Results Generated From:
Embase <1980 to 2011 Week 19>
Embase (updates since 2011-05-10)
<1>
Accession Number
2011233291
Authors
Haykowsky M. Scott J. Esch B. Schopflocher D. Myers J. Paterson I.
Warburton D. Jones L. Clark A.M.
Institution
(Haykowsky) Faculty of Rehabilitation Medicine, University of Alberta,
Edmonton, Canada
(Scott, Esch, Warburton) Cardiovascular Physiology and Rehabilitation
Laboratory, University of British Columbia, Vancouver, BC, Canada
(Schopflocher) School of Public Health Sciences, University of Alberta,
Edmonton, AB, Canada
(Myers) Cardiology Division (111C), VA Palo Alto Health Care System,
Stanford University, Palo Alto, CA, United States
(Paterson) Faculty of Medicine, University of Alberta, Edmonton, AB,
Canada
(Jones) Department of Radiation Oncology, Duke University Medical Center,
Durham, NC, United States
(Clark) Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
Title
A Meta-analysis of the effects of Exercise Training on Left Ventricular
Remodeling Following Myocardial Infarction: Start early and go longer for
greatest exercise benefits on remodeling.
Source
Trials. 12 , 2011. Article Number: 92. Date of Publication: 04 Apr
2011.
Publisher
BioMed Central Ltd. (34 - 42 Cleveland Street, London W1T 4LB, United
Kingdom)
Abstract
Background: The effects of variations in exercise training on Left
ventricular (LV) remodeling in patients shortly after Myocardial
Infarction (MI) are important but poorly understood.Methods: Systematic
review incorporating meta-analysis using meta-regression. Studies were
identified via systematic searches of: OVID MEDLINE (1950 to 2009),
Cochrane Central Register of Controlled Trials (1991 to 2009), AMED (1985
to 2009), EMBASE (1988 to 2009), PUBMED (1966 to 2009), SPORT DISCUS (1975
to 2009), SCOPUS (1950 to 2009) and WEB OF SCIENCE (1950 to 2009) using
the medical subject headings: myocardial infarction, post myocardial
infarction, post infarction, heart attack, ventricular remodeling,
ventricular volumes, ejection fraction, left ventricular function,
exercise, exercise therapy, kinesiotherapy, exercise training. Reference
lists of all identified studies were also manually searched for further
relevant studies. Studies selected were randomized controlled trials of
exercise training interventions reporting ejection fraction (EF) and/or
ventricular volumes in patients following recent MI (<= 3 months) post-MI
patients involving control groups. Studies were excluded if they were not
randomized, did not have a 'usual-care' control (involving no exercise),
evaluated a non-exercise intervention, or did not involve human subjects.
Non-English studies were also excluded.Results: After screening of 1029
trials, trials were identified that reported EF (12 trials, n = 647), End
Systolic Volumes (ESV) (9 trials, n = 475) and End Diastolic Volumes (EDV)
(10 trials, n = 512). Meta-regression identified that changes in EF effect
size difference decreased as the time between MI and initiation of the
exercise program lengthened, and increased as the duration of the program
increased (Q = 25.48, df = 2, p < 0.01, R<sup>2 </sup>= 0.76). Greater
reductions in ESV and EDV (as indicated by effect size decreases) occurred
with earlier initiation of exercise training and with longer training
durations (ESV: Q = 23.89, df = 2, p < 0.05, R<sup>2 </sup>= 0.79; EDV: Q
= 27.42, df = 2, p < 0.01, R<sup>2 </sup>= 0.83). Differences remained
following sensitivity analysis. Each week that exercise was delayed
required an additional month of training to achieve the same level of
benefit on LV remodeling.Conclusions: Exercise training has beneficial
effects on LV remodeling in clinically stable post-MI patients with
greatest benefits occurring when training starts earlier following MI
(from one week) and lasts longer than 3 months. 2011 Haykowsky et al;
licensee BioMed Central Ltd.
<2>
Accession Number
2011219869
Authors
Gupta R. Wayangankar S.A. Targoff I.N. Hennebry T.A.
Institution
(Gupta, Hennebry) Section of Cardiovascular Disease, University of
Oklahoma Health Sciences Center, 920 SL Young Blvd, WP 3010, Oklahoma
City, OK 73104, United States
(Targoff) Section of Rheumatology, University of Oklahoma Health Sciences
Center, Oklahoma City, OK, United States
(Wayangankar) Department on Internal Medicine, University of Oklahoma
Health Sciences Center, Oklahoma City, OK, United States
Title
Clinical cardiac involvement in idiopathic inflammatory myopathies: A
systematic review.
Source
International Journal of Cardiology. 148 (3) (pp 261-270), 2011. Date of
Publication: 05 May 2011.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Background: Idiopathic inflammatory myopathies (IIM) presenting with
diffuse skeletal muscular inflammation and cardiac involvement is one of
the major causes of clinical deterioration. Our purpose was to observe the
frequency of various reported clinical cardiac afflictions, cardiovascular
mortality and its most important contributors in the IIM population.
Methods: MEDLINE database was searched from 1977 through 2009. Articles
reporting objective evidence of cardiac involvement were assessed.
Patients were included if they satisfied Bohan and Peter criteria for
definite or probable diagnosis of IIM. The review conforms to the criteria
of the new PRISMA statement of preferred reporting items for systematic
reviews and meta-analyses. Results: Thirty-three out of 90 articles
reported cardiac data. Twelve were case reports, while 21 articles were
either cohort studies or case series. Angina was reported in 7% of
cumulative prospective cohort. Dysrhythmias were seen in 31.8% of
electrocardiograms. Diastolic dysfunction was the most common
echocardiographic finding. Congestive heart failure was reported in 5.6%
of the prospective cohort and was the most common cause of death
accounting for 21% of total cardiac mortality. Myocarditis was the most
common feature in reported pathology literature (38%), followed by focal
myocardial fibrosis (22%). Conclusion: Cardiac involvement is an important
cause of morbidity and mortality in patients with IIM. Myocardial fibrosis
puts the patient at risk for systolic or diastolic heart failure and
dysrhythmias. This review, therefore, suggests the importance of early and
comprehensive cardiac evaluation in IIM population. Confirmation of these
findings will require prospective studies of consecutive patients with
long-term follow-up. 2010 Elsevier Ireland Ltd.
<3>
Accession Number
2011224809
Authors
Desch S. Schloma D. Mbius-Winkler S. Erbs S. Gielen S. Linke A. Yu J.
Lauer B. Kleinertz K. Dnschel W. Schuler G. Thiele H.
Institution
(Desch, Schloma, Mbius-Winkler, Erbs, Gielen, Linke, Schuler, Thiele)
Department of Internal Medicine/Cardiology, University of Leipzig, Heart
Center, Strmpellstrasse 39, 04289 Leipzig, Germany
(Yu, Lauer) Department of Cardiology, Zentralklinik Bad Berka, Bad Berka,
Germany
(Kleinertz, Dnschel) Chemnitz Heart Center, Chemnitz, Germany
Title
Randomized comparison of a polymer-free sirolimus-eluting stent versus a
polymer-based paclitaxel-eluting stent in patients with diabetes mellitus:
The LIPSIA yukon trial.
Source
JACC: Cardiovascular Interventions. 4 (4) (pp 452-459), 2011. Date of
Publication: April 2011.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
Objectives: The objective of the study was to assess noninferiority of the
polymer-free sirolimus-eluting Yukon Choice stent (Translumina GmbH,
Hechingen, Germany) compared with the polymer-based Taxus Libert stent
(Boston Scientific, Natick, Massachusetts) with regard to the primary
endpoint, in-stent late lumen loss, at 9 months in patients with diabetes
mellitus. Background: The Yukon Choice stent has been evaluated in several
randomized controlled trials before, albeit to date, there has been no
trial that exclusively enrolled patients with diabetes mellitus. Methods:
Patients with diabetes mellitus undergoing percutaneous coronary
intervention for clinically significant de novo coronary artery stenosis
were randomized 1:1 to receive either the polymer-free sirolimus-eluting
Yukon Choice stent or the polymer-based paclitaxel-eluting Taxus Libert
stent. Results: A total of 240 patients were randomized. Quantitative
coronary angiography was available for 79% of patients. Mean in-stent late
lumen loss was 0.63 +/- 0.62 mm for the Yukon Choice stent and 0.45 +/-
0.60 mm for the Taxus Libert stent. Based on the pre-specified margin, the
Yukon Choice stent failed to show noninferiority for the primary endpoint.
During follow-up, there were no significant differences between groups
regarding death, myocardial infarction, stent thrombosis, target lesion
revascularization, target vessel revascularization, or nontarget vessel
revascularization. Conclusions: Compared with the Taxus Libert stent, the
polymer-free sirolimus-eluting Yukon Choice stent failed to show
noninferiority with regard to the primary endpoint, in-stent late lumen
loss, in patients with diabetes mellitus after 9-month follow-up. Both
stents showed comparable clinical efficacy and safety. (Yukon Choice
Versus Taxus Libert in Diabetes Mellitus; NCT00368953) 2011 American
College of Cardiology Foundation.
