracic Surgery Unit, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy (Villano) Department of Cardiothoracic and Vascular Anesthesia and ICU, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy (Cusumano) UOC Chirurgia Toracica, Azienda Ospedaliero Universitaria Policlinico San Marco, Catania, Italy (Cusumano) Universita di Catania, Catania, Italy (Colombo) Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy (Colombo) Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy (Romano) Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy (Dinatale) Department of General and Emergency Surgery, San Carlo Hospital, Potenza, Italy (Meda) Department of Thoracic Surgery, University Hospital of Alessandria, Alessandria, Italy (Meroi) Department of Emergency, University Hospital of Udine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy (D'Amico, Veneziano, Notarianni, Oliva, De Piccoli, Pontillo, Turi, Fossati, Ghezzi, Tucci, Belhassen, Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Misceo, Novellis, Veronesi) Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy (Benato) Mini-Invasive and Robotic Thoracic Surgery Unit, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy (Maj) Department of Cardiothoracic and Vascular Anesthesia, University Hospital of Alessandria, Alessandria, Italy (Valsecchi) Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy (Bove) Department of Basic Biotechnological Sciences, Intensive Care Peri-Operative Clinics, Universita Cattolica del Sacro Cuore, Rome, Italy (Bove) Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy (Misceo, Novellis, Landoni, Veronesi) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Gottin, Donadello) Department of Surgery, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy (Gottin) Cardio-Thoraco-Vascular Anesthesia and Intensive Care Unit, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy (Paternoster) Department of Health Sciences, University of Basilicata, Potenza, Italy (Paternoster) Anesthesia and ICU, San Carlo Hospital, Potenza, Italy (Donadello) Anesthesia and Intensive Care Unit B, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy (Guarracino) Department of Medical, Dental and Biotechnological Sciences, University "G. D'Annunzio" Chieti - Pescara, Chieti, Italy (Guarracino) Department of Anaesthesia, Resuscitation and Intensive Care, University Hospital SS Annunziata, Chieti, Italy Publisher Elsevier Inc. Abstract Background: Prehabilitation improves physiological readiness for major surgery; however, its implementation and evaluation remain inconsistent, particularly in thoracic surgery. Current assessments largely rely on functional tests, which are difficult to standardize and provide limited knowledge of biological resilience. Heart-rate variability (HRV) is an objective marker of autonomic nervous system balance and is already widely used in sports medicine to guide training intensity and evaluate the relationship between physiological stress and recovery. Given its ability to capture the dynamicity and flexibility of autonomic regulation, HRV may become a practical tool to assess the physiological effects of prehabilitation interventions, going beyond traditional endpoints. Method(s): The TUNE trial is a multicenter, open label, randomized controlled trial involving patients scheduled for elective major thoracic surgery. Participants are randomized in a 1:1 ratio to receive either a home-based multimodal prehabilitation program in addition to standard care or standard care alone. The intervention consists of a 4 week remotely delivered program including structured physical exercise, personalized nutritional optimization and psychological support. Result(s): The trial is ongoing and currently recruiting participants. The primary endpoint is the between-group difference in the change of HRV, measured as the standard deviation of normal-to-normal intervals (SDNN), from baseline to preoperative assessment. Secondary outcomes include correlations between HRV and clinical outcomes. Conclusion(s): The TUNE trial will provide data to assess whether a prehabilitation program can improve HRV and facilitate recovery in patients undergoing major thoracic surgery. Trial registration: This trial was registered on ClinicalTrials.gov with the trial identification NCT06398301. Copyright © 2026 Published by Elsevier Inc. <65> Accession Number 2050176771 Title Predictors of Recurrent Myocardial Ischemia After Coronary Artery Bypass Grafting and Subsequent Need for Percutaneous Coronary Intervention: A Prospective Cohort Study. Source International Journal of Drug Delivery Technology. 16(85 supplement) (pp 1016-1030), 2026. Date of Publication: 2026. Author Khan M.Y.; Shahzad K.; Alrashid F.F.; Ilyas M.; Bhatti M.I.; Atzaz N.; Alsareii S.A.; Khatoon F. Institution (Khan) Cardiac Surgery, Sardar Fateh Muhammad Khan Buzdar Institute of Cardiology, DG Khan, Pakistan (Shahzad) Cardiology, DHQ Hospital, Hafizabad, Pakistan (Alrashid) Surgery Department, University of Ha'il, Saudi Arabia (Ilyas) Medicine, Watim Medical College, Rawalpindi, Pakistan (Bhatti) Biochemistry, Indus Medical College, Tando, Pakistan (Atzaz) Chemical Pathology, Rawal Institute of Health Sciences, Islamabad, Pakistan (Alsareii) College of Medicine, Najran University, Saudi Arabia (Khatoon) College of Medicine, University of Ha'il, Saudi Arabia Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Patients with a severe coronary artery condition benefit from coronary artery bypass grafting (CABG) as one of the available revascularisation options, but recurrent myocardial ischemia and the downstream requirement of PCI (percutaneous coronary intervention) are a major challenge in the long-term clinical management. Proper identification of high-risk patients for recurrent ischemic events after CABG could have the potential to optimize aftercare plans, allow early intervention and achieve better cardiovascular outcomes. This study was an attempt to identify clinical, metabolic and surgical predictors for recurrent myocardial ischemia and subsequent PCI requirement after CABG. Method(s): A prospective cohort study was conducted at Niazi Hospital Sargodha, Pakistan, on patients with coronary artery disease (CAD) undergoing coronary artery bypass graft surgery (CABG). Prospective data regarding demographics, clinical, laboratory, angiography and surgical parameters were obtained. Age, gender, BMI, DM, HbA1c, hypertension, chronic kidney disease, smoker, LVEF, graft characteristics, complete revascularisation and complications were evaluated. Patients were systemically followed for the development of recurrent myocardial ischemia and the need for subsequent PCI. The descriptive analysis, normality testing, independent samples t-test, one-way ANOVA, Kruskal-Wallis test and Chi-square test for differences and comparisons were used in statistical analysis. A multivariable regression analysis and Pearson correlation were used to look for independent predictors of PCI following CABG. Result(s): Multiple clinical and procedural parameters were significantly linked with recurrent myocardial ischemia and need for subsequent PCI. Higher cardiovascular risk was associated with increased incidence of