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<1>
Accession Number
2011129388
Authors
Winchester D.E. Wen X. Brearley W.D. Park K.E. Anderson R.D. Bavry A.A.
Institution
(Winchester, Brearley, Park, Anderson, Bavry) Department of Medicine,
Division of Cardiovascular Medicine, University of Florida, Gainesville,
FL, United States
(Wen) Department of Epidemiology and Health Policy Research, University of
Florida, Gainesville, FL, United States
Title
Efficacy and safety of glycoprotein IIb/IIIa inhibitors during elective
coronary revascularization: A meta-analysis of randomized trials performed
in the era of stents and thienopyridines.
Source
Journal of the American College of Cardiology. 57 (10) (pp 1190-1199),
2011. Date of Publication: 08 Mar 2011.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Objectives: The purpose of this study was to investigate the efficacy and
safety of glycoprotein IIb/IIIa inhibitors (GPIs) during elective
percutaneous coronary intervention (PCI). Background: Studies have
documented that GPIs are useful during PCI; however, much of this research
was conducted before the routine use of coronary stents and
thienopyridines. Methods: We searched the MEDLINE, Cochrane clinical
trials, and ClinicalTrials.gov databases from inception for studies that
randomly assigned patients undergoing elective PCI to a GPI versus
control. Trials were included if stents and thienopyridines were used
routinely and clinical outcomes were reported. Outcomes were assessed
within 30 days. A DerSimonian-Laird model was used to construct random
effects summary risk ratios (RRs) and 95% confidence intervals (CIs).
Results: Our search yielded 22 studies with 10,123 patients. The incidence
of nonfatal myocardial infarction was 5.1% with GPI versus 8.3% with
control (RR: 0.66, 95% CI: 0.55 to 0.79, p < 0.0001). Major bleeding was
1.2% versus 0.9% (RR: 1.37, 95% CI: 0.83 to 2.25, p = 0.22), minor
bleeding was 3.0% versus 1.7% (RR: 1.70, 95% CI: 1.28 to 2.26, p <
0.0001), and mortality was 0.3% versus 0.5% (RR: 0.70, 95% CI: 0.36 to
1.33, p = 0.27), respectively. Conclusions: In the current era of elective
PCI performed with stents and thienopyridines, GPIs provide clinical
benefit. These agents reduce nonfatal myocardial infarction without a
notable increase in major bleeding; however, they increase the risk of
minor bleeding. All-cause mortality is not reduced. 2011 American College
of Cardiology Foundation.
<2>
Accession Number
21313894
Authors
Talebi H. Yazdi B. Alizadeh S. Moshiry E. Nourozi A. Eghtesadi-Araghi P.
Institution
(Talebi, Yazdi, Moshiry, Nourozi) Department of Anesthesiology, Arak
University of Medical Sciences, Arak, Iran, Islamic Republic of
(Alizadeh) Department of Surgery, Arak University of Medical Sciences,
Arak, Iran, Islamic Republic of
(Eghtesadi-Araghi) President of Parsteb Pajouheshyar Medical Sciences
Research Institute, No. 30, Apartment No. 5, 1st Golzar St., Ashrafi
Esfahani Blvd., Ponak Sq., Tehran, 1476783476, Iran, Islamic Republic of
Title
Effects of combination of intrathecal lidocaine and two doses of
intrathecal midazolam on post-operative pain in patients undergoing
herniorrhaphy: A Randomized controlled Trial.
Source
Pakistan Journal of Biological Sciences. 13 (23) (pp 1156-1160), 2010.
Date of Publication: 2010.
Publisher
Asian Network for Scientific Information (308-Lasani Town, Sargodha Road,
Faisalabad, Pakistan)
Abstract
Assessment of the effect of combination of intratechal midazolam and
lidocaine on postoperative pain was the aim of this study. This randomized
controlled trial was performed during 2007 in a teaching hospital of Arak
University of Medical Sciences. Forty five male patients who were
candidates for elective inguinal herniorrhaphy entered the study and
randomly divided into three groups of control (lidocaine 5% plus normal
saline), M 0.5 (lidocaine 5% and midazolam 0.5 mg) and M 1.0 (lidocaine 5%
and midazolam 1 mg) according intrathecal solution injected for spinal
anesthesia. Mean arterial blood pressure, heart rate, post-operative pain,
narcotic requirements and complications (nausea, vomiting, pruritis,
headache, hypotension and bradycardia) were recorded. The severity of
post-operative pain was lowest in M 1.0 group in all postoperative
measurements except at 2 h after operation. With regard of complications,
only there was significant difference in vomiting between three groups
which had the highest frequency in M 0.5 group. No severe hypotension was
seen; though, bradycardia occurred in one patient in M 0.5 group which
needed treatment. Present findings suggest that administration of
intrathecal midazolam (especially 1 mg) together with lidocaine is
effective in reducing post-operative pain in patients undergoing open
inguinal herniorrhaphy and is not associated with adverse effect. 2010
Asian Network for Scientific Information.
