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<1>
Accession Number
2013000143
Authors
Haroutiunian S. Nikolajsen L. Finnerup N.B. Jensen T.S.
Institution
(Haroutiunian, Nikolajsen, Finnerup, Jensen) Danish Pain Research Center,
Aarhus University Hospital, Building 1A, Norrebrogade 44, DK-8000 Aarhus,
Denmark
(Nikolajsen) Department of Anesthesiology, Aarhus University Hospital,
Aarhus, Denmark
(Jensen) Department of Neurology, Aarhus University Hospital, Aarhus,
Denmark
Title
The neuropathic component in persistent postsurgical pain: A systematic
literature review.
Source
Pain. 154 (1) (pp 95-102), 2013. Date of Publication: January 2013.
Publisher
Elsevier (P.O. Box 211, Amsterdam 1000 AE, Netherlands)
Abstract
Persistent postsurgical pain (PPSP) is a frequent and often disabling
complication of many surgical procedures. Nerve injury-induced neuropathic
pain (NeuP) has repeatedly been proposed as a major cause of PPSP.
However, there is a lack of uniformity in NeuP assessment across studies,
and the prevalence of NeuP may differ after various surgeries. We
performed a systematic search of the PubMed, CENTRAL, and Embase databases
and assessed 281 studies that investigated PPSP after 11 types of surgery.
The prevalence of PPSP in each surgical group was examined. The prevalence
of NeuP was determined by applying the recently published NeuP probability
grading system. The prevalence of probable or definite NeuP was high in
patients with persistent pain after thoracic and breast surgeries - 66%
and 68%, respectively. In patients with PPSP after groin hernia repair,
the prevalence of NeuP was 31%, and after total hip or knee arthroplasty
it was 6%. The results suggest that the prevalence of NeuP among PPSP
cases differs in various types of surgery, probably depending on the
likelihood of surgical iatrogenic nerve injury. Because of large
methodological variability across studies, a more uniform approach is
desirable in future studies for evaluating persistent postsurgical NeuP.
2012 International Association for the Study of Pain. All rights reserved.

<2>
Accession Number
2013000407
Authors
Zirak N. Soltani G. Abbasi M. Hamadanchi A. Moeinipour A.A. Javan H.
Bagheri R.K. Shamloo A.S.
Institution
(Zirak, Abbasi, Moeinipour, Bagheri) Department of Anesthesiology, Imam
Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran,
Islamic Republic of
(Soltani) Department of Cardiac Surgery, Imam Reza Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Hamadanchi) Department of Cardiology, Clinic of Internal Medicine,
University Hospital of Jena, Erlanger Allee 101, Jena 07747, Germany
(Javan) Research Administrator, Imam Reza Hospital, Mashhad University of
Medical Sciences, Mashhad, Iran, Islamic Republic of
(Shamloo) Student of Medicine, Mashhad University of Medical Sciences,
Mashhad, Iran, Islamic Republic of
Title
Prophylactic effect of a single intravenous dose of a combination of
Digoxin, Hydrocortisone, and amiodarone on atrial fibrillation after
off-pump coronary artery bypasses graft surgery.
Source
Iranian Heart Journal. 13 (3) (pp 33-38), 2012. Date of Publication: 2012.
Publisher
Iranian Heart Association (P.O. Box 15745-1341, Tehran, Iran, Islamic
Republic of)
Abstract
Objective: Postoperative atrial fibrillation (POAF) is the most common
complication after coronary artery bypass graft surgery (CABG) and a major
cause of increased hospital costs. Dispersed atrial refractoriness is
thought to be the primary mechanism, whereas myocardial inflammation has
an important role in altering atrial conduction. We evaluated the
preventive effect of an intravenous combination of Digoxin,
Hydrocortisone, and Amiodarone as antiinflammatory and anti-arrhythmic
agents on AF after off-pump CABG. Material and Methods: One hundred fifty
patients who underwent off-pump CABG between March 2010 and April 2011 and
met our inclusion criteria were enrolled. The patients were randomized
into two groups: the study group received 300 mg Amiodarone, 0.5 mg
Digoxin, and 200 mg Hydrocortisone before the induction of anesthesia, but
the control group did not. Surgical and anesthetic techniques were
identical in both groups. Results: Patient characteristics and surgical
variables were similar in both groups (p value<0.05). POAF was observed in
6 (8%) patients in the case group and in 18 (24%) of the controls. There
was a significant difference between the two groups in the prevalence of
new-onset POAF (p value=0.03). Conclusion: A preoperative dose of a
combination of Digoxin, Hydrocortisone, and Amiodarone is a safe and
feasible method to reduce POAF prevalence, produce a better outcome, and
reduce the duration of hospital stay and hospital costs.

