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<1>
Accession Number
2010179895
Authors
Nishikimi T. Minamino N. Ikeda M. Takeda Y. Tadokoro K. Shibasaki I.
Fukuda H. Horiuchi Y. Oikawa S. Ieiri T. Matsubara M. Ishimitsu T.
Institution
(Nishikimi, Takeda, Tadokoro, Ishimitsu) Department of Hypertension and
Cardiorenal Medicine, Dokkyo Medical University, Mibu, Tochigi 321-0293,
Japan.
(Minamino, Matsubara) Department of Pharmacology, National Cardiovascular
Center, Research Institute, Osaka, Japan.
(Ikeda) Institute of International Education and Research, Dokkyo Medical
University, Tochigi, Japan.
(Shibasaki, Fukuda) Department of Cardiovascular Surgery, Dokkyo Medical
University, Tochigi, Japan.
(Horiuchi, Oikawa, Ieiri) Department of Clinical Laboratory, Dokkyo
Medical University, Tochigi, Japan.
Title
Diversity of molecular forms of plasma brain natriuretic peptide in heart
failured - Different proBNP-108 to BNP-32 ratios in atrial and ventricular
overload.
Source
Heart. 96(6)(pp 432-439), 2010. Date of Publication: March 2010.
Publisher
BMJ Publishing Group
Abstract
Objective: Recent studies have shown that plasma levels of brain
natriuretic peptide (BNP)-32 and proBNP-108 are increased in heart failure
(HF) and that the BNP-32 assay kit in current clinical use cross-reacts
with proBNP-108. We investigated why proBNP is increased without
processing in HF was investigated. Design, setting and patients: Plasma
BNP-32 and proBNP-108 in normal individuals (n=10) and in patients with
atrial fibrillation (AF) (n=18) and HF (n=132) was measured. BNP-32 and
proBNP-108 in ventricular and atrial tissue and in pericardial fluid using
a specific fluorescent enzyme immunoassay following Sep-Pak C18 (Waters,
Milford, Massachusetts, USA) cartridge extraction and gel filtration was
also measured. Main outcome measures: Levels of both BNP-32 and proBNP-108
were higher in HF than in control or AF (both p<0.01), and the levels of
these peptides significantly correlated (r=0.94, p<0.001). The
proBNP-108/total BNP (BNP-32+proBNP-108) ratio was widely distributed and
lower in HF (0.33 (0.17)) than in control (0.41 (0.06), p<0.05) and AF
(0.45 (0.04), p<0.002). The proBNP-108/total BNP ratio was higher in HF
with ventricular than in HF with atrial overload (0.45 (0.10) vs 0.20
(0.11), p<0.001). Consistent with this finding, the major molecular form
were proBNP-108 and BNP-32 in ventricular (n=6, 0.67 (0.04)) and atrial
(n=7, 0.76 (0.05), p<0.0001) tissues, respectively. ProBNP-108 was also
the major molecular form of BNP in pericardial fluid (n=8, 0.82 (0.05)).
The proBNP-108/total BNP ratio increased and decreased with HF
deterioration and improvement, respectively. Conclusion: These results
suggest that BNP-32 and proBNP-108 is increased in HF and that the
proBNP/total BNP ratio increases in association with pathophysiological
conditions such as ventricular overload.
<2>
Accession Number
2010168918
Authors
Thiara A.S. Andersen V.Y. Videm V. Mollnes T.E. Svennevig K. Hoel T.N.
Fiane A.E.
Institution
(Thiara, Andersen, Hoel, Fiane) Department of Thoracic and Cardiovascular
Surgery, Oslo University Hospital, 0027 Oslo, Norway.
(Videm) Department of Immunology and Transfusion Medicine, Norwegian
University of Science and Technology, Trondheim University Hospital,
Trondheim, Norway.
(Mollnes) Institute of Immunology, Oslo University Hospital, Oslo, Norway.
(Mollnes) Nordland Hospital, Bodo and University of Tromso, Norway.
(Mollnes, Fiane) Faculty Division Rikshospitalet, University of Oslo,
Oslo, Norway.
(Svennevig) Department of Nutrition, Institute of Basic Medical Sciences,
University of Oslo, Norway.
Title
Comparable biocompatibility of Phisio- and Bioline-coated cardiopulmonary
bypass circuits indicated by the inflammatory response.
Source
Perfusion. 25(1)(pp 9-16), 2010. Date of Publication: January 2010.
Publisher
SAGE Publications Ltd
Abstract
Background: The biocompatibility of cardiopulmonary bypass surfaces has
been improved by heparin and polymer surface modifications. The present
study compared the effect of two such coatings on the inflammatory
reactions after open heart surgery. Methods:Thirty patients undergoing
elective heart surgery were randomly assigned to receive one of two types
of coated circuits: Bioline (n=15) or phosphorylcholine (Phisio, n=15).
The platelet and leukocyte counts, neutrophil activation
(myeloperoxidase), complement activation (C3a and TCC), concentrations of
lactate dehydrogenase, 27 cytokines (including interleukins, chemokines
and growth factors), thrombin-antithrombin complexes, and the endothelial
cell marker syndecan-1 were analyzed at five predetermined time points
until 24 hrs post operatively. Results: Most measurements were comparable
in both groups. However, myeloperoxidase was significantly higher in the
Bioline group (p < 0.001). Postoperative lactate dehydrogenase
concentrations were significantly higher in the Phisio group (p<0.01) and
the maximal concentration of thrombin-antithrombin complexes 2 hours
postoperatively tended to be higher in the Phisio group (p=0.08),
consistent with a longer aortic cross-clamp and cardiopulmonary bypass
time. Conclusions: The two circuits exhibited a comparable degree of in
vivo biocompatibility.
<3>
Accession Number
2010173227
Authors
Aiyagari R. Gelehrter S. Bove E.L. Ohye R.G. Devaney E.J. Hirsch J.C.
Gurney J.G. Charpie J.R.
Institution
(Aiyagari, Gelehrter, Gurney, Charpie) Division of Pediatric Cardiology,
University of Michigan Medical School, Ann Arbor, Mich, United States.
