EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
2010475166
Authors
Siragy H.M.
Institution
(Siragy) Department of Medicine, Hypertension Center, University of
Virginia, PO Box 801409, Charlottesville, VA 22908, United States
Title
Comparing angiotensin II receptor blockers on benefits beyond blood
pressure.
Source
Advances in Therapy. 27 (5) (pp 257-284), 2010. Date of Publication: May
2010.
Publisher
Springer Healthcare Communications (Lower Makefield Corporate Center
South, 770 Township Line RD, Suite 300, Yardley PA 19067, United States)
Abstract
The renin-angiotensin-aldosterone system (RAAS) is one of the main
regulators of blood pressure, renal hemodynamics, and volume homeostasis
in normal physiology, and contributes to the development of renal and
cardiovascular (CV) diseases. Therefore, pharmacologic blockade of RAAS
constitutes an attractive strategy in preventing the progression of renal
and CV diseases. This concept has been supported by clinical trials
involving patients with hypertension, diabetic nephropathy, and heart
failure, and those after myocardial infarction. The use of angiotensin II
receptor blockers (ARBs) in clinical practice has increased over the last
decade. Since their introduction in 1995, seven ARBs have been made
available, with approved indications for hypertension and some with
additional indications beyond blood pressure reduction. Considering that
ARBs share a similar mechanism of action and exhibit similar tolerability
profiles, it is assumed that a class effect exists and that they can be
used interchangeably. However, pharmacologic and dosing differences exist
among the various ARBs, and these differences can potentially influence
their individual effectiveness. Understanding these differences has
important implications when choosing an ARB for any particular condition
in an individual patient, such as heart failure, stroke, and CV risk
reduction (prevention of myocardial infarction). A review of the
literature for existing randomized controlled trials across various ARBs
clearly indicates differences within this class of agents. Ongoing
clinical trials are evaluating the role of ARBs in the prevention and
reduction of CV rates of morbidity and mortality in highrisk patients.
Springer Healthcare 2010.

<2>
Accession Number
2012644824
Authors
Song B.-h. Jiang P.-j. Wang Z.-h.
Institution
(Song) Anesthesiology Department, Xinjiang Cardiovascular and
Cerebrovascular Hospital, Urumqi 830054, China
(Jiang) Anesthesiology Department, Fangcaohu Hospital of the Sixth
Xinjiang Construction Corps, Fangcaohu 831100, China
(Wang) People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi
830054, China
Title
Clinical effects of strict control versus conventional control of blood
glucose on perioperative cardiac surgery: A meta-analysis.
Source
Chinese Journal of Evidence-Based Medicine. 12 (10) (pp 1229-1234), 2012.
Date of Publication: 2012.
Publisher
West China University of Medical Science (37 Wainan Guoxue Xiang, Chengdu,
Sichuan 610041, China)
Abstract
Objective To evaluate clinical effects of strict control vs. conventional
control of blood glucose in perioperative cardiac surgery. Methods
Databases including PubMed, EMbase, HighWire, The Cochrane Library, CBM
and VIP were searched to collect the randomized controlled trials (RCTs)
on strict control vs. conventional control of blood glucose in
perioperative cardiac surgery, published from 2000 to 2011. Two reviewers
independently screened articles according to the inclusion and exclusion
criteria, extracted data, and assessed quality of the included studies.
Then metaanalysis was performed using RevMan 5.1. Results A total of 8
RCTs involving 2 250 patients were included. The results of meta-analysis
showed that compared with the conventional group, the strict control of
blood glucose could reduce postoperative short-term mortality (OR=0.52,
95% CI 0.30 to 0.91, P=0.02) and postoperative incidence rate of both
atrial fibrillation (OR=0.64, 95%CI 0.43 to 0.96, P=0.03) and incision
infection (OR=0.30, 95%CI 0.15 to 0.57, P=0.000 2), and shorten hospital
stay (MD=1.75, 95%CI -3.18 to -0.32, P<0.02) and time of mechanical
ventilation (MD= -0.9, 95%CI -1.43 to -0.38, P<0.000 8). Conclusion
Current evidence shows that the strict control of blood glucose in
perioperative cardiac surgery can reduce postoperative short-term
mortality and postoperative incidence rate of both atrial fibrillation and
incision infection, shorten hospital stay and time of mechanical
ventilation, and have important clinical values and social and economic
significance. However, this conclusion has to be proved by more
high-quality and large-scale RCTs for the limitation of quantity and
quality of the included studies. 2012 Editorial Board of Chin J
Evid-based Med.