<3>
Accession Number
2012648007
Title
Meta-analysis: Lowering LDL-C levels using statins reduces major vascular
events regardless of baseline risk.
Source
Annals of Internal Medicine. 157 (8) (pp JC4-JC2), 2012. Date of
Publication: 16 Oct 2012.
Publisher
American College of Physicians (190 N. Indenpence Mall West, Philadelphia
PA 19106-1572, United States)

<4>
Accession Number
2012740911
Authors
Latib A. Colombo A. Castriota F. Micari A. Cremonesi A. De Felice F.
Marchese A. Tespili M. Presbitero P. Sgueglia G.A. Buffoli F. Tamburino C.
Varbella F. Menozzi A.
Institution
(Latib, Colombo) Interventional Cardiology Unit, EMO-GVM Centro Cuore
Columbus, San Raffaele Scientific Institute, Via Buonarroti 48, 20145
Milan, Italy
(Castriota) Interventional Cardiology Unit, Citta di Lecce Hospital, GVM
Care and Research, Lecce, Italy
(Micari) Interventional Cardiology Unit, Maria Eleonora Hospital, GVM Care
and Research, Palermo, Italy
(Cremonesi) Interventional Cardiology Unit, Maria Cecilia Hospital, GVM
Care and Research, Cotignola, Italy
(De Felice) Interventional Cardiology Unit, Ospedale San Camillo, Rome,
Italy
(Marchese) Interventional Cardiology Unit, Anthea Hospital, GVM Care and
Research, Bari, Italy
(Tespili) Interventional Cardiology Unit, Ospedale Bolognini, Seriate,
Bergamo, Italy
(Presbitero) Interventional Cardiology Unit, Istituto Clinico Humanitas,
Rozzano, Milan, Italy
(Sgueglia) Interventional Cardiology Unit, Ospedale Santa Maria Goretti,
Latina, Italy
(Buffoli) Interventional Cardiology Unit, Ospedale di Mantova, Mantova,
Italy
(Tamburino) Division of Cardiology, Ferrarotto Hospital, University of
Catania, Catania, Italy
(Varbella) Interventional Cardiology Unit, Ospedale di Rivoli, Torino,
Italy
(Menozzi) Interventional Cardiology Unit, Cardiology Department, Ospedale
di Parma, Parma, Italy
Title
A randomized multicenter study comparing a paclitaxel drug-eluting balloon
with a paclitaxel-eluting stent in small coronary vessels: The bello
(balloon elution and late loss optimization) study.
Source
Journal of the American College of Cardiology. 60 (24) (pp 2473-2480),
2012. Date of Publication: 18 Dec 2012.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Objectives: The aim of this study was to evaluate the efficacy of
drug-eluting balloons (DEB) compared with paclitaxel-eluting stents (PES)
for the reduction of restenosis in small vessels. Background: DEB have
been shown to be effective in the treatment of coronary in-stent
restenosis, but data are limited regarding their efficacy in de novo
disease. Methods: BELLO (Balloon Elution and Late Loss Optimization) is a
prospective, multicenter trial that randomized 182 patients with lesions
located in small vessels (reference diameter <2.8 mm) to treatment with
paclitaxel DEB and provisional bare-metal stenting (n = 90) or PES
implantation (n = 92). The primary endpoint was noninferiority of
angiographic in-stent (in-balloon) late loss with a delta of 0.25 mm.
Secondary endpoints were angiographic restenosis, target lesion
revascularization, and major adverse cardiac events (MACE; death,
myocardial infarction, target vessel revascularization) at 6 months.
Results: Baseline characteristics were well matched, except for a smaller
vessel size in the DEB group (2.15 +/- 0.27 mm vs. 2.25 +/- 0.24 mm; p =
0.003). The majority (89%) of lesions involved vessels with a diameter
<2.5 mm. Bailout stenting was required in 20% of lesions in the DEB group.
The primary endpoint of in-stent (in-balloon) late loss was significantly
less with DEB compared with PES (0.08 +/- 0.38 mm vs. 0.29 +/- 0.44 mm;
difference -0.21; 95% CI: -0.34 to -0.09; p_{noninferiority} <
0.001; p_superiority = 0.001). At 6 months, DEB and PES were
associated with similar rates of angiographic restenosis (8.9% vs. 14.1%;
p = 0.25), target lesion revascularization (4.4% vs. 7.6%; p = 0.37), and
MACE (7.8% vs. 13.2%; p = 0.77). Conclusions: Treatment of small-vessel
disease with a paclitaxel DEB was associated with less angiographic late
loss and similar rates of restenosis and revascularization as a PES.
