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<1>
Accession Number
2011101209
Authors
Baxter G.D.
Institution
(Baxter) Centre for Physiotherapy Research, School of Physiotherapy,
University of Otago, New Zealand
Title
Massage therapy after heart surgery: Possibly pleasant, but not effective.
Source
Focus on Alternative and Complementary Therapies. 16 (1) (pp 76-77),
2011. Date of Publication: March 2011.
Publisher
Wiley-Blackwell (350 Main Street, Malden MA 02148, United States)

<2>
Accession Number
2011093717
Authors
Politi L. Aprile A. Paganelli C. Amato A. Zoccai G.B. Sgura F. Monopoli D.
Rossi R. Modena M.G. Sangiorgi G.M.
Institution
(Politi, Aprile, Paganelli, Amato, Zoccai, Sgura, Monopoli, Rossi, Modena,
Sangiorgi) Interventional Cardiology, University of Modena and Reggio
Emilia, Policlinico Hospital, Via del Pozzo 71, Modena 41100, Italy
Title
Randomized clinical trial on short-time compression with kaolin-filled
pad: A new strategy to avoid early bleeding and subacute radial artery
occlusion after percutaneous coronary intervention.
Source
Journal of Interventional Cardiology. 24 (1) (pp 65-72), 2011. Date of
Publication: January 2011.
Publisher
Blackwell Publishing Inc. (350 Main Street, Malden MA 02148, United
States)
Abstract
Background: Despite the increasing use of transradial techniques for
cardiac percutaneous procedures, none of the strategies commonly utilized
for hemostasis has been able to reduce the occurrence of radial artery
occlusion (RAO). The aim of this study was to evaluate the occurrence of
24-hour RAO and the rate of bleeding of a novel hemostatic device for
radial closure after percutaneous interventions, in adjunct to short-time
compression. Methods: Once the radial access was obtained, patients were
randomized to 3 different strategies of radial closure: a short
compression with the QuikClot Interventional pad (Z-Medica Corporation,
Wallingford, CT, USA) (15 minutes, group 1), a short compression (15
minutes, group 2), and a conventional prolonged compression (2 hours,
group 3) both without QuikClot utilization. Results: Fifty patients in
group 1, 20 in group 2, and 50 in group 3 were enrolled. The three groups
were homogenous for baseline and procedural characteristics. None of
patients in group 1 developed RAO, 1 (5%) occurred in group 2, and 5 (10%)
in group 3 (P = 0.05). Active bleeding after compression removal occurred
in 10 patients (20%) in group 1, 18 (90%) in group 2, and 1 (2%) in group
3 (P < 0.001). Among patients in group 1, at univariate analysis, the
predictors of acute bleeding resulted in chronic therapy with clopidogrel
(Odds Ratio 28.78, 95% Confidence Intervals 4.79-172.82, P < 0.001) and
high levels of activated clotting time (ACT) at the time of sheath removal
(OR 1.02, 95% CI 1.00-1.03, P = 0.009). At ROC analysis, the cutoff value
of ACT for the risk of bleeding with a sensitivity of 80% and specificity
of 75% was 287 seconds. Conclusions: Early sheet removal and short-time
compression with QuikClot Interventional can reduce the rate of RAO after
diagnostic or interventional procedures especially in patients not on
double antiplatelet therapy. 2010, Wiley Periodicals, Inc.

<3>
[Use Link to view the full text]
Accession Number
2011095001
Authors
Groeneveld A.B.J. Navickis R.J. Wilkes M.M.
Institution
(Groeneveld) Department of Intensive Care, Vrije Universiteit Medical
Center, Amsterdam, Netherlands
(Navickis, Wilkes) Hygeia Associates, Grass Valley, CA, United States
Title
Update on the comparative safety of colloids: A systematic review of
clinical studies.
Source
Annals of Surgery. 253 (3) (pp 470-483), 2011. Date of Publication:
March 2011.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street, Philadelphia PA
19106-3621, United States)
Abstract
Objective: To provide an updated systematic review on the comparative
safety of colloids based on recent clinical studies. Background: Recent
investigations, including large-scale randomized trials and meta-analyses,
have sought to determine the effects of colloids on mortality and
morbidity. Hypothesized differences in safety profile between hydroxyethyl
starch (HES) solutions have also been evaluated in randomized trials.
Methods: Clinical studies reported since 2002 with safety data for acutely
ill patients receiving HES, gelatin, dextran, or albumin were sought by
computer searches and other methods. Safety endpoints included mortality,
morbidity, bleeding and impaired coagulation, and acute kidney injury
(AKI). Data extracted from the included study reports were qualitatively
summarized. Results:: Sixty-nine clinical studies were included. Of those,
42 were randomized controlled trials (RCTs) with 10,382 total patients.
New safety data, since 2002, predominantly concerned albumin or HES. A
large RCT of intensive care unit patients showed that albumin does not
adversely affect survival. Acute kidney injury and a dose-dependent
increase in mortality were observed in a large RCT of patients with severe
sepsis or septic shock receiving HES. Impaired coagulation and clinical
bleeding were frequently reported after HES infusion, especially in
cardiac surgery. In head-to-head randomized comparisons of different HES
solutions, observed effects on coagulation and renal function were
similar. Gelatin showed less impairment of coagulation than HES. Very few
safety data related to dextran were identified. Conclusions: Albumin
displayed a more favorable safety profile than HES. Available evidence
does not support the existence of consistent safety differences between
HES solutions. Copyright 2011 by Lippincott Williams & Wilkins.