<3>
Accession Number
22068879
Authors
de Tournay-Jette E. Dupuis G. Denault A. Cartier R. Bherer L.
Institution
(de Tournay-Jette) Department of Psychology, Universite du Quebec a
Montreal (UQAM), Case Postale 8888, Succursale Centre-ville, Montreal, QC,
H3C 3P8, Canada.
Title
The benefits of cognitive training after a coronary artery bypass graft
surgery.
Source
Journal of behavioral medicine. 35 (5) (pp 557-568), 2012. Date of
Publication: Oct 2012.
Abstract
Cognitive deficits are frequent after coronary artery bypass graft surgery
(CABG) in the elderly population. In fact, memory and attention deficits
can persist several months after the surgery. Recent studies with healthy
older adults have shown that memory and attention can be improved through
cognitive training programs. The present study examined whether memory
training (method of loci and story generation) and attentional training
(dual-task computerized training) could improve cognitive functions in
patients aged 65 years and older who underwent CABG surgery. Participants
(n = 51) were assigned to one of three groups: (1) control group (tested
at 1, 3 and 6 months after the surgery), (2) attention training followed
by memory training, (3) memory training followed by attention training
(groups 2 and 3: tested at 1, 2, 3 and 6 months after the surgery). The
trainings took place between the 6th and 10th week following the surgery.
The three groups were compared before and after each training program
using attention and memory tests and neuropsychological tests. The results
showed that attention and memory trainings lead to significant improvement
in the cognitive domain that was trained. It thus seems that cognitive
training can be a promising tool to enhance cognitive functions after a
CABG surgery.

<4>
Accession Number
2012642570
Authors
Imantalab V. Seddighinejad A. Mansouri A.M. Meibodi A.S. Haghighi M.
Dadkhah H. Mobayen M.
Institution
(Imantalab, Seddighinejad, Mansouri, Meibodi, Haghighi, Dadkhah)
Department of Cardiac anesthesia, Rasht University of Medical Sciences,
Rasht, Iran, Islamic Republic of
(Mobayen) Department of Burn Surgery, Motahari Burn Hospital, Rasht
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Title
A comparative study of cardioprotective effect of three anesthetic agents
by measuring serum level of Troponin-T after coronary artery bypass
grafting.
Source
Iranian Cardiovascular Research Journal. 6 (3) (pp 70-74), 2012. Date of
Publication: 15 Sep 2012.
Publisher
Iranian Cardiovascular Research Journal (Zand Ave., Shiraz, Iran, Islamic
Republic of)
Abstract
Background: Cardiac surgery is associated with some degree of myocardial
injury. Preconditioning first described in 1986 was pharmacologic and non-
pharmacologic. Among the long list of anesthetic drugs, isoflurane as an
inhaling agent along with midazolam and propofol as injectable substances
have been documented to confer some preconditioning effects on myocardium.
Objectives: In this study cardiac Troponin T (cTnT),as a reliable marker,
was used for evaluating myocardial injury. Methods: This prospective
double blind study was comprised of 60 patients scheduled for CABG and
were randomly assigned into three groups who received infusion of propofol
or midazolam or isoflorane. Surgical procedures and anesthetics were
similar for 3 groups. cTnT measured preoperatively and at 12, 24 and 36hr
after arrival in ICU. Results: There were no statistically significant
differences in mean cTnT levels between three groups in the preoperative
period and 12-24 hours after arrival in ICU. However, mean cTnT in 3
groups at 36 hours after arrival in ICU were different (P< 0.013) and cTnT
level was significantly higher in midazolam group (P<0.001) and lowest in
isoflurane group (P=0.002). Conclusion: There were significant differences
on cTnT levels between anesthetic groups of isofluran, midazolam and
propofol at 36 hr after surgery. Preconditioning effect of isoflurane was
higher than the other two groups.

<5>
Accession Number
2012637463
Authors
Sa M.P.B.O. Rueda F.G. Ferraz P.E. Chalegre S.T. Vasconcelos F.P. Lima
R.C.
Institution
(Sa, Rueda, Ferraz, Chalegre, Vasconcelos, Lima) Division of
Cardiovascular Surgery of Pronto Socorro Cardiologico de
Pernambuco-PROCAPE, Recife-Brazil, Brazil
(Sa, Rueda, Ferraz, Chalegre, Vasconcelos, Lima) University of
Pernambuco-UPE, Recife-Brazil, Brazil
(Sa, Rueda, Ferraz, Chalegre, Lima) Nucleus of Postgraduate and Research
in Health Sciences, Faculty of Medical Sciences, Biological Sciences
Instituite-FCM/ICB, Recife-Brazil, Brazil
Title
Is there any difference between blood and crystalloid cardioplegia for
myocardial protection during cardiac surgery? A meta-analysis of 5576
patients from 36 randomized trials.
Source
Perfusion (United Kingdom). 27 (6) (pp 535-546), 2012. Date of
Publication: November 2012.
Publisher
SAGE Publications Ltd (55 City Road, London EC1Y 1SP, United Kingdom)
Abstract
Objective: To compare the efficacy of blood versus crystalloid
cardioplegia for myocardial protection in patients undergoing cardiac
surgery. Methods: MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google
Scholar and reference lists of relevant articles were searched for
clinical studies that reported in-hospital outcomes after blood or
crystalloid cardioplegia for myocardial protection during cardiac surgery
procedures from 1966 to 2011. The principal summary measures were risk
ratio (RR) for blood compared to crystalloid cardioplegia with 95%
Confidence Interval (CI) and P values (considered statistically
significant when <0.05). The RRs were combined across studies using the
DerSimonian-Laird random effects model and fixed effects model using the
Mantel-Haenszel model - both models were weighted. The meta-analysis was
completed using the software Comprehensive Meta-Analysis version 2
(Biostat Inc., Englewood, New Jersey). Results: Thirty-six studies
(randomized trials) were identified and included a total of 5576 patients
(2834 for blood and 2742 for crystalloid). There was no significant
difference between the blood and crystalloid groups in the risk for death
(risk ratio [RR] 0.951, 95% CI 0.598 to 1.514, P=0.828, for both effect
models) or myocardial infarction (RR 0.795, 95% CI 0.547 to 1.118,
P=0.164, for both effect models) or low cardiac output syndrome (RR 0.765,
95% CI 0.580 to 1.142, P=0.094, for the fixed effect model; RR 0.690, 95%
CI 0.480 to 1.042, P=0.072, for the random effect model). It was observed
that there was no publication bias or heterogeneity of effects about any
outcome. Conclusion: We found evidence that argues against any superiority
in terms of hard outcomes between blood or crystalloid cardioplegia for
myocardial protection during cardiac surgery. 2012 The Author(s).