(Balloon Elution and Late Loss Optimization [BELLO]; Study NCT01086579)
2012 American College of Cardiology Foundation.

<5>
Accession Number
2012750960
Authors
de Betue C.T.I. Verbruggen S.C.A.T. Schierbeek H. Chacko S.K. Bogers
A.J.J.C. van Goudoever J.B. Joosten K.F.M.
Institution
(de Betue) Intensive Care and Department of Pediatric Surgery, Erasmus MC
- Sophia Children's Hospital, University Medical Center Rotterdam, Dr.
Molewaterplein 60, 3015 GJ, Rotterdam, Netherlands
(Verbruggen, Joosten) Department of Pediatrics, Erasmus MC - Sophia
Children's Hospital, University Medical Center Rotterdam, Dr.
Molewaterplein 60, 3015 GJ, Rotterdam, Netherlands
(Schierbeek, van Goudoever) Department of Pediatrics, Emma Children's
Hospital, Academic Medical Center, University of Amsterdam, Meibergdreef
9, 1105 AZ, Amsterdam, Netherlands
(Chacko) Department of Pediatrics, Baylor College of Medicine, USDA-ARS
Children's Nutrition Research Center, 1100 Bates Street, Houston, TX
77030, United States
(Bogers) Department of Cardiothoracic Surgery, Erasmus MC, University
Medical Center Rotterdam, Dr. Molewaterplein 50, 3015 GE, Rotterdam,
Netherlands
(van Goudoever) Department of Pediatrics, VU University Medical Center, De
Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
Title
Does a reduced glucose intake prevent hyperglycemia in children early
after cardiac surgery? A randomized controlled crossover study.
Source
Critical Care. 16 (5) , 2012. Article Number: R176. Date of Publication:
02 Oct 2012.
Publisher
BioMed Central Ltd. (Floor 6, 236 Gray's Inn Road, London WC1X 8HB, United
Kingdom)
Abstract
Introduction: Hyperglycemia in children after cardiac surgery can be
treated with intensive insulin therapy, but hypoglycemia is a potential
serious side effect. The aim of this study was to investigate the effects
of reducing glucose intake below standard intakes to prevent
hyperglycemia, on blood glucose concentrations, glucose kinetics and
protein catabolism in children after cardiac surgery with cardiopulmonary
bypass (CPB).Methods: Subjects received a 4-hour low glucose (LG; 2.5
mg/kg per minute) and a 4-hour standard glucose (SG; 5.0 mg/kg per minute)
infusion in a randomized blinded crossover setting. Simultaneously, an
8-hour stable isotope tracer protocol was conducted to determine glucose
and leucine kinetics. Data are presented as mean +/- SD or median (IQR);
comparison was made by paired samples t test.Results: Eleven subjects (age
5.1 (20.2) months) were studied 9.5 +/- 1.9 hours post-cardiac surgery.
Blood glucose concentrations were lower during LG than SG (LG 7.3 +/- 0.7
vs. SG 9.3 +/- 1.8 mmol/L; P < 0.01), although the glycemic target
(4.0-6.0 mmol/L) was not achieved. No hypoglycemic events occurred.
Endogenous glucose production was higher during LG than SG (LG 2.9 +/- 0.8
vs. SG 1.5 +/- 1.1 mg/kg per minute; P = 0.02), due to increased
glycogenolysis (LG 1.0 +/- 0.6 vs. SG 0.0 +/- 1.0 mg/kg per minute; P <
0.05). Leucine balance, indicating protein balance, was negative but not
affected by glucose intake (LG -54.8 +/- 14.6 vs. SG -58.8 +/- 16.7
mumol/kg per hour; P = 0.57).Conclusions: Currently recommended glucose
intakes aggravated hyperglycemia in children early after cardiac surgery
with CPB. Reduced glucose intake decreased blood glucose concentrations
without causing hypoglycemia or affecting protein catabolism, but
increased glycogenolysis.Trial registration: Dutch trial register NTR2079.
2012 de Betue et al.; licensee BioMed Central Ltd.

<6>
Accession Number
2012740901
Authors
Romagnoli E. Biondi-Zoccai G. Sciahbasi A. Politi L. Rigattieri S.
Pendenza G. Summaria F. Patrizi R. Borghi A. Di Russo C. Moretti C.
Agostoni P. Loschiavo P. Lioy E. Sheiban I. Sangiorgi G.