<4>
Accession Number
2011099353
Authors
Sheu J.-J. Chua S. Sun C.-K. Chang L.-T. Yen C.-H. Wu C.-J. Fu M. Yip
H.-K.
Institution
(Sheu, Sun) Department of Surgery, Chang Gung Memorial Hospital-Kaohsiung
Medical Center, Chang Gung University College of Medicine, Kaohsiung,
Taiwan (Republic of China)
(Chua, Wu, Fu, Yip) Division of Cardiology, Department of Internal
Medicine, Chang Gung Memorial Hospital, 123, Ta Pei Road, Niao Sung
Hsiang, Kaohsiung Hsien, 83301, Taiwan (Republic of China)
(Chang) Basic Science, Nursing Department, Meiho Institute of Technology,
Pingtung, Taiwan (Republic of China)
(Yen) Department of Life Science, National Pingtung University of Science
and Technology, Taiwan (Republic of China)
Title
Intra-coronary administration of cyclosporine limits infarct size,
attenuates remodeling and preserves left ventricular function in porcine
acute anterior infarction.
Source
International Journal of Cardiology. 147 (1) (pp 79-87), 2011. Date of
Publication: 17 Feb 2011.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Background: We tested whether intra-coronary administration of
cyclosporine effectively preserves left ventricular (LV) function in
porcine acute anterior wall infarction (AMI). Methods and results:
Eighteen male mini-pigs were randomized into groups 1 (control), 2 (AMI
alone), and 3 (AMI with cyclosporine treatment). AMI was induced by
ligating middle left anterior descending artery (LAD). Fifteen minutes
after ligation, saline and cyclosporine (2.5 mg) combination was injected
into LAD beyond ligation in groups 2 and 3, respectively. Echocardiography
was performed after 14 days, followed by animal sacrifice. Larger
infarcted area (IA) was noted in group 2 than in group 3 (p < 0.001). In
both IA and peri-IA, mRNA expressions of IL-8, MMP-9, caspase 3 and Bax
were higher, whereas PGC-1alpha, eNOS and Bcl-2 were lower in group 2 than
in groups 1 and 3 (p < 0.01). The mRNA expression of IL-10 was upregulated
in both IA and peri-IA in group 3 compared with groups 1 and 2. Apoptotic
nuclei and CD40-positive cells were higher in both peri-IA and non-IA in
group 2 than in groups 1 and 3 (p < 0.001). Oxidative stress and cytosolic
cytochrome C in IA were increased in group 2 than in groups 1 and 3 (p <
0.001). Mid-LV end-systolic areas were higher, whereas mid-LV wall
fractional area change was lower in group 2 than in groups 1 and 3 (p <
0.001). Conclusions: Intra-coronary administration of cyclosporine
effectively limits infarct size, attenuates LV remodeling and preserves LV
function.

<5>
Accession Number
20186295
Authors
Basagan-Mogol E. Goren S. Korfali G. Turker G. Kaya F.N.
Institution
(Basagan-Mogol, Goren, Korfali, Turker, Kaya) Uludag University School of
Medicine, Department of Anesthesiology and Reanimation, Bursa, Turkey
Title
Induction of anesthesia in coronary artery bypass graft surgery: The
hemodynamic and analgesic effects of ketamine.
Source
Clinics. 65 (2) (pp 133-138), 2010. Date of Publication: 2010.
Publisher
Universidade de Sao Paulo (Av.Dr.Arnaldo 455-Cerqueira Cesar, Sao Paulo
01246903, Brazil)
Abstract
OBJECTIVE: The aim of this prospective, randomized study was to evaluate
the hemodynamic and analgesic effects of ketamine by comparing it with
propofol starting at the induction of anesthesia until the end of
sternotomy in patients undergoing coronary artery bypass grafting surgery.
INTRODUCTION: Anesthetic induction and maintenance may induce myocardial
ischemia in patients with coronary artery disease. A primary goal in the
anesthesia of patients undergoing coronary artery bypass grafting surgery
is both the attenuation of sympathetic responses to noxious stimuli and
the prevention of hypotension. METHODS: Thirty patients undergoing
coronary artery bypass grafting surgery were randomized to receive either
ketamine 2 mg.kg-1 (Group K) or propofol 0.5 mg.kg-1 (Group P) during
induction of anesthesia. Patients also received standardized doses of
midazolam, fentanyl, and rocuronium in the induction sequence. The
duration of anesthesia from induction to skin incision and sternotomy, as
well as the supplemental doses of fentanyl and sevoflurane, were recorded.
Heart rate, mean arterial pressure, central venous pressure, pulmonary
arterial pressure, pulmonary capillary wedge pressure, cardiac index,
systemic and pulmonary vascular resistance indices, stroke work index, and
left and right ventricular stroke work indices were obtained before
induction of anesthesia; one minute after induction; one, three, five, and
ten minutes after intubation; one minute after skin incision; and at one
minute after sternotomy. RESULTS: There were significant changes in the
measured and calculated hemodynamic variables when compared to their
values before induction. One minute after induction, mean arterial
pressure and the systemic vascular resistance index decreased
significantly in group P (p<0.01). CONCLUSION: There were no differences
between groups in the consumption of sevoflurane or in the use of
additional fentanyl. The combination of ketamine, midazolam, and fentanyl
for the induction of anesthesia provided better hemodynamic stability
during induction and until the end of sternotomy in patients undergoing
coronary artery bypass grafting surgery.