<6>
Accession Number
22717589
Authors
Jarral O.A. Saso S. Harling L. Casula R. Athanasiou T.
Institution
(Jarral) Department of Surgery and Cancer, Imperial College London, United
Kingdom.
Title
Atrial fibrillation, blood loss, and transfusion in patients with left
ventricular dysfunction: what is the effect of cardiopulmonary bypass?.
Source
ASAIO journal (American Society for Artificial Internal Organs : 1992). 58
(4) (pp 311-319), 2012. Date of Publication: 2012 Jul-Aug.
Abstract
Despite advancements in surgical technique, intensive care methods and
pharmaceutical prophylaxis atrial fibrillation (AF) after on-pump coronary
artery bypass remains common. Transfusion, blood loss, and cardiopulmonary
bypass (CPB) have been identified as risk factors for AF and adverse
outcomes such as early mortality. This study examines outcomes in patients
with left ventricular dysfunction after revascularization with and without
CPB. A systematic literature review identified 22 studies including 7,454
patients. Meta-analysis through subgroup analysis of the highest-quality
studies revealed that the off-pump coronary artery bypass (OPCAB)
technique is associated with a significantly lower incidence of blood
loss, transfusion requirement, reoperation for bleeding, and length of
stay. There was also a reduction in the incidence of AF in the OPCAB group
but this was not statistically significant (odds ratio = 0.77, 95%
confidence interval 0.58-1.02, p = 0.07). The results strengthen research
suggesting that CPB has a damaging effect on hemostasis and subsequent
transfusion requirements in this patient group. More research is required
to assess the association between OPCAB and AF in patients with
ventricular dysfunction.

<7>
Accession Number
2012632742
Authors
Rubino A.S. Serraino G.F. Marsico R. Ventura V. Foti D. Gulletta E.
Renzulli A.
Institution
(Rubino) Cardiac Surgery Unit, Ferrarotto Hospital, University of Catania,
Catania, Italy
(Serraino, Marsico, Renzulli) Department of Experimental and Clinical
Medicine, Cardiac Surgery Unit, Magna Graecia University of Catanzaro,
Catanzaro, Italy
(Ventura, Foti, Gulletta) Department of Experimental and Clinical
Medicine, Pathology Unit, Magna Graecia University of Catanzaro,
Catanzaro, Italy
Title
Leukocyte filtration improves pulmonary function and reduces the need for
postoperative non-invasive ventilation.
Source
International Journal of Artificial Organs. 35 (9) (pp 679-688), 2012.
Date of Publication: September 2012.
Publisher
Wichtig Editore s.r.l. (Via Friuli 72/74, Milan 20135, Italy)
Abstract
Objectives: Leukocyte depletion (LD) has been reported to reduce
inflammatory damage during cardiopulmonary bypass (CPB). We evaluated the
role of LD in pulmonary function and inflammatory response. Methods:
Seventy consecutive CABG patients were randomized (1:1) to receive LD on
both arterial and cardioplegia lines (Filters) or standard arterial
filters (Controls) during CPB. Estimates of pulmonary function,
inflammatory and anti-inflammatory cytokines were collected pre-, intra-
and postoperatively. Results: Hospital mortality, intensive care and
in-hospital lengths of stay were similar. Although duration of ventilation
and incidence of pneumonia were comparable, leukodepleted patients showed
higher PaO₂/ FiO₂ (p-between groups = 0.005; ICU
arrival p = 0.023; 24 hours p = 0.039; 48 hours p<0.001) and lower need
for postoperative non-invasive ventilation (NIV), (p = 0.029). Moreover,
Filters showed lower inflammatory burst at 24 hours (IL-6 p<0.001; IL-8 p
= 0.002) and 48 hours (IL-6 p = 0.015). This was associated with a lower
release of the anti-inflammatory IL-10 (p-between groups = 0.030; ICU
admission p = 0.002; 24 hours p = 0.003). Furthermore, IL-2 concentration
proved higher in Filters (p-between groups = 0.013; ICU arrival p = 0.029;
24 hours p = 0.040; 48 hours p = 0.021) in association with lower
leukocyte and platelet counts at ICU admission. Conclusions: LD resulted
in lower inflammatory burst and less need for release of anti-inflammatory
cytokines. Although hospital outcomes were similar in terms of mortality
and length of stay, improvements in pulmonary function and reduced need
for postoperative NIV support the use of LD. 2012 Wichtig Editore.