<4>
Accession Number
2011206256
Authors
Garg S. Wykrzykowska J. Serruys P.W. De Vries T. Buszman P. Trznadel S.
Linke A. Lenk K. Ischinger T. Klauss V. Eberli F. Corti R. Wijns W. Morice
M.-C. Di Mario C. Tyczynski P. Van Geuns R.J. Eerdmans P. Van Es G.-A.
Meier B. Juni P. Windecker S.
Institution
(Garg, Wykrzykowska, Serruys, Van Geuns) Department of Interventional
Cardiology, Erasmus MC, Rotterdam, Netherlands
(De Vries, Van Es) Cardialysis B.V, Rotterdam, Netherlands
(Buszman, Trznadel) Medical University of Silesia, Katowice, Poland
(Linke, Lenk) Herzzentrum Leipzig, Leipzig, Germany
(Ischinger) Department of Cardiology, Hospital Bogenhausen, Munich,
Germany
(Klauss) Department of Cardiology, University Hospital Munich
(Innenstadt), Munich, Germany
(Eberli) Department of Cardiology, Triemli Spital, Zurich, Switzerland
(Corti) Department of Cardiology, University Hospital Zurich, Zurich,
Switzerland
(Wijns) Department of Cardiology, Onze Lieve Vrouw Ziekenhuis, Aalst,
Belgium
(Morice) Institut Jacques Cartier Massy, France
(Di Mario, Tyczynski) Department of Cardiology, Royal Brompton Hospital,
London, United Kingdom
(Eerdmans) Biosensors Europe SA, Morges, Switzerland
(Meier, Windecker) Department of Cardiology, Bern University Hospital,
Bern, Switzerland
(Juni, Windecker) CTU Bern, Bern University Hospital, Bern, Switzerland
(Juni) Institute of Social and Preventive Medicine, University of Bern,
Bern, Switzerland
Title
The outcome of bifurcation lesion stenting using a biolimus-eluting stent
with a bio-degradable polymer compared to a sirolimus-eluting stent with a
durable polymer.
Source
EuroIntervention. 6 (8) (pp 928-935), 2011. Date of Publication: March
2011.
Publisher
EuroPCR (5 Rue Saint-Pantaleon, Toulouse 31015, France)
Abstract
Aims: This study investigated the differences in clinical outcomes between
patients with bifurcation lesions (BL) treated with a biolimus-eluting
stent (BES) with a biodegradable polymer, and a sirolimus-eluting stent
(SES) with a durable polymer. Methods and results: The clinical outcomes
were assessed in the 497 patients (BES 258, SES 239) enrolled in the
multicentre, randomised LEADERS trial who underwent treatment of Y1 BL
(total=534 BL). At 12-months follow-up there was no significant difference
in the primary endpoint of MACE, a composite of cardiac death, myocardial
infarction and clinically indicated target vessel revascularisation (BES
12.8% vs. SES 16.3%, p=0.31). Patients treated with BES had comparable
rates of cardiac death (BES 2.7% vs. SES 2.9%, p=1.00), numerically higher
rates of myocardial infarction (BES 8.9% vs. SES 5.4%, p=0.17), and
significantly lower rates of clinically indicated target vessel
revascularisation (4.3% vs. 11.3%, p=0.004) when compared to those treated
with SES. The rate of stent thrombosis at 12-months was 4.3% and 3.8% for
BES and SES, respectively (p=0.82). Conclusions: In the treatment of BL
the use of BES lead to superior efficacy and comparable safety compared to
SES. Europa Edition 2011. All rights reserved.
<5>
Accession Number
2011230786
Authors
Gold M.R. Linde C. Abraham W.T. Gardiwal A. Daubert J.-C.
Institution
(Gold) Division of Cardiology, Medical University of South Carolina, 25
Courtenay Drive, Charleston, SC 29425-5920, United States
(Linde) Department of Cardiology, Karolinska University Hospital,
Stockholm, Sweden
(Abraham) Division of Cardiovascular Medicine, Davis Heart and Lung
Research Institute, Ohio State University, Columbus, OH, United States
(Gardiwal) Department of Cardiovascular Medicine, Hannover Medical School,
Hannover, Germany
(Daubert) Dpartement de Cardiologie et Maladies Vasculaires, CHU, Rennes,
France
Title
The impact of cardiac resynchronization therapy on the incidence of
ventricular arrhythmias in mild heart failure.
Source
Heart Rhythm. 8 (5) (pp 679-684), 2011. Date of Publication: May 2011.
Publisher
Elsevier (P.O. Box 211, Amsterdam 1000 AE, Netherlands)
Abstract
Background: Cardiac resynchronization therapy (CRT) decreases mortality,
improves functional status, and induces reverse left ventricular (LV)
remodeling in selected populations. However, the effect of CRT on
ventricular arrhythmias is controversial. This is particularly important
among patients with mild heart failure (HF), in whom sudden death is a
leading cause of mortality. Objective: This study sought to assess the
impact of CRT on ventricular arrhythmias in mild HF. Methods: The
REsynchronization reVErses Remodeling in Systolic left vEntricular
dysfunction (REVERSE) study is a multicenter randomized, double-blind
trial of CRT among patients with mild systolic HF. The time to first
appropriate, treated ventricular tachycardia/ventricular fibrillation
(VT/VF) episode or spontaneous sustained VT in cardiac resynchronization
therapy plus defibrillation device (CRT-D) patients was compared between
groups, as were predictors of VT/VF. Results: The study randomized 508
patients who received CRT-D devices. There were no significant demographic
differences between groups. There were no differences in VT/VF episodes or
VT storm between groups. Specifically, in the CRT ON group, the estimated
event rate was 18.7% at 2 years, compared with 21.9% in the CRT OFF group
(hazard ratio 1.05, P = .84). However, among CRT ON patients, those with
reverse remodeling had a reduced incidence of VT/VF compared with those
without remodeling (5.6% vs. 16.3%, hazard ratio 0.31, P = .001).
Conclusion: CRT for up to 2 years does not impact VT/VF in mild HF despite
marked clinical and remodeling effects of pacing. This neutral effect may
be attributable to competing antiarrhythmic effects of reverse remodeling
and proarrhythmic effect of pacing. Clinical Trial Registration:
http://www.clinicaltrials.gov/ct2/show/NCT00271154 2011 Heart Rhythm
Society.
<6>
Accession Number
21240162
Authors
Rahman Z. Hoque R. Ali A. Rahman M. Rahman M.S.
Institution
(Rahman) Department of Anaesthesia, Bangabandhu Sheikh Mujib Medical
University, Shahbagh, Dhaka, Bangladesh.
Title
Blood conservation strategies for reducing peri-operative blood loss in
open heart surgery.
Source
Mymensingh medical journal : MMJ. 20 (1) (pp 45-53), 2011. Date of
Publication: Jan 2011.
Abstract
Defects in hemostasis are frequently seen in open heart surgery.
Strategies should be reviewed about the peri-operative blood loss and
conservation of blood here. In this study, comparison among three agents
(Aprotinin, Tranaexaemic Acid & Epsilon Amino Caproic Acid) is done to
reduce the peri-operative blood loss in open-heart surgery. Ninety male
and female patients within 20-60 years of age were selected who underwent
conventional cardiac surgery and anesthesia with Cardio-pulmonary-bypass
for common open heart surgeries (ASD, VSD, AVR, etc) and randomly divided
into three groups 30 patients in each. Group A, B, C was administered Inj.
Aprotinin, Tranaexaemic acid & EACA respectively. Perioperative
hemodynamic parameters and blood loss in suction bottle & drainage tube
were noted until the 3rd POD. Requirement of blood transfusion, heparin,
protamine and blood derived products were also noted. Activated clotting
time was documented in the perioperative period. Clinically relevant
outcome like re-exploration, mechanical ventilation, morbidities,
mortality etc were also verified. Data were analyzed and results were
calculated with student's T test & ANOVA. The groups were matched
regarding recorded peri-operative variables. Peri-operative blood loss is
significantly reduced (p<0.05) both in the Aprotinin and Tranexamic acid
groups. Renal dysfunction was reported in 20% of aprotinin patients,
14.29% of tranexaemic acid patients and 18.51% of EACA patients. A
conclusion was drawn from the study that Tranexamic acid can significantly
reduce the peri-operative blood loss in open heart surgery cases and that
it can be preferred as an agent of choice in blood conservation strategy
in these cases.
<7>
[Use Link to view the full text]
Accession Number
2011234491
Authors
Lurati Buse G.A. Koller M.T. Burkhart C. Seeberger M.D. Filipovic M.