(Bove, Ohye, Devaney, Hirsch) Division of Pediatric Cardiovascular
Surgery, Section of Cardiac Surgery, University of Michigan Medical
School, Ann Arbor, Mich, United States.
Title
Effects of N-acetylcysteine on renal dysfunction in neonates undergoing
the arterial switch operation.
Source
Journal of Thoracic and Cardiovascular Surgery. 139(4)(pp 956-961), 2010.
Date of Publication: April 2010.
Publisher
Mosby Inc.
Abstract
Objective: We evaluated N-acetylcysteine, a potent antioxidant, as
prevention for renal dysfunction in infants undergoing cardiac surgery for
dextro-transposition of the great arteries. Methods: Twenty-one neonates
undergoing the arterial switch operation were randomized to receive either
placebo or intravenous N-acetylcysteine. Serial data were collected on
fluid balance, serum creatinine, inotropic support, cardiac output, and
length of stay. Results: Hospital and 30-day survival was 100%. No serious
adverse events were attributable to the drug. Subjects treated with
N-acetylcysteine had a higher urine output at 24 hours (175 mL vs 96 mL; P
< .01) and a shorter median time to first negative fluid balance (27 hours
vs 39.5 hours; P = .02). There were no differences between groups in
diuretic therapy, inotropic support, fluid intake, or chest tube output.
Serum creatinine increased at 24 hours after the operation by a mean of
0.27 mg/dL with placebo (P < .01) but was unchanged with N-acetylcysteine
treatment. By postoperative day 3, serum creatinine increased by 92% in
the placebo group but only 38% in the N-acetylcysteine group (P = .04).
Length of intensive care unit stay was shorter by an average of 5 days (P
= .04) with N-acetylcysteine treatment. Conclusions: In this pilot study,
perioperative treatment with N-acetylcysteine resulted in improved urine
output, shorter time to negative fluid balance, and attenuation of the
rise in creatinine. These effects of N-acetylcysteine may translate to
improved outcomes for infants undergoing complex cardiac operations.
copyright 2010 The American Association for Thoracic Surgery.
<4>
Accession Number
2010173214
Authors
Braathen B. Tonnessen T.
Institution
(Braathen, Tonnessen) Department of Cardiothoracic Surgery, Ulleval
University Hospital, University of Oslo, Oslo, Norway.
Title
Cold blood cardioplegia reduces the increase in cardiac enzyme levels
compared with cold crystalloid cardioplegia in patients undergoing aortic
valve replacement for isolated aortic stenosis.
Source
Journal of Thoracic and Cardiovascular Surgery. 139(4)(pp 874-880), 2010.
Date of Publication: April 2010.
Publisher
Mosby Inc.
Abstract
Objectives: Cardiac arrest during cardiac surgery is most commonly induced
by cold blood or cold crystalloid cardioplegia. The results from clinical
studies are divergent regarding which of the 2 solutions provides better
myocardial protection. This might be explained by several factors. Both
heterogeneity in disease for the included patients and the fact that most
studies are retrospective in design and that patients with coronary artery
disease with different degrees of myocardial ischemia are included might
explain these findings. To circumvent these potentially confounding
factors, we included in a prospective randomized study only patients
undergoing aortic valve replacement for aortic stenosis without other
significant cardiac disease. Patients were randomized to antegrade cold
crystalloid or cold blood cardioplegia. Methods: Eighty patients with
aortic stenosis undergoing aortic valve replacement without significant
coronary artery stenosis or other significant concomitant heart valve
disease were included in the study. They were randomized to either
antegrade cold blood or cold crystalloid cardioplegic solution delivered
through the coronary ostia every 20 minutes throughout the period of
aortic crossclamping. Maximum postoperative creatine kinase isoenzyme MB
and troponin-T levels, well-established markers of myocardial damage, were
compared between the 2 groups. Results: Both maximum postoperative
creatine kinase isoenzyme MB and troponin-T levels were significantly
higher by approximately 100% in the cohort of patients receiving
crystalloid compared with blood cardioplegia. Only in the group of
patients receiving cold crystalloid cardioplegia was there a positive
correlation between cardiac enzyme levels and crossclamp time. Conclusion:
Antegrade cold blood cardioplegia provides better myocardial protection
than cold crystalloid cardioplegia in patients undergoing aortic valve
replacement. copyright 2010 The American Association for Thoracic Surgery.
<5>
Accession Number
2010117077
Authors
Saltzman A.J. Mehran R. Hooper W.C. Moses J.W. Weisz G. Collins M.B.
Lansky A.J. Kreps E.M. Leon M.B. Stone G.W. Dangas G.
Institution
(Saltzman, Mehran, Hooper, Moses, Weisz, Collins, Lansky, Kreps, Leon,
Stone, Dangas) Cardiovascular Medicine, Center for Interventional Vascular
Therapy, Columbia University, New York, United States.
(Hooper) Division of Blood Disorders, National Center for Birth Defects
and Developmental Disabilities, Centers for Disease Control and
Prevention, Atlanta, GA, United States.
Title
The relative effects of abciximab and tirofiban on platelet inhibition and
C-reactive protein during coronary intervention.
Source
Journal of Invasive Cardiology. 22(1)(pp 2-6), 2010. Date of Publication:
January 2010.
Publisher
HMP Communications
Abstract
Background: We sought to compare the efficacy of tirofiban and abciximab
on platelet inhibition as well as their effects of platelet inhibition on
C-reactive protein levels during percutaneous coronary intervention (PCI).
Methods: Using a randomized, double-blind study design, 95 consecutively
eligible patients were randomized to receive either tirofiban or abciximab
before undergoing native coronary artery revascularization with a stent.
Clinical endpoints were death, nonfatal MI, target vessel
revascularization (TVR) with coronary artery bypass grafting or PCI within
30 days of the study procedure. The medications were compared for
differences in platelet aggregation as measured by a rapid function
platelet assay, as well as measurements of the inflammatory marker
C-reactive protein (CRP) at frequent intervals following drug
administration during PCI. Results: A total of 95 patients were randomized
to abciximab (n = 44) or tirofiban (n= 51). There was no significant
difference in platelet aggregation documented throughout the procedure
(10-, 20-, 30-, 45-minute time points). In diabetic patients abciximab had
significantly lower platelet inhibition as compared to tirofiban at 10
minutes (84.17 +/- 8.28% vs. 90.40 +/- 5.79%; p = 0.0097). Using a
Spearman correlation coefficient model, hs-CRP demonstrated an inverse
relationship with platelet inhibition over time (-0.7307, p=0.0002) in
patients treated with abciximab. Conclusion: There is no major difference
in platelet inhibition between tirofiban and abciximab during PCI. In this
study, tirofiban showed a greater inhibition in diabetic subsets at the
first time point within PCI. Platelet inhibition may be inversely related
to the levels of CRP during PCI.