<8>
Accession Number
2012635008
Authors
Robinson J.G. Wang S. Jacobson T.A.
Institution
(Robinson) University of Iowa, Iowa City, IA, United States
(Wang) University of South Carolina, Columbia, SC, United States
(Jacobson) Emory University, Atlanta, GA, United States
Title
Meta-analysis of comparison of effectiveness of lowering apolipoprotein B
versus low-density lipoprotein cholesterol and nonhigh-density lipoprotein
cholesterol for cardiovascular risk reduction in randomized trials.
Source
American Journal of Cardiology. 110 (10) (pp 1468-1476), 2012. Date of
Publication: 15 Nov 2012.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
This study evaluated the relation between apolipoprotein B (apoB) decrease
and coronary heart disease, stroke, and cardiovascular disease risk.
Bayesian random-effects meta-analysis was used to evaluate the association
of mean absolute apoB decrease (milligrams per deciliter) with relative
risk of coronary heart disease (nonfatal myocardial infarction and
coronary heart disease death), stroke (nonfatal stroke and fatal stroke),
or cardiovascular disease (coronary heart disease, stroke, and coronary
revascularization). Analysis included 25 trials (n = 131,134): 12 on
statin, 4 on fibrate, 5 on niacin, 2 on simvastatin-ezetimibe, 1 on ileal
bypass surgery, and 1 on aggressive versus standard low-density
lipoprotein (LDL) cholesterol and blood pressure targets. Combining the 25
trials, each 10-mg/dl decrease in apoB was associated with a 9% decrease
in coronary heart disease, no decrease in stroke, and a 6% decrease in
major cardiovascular disease risk. Non-high-density lipoprotein (non-HDL)
cholesterol decrease modestly outperformed apoB decrease for prediction of
coronary heart disease (Bayes factor [BF] 1.45) and cardiovascular disease
(BF 2.07) risk decrease; apoB decrease added to non-HDL cholesterol plus
LDL cholesterol decrease slightly improved cardiovascular disease risk
prediction (1.13) but did not improve coronary heart disease risk
prediction (BF 1.03) and worsened stroke risk prediction (BF 0.83). In the
12 statin trials, apoB and non-HDL cholesterol decreases similarly
predicted cardiovascular disease risk; apoB improved coronary heart
disease prediction when added to non-HDL cholesterol/LDL cholesterol
decrease (BF 3.33) but did not improve stroke risk prediction when added
to non-HDL cholesterol/LDL cholesterol decrease (BF 1.06). In conclusion,
across all drug classes, apoB decreases did not consistently improve risk
prediction over LDL cholesterol and non-HDL cholesterol decreases. For
statins, apoB decreases added information to LDL cholesterol and non-HDL
cholesterol decreases for predicting coronary heart disease but not stroke
or overall cardiovascular disease risk decrease. 2012 Elsevier Inc. All
rights reserved.

<9>
Accession Number
2012634999
Authors
Jang J.-S. Choi K.-N. Jin H.-Y. Seo J.-S. Yang T.-H. Kim D.-K. Kim D.-S.
Urm S.-H. Chun J.H. Kang S.-J. Park D.-W. Lee S.-W. Kim Y.-H. Lee C.W.
Park S.-W. Park S.-J.
Institution
(Jang, Choi, Jin, Seo, Yang, Kim, Kim) Department of Cardiology, Busan
Paik Hospital, University of Inje College of Medicine, Busan, South Korea
(Urm, Chun) Department of Preventive Medicine, University of Inje College
of Medicine, Busan, South Korea
(Kang, Park, Lee, Kim, Lee, Park, Park) Department of Cardiology, Asan
Medical Center, University of Ulsan College of Medicine, Seoul, South
Korea
Title
Meta-analysis of three randomized trials and nine observational studies
comparing drug-eluting stents versus coronary artery bypass grafting for
unprotected left main coronary artery disease.
Source
American Journal of Cardiology. 110 (10) (pp 1411-1418), 2012. Date of
Publication: 15 Nov 2012.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
Clinical outcomes for unprotected left main coronary artery (ULMCA)
disease between coronary artery bypass grafting (CABG) and drug-eluting
stents (DESs) remain controversial. We aimed to compare the safety and
efficacy of percutaneous coronary intervention (PCI) using DESs with CABG
in patients with ULMCA disease. Databases were searched for clinical
studies that reported outcomes after PCI with DESs and CABG for treatment
of ULMCA disease. End points of this meta-analysis were mortality;
composite of death, myocardial infarction (MI), or stroke; and target
vessel revascularization at 1-year follow-up. Pooled effects were
calculated using fixed-effects model (Mantel-Haenszel method) or
random-effects models (Dersimonian-Laird method). Twelve clinical studies
(3 randomized trials and 9 observational studies) with 5,079 patients were
involved in this study. At 1-year follow-up, there were trends toward
lower risk of death (odds ratio [OR] 0.68, 95% confidence interval [CI]
0.45 to 1.02) and the composite end point of death, MI, or stroke (OR
0.70, 95% CI 0.49 to 1.00) in the DES group compared to the CABG group.
However, target vessel revascularization was significantly higher in the
DES group compared to the CABG group (OR 3.52, 95% CI 2.72 to 4.56). In
conclusion, PCI with DESs is associated with favorable outcomes for
mortality; composite end point of death, MI, or stroke; and a higher risk
of target vessel revascularization compared to CABG in patients with ULMCA
disease. 2012 Elsevier Inc. All rights reserved.