Institution
(Lurati Buse, Burkhart, Seeberger, Filipovic) Department of Anesthesia and
Intensive Care Medicine, University Hospital Basel, Spitalstrasse
21CH-4031, Basel, Switzerland
(Koller) Basel Institute of Clinical Epidemiology, University Hospital
Basel, Basel, Switzerland
(Filipovic) Department of Anaesthesiology, Kantonsspital St. Gallen, St.
Gallen, Switzerland
Title
The predictive value of preoperative natriuretic peptide concentrations in
adults undergoing surgery: A systematic review and meta-analysis.
Source
Anesthesia and Analgesia. 112 (5) (pp 1019-1033), 2011. Date of
Publication: May 2011.
Publisher
Lippincott Williams and Wilkins (351 West Camden Street, Baltimore MD
21201-2436, United States)
Abstract
BACKGROUND: Several studies have evaluated preoperative B-type natriuretic
peptides (NPs) for predicting mortality after surgery; however, the number
of deaths in each study was small, limiting the power of these studies. We
conducted a systematic review and meta-analysis of studies addressing
preoperative NP levels to predict mortality after cardiac and noncardiac
surgery. METHODS: We searched MEDLINE and EMBASE using the terms
"natriuretic peptides," "surgery or surgical procedures," and a validated
combination of prognostic and diagnostic terms. Two investigators
independently assessed studies for eligibility and extracted data. The end
points were all-cause mortality at >=6 months and at <=90 days. We used a
bivariate model to derive measures of prognostic accuracy and their
heterogeneity. We calculated the pooled positive predictive value (PPV)
and negative predictive value (NPV) by Bayesian Markov chain Monte Carlo
methods. RESULTS: Of the 1558 retrieved articles, 23 studies satisfied the
predefined eligibility criteria. After cardiac surgery, the diagnostic
odds ratio of NP was 4.11 (95% confidence interval, 2.22-7.60) for
>=6-month mortality, the PPV 0.17 (95% Bayesian confidence interval,
0.07-0.36), and the NPV 0.96 (0.90-0.98). After noncardiac surgery, the
diagnostic odds ratio of NP was 4.97 (3.06-8.07) for >=6-month mortality.
The corresponding PPV was 0.24 (0.14-0.38) and the NPV 0.94 (0.88-0.97).
Results were similar for <=90-day mortality. CONCLUSIONS: Preoperative NP
concentrations were associated with mortality after cardiac and noncardiac
surgery. NP had high NPVs for both types of surgery suggesting that
preoperative NP concentrations may be helpful in preoperative risk
stratification. Copyright 2011 International Anesthesia Research Society.
<8>
Accession Number
2011215821
Authors
Edelman J.J. Yan T.D. Bannon P.G. Wilson M.K. Vallely M.P.
Institution
(Edelman, Yan, Bannon, Wilson, Vallely) Cardiothoracic Surgical Unit,
Royal Prince Alfred Hospital, Sydney, Australia
(Edelman, Yan, Bannon, Wilson, Vallely) The Baird Institute, Sydney,
Australia
(Edelman, Yan, Bannon, Wilson, Vallely) Faculty of Medicine, University of
Sydney, Sydney, Australia
Title
Coronary artery bypass grafting with and without manipulation of the
ascending aorta - A meta-analysis.
Source
Heart Lung and Circulation. 20 (5) (pp 318-324), 2011. Date of
Publication: May 2011.
Publisher
Elsevier Ltd (Langford Lane, Kidlington, Oxford OX5 1GB, United Kingdom)
Abstract
Background: The main criticism of surgery in the SYNTAX trial was
increased rate of stroke when compared to percutaneous coronary
intervention. We aimed to determine whether avoiding aortic manipulation
would decrease the rate of stroke. Method: We performed a meta-analysis of
seven studies comparing coronary artery bypass grafting (CABG) with and
without manipulation of the ascending aorta. Results: When anaortic
off-pump coronary artery bypass grafting (OPCAB) was compared with
conventional CABG, the rate of stroke was 0.38% vs. 1.87% (p< 0.0001).
When anaortic OPCAB was compared with OPCAB using a side-clamp or proximal
graft anastomosis device the rate of stroke was 0.31% vs. 1.35% (p=
0.003). Conclusion: Avoiding aortic manipulation during CABG may decrease
the rate of peri-operative stroke. 2011 Australasian Society of Cardiac
and Thoracic Surgeons and the Cardiac Society of Australia and New
Zealand.
<9>
Accession Number
21463150
Authors
Velazquez E.J. Lee K.L. Deja M.A. Jain A. Sopko G. Marchenko A. Ali I.S.
Pohost G. Gradinac S. Abraham W.T. Yii M. Prabhakaran D. Szwed H. Ferrazzi
P. Petrie M.C. O'Connor C.M. Panchavinnin P. She L. Bonow R.O. Rankin G.R.
Jones R.H. Rouleau J.L. STICH Investigators
Institution
(Velazquez) Division of Cardiovascular Medicine, Duke University Medical
Center, Durham, NC, USA.
Title
Coronary-artery bypass surgery in patients with left ventricular
dysfunction.
Source
The New England journal of medicine. 364 (17) (pp 1607-1616), 2011. Date
of Publication: 28 Apr 2011.
Abstract
The role of coronary-artery bypass grafting (CABG) in the treatment of
patients with coronary artery disease and heart failure has not been
clearly established. Between July 2002 and May 2007, a total of 1212
patients with an ejection fraction of 35% or less and coronary artery
disease amenable to CABG were randomly assigned to medical therapy alone
(602 patients) or medical therapy plus CABG (610 patients). The primary
outcome was the rate of death from any cause. Major secondary outcomes
included the rates of death from cardiovascular causes and of death from
any cause or hospitalization for cardiovascular causes. The primary
outcome occurred in 244 patients (41%) in the medical-therapy group and
218 (36%) in the CABG group (hazard ratio with CABG, 0.86; 95% confidence
interval [CI], 0.72 to 1.04; P=0.12). A total of 201 patients (33%) in the
medical-therapy group and 168 (28%) in the CABG group died from an
adjudicated cardiovascular cause (hazard ratio with CABG, 0.81; 95% CI,
0.66 to 1.00; P=0.05). Death from any cause or hospitalization for
cardiovascular causes occurred in 411 patients (68%) in the
medical-therapy group and 351 (58%) in the CABG group (hazard ratio with
CABG, 0.74; 95% CI, 0.64 to 0.85; P<0.001). By the end of the follow-up
period (median, 56 months), 100 patients in the medical-therapy group
(17%) underwent CABG, and 555 patients in the CABG group (91%) underwent
CABG. In this randomized trial, there was no significant difference
between medical therapy alone and medical therapy plus CABG with respect
to the primary end point of death from any cause. Patients assigned to
CABG, as compared with those assigned to medical therapy alone, had lower
rates of death from cardiovascular causes and of death from any cause or
hospitalization for cardiovascular causes. (Funded by the National Heart,
Lung, and Blood Institute and Abbott Laboratories; STICH
ClinicalTrials.gov number, NCT00023595.).
<10>
[Use Link to view the full text]
Accession Number
2011240249
Authors
Bostom A.G. Carpenter M.A. Kusek J.W. Levey A.S. Hunsicker L. Pfeffer M.A.
Selhub J. Jacques P.F. Cole E. Gravens-Mueller L. House A.A. Kew C.
McKenney J.L. Pacheco-Silva A. Pesavento T. Pirsch J. Smith S. Solomon S.
Weir M.
Institution
(Bostom, McKenney) Rhode Island Hospital, 110 Lockwood St., Providence, RI
02903, United States
(Carpenter, Gravens-Mueller) Department of Biostatistics, University of
North Carolina, Chapel Hill, United States
(Kusek) National Institute of Diabetes and Digestive and Kidney Diseases,
Bethesda, MD, United States
(Levey) Tufts Medical Center, Boston, MA, United States
(Hunsicker) University of Iowa, Iowa City, United States
(Pfeffer, Solomon) Brigham and Womens Hospital, Boston, MA, United States
(Selhub, Jacques) US Department of Agriculture, Jean Mayer Human Nutrition
Research Center on Aging, Boston, MA, United States
(Cole) University of Toronto, Toronto, Canada
(House) London Health Sciences Center, London, Canada
(Kew) University of Alabama, Birmingham, United States
(Pacheco-Silva) Universidade Federal de Sao Paulo, Sao Paulo, Brazil
(Pesavento) Ohio State University, Columbus, United States
(Pirsch) University of Wisconsin, Madison, United States
(Smith) Duke University, Durham, NC, United States
(Weir) University of Maryland, Baltimore, United States
Title
Homocysteine-lowering and cardiovascular disease outcomes in kidney
transplant recipients: Primary results from the folic acid for vascular
outcome reduction in transplantation trial.