<6>
Accession Number
70348889
Authors
Ng K. Grounds R. Haga K. Carter G. Clarke S. Loveless R. Glyde D.
McClymont K. Alston R.P.
Institution
(Ng, Grounds, Haga, Carter, Clarke, Loveless, Glyde, McClymont, Alston)
Department of Anaesthesia, Critical Care and Pain Medicine, School of
Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh,
United Kingdom
Source
Anaesthesia. Conference: Meeting of the Association of Cardiothoracic
Anaesthetists Cambridge United Kingdom. Conference Start: 20090619
Conference End: 20090619. Conference Publication: (var.pagings). 64 (12)
(pp 1389), 2009. Date of Publication: December 2009.
Publisher
Blackwell Publishing Ltd
Abstract
Tight blood glucose control in critical care has been associated with
improved outcomes but may result in more episodes of hypoglycaemia [1].
The aim of this study was to review systematically the literature to
determine the efficacy and safety of tight blood glucose control during
heart surgery. Methods A literature search of the major databases was
performed and the reference lists of identified papers were hand searched.
Identified studies were critically appraised. Inclusion criteria were
randomised controlled trials (RCTs), patients undergoing heart surgery and
explicit definitions of 'tight' and 'normal' control of blood glucose.
Results Nine of the 51 identified RCTs met the entry criteria and only
four outcomes were suitable for meta-analyses. Tight blood glucose control
reduced the incidences of atrial fibrillation (OR 0.76 (95% CI 0.58-0.99))
and the use of epicardial pacing (OR 0.32 (95% CI 0.17-0.60)), as well as
reducing the duration of mechanical ventilation (mean difference )0.36
(95% CI )3.85 to )3.54)) h and stay in the ICU (mean difference )0.57 (95%
CI )0.60 to )0.55)) days. Heterogeneity was high for the incidences of
atrial fibrillation (I² 55%) and pacing (I² 75%) and
extremely high for the duration of mechanical ventilation (I²
94%) and ICU stay (I² 99%). Only one of nine studies found
'tight' blood glucose control to be associated with significantly more
episodes of hypoglycaemia. Discussion Tight blood glucose control during
heart surgery appears to be safe and associated with some beneficial
effects on outcome following surgery. However, these findings are greatly
limited by the high levels of heterogeneity in the meta-analyses and the
poor quantification and wide variation in definition of hypoglycaemia. In
addition, there were insufficient data to examine other important adverse
events such as infection, myocardial infarction, renal failure and stroke.
A consensus on the definitions of 'tight', 'normal' and hypoglycaemia
would facilitate comparison of future studies during and after heart
surgery. A well designed and conducted RCT is required to determine the
efficacy and safety of 'tight' compared to 'normal' blood glucose control
during and after heart surgery.

<7>
Accession Number
70348890
Source
Anaesthesia. Conference: Meeting of the Association of Cardiothoracic
Anaesthetists Cambridge United Kingdom. Conference Start: 20090619
Conference End: 20090619. Conference Publication: (var.pagings). 64 (12)
, 2009. Date of Publication: December 2009.
Publisher
Blackwell Publishing Ltd
Abstract
The proceedings contain 4 papers. The topics discussed include: a survey
of post-sternotomy chronic pain following cardiac surgery; right heart
function during one-lung ventilation - observations using transoesophageal
echocardiography; heparin concentrations in neonates during
cardiopulmonary bypass as measured by the activated clotting time and
anti-Xa assay; and the efficacy and safety of tight blood glucose control
during heart surgery: a systematic review and meta-analysis.

<8>
Accession Number
70348538
Source
Contraception. Conference: Reproductive Health 2009 Los Angeles, CA
United States. Conference Start: 20090930 Conference End: 20091003.
Conference Publication: (var.pagings). 80 (2) , 2009. Date of
Publication: August 2009.
Publisher
Elsevier USA
Abstract
The proceedings contain 114 papers. The topics discussed include:
menstrual pattern changes from levonorgestrel subdermal implants and DMPA:
systematic review and evidence-based comparisons; impact of obesity on
oral contraceptive pharmacokinetics and hypothalamic-pituitary-ovarian
activity; bone mineral density in young women aged 19-24 after 4-5 years
of exclusive and mixed use of hormonal contraception; the frameless copper
IUD (GyneFix) and the TCu380A IUD: results of an 8-year multicenter
randomized comparative trial; the risk of unintended pregnancies in users
of the contraceptive patch compared to users of oral contraceptives in the
UK General Practice Research Database; the effect of
levonorgestrel-releasing intrauterine device on menorrhagia in women
taking anticoagulant medication after cardiac valve replacement; and age
of sexual debut among US adolescents.