<10>
Accession Number
2012625712
Authors
Post S. Post M.C. Van Den Branden B.J. Eefting F.D. Goumans M.-J. Stella
P.R. Van Es H.W. Wildbergh T.X. Rensing B.J. Doevendans P.A.
Institution
(Post, Post, Van Den Branden, Eefting, Rensing) Department of Cardiology,
St. Antonius Hospital Nieuwegein, Netherlands
(Post, Goumans, Stella, Wildbergh, Doevendans) Division Heart and Lungs,
G02-523, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX
Utrecht, Netherlands
(Van Es) Department of Radiology, St. Antonius Hospital Nieuwegein,
Netherlands
Title
Early statin treatment prior to primary PCI for acute myocardial
infarction: REPERATOR, a randomized placebo-controlled pilot trial.
Source
Catheterization and Cardiovascular Interventions. 80 (5) (pp 756-765),
2012. Date of Publication: 01 Nov 2012.
Publisher
Wiley-Liss Inc. (111 River Street, Hoboken NJ 07030-5774, United States)
Abstract
Objective: The aim of this pilot study was to determine whether early
atorvastatin treatment will reduce left ventricle (LV) remodeling, infarct
size, and improve microvascular perfusion. Background: In animal studies,
early statin therapy reduces reperfusion injury after a percutaneous
coronary intervention (PCI) for acute myocardial infarction (AMI).
Methods: Forty-two consecutive patients (82% male, mean age 61.2 +/- 9.8)
who underwent a primary PCI for a first ST-elevated AMI were randomized
for pretreatment with atorvastatin 80 mg (n = 20) or placebo (n = 22) and
continued with the same dosage daily for 1 week. All patients received
atorvastatin 80 mg once daily 7 days after primary PCI. The LV function
and infarct size were measured by magnetic resonance imaging within 1 day,
at 1 week, and 3 months follow up. The primary endpoint was the
end-systolic volume index (ESVI) at 3 months. Secondary endpoints were
global LV function measurements, myocardial infarct size, biochemical
cardiac markers, TIMI flow, and ST-T elevation resolution. Results: ESVI 3
months after AMI was 25.1 mL/m² in the atorvastatin arm and
25.0 mL/m² in the placebo arm (P = 0.74). The differences in
change from baseline to 3 months follow up in global LV function and
myocardial infarct size did not differ between both treatment arms.
Furthermore, biochemical markers, TIMI flow, and ST-T elevation resolution
did not differ between atorvastatin and placebo arm. Conclusions: In this
pilot study, pretreatment with atorvastatin in an acute myocardial
infarction does not result in an improved cardiac function, microvascular
perfusion, or decreased myocardial infarct size. 2012 Wiley Periodicals
Inc. Copyright 2012 Wiley Periodicals, Inc.

<11>
Accession Number
2012625710
Authors
Kim H.-S. Park S.-J. Park D.-W. Park S.-W. Cheong S.-S. Lee S.-G. Cho
B.-R. Lee S.-W. Lee N.-H. Lee K.
Institution
(Kim) Division of Cardiology, Department of Internal Medicine, Hallym
University Sacred Heart Hospital, Anyang, South Korea
(Park, Park, Park) Cardiac Center, Department of Cardiology, University of
Ulsan College of Medicine, 388-1 Poongnap-Dong, Songpa-Gu, Seoul 138-736,
South Korea
(Cheong) Division of Cardiology, Department of Internal Medicine,
GangNeung Asan Medical Center, GangNeung, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Ulsan
University Hospital, Ulsan, South Korea
(Cho) Division of Cardiology, Department of Internal Medicine, Kangwon
National University Hospital, Chuncheon, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Kwangju
Christian Hospital, Gwangju, South Korea
(Lee) Department of Internal Medicine, Soon Chun Hyang University, Bucheon
Hospital, Bucheon, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Seoul
Veterans Hospital, Seoul, South Korea
Title
Comparison of the efficacy and safety of paclitaxel-eluting coroflex
please stents and paclitaxel-eluting stents in patients with coronary
artery disease: A randomized PIPA trial.
Source
Catheterization and Cardiovascular Interventions. 80 (5) (pp 799-806),
2012. Date of Publication: 01 Nov 2012.
Publisher
Wiley-Liss Inc. (111 River Street, Hoboken NJ 07030-5774, United States)
Abstract
Objectives: To compare the safety and efficacy of the new Coroflex Please
stents with conventional Taxus Liberte stents in patients with coronary
artery lesions. Background: The Coroflex Please stent is a new version of
paclitaxel-eluting stent, and observational cohort studies have reported
similar angiographic and clinical outcomes as with the first-generation
stents. However, it has not been directly compared with the early
generation paclitaxel-eluting stents in a multicenter, prospective, and
randomized study. Methods: We randomly assigned 319 patients to receive
Coroflex Please stents (159 patients; 198 lesions) or Taxus Liberte stents
(160 patients; 232 lesions). The primary end point was angiographic
in-segment late luminal loss at 9 months. Results: Most baseline clinical
and angiographic characteristics were similar between these two groups.
The Coroflex Please and Taxus Liberte stents showed similar in-segment
late loss (0.40 +/- 0.53 mm vs. 0.39 +/- 0.52 mm, P = 0.98) and rates of
in-segment binary restenosis (22.2% vs. 18.8%, P = 0.48) at 9 months.
After clinical follow-up for 12 months, the two groups had similar rates
of death (1.3% vs. 1.3%, P > 0.99), myocardial infarction (3.8% vs. 7.5%,
P = 0.22), stent thrombosis (2.5% vs. 1.9%, P = 0.72), and target-lesion
revascularization (7.5% vs. 7.5%, P = 0.99). Conclusions: The Coroflex
Please stent resulted in similar angiographic and clinical outcomes as the
Taxus Liberte stent in patients with coronary artery lesions. 2012 Wiley
Periodicals, Inc. Copyright 2012 Wiley Periodicals, Inc.

