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Embase <1980 to 2013 Week 17>
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Embase <1980 to 2013 Week 17>
Embase (updates since 2013-04-19)
<1>
Accession Number
2013230093
Authors
Chan W.W.N. Wong G.T.C. Irwin M.G.
Institution
(Chan) Queen Mary Hospital, Department of Anaesthesiology, Pokfulam Road,
Hong Kong, Hong Kong
(Wong, Irwin) University of Hong Kong, Department of Anaesthesiology,
Queen Mary Hospital, Pokfulam Road, Hong Kong, Hong Kong
Title
Perioperative statin therapy.
Source
Expert Opinion on Pharmacotherapy. 14 (7) (pp 831-842), 2013. Date of
Publication: May 2013.
Publisher
Informa Healthcare (69-77 Paul Street, London EC2A 4LQ, United Kingdom)
Abstract
Introduction: The lipid lowering class of drugs known as "Statins" are
being increasing recognized for their pleiotropic effects which include
anti-inflammation, antioxidant, vasodilatation, improved endothelial
function and stabilization of atherosclerotic plaques. These effects may
counteract, to some extent, the deleterious impact of surgical stress on
various organ systems during the perioperative period. Areas covered: A
literature review was undertaken to examine current evidence for the
effect of perioperative statin use on postoperative morbidity and
mortality. A search of PubMed, Medline and Scopus databases was performed
using a combination of search terms including statins and perioperative
risk reduction, outcomes, morbidity and mortality. Further searches were
made on specific areas such as statins and thrombosis, kidney injury,
renal protection, cancer, cost and safety. Expert opinion: Current
evidence supports a reduction in cardiovascular morbidity and mortality
associated with perioperative statin use in high risk patients undergoing
non cardiac surgery and this represents a very cost effective application
of statin therapy with few adverse events reported. Data is emerging that
point to other benefits such as renal protection but this requires further
confirmation from prospective studies. Future research needs to address
the questions of the optimal type, timing and dosage of statin therapy as
well as whether there are problems associated with abrupt withdrawal and
adverse effects associated with long term use. Informa UK, Ltd.
<2>
[Use Link to view the full text]
Accession Number
2013241655
Authors
Wasem S. Lazarus M. Hain J. Festl J. Kranke P. Roewer N. Lange M. Smul
T.M.
Institution
(Wasem, Lazarus, Kranke, Roewer, Lange, Smul) Department of Anaesthesia
and Critical Care, University Hospital of Wurzburg, Oberdurrbacherstr. 6,
Wurzburg, Germany
(Hain) Department of Mathematics, Wurzburg, Germany
(Festl) Faculty of Medicine, University of Wurzburg, Wurzburg, Germany
Title
Comparison of the airtraq and the macintosh laryngoscope for double-lumen
tube intubation: A randomised clinical trial.
Source
European Journal of Anaesthesiology. 30 (4) (pp 180-186), 2013. Date of
Publication: April 2013.
Publisher
Lippincott Williams and Wilkins (250 Waterloo Road, London SE1 8RD, United
Kingdom)
Abstract
CONTEXT The Airtraq is a disposable optical laryngoscope that is available
in a double-lumen tube version. Inserting a double-lumen tube is generally
more difficult compared to conventional endotracheal intubation, mainly
due to its configuration. OBJECTIVE The aim of this study was to compare
the Airtraq with the Macintosh laryngoscope for intubation with a
double-lumen tube in patients undergoing elective thoracic surgery. The
main outcome was time needed for successful intubation. DESIGN
Prospective, randomised clinical trial. SETTING A single centre,
University Hospital of Wu rzburg, Germany, between July 2009 and June
2011. PATIENTS After a scout laryngoscopy with a Macintosh laryngoscope,
60 adult patients were intubated by an anaesthesiologist with either an
Airtraq (n=30) or a Macintosh laryngoscope (n=30). MAIN OUTCOME MEASURES
The time needed for correct intubation, checked by flexible bronchoscopy,
was recorded. The intubation difficulty scale (IDS) and Cormack and Lehane
grade were noted. Haemodynamic variables and any evidence of oropharyngeal
trauma were documented as well as postoperative sore throat, hoarseness
and dysphagia. RESULTS The mean time needed for correct intubation was
20.1+/-16.5 s in the Airtraq group and 17.5+/-10 s in the Macintosh group
(P=0.86). All intubations in both groups had an IDS less than 4. The
Cormack and Lehane grade was I in all 30 patients in the Airtraq group; in
the Macintosh group, it was I and II in 17 and 13 patients, respectively.