<3>
Accession Number
2011119394
Authors
Tulner D.M. Smith O.R.F. Schins A. De Jonge P. Quere M. Delanghe J.R.
Crijns H.J. Den Boer J.A. Korf J. Honig A.
Institution
(Tulner) Department of Psychiatry, Medical Centre Leeuwarden, Leeuwarden,
Netherlands
(Quere) Department of Cardiology, Medical Centre Leeuwarden, Leeuwarden,
Netherlands
(Schins) Department of Psychiatry, University Hospital Maastricht,
Maastricht, Netherlands
(Crijns) Department of Cardiology, University Hospital Maastricht,
Maastricht, Netherlands
(De Jonge) Internal Medicine and Psychiatry, University Medical Centre
Groningen, Groningen, Netherlands
(Den Boer, Korf) Department of Biological Psychiatry, University Medical
Centre Groningen, Groningen, Netherlands
(Honig) Department of Psychiatry, St. Lucas Andreas Hospital, Netherlands
(Honig) Department of Psychiatry, Free University of Amsterdam, Amsterdam,
Netherlands
(Smith) Department of Health Promotion and Development, Faculty of
Psychology, University of Bergen, Bergen, Norway
(Delanghe) Department of Clinical Chemistry, Ghent University, Ghent,
Belgium
Title
Antidepressive effect of mirtazapine in post-myocardial infarction
depression is associated with soluble TNF-R1 increase: Data from the
MIND-IT.
Source
Neuropsychobiology. 63 (3) (pp 169-176), 2011. Date of Publication:
February 2011.
Publisher
S. Karger AG (Allschwilerstrasse 10, P.O. Box, Basel CH-4009, Switzerland)
Abstract
Background: Depressive disorder after myocardial infarction (MI) is
associated with increased cardiac morbidity and mortality. Immune activity
such as inflammation might be implicated as an underlying mechanism. The
purpose of this study is to investigate whether the response to an
antidepressant in post-MI depression is associated with changes of
inflammatory markers in serum. Methods: In a double-blind
placebo-controlled study with mirtazapine 30 mg/day (50 patients), the
antidepressive effect was related to immune activation parameters. The
cytokines interleukin 6 (IL-6) and tumor necrosis factor alpha
(TNF-alpha), the soluble cytokine receptors sIL-6R, sTNF-R1 and sTNF-R2,
and the inflammation-sensitive plasma proteins C-reactive protein and
neopterin were assessed. Results: Subgroup analyses revealed a highly
significant correlation of pronounced sTNF-R1 increase with a decrease in
depressive symptoms in antidepressant responders. Conclusion: Significant
effects on inflammation accompany the therapeutic efficacy of mirtazapine
in contrast to the therapeutic efficacy of placebo and the nontherapeutic
efficacy of mirtazapine. Copyright 2011 S. Karger AG.
<4>
Accession Number
2011123955
Authors
Guthrie R.
Institution
(Guthrie) Department of Emergency Medicine, Ohio State University, 1380
Edgehill Rd., Columbus, OH 43212, United States
Title
Use of omega-3 fish oil supplementation to reduce recurrent cardiovascular
events.
Source
Physician and Sportsmedicine. 39 (1) (pp 166-168), 2011. Date of
Publication: February 2011.
Publisher
JTE Multimedia (1235 Westlakes Dr, Ste 220, Berwyn PA 19312, United
States)
<5>
Accession Number
2011126191
Authors
Wilczynski M. Krzych L.J. Bis J. Szmagala P. Ulczok R. Bochenek A.
Institution
(Wilczynski, Krzych, Bis, Szmagala, Ulczok, Bochenek) 1st Department of
Cardiac Surgery, Medical University of Silesia, GCM, ul. Ziolowa 45/47,
40-635 Katowice, Poland
Title
Effect of gender on efficacy of preoperative intra-aortic balloon pump in
high risk patients undergoing surgical coronary revascularisation.