<9>
[Use Link to view the full text]
Accession Number
2011087033
Authors
Kim H.J. Lee J.-M. Kim J.H. Hong D.M. Jeon Y. Roh Y.-J. Lim Y.J. Bahk
J.-H.
Institution
(Kim, Lee, Kim, Hong, Jeon, Roh, Lim, Bahk) Department of Anesthesiology
and Pain Medicine, Seoul National University Hospital, Seoul, South Korea
Title
The head-down tilt position decreases vasopressor requirement during
hypotension following induction of anaesthesia in patients undergoing
elective coronary artery bypass graft and valvular heart surgeries.
Source
European Journal of Anaesthesiology. 28 (1) (pp 45-50), 2011. Date of
Publication: January 2011.
Publisher
Lippincott Williams and Wilkins (250 Waterloo Road, London SE1 8RD, United
Kingdom)
Abstract
Background and objective Previous studies have failed to demonstrate that
the head-down tilt position confers benefits in hypovolaemic hypotensive
patients. The aim of this study was to evaluate the haemodynamic effect
and vasopressor use by this position in hypotensive patients after the
induction of general anaesthesia. Methods This prospective randomised
study involved 98 patients scheduled for elective cardiac surgery and 40
patients (40.1%) developed hypotension after anaesthesia induction. Upon
occurrence of hypotension, patients were randomly allocated to the supine
(n1/419) or head-down tilt (n1/421) groups (15degree head-down tilt
position). Blood pressure, heart rate, cardiac index and stroke volume
index were recorded at 1-min interval for 10 min from the occurrence of
hypotension. Vasopressors were administered to treat hypotension in both
groups. Results No haemodynamic difference was observed between the supine
and head-down tilt groups except for SBP changes from baseline at 1 min
(-3.98+/-6.31 vs. 1.84+/-8.25%, P1/40.004) and 2 min (1.51+/-14.34 vs.
9.37+/-10.57%, P1/40.032). The number of vasopressor administrations and
percentage of the patients requiring vasopressors in the supine group were
greater than that in the head-down tilt group [median 1 (range 1-5) vs.
median 0 (range 0-2), P1/40.002, 19/19 (100%) vs. 10/21 (47.6%), P<0.001].
Conclusion The head-down tilt position in hypotensive patients following
anaesthesia induction reduced vasopressor requirement by almost one third.
Minimal haemodynamic effect may be caused by different vasopressor
administrations. This result suggests that the head-down tilt position may
enable more stable anaesthesia induction in patients undergoing elective
coronary artery bypass graft or valvular heart surgeries. 2011 Copyright
European Society of Anaesthesiology.

<10>
Accession Number
2011091462
Authors
Leppikangas H. Jrvela K. Sisto T. Maaranen P. Virtanen M. Lehto P.
Karlsson S. Koobi T. Lindgren L.
Institution
(Leppikangas, Lindgren) Department of Anaesthesia, Tampere University
Hospital, PO Box 2000, Tampere 33521, Finland
(Jrvela, Sisto, Maaranen, Virtanen, Lehto) Heart Center, Tampere
University Hospital, PO Box 2000, Tampere 33521, Finland
(Karlsson) Department of Intensive Care, Tampere University Hospital, PO
Box 2000, Tampere 33521, Finland
(Koobi) Deparment of Clinical Physiology, Tampere University Hospital, PO
Box 2000, Tampere 33521, Finland
Title
Preoperative levosimendan infusion in combined aortic valve and coronary
bypass surgery.
Source
British Journal of Anaesthesia. 106 (3) (pp 298-304), 2011. Date of
Publication: March 2011.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Background. Cardiopulmonary bypass may have detrimental effects on
intestinal function and decrease the concentrations of the active,
long-acting metabolites of levosimendan, an inodilator used to improve
cardiac function. The aim of this study was to evaluate the haemodynamic
effects of preoperative levosimendan in patients undergoing high-risk
cardiac surgery. Methods. Twenty-four patients were randomized to receive
levosimendan (12 g bolus followed by an infusion of 0.2 mug
kg^-1 min^-1) or a placebo 24 h before surgery. The
inclusion criteria were left ventricular ejection fraction (LVEF) <50 or
LV hypertrophy indicated by a wall thickness of >12 mm. Haemodynamics were
recorded every hour for 24 h (pulmonary artery catheter) and daily until
postoperative day 4 (whole-body impedance cardiography). Doppler
echocardiography with tissue Doppler imaging was used to assess systolic
and diastolic cardiac function. Results. The cardiac index (CI) and stroke
volume index (SI) were higher in the levosimendan group (LG) for the 4 day
postoperative period (P<0.05); on the fourth postoperative day, the CI was
3.0 litre m^-2 min^-1 in the LG compared with 2.4
litre m^-2 min^-1 in the control group (CG) and the SI
was 30 vs 25 ml m^-2, respectively. The LVEF measured at
baseline and on the fourth postoperative morning decreased in the CG, but
was maintained in the LG. Conclusions. Levosimendan improved haemodynamics
compared with a placebo in patients undergoing high-risk cardiac surgery.
The concentrations of levosimendans metabolites were higher compared with
earlier studies using perioperative dosing. The Author [2010].