adverse ischemic outcomes, with patients with cardiovascular risk factors such as diabetes mellitus, high HbA1C, chronic kidney disease, smoking history and risk scores having higher risk. Failure of the graft was found to be one of the greatest risk factors for repeat intervention. A positive association between each cardiovascular risk factor (except for age) and recurrent ischemia and PCI requirement was shown by correlation analysis. Graft failure, diabetes mellitus, poor glucose control, chronic kidney disease, smoking and overall risk burden were found to be independent predictors of subsequent PCI after CABG by multivariable regression analysis. Conclusion(s): Patient-related, metabolic and graft-related factors all play a role in the development of recurrent myocardial ischemia after CABG. Graft failure, diabetes, inadequate glycemic control, renal dysfunction, smoking and cardiac dysfunction are significant risks for repeat coronary interventions. Recognizing high-risk patients at the early stage and beginning appropriate secondary prevention measures could lead to a better long-term outcome and help minimize recurrent ischaemic events after CABG. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <66> Accession Number 2049434134 Title A visualization analysis of research hotspots and trends in enhanced recovery after surgery (ERAS) for elderly patients based on web of science and scopus. Source Journal of Cardiothoracic Surgery. 21(1) (no pagination), 2026. Article Number: 725. Date of Publication: 01 Dec 2026. Author Xiao C.; Wang Y.; Sun Y.; Zou S.; Yang X. Institution (Xiao, Wang, Zou, Yang) Department of Anesthesiology, Affiliated Hospital of Jiangsu University, Jiangsu, Zhenjiang, China (Sun) Binzhou People's Hospital, Shandong, Binzhou, China Publisher BioMed Central Ltd Abstract Aims: To analyze the research landscape and thematic evolution of enhanced recovery after surgery (ERAS) in elderly patients from 2009 to 2025 using bibliometric methods. Method(s): Publications were retrieved from the Web of Science Core Collection and Scopus databases, limited to English articles and reviews. CiteSpace and VOSviewer were used to analyze annual publication trends, international and institutional collaboration networks, keyword co-occurrence, clustering, and burst detection. Result(s): A total of 773 publications were included. Annual publication output increased markedly after 2017. China (183 publications, 23.7%) and the United States (152 publications, 19.7%) were the leading contributors. Keyword clustering identified nine major thematic clusters (Q = 0.4617,S = 0.7527),with "lung neoplasms" and "esophagus resection" emerging as independent clusters. A sub-analysis revealed that 37 publications (4.8%) specifically addressed thoracic surgery, indicating that thoracic ERAS represents an emerging but still underdeveloped subfield within the overall ERAS research landscape. Among the top 20 high-frequency keywords, "aged" (519 occurrences, 67.1%) and "enhanced recovery after surgery" (504 occurrences, 65.2%) were the most prominent. Burst detection revealed 25 keywords with significant citation surges. Recent high-intensity bursts included "functional status" (strength = 7.18), "preoperative exercise" (strength = 6.28), and "physiotherapy" (strength = 5.38), indicating a shift toward functional recovery and prehabilitation. Major research themes focused on frail older populations, colorectal and oncologic surgical applications, perioperative analgesia, and prehabilitation strategies. Temporal overlay and burst analyses indicated sustained prominence of terms such as "functional status", "frailty", and "preoperative exercise". Conclusion(s): Research on ERAS in elderly patients has evolved into a multi-thematic knowledge structure with an increasing emphasis on functional outcomes and personalized perioperative management. Copyright © The Author(s) 2026. <67> Accession Number 2049424593 Title Baseline peak VO2 and treatment effect consistency of perioperative rehabilitation in cardiac valve surgery: an exploratory subgroup analysis of the PORT trial. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 588. Date of Publication: 01 Dec 2026. Author Wang R.; Huang Z.; Jiang Z.; Bai B.; Chang J.; Zhu J.; Lin K.; Ma H. Institution (Wang, Zhu, Ma) School of Medicine South China University of Technology, Guangzhou, China (Wang, Bai, Zhu, Ma) Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, No. 106, Zhongshan Second Road, Yuexiu District, Guangdong, Guangzhou, China (Huang) Department of Traditional Chinese Medicine, Zhujiang Hospital, Southern Medical University, Guangdong, Guangzhou, China (Jiang) Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China (Bai) The Third Affiliated Hospital of Zhengzhou Universit, The Third Affiliated Clinical Medical College of Zhengzhou University, Zhengzhou, China (Chang) Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Lin) Zhongshan Hospital of Traditional Chinese Medicine, No. 3 Kangxin Road, West District, Guangdong, Zhongshan, China Publisher BioMed Central Ltd Abstract Background: In the PORT trial (Perioperative Rehabilitation in Patients Undergoing Elective Cardiac Valve Surgery: A Randomised Controlled Trial), a short-term multidomain perioperative rehabilitation programme was associated with a reduced incidence of postoperative pneumonia in patients undergoing elective cardiac valve surgery. Whether baseline peak oxygen consumption (peak VO2), a marker of cardiorespiratory reserve, modifies the effect of this intervention remains uncertain. Objective(s): To evaluate whether the association between perioperative rehabilitation and postoperative outcomes differs according to baseline peak VO2 (<= 20 vs. > 20 mL.kg-1.min-1). Method(s): This exploratory subgroup analysis included 702 participants from the PORT trial who underwent preoperative cardiopulmonary exercise testing. Patients were stratified by baseline peak VO2 and randomized to perioperative rehabilitation-comprising education, inspiratory muscle training, active cycle of breathing techniques, and early mobilization-or usual care. The primary endpoint was a composite of in-hospital all-cause mortality, postoperative pulmonary complications (PPCs), and prolonged hospitalization (> 7 days). Logistic and Cox regression models adjusted for prespecified covariates were used to estimate treatment effects within peak VO2 strata, and treatment-by-peak VO2 interactions were tested. Result(s): Of 702 participants, 202 (29%) had peak VO2 >20 and 500 (71%) had peak VO2 <=20 mL.kg-1.min-1. The composite primary endpoint did not differ significantly between rehabilitation and usual care in either stratum (interaction P = 0.62). Perioperative rehabilitation was associated with a lower incidence of postoperative pneumonia in both peak VO2 >20 mL.kg-1.min-1 (adjusted OR 0.30; 95% CI 0.13-0.71) and <= 20 mL.kg-1.min-1 (adjusted OR 0.65; 95% CI 0.47-0.90), with no significant interaction between peak VO2 category and treatment effect (P for interaction = 0.12). No significant effect modification was observed for other outcomes, including SICU stay, total hospitalization duration, or 3-month mortality. Conclusion(s): In