<6>
Accession Number
0020031836
Authors
Melsop K. Brooks M.M. Boothroyd D.B. Hlatky M.A.
Institution
(Melsop, Brooks, Boothroyd, Hlatky) Stanford University School of
Medicine, Stanford, Calif, USA.
Title
Effect of race on the clinical outcomes in the bypass angioplasty
revascularization investigation trial..
Source
Circulation. Cardiovascular quality and outcomes. 2(3)(pp 186-190), 2009.
Date of Publication: May 2009.
Abstract
BACKGROUND: In observational studies, clinical outcomes for black patients
with coronary disease have been worse than for white patients. There are
few data from randomized trials comparing the outcomes of coronary
revascularization between black patients and white patients. METHODS AND
RESULTS: We analyzed data from the Bypass Angioplasty Revascularization
Investigation randomized trial. At study entry, the 113 black patients had
significantly higher rates of diabetes, hypertension, smoking, heart
failure, and abnormal left ventricular function than the 1653 white
patients. Black patients had significantly higher mortality than white
patients (hazard ratio, 2.16; P<0.001), which remained significant after
statistical adjustment for differences in baseline clinical
characteristics (hazard ratio, 1.59; P=0.003). In a substudy of economic
and quality of life outcomes, the 67 black patients had similar frequency
of physician visits and use of evidence-based cardiac medications but
significantly worse physical function scores than the 885 white patients.
The effect of random assignment to either surgery or angioplasty on
clinical outcomes was not significantly modified by race (interaction
probability values >or=0.18). CONCLUSIONS: Clinical outcomes of black
patients after coronary revascularization were worse than those of white
patients in a clinical trial setting with similar treatment and access to
care. The differences in outcome between black and white patients were not
completely attributable to the greater levels of comorbidity among black
patients at study entry.
<7>
Accession Number
0019840397
Authors
Morgan C. Zappitelli M. Gill P.
Institution
(Morgan, Zappitelli, Gill) Division of Nephrology, Department of
Pediatrics, University of Alberta, 2B2-42 WC Mackenzie Health Sciences
Centre, Edmonton, Alberta T6G 2R7, Canada.
Title
Statin prophylaxis and inflammatory mediators following cardiopulmonary
bypass: a systematic review..
Source
Critical care (London, England). 13(5)(pp R165), 2009. Date of
Publication: 2009.
Abstract
INTRODUCTION: Induction of an inflammatory response is thought to have a
significant role in the complications that follow cardiopulmonary bypass
(CPB). The statin drugs are increasingly being recognized as having potent
anti-inflammatory effects and hence have potential to influence an
important mechanism of injury in CPB, although there is no current
confirmation that this is indeed the case. Our objective was to
systematically review if pre-operative prophylactic statin therapy,
compared with placebo or standard of care, can decrease the inflammatory
response in people undergoing heart surgery with CPB. METHODS: We
performed a systematic and comprehensive literature search for all
randomized controlled trials (RCTs) of open heart surgery with CPB in
adults or children who received prophylactic statin treatment prior to
CPB, with reported outcomes which included markers of inflammation. Two
authors independently identified eligible studies, extracted data, and
assessed study quality using standardized instruments. Weighted mean
difference (WMD) was the primary summary statistic with data pooled using
a random effects model. Descriptive analysis was used when data could not
be pooled. RESULTS: Eight RCTs were included in the review, with the
number of trials for each inflammatory outcome being even more limited.
Pooled data demonstrated benefit with the use of statin to attenuate the
post-CPB increase in interleukins 6 and 8 (IL-6, IL-8), peak high
sensitivity C-reactive protein (hsCRP), and tumor necrosis factor-alpha
(TNF-alpha) post-CPB (WMD [95% confidence interval (CI)] -23.5 pg/ml
[-36.6 to -10.5]; -23.4 pg/ml [-35.8 to -11.0]; -15.3 mg/L [CI -26.9 to
-3.7]; -2.10 pg/ml [-3.83 to -0.37] respectively). Very limited RCT
evidence suggests that prophylactic statin therapy may also decrease
adhesion molecules following CPB including neutrophil CD11b and soluble P
(sP)-selectin. CONCLUSIONS: Although the RCT evidence may suggest a
reduction in post-CPB inflammation by statin therapy, the evidence is not
definitive due to significant limitations. Several of the trials were not
methodologically rigorous and statin intervention was highly variable in
this small number of studies. This systematic review demonstrates that
there is a significant gap that exists in the current literature in
regards to the potential anti-inflammatory effect of statin therapy prior
to CPB.
<8>
Accession Number
0019747406
Authors
Sander M. Spies C.D. Berger K. Schroder T. Grubitzsch H. Wernecke K.D. von
Heymann C.
Institution
(Sander, Spies, Berger, Schroder, Grubitzsch, Wernecke, von Heymann)
Department of Anaesthesiology and Intensive Care Medicine, Charite
Universitatsmedizin - Berlin, Campus Virchow Klinikum and Campus Charite
Mitte, Chariteplatz 1, 10117 Berlin, Germany.
Title
Perioperative indocyanine green clearance is predictive for prolonged
intensive care unit stay after coronary artery bypass grafting--an
observational study..
Source
Critical care (London, England). 13(5)(pp R149), 2009. Date of
Publication: 2009.