<11>
Accession Number
2011091465
Authors
Maund E. McDaid C. Rice S. Wright K. Jenkins B. Woolacott N.
Institution
(Maund, McDaid, Rice, Wright, Jenkins, Woolacott) Centre for Reviews and
Dissemination, University of York, York YO10 5DD, United Kingdom
Title
Paracetamol and selective and non-selective non-steroidal
anti-inflammatory drugs for the reduction in morphine-related side-effects
after major surgery: A systematic review.
Source
British Journal of Anaesthesia. 106 (3) (pp 292-297), 2011. Date of
Publication: March 2011.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Non-opioid analgesics, paracetamol, non-steroidal anti-inflammatory drugs
(NSAIDs), or cyclo-oxygenase 2 (COX-2) inhibitors are often given along
with morphine as part of multimodal analgesia after major surgery. We have
undertaken a systematic review and a mixed treatment comparison (MTC)
analysis in order to determine explicitly which class of non-opioid
analgesic, paracetamol, NSAIDs, or COX-2 inhibitors is the most effective
in reducing morphine consumption and morphine-related adverse effects.
Sixty relevant studies were identified. The MTC found that when
paracetamol, NSAIDs, or COX-2 inhibitors were added to patient-controlled
analgesia (PCA) morphine, there was a statistically significant reduction
in morphine consumption: paracetamol [mean difference (MD)-6.34 mg; 95
credibility interval (CrI)-9.02,-3.65], NSAIDs (MD-10.18; 95
CrI-11.65,-8.72), and COX-2 inhibitors (MD-10.92; 95 CrI-12.77,-9.08).
There was a significant reduction in nausea and postoperative nausea and
vomiting with NSAIDs compared with placebo (odds ratio 0.70; 95 CrI 0.53,
0.88) but not for paracetamol or COX-2 inhibitors, nor for NSAIDs compared
with paracetamol or COX-2 inhibitors. There was no statistically
significant difference in sedation between any intervention and
comparator. On the basis of six trials (n=695), 2.4 of participants
receiving an NSAID experienced surgical-related bleeding compared with 0.4
with placebo. The MTC found that there is a decrease in 24 h morphine
consumption when paracetamol, NSAID, or COX-2 inhibitors are given in
addition to PCA morphine after surgery, with no clear difference between
them. Similarly, the benefits in terms of reduction in morphine-related
adverse effects do not strongly favour one of the three non-opioid
analgesics. The Author [2010].

<12>
Accession Number
2011097914
Authors
Sasmazel A. Erkilic A. Buyukbayrak F. Baysal A. Tigen K. Tuncer A. Tuncer
E. Bugra O. Ozkokeli M. Kucukcerit T. Sunar H. Zeybek R.
Institution
(Sasmazel, Buyukbayrak, Tuncer, Tuncer, Bugra, Ozkokeli, Sunar, Zeybek)
Department of Cardiac Surgery, Istanbul, Turkey
(Erkilic, Baysal, Kucukcerit) Department of Anaesthesiology, Istanbul,
Turkey
(Tigen) Department of Cardiology, Kartal Kosuyolu Heart and Research
Center, Istanbul, Turkey
Title
The Effects of Reactive Hyperemia on Stimulation of Endothelium-Derived
Nitric Oxide in On-Pump and Off-Pump Coronary Artery Bypass Surgeries.
Source
Artificial Organs. 35 (2) (pp 131-136), 2011. Date of Publication:
February 2011.
Publisher
Blackwell Publishing Inc. (350 Main Street, Malden MA 02148, United
States)
Abstract
The purpose of this study is to compare the effects of cardiopulmonary
bypass (CPB) on the endothelium-derived nitric oxide (NO) levels in
on-pump and off-pump coronary artery bypass surgeries. Forty consecutive
patients were divided randomly into two groups depending on use of CPB in
coronary artery bypass graft surgery (group 1: n=20, off-pump, and group
2: n=20, on-pump). The plasma endothelium-derived NO levels were
determined at baseline and after reactive hyperemia before and after
surgery. Reactive hyperemia was induced by inflating a blood pressure cuff
placed on the upper forearm, for 5min at 250mmHg followed by a rapid
deflation. Blood was collected at 1min after cuff deflation from the
radial artery on the same side. Preoperative use of all medications was
recorded. The baseline plasma NO levels before operation were 17.10+/-7.58
in group 1 and 15.49+/-5.26nmol/L in group 2. Before operation after
reactive hyperemia, the plasma NO levels were 26.97+/-11.49 in group 1 and
26.57+/-12.87nmol/L in group 2. Two hours after surgery, the plasma NO
levels at baseline and after reactive hyperemia were not significantly
different from each other (group 1: 18.03+/-6.37 and group 2:
19.89+/-9.83nmol/L; group 1: 27.89+/-18.36 and group 2:
39.13+/-23.60nmol/L, respectively; P>0.05). A positive correlation was
shown between preoperative nitroglycerine use and the postoperative plasma
NO levels after reactive hyperemia (r=0.51, P=0.001). Linear regression
analysis was performed (F=4.10, R=0.56, R²=0.32, P= 0.008) and
the only independent parameter that had an effect on postoperative plasma
NO levels after reactive hyperemia was found to be preoperative
nitroglycerine use (t=3.68, P=0.001). Coronary artery bypass surgery with
CPB does not have significant effect on plasma endothelial derived NO
levels. The postoperative plasma NO levels after reactive hyperemia
significantly correlated with preoperative nitroglycerine use. 2010,
Copyright the Authors. Journal compilation 2010, International Center for
Artificial Organs and Transplantation and Wiley Periodicals, Inc..