The incidence of hoarseness was significantly higher in the Airtraq group
24 h postoperatively (P=0.01). CONCLUSION There was no significant
difference between the Airtraq and the Macintosh laryngoscopes regarding
the time needed to insert a double-lumen tube during elective thoracic
surgery. Only subtle enhancement of visualisation and a higher incidence
of hoarseness were observed in the Airtraq group. The Airtraq device did
not result in superior patient safety in this setting. 2013 Copyright
European Society of Anaesthesiology.
<3>
Accession Number
2013233436
Authors
Bonaca M.P. Scirica B.M. Creager M.A. Olin J. Bounameaux H. Dellborg M.
Lamp J.M. Murphy S.A. Braunwald E. Morrow D.A.
Institution
(Bonaca, Scirica, Creager, Lamp, Murphy, Braunwald, Morrow) Cardiovascular
Division, Department of Medicine, Brigham and Women's Hospital, 75 Francis
St, Boston, MA 02115, United States
(Olin) Wiener Cardiovascular Institute, Marie-Jose and Henry R. Kravis
Center for Cardiovascular Health, Mount Sinai School of Medicine, New
York, NY, United States
(Bounameaux) Division of Angiology and Hemostasis, Department of Medical
Specialties, University Hospitals of Geneva, Geneva, Switzerland
(Dellborg) Institute of Medicine, Sahlgrenska Academy, University of
Gothenburg and Sahlgrenska University Hospital/Ostra, Gothenburg, Sweden
Title
Vorapaxar in patients with peripheral artery disease results from
TRA2degreeP-TIMI 50.
Source
Circulation. 127 (14) (pp 1522-1529), 2013. Date of Publication: 09 Apr
2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Background-Vorapaxar is a novel antagonist of protease-activated
receptor-1, the primary receptor for thrombin on human platelets that is
also present on vascular endothelium and smooth muscle. Patients with
peripheral artery disease are at risk of systemic atherothrombotic events,
as well as acute and chronic limb ischemia and the need for peripheral
revascularization. Methods and Results-The Trial to Assess the Effects of
SCH 530348 in Preventing Heart Attack and Stroke in Patients With
Atherosclerosis (TRA2degreeP-TIMI 50) was a randomized, double-blind,
placebo-controlled trial of vorapaxar in 26 449 patients with stable
atherosclerotic vascular disease (myocardial infarction, stroke, or
peripheral artery disease). Patients with qualifying peripheral artery
disease (n=3787) had a history of claudication and an ankle-brachial index
of <0.85 or prior revascularization for limb ischemia. The primary
efficacy end point was cardiovascular death, myocardial infarction, or
stroke, and the principal safety end point was Global Utilization of
Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) bleeding. In
the peripheral artery disease cohort, the primary end point did not differ
significantly with vorapaxar (11.3% versus 11.9%; hazard ratio, 0.94; 95%
confidence interval, 0.78-1.14; P=0.53). However, rates of hospitalization
for acute limb ischemia (2.3% versus 3.9%; hazard ratio, 0.58; 95%
confidence interval, 0.39-0.86; P=0.006) and peripheral artery
revascularization (18.4% versus 22.2%; hazard ratio, 0.84; 95% confidence
interval, 0.73- 0.97; P=0.017) were significantly lower in patients
randomized to vorapaxar. Bleeding occurred more frequently with vorapaxar
compared with placebo (7.4% versus 4.5%; hazard ratio, 1.62; 95%
confidence interval, 1.21-2.18; P=0.001). Conclusions-Vorapaxar did not
reduce the risk of cardiovascular death, myocardial infarction, or stroke
in patients with peripheral artery disease; however, vorapaxar
significantly reduced acute limb ischemia and peripheral
revascularization. The beneficial effects of protease-activated receptor-1
antagonism on limb vascular events were accompanied by an increased risk
of bleeding. Clinical Trial Registration-URL:
http://www.clinicaltrials.gov. Unique identifier: NCT00526474. 2013
American Heart Association, Inc.