Source
Circulation. 123 (16) (pp 1763-1770), 2011. Date of Publication: 26 Apr
2011.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street, Philadelphia PA
19106-3621, United States)
Abstract
Background-: Kidney transplant recipients, like other patients with
chronic kidney disease, experience excess risk of cardiovascular disease
and elevated total homocysteine concentrations. Observational studies of
patients with chronic kidney disease suggest increased homocysteine is a
risk factor for cardiovascular disease. The impact of lowering total
homocysteine levels in kidney transplant recipients is unknown. Methods
and Results-: In a double-blind controlled trial, we randomized 4110
stable kidney transplant recipients to a multivitamin that included either
a high dose (n=2056) or low dose (n=2054) of folic acid, vitamin B6, and
vitamin B12 to determine whether decreasing total homocysteine
concentrations reduced the rate of the primary composite arteriosclerotic
cardiovascular disease outcome (myocardial infarction, stroke,
cardiovascular disease death, resuscitated sudden death, coronary artery
or renal artery revascularization, lower-extremity arterial disease,
carotid endarterectomy or angioplasty, or abdominal aortic aneurysm
repair). Mean follow-up was 4.0 years. Treatment with the high-dose
multivitamin reduced homocysteine but did not reduce the rates of the
primary outcome (n=547 total events; hazards ratio [95 confidence
interval]=0.99 [0.84 to 1.17]), secondary outcomes of all-cause mortality
(n=431 deaths; 1.04 [0.86 to 1.26]), or dialysis-dependent kidney failure
(n=343 events; 1.15 [0.93 to 1.43]) compared to the low-dose multivitamin.
Conclusions-: Treatment with a high-dose folic acid, B6, and B12
multivitamin in kidney transplant recipients did not reduce a composite
cardiovascular disease outcome, all-cause mortality, or dialysis-dependent
kidney failure despite significant reduction in homocysteine level.
Clinical Trial Registration-: http://www.clinicaltrials.gov. Unique
identifier: NCT00064753. 2011 American Heart Association, Inc.
<11>
[Use Link to view the full text]
Accession Number
2011231691
Authors
Sundar S. Novack V. Jervis K. Bender S.P. Lerner A. Panzica P. Mahmood F.
Malhotra A. Talmor D.
Institution
(Sundar, Novack, Jervis, Bender, Talmor) Department of Anesthesia,
Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 1
Deaconess Road, Boston, MA 02215, United States
(Sundar, Novack, Jervis, Bender, Talmor) Harvard Medical School, Boston,
MA, United States
(Lerner, Panzica, Mahmood) Department of Anesthesia, Critical Care and
Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical
School, Cambridge, MA, United States
(Lerner, Panzica, Mahmood) Clinical Research Center, Soroka Medical
Center, Beer-Sheva, Israel
(Malhotra) Division of Pulmonary and Critical Care Medicine, Brigham and
Women's Hospital, Boston, MA, United States
(Malhotra) Harvard Medical School, Cambridge, MA, United States
Title
Influence of low tidal volume ventilation on time to extubation in cardiac
surgical patients.
Source
Anesthesiology. 114 (5) (pp 1102-1110), 2011. Date of Publication: May
2011.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street, Philadelphia PA
19106-3621, United States)
Abstract
Background: Low tidal volumes have been associated with improved outcomes
in patients with established acute lung injury. The role of low tidal
volume ventilation in patients without lung injury is still unresolved. We
hypothesized that such a strategy in patients undergoing elective surgery
would reduce ventilator-associated lung injury and that this improvement
would lead to a shortened time to extubation Methods: A single-center
randomized controlled trial was undertaken in 149 patients undergoing
elective cardiac surgery. Ventilation with 6 versus 10 ml/kg tidal volume
was compared. Ventilator settings were applied immediately after
anesthesia induction and continued throughout surgery and the subsequent
intensive care unit stay. The primary endpoint of the study was time to
extubation. Secondary endpoints included the proportion of patients
extubated at 6 h and indices of lung mechanics and gas exchange as well as
patient clinical outcomes. Results: Median ventilation time was not
significantly different in the low tidal volume group; a median
(interquartile range) of 450 (264-1,044) min was achieved compared with
643 (417-1,032) min in the control group (P = 0.10). However, a higher
proportion of patients in the low tidal volume group was free of any
ventilation at 6 h: 37.3% compared with 20.3% in the control group (P =
0.02). In addition, fewer patients in the low tidal volume group required
reintubation (1.3 vs. 9.5%; P = 0.03). Conclusions: Although reduction of
tidal volume in mechanically ventilated patients undergoing elective
cardiac surgery did not significantly shorten time to extubation, several
improvements were observed in secondary outcomes. When these data are
combined with a lack of observed complications, a strategy of reduced
tidal volume could still be beneficial in this patient population.
Copyright 2011, the American Society of Anesthesiologists, Inc.
Lippincott Williams & Wilkins. Anesthesiology.
<12>
Accession Number
2011239897
Authors
Ma J. Yang W. Singh M. Peng T. Fang N. Wei M.
Institution
(Ma, Wei) Division of Cardiology, Shanghai Sixth People's Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Yang, Fang) Division of Geriatrics, Shanghai Ren-Ji Hospital, Shanghai
Jiao Tong University School of Medicine, Shanghai, China
(Singh) Department of Pathology, University of Western Ontario, London,
ON, Canada
(Peng) Critical Illness Research, Lawson Health Research Institute,
Department of Medicine and Department of Pathology, University of Western
Ontario, London, ON, Canada
Title
Meta-analysis of long-term outcomes of drug-eluting stent implantations
for chronic total coronary occlusions.
Source
Heart and Lung: Journal of Acute and Critical Care. 40 (3) (pp e32-e40),
2011. Date of Publication: May-June 2011.
Publisher
Mosby Inc. (11830 Westline Industrial Drive, St. Louis MO 63146, United
States)
Abstract
Background: In the treatment of chronic total occlusions (CTOs), some
uncertainty exists regarding the effect of drug-eluting stents (DESs)
compared with the effects of bare mental stents (BMSs). We reviewed
outcomes of DES vs. BMS implantation for CTO lesions, to evaluate the
risk-benefit ratio of DES implantation. Methods: Relevant studies of
long-term clinical outcomes or angiographic outcomes of both BMS and DES
implantation were examined. The primary endpoint comprised major adverse
cardiovascular events (MACEs), including all-cause deaths, myocardial
infarctions (MIs), and target lesion revascularizations (TLRs). A
fixed-effect model and random-effect model were used to analyze the
pooling results. Results: Ten studies were included according to the
selection criteria. Eight were nonrandomized controlled trials, and two
consisted of a randomized controlled comparison between DES and BMS
implantation. No significant difference was evident for in-hospital MACE
rates between the two groups (odds ratio [OR], 1.07; 95% confidence
interval [CI], .53 to 2.13), but the long-term MACE rates in the DES group
were significantly lower than in the BMS group (OR, .22; 95% CI, .13 to
.38; P < .00001). The rates of stent restenosis and reocclusions were also
significantly lower in the DES group (OR, .14; 95% CI, .09 to .20; and OR,
.23; 95% CI, .12 to .41, respectively). Conclusion: Implantation of the
DES improves long-term angiographic and clinical outcomes compared with
BMS in the treatment of CTO lesions. 2011 Elsevier Inc.
<13>
Accession Number
2011230409
Authors
Steinlechner B. Zeidler P. Base E. Birkenberg B. Ankersmit H.J. Spannagl
M. Quehenberger P. Hiesmayr M. Jilma B.
Institution
(Steinlechner, Zeidler, Base, Birkenberg, Hiesmayr) Division of
Cardiothoracic and Vascular Anaesthesia and Intensive Care, Medical
University of Vienna, Vienna, Austria
(Ankersmit) Department of Thoracic Surgery, Medical University of Vienna,
Vienna, Austria
(Spannagl) Department of Laboratory Medicine, Medical University of
Vienna, Vienna, Austria
(Quehenberger, Jilma) Department of Clinical Pharmacology, Medical
University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
(Jilma) Department of Transfusion Medicine and Haemostaseology,
Ludwig-Maximilians-University, Munich, Germany
Title
Patients with severe aortic valve stenosis and impaired platelet function
benefit from preoperative desmopressin infusion.
Source
Annals of Thoracic Surgery. 91 (5) (pp 1420-1426), 2011. Date of
Publication: May 2011.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Background: Patients with severe aortic valve stenosis have a markedly
reduced platelet function as measured by a prolonged collagen adenosine
diphosphate closure time (CADP-CT) determined by the platelet function
analyzer PFA-100. We hypothesized that such patients may benefit from
desmopressin when they present with prolonged CADP-CT due to the specific
action of desmopressin on von Willebrand factor (VWF) and CADP-CT.