<12>
Accession Number
2012625702
Authors
Kadota K. Muramatsu T. Iwabuchi M. Saito S. Hayashi Y. Ikari Y. Nanto S.
Fujii K. Inoue N. Namiki A. Kimura T. Mitsudo K.
Institution
(Kadota, Mitsudo) Kurashiki Central Hospital, Kurashiki, Japan
(Muramatsu) Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
(Iwabuchi) Kokura Memorial Hospital, Kitakyushu, Japan
(Saito) Shonan Kamakura General Hospital, Kamakura, Japan
(Hayashi) Tsuchiya General Hospital, Hiroshima, Japan
(Ikari) Tokai University Hospital, Isehara, Japan
(Nanto) Kansai Rosai Hospital, Amagasaki, Japan
(Fujii) Sakurabashi Watanabe Hospital, Osaka, Japan
(Inoue) Sendai Kousei Hospital, Sendai, Japan
(Namiki) Kanto Rosai Hospital, Kawasaki, Japan
(Kimura) Kyoto University Hospital, Kyoto, Japan
Title
Randomized comparison of the nobori biolimus A9-eluting stent with the
sirolimus-eluting stent in patients with stenosis in native coronary
arteries.
Source
Catheterization and Cardiovascular Interventions. 80 (5) (pp 789-796),
2012. Date of Publication: 01 Nov 2012.
Publisher
Wiley-Liss Inc. (111 River Street, Hoboken NJ 07030-5774, United States)
Abstract
Objectives: The aim of this randomized-controlled trial is to compare
Biolimus A9-eluting stent (Nobori) to sirolimus eluting stent (Cypher).
Background: The Nobori coronary stent is coated only abluminally with a
biodegradable polymer, poly-lactic acid, and the antiproliferative agent
Biolimus A9. This stent has been studied in randomized trials versus Taxus
Express and Taxus Liberte and showed noninferiority and superiority for
in-stent late loss. This is the first randomized trial of Nobori stent
versus Cypher stent. Methods: We conducted a randomized (3:2), controlled
trial comparing Nobori and Cypher, in 335 patients (198 Nobori and 137
Cypher) at 15 centers in Japan. Patients with de-novo lesions in up to two
native coronary arteries were considered for enrollment. The primary
endpoint was freedom from target vessel failure (TVF), a composite of
cardiac death, myocardial infarction, and target vessel revascularization
at 9 months. Results: At 9 months, the primary endpoint of freedom from
TVF was 92.6% in Nobori and 93.8% in Cypher arm (noninferiority test P <
0.001). As main secondary endpoints, the in-stent late loss was 0.12 +/-
0.30 mm and 0.14 +/- 0.34 mm in Nobori and Cypher stents, respectively.
Target lesion revascularization was 0.5% in Nobori and 3.9% in Cypher
treated patients (P = 0.04). Definite and probable stent thromboses were
not recorded in any patient. Conclusions: Despite the relatively small
number of patients, this well controlled clinical trial confirmed the
primary hypothesis of non-inferiority of the Nobori Biolimus A9-eluting
stent to the Cypher sirolimus-eluting stent for freedom from TVF. Both
stents showed excellent midterm results. 2011 Wiley Periodicals, Inc.
Copyright 2011 Wiley Periodicals, Inc.