Abstract
INTRODUCTION: During cardiac surgery with cardiopulmonary bypass (CPB)
haemodilution occurs. Hepatic dysfunction after CPB is a rare, but
serious, complication. Clinical data have validated the
plasma-disappearance rate of indocyanine green (PDR ICG) as a marker of
hepatic function and perfusion. Primary objective of this analysis was to
investigate the impact of haemodilutional anaemia on hepatic function and
perfusion by the time course of PDR ICG and liver enzymes in elective CABG
surgery. Secondary objective was to define predictors of prolonged ICU
treatment like decreased PDR ICG after surgery. METHODS: 60 Patients were
subjected to normothermic CPB with predefined levels of haemodilution
anaemia (haemotacrit (Hct) of 25% versus 20% during CPB). Hepatic function
and perfusion was assessed by PDR ICG, plasma levels of aspartate
aminotransferase (ASAT) and alpha-GST. Prolonged ICU treatment was defined
as treatment >or= 48 hours. RESULTS: Logistic regression analysis showed
that all postoperative measurements of PDR ICG (P < 0.01), and the late
postoperative ASAT (P < 0.01) measurement were independent risk factors
for prolonged ICU treatment. The predictive capacity for prolonged ICU
treatment was best of the PDR ICG one hour after admission to the ICU.
Furthermore, the time course of PDR ICG as well as ASAT and alpha-GST did
not differ between groups of haemodilutional anaemia. CONCLUSIONS: Our
study provides evidence that impaired PDR ICG as a marker of hepatic
dysfunction and hypoperfusion may be a valid marker of prolonged ICU
treatment. Additionally this study provides evidence that haemodilutional
anaemia to a Hct of 20% does not impair hepatic function and perfusion.
TRIAL REGISTRATION: [ISRCTN35655335].
<9>
[Use Link to view the full text]
Accession Number
2010167623
Authors
Mora S. Glynn R.J. Hsia J. MacFadyen J.G. Genest J. Ridker P.M.
Institution
(Mora, Glynn, MacFadyen, Ridker) Center for Cardiovascular Disease
Prevention, Divisions of Preventive Medicine, Boston, MA, United States.
(Mora, Ridker) Divisions of Preventive Medicine and Cardiovascular
Medicine, Brigham and Women's Hospital, Harvard Medical School, 900
Commonwealth Ave E, Boston, MA 02215, United States.
(Glynn) Department of Biostatistics, Harvard School of Public Health,
Boston, MA, United States.
(Hsia) AstraZeneca, Philadelphia, PA, United States.
(Genest) McGill University Health Center, Montreal, QC, Canada.
Title
Statins for the primary prevention of cardiovascular events in women with
elevated high-sensitivity C-reactive protein or dyslipidemia: Results from
the justification for the use of statins in prevention: An intervention
trial evaluating rosuvastatin (JUPITER) and meta-analysis of women from
primary prevention trials.
Source
Circulation. 121(9)(pp 1069-1077), 2010. Date of Publication: March 2010.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Statin therapy in women without cardiovascular disease (CVD)
is controversial, given the insufficient evidence of benefit. We analyzed
sex-specific outcomes in the Justification for the Use of Statins in
Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) and
synthesized the results with prior trials. Methods and results: JUPITER
participants included 6801 women [greater-than or equal to]60 years of age
and 11 001 men [greater-than or equal to]50 years of age with
high-sensitivity C-reactive protein [greater-than or equal to]2 mg/L and
low-density lipoprotein cholesterol <130 mg/dL randomized to rosuvastatin
versus placebo. Meta-analysis studies were randomized placebo-controlled
statin trials with predominantly or exclusively primary prevention in
women and sex-specific outcomes (20 147 women; >276 CVD events; mean age,
63 to 69 years). Absolute CVD rates (per 100 person-years) in JUPITER
women for rosuvastatin and placebo (0.57 and 1.04, respectively) were
lower than for men (0.88 and 1.54, respectively), with similar relative
risk reduction in women (hazard ratio, 0.54; 95% confidence interval, 0.37
to 0.80; P=0.002) and men (hazard ratio, 0.58; 95% confidence interval,
0.45 to 0.73; P<0.001). In women, there was significant reduction in
revascularization/unstable angina and nonsignificant reductions in other
components of the primary end point. Meta-analysis of 13 154 women (240
CVD events; 216 total deaths) from exclusively primary prevention trials
found a significant reduction in primary CVD events with statins by a
third (relative risk, 0.63; 95% confidence interval, 0.49 to 0.82;
P<0.001; P for heterogeneity=0.56) with a smaller nonsignificant effect on
total mortality (relative risk, 0.78; 95% confidence interval, 0.53 to
1.15; P=0.21; P for heterogeneity=0.20). Similar results were obtained for
trials that were predominantly but not exclusively primary prevention.
Conclusion: JUPITER demonstrated that in primary prevention rosuvastatin
reduced CVD events in women with a relative risk reduction similar to that
in men, a finding supported by meta-analysis of primary prevention statin
trials. Clinical trial registration: URL: http://www.clinicaltrials.gov.
Unique identifier: NCT00239681. Copyright copyright 2010 American Heart
Association. All rights reserved.
<10>
Accession Number
2010161900
Authors
Brambilla M. Parolari A. Camera M. Colli S. Eligini S. Centenaro C.
Anselmo A. Alamanni F. Tremoli E.
Institution
(Brambilla, Parolari, Camera, Centenaro, Anselmo, Alamanni, Tremoli)
Centro Cardiologico Monzino, IRCCS, Via Parea, 4, 20138 Milano, Italy.
(Camera, Colli, Eligini, Tremoli) Department of Pharmacological Sciences,
Universita degli Studi di Milano, Milano, Italy.
(Anselmo) Department of Inflammation and Immunology, Istituto Clinico
Humanitas, Rozzano, Milano, Italy.
(Parolari, Alamanni) Department of Cardiovascular Sciences, Universita
degli Studi di Milano, Milano, Italy.
Title
Effect of two doses of aspirin on thromboxane biosynthesis and platelet
function in patients undergoing coronary surgery.
Source
Thrombosis and Haemostasis. 103(3)(pp 516-524), 2010. Date of
Publication: March 2010.
Publisher
Schattauer GmbH
Abstract
Early post-operative aspirin improves survival in patients undergoing
coronary artery bypass graft (CABG). However, most patients do not benefit
of aspirin after CABG, still remaining at risk of thrombotic events due to
insufficient platelet inhibition, specifically via the thromboxane (TX)
pathway. We evaluated the effect of two aspirin doses (100 or 325 mg
daily, enteric coated formulations) on platelet function and TX
biosynthesis in patients after CABG and assessed whether the incidence of
residual platelet reactivity could be reduced by the higher dose.