Methods: In this double-blind, randomized placebo controlled trial, 43
patients undergoing aortic valve replacement (due to severe aortic valve
stenosis with CADP-CT > 170 seconds) were given desmopressin 0.3 mug/kg or
saline intravenously after induction of anesthesia. Measurement of
CADP-CT, factor VIII activity, von Willebrand factor antigen, GpIb binding
activity, ristocetin cofactor activity, collagen-binding activity, and
multimers were performed after induction of anesthesia, one hour after
desmopressin infusion, and 24 hours postoperatively. Results: In the
majority of patients, baseline values of von Willebrand factor related
indices were normal, but increased one hour after infusion of desmopressin
by 73% to 90% as compared with placebo. Selective loss of high molecular
weight multimers was seen only in a minority of patients. The CADP-CT was
greater than 170 seconds in 92% of screened patients, and desmopressin
shortened CADP-CT by 48% versus baseline and reduced postoperative blood
loss by 42% (p < 0.001). Conclusions: Prolonged CADP-CT indicates platelet
dysfunction in severe aortic valve stenosis, and can guide the use of
desmopressin as an effective prohemostatic agent in patients with severe
aortic valve stenosis. 2011 The Society of Thoracic Surgeons.
<14>
Accession Number
2011226167
Authors
Naylor A.R. Bown M.J.
Institution
(Naylor, Bown) Department of Vascular Surgery, Leicester Royal Infirmary,
Leicester LE2 7LX, United Kingdom
(Naylor) Vascular Surgery Group, Division of Cardiovascular Sciences,
Clinical Sciences Building, Leicester LE2 7LX, United Kingdom
Title
Stroke after Cardiac surgery and its association with asymptomatic carotid
disease: An updated systematic review and meta-analysis.
Source
European Journal of Vascular and Endovascular Surgery. 41 (5) (pp
607-624), 2011. Date of Publication: May 2011.
Publisher
W.B. Saunders Ltd (32 Jamestown Road, London NW1 7BY, United Kingdom)
Abstract
Objectives: (i) Prevalence of stroke in neurologically symptomatic/
asymptomatic patients with unilateral/bilateral carotid disease (including
occlusion) undergoing cardiac surgery without prophylactic carotid
endarterectomy (CEA) or carotid stenting (CAS). (ii) Prevalence of stroke
in asymptomatic patients with unilateral/bilateral carotid disease
(excluding occlusion) who underwent isolated cardiac surgery. (iii)
Prevalence of stroke in the hemisphere ipsilateral to a non-operated
asymptomatic stenosis in patients with severe bilateral carotid disease
undergoing a synchronous unilateral CEA + cardiac procedure. Methods:
Systematic Review and meta-analysis. Results: Cardiac surgery patients
with a symptomatic/asymptomatic 50-99% stenosis or occlusion incurred a
7.4% stroke risk (95%CI 4.8-9.9), increasing to 9.1% (95%CI 4.8-16) in
those with 80-99% stenoses or occlusion. After excluding patients with a
history of stroke/TIA and those with isolated/bilateral occlusions, the
stroke risk fell to 3.8% (95%CI 2.0-4.8) in patients with asymptomatic
50-99% stenoses and 2.0% in those with 70-99% stenoses (95%CI 1.0-5.7).
The prevalence of ipsilateral stroke in patients with a unilateral,
asymptomatic 50-99% stenosis was 2.0% (1.0-3.8), while the risk of any
stroke was only 2.9% (2%-5.7%). These risks did not increase with stenosis
severity (70-99%, 80-99%). Patients with bilateral, asymptomatic 50-99%
stenoses or a 50-99% stenosis + contralateral occlusion incurred a 6.5%
stroke risk following cardiac surgery, while the risk of death/stroke was
9.1% (3.8%-20.6%). Patients with bilateral 80-99% stenoses undergoing a
unilateral synchronous cardiac/carotid revascularisation incurred a 5.7%
risk of stroke in the hemisphere ipsilateral to the non-operated,
contralateral stenosis. Conclusions: There is no compelling evidence
supporting a role for prophylactic CEA/CAS in cardiac surgery patients
with unilateral asymptomatic carotid disease. Prophylactic CEA/CAS might
still be considered in patients with severe, bilateral asymptomatic
carotid disease, but such a strategy would only benefit 1-2% of all
cardiac surgery patients. 2010 European Society for Vascular Surgery.
<15>
Accession Number
2011226858
Authors
Iblher P. Mahler H. Heinze H. Huppe M. Klotz K.-F. Eichler W.
Institution
(Iblher, Mahler, Heinze, Huppe, Klotz) Department of Anaesthesiology,
University of Lubeck Medical School, Ratzeburger Allee 160, 23538 Lubeck,
Germany
(Eichler) Schon Clinics Neustadt Dept. of Anaesthesiology and Intensiv
Care, Neustadt in Holstein, Germany
Title
Does music harm patients after cardiac surgery? A randomized, controlled
study.
Source
Applied Cardiopulmonary Pathophysiology. 15 (1) (pp 14-23), 2011. Date
of Publication: 2011.
Publisher
Pabst Science Publishers (Eichengrund 28, Lengerich D-49525, Germany)
Abstract
Background: Positive effects of music on the state of mood as well as on
anxiety, pain and physiological measures were described for the
postoperative setting on the ICU. Objectives: To examine the influence of
a music intervention in the early postoperative period on patients
undergoing open heart surgery. Methods: We examined 126 patients
undergoing open cardiac surgery, randomly assigned to one of five groups:
1) Music intervention transmitted by a closed headphone for 60 minutes
immediately after arrival on the ICU, 2) Like (1) but only headphone
without music, 3) Music intervention transmitted by a closed headphone for
60 minutes immediately after discontinuation of sedation, 4) like (3) but
only headphone without music 5) Control without headphone or music. Music
intervention was provided by a conventional CD player. For the self
assessment of postoperative complaints and patient satisfaction we used
the Anaesthesiological Questionaire (ANP2). Furthermore blood pressure,
heart rate and infused catecholamines, peripheral saturation and
consumption on opiod analgesics were recorded. Results: We found no
difference between the five groups. In the analysis of variance for the
factor music there was a significant increase of pain in the operated
area, thirst, nausea and remembrance of the postoperative period with
music in the ANP (p<0.05 respectively). For the factor early versus late
intervention we found a significant improvement of pain in the operated
area, discomfort and satisfaction within the perioperative course (p<0.05
respectively) when intervention was applied early. There was neither a
combined effect of both factors nor differences between further recorded
data. Conclusions: Music intervention seems to pronounce typical
perioperative complaints in this setting. This might be explained by an
intensified awareness of the situation on the ICU. The difference between
early and late intervention may indicate the importance of a sufficient
noise protection even during continuous sedation of the patient.
<16>
Accession Number
2011226812
Authors
Alshawabkeh L.I. Banerjee S. Brilakis E.S.
Institution
(Alshawabkeh) Department of Internal Medicine, University of Texas
Southwestern Medical Center at Dallas, United States
(Banerjee, Brilakis) VA North Texas Health Care System, The University of
Texas Southwestern Medical Center at Dallas, Dallas, TX 75216, United
States
Title
Systematic review of the frequency and outcomes of non-cardiac surgery
after drug-eluting stent implantation.
Source
Hellenic Journal of Cardiology. 52 (2) (pp 141-148), 2011. Date of
Publication: March - April 2011.
Publisher
Hellenic Cardiological Society (Potamianou 8, Athens GR-11528, Greece)
<17>
Accession Number
2011206427
Authors
Brilakis E.S. Saeed B. Banerjee S.
Institution
(Brilakis, Banerjee) VA North Texas Healthcare System, University of Texas
Southwestern Medical Center, Dallas, TX, United States
(Saeed) University of Toledo, Toledo, OH, United States
Title
Drug-eluting stents in saphenous vein graft interventions: A systematic
review.
Source
EuroIntervention. 5 (6) (pp 722-730), 2010. Date of Publication: January
2010.
Publisher
EuroPCR (5 Rue Saint-Pantaleon, Toulouse 31015, France)
Abstract
Aims: A systematic review of the outcomes after drug-eluting stents (DES)
implantation in saphenous vein grafts (SVGs) was performed. Methods and
results: The majority of the 33 published studies were retrospective with
only two prospective randomised trials. Late loss and binary restenosis
was reduced compared to bare metal stents (BMS) in all seven studies with
angiographic follow-up. With the exception of one study there was no
difference in mortality, myocardial infarction, or stent thrombosis
between BMS and DES. The need for repeat target vessel or lesion
revascularisation was lower in the DES arm in approximately half the
published studies and similar in the remaining studies. Conclusions: Until
data from large, prospective, randomised-controlled studies become
available, DES implantation in SVGs appears to be safe and, although not
yet definitively proven, likely to reduce angiographic restenosis and the
need for repeat target lesion revascularisation. Europa Edition. All
rights reserved.
<18>
Accession Number
2011198437
Authors
Onuma Y. Serruys P.W. Ormiston J.A. Regar E. Webster M. Thuesen L. Dudek
D. Veldhof S. Rapoza R.
Institution
(Onuma, Serruys, Regar) Thoraxcenter, Erasmus Medical Center, Rotterdam,
Netherlands
(Ormiston, Webster) Auckland City Hospital, Auckland, New Zealand
(Thuesen) Skejby Sygehus, Aarhus University Hospital, Skejby, Denmark
(Dudek) Jagiellonian University, Krakow, Poland
(Veldhof) Abbott Vascular, Diegem, Belgium
(Rapoza) Abbott Vascular, Santa Clara, United States
Title
Three-year results of clinical follow-up after a bioresorbable
everolimus-eluting scaffold in patients with de novo coronary artery
disease: The ABSORB trial.