<13>
Accession Number
2012630147
Authors
Joyeux-Faure M. Durand M. Bedague D. Protar D. Incagnoli P. Paris A.
Ribuot C. Levy P. Chavanon O.
Institution
(Joyeux-Faure, Ribuot, Levy, Chavanon) UJF, Laboratoire HP2, Grenoble
F-38000, France
(Joyeux-Faure, Ribuot, Levy) INSERM U1042, Grenoble F-38000, France
(Durand, Bedague, Protar, Incagnoli) CHU de Grenoble, Pole
Anesthesie-Reanimation, Grenoble F-38000, France
(Paris) INSERM CIC003, CHU de Grenoble, Grenoble F-38000, France
(Levy) CHU de Grenoble, EFCR et Laboratoire du sommeil, Grenoble F-38000,
France
(Chavanon) CHU de Grenoble, Pole Cardio-vasculaire et Thoracique, Clinique
de Chirurgie, Cardiaque F-38000, France
Title
Evaluation of the effect of one large dose of erythropoietin against
cardiac and cerebral ischemic injury occurring during cardiac surgery with
cardiopulmonary bypass: A randomized double-blind placebo-controlled pilot
study.
Source
Fundamental and Clinical Pharmacology. 26 (6) (pp 761-770), 2012. Date of
Publication: December 2012.
Publisher
Blackwell Publishing Ltd (9600 Garsington Road, Oxford OX4 2XG, United
Kingdom)
Abstract
Cardiac surgery and cardiopulmonary bypass (CPB) induce
ischemia-reperfusion and subsequent cellular injury with inflammatory
reaction. Clinical and experimental studies suggest that recombinant human
erythropoietin (EPO) independently of its erythropoietic effect may be
used as a cytoprotective agent against ischemic injury. We tested the
hypothesis that one large dose of EPO administered shortly before CPB
prevents the elevation of cardiac and cerebral ischemic blood markers as
well as the systemic inflammatory response induced by cardiac surgery with
CBP through this randomized double-blind placebo-controlled pilot trial.
Fifty patients scheduled for coronary artery bypass graft (CABG) surgery
with CPB were randomly allocated to EPO or control groups. EPO (800IU/kg
intravenously) or placebo (saline) was administered before CPB. The
primary end point was to study the effect of EPO administration on several
blood markers of myocardial and cerebral ischemia in relation to CABG with
CPB. In both groups, surgery increased plasma concentrations of cardiac
(troponin T, NT-proBNP, and creatine kinase MB) and cerebral (S100beta
protein) markers ischemic as well as the pro-inflammatory marker
interleukin-6. Compared with the placebo, EPO administration before CPB
did not prevent an increase of all these markers following CPB. In
conclusion, one large dose of EPO, given shortly before CPB, did not
protect against cardiac and cerebral ischemia and inflammatory response
occurring during CABG surgery with CPB. Although the long-term clinical
implications remain unknown, the findings do not support use of EPO at
this dose as a cytoprotective agent in patients undergoing cardiac
surgery. 2011 Societe Francaise de Pharmacologie et de Therapeutique.

<14>
Accession Number
22747980
Authors
Donndorf P. Kaminski A. Tiedemann G. Kundt G. Steinhoff G.
Institution
(Donndorf) Department of Cardiac Surgery, Reference and Translation Centre
for Cardiac Stem Cell Therapy, University of Rostock, Schillingallee 35,
Rostock, 18057 Germany.
Title
Validating intramyocardial bone marrow stem cell therapy in combination
with coronary artery bypass grafting, the PERFECT Phase III randomized
multicenter trial: study protocol for a randomized controlled trial.
Source
Trials. 13 (pp 99), 2012. Date of Publication: 2012.
Abstract
For the last decade continuous efforts have been made to translate
regenerative cell therapy protocols in the cardiovascular field from
'bench to bedside'. Successful clinical introduction, supporting safety,
and feasibility of this new therapeutic approach, led to the initiation of
the German, Phase III, multicenter trial - termed the PERFECT trial
(ClinicalTrials.gov Identifier: NCT00950274), in order to evaluate the
efficacy of surgical cardiac cell therapy on left ventricular function.
The PERFECT trial has been designed as a prospective, randomized,
double-blind, placebo controlled, multicenter trial, analyzing the effect
of intramyocardial CD 133(+) bone marrow stem cell injection in
combination with coronary artery bypass grafting on postoperative left
ventricular function. The trial includes patients aged between 18 and 79
years presenting with a coronary disease with indication for surgical
revascularization and reduced global left ventricular ejection fraction as
assessed by cardiac magnet resonance imaging. The included patients are
treated in the chronic phase of ischemic cardiomyopathy after previous
myocardial infarction. Patients undergoing coronary artery bypass grafting
in combination with intramyocardial CD133+ cell injection will have a
higher LV ejection fraction than patient who undergo CABG alone, measured
6 months after the operation. ClinicalTrials.gov Identifier: NCT00950274.