Fifty-six patients undergoing CABG were randomly assigned to 100 or 325 mg
aspirin daily for five days in a prospective single-centre study.
Treatment effect was assessed by measuring either platelet function
(light-transmission aggregometry and point-of-care PFA-100 ) or TX
biosynthesis in collagen-stimulated platelets, serum, urine, and in
lipopolysaccharide (LPS)-cultured whole blood (WB). An insufficient TX
inhibition was observed with 100 mg aspirin but not with the higher dose.
The different effect of the two doses was, however, highlighted by either
TX (platelet- or serum-derived) or by PFA-100 but not by the other assays.
In conclusion, early after CABG, the incidence of residual platelet
activity was lower in patients who received 325 mg aspirin. Moreover,
evidence was provided that different methods yield different results in
the detection of aspirin resistance, rendering them not interchangeable.
copyright Schattauer 2010.
<11>
Accession Number
2010128153
Authors
Iskesen I. Kurdal A.T. Eserdag M. Cerrahoglu M. Sirin B.H.
Institution
(Iskesen, Kurdal, Eserdag, Cerrahoglu, Sirin) Department of Cardiovascular
Surgery, Celal Bayar University, School of Medicine, Manisa, Turkey.
Title
Trimetazidine may protect the myocardium during cardiac surgery.
Source
Heart Surgery Forum. 12(3)(pp E175-E179), 2009. Date of Publication: June
2009.
Publisher
Carden Jennings Publishing Co. Ltd
Abstract
Background: Trimetazidine is an anti-ischemic agent with cardioprotective
effects. The purpose of this double-blind, controlled, prospective
randomized study was to investigate the possible effects of the
preoperative use of trimetazidine on the biochemical markers of myocardial
injury during open heart surgery and to determine if it has any myocardial
protective effects. Methods: Thirty patients undergoing coronary artery
bypass grafting surgery, received either trimetazidine (study group, n =
15) or not (control group, n = 15). Pretreatment began 2 weeks before the
operation with trimetazidine (60 mg/day orally), and the control group
received no medication. We measured the levels of serum creatine kinase
(CK), CK isoenzyme MB (CK-MB), myoglobin, and troponin T in venous blood
samples obtained before and after the operation to evaluate the effect of
this drug against myocardial damage. We also took serial blood samples
from the radial artery and the coronary sinus before the institution of
cardiopulmonary bypass (CPB) and at 2 and 15 minutes after the removal of
the cross-clamp to measure lactate levels and calculate the lactate
extraction of the myocardium. Results: Postoperative levels of myoglobin,
troponin T, CK, and CK-MB were significantly lower in the trimetazidine
group than in the control group (P < .05). There was also a significant
difference in the values for the lactate extraction calculation between
the groups at minute 2 after the removal of the cross-clamp (P < .05).
Conclusion: We conclude that pretreatment with trimetazidine has some
beneficial effects in protecting the myocardium and decreasing myocardial
injury during the cardioplegic arrest period in open heart surgery without
affecting postoperative hemodynamics. copyright 2009 Forum Multimedia
Publishing, LLC.
<12>
Accession Number
2010162188
Authors
Metcalf R.G. Cleland L.G. Gibson R.A. Roberts-Thomson K.C. Edwards J.R.M.
Sanders P. Stuklis R. James M.J. Young G.D.
Institution
(Metcalf, Cleland, James) Rheumatology Unit, Eleanor Harrald Building,
Royal Adelaide Hospital, North Tce, Adelaide, SA 5000, Australia.
(Edwards, Stuklis) Cardiothoracic Surgery Unit, Royal Adelaide Hospital,
Adelaide, SA, Australia.
(Metcalf, Cleland, Sanders, James, Young) Cardiovascular Research Centre,
Royal Adelaide Hospital, Adelaide, SA, Australia.
(Roberts-Thomson, Sanders, Young) Department of Cardiology, Royal Adelaide
Hospital, Adelaide, SA, Australia.
(Cleland, Roberts-Thomson, Sanders, James, Young) Discipline of Medicine,
University of Adelaide, Adelaide, SA, Australia.
(Gibson) School of Agriculture, Food and Wine, University of Adelaide,
Adelaide, SA, Australia.
(Gibson) Women's and Children's Health Research Institute, Adelaide, SA,
Australia.
(Cleland, James) Hanson Institute, Adelaide, SA, Australia.
Title
Relation between blood and atrial fatty acids in patients undergoing
cardiac bypass surgery.
Source
American Journal of Clinical Nutrition. 91(3)(pp 528-534), 2010. Date of
Publication: 01 Mar 2010.
Publisher
American Society for Nutrition
Abstract
Background: Studies relating cardiovascular outcomes to dietary or blood
measures of various fatty acids rely on the implicit assumptions that
dietary change results in changes in blood fatty acids that, in turn,
alter cardiac fatty acids. Although dietary intakes of n-3 (omega-3), n-6
(omega-6), and trans fatty acids are reflected in their concentrations in
blood, there are few human data on the relation between blood and cardiac
concentrations of fatty acids. Objective: The objective was to explore
relations between blood and myocardial n-3, n-6, trans, monosaturated, and
saturated fatty acids over a range of community intakes to evaluate
whether blood fatty acids are useful surrogate markers of their cardiac
counterparts. Design: Patients undergoing on-pump coronary bypass surgery
were recruited. Right atrial appendages and blood were collected at
surgery for fatty acid analysis. Results: Atrial appendages and matching
blood samples were collected from 61 patients. Highly significant
correlations were identified between atrial and erythrocyte or plasma n-3
[eg, eicosapentaenoic acid (erythrocytes: r = 0.93, P < 0.0001; plasma: r
= 0.87, P < 0.0001)], some n26 [eg, arachidonic acid (erythrocytes: r =
0.45, P = 0.0003; plasma: r = 0.39, P = 0.002)], trans [eg, total trans
18:1 (erythrocytes: r = 0.89, P < 0.0001; plasma: r = 0.74, P < 0.0001)],
and monounsaturated [eg, oleic acid (erythrocytes: r = 0.37, P = 0.003)]
fatty acids. There were no statistical associations between blood and
cardiac saturated fatty acids. Conclusion: Erythrocyte- and plasma
phospholipid-derived fatty acids can be used to estimate cardiac fatty
acid status in humans. copyright 2010 American Society for Nutrition.