Source
Kardiologia Polska. 68 (12) (pp 1361-1368), 2010. Date of Publication:
2010.
Publisher
Klinika Kardiologii CMKP (ul. Grenadierow 51/59, Warsaw 04-073, Poland)
Abstract
Background: There is no strong evidence supporting the use of preoperative
intra-aortic balloon pump (IABP) in high-risk patients undergoing coronary
artery bypass grafting (CABG). This issue has only been investigated in
small studies which analysed the general population of patients, without
focusing on specific subgroups, including gender. Aim: We sought to
determine if there is any benefit from preoperative IABP in high-risk
patients undergoing CABG with the analysis of its determinants including
gender. Methods: We randomly assigned 502 high-risk patients (351 men, 151
women) to the group receiving preoperative IABP support or to the control
group with no preoperative IABP. Primary end-point was a major adverse
cardiac or cerebrovascular event (MACCE), defined as death from any cause,
myocardial infarction, cerebrovascular accident or repeat
revascularisation within 30 days post-surgery. Results: A significant
reduction of MACCE rate in patients with the preoperative IABP
counterpulsation in comparison to controls was noticed in the total
population of high risk patients (p = 0.001) and in the female subgroup (p
= 0.005). After adjustment for baseline characteristics, the hazard ratio
for MACCE was 0.7 (p = 0.005) in the total population; 0.6 (p = 0.01) for
females and 0.8 (p = 0.1) for males. Conclusions: There is a beneficial
effect of preoperative IABP use in high-risk patients undergoing CABG,
particularly in women and patients with co-morbidities (diabetes, obesity,
and peripheral vascular disease). Copyright Via Medica.
<6>
Accession Number
2011112406
Authors
Takagi H. Manabe H. Umemoto T.
Institution
(Takagi, Manabe, Umemoto) Department of Cardiovascular Surgery, Shizuoka
Medical Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka 411-8611,
Japan
Title
Preoperative statin therapy reduces early mortality in patients undergoing
cardiac operations.
Source
Annals of Thoracic Surgery. 91 (3) (pp 983-984), 2011. Date of
Publication: March 2011.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
<7>
Accession Number
2011120008
Authors
Calvert P.A. Rana B.S. Kydd A.C. Shapiro L.M.
Institution
(Calvert, Rana, Kydd, Shapiro) Cardiology Department, Papworth Hospital
NHS Foundation Trust, Papworth Everard, Cambridge CB23 3RE, United Kingdom
Title
Patent foramen ovale: Anatomy, outcomes, and closure.
Source
Nature Reviews Cardiology. 8 (3) (pp 148-160), 2011. Date of
Publication: March 2011.
Publisher
Nature Publishing Group (Houndmills, Basingstoke, Hampshire RG21 6XS,
United Kingdom)
Abstract
Patent foramen ovale (PFO) is a normal fetal communication between the
right and left atria that persists after birth. PFO is a common finding
that occurs in 20-34% of the population, although its prevalence decreases
with age. In most cases, a PFO poses no threat to health. However, some
PFOs have the ability to open widely under certain hemodynamic conditions,
which enables any bloodborne material, such as thrombi, air, or vasoactive
substances, to pass from the venous to the arterial circulation, with the
potential to cause a cerebrovascular event. PFO has been linked to several
conditions, including cryptogenic stroke, migraine with aura,
decompression illness, and systemic arterial embolism. However, the data
that support PFO closure in these conditions are mostly from nonrandomized
cohort series, and are often contradictory. In this Review, we discuss the
existing data on PFO closure, including results of the first randomized,
controlled trial comparing device closure of PFO with medical therapy for
cryptogenic stroke, and we examine controversies in the literature as well
as ongoing studies. We also focus on the anatomy of a PFO and how it
impacts on the procedure of PFO closure with a percutaneous device. 2011
Macmillan Publishers Limited. All rights reserved.
<8>
Accession Number
70358305
Authors
Nurkin S. Kakarla V.R. Nguyen A. Paul S.A. Wilkinson N.