<13>
Accession Number
2011098798
Authors
Navarese E.P. De Servi S. Buffon A. Suryapranata H. De Luca G.
Institution
(Navarese, De Luca) Division of Cardiology, Ospedale Maggiore della
Carita, Eastern Piedmont University, Novara, Italy
(De Servi) Department of Cardiovascular Diseases, Civic Hospital, Legnano,
Italy
(Buffon) Department of Cardiology, Catholic University of Sacred Heart,
Rome, Italy
(Suryapranata) Division of Cardiology, De Weezenlanden Hospital, Zwolle,
Netherlands
Title
Clinical impact of simultaneous complete revascularization vs. culprit
only primary angioplasty in patients with st-elevation myocardial
infarction and multivessel disease: A meta-analysis.
Source
Journal of Thrombosis and Thrombolysis. 31 (2) (pp 217-225), 2011. Date
of Publication: February 2011.
Publisher
Springer Netherlands (Van Godewijckstraat 30, Dordrecht 3311 GZ,
Netherlands)
Abstract
Primary Percutaneous Intervention (PCI) is the treatment of choice for
acute ST-elevation myocardial infarction (STEMI). Nearly half of STEMI
patients have multivessel (MV) disease that has been associated with worse
survival. However, current guidelines recommend to treat only the culprit
artery (COR) during the acute procedure. Thus, the aim of the current
study was to perform a meta-analysis of trials comparing MV PCI vs. COR
for STEMI patients with MV disease. Medline/CENTRAL and Web were searched
for comparative studies (both randomized and non randomized trials) about
MV PCI vs. COR for STEMI patients reporting mortality, re-PCI and re-MI
data. Primary endpoint was 30-day mortality. The meta-analysis included 10
studies (2 randomized and 8 registries; N = 31224). As compared with COR,
MV PCI significantly reduced long term rate of re-PCI (OR [95% CI] = 0.47
[0.28-0.78], P = 0.003) without increasing 30-day mortality (OR [95% CI] =
1.30 [0.79-2.12], P = 0.31) and long term re-MI (OR [95% CI] = 0.94
[0.43-2.06], P = 0.88). This meta-analysis showed safety and efficacy of
MV PCI approach as compared with COR, with a significant reduction in rate
of revascularizations, but no advantages in death and re-MI. 2010
Springer Science+Business Media, LLC.

<14>
Accession Number
2011098800
Authors
Caixeta A. Stone G.W. Mehran R. Lee E.A. McLaurin B.T. Cox D.A. Bertrand
M.E. Lincoff A.M. Moses J.W. White H.D. Ohman E.M. Palmerini T. Syros G.
Kittas C. Fahy M. Hooper W.C. Lansky A.J. Dangas G.D.
Institution
(Mehran, Dangas) Cardiovascular Research Foundation NY, Mount Sinai
Medical Center, Cardiovascular Institute (Box 1030), One Gustave L. Levy
Place, New York, NY 10029, United States
(Caixeta, Stone, Lee, Moses, Fahy) Columbia University Medical Center,
Cardiovascular Research Foundation, New York, NY, United States
(McLaurin) AnMed Health, Anderson, SC, United States
(Cox) Mid Carolina Cardiology, Charlotte, NC, United States
(Bertrand) Hopital Cardiologique, Lille, France
(Lincoff) Cleveland Clinic, Cleveland, OH, United States
(White) Auckland City Hospital, Auckland, New Zealand
(Ohman) Duke University Medical Center, Durham, NC, United States
(Palmerini) University of Bologna, Bologna, Italy
(Syros) St Elizabeth Hospital, Boston, MA, United States
(Kittas) University of Athens, Athens, Greece
(Lansky) Yale University Medical Center, New Haven, CT, United States
(Hooper) Division of Blood Disorders, Centers for Disease Control and
Prevention, Atlanta, GA, United States
Title
Predictive value of C-reactive protein on 30-day and 1-year mortality in
acute coronary syndromes: An analysis from the ACUITY trial.
Source
Journal of Thrombosis and Thrombolysis. 31 (2) (pp 154-164), 2011. Date
of Publication: February 2011.
Publisher
Springer Netherlands (Van Godewijckstraat 30, Dordrecht 3311 GZ,
Netherlands)
Abstract
We sought to evaluate the association between C-reactive protein (CRP)
sampled on admission and short- and long-term mortality in patients with
acute coronary syndromes (ACS) undergoing early invasive treatment.
Baseline levels of CRP were determined in 2,974 patients with moderate and
high-risk ACS undergoing an early invasive treatment strategy in the
large-scale randomized ACUITY trial. The relationship of CRP to 30-day and
1-year clinical outcomes were assessed according to quartiles of CRP
values. Patients with CRP levels in the fourth quartile compared to the
first quartile had significantly higher 30-day mortality (2.3 vs. 0.3%, P
= 0.0004) and 1-year mortality (5.5 vs. 2.8%, P = 0.0003). CRP level as a
continuous variable was associated with 30-day mortality (OR [95% CI] for
one unit increase in logarithmically transformed CRP level = 1.42
[1.08-1.89], P = 0.01) and 1-year mortality (OR [95% CI] = 1.24,
[1.04-1.47], P = 0.02). By multivariable analysis, higher baseline CRP
levels independently predicted 30-day and 1-year mortality, a relationship
that was particularly strong for patients with the highest quartile of CRP
(OR [95% CI] = 5.19 [1.14-23.68], P = 0.009). In troponin-positive
patients, increasing quartiles of CRP were associated with a trend for
30-day mortality (P _trend = 0.08) and a significant increase in
1-year mortality (P _trend = 0.02); this relationship was not
present in troponin-negative patients. Baseline CRP level is a powerful
independent predictor of both early and late mortality in patients with
ACS being treated with an early invasive strategy, especially in troponin
positive patients. 2010 Springer Science+Business Media, LLC.