Institution
(Romagnoli, Sciahbasi, Pendenza, Summaria, Patrizi, Lioy) Policlinico
Casilino, via Ugo de Carolis 48, 00136 Rome, Italy
(Biondi-Zoccai) Sapienza University of Rome, Rome, Italy
(Politi, Borghi) Meta-Analysis and Evidence-based Medicine Training in
Cardiology, Ospedaletti, Italy
(Rigattieri, Di Russo, Loschiavo) Sandro Pertini Hospital, Rome, Italy
(Moretti, Sheiban) University of Turin, San Giovanni Battista Hospital,
Turin, Italy
(Agostoni) University Medical Center Utrecht, Utrecht, Netherlands
(Sangiorgi) Universita Degli Studi di Roma Tor Vergata, Rome, Italy
Title
Radial versus femoral randomized investigation in st-segment elevation
acute coronary syndrome: The rifle-steacs (radial versus femoral
randomized investigation in st-elevation acute coronary syndrome) study.
Source
Journal of the American College of Cardiology. 60 (24) (pp 2481-2489),
2012. Date of Publication: 18 Dec 2012.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Objectives: The purpose of this study was to assess whether transradial
access for ST-segment elevation acute coronary syndrome undergoing early
invasive treatment is associated with better outcome compared with
conventional transfemoral access. Background: In patients with acute
coronary syndrome, bleeding is a significant predictor of worse outcome.
Access site complications represent a significant source of bleeding for
those patients undergoing revascularization, especially when femoral
access is used. Methods: The RIFLE-STEACS (Radial Versus Femoral
Randomized Investigation in ST-Elevation Acute Coronary Syndrome) was a
multicenter, randomized, parallel-group study. Between January 2009 and
July 2011, 1,001 acute ST-segment elevation acute coronary syndrome
patients undergoing primary/rescue percutaneous coronary intervention were
randomized to the radial (500) or femoral (501) approach at 4 high-volume
centers. The primary endpoint was the 30-day rate of net adverse clinical
events (NACEs), defined as a composite of cardiac death, stroke,
myocardial infarction, target lesion revascularization, and bleeding).
Individual components of NACEs and length of hospital stay were secondary
endpoints. Results: The primary endpoint of 30-day NACEs occurred in 68
patients (13.6%) in the radial arm and 105 patients (21.0%) in the femoral
arm (p = 0.003). In particular, compared with femoral, radial access was
associated with significantly lower rates of cardiac mortality (5.2% vs.
9.2%, p = 0.020), bleeding (7.8% vs. 12.2%, p = 0.026), and shorter
hospital stay (5 days first to third quartile range, 4 to 7 days] vs. 6
[range, 5 to 8 days]; p = 0.03). Conclusions: Radial access in patients
with ST-segment elevation acute coronary syndrome is associated with
significant clinical benefits, in terms of both lower morbidity and
cardiac mortality. Thus, it should become the recommended approach in
these patients, provided adequate operator and center expertise is
present. (Radial Versus Femoral Investigation in ST Elevation Acute
Coronary Syndrome [RIFLE-STEACS]; NCT01420614) 2012 American College of
Cardiology Foundation.

<7>
Accession Number
2012755513
Authors
Honold J. Fischer-Rasokat U. Lehmann R. Leistner D.M. Seeger F.H.
Schachinger V. Martin H. Dimmeler S. Zeiher A.M. Assmus B.
Institution
(Honold, Fischer-Rasokat, Lehmann, Leistner, Seeger, Zeiher, Assmus)
Division of Cardiology, Department of Medicine III, Goethe University
Frankfurt, Frankfurt, Germany
(Schachinger) Department of Medicine I, Klinikum Fulda, Germany
(Martin) Division of Hematology and Oncology, Department of Medicine II,
Goethe University Frankfurt, Frankfurt, Germany
(Dimmeler) Institute for Cardiovascular Regeneration, Center of Molecular
Medicine, Goethe University Frankfurt, Frankfurt, Germany
Title
G-CSF stimulation and coronary reinfusion of mobilized circulating
mononuclear proangiogenic cells in patients with chronic ischemic heart
disease: Five-year results of the TOPCARE-G-CSF trial.
Source
Cell Transplantation. 21 (11) (pp 2325-2337), 2012. Date of Publication:
2012.
Publisher
Cognizant Communication Corporation (3 Hartsdale Road, Elmsford NY
10523-3701, United States)
Abstract
Prognosis of patients with heart failure remains poor despite improved
conventional and interventional treatment regimens. The improvement of
neovascularization and repair processes by administration of bone
marrow-derived cells modestly improved the recovery after acute myocardial
infarction. However, circulating patient-derived cells are reduced in
number and function particularly in chronic heart failure. Therefore, we
tested the hypothesis whether the mobilization of circulating mononuclear
proangiogenic cells (CPCs) by G-CSF may overcome some of these
limitations. In the present pilot study, 32 patients with at least
3-month-old myocardial infarction were randomized to G-CSF alone (G-CSF
group) or intracoronary infusion of G-CSFmobilized and cultured CPCs into
the infarct-related artery (G-CSF/CPC group). Primary endpoint of the
study was safety. Efficacy parameters included serial assessment of LV
function, NT-proBNP levels, and cardiopulmonary exercise testing. G-CSF
effectively mobilized circulating CD34⁺CD45⁺ cells
after 5 days in all patients (408 +/- 64%) without serious adverse events.