Institution
(Nurkin, Wilkinson) Surgical Oncology, Roswell Park Cancer Institute,
Buffalo, NY, United States
(Kakarla, Nguyen, Paul) New York Hospital Queens, Flushing, NY, United
States
Source
Annals of Surgical Oncology. Conference: 64th Annual Cancer Symposium of
the Society of Surgical Oncology San Antonio, TX United States. Conference
Start: 20110302 Conference End: 20110305. Conference Publication:
(var.pagings). 18 (pp S98), 2011. Date of Publication: February 2011.
Publisher
Springer New York
Abstract
Background:Although still investigational,preoperative chemoradiation
followed by surgery has become the most common approach to resectable
esophageal cancer.Two meta-analyses have shown that this therapy decreased
local recurrences rates, down-staged tumors and increased 3-year overall
survival. However, a recent phase III trial(FFCD 9901)showed that
neoadjuvant therapy increased postoperative 30-day mortality.As
neoadjuvant therapy is becoming the more common approach for resectable
esophageal cancer, it is important to make sure that this modality is safe
in the short-term. Methods: Using the American College of
Surgeons-National Surgical Quality Improvement Project(ACS-NSQIP)
participant-use file, patients were identified who underwent esophagectomy
for cancer at the 211 participating hospitals in 2005 - 2008.Demographic,
clinical, intra-operative variables and 30-day morbidity and mortality
were collected.Logistic regression analysis was performed to determine
factors that increased risk of poor outcomes following resection.
Results:We identified a total of 582 patients that underwent
esophagectomy. Patients were subdivided into 2 groups: Surgery alone
(n-400) versus neoadjuvant and surgery (n-182). There were no differences
in age, sex, comorbidities or ASA class between the two groups.There were
no differences noted in intra-operative outcomes including operative time
or transfusion requirements. When comparing surgery alone to neoadjuvant
and surgery, there were no differences in post-operative length of
stay(17.6 days vs. 16.0 days, p=0.31), serious morbidity(34% vs. 34.6%,
p=0.4), wound complications(19.5% vs. 22.5%, p=0.4) or 30-day
mortality(3.3% vs. 4.4%, p=0.48). Using logistic regression analysis,
patients that had PVD and previous cardiac surgery were at an increased
risk of mortality and morbidity within 30 days, respectively.
Conclusion:In an NSQIP analysis of 582 patients that underwent
esophagectomy, there was no difference in post-operative morbidity or
mortality if they had neoadjuvant therapy prior to surgery.As
multimodality therapy is becoming the standard for resectable, locally
advanced esophageal cancer, it appears to be as safe as surgery alone in
the short-term.
<9>
Accession Number
2011107661
Authors
Saeed B. Kandzari D.E. Agostoni P. Lombardi W.L. Rangan B.V. Banerjee S.
Brilakis E.S.
Institution
(Saeed) University of Toledo, Toledo, OH, United States
(Kandzari) Scripps Clinic, San Diego, CA, United States
(Agostoni) University Medical Center Utrecht, Utrecht, Netherlands
(Lombardi) St. Joseph's Hospital, Bellingham, WA, United States
(Rangan, Banerjee, Brilakis) VA North Texas Healthcare System, University
of Texas Southwestern Medical Center at Dallas, Division of Cardiology
(111A), 4500 S. Lancaster Rd, Dallas, TX 75216, United States
Title
Use of drug-eluting stents for chronic total occlusions: A systematic
review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 77 (3) (pp 315-332),
2011. Date of Publication: 15 Feb 2011.
Publisher
Wiley-Liss Inc. (111 River Street, Hoboken NJ 07030-5774, United States)
Abstract
Aim: To perform a systematic review and meta-analysis of studies reporting
outcomes after drug-eluting stent (DES) implantation in chronic total
occlusions (CTOs). Methods: A review of publications and online databases
in January 2010 retrieved 17 published studies that reported outcomes
after DES implantation in CTOs: eight uncontrolled studies, seven
nonrandomized comparative studies with bare-metal stents (BMS), one
post-hoc analysis of a randomized trial, and one randomized trial. Data
were pooled using random-effects meta-analysis models. Results: All
published studies evaluated sirolimus- or paclitaxel-eluting stents. All
studies reporting comparative angiographic outcomes revealed less binary
angiographic restenosis with DES implantation compared to BMS (odds ratio:
0.15, 95% CI: 0.08, 0.26). Over a mean follow-up period of 18.9 +/- 16.5
months, the cumulative incidence of death, myocardial infarction, or stent
thrombosis was similar between DES and BMS in all studies. Target lesion
revascularization (odds ratio: 0.13, 95% CI: 0.06, 0.26) and target vessel
revascularization (odds ratio 0.18, 95% CI: 0.11, 0.31) at 6-12 months
were consistently lower among DES-treated patients. Similar patterns of
safety and efficacy event rates were also observed in studies reporting
>12 month outcomes. Conclusions: Compared with BMS, treatment of chronic
total coronary occlusions with DES is associated with significant
reductions in angiographic and clinical restenosis with similar safety.