this exploratory analysis of the PORT trial, the reduction in postoperative pneumonia associated with short-term perioperative rehabilitation was consistent across strata of baseline peak VO2. These findings suggest that the pneumonia benefit of respiratory-focused perioperative rehabilitation may not depend on baseline cardiorespiratory fitness, although adequately powered studies are required to definitively assess effect modification. Although the observed reduction in pneumonia was statistically significant and biologically plausible, it arose from a secondary exploratory analysis without adjustment for multiple comparisons and should therefore be interpreted with caution. Copyright © The Author(s) 2026. <68> Accession Number 2050098931 Title Pretreatment with P2Y<inf>12</inf> inhibitors in Acute and Chronic Coronary Syndromes: for whom, when and how. Source American Journal of Medicine. (no pagination), 2026. Date of Publication: 2026. Author Cirillo P.; Berteotti M.; Galli M.; Gargiulo G.; Gragnano F.; Terracciano F.; Cavallari I.; Ricottini E.; Greco A.; Capranzano P.; Renda G.; Prisco D.; Calabro P.; Patti G.; Marcucci R.; Capodanno D.; Filardi P.P.; Angiolillo D.J.; Gibson C.M.; De Caterina R. Institution (Cirillo, Gargiulo, Filardi) Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy (Berteotti, Prisco, Marcucci) Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy (Galli) Istituto di Ricovero e Cura a Carattere Scientifico Maria Cecilia Hospital, Gruppo Villa Maria Care & Research, Cotignola, Italy (Gragnano, Terracciano, Calabro) Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Caserta, Italy (Gragnano, Terracciano, Calabro) Division of Clinical Cardiology, Azienda Ospedaliera di Rilievo Nazionale "Sant'Anna e San Sebastiano", Caserta, Italy (Cavallari, Ricottini) Unit of Cardiac Sciences, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy (Greco, Capranzano, Capodanno) Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy (Renda) Department of Neuroscience, Imaging and Clinical Sciences, and Center for Advanced Studies and Technology (CAST), G. d'Annunzio University Chieti-Pescara, Italy (Patti) University of Piemonte Orientale, Department of Cardiology, Ospedale Maggiore della Carita di Novara, Italy (Angiolillo) Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, United States (Gibson) Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States (De Caterina) Department of Surgical, Medical and Molecular Pathology and of Critical Sciences, University of Pisa, Pisa, Italy Publisher Elsevier Inc. Abstract In patients with acute or chronic coronary syndromes undergoing percutaneous coronary intervention, dual antiplatelet therapy-with aspirin and a P2Y<inf>12</inf> inhibitor-is the cornerstone of pharmacological treatment to prevent stent thrombosis and atherothrombotic complications. However, the timing of P2Y<inf>12</inf> inhibitor initiation has been a matter of considerable debate. Administering a P2Y<inf>12</inf> inhibitor added to aspirin before percutaneous coronary intervention without knowing coronary anatomy has the potential to ensure antithrombotic protection at percutaneous coronary intervention and to reduce procedural thrombotic complications, but also exposes patients to an increased bleeding risk, may prevent or retard surgical myocardial revascularization when needed, and may be futile or even dangerous in patients not requiring percutaneous coronary intervention. The latest 2023 European Society of Cardiology guidelines have downgraded previous recommendations to pretreatment also in ST-elevation myocardial infarction. The present Systematic Review and Consensus Document aims at reviewing clinical evidence on pretreatment across various clinical scenarios, proposing a nuanced approach that considers clinical presentation, time to treatment, the clinical setting and the probability of non-thrombotic primary causes. Copyright © 2026 Elsevier Inc. <69> Accession Number 2049999811 Title Continuous superficial parasternal intercostal plane block after cardiac surgery: a systematic review of preliminary evidence. Source British Journal of Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Dost B.; Turunc E.; Karapinar Y.E.; De Cassai A. Institution (Dost, Turunc) Department of Anesthesiology and Reanimation, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey (Karapinar) Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpasa Faculty of Medicine, Istanbul, Turkey (De Cassai) Department of Medicine (DIMED), University of Padua, Padua, Italy (De Cassai) Institute of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy Publisher Elsevier Ltd <70> Accession Number 2049865962 Title Triglyceride-glucose index as a metabolic risk marker for adverse outcomes after coronary artery bypass grafting: a systematic review and meta-analysis. Source Frontiers in Endocrinology. 17 (no pagination), 2026. Article Number: 1909829. Date of Publication: 11 Sep 2026. Author Zhang Y.; Zeng Y.; Ning Y.; Wang H.; Yang X.; Liao X.; Zhang Z. Institution (Zhang, Zeng, Liao, Zhang) Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China (Ning) Xiangya School of Medicine, Central South University, Hunan, Changsha, China (Wang) The Second Xiangya Hospital of Central South University, Hunan, Changsha, China (Yang) The First Clinical Medical College, Shanxi Medical University, Shanxi, Taiyuan, China (Liao, Zhang) Hunan Provincial Clinical Research Center for Cardiovascular Surgery, Hunan, Changsha, China Publisher Frontiers Media SA Abstract Aims - To evaluate the prognostic value of the triglyceride-glucose index (TyG), a surrogate marker of insulin resistance, for adverse cardiovascular outcomes in patients undergoing coronary artery bypass grafting (CABG). Materials and methods - This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies evaluating the association between the TyG index and postoperative outcomes after CABG were retrieved from four databases as of Jul 10, 2026. Multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were used as the primary effect estimates for major adverse cardiovascular events (MACE), with separate analyses conducted for each 1-unit increase in the TyG index and for TyG index tertiles. Crude odds ratios (ORs) comparing the higher TyG group with the lower TyG group were estimated as a supplementary event-based analysis. Results - Six retrospective cohort reports, comprising 5, 978 participants and four independent cohort families, were included, with two being multi-center studies. Each 1-unit increase in the TyG index was associated with a 62.4% higher hazard of MACE (HR: 1.624, 95% CI: 1.349-1.955). Compared with the lowest tertile group, the highest tertile group demonstrated a statistically higher hazard of MACE (HR = 2.093, 95% CI: 1.635-2.680). A higher TyG index was associated with higher odds of MACE (OR: 2.59, 95% CI: 1.97-3.40). In addition, a higher TyG index was associated with an elevated risk of all-cause mortality, nonfatal stroke, and nonfatal myocardial infarction, but was not associated with revascularization. Conclusion - The TyG index may serve as an accessible supplementary metabolic risk marker following CABG. Further prospective validation is required before it is routinely applied to individual risk prediction. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251158075 Copyright © 2026 Zhang, Zeng, Ning, Wang, Yang, Liao and Zhang. <71> Accession Number 2049947242 Title Association of SGLT2i With Cardiovascular and Renal Outcomes After Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis. Source CJC Open. (no pagination), 2026. Date of Publication: 2026. Author Hu C.; Wang X.; Ye Q.; Ernst M.; Paneni F.; Oudit G.Y.; Baczko I.; Bojti I.; Abraham D.; Szabo G.T.; Bergler-Klein J.; Pokreisz P.; Kiss A.; Podesser B.K. Institution (Hu, Ye, Ernst, Szabo, Pokreisz, Kiss, Podesser) Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Vienna, Austria (Hu, Ye, Ernst, Kiss, Podesser) Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria (Wang) Department of General Surgery, Sichuan Provincial People's Hospital East Sichuan Hospital & Dazhou First People's Hospital, Sichuan Province, Dazhou, China (Wang) Dazhou Maternal and Child Health Hospital, Sichuan Province, Dazhou, China (Paneni) Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, University Hospital Zurich and University of Zurich, Schlieren, Switzerland (Paneni) Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland (Oudit) Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada (Oudit) Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada (Baczko) Department of Pharmacology and Pharmacotherapy, Albert Szent-Gyorgyi Medical School, University of Szeged, Szeged, Hungary (Bojti) Department of Cardiology and Angiology, University Heart Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany (Abraham) Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria (Szabo) Institute of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary (Bergler-Klein) Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria Publisher Elsevier Inc. Abstract Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have demonstrated consistent cardiovascular benefits across a broad range of high risk populations. However, their role after transcatheter aortic valve implantation (TAVI) remains incompletely defined. Therefore, we conducted this systematic review to comprehensively evaluate the association of SGLT2i therapy with mortality, heart failure, and renal outcomes after TAVI. Method(s): Randomised controlled trials and observational cohort studies comparing SGLT2i users with nonusers or standard care were included. The prespecified outcomes were 1-year all-cause mortality, long-term all-cause mortality (follow-up >= 2 years), heart failure hospitalisation, a composite clinical end point, and acute kidney injury (AKI). Random-effects models were used to pool hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs). Result(s): Eight studies comprising 14,785 patients were included. Post-TAVI SGLT2i therapy was associated with a lower risk of 1-year all-cause mortality (HR 0.72, 95% CI 0.61-0.84; P < 0.001), >= 2-year all-cause mortality (HR 0.59, 95% CI 0.51-0.67; P < 0.001), heart failure hospitalisation (HR 0.63, 95% CI 0.44-0.91; P = 0.013), and the composite clinical end point (HR 0.74, 95% CI 0.64-0.84; P < 0.001). In contrast, no significant overall reduction was observed for AKI (OR 0.68 95% CI 0.36-1.30; P = 0.247). The 1-year mortality and HF hospitalisation estimates were sensitive to omission of individual studies. Conclusion(s): In patients undergoing TAVI, SGLT2i therapy was associated with lower risks of short- and long-term mortality, heart failure hospitalisation, and composite clinical events, whereas no statistically significant association with AKI was observed. Copyright © 2026 The Authors <72> Accession Number 652280844 Title Efficacy of perioperative recombinant human brain natriuretic peptide for preventing acute kidney injury after cardiac surgery: Rationale, design, and study protocol for a multicenter, double-blind, randomized controlled trial (PROTECT-CS). Source American heart journal. (pp 107615), 2026. Date of Publication: 26 Sep 2026. Author Han J.; Ma X.; Chen Q.; Zhou H.; Li F.; Li H.; Liu L.; Cai J.; Du J.; Zhang H.; Liu S. Institution (Han, Ma, Li) National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Chen) Department of Cardiovascular Surgery, First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Fujian Province, Xiamen, China (Zhou, Li, Du, Zhang, Liu) National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Liu, Cai) National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Nephrology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China Abstract BACKGROUND: Acute kidney injury (AKI) is one of the most common and consequential complications after cardiac surgery. Despite improvements in perioperative care, no pharmacological intervention has been definitively shown to prevent AKI following cardiac surgery. Recombinant human brain natriuretic peptide (rhBNP) shares structural and biological activity with endogenous brain natriuretic peptide and has demonstrated favorable natriuretic, diuretic, and renal hemodynamic effects in prior studies. However, robust randomized evidence on whether perioperative rhBNP can prevent AKI is lacking. DESIGN: This is an investigator-initiated, multicenter, prospective, randomized, double-blind, placebo-controlled, parallel-group trial comparing perioperative rhBNP with placebo in high-risk patients undergoing elective on-pump cardiac surgery. A total of 694 participants will be randomized 1:1 to receive a continuous intravenous infusion of rhBNP (0.01 microg/kg/min) or matched normal-saline placebo, initiated between anesthesia induction and the onset of cardiopulmonary bypass and continued for 48 +/- 2 hours. The primary efficacy endpoint is the incidence of AKI within 7 postoperative days defined by Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints include AKI severity and duration, renal replacement therapy during the index hospitalization, major adverse kidney events at 30 and 90 days (MAKE-30, MAKE-90), 30-day all-cause mortality, intensive care unit and total length of stay. CONCLUSION(S): To our knowledge, PROTECT-CS is the first adequately powered, multicenter, double-blind randomized trial designed to evaluate whether perioperative rhBNP prevents AKI after high-risk cardiac surgery. The study is intended to provide high-quality evidence to inform clinical practice and future guideline recommendations on pharmacological renal protection in cardiac surgery patients. TRIAL REGISTRATION: ClinicalTrials.gov, identifier NCT07617675. Copyright © 2026. Published by Elsevier Inc. <73> Accession Number 2049983491 Title Statins for older adults: Still useful at declining life expectancy?. Source Geneesmiddelenbulletin. 