At 3 months, NYHA class and global LV function did not show significant
improvements in both treatment groups (G-CSF: LVEF 1.6 +/- 2.4%; p = 0.10;
G-CSF/CPC: LVEF 1.4 +/- 4.1%; p = 0.16). In contrast, target area
contractility improved significantly in the G-CSF/CPC group. During 5-year
follow-up, one patient died after rehospitalization for worsening heart
failure. Eleven patients underwent further revascularization procedures.
NT-proBNP levels, cardiopulmonary exercise capacity, and NYHA class
remained stable in both treatment groups. The results from our pilot trial
indicate that administration of G-CSF alone or G-CSF-mobilized and
cultured CPCs can be performed safely in patients with chronic ischemic
heart disease. However, only minor effects on LV function, NT-proBNP
levels, and NYHA classification were observed during follow-up, suggesting
that the enhancement of CPCs by G-CSF alone does not substantially improve
intracoronary cell therapy effects in patients with chronic ischemic heart
failure. 2012 Cognizant Comm. Corp.

<8>
Accession Number
2012685186
Authors
de Bruyne B.
Institution
(de Bruyne) OLV-Clinic, Aalst, Belgium
Title
Fractional flow reserve-guided PCI reduced urgent revascularization at 7
months in coronary artery disease.
Source
Annals of Internal Medicine. 157 (10) (pp JC5-9), 2012. Date of
Publication: 20 Nov 2012.
Publisher
American College of Physicians (190 N. Indenpence Mall West, Philadelphia
PA 19106-1572, United States)

<9>
Accession Number
2012744604
Authors
Clark S.C. Dunning J. Alfieri O.R. Elia S. Hamilton L.R. Kappetein P.A.
Lockowandt U. Sarris G.E. Kolh P.H.
Institution
(Clark, Hamilton) Department of Cardiothoracic Surgery, Freeman Hospital,
Newcastle upon Tyne, United Kingdom
(Dunning) Department of Cardiothoracic Surgery, James Cook University
Hospital, Middlesbrough, United Kingdom
(Alfieri) Division of Cardiac Surgery, Ospedale San Raffaele, Milan, Italy
(Elia) Department of Thoracic Surgery, University Tor Vergata, Rome, Italy
(Kappetein) Thoraxcenter, Erasmus MC, Rotterdam, Netherlands
(Lockowandt) Department of Cardiothoracic Surgery, Karolinska University
Hospital, Stockholm, Sweden
(Sarris) Department of Pediatric and Congenital Heart Surgery, Mitera
Children's and Hygeia Hospitals, Athens, Greece
(Kolh) Department of Cardiovascular Surgery, University Hospital of Liege,
Liege, Belgium
Title
EACTS guidelines for the use of patient safety checklists.
Source
European Journal of Cardio-thoracic Surgery. 41 (5) (pp 993-1004), 2012.
Date of Publication: 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
The Safety Checklist concept has been an integral part of many industries
that face high-complexity tasks for many decades and in industries such as
aviation and engineering checklists have evolved from their very
inception. Investigations of the causes of surgical deaths around the
world have repeatedly pointed to medical errors that could be prevented as
an important cause of death and disability. As a result, the World Health
Organisation developed and evaluated a three-stage surgical checklist in
2007 demonstrating that complications were significantly reduced,
including surgical infection rates and even mortality. Together with the
results from other large cohort studies into the utility of the surgical
checklist, many countries have fully implemented the use of surgical
checklists into routine practice. A key factor in the successful
implementation of a surgical checklist is engagement of the staff
implementing the checklist. In surgical specialties such as our own it was
quickly seen that there were many important omissions in the generic
checklist that did not cover issues particular to our specialty, and thus
the European Association for Cardio-Thoracic Surgery embarked on a process
to create a version of the checklist that might be more appropriate and
specific to cardiothoracic surgery, including checks on preparations for
excessive bleeding, perfusion arrangements and ICU preparations, for
example. The guideline presented here summarizes the evidence for the
surgical checklist and also goes through in detail the changes recommended
for our specialty. The Author 2012. Published by Oxford University Press
on behalf of the European Association for Cardio-Thoracic Surgery. All
rights reserved.