The consistency and magnitude of treatment effect across both individual
trials and the pooled analysis establish DES as the preferred therapy for
percutaneous revascularization of CTOs. 2010 Wiley-Liss, Inc.
<10>
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Accession Number
2011116206
Authors
Wang T.Y. White J.A. Tricoci P. Giugliano R.P. Zeymer U. Harrington R.A.
Montalescot G. James S.K. Van De Werf F. Armstrong P.W. Braunwald E.
Califf R.M. Newby L.K.
Institution
(Wang, White, Tricoci, Harrington, Newby) Duke Clinical Research
Institute, 2400 Pratt St, Durham, NC 27705, United States
(Giugliano, Braunwald) TIMI Study Group, Brigham and Women's Hospital,
Boston, MA, United States
(Zeymer) Herzzentrum Ludwigshafen, Ludwigshafen, Germany
(Montalescot) Institut de Cardiologie, Pitie-Salpetriere Hospital, Paris,
France
(James) Uppsala University Hospital, Uppsala, Sweden
(Van De Werf) University Hospital Gasthuisberg, Leuven Coordinating
Center, Leuven, Belgium
(Armstrong) University of Alberta, Edmonton, AB, Canada
(Califf) Duke Translational Medicine Institute, Durham, NC, United States
Title
Upstream clopidogrel use and the efficacy and safety of early eptifibatide
treatment in patients with acute coronary syndrome: An analysis from the
early glycoprotein IIb/IIIa inhibition in patients with non-ST-segment
elevation acute coronary syndrome (EARLY ACS) trial.
Source
Circulation. 123 (7) (pp 722-730), 2011. Date of Publication: 22 Feb
2011.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street, Philadelphia PA
19106-3621, United States)
Abstract
BACKGROUND - In the Early Glycoprotein IIb/IIIa Inhibition in Patients
with Non-ST-Segment Elevation Acute Coronary Syndrome (EARLY ACS) trial,
routine preangiography eptifibatide use was not superior to delayed
provisional use but led to more bleeding. This analysis examines efficacy
and safety of early eptifibatide in the setting of concurrent upstream
clopidogrel use. METHODS AND RESULTS - In EARLY-ACS, clopidogrel use and
timing were determined by treating physicians, but randomization to early
eptifibatide versus placebo was stratified by the intent to use upstream
clopidogrel. Among 9166 non-ST-elevation acute coronary syndrome patients
who underwent coronary angiography, intent to use upstream clopidogrel was
declared in 6895 (75%), and 7068 (77%) received upstream clopidogrel.
After multivariable adjustment, intended upstream clopidogrel use did not
differentially influence the effect of early eptifibatide on the primary
end point of 96-hour death/myocardial infarction/recurrent ischemia
requiring urgent revascularization/thrombotic bailout (interaction
P=0.988). Early eptifibatide use reduced 30-day death/myocardial
infarction among patients with intended upstream clopidogrel (adjusted
odds ratio 0.85; 95% confidence interval 0.73 to 0.99) but not among those
without intended upstream clopidogrel use (adjusted odds ratio 1.02; 95%
confidence interval 0.80 to 1.30). However, the clopidogrel by randomized
treatment interaction term was not significant (P=0.23). Thrombolysis in
Myocardial Infarction major bleeding risk was increased with early
eptifibatide in the setting of upstream clopidogrel use. Results were
similar using actual clopidogrel treatment strata. CONCLUSIONS - Routine
early eptifibatide use, compared with delayed provisional use, may be
associated with lower 30-day ischemic risk in non-ST-elevation acute
coronary syndrome patients also treated with clopidogrel before
angiography. The benefit-risk ratio of intensive platelet inhibition with
combined early use of antiplatelet agents needs further evaluation in
prospective randomized trials. CLINICAL TRIAL REGISTRATION -
http://www.clinicaltrials.gov. Unique identifier NCT00089895. 2011
American Heart Association, Inc.
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