<15>
Accession Number
2011099602
Authors
Anderson R.J. Bahn G.D. Moritz T.E. Kaufman D. Abraira C. Duckworth W.
Institution
(Anderson) Section of Endocrinology, VA Medical Center, Omaha, NE, United
States
(Bahn, Moritz, Kaufman) Cooperative Studies Program Coordinating Center,
Hines VA Hospital, Hines, IL, United States
(Abraira) Research Service, VA Medical Center, Miami, FL, United States
(Duckworth) Section of Endocrinology, VA Medical Center, Phoenix, AZ,
United States
Title
Blood pressure and cardiovascular disease risk in the Veterans Affairs
Diabetes Trial.
Source
Diabetes Care. 34 (1) (pp 34-38), 2011. Date of Publication: January
2011.
Publisher
American Diabetes Association Inc. (1701 North Beauregard St., Alexandria
VA 22311, United States)
Abstract
OBJECTIVE - Blood pressure ranges associated with cardiovascular disease
(CVD) events in advanced type 2 diabetes are not clear. Our objective was
to determine whether baseline and follow-up (On-Study) systolic blood
pressure (SBP), diastolic blood pressure (DBP), and SBP combined with DBP
predict CVD events in the Veterans Affairs Diabetes Trial (VADT). RESEARCH
DESIGN AND METHODS - Participants in the VADT (n = 1,791) with
hypertension received stepped treatment to maintain blood pressure below
the target of 130/80 mmHg in standard and intensive glycemic treatment
groups. Blood pressure levels of all subjects at baseline and On-Study
were analyzed to detect associations with CVD risk. The primary outcome
was the time from randomization to the first occurrence of myocardial
infarction, stroke, congestive heart failure, surgery for vascular
disease, inoperable coronary disease, amputation for ischemic gangrene, or
CVD death. RESULTS - Separated SBP >=140 mmHg had significant risk at
baseline (hazards ratio [HR] 1.508, P<0.001) and On-Study (HR 1.469,
P=0.002). DBP <70mmHg increased CVD events at baseline (HR 1.482, P <
0.001) and On-Study (HR 1.491, P < 0.001). Combined blood pressure
categories indicated high risk for CVD events for SBP >=140 with DBP <70
mmHg at baseline (HR 1.785, P=0.03) and On-Study (HR 2.042, P=0.003) and
nearly all SBP with DBP <70 mmHg. CONCLUSIONS - Increased risk of CVD
events with SBP >=140 mmHg emphasizes the urgency for treatment of
systolic hypertension. Increased risk with DBP <70 mmHg, even when
combined with SBP in guideline-recommended target ranges, supports a new
finding in patients with type 2 diabetes. The results emphasize that DBP
<70 mmHg in these patients was associated with elevated CVD risk and may
best be avoided. 2011 by the American Diabetes Association.

<16>
Accession Number
2011101579
Authors
Chen Q. Chen L.-W. Cao H. Zhang G.-C. Chen D.-Z. Zhang H.
Institution
(Chen, Chen, Cao, Zhang, Chen, Zhang) Department of Cardiovascular
Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, China
Title
Intraoperative device closure of atrial septal defects with inferior vena
cava rim deficiency: A safe alternative to surgical repair.
Source
Journal of Thoracic and Cardiovascular Surgery. 141 (3) (pp 631-636),
2011. Date of Publication: March 2011.
Publisher
Mosby Inc. (11830 Westline Industrial Drive, St. Louis MO 63146, United
States)
Abstract
Objective: Our objective was to evaluate the safety and feasibility of
intraoperative device closure of atrial septal defects with inferior vena
cava rim deficiency. Methods: From January 2005 to December 2008, we
enrolled 65 patients who had a secundum atrial septal defect with inferior
vena cava rim deficiency closure in our institution. Patients were divided
into 2 groups: 35 patients in group I underwent intraoperative device
closure with a right lateral minithoracotomy and 30 in group II underwent
open cardiac repair with a right lateral thoracotomy and cardiopulmonary
bypass. Intraoperative device closure involved a minimal intercostal
incision that was performed after full evaluation of the atrial septal
defect by transthoracic echocardiography and the insertion of the device
through the delivery sheath to occlude the atrial septal defect. Results:
The procedure was successful in all patients. In group I, the diameter of
the atrial septal defect ranged from 30 to 44 mm (mean, 35.3 +/- 3.9 mm),
and the size of the implanted occluder ranged from 34 to 48 mm (mean, 40
+/- 2.1 mm). The total occlusion rate was 82.9% immediately after the
operation, 97.1% at 3 months, and 100% at 12 and 24 months of follow-up.
In group II, all patients had successful closure. A follow-up period of 12
to 24 months was obtained in both groups. During the follow-up, there was
no recurrence, thrombosis, or device failure. In our comparative studies,
group II had significantly longer operative time, intensive care unit
stay, and hospital stay than group I (P < .001). The cost of group I was
less than that of group II (20,450.9 +/- 840.8 RMB vs 25,884.9 +/- 701.8;
P < .001). Conclusions: Intraoperative device closure of atrial septal
defects with inferior vena cava rim deficiency is a safe and feasible
technique. It has the advantages of cost savings, cosmetic results, and
less trauma than surgical closure. Early and midterm results are
encouraging. Crown Copyright 2011 Published by Elsevier Inc. on behalf of
The American Association for Thoracic Surgery.