<13>
Accession Number
2010160317
Authors
Schulz S. Mehilli J. Ndrepepa G. Neumann F.-J. Birkmeier K.A. Kufner S.
Richardt G. Berger P.B. Schomig A. Kastrati A.
Institution
(Schulz, Mehilli, Ndrepepa, Birkmeier, Kufner, Schomig, Kastrati)
Deutsches Herzzentrum, Technische Universitat, Lazarettstr. 36, 80636
Munich, Germany.
(Neumann) Herz-Zentrum, Bad Krozingen, Germany.
(Richardt) Herzzentrum der Segeberger Kliniken, Bad Segeberg, Germany.
(Berger) Geisinger Clinic, Danville, PA, United States.
(Schomig) 1. Medizinische Klinik Rechts der Isar, Technische Universitat,
Munich, Germany.
Title
Bivalirudin vs. unfractionated heparin during percutaneous coronary
interventions in patients with stable and unstable angina pectoris: 1-year
results of the ISAR-REACT 3 trial.
Source
European Heart Journal. 31(5)(pp 582-587), 2010. Date of Publication:
March 2010.
Publisher
Oxford University Press
Abstract
Aims In ISAR-REACT 3, 30-day outcomes in 4570 biomarker negative patients
undergoing percutaneous coronary intervention (PCI) [greater-than or equal
to]2 h after pre-treatment with 600 mg of clopidogrel revealed less
bleeding with bivalirudin compared with unfractionated heparin, but no
difference in 30-day net clinical benefit. The objective of the present
analysis was to assess the impact of bivalirudin vs. heparin on 1-year
outcomes in ISAR-REACT 3.Methods and resultsThe primary outcome for this
analysis was the composite of death, myocardial infarction, or target
vessel revascularization 1 year after randomization. The composite of
death or myocardial infarction was a secondary outcome. At 1 year, the
primary outcome occurred in 17.1 of patients assigned to bivalirudin vs.
17.5 assigned to heparin [hazard ratio (HR), 0.98; 95 confidence interval
(CI), 0.86-1.13; P = 0.816]. The combined incidence of death or myocardial
infarction was 7.7 in the bivalirudin group vs. 6.7 in the heparin group
(HR, 1.15; 95 CI, 0.93-1.43; P = 0.200). The mortality rate was 1.9 in the
bivalirudin group and 1.7 in the heparin group (HR, 1.10; 95 CI,
0.71-1.70; P = 0.667). At 1 year, no significant differences in the
primary outcome were observed with bivalirudin and heparin in any of the
subgroups analysed.ConclusionBivalirudin and unfractionated heparin during
PCI provide comparable outcomes at 1 year in biomarker negative patients
undergoing PCI after pre-treatment with 600 mg of clopidogrel.Clinical
trial registration information: URL www.clinicaltrials.gov; Unique
identifier NCT00262054.
<14>
Accession Number
2010156702
Authors
James S.R. Ranasinghe A.M. Venkateswaran R. McCabe C.J. Franklyn J.A.
Bonser R.S.
Institution
(James, Ranasinghe, McCabe, Franklyn, Bonser) Institute of Biomedical
Research, School of Clinical and Experimental Medicine, University of
Birmingham, Birmingham B15 2TH, United Kingdom.
(Ranasinghe, Venkateswaran, Bonser) Department of Cardiothoracic Surgery,
University Hospitals Birmingham, National Health Service Foundation Trust,
Edgbaston, Birmingham B15 2TH, United Kingdom.
Title
The effects of acute triiodothyronine therapy on myocardial gene
expression in brain stem dead cardiac donors.
Source
Journal of Clinical Endocrinology and Metabolism. 95(3)(pp 1338-1343),
2010. Date of Publication: March 2010.
Publisher
Endocrine Society
Abstract
Context: After brain stem death (BSD), a low T3 state is common, and T3
supplementation has been advocated to improve heart function and yield for
transplantation. Objectives: The aim of the study was to assess the
effects of T3 on expression of mRNAs encoding T 3-responsive genes in the
post-BSD human heart. Design: Within a prospective double-blind trial,
potential BSD cardiac donors undergoing hemodynamic optimization were
randomized to T3 (0.8 mug . kg-1 bolus; infusion 0.113 mug . kg-1 . h-1)
or placebo (5% dextrose) for up to 6 h. Left ventricular biopsies were
obtained at end-assessment from 30 donors (T3; n=16). TaqMan real-time PCR
was performed to investigate mRNA expression of the voltage-gated
potassium channel Kv1.5, beta-1 adrenergic receptor (ADRB1), sarcoplasmic
reticulum calcium ATPase type 2a (SERCA2a), and phospholamban (PLB).
Results: Time between diagnosis of BSD and donor management was 13.2 h
(range, 9.7-16.8 h). T3 donors were managed for 7.6 (6.9-8.3) h. Median
serum free T3 (fT3) at baseline was 2.9 (2.3-3.8) pmol . liter-1
(reference range, 3.3-7.5 pmol . liter-1). At baseline, 19 of 30 (56.7%)
had low serum fT3, and T3 treatment increased fT3 to supraphysiological
levels (P < 0.001). Expression of mRNAs encoding Kv1.5 and SERCA2a was
increased 1.99-fold and 1.51-fold (P = 0.015 and 0.043). There was no
significant change in the expression of mRNAs encoding ADRB1 and PLB.
Treatment with T3 did not improve hemodynamic function compared with
placebo. Conclusions: Acute administration of T3 in the BSD cardiac donor
reverses the low T3 state and increases expression of the mRNAs encoding
Kv1.5 and SERCA2a, but not ADRB1 or PLB and is not associated with any
improvement in hemodynamic performance. Copyright copyright 2010 by The
Endocrine Society.