59(8) (no pagination), 2025. Article Number: e2025.8.21. Date of Publication: 2025. Author van de Peppel R. Publisher Stichting Geneesmiddelenbulletin Abstract Introduction Statins still constitute the cornerstone of cholesterol-lowering therapy to prevent cardiovascular diseases. In 2023, no less than 40% of the Dutch population aged over 75 years were using cholesterol-lowering pharmacotherapy. This article discusses the scientific rationale of this large-scale use among the older population. Methods A literature search found a meta-analysis on statins from 2019, which included a large cohort of patients aged over 75 years. This meta-analysis also included the PROSPER study, which exclusively concerned persons older than 70 years. The main outcome measure was the incidence of serious vascular events (myocardial infarction, whether or not fatal, coronary revascularisation or stroke). Results The meta-analysis included 14,483 participants aged over 75 years, over a median period of 4.9 years. The relative risk of a serious vascular event was 0.87 (95% CI 0.77 to 0.99) per 1 mmol/L decline of LDL-cholesterol levels. The relative risk for the indication of primary prevention was 0.92 (0.73 to 1.16) while the relative risk for secondary prevention was 0.85 (0.73 to 0.98) per 1 mmol/L decline of LDL-cholesterol levels. The PROSPER study, which included 5804 patients, found a 15% reduction of the relative risk of vascular events (whether or not fatal) in the pravastatin group compared to the placebo group. For the indication of primary prevention, the hazard ratio was 0.94 (0.77 to 1.15), and for secondary prevention this was 0.78 (0.66 to 0.93). Conclusion The meta-analysis and the PROSPER study show, with a very high evidence level, that statins are effective, based on hard cardiovascular endpoints, in patients older than 75 years with a history of cardiovascular diseases. As regards primary prevention of cardiovascular diseases, no statistically significant reduction of the number of serious cardiovascular events has been found. Hence, starting statin treatment in the over-70 population is only suitable for fit older adults who are at greatly increased risk of cardiovascular diseases. Copyright © 2025 Stichting Geneesmiddelenbulletin. All rights reserved. <74> Accession Number 2050039691 Title Mitral Papillary Muscle Papillary Fibroelastoma in Obstructive Hypertrophic Cardiomyopathy: A Surgically Treated Embolic Source. Source JACC: Case Reports. 31(40) (no pagination), 2026. Article Number: 110553. Date of Publication: 07 Oct 2026. Author Rashidi N.; Montazeri M.; Cao C.; Seidman M.; Ralph-Edwards A.; Rakowski H. Institution (Rashidi, Montazeri, Rakowski) Division of Cardiology, Toronto General Hospital, Toronto, ON, Canada (Cao, Seidman) Division of Pathology, Toronto General Hospital, Toronto, ON, Canada (Ralph-Edwards) Division of Cardiovascular Surgery, Toronto General Hospital, Toronto, ON, Canada Publisher Elsevier Inc. Abstract Background: Papillary fibroelastoma, an uncommon cardiac tumor, can cause systemic embolization and raise unique diagnostic and therapeutic challenges when superimposed on a hypertrophic cardiomyopathy. Case Summary: A 71-year-old woman with obstructive HCM, prior unilateral retinal artery occlusion (RAO), and progressive exertional dyspnea was referred for Mavacamten therapy. An incidental mitral chordal mass was found on baseline transthoracic echocardiography, suspicious for papillary fibroelastoma. Given the prior unilateral RAO and symptomatic LVOT obstruction, septal myectomy and mass excision were performed. Histopathology confirmed papillary fibroelastoma, and her symptoms and LVOT gradients improved significantly. Discussion(s): This case underscores the importance of comprehensive imaging to identify rare valvular tumors as potential embolic sources in patients with obstructive HCM and prior embolic events, with important management implications. Take-Home Message: Mitral papillary fibroelastoma in obstructive HCM, even if "incidental," can be a surgically correctable embolic source beyond atrial fibrillation and may warrant combined resection and myectomy. Copyright © 2026 <75> Accession Number 2050041619 Title Intracardiac vs. transesophageal echocardiography in patients undergoing ablation for atrial fibrillation: a systematic review and meta-analysis. Source European Heart Journal Cardiovascular Imaging. 27(10) (pp 1845-1856), 2026. Date of Publication: 01 Oct 2026. Author Dandamudi M.; Hakkeem B.; Pinilla J.; Samad N.S.; de Lucena L.A.; Humayun Z.; Khairallah T.T.; Stabile F. Institution (Dandamudi) Department of Cardiology, Charleston Area Medical Center (CAMC), Charleston, WV, United States (Hakkeem) Department of Anesthesia, Government Medical College Kozhikode, Kerala, Kozhikode, India (Pinilla) Department of Medicine, CES University School of Medicine, Medellin, Colombia (Samad) College of Arts and Science, New York University, CAS XUSOM, Woodbury, NY, United States (de Lucena) Department of Medicine, Federal University of Rio Grande do Norte, RN, Natal, Brazil (Humayun) Department of Medicine, University of Missouri, Kansas City, MO, United States (Khairallah) Department of Medicine, University of Georgia, Tbilisi, Georgia (Stabile) Division of Cardiology, University Hospital Paolo Giaccone, Palermo, Italy Publisher Oxford University Press Abstract Aims: Intracardiac echocardiography (ICE) is a valuable, real-time imaging tool in structural cardiology and electrophysiology, performed without general anaesthesia. However, its safety compared to transesophageal echocardiography (TEE) remains unclear. Objective(s): To conduct a meta-analysis evaluating outcomes of catheter ablation for atrial fibrillation (AF) with or without left atrial appendage closure (LAAC) guided by TEE vs. ICE. Methods and Results: Databases were searched for studies comparing ICE with TEE guidance during AF ablation +/- LAAC. Outcomes were pooled using the inverse-variance (IV) random-effects model in R, with risk ratios (RRs) for dichotomous variables and mean or standardized mean differences (MD or SMD) for continuous variables, and 95% confidence intervals (CIs) reported. We included eight studies involving 7671 patients, of whom 3903 (50.9%) underwent procedures with ICE guidance. There were no significant differences between groups in cardiac tamponade risk (RR 0.86; 95% CI 0.44-1.66; P = 0.39), stroke, or transient ischaemic attack (RR 1.00; 95% CI 0.39-2.55; P = 0.57), and vascular complications (RR 0.80; 95% CI 0.51-1.25; P = 0.37). ICE was associated with lower pre-procedure LAA thrombus detection (RR 0.32; 95% CI 0.11-0.94; P = 0.04), radiation dose (SMD -0.47; 95% CI -0.90 to -0.04; P = 0.03), and fluoroscopy time (-4.25 min; 95% CI -6.01 to -2.49; P < 0.01) but the procedure duration was significantly lower only in combined AF ablation + LAAC (MD -19.56 min; 95% CI -24.15 to -14.97; P < 0.01). Conclusion(s): This meta-analysis indicates that ICE is a safe, effective, and non-inferior alternative to TEE for patients undergoing AF ablation +/- LAAC. However, TEE remains an effective tool for detecting LAA thrombus. 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 journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <76> Accession Number 2049985557 Title Colchicine for secondary prevention coronary heart disease: an update. Source Geneesmiddelenbulletin. 