<17>
Accession Number
2011101594
Authors
Darling G.E. Allen M.S. Decker P.A. Ballman K. Malthaner R.A. Inculet R.I.
Jones D.R. McKenna R.J. Landreneau R.J. Rusch V.W. Putnam Jr. J.B.
Institution
(Darling) University of Toronto, Toronto, ON, Canada
(Allen, Decker, Ballman) Mayo Clinic, Rochester, MN, United States
(Malthaner, Inculet) London Health Sciences Center, London, ON, Canada
(Jones) University of Virginia, Charlottesville, VA, United States
(McKenna) Cedars Sinai Medical Center, Los Angeles, CA, United States
(Landreneau) University of Pittsburgh, Pittsburgh, PA, United States
(Rusch) Memorial Sloan Kettering Cancer Center, New York, NY, United
States
(Putnam Jr.) Vanderbilt University Medical Center, Nashville, TN, United
States
Title
Randomized trial of mediastinal lymph node sampling versus complete
lymphadenectomy during pulmonary resection in the patient with N0 or N1
(less than hilar) non-small cell carcinoma: Results of the American
College of Surgery Oncology Group Z0030 Trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 141 (3) (pp 662-668),
2011. Date of Publication: March 2011.
Publisher
Mosby Inc. (11830 Westline Industrial Drive, St. Louis MO 63146, United
States)
Abstract
Objective: To determine whether mediastinal lymph node dissection improves
survival compared with mediastinal lymph node sampling in patients
undergoing resection for N0 or nonhilar N1, T1, or T2 non-small cell lung
cancer. Methods: Patients with non-small cell lung cancer underwent
sampling of 2R, 4R, 7, and 10R for right-sided tumors and 5, 6, 7, and 10L
for left-sided tumors. If all tumors were negative for malignancy,
patients were randomized to no further lymph node sampling (mediastinal
lymph node sampling) or complete mediastinal lymph node dissection.
Results: Of 1111 patients randomized, 1023 (mediastinal lymph node
sampling in 498, mediastinal lymph node dissection in 525) were eligible
and evaluable. There were no significant differences between the 2 groups
in terms of demographics, Eastern Cooperative Oncology Group status,
histology, cancer location, type or extent of resection, and pathologic
stage. Occult N2 disease was found in 21 patients in the mediastinal lymph
node dissection group. At a median follow-up of 6.5 years, 435 patients
(43%) have died: mediastinal lymph node sampling in 217 (44%) and
mediastinal lymph node dissection in 218 (42%). The median survival is 8.1
years for mediastinal lymph node sampling and 8.5 years for mediastinal
lymph node dissection (P = .25). The 5-year disease-free survival was 69%
(95% confidence interval, 64-74) in the mediastinal lymph node sampling
group and 68% (95% confidence interval, 64-73) years in the mediastinal
lymph node dissection group (P = .92). There was no difference in local (P
= .52), regional (P = .10), or distant (P = .76) recurrence between the 2
groups. Conclusions: If systematic and thorough presection sampling of the
mediastinal and hilar lymph nodes is negative, mediastinal lymph node
dissection does not improve survival in patients with early stage
non-small cell lung cancer, but these results are not generalizable to
patients staged radiographically or those with higher stage tumors.
Copyright 2011 by The American Association for Thoracic Surgery.

<18>
[Use Link to view the full text]
Accession Number
2011091373
Authors
Krishnan E. Sokolove J.
Institution
(Krishnan, Sokolove) Stanford University School of Medicine, Stanford, CA,
United States
Title
Uric acid in heart disease: A new C-reactive protein?.
Source
Current Opinion in Rheumatology. 23 (2) (pp 174-177), 2011. Date of
Publication: March 2011.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street, Philadelphia PA
19106-3621, United States)
Abstract
Purpose of Review: To review and interpret the recently published data on
hyperuricemia and cardiovascular disease to present an opinion on the
nature of link between serum uric acid concentration and the risk for
cardiovascular outcomes, and to comment on its implications for clinical
practice. Recent Findings: Evidence has accumulated in prospective
observational studies that link hyperuricemia among younger adults with
the risk of subsequent hypertension. Such associations have been observed
with respect to insulin resistance, diabetes, and other cardiovascular
risk factors. Newer data confirm the link between hyperuricemia and
cardiovascular mortality. The use of allopurinol has been shown to be
associated with reduced mortality risk in longer term observational
studies and with reduced blood pressure in short-term randomized
controlled trials. None of these findings is confounded by traditional
risk factors. Summary: The available evidence has established a link
between hyperuricemia and cardiovascular disease and this may be causal.
Without waiting for the resolution of causality arguments, one can start
using serum uric acid concentration as an inexpensive cardiovascular risk
marker. 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.