<15>
Accession Number
2010122203
Authors
Vigano M. Dengler T. Mattei M.F. Poncelet A. Vanhaecke J. Vermes E.
Kleinloog R. Li Y. Gezahegen Y. Delgado J.F.
Institution
(Vigano) Department of Cardiac Surgery, Policlinico S. Matteo, IRCCS
Universita Degli Studi di Pavia, Pavia, Italy.
(Dengler) Department of Cardiology, University of Heidelberg, Heidelberg,
Germany.
(Mattei) Department of Cardiology and Transplantation, CHU Hopital de
Brabois, Vandoeuvre les Nancy, France.
(Poncelet) Cardio-Thoracic and Vascular Unit, Cliniques Universitaires St
Luc, Bruxelles, Belgium.
(Vanhaecke) Department of Cardiac Surgery, UZ Gasthuisberg, Leuven,
Belgium.
(Vermes) Department of Cardiology and Transplantation, Hopital Henri
Mondor, Creteil, France.
(Kleinloog) Transplant Division, Entabeni Hospital, Durban, South Africa.
(Li) Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover,
NJ, United States.
(Gezahegen) Novartis Pharma AG, Basel, Switzerland.
(Delgado) Department of Cardiology, Hospital 12 de Octubre, Madrid, Spain.
(Delgado) Unidad de IC y Trasplante, Servicio de Cardiologia, Hospital
Doce de Octubre, Avenida de Cordoba sn, 28041 Madrid, Spain.
Title
Lower incidence of cytomegalovirus infection with everolimus versus
mycophenolate mofetil in de novo cardiac transplant recipients: A
randomized, multicenter study.
Source
Transplant Infectious Disease. 12(1)(pp 23-30), 2010. Date of
Publication: February 2010.
Publisher
Blackwell Publishing Ltd
Abstract
Cytomegalovirus (CMV) is a major cause of infectious complications
following cardiac transplantation, severely affecting short- and long-term
outcomes. A 12-month, multicenter, randomized, open-label study in de novo
cardiac transplant patients was undertaken to compare the efficacy, renal
function, and safety of everolimus plus reduced cyclosporine versus
mycophenolate mofetil (MMF) plus standard cyclosporine (ClinicalTrials.gov
NCT00150046). CMV-specific data was prospectively collected on infections,
laboratory evidence, CMV syndrome, and CMV disease. In total, 176 patients
were randomized (everolimus 92; MMF 84). Use of CMV prophylaxis was
similar between groups (everolimus 20.8%; MMF 24.0%). Patients in the
everolimus arm had a significantly lower incidence of any CMV event (8.8%
versus 32.5% with MMF, P<0.001), CMV infection as an adverse event (4.4%
versus 16.9%, P=0.011), laboratory evidence of CMV (antigenemia 7.7%
versus 27.7%, P<0.001; polymerase chain reaction assay 2.2% versus 12.0%,
P=0.015), and CMV syndrome (1.1% versus 8.4%, P=0.028). In the donor
(D)+/recipient (R)+and D-/R+ subgroups, even after adjusting for use of
prophylaxis, the CMV event rate remained significantly lower with
everolimus than with MMF (P=0.0015 and P=0.0381, respectively). In
conclusion, de novo cardiac transplant recipients experienced lower rates
of CMV infection, CMV syndrome, or organ involvement on an
everolimus-based immunosuppressant regimen compared with MMF. copyright
2009 John Wiley & Sons A/S.
<16>
Accession Number
2010111808
Authors
Van Geldorp I.E. Vernooy K. Delhaas T. Prins M.H. Crijns H.J. Prinzen F.W.
Dijkman B.
Institution
(Van Geldorp, Vernooy, Crijns, Dijkman) Department of Cardiology,
Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University Medical Center, Maastricht, Netherlands.
(Van Geldorp, Vernooy, Delhaas, Prinzen) Department of Physiology,
Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University Medical Center, P.O. Box 616, NL-6200 MD Maastricht,
Netherlands.
(Delhaas) Department of Pediatrics, Maastricht University Medical Center,
Maastricht, Netherlands.
(Prins) Department of Clinical Epidemiology and Medical Technology
Assessment (KEMTA), Maastricht University Medical Center, Maastricht,
Netherlands.
Title
Beneficial effects of biventricular pacing in chronically right
ventricular paced patients with mild cardiomyopathy.
Source
Europace. 12(2)(pp 223-229), 2010. Date of Publication: February 2010.
Publisher
Oxford University Press
Abstract
Aims To investigate whether cardiac resynchronization therapy (CRT) by
means of biventricular (BiV) pacing can improve left ventricular (LV)
function, remodelling and clinical status in chronically right ventricular
(RV) paced patients with mild cardiomyopathy. Methods and results
Thirty-six chronically (10 +/- 7 years) RV paced patients with left
ventricular ejection fraction (LVEF) < 40% or LVEDD > 55 mm, without an
established indication for CRT, were subjected to 6 months RV and BiV
pacing in a patient-blinded, randomized crossover design.
Treatment-effects of BiV pacing were evaluated for LV function, LV
remodelling and clinical status. As compared with RV pacing, BiV pacing
significantly improved LV function (LVEF 46 +/- 12 vs. 39 +/- 12 and LVFS
24 +/- 7 vs. 21 +/- 7) and reduced LV end-diastolic and end-systolic
diameters and volumes (LVEDD 56 +/- 8 vs. 59 +/- 8 mm, LVESD 43 +/- 8 vs.
47 +/- 9 mm, LVEDV 132 +/- 65 vs.144 +/- 62 mL and LVESV 77 +/- 56 vs. 92
+/- 55 mL, respectively). In 19 patients (53%) response to BiV pacing was
clinically relevant, defined as LVESV reduction >15. BiV pacing also
significantly improved NYHA classification. Conclusion BiV pacing
following chronic RV pacing may improve LV function and reverse LV
remodelling in patients with relatively mild LV dysfunction or
remodelling. Hence, upgrade to BiV pacing might be considered in
chronically RV paced patients with mild cardiomyopathy.
<17>
Accession Number
2010107141
Authors
Lamas G.A. Escolar E. Faxon D.P.
Institution
(Lamas, Escolar) Columbia University Division of Cardiology, Mount Sinai
Medical Center, 4300 Alton Road, Miami Beach, FL 33140, United States.