<10>
Accession Number
2012741485
Authors
Parenica J. Nemec P. Tomandl J. Ondrasek J. Pavkova-Goldbergova M. Tretina
M. Jarkovsky J. Littnerova S. Poloczek M. Pokorny P. Spinar J. Cermakova
Z. Miklik R. Malik P. Pes O. Lipkova J. Tomandlova M. Kala P.
Institution
(Parenica, Poloczek, Spinar, Miklik, Kala) University Hospital Brno, Brno,
Czech Republic
(Parenica, Poloczek, Spinar, Kala) Medical Faculty, Masaryk University,
Brno, Czech Republic
(Parenica, Nemec, Spinar) International Clinical Research
Center-Department of Cardiovascular Disease, University Hospital St.
Anne's, Brno, Czech Republic
(Nemec, Ondrasek, Tretina, Pokorny, Malik) Center of Cardiovascular
Surgery and Transplantations, Brno, Czech Republic
(Tomandl, Pes, Tomandlova) Institute of Biochemistry, Medical Faculty,
Masaryk University, Brno, Czech Republic
(Pavkova-Goldbergova, Lipkova) Institute of Pathological Physiology,
Faculty of Medicine, Masaryk University, Brno, Czech Republic
(Jarkovsky, Littnerova) Institute of Biostatistics and Analyses, Faculty
of Medicine, Masaryk University, Brno, Czech Republic
(Cermakova) Biochemistry Department, Faculty Hospital Brno, Brno, Czech
Republic
(Cermakova) Institute of Laboratory Methods, Masaryk University, Brno,
Czech Republic
Title
Prognostic Utility of Biomarkers in Predicting of One-Year Outcomes in
Patients with Aortic Stenosis Treated with Transcatheter or Surgical
Aortic Valve Implantation.
Source
PLoS ONE. 7 (12) , 2012. Article Number: e48851. Date of Publication: 14
Dec 2012.
Publisher
Public Library of Science (185 Berry Street, Suite 1300, San Francisco CA
94107, United States)
Abstract
Objectives: The aim of the work was to find biomarkers identifying
patients at high risk of adverse clinical outcomes after TAVI and SAVR in
addition to currently used predictive model (EuroSCORE). Background: There
is limited data about the role of biomarkers in predicting prognosis,
especially when TAVI is available. Methods: The multi-biomarker sub-study
included 42 consecutive high-risk patients (average age 82.0 years;
logistic EuroSCORE 21.0%) allocated to TAVI transfemoral and transapical
using the Edwards-Sapien valve (n = 29), or SAVR with the Edwards
Perimount bioprosthesis (n = 13). Standardized endpoints were
prospectively followed during the 12-month follow-up. Results: The
clinical outcomes after both TAVI and SAVR were comparable.
Malondialdehyde served as the best predictor of a combined endpoint at 1
year with AUC (ROC analysis) = 0.872 for TAVI group, resp. 0.765 (p<0.05)
for both TAVI and SAVR groups. Increased levels of MDA, matrix
metalloproteinase 2, tissue inhibitor of metalloproteinase (TIMP1),
ferritin-reducing ability of plasma, homocysteine, cysteine and
8-hydroxy-2-deoxyguanosine were all predictors of the occurrence of
combined safety endpoints at 30 days (AUC 0.750-0.948; p<0.05 for all).
The addition of MDA to a currently used clinical model (EuroSCORE)
significantly improved prediction of a combined safety endpoint at 30 days
and a combined endpoint (0-365 days) by the net reclassification
improvement (NRI) and the integrated discrimination improvement (IDI)
(p<0.05). Cystatin C, glutathione, cysteinylglycine, asymmetric
dimethylarginine, nitrite/nitrate and MMP9 did not prove to be
significant. Total of 14.3% died during 1-year follow-up. Conclusion: We
identified malondialdehyde, a marker of oxidative stress, as the most
promising predictor of adverse outcomes during the 30-day and 1-year
follow-up in high-risk patients with symptomatic, severe aortic stenosis
treated with TAVI. The development of a clinical "TAVIscore" would be
highly appreciated. Such dedicated scoring system would enable further
testing of adjunctive value of various biomarkers. 2012 Parenica et al.

<11>
Accession Number
2012745067
Authors
D'Ascenzo F. Agostoni P. Abbate A. Castagno D. Lipinski M.J. Vetrovec G.W.
Frati G. Presutti D.G. Quadri G. Moretti C. Gaita F. Zoccai G.B.