59(8) (no pagination), 2025. Article Number: e2025.8.20. Date of Publication: 2025. Author Stolk L.M.L. Publisher Stichting Geneesmiddelenbulletin Abstract Based on the findings of two meta-analyses, a previous Ge-Bu article (2021) concluded that low-dose colchicine was effective for the secondary prevention of coronary heart disease. The present update discusses a recent large randomised trial, which found no efficacy of colchicine. Methods This trial included patients who had ST-elevation myocardial infarction (STEMI) and percutaneous coronary intervention (PCI) or Non-ST-elevation myocardial infarction (NSTEMI) with risk factors and PCI. As soon as possible after the PCI, the patients were randomised 1:1 to a group given colchicine and a group given identical placebo tablets. The primary endpoint was composed of major adverse cardiac events (MACEs): death from a cardiovascular cause, recurring myocardial infarction, stroke or unplanned coronary revascularisation because of ischemia. The follow-up lasted 3 years. Results Between February 2018 and November 2022, 7,062 patients were included in 104 centres in 14 countries. The result for the primary endpoint was almost identical for both groups. The primary outcome occurred in 322 of the 3,528 patients (9.1%) in the colchicine group and in 327 of the 3,534 patients (9.3%) in the placebo group. There was no difference between the groups in serious adverse effects. Diarrhoea was more common in the colchicine group. Discussion The evidence for the efficacy of colchicine for the secondary prevention of cardiovascular diseases is partially refuted by this recent trial. The efficacy might differ between different patient populations, such as those with more acute versus those with more chronic disease. However, drawing an unequivocal conclusion for this aspect requires more research. Pending the results of three ongoing randomised trials, colchicine can, with some caution, still be considered for the secondary prevention of coronary heart diseases. Copyright © 2025 Stichting Geneesmiddelenbulletin. All rights reserved. <77> Accession Number 652282277 Title The effect of surgical prehabilitation on autonomic nervous system regulation: Rationale and design of the TUNE trial. Source Contemporary clinical trials. (pp 108486), 2026. Date of Publication: 27 Sep 2026. Author D'Amico F.; Misceo F.; Benato C.; Veneziano M.; Maj G.; Notarianni L.; Guarracino F.; Oliva F.M.; Valsecchi C.; De Piccoli N.; Pontillo D.; Turi S.; Fossati L.; Ghezzi M.; Tucci M.; Belhassen L.; Bove T.; Novellis P.; Gottin L.; Paternoster G.; Landoni G.; Donadello K.; Veronesi G. Institution (D'Amico, Veneziano, Notarianni, Oliva, De Piccoli, Pontillo, Turi, Fossati, Ghezzi, Tucci, Belhassen) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Misceo) Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy (Benato) Mini-Invasive and Robotic Thoracic Surgery Unit, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy (Maj) Department of Cardiothoracic and Vascular Anesthesia, University Hospital of Alessandria, Alessandria, Italy (Guarracino) Department of Cardiothoracic and Vascular Anaesthesia and ICU, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy (Valsecchi) Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy (Bove) Department of Basic Biotechnological Sciences, Intensive Care Peri-Operative Clinics, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy (Novellis, Veronesi) Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Gottin) Department of Surgery, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy; Cardio-Thoraco-Vascular Anesthesia and Intensive Care Unit, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy (Paternoster) Department of Health Sciences, University of Basilicata, Potenza, Italy; Anesthesia and ICU, San Carlo Hospital, Potenza, Italy (Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Donadello) Department of Surgery, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy; Anesthesia and Intensive Care Unit B, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy Abstract BACKGROUND: Prehabilitation improves physiological readiness for major surgery; however, its implementation and evaluation remain inconsistent, particularly in thoracic surgery. Current assessments largely rely on functional tests, which are difficult to standardize and provide limited knowledge of biological resilience. Heart-rate variability (HRV) is an objective marker of autonomic nervous system balance and is already widely used in sports medicine to guide training intensity and evaluate the relationship between physiological stress and recovery. Given its ability to capture the dynamicity and flexibility of autonomic regulation, HRV may become a practical tool to assess the physiological effects of prehabilitation interventions, going beyond traditional endpoints. METHOD(S): The TUNE trial is a multicenter, open label, randomized controlled trial involving patients scheduled for elective major thoracic surgery. Participants are randomized in a 1:1 ratio to receive either a home-based multimodal prehabilitation program in addition to standard care or standard care alone. The intervention consists of a 4 week remotely delivered program including structured physical exercise, personalized nutritional optimization and psychological support. RESULT(S): The trial is ongoing and currently recruiting participants. The primary endpoint is the between-group difference in the change of HRV, measured as the standard deviation of normal-to-normal intervals (SDNN), from baseline to preoperative assessment. Secondary outcomes include correlations between HRV and clinical outcomes. CONCLUSION(S): The TUNE trial will provide data to assess whether a prehabilitation program can improve HRV and facilitate recovery in patients undergoing major thoracic surgery. TRIAL REGISTRATION: This trial was registered on ClinicalTrials.gov with the trial identification NCT06398301. Copyright © 2026. Published by Elsevier Inc. <78> Accession Number 652280836 Title Efficacy and Safety of Left Atrial Appendage Occlusion versus Oral Anticoagulation for Stroke Prevention in Non-valvular Atrial Fibrillation: Do Meta-analyses Sharpen Blurred Images?. Source Trends in cardiovascular medicine. (no pagination), 2026. Date of Publication: 26 Sep 2026. Author Slee A.; Olshansky B.; Kantharia B.K. Institution (Slee) New Arch Consulting LLC, Seattle, WA, United States (Olshansky) Francois M. Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA, United States (Kantharia) Cardiovascular and Heart Rhythm Consultants, Icahn School of Medicine at Mount Sinai, New York, NY, United States <79> Accession Number 2049328039 Title Alpha-gal xenoantigens in bioprosthetic valve recipients: clinical implications for bioprosthesis longevity. Source Journal of Cardiothoracic Surgery. 