Source
EuroIntervention. 6 (4) (pp 447-453), 2010. Date of Publication:
September 2010.
Publisher
EuroPCR (5 Rue Saint-Pantaleon, Toulouse 31015, France)
Abstract
Aims: Multimodality imaging of the first-in-man trial using a fully
resorbable everolimus-eluting scaffold (BVS, Abbott Vascular, Santa Clara,
CA, USA) demonstrated at two years the bioresorption of the device while
preventing restenosis. Nevertheless, the long-term safety and efficacy of
this novel therapy remain to be documented. Methods and results: The
ABSORB trial completed in July 2006 at four clinical sites in Europe and
New Zealand the enrolment of 30 patients with a single de novo native
coronary artery lesion. The major clinical endpoint was ischaemia-driven
major adverse cardiac events (ID-MACE) defined as a composite of cardiac
death, myocardial infarction, or ischaemia-driven target lesion
revascularisation. Clinical follow-up was available in 29 patients since
one patient withdrew consent. At 46 days, one patient experienced a single
episode of chest pain and underwent a diagnostic optical coherence
tomography and subsequently a target lesion revascularisation with slight
troponin rise after the procedure. At 3-year the hierarchical ID-MACE of
3.4% remained unchanged. Clopidogrel therapy was discontinued in all but
one patient. There has been no stent thrombosis reported. Two non-cardiac
deaths were reported; one from duodenal perforation, the other from
Hodgkin disease. Two patients underwent non-ischaemia driven target vessel
revascularisation. Conclusions: Three-year clinical results have
demonstrated a sustained low MACE rate (3.4%) without any late
complication such as stent thrombosis. Europa Edition 2010. All rights
reserved.
<19>
Accession Number
2011198436
Authors
Applegate R.J. Hermiller J.B. Sanz M. Doostzadeh J. Pierson W. Su X.
Lansky A.J. Sudhir K. Stone G.W.
Institution
(Applegate) Wake Forest University Health Sciences, Medical Center Blvd.,
Winston-Salem, NC, United States
(Hermiller) Heart Center of IN, Indianapolis, IN, United States
(Sanz) St. Patrick Hospital, Missoula, MT, United States
(Doostzadeh, Pierson, Su, Sudhir) Abbott Vascular, Santa Clara, CA, United
States
(Lansky, Stone) Columbia University Medical Center, Cardiovascular
Research Foundation, New York, NY, United States
Title
Comparison of everolimus-eluting and paclitaxel-eluting coronary stents in
patients with two treated vessels: 2-year results from the SPIRIT III
randomised trial.
Source
EuroIntervention. 6 (4) (pp 437-446), 2010. Date of Publication:
September 2010.
Publisher
EuroPCR (5 Rue Saint-Pantaleon, Toulouse 31015, France)
Abstract
Aims: To examine the two year clinical outcomes in dual-vessel disease
from the SPIRIT III trial comparing the XIENCE V everolimus-eluting stent
(EES) to the TAXUS Express2 paclitaxel-eluting stent (PES). Methods and
results: From a total of 1,002 randomised subjects, 103 and 51 patients in
the EES and PES groups respectively underwent stenting of two lesions in
two vessels (one lesion per epicardial vessel). Two-year event rates were
lower in one compared to two-vessel treated patients regardless of stent
type. For EES vs. PES, major adverse cardiac events (MACE=cardiac death,
MI or TLR) was clinically reduced 35.0% in the single vessel patients
(6.5% vs. 9.6%, p=0.09) and was significantly reduced 64% in dual vessel
patients (11.9% vs. 30.1%, p=0.006). There was no significant interaction
between stent type (EES vs. PES) and the number of stented vessels (two
vs. single) for either 2-year TVF and MACE (interaction p values were 0.69
and 0.16, respectively). Conclusions: In the SPIRIT III randomised trial,
patients with both single and dual vessel treatment with EES showed
improved clinical outcomes at two years compared to those treated with
PES. Follow-up to five years is ongoing. Europa Edition 2010. All rights
reserved.
<20>
Accession Number
2011198420
Authors
Garg S. Sarno G. Serruys P.W. De Vries T. Buszman P. Linke A. Ischinger T.
Klauss V. Eberli F. Corti R. Wijns W. Morice M.-C. Di Mario C. Van Geuns
R.J. Eerdmans P. Van Es G.-A. Meier B. Juni P. Windecker S.
Institution
(Garg, Sarno, Serruys, Van Geuns) Department of Interventional Cardiology,
Erasmus MC, Rotterdam, Netherlands
(De Vries, Van Es) Cardialysis B.V, Rotterdam, Netherlands
(Buszman) Medical University of Silesia, Katowice, Poland
(Linke) Herzzentrum Leipzig, Leipzig, Germany
(Ischinger) Department of Cardiology, Hospital Bogenhausen, Munich,
Germany
(Klauss) Department of Cardiology, University Hospital Munich
(Innenstadt), Munich, Germany
(Eberli) Department of Cardiology, Triemli Spital, Zurich, Switzerland
(Corti) Department of Cardiology, University Hospital Zurich, Zurich,
Switzerland
(Wijns) Department of Cardiology, Onze Lieve Vrouw Ziekenhuis, Aalst,
Belgium
(Morice) Institut Jacques Cartier Massy, France
(Di Mario) Department of Cardiology, Royal Brompton Hospital, London,
United Kingdom
(Eerdmans) Biosensors Europe SA, Morges, Switzerland
(Meier, Windecker) Department of Cardiology, University Hospital Bern,
Bern, Switzerland
(Juni, Windecker) CTU Bern, Bern University Hospital, Bern, Switzerland
(Juni) Institute of Social and Preventive Medicine, University of Bern,
Bern, Switzerland
Title
The twelve-month outcomes of a biolimus eluting stent with a biodegradable
polymer compared with a sirolimus eluting stent with a durable polymer.
Source
EuroIntervention. 6 (2) (pp 233-239), 2010. Date of Publication: June
2010.
Publisher
EuroPCR (5 Rue Saint-Pantaleon, Toulouse 31015, France)
Abstract
Aims: This study reports the 12-month clinical outcomes of the LEADERS
clinical trial which compared a biolimus eluting stent with a
biodegradable polymer (BES) to a sirolimus eluting stent with a durable
polymer (SES). Methods and results: The multicentre LEADERS trial employed
an all-comers approach to recruit 1,707 patients who were randomised to
treatment with either BES (n=857) or SES (n=850) in a noninferiority
design. The primary clinical endpoint of this study was a composite of
cardiac death, myocardial infarction and clinical-indicated target vessel
revascularisation. Follow-up was obtained in 97.6% of patients. At 12
months, BES remained non-inferior compared to SES for the primary endpoint
(BES 10.6% vs. SES 12.0%, HR:0.88, 95% CI:0.66-1.17, p=0.37). Rates of
cardiac death (2.1% vs. 2.7%, HR:0.77, 95% CI:0.42-1.44, p=0.42), MI (5.8%
vs. 4.6%, HR:1.27, 95% CI:0.84-1.94, p=0.26) and clinically-indicated
target vessel revascularisation (5.8% vs. 7.1%, HR:0.82, 95%CI:0.56-1.19,
p=0.29) were similar for BES and SES. Similarly, there was no difference
in the incidence of definite stent thrombosis at 12 months. Conclusions:
These findings support the safety and efficacy of the BES stent with a
biodegradable polymer at 12-month clinical follow-up, and suggest it is a
suitable alternative to the SES stent with a durable polymer. Europa
Edition 2010. All rights reserved.
<21>
Accession Number
2011189255
Authors
Zhao Y. Pan J. Wang D.-J.
Institution
(Zhao, Pan, Wang) Department of Cardio-thoracic Surgery, Drum Tower
Clinical College, Nanjing Medical University, Nanjing 210008, Jiangsu
Province, China
Title
Comparative study between off-pump and on-pump coronary artery bypass
grafting: A meta-analysis.
Source
Journal of Clinical Rehabilitative Tissue Engineering Research. 14 (31)
(pp 5773-5777), 2010. Date of Publication: July 2010.