<15>
Accession Number
22348447
Authors
Russell S.J. Tan C. O'Keefe P. Ashraf S. Zaidi A. Fraser A.G. Yousef Z.R.
Institution
(Russell) Wales Heart Research Institute, Heath Park, Cardiff, CF14 4XN,
UK.
Title
Temporary epicardial cardiac resynchronisation versus conventional right
ventricular pacing after cardiac surgery: study protocol for a randomised
control trial.
Source
Trials. 13 (pp 20), 2012. Date of Publication: 2012.
Abstract
BACKGROUND: Heart failure patients with stable angina, acute coronary
syndromes and valvular heart disease may benefit from revascularisation
and/or valve surgery. However, the mortality rate is increased- 5-30%.
Biventricular pacing using temporary epicardial wires after surgery is a
potential mechanism to improve cardiac function and clinical endpoints.
METHOD/DESIGN: A multi-centred, prospective, randomised, single-blinded,
intervention-control trial of temporary biventricular pacing versus
standard pacing. Patients with ischaemic cardiomyopathy, valvular heart
disease or both, an ejection fraction <= 35% and a conventional indication
for cardiac surgery will be recruited from 2 cardiac centres. Baseline
investigations will include: an electrocardiogram to confirm sinus rhythm
and measure QRS duration; echocardiogram to evaluate left ventricular
function and markers of mechanical dyssynchrony; dobutamine echocardiogram
for viability and blood tests for renal function and biomarkers of
myocardial injury- troponin T and brain naturetic peptide. Blood tests
will be repeated at 18, 48 and 72 hours. The principal exclusions will be
subjects with permanent atrial arrhythmias, permanent pacemakers,
infective endocarditis or end-stage renal disease.After surgery, temporary
pacing wires will be attached to the postero-lateral wall of the left
ventricle, the right atrium and right ventricle and connected to a triple
chamber temporary pacemaker. Subjects will be randomised to receive either
temporary biventricular pacing or standard pacing (atrial inhibited pacing
or atrial-synchronous right ventricular pacing) for 48 hours.The primary
endpoint will be the duration of level 3 care. In brief, this is the
requirement for invasive ventilation, multi-organ support or more than one
inotrope/vasoconstrictor. Haemodynamic studies will be performed at
baseline, 6, 18 and 24 hours after surgery using a pulmonary arterial
catheter. Measurements will be taken in the following pacing modes: atrial
inhibited; right ventricular only; atrial synchronous-right ventricular;
atrial synchronous-left ventricular and biventricular pacing. Optimisation
of the atrioventricular and interventricular delay will be performed in
the biventricular pacing group at 18 hours. The effect of biventricular
pacing on myocardial injury, post operative arrhythmias and renal function
will also be quantified. TRIAL REGISTRATION: ClinicalTrials.gov:
NCT01027299.

<16>
Accession Number
2012629131
Authors
Imazio M.
Institution
(Imazio) Cardiology Department, Maria Vittoria Hospital, Torino, Italy
Title
Treatment of recurrent pericarditis.
Source
Expert Review of Cardiovascular Therapy. 10 (9) (pp 1165-1172), 2012. Date
of Publication: September 2012.
Publisher
Expert Reviews Ltd. (2 Albert Place, London N3 1QB, United Kingdom)
Abstract
Recurrent pericarditis is the most common and troublesome complication of
pericarditis affecting around a third of patients. Treatment of this
condition is often one of the most challenging task in pericardial
diseases management, especially in corticosteroids-dependent cases. The
aim of this review is to report current knowledge on the treatment,
prevention and prognosis of this disease, with a special focus on more
recently published contributions during the last 5 years. 2012 Expert
Reviews Ltd.

<17>
Accession Number
2012627441
Authors
Attaran S. Punjabi P.P. Anderson J.
Institution
(Attaran, Punjabi, Anderson) Cardiothoracic Department, Hammersmith
Hospital, Imperial College, London, United Kingdom
Title
Postoperative atrial fibrillation: Year 2011 review of predictive and
preventative factors of atrial fibrillation post cardiac surgery.
Source
Journal of Atrial Fibrillation. 5 (3) (pp 54-78), 2012. Date of
Publication: October-November 2012.
Publisher
CardioFront LLC (135th St, Ste 264, Overland Park KS 66223, United States)
Abstract
Background: Post cardiac surgery atrial fibrillation is common after
cardiac surgery. Despite the advances in medical and surgical treatment,
its incidence remains high and unchanged for decades. The aim of this
review was to summarize studies published in 2011 on identifying factors,
prevention strategies, treatment and effect of post operative atrial
fibrillation (POAF) on the outcome after cardiac surgery. Methods: A
review was performed on Medline, Embase and Chocrane on all of the
English-language, peer-reviewed published clinical studies on POAF;
studies investigating the mechanism of developing POAF, prevention,
treatment and outcome were all included and analyzed. Case reports,
studies on persistent/preoperative atrial fibrillation (AF), POAF after
cardiac transplant, congenital cases and nonclinical studies were all
excluded. We have also valuated these studies based on the type of the
study, their originality, impact factor of the journal and their
limitations. Results: Overall 62 studies were reviewed and analyzed; 26 on
POAF predictive factors, 31 on preventative strategies and 6 on the
outcome of POAF. Of these studies only two were original and the remaining
were either performed in AF in general population (n=10) or had been
studied and reported several times before in cardiac surgery (n=50). The
average impact factor of the journals that POAF was published in was only
2.8 ranging between 0.5 and 14.5. Conclusion: Post cardiac surgery atrial
fibrillation is a multi-factorial and complex condition. Cardiac surgery
may be a risk factor for developing POAF in patients already susceptible
to this condition and may not be a complication of cardiac surgery. Future
studies should mainly focus on histological changes in the conductive
tissue of atrium and related treatment strategies rather than predictive
factors of POAF and more funding should be made available to study this
condition from new and entirely different perspectives.