Institution
(D'Ascenzo, Castagno, Presutti, Quadri, Moretti, Gaita) Division of
Cardiology, University of Turin, Italy
(Frati, Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Italy
(Agostoni) Department of Cardiology, University Medical Center Utrecht,
Netherlands
(Abbate, Lipinski, Vetrovec) Virginia Commonwealth University, Richmond,
VA, United States
(Abbate, Lipinski, Vetrovec) University of Virginia, Charlottesville, VA,
United States
Title
Atherosclerotic coronary plaque regression and the risk of adverse
cardiovascular events: A meta-regression of randomized clinical trials.
Source
Atherosclerosis. 226 (1) (pp 178-185), 2013. Date of Publication: January
2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Introduction: Atherosclerotic coronary plaques represent the main
substrate for coronary artery disease (CAD), and changes in plaque volume,
investigated with intravascular ultrasound (IVUS), have been used as
surrogate end-points in several clinical trials. However, no conclusive
data are available to support the exploitation of IVUS-based plaque
changes as a measure of clinically meaningful treatment's effect. Methods:
Biomed Central, CENTRAL, and Medline/PubMed were searched for randomized
clinical trials investigating IVUS variations of plaque and reporting
clinical events. End-points of interest were major adverse cardiovascular
events (MACE, a composite of death, myocardial infarction [MI] or
revascularization), and the rates of MI or revascularization combined.
Meta-regression analysis was performed to appraise the association between
plaque changes and clinical events during follow-up. Results: Eleven
studies (2 focusing on patients with ACS) with 7864 patients were
included. After a median follow-up of 18 months, percentage of atheroma
volume (PAV) was 0.50 (95% confidence interval -0.25; 1.00), with a 15.0%
(95% CI 9.6%; 22.5%) rate of MACE and a 14.1% (95% CI 10.2%; 19.5%) rate
of MI or revascularization. Rates of plaque volume regression were
significantly associated with the incidence of MI or revascularization
(Beta = 6.3; p = 0.006) but not with MACE (Beta = 0.42; p = 0.208).
Conclusion: Regression of atherosclerotic coronary plaque volume may
represent a surrogate for myocardial infarction and repeat
revascularization but not for MACE. These results derive largely from
stable patients, and should consequently be applied only to this
population. 2012 Elsevier Ireland Ltd.

<12>
Accession Number
2012738258
Authors
Farkouh M.E. Domanski M. Sleeper L.A. Siami F.S. Dangas G. Mack M. Yang M.
Cohen D.J. Rosenberg Y. Solomon S.D. Desai A.S. Gersh B.J. Magnuson E.A.
Lansky A. Boineau R. Weinberger J. Ramanathan K. Sousa J.E. Rankin J.
Bhargava B. Buse J. Hueb W. Smith C.R. Muratov V. Bansilal S. King III S.
Bertrand M. Fuster V.
Institution
(Farkouh, Domanski, Dangas, Weinberger, Bansilal, Fuster) Michael A.
Wiener Cardiovascular Institute, Marie-Josee and Henry R. Kravis Center
for Cardiovascular Health, Mount Sinai School of Medicine, 1 Gustave L.
Levy Pl., Box 1030, New York, NY 10029, United States
(Dangas) Cardiovascular Research Foundation, New York, NY, United States
(Smith) New York Presbyterian Medical Center, New York, NY, United States
(Farkouh) Peter Munk Cardiac Centre, Li Ka Shing Knowledge Institute,
University of Toronto, Toronto, Canada
(Ramanathan) University of British Columbia, Vancouver, BC, Canada
(Sleeper, Siami, Yang, Muratov) New England Research Institutes,
Watertown, MA, United States
(Solomon, Desai) Cardiovascular Division, Brigham and Women's Hospital,
Boston, MA, United States
(Mack) Baylor University Medical Center, Dallas, TX, United States
(Cohen, Magnuson) St. Luke's Mid-America Heart Institute, University of
Missouri-Kansas City, Kansas City, MO, United States
(Rosenberg, Boineau) National Heart, Lung, and Blood Institute, Bethesda,
MD, United States
(Gersh) Mayo Clinic, Rochester, MN, United States
(Lansky) Yale University, New Haven, CT, United States
(Sousa) Dante Pazzanese Hospital, Sao Paulo, Brazil
(Hueb) Heart Institute InCor, University of Sao Paulo Medical School, Sao
Paulo, Brazil
(Rankin) Royal Perth Hospital, Perth, WA, Australia
(Bhargava) All India Institute of Medical Sciences, New Delhi, India
(Buse) University of North Carolina, Chapel Hill, NC, United States
(King III) St. Joseph's Hospital, Atlanta, United States
(Bertrand) University of Lille, Lille, France
(Fuster) Centro Nacional de Investigaciones Cardiovasculares, Madrid,
Spain
Title
Strategies for multivessel revascularization in patients with diabetes.