Publisher
Journal of Clinical Rehabilitative (P.O. Box 1200, Shenyang 110004, China)
Abstract
BACKGROUND: Studies demonstrated that the living quality of patients had
no significant differences following off-pump (OPCAB) or on-pump coronary
artery bypass grafting (CCAB). The decrease of living quality related to
graft lesions and arrhythmia. OBJECTIVE: To evaluate whether OPCAB is
superior to conventional CCAB. METHODS: The comparative studies regarding
therapeutic effects of OPCAB and CCAB from 2000 to 2009 were searched, and
collecting relevant data was Meta analyzed using RevMan 4.2 statistical
software. RESULTS AND CONCLUSION: A total 16 documents were included in
this study, including 1 392 cases in the OPCAB group and 1 252 cases in
the CCAB group. Results of Meta analysis demonstrated that, OPCAB was
superior to CCAB in ICU duration, ventilation time, hospitalization time,
postoperative 24-hour drainage volume, and postoperative complications (P
< 0.05), but the graft number was lower than that of the CCAB group (P <
0.05). However, the age had no difference between the two groups (P >
0.05). The results revealed that compared with CCAB, OPCAB receives
superior short term outcome in the treatment of coronary artery disease,
but the long term effectiveness needs to be explored.
<22>
Accession Number
2011206391
Authors
Dambrink J.-H.E. Debrauwere J.P. Van 't Hof A.W.J. Ottervanger J.-P.
Gosselink A.T.M. Hoorntje J.C.A. De Boer M.-J. Suryapranata H.
Institution
(Dambrink, Debrauwere, Van 't Hof, Ottervanger, Gosselink, Hoorntje, De
Boer, Suryapranata) Isala Klinieken, Department of Cardiology, Locatie
Weezenlanden, Groot Wezenland 20, 8011 JW Zwolle, Netherlands
Title
Non-culprit lesions detected during primary PCI: Treat invasively or
follow the guidelines?.
Source
EuroIntervention. 5 (8) (pp 968-975), 2010. Date of Publication: April
2010.
Publisher
EuroPCR (5 Rue Saint-Pantaleon, Toulouse 31015, France)
Abstract
Aims: Evidence regarding the optimal treatment of non-culprit lesions
detected during primary PCI is lacking. Our aim was to investigate whether
early invasive treatment improves left ventricular ejection fraction (EF)
and prevents major adverse cardiac events (MACE). Methods and results: Of
121 patients with at least one non-culprit lesion, 80 were randomised to
early FFR-guided PCI (invasive group), and 41 to medical treatment
(conservative group). Primary endpoint was EF at six months, secondary
endpoints included MACE. In the invasive group, early angiography was
performed 7.5 days (5-20) after primary PCI. Forty percent of the
non-culprit lesions did not show haemodynamic significance (FFR > 0.75).
Subsequent PCI of at least one non-culprit lesion was performed in 52%,
PCI without preceding FFR was performed in 8% and elective CABG was done
in 4%. No in-hospital events occurred in the conservative group. After six
months, EF was comparable (59+/-9% vs. 57+/-9%, p=0.362), and there was no
difference in MACE between invasively and conservatively treated patients
(21 vs. 22%, p=0.929). Conclusions: An invasive strategy towards
non-culprit lesions does not lead to an increase in EF or a reduction in
MACE. The functional stenosis severity of non-culprit lesions is
frequently overestimated. Europa Edition 2010. All rights reserved.
<23>
Accession Number
2011206389
Authors
Varani E. Guastaroba P. Tanna G.L.D. Saia F. Balducelli M. Campo G.
Vignali L. Rossi R. Manari A. Piovaccari G. De Palma R. Marzocchi A.
Institution
(Varani, Balducelli) Unita Operativa di Cardiologia, Ospedale S. Maria
Delle Croci, Ravenna, Italy
(Guastaroba, De Palma) Agenzia Sanitaria Regionale dell'Emilia-Romagna,
Bologna, Italy
(Tanna) Dipartimento di Medicina Sperimentale, Universita La Sapienza,
Roma, Italy
(Saia, Marzocchi) Istituto di Cardiologia, Universita di Bologna,
Policlinico S.Orsola-Malpighi, Bologna, Italy
(Campo) Laboratorio di Emodinamica, Ospedale di Ferrara, Italy
(Vignali) Divisione di Cardiologia, Azienda Ospedaliero-Universitaria,
Parma, Italy
(Rossi) Divisione di Cardiologia, Policlinico di Modena, Italy
(Manari) Unita Operativa di Cardiologia Interventistica, Ospedale S. Maria
Nuova, Reggio Emilia, Italy
(Piovaccari) Unita Operativa di Cardiologia, Ospedale degli Infermi,
Rimini, Italy
Title
Long-term clinical outcomes and cost-effectiveness analysis in multivessel
percutaneous coronary interventions: Comparison of drug-eluting stents,
bare-metal stents and a mixed approach in patients at high and low risk of
repeat revascularisation.
Source
EuroIntervention. 5 (8) (pp 953-961), 2010. Date of Publication: April
2010.
Publisher
EuroPCR (5 Rue Saint-Pantaleon, Toulouse 31015, France)
Abstract
Aims: To evaluate the long-term effectiveness and cost-efficacy of
drug-eluting stents (DES) in a real world setting of multivessel
percutaneous coronary intervention (PCI). Methods and results: We
evaluated the 2-year outcome of all multivessel PCI in de novo lesions
enrolled in a prospective web-based multicentre registry from July 2003 to
December 2006. Among the 2,898 eligible patients, 1,315 were treated with
bare-metal stent (BMS) alone, 657 with DES alone, and 926 with both. At
2-years, use of DES was associated with a lower propensity score adjusted
incidence of major adverse cardiac events (MACE), death and myocardial
infarction, and target vessel revascularisation (TVR) compared with BMS
but only in patients at high risk of TVR. No difference was apparent
between "pure" DES and the mixed approach. The matched cost-effectiveness
analysis revealed DES to be more costly and more effective with a
reasonable incremental cost-efficacy ratio for any MACE avoided only in
patients with a high risk of TVR and only in comparison with "pure" BMS
patients. Conclusions: In this real-world multivessel PCI registry, the
use of DES and a mixed approach were associated with a 2-year reduction of
adverse clinical outcomes in comparison with BMS especially in patients
with a high risk of TVR. DES were cost-effective only in patients at high
risk of TVR. Europa Edition 2010. All rights reserved.
<24>
Accession Number
2011198444
Authors
Testa L. Agostoni P. Vermeersch P. Biondi-Zoccai G. Van Gaal W. Bhindi R.
Brilakis E. Latini R.A. Laudisa M.-L. Pizzocri S. Lanotte S. Brambilla N.
Banning A. Bedogni F.
Institution
(Testa, Latini, Laudisa, Pizzocri, Lanotte, Brambilla, Bedogni) Dept. of
Interventional Cardiology, Istituto Clinico S. Ambrogio, Via Faravelli 16,
20148, Milan, Italy
(Agostoni) Department of Cardiology, University Medical Center, Utrecht,
Netherlands
(Vermeersch) Antwerp Cardiovascular Institute, Middelheim, Antwerp,
Belgium
(Biondi-Zoccai) Institute of Cardiology, University of Turin, Turin, Italy
(Van Gaal) Institute of Cardiology, Northern Hospital, Melbourne, VIC,
Australia
(Bhindi) Department of Cardiology, Royal North Shore Hospital, Sydney,
NSW, Australia
(Brilakis) Institute of Cardiology, University of Texas Southwestern
Medical Center, Dallas, TX, United States
(Banning) Institute of Cardiology, John Radcliffe Hospital, Oxford, United
Kingdom
Title
Drug eluting stents versus bare metal stents in the treatment of saphenous
vein graft disease: A systematic review and meta-analysis.
Source
EuroIntervention. 6 (4) (pp 527-536), 2010. Date of Publication:
September 2010.
Publisher
EuroPCR (5 Rue Saint-Pantaleon, Toulouse 31015, France)
Abstract
Aims: Treatment of saphenous vein graft (SVG) disease is still a matter of
debate given the uncertainty of the available conflicting data. Our aim
was to assess, by means of a meta-analytic approach, the risk/benefit
profile of drug eluting stents (DES) versus bare metal stents (BMS) in the
treatment of SVG disease. Methods and results: A search of relevant
studies in several databases was performed. The endpoints of interest such
as: major adverse events (MAE) (the combination of overall death and
non-fatal myocardial infarction [AMI]), target vessel revascularisation
(TVR), and target lesion revascularisation (TLR) have been calculated
in-hospital and at the longest follow-up. Single endpoints and the rate of
stent thrombosis (ST) were also assessed. Three randomised controlled
trials and 15 registry studies were appraised, totalling 3,294 patients.
During hospitalisation, there was no difference in the risk of MAE,
overall death, AMI and TVR. No data were available to calculate the TLR
rate. At a mean follow-up of 19.8 months, no significant differences were
found in the risk of MAE and AMI. BMS were associated with a trend towards
a higher risk of overall death (OR 1.32 [1,00-1.74], p=0.05, number needed
to treat [NNT]=55). DES showed superiority in terms of TVR (OR 1.86
[1.33-2.61], p=0.0003, NNT=16), and TLR (OR 1.77 [1.27-2.48], p<0.0001,
NNT=25). According to pre-specified subgroup analyses, these effects seem
less evident at the long-term follow-up. DES were not associated with an
increased risk of ST. Conclusions: Use of DES in SVG substantially reduces
both TVR and TLR. These data also demonstrate that using DES in SVG is
safe and contradict previous reports of potential risks. Europa Edition
2010. All rights reserved.
<25>
Accession Number
2011198426
Authors
From A.M. Al Badarin F.J. Cha S.S. Rihal C.S.