(Faxon) Division of Cardiology, Department of Medicine, Brigham and
Women's Hospital, Boston, MA, United States.
Title
Review article: Examining treatment of st-elevation myocardial infarction:
The importance of early intervention.
Source
Journal of Cardiovascular Pharmacology and Therapeutics. 15(1)(pp 6-16),
2010. Date of Publication: March 2010.
Publisher
SAGE Publications Ltd
Abstract
Early reperfusion in ST-segment elevation myocardial infarction (STEMI) is
imperative. Acute reperfusion may be achieved with fibrinolytic agents
and/or percutaneous coronary intervention (PCI); however, PCI is
associated with lower rates of death and myocardial infarction compared
with fibrinolysis. As treatment delays are associated with worse outcomes,
current guidelines recommend minimizing time from symptom onset to
treatment initiation. Regardless of the reperfusion strategy, patients
with STEMI are at increased risk of early recurrent ischemic events and
death. These risks can be significantly reduced by promptly initiating a
combination of pharmacotherapies that includes antiplatelet and
anticoagulant agents, beta-blockers, and inhibitors of the
renin-angiotensin-aldosterone system. This manuscript reviews the evidence
supporting the most recent guidelines for STEMI management published
jointly by the American College of Cardiology and American Heart
Association. More recent evidence and its potential impact on future
evidence-based guidelines are also addressed.
<18>
[Use Link to view the full text]
Accession Number
2010092561
Authors
Katragadda S. Arora R.R.
Institution
(Katragadda, Arora) Department of Medicine, Chicago Medical School, North
Chicago, IL, United States.
Title
Role of angiotensin-converting enzyme inhibitors in vascular modulation:
Beyond the hypertensive effects.
Source
American Journal of Therapeutics. 17(1)(pp e11-e23), 2010. Date of
Publication: January-February 2010.
Publisher
Lippincott Williams and Wilkins
Abstract
Angiotensin-converting enzyme (ACE) inhibitors are being widely used as
antihypertensives by clinicians worldwide. One in every three Americans
has hypertension. Hypertension, diabetes, obesity, active smoking,
hypercholesterolemia, and inactivity are the major cardiovascular risk
factors, which can produce compounding effects on human health, leading to
cardiovascular morbidity and mortality. We review the mechanism of action
of ACE inhibitors and explain the rationale for using ACE inhibitors not
only in hypertensive patients but also in patients with congestive heart
failure, acute myocardial infarction, or coronary artery disease. ACE
inhibitors can reduce preload and afterload on the heart, prevent
ventricular remodeling, and even retard atherogenic changes in the vessel
walls. ACE inhibitors can also be helpful in slowing the progression of
kidney disease, especially in diabetics. Some studies such as the Heart
Outcomes Prevention Evaluation study have shown that ACE inhibitors can
reduce the risk of cardiovascular morbidity and mortality, particularly in
high-risk individuals. The renin-angiotensin-aldosterone system plays an
important role in regulating blood pressure and body volume in the human
body. ACE inhibitors and angiotensin-receptor blockers are the two classes
of antihypertensives that primarily act on the
renin-angiotensin-aldosterone system. We discuss randomized, controlled
trials that evaluated different ACE inhibitors and compare them with
angiotensin-receptor blockers. copyright 2010 Lippincott Williams &
Wilkins.
<19>
Accession Number
2010107804
Authors
He Q.-Y. Wang J. Zhang Y.-L. Tang Y.-L. Chu F.-Y. Xiong X.-J.
Institution
(He, Wang, Tang, Chu) Cardiology Department of Guang'Anmen Hospital, China
Academy of Chinese Medical Sciences, Beijing (100053), China.
(He, Zhang) Department of Traditional Chinese Medical Internal Medicine,
Dongfang Hospital, Beijing University of Chinese Medicine, Beijing
(100078), China.
Title
Effect of Yiqi Yangyin decoction on the quality of life of patients with
unstable angina pectoris.
Source
Chinese Journal of Integrative Medicine. 16(1)(pp 13-18), 2010. Date of
Publication: February 2010.
Publisher
Chinese Journal of Integrated Traditional and
Abstract
Objective: To observe the effect of Yiqi Yangyin Decoction (YQYYD) on the
quality of life (QOL) of patients with unstable angina pectoris (UAP).
Methods: A total of 108 patients with UAP of qi-yin deficiency syndrome
confirmed by coronary angiography were enrolled and assigned to the
treated group (treated with YQYYD and conventional therapy of Western
medicine) and the control group (treated with conventional therapy of
Western medicine), by the use of the PROC PLAN of the SAS 6.12 software,
in a prospective, randomized, controlled design. The clinical total
effective rate, symptom score, QOL scale [Seattle Angina Questionnaire
(SAQ)] and incidence of important clinical events were defined as the
observation indices to evaluate the interventional effect of YQYYD on the
QOL of patients with UAP of the qi-yin deficiency syndrome. Results:
During the study, three cases dropped out in the treated group, one case
dropped out in the control group, and 104 cases, including 51 cases in the
treatment group and 53 cases in the control group, finished the trial.
After four weeks of treatment, the total clinical effective rates in the
treated group and the control group were 80.4% and 75.5% respectively, and
there was no obvious difference between them (P>0.05). However, the
symptom score of the treated group (9.31+/-2.02) was significantly lesser
than that of the control group (11.62+/-3.04, P<0.05), and the total score
of the QOL scale of the treated group (68.76+/-5.74) was significantly
higher than that of the control group (61.06+/-3.31, P<0.01). Among those
in the treated group physical limitation, angina stability, angina
frequency, and treatment satisfaction were significantly ameliorated when
compared with the control group after treatment (P<0.05, P<0.01). The
incidence of important clinical events in the treated group (3.9%) was
lower than that in the control group (5.7%) during the 8-month follow-up
period, but the difference was insignificant (P>0.05). Conclusion: YQYYD
could improve the clinical symptoms of patients with UAP of qi-yin
deficiency syndrome and greatly improve their QOL. copyrightThe Chinese
Journal of Integrated Traditional and Western Medicine Press and
Springer-Verlag 2010.
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