Source
New England Journal of Medicine. 367 (25) (pp 2375-2384), 2012. Date of
Publication: 20 Dec 2012.
Publisher
Massachussetts Medical Society (860 Winter Street, Waltham MA 02451-1413,
United States)
Abstract
BACKGROUND: In some randomized trials comparing revascularization
strategies for patients with diabetes, coronary-artery bypass grafting
(CABG) has had a better outcome than percutaneous coronary intervention
(PCI). We sought to discover whether aggressive medical therapy and the
use of drug-eluting stents could alter the revascularization approach for
patients with diabetes and multivessel coronary artery disease. METHODS:
In this randomized trial, we assigned patients with diabetes and
multivessel coronary artery disease to undergo either PCI with
drug-eluting stents or CABG. The patients were followed for a minimum of 2
years (median among survivors, 3.8 years). All patients were prescribed
currently recommended medical therapies for the control of low-density
lipoprotein cholesterol, systolic blood pressure, and glycated hemoglobin.
The primary outcome measure was a composite of death from any cause,
nonfatal myocardial infarction, or nonfatal stroke. RESULTS: From 2005
through 2010, we enrolled 1900 patients at 140 international centers. The
patients' mean age was 63.1+/-9.1 years, 29% were women, and 83% had
three-vessel disease. The primary outcome occurred more frequently in the
PCI group (P = 0.005), with 5-year rates of 26.6% in the PCI group and
18.7% in the CABG group. The benefit of CABG was driven by differences in
rates of both myocardial infarction (P<0.001) and death from any cause (P
= 0.049). Stroke was more frequent in the CABG group, with 5-year rates of
2.4% in the PCI group and 5.2% in the CABG group (P = 0.03). CONCLUSIONS:
For patients with diabetes and advanced coronary artery disease, CABG was
superior to PCI in that it significantly reduced rates of death and
myocardial infarction, with a higher rate of stroke. (Funded by the
National Heart, Lung, and Blood Institute and others; FREEDOM
ClinicalTrials.gov number, NCT00086450.) Copyright 2012 Massachusetts
Medical Society.

<13>
Accession Number
2012747719
Authors
Prasad S.R. Simha P.P. Jagadeesh A.M.
Institution
(Prasad, Simha, Jagadeesh) Department of Cardiac Anaesthesia, Sri Jayadeva
Institute of Cardiovascular Sciences and Research, Bannerghatta Road,
Bangalore, Karnataka, India
Title
Comparative study between dexmedetomidine and fentanyl for sedation during
mechanical ventilation in post-operative paediatric cardiac surgical
patients.
Source
Indian Journal of Anaesthesia. 56 (6) (pp 547-552), 2012. Date of
Publication: 2012.
Publisher
Indian Society of Anaesthetists (Flat No 12/1A K Point, 68-BAPC Roy Road,
Kolkata 700009, India)
Abstract
Aims and Objectives: To compare the effcacy of sedation and time taken for
extubation using dexmedetomidine and fentanyl sedation in post-operative
paediatric cardiac surgical patients. Methods: A prospective randomized
double-blind study involving 60 children undergoing open heart surgery was
conducted. The patients were divided into two groups, each involving 30
patients. One group received fentanyl at 1 mug/kg/h (Group A) and the
other received dexmedetomidine at 0.5 mug/kg/h (Group B) for
post-operative sedation with intermittent rescue fentanyl 0.5 mug/kg bolus
in either group as per requirement during suctioning. The effcacy of
sedation was assessed using the Ramsay sedation score, paediatric
intensive care unit sedation score and the tracheal suction score. The
time taken for extubation from the stoppage of infusion was noted.
Results: Haemodynamic parameters between the two groups were comparable.
All sedation scores were comparable in the fentanyl and dexmedetomidine
groups. Average time (in minutes) required for extubation was 131.0
(+/-51.06 SD) in the dexmedetomidine group compared with 373.0 (+/-121.4
SD) in the fentanyl group. The difference in mean time for extubation was
statistically significant. Conclusions: Dexmedetomidine facilitates
adequate sedation for mechanical ventilation and also early extubation as
compared with fentanyl.

<14>
Accession Number
2012647656
Title
Glargine did not reduce CV events more than standard care in patients with
dysglycemia.
Source
Annals of Internal Medicine. 157 (6) (pp JC3-10), 2012. Date of
Publication: 18 Sep 2012.
Publisher
American College of Physicians (190 N. Indenpence Mall West, Philadelphia
PA 19106-1572, United States)