Institution
(From, Al Badarin, Rihal) Division of Cardiovascular Diseases, Mayo Clinic
College of Medicine and Mayo Foundation, Rochester, MN, United States
(Cha) Division of Biostatistics, Mayo Clinic College of Medicine and Mayo
Foundation, Rochester, MN, United States
Title
Percutaneous coronary intervention with drug-eluting stents versus
coronary artery bypass surgery for multivessel coronary artery disease: A
meta-analysis of data from the ARTS II, CARDia, ERACI III, and SYNTAX
studies and systematic review of observational data.
Source
EuroIntervention. 6 (2) (pp 269-276), 2010. Date of Publication: June
2010.
Publisher
EuroPCR (5 Rue Saint-Pantaleon, Toulouse 31015, France)
Abstract
Aims: The aim of this study was to systematically analyse the available
data from trials comparing revascularisation by drug-eluting stent (DES)
placement versus coronary artery bypass grafting (CABG) in patients with
multivessel coronary artery disease (CAD). Methods and results: We
searched PubMed, Medline and several internet sources for randomised
controlled trials comparing DES placement to CABG in patients with
multivessel coronary artery disease. There were no restrictions on journal
type or population studied. Prior to data collection we chose to analyse
the prospectively performed trials separately from data obtained
retrospectively. Four prospective trials were identified which enrolled a
total of 3,895 patients: 1,914 in the DES arm and 1,981 patients in the
CABG arm. Pooled analysis of data from these four studies showed that in
patients treated DES compared to CABG there was a similar risk of the
combined endpoints of death, myocardial infarction and stroke (10.2%
versus 10.8%, respectively; RR=0.94 [95% CI=0.77-1.116]; p=0.56), but a
significantly higher risk of target vessel revascularisation (TVR) (14.6%
versus 6.8%, respectively; RR=2.09 [95% CI=1.72-2.55]; <0.001) and,
therefore, a significantly higher risk of MACCE (21.2% versus 16.3%,
respectively; RR=1.27 [95% CI=1.09-1.48]; p=0.002). Interestingly, when
MACCE rates at one year are used for these trials the risk is equivalent
between DES and CABG (14.4% versus 12.5%, respectively; RR=1.05 [95%
CI=0.70-1.57]; p=0.83). Analysis of observational data revealed similar
findings. Conclusions: Overall, PCI with DES placement was safe in
patients with multivessel disease compared to CABG, but is associated with
a significantly higher risk of TVR. Europa Edition 2010. All rights
reserved.
<26>
Accession Number
2011198416
Authors
Serruys P.W. Garg S. Abizaid A. Ormiston J. Windecker S. Verheye S. Dubois
C. Stewart J. Hauptmann K.E. Schofer J. Stangl K. Witzenbichler B. Wiemer
M. Barbato E. De Vries T. Den Drijver A.-M. Otake H. Meredith L. Toyloy S.
Fitzgerald P.
Institution
(Serruys, Garg) Ba583a, Thoraxcentre, Erasmus MC, 's-Gravendijkwal 230,
3015 CE Rotterdam, Netherlands
(Abizaid) Instituto Dante Pazzanese, Sao Paulo, Brazil
(Ormiston, Stewart) Mercy Angiography Unit, Auckland, New Zealand
(Windecker) University Hospital Bern, Bern, Switzerland
(Verheye) Academisch Ziekenhuis Middelheim, Antwerpen, Belgium
(Dubois) Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium
(Hauptmann) Krankenhaus der Barmherzigen Bruder, Trier, Germany
(Schofer) Universitares Herz-und Gefaszentrum, Hamburg, Germany
(Stangl) Charite, University Clinic Berlin, Campus Charite Mitte, Berlin,
Germany
(Witzenbichler) Charite, University Clinic Berlin, Campus
Benjamin-Franklin, Berlin, Germany
(Wiemer) Herz-und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen,
Germany
(Barbato) Onze Lieve Vrouw Ziekenhuis, Aalst, Belgium
(De Vries, Den Drijver) Cardialysis, Rotterdam, Netherlands
(Otake, Toyloy, Fitzgerald) Stanford Cardiovascular Core Analysis
Laboratory, Stanford University, CA, United States
(Meredith) Elixir Medical Corp., Sunnyvale, CA, United States
Title
A randomised comparison of novolimus-eluting and zotarolimus-eluting
coronary stents: 9-Month follow-up results of the EXCELLA II study.
Source
EuroIntervention. 6 (2) (pp 195-205), 2010. Date of Publication: June
2010.
Publisher
EuroPCR (5 Rue Saint-Pantaleon, Toulouse 31015, France)
Abstract
Aims: Novolimus, a macrocyclic lactone with anti-proliferative properties,
has a similar efficacy to currently available agents; however it requires
a lower dose, and less polymer, and is therefore conceivably safer.
Methods and results: The EXCELLA II study was a prospective, multicentre,
single-blind, non-inferiority clinical trial which randomised 210 patients
with a maximum of two de novo coronary artery lesions in two different
epicardial vessels in a ratio of 2:1 to treatment with either the Elixir
DESyne Novolimus Eluting Coronary Stent System (NES n=139, Elixir Medical,
Sunnyvale, CA, USA) or the Endeavor zotarolimus eluting stent (ZES n=71,
Medtronic, Santa Rosa, CA, USA). The primary endpoint was in-stent mean
late lumen loss (LLL) at 9-months follow-up. In-stent percent volume
obstruction (%VO) was measured in a sub-group of 65 patients having
9-month intravascular ultrasound (IVUS) follow-up. Clinical secondary
endpoints included a device orientated composite of cardiac death, target
vessel myocardial infarction (MI), and clinically indicated target lesion
revascularisation (CI-TLR) assessed at 9-months follow-up. At 9-months,
the in-stent LLL was 0.11+/-0.32 mm in the NES arm, as compared to
0.63+/-0.42 mm in the ZES (p<0.0001 non-inferiority, p<0.0001
superiority). In-stent%VO was 4.5+/-5.1% and 20.9+/-11.3% for NES and ZES,
respectively (p<0.001). There was no significant difference between stent
groups in the device orientated composite endpoint (NES 2.9% vs. ZES 5.6%,
-2.8% [-8.8%, 3.3%], p=0.45) or its individual components of cardiac
death, target vessel MI and CI-TLR. Conclusions: This non-inferiority
randomised study not only met its primary endpoint, but also demonstrated
superiority of NES compared to the ZES in terms of in-stent LLL. Europa
Edition 2010. All rights reserved.
<27>
Accession Number
2011198378
Authors
Brar S.S. Gray W.A. Dangas G. Leon M.B. Aharonian V.J. Brar S.K. Moses
J.W.
Institution
(Brar, Gray, Dangas, Leon, Moses) Center for Interventional Vascular
Therapy, Columbia University Medical Center, 161 Washington Ave, New York,
NY 10032, United States
(Brar, Gray, Dangas, Leon, Moses) Cardiovascular Research Foundation, New
York, NY, United States
(Aharonian, Brar) Regional Cardiac Catheterisation Laboratory, Kaiser
Permanente, Los Angeles, CA, United States
Title
Bifurcation stenting with drug-eluting stents: A systematic review and
meta-analysis of randomised trials.
Source
EuroIntervention. 5 (4) (pp 475-484), 2009. Date of Publication:
September 2009.
Publisher
EuroPCR (5 Rue Saint-Pantaleon, Toulouse 31015, France)
Abstract
Aims: We sought to determine if outcomes differ between provisional
(elective side branch stenting) compared to a routine two-stent strategy
(mandatory side branch stenting) for the treatment of bifurcation stenoses
of the coronary arteries using drug-eluting stents. Methods and results:
We searched Medline, EMBASE, and the Cochrane library from January 2000 to
February 2009 for studies comparing the provisional and two-stent
strategies. Six randomised controlled trials, including 1,641 patients,
were identified. The relative risk (95% confidence interval) for death,
MI, target lesion revascularisation, and stent thrombosis within 1-year of
the index procedure for a provisional vs. two-stent strategy were 1.12
(0.42-3.02), 0.57 (0.37-0.87), 0.91 (0.61-1.35), and 0.56 (0.23-1.35),
respectively. By quantitative coronary angiography, there was no
difference in the difference in means (95% CI) between the provisional and
two-stent strategies for percent diameter stenosis (95% CI) in the main
vessel or side branch, -1.08 (-2.91 to 0.74) and 1.30 (-3.35 to 5.96),
respectively. Conclusion: While death, stent thrombosis, and restenosis
were similar between the treatment groups, MI was more common with the
two-stent strategy. Thus, compared to a routine two-stent strategy,
provisional stenting yields similar efficacy with superior safety and
lower costs. Europa Edition. All rights reserved.
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