21(1) (no pagination), 2026. Article Number: 719. Date of Publication: 01 Dec 2026. Author Gosden J.; Ascione G.; Wolf S.; Turek J.W.; George I. Institution (Gosden, Ascione, George) New York Presbyterian Hospital - Columbia University Irving Medical Center, New York, NY, United States (Wolf, Turek) Duke University School of Medicine, Durham, NC, United States (George) Division of Cardiothoracic Surgery/Structural Heart & Valve Center, New-York Presbyterian Hospital-Columbia University Medical Center, 177 Fort Washington Ave, New York, NY, United States Publisher BioMed Central Ltd Abstract Background: Structural valve degeneration (SVD) is a key limitation of bioprosthetic heart valves (BHVs). The underlying mechanisms for this degeneration and pathophysiology remains only partially defined. Emerging evidence implicates a xenogeneic carbohydrate epitope, galactose-alpha-1,3-galactose (Alpha-gal), as a potential driver of immune-mediated valve deterioration. This review explores the current knowledge on alpha-gal (AG) sensitization and evidence linking it to SVD and the potential clinical implications. Method(s): A literature search was conducted using Embase, PubMed and Scopus, using variants of the following keywords, such as "alpha-gal", "bioprosthetic valve", and "degeneration". Studies included reported human subject findings and focused on BHVs. Only original works were permitted, published between January 2014 and December 2025. Result(s): Six studies met the inclusion criteria. Case reports demonstrated heterogenous clinical outcomes with, rapid SVD observed in some alpha-gal sensitized patients, while other patients showed tolerance to bioprosthetic implantation in the perioperative and short-term period. The only study with longitudinal follow-up demonstrated that anti-AG IgG responses were associated with increased SVD and calcification. Another study found no perioperative adverse valvular outcomes, although follow-up was limited to in-hospital assessment. Overall, his manuscript identifies that AG sensitization may contribute to SVD in certain patients, however, its broader significance remains uncertain. Conclusion(s): Immune recognition of AG may contribute to SVD based on the limited available evidence. Larger prospective investigations are required to clarify a causal relationship and to assist in guiding potential preventative strategies. Recognition of this mechanism may ultimately inform management of valve replacement and bioprosthesis selection plans. Copyright © The Author(s) 2026. <80> Accession Number 2049238198 Title Heterogeneity in MACE Definitions and Its Impact on Treatment Effect Estimates in Coronary Stent Trials: A Meta-Epidemiological Study. Source Journal of Evidence-Based Medicine. (no pagination), 2026. Date of Publication: 2026. Author Wang X.; Yang J.; Long Y.; Ran J.; Li S.; Xu Z.; Jiang Z.; Wan X.; Li Y.; Fang K.; Huang S.; Gu R.; Zhang N.; He W.; Huang J.; Li Z.; Du L. Institution (Wang, Long, Ran, Li, Zhang, Huang, Li, Du) Department of Cardiac Surgery, and Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Wang, Long, Ran, Li, Xu, Zhang, He, Huang, Du) Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, China (Yang, Li, Fang, Huang) West China School of Public Health, Sichuan University, Chengdu, China (Jiang) Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China (Wan) Department of Nursing, West China Second Hospital of Sichuan University, Chengdu, China (Gu) School of Mechanical and Electrical Engineering, University of Electronic Science and Technology of China, Chengdu, China (Li, Du) Center for Education of Medical Humanities, West China Hospital, Sichuan University, Chengdu, China Publisher John Wiley and Sons Inc Abstract Background: Major adverse cardiac events (MACE) are widely used composite endpoints in cardiovascular trials. However, heterogeneity in MACE definitions may influence treatment effect estimates, with potential implications for clinical decision-making. This study explored variability in MACE definitions across coronary stent trials and assessed the influence of individual components on effect estimates. Method(s): We systematically searched PubMed and Embase (via Ovid) from inception to March 5, 2026, for meta-analyses and extracted eligible coronary stent randomized controlled trials (RCTs) from their forest plots. Data on MACE definitions, outcomes, and trial characteristics were extracted. Consistency between MACE outcomes and individual component outcomes was assessed. Meta-regression analyses assessed the associations between MACE components and treatment effect estimates. Result(s): Among 301 included RCTs, 62.79% reported individual component results, and substantial heterogeneity was observed in MACE definitions. Among trials with comparable MACE and component results, 8.96% had non-significant MACE results despite significant mortality differences, whereas 14.81% had significant MACE results despite no significant differences in any individual component. In addition, 52.72% showed opposite effect directions between MACE and at least one component. Meta-regression further showed that inclusion of mortality, myocardial infarction, stent thrombosis, target lesion revascularization, coronary artery bypass grafting, and overall revascularization was associated with lower estimated effects, whereas inclusion of stroke was associated with higher estimated effects. Conclusion(s): Substantial heterogeneity exists in MACE definitions, impacting treatment effect estimates in coronary stent trials. Standardized reporting of composite and individual component outcomes is essential to improve the interpretation of trial findings and reliability of evidence synthesis. Copyright © 2026 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd. <81> Accession Number 2049863651 Title Clinical Presentation, Diagnosis, Treatment, and Outcome of Heart Disease in Becker Muscular Dystrophy. Source Anatolian Journal of Cardiology. 30(10) (pp 631-643), 2026. Date of Publication: 01 Oct 2026. Author Finsterer J. Institution (Finsterer) Department of Neurology, Neurology & Neurophysiology Center, Vienna, Austria Publisher Turkish Society of Cardiology Abstract Becker muscular dystrophy (BMD) is a primary myopathy caused by mutations in the dystrophin gene on chromosome Xq21.2, which often affects the myocardium and cardiac conduction system. However, there is limited experience with cardiac disease in BMD. This review aims to summarize and discuss recent advances and future perspectives regarding the clinical presentation, diagnosis, treatment, and outcome of cardiac involvement in BMD. Data were retrieved by searching for relevant articles in the PubMed and Google Scholar databases. Cardiac disease in BMD is characterized by myocardial fibrosis, can be subclinical or clinical, and manifests as left or right ventricular systolic dysfunction with/without heart failure due to dilated or hypertrophic cardiomyopathy, diastolic dysfunction with preserved/decreased systolic function, conduction disturbances and supraventricular/ventricular arrhythmias, thrombus formation, arterial hypertension, pulmonary hypertension, left ventricular hyperrabeculation, coronary artery disease, and valve defects. Cardiac involvement in BMD must be detected and treated at an early stage, because it progresses over time and has a significant impact on the course of the disease. Established treatment methods include non-invasive therapies with small molecules and catheter-based invasive therapies (stent implantation, endocardial and epicardial ablation), device-related treatments (pacemaker, implantable cardioverter-defibrillator, cardiac resynchronization therapy, left ventricular assist device), and heart surgery. Cardiac involvement in BMD occurs in about two-thirds of patients, is subclinical in the early stages but becomes symptomatic as the heart disease progresses, requires early diagnosis, and can be treated with non-invasive and invasive therapies, with prognosis improving with early detection and adequate treatment. Copyright © Available online at anatoljcardiol.com. Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. <82> Accession Number 2049329363 Title Physical and Emotional Well-Being Outcomes Associated with Cardiac Rehabilitation Among Adults Recovering from Heart Disease: A Scoping Review. Source SN Comprehensive Clinical Medicine. 8(1) (no pagination), 2026. Article Number: 457. Date of Publication: 01 Dec 2026. Author Rathod F.; Patel V. Institution (Rathod) Department of Medical Surgical Nursing, Sumandeep Nursing College, Sumandeep Vidyapeeth Deemed to be University, At & Po. Piparia - 391760, Dist. Waghodia, Gujarat, Vadodara, India (Patel) Department of Obstetrics and Gynaecology, Sumandeep Nursing College, Sumandeep Vidyapeeth Deemed to be University, Gujarat, Vadodara, India Publisher Springer Nature Abstract Background: Cardiac rehabilitation (CR) is a comprehensive secondary prevention strategy designed to support recovery and well-being following heart disease. Evidence regarding the physical and emotional well-being outcomes associated with contemporary CR is dispersed across different cardiac populations, rehabilitation approaches, and outcome measures. Aim(s): This scoping review aimed to map and synthesize recent evidence on predefined physical and emotional well-being outcomes associated with cardiac rehabilitation among adults recovering from heart disease. Method(s): The review was conducted using the Arksey and O'Malley framework and reported in accordance with the PRISMA-ScR guidelines. A comprehensive search of PubMed, Google Scholar, and the Cochrane Library was undertaken to identify English-language studies published between January 2020 and August 2025. Eligible studies included randomized controlled trials, cohort studies, observational studies, and interventional studies involving adults aged > 18 years with myocardial infarction, coronary artery disease, heart failure, or post-cardiac surgery status. Data were charted and descriptively synthesized according to participant characteristics, CR characteristics, and predefined physical and emotional well-being outcomes. Result(s): Seventeen studies met the inclusion criteria and represented diverse CR approaches, including center-based, home-based, hybrid, telemonitored, mHealth, nurse-led, and exercise-enhanced programs. Physical outcomes frequently reported across the included studies included exercise capacity, functional performance, cardiovascular and other biophysiological parameters. Emotional outcomes included anxiety, depression, psychological well-being, and quality of life. Overall, the included studies reported generally favourable physical and emotional well-being outcomes among adults participating in CR, although considerable heterogeneity was observed in populations, intervention characteristics, outcome measures, and study designs. Conclusion(s): As the primary purpose of this scoping review was evidence mapping, no formal methodological quality or risk-of-bias assessment was undertaken; therefore, the findings should not be interpreted as establishing intervention effectiveness or causality. Overall, this review maps the recent evidence on physical and emotional well-being outcomes associated with CR and highlights the breadth of outcomes assessed across contemporary CR approaches. The findings may inform future research, clinical practice, and the development of outcome-focused cardiac rehabilitation programs. Copyright © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2026. <83> Accession Number 652268398 Title Impact of Colloid Cardiopulmonary Bypass Priming Strategy on Perioperative Acid-Base Balance in Coronary Artery Bypass Surgery: Physicochemical Analysis of a Double-Blinded Randomized Controlled Study. Source Journal of cardiothoracic and vascular anesthesia. (no pagination), 2026. Date of Publication: 29 Aug 2026. Author Boer R.; Beukers A.M.; Pols J.M.; Seegers J.C.; van Haasteren N.; Ghantous D.; Nieuwenhuizen R.; Brouwers M.; Bulte C.S.E.; Duska F.; Vonk A.B.A.; Loer S.A.; Heldeweg M.L.A. Institution (Boer, Beukers, Bulte, Loer) Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, Netherlands (Pols, Vonk) Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands (Seegers) Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, The Netherlands; Department of Intensive Care Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands; Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands (van Haasteren, Ghantous, Nieuwenhuizen, Brouwers) Department of Anaesthesiology, University of Amsterdam, Amsterdam, Netherlands (Duska) Department of Anesthesia and Intensive Care Medicine, Third Faculty of Medicine, Charles University and FNKV University Hospital, Prague, Czechia (Heldeweg) Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, The Netherlands; Department of Anesthesia and Intensive Care Medicine, The Third Faculty of Medicine, Charles University and FNKV University Hospital, Prague, Czech Republic Abstract OBJECTIVE: To determine whether colloid choice within the cardiopulmonary bypass (CPB) priming strategy independently modifies the perioperative acid-base trajectory. DESIGN: Preplanned analysis of a single-center, double-blind, 3-arm randomized controlled trial. SETTING: A tertiary academic teaching hospital. PARTICIPANTS: Thirty-four adult patients undergoing elective coronary artery bypass grafting with CPB. INTERVENTIONS: Patients were randomized 1:1:1 to 3 priming strategies (total 1500 mL): albumin-based, gelofusine-based, and retrograde autologous priming (reference group). MEASUREMENTS AND MAIN RESULTS: Acid-base status was characterized using Stewart's physicochemical approach at 5 perioperative time points (postinduction to 24 hours post-intensive care unit admission). A linear mixed model was used to assess the effects of priming strategy, time, and additional crystalloids. Across 170 observations, initiation of CPB induced substantial metabolic acidosis (-0.1 pH, -4.3 mmol/L standard base excess, -6.6 mEq/L effective strong ion difference), driven by reductions in apparent strong ion difference and persisting at 24 hours. pH, standard base excess, and effective strong ion difference did not differ among the priming strategies. Albumin attenuated weak acid-anion dilution (+0.79 mEq/L; p = 0.037), while gelofusine increased the strong ion gap (+2.19 mEq/L; p < 0.001). Each additional liter of crystalloid independently lowered pH (-0.011; p = 0.035), standard base excess (-0.99 mmol/L; p = 0.022), and effective strong ion difference (-1.03 mEq/L; p = 0.025), driven by a rise in strong ion gap (+1.24 mEq/L; p = 0.001). CONCLUSION(S): CPB-induced metabolic acidosis is driven predominantly by reductions in apparent strong ion difference and sustained by unbalanced crystalloid load rather than by colloid choice. Acid-base optimization should prioritize balanced, strong ion difference-guided priming fluid and crystalloid strategies over colloid selection. Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved.

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