<4>
Accession Number
2013215265
Authors
Bhatt D.L. Stone G.W. Mahaffey K.W. Gibson C.M. Steg P.G. Hamm C.W. Price
M.J. Leonardi S. Gallup D. Bramucci E. Radke P.W. Widimsky P. Tousek F.
Tauth J. Spriggs D. McLaurin B.T. Angiolillo D.J. Genereux P. Liu T. Prats
J. Todd M. Skerjanec S. White H.D. Harrington R.A.
Institution
(Bhatt) VA Boston Healthcare System, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Stone, Genereux) Columbia University Medical Center, Cardiovascular
Research Foundation, New York, NY, United States
(Mahaffey, Gallup) Duke Clinical Research Institute, Durham, NC, United
States
(Gibson) Beth Israel Deaconess Medical Center, Division of Cardiology,
Boston, MA, United States
(Steg) INSERM Unite 698, Universite Paris-Diderot,
Assistance-Publique-Hopitaux de Paris, Paris, France
(Hamm) Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
(Price) Scripps Clinic and Scripps Translational Science Institute, San
Diego, CA, United States
(Leonardi, Bramucci) Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
(Radke) Universitatsklinikum Schleswig-Holstein, Lubeck, Germany
(Widimsky) Fakultni Nemocnice Kralovske Vinohrady, Prague, Czech Republic
(Tousek) Nemocnice Ceske Budejovice, Ceske Budejovice, Czech Republic
(Tauth) National Park Medical Center, Hot Springs, AR, United States
(Spriggs) Clearwater Cardiovascular and Interventional Consultants,
Clearwater, FL, United States
(McLaurin) AnMed Health, Anderson, SC, United States
(Angiolillo) University of Florida College of Medicine, Jacksonville, FL,
United States
(Liu, Prats, Todd, Skerjanec) Medicines Company, Parsippany, NJ, United
States
(White) Green Lane Cardiovascular Service, Auckland, New Zealand
(Harrington) Stanford University Medical School, Stanford, CA, United
States
Title
Effect of platelet inhibition with Cangrelor during PCI on ischemic
events.
Source
New England Journal of Medicine. 368 (14) (pp 1303-1313), 2013. Date of
Publication: 04 Apr 2013.
Publisher
Massachussetts Medical Society (860 Winter Street, Waltham MA 02451-1413,
United States)
Abstract
Background: The intensity of antiplatelet therapy during percutaneous
coronary intervention (PCI) is an important determinant of PCI-related
ischemic complications. Cangrelor is a potent intravenous adenosine
diphosphate (ADP)-receptor antagonist that acts rapidly and has quickly
reversible effects. Methods: In a double-blind, placebo-controlled trial,
we randomly assigned 11,145 patients who were undergoing either urgent or
elective PCI and were receiving guidelinerecommended therapy to receive a
bolus and infusion of cangrelor or to receive a loading dose of 600 mg or
300 mg of clopidogrel. The primary efficacy end point was a composite of
death, myocardial infarction, ischemia-driven revascularization, or stent
thrombosis at 48 hours after randomization; the key secondary end point
was stent thrombosis at 48 hours. The primary safety end point was severe
bleeding at 48 hours. Results: The rate of the primary efficacy end point
was 4.7% in the cangrelor group and 5.9% in the clopidogrel group
(adjusted odds ratio with cangrelor, 0.78; 95% confidence interval [CI],
0.66 to 0.93; P = 0.005). The rate of the primary safety end point was
0.16% in the cangrelor group and 0.11% in the clopidogrel group (odds
ratio, 1.50; 95% CI, 0.53 to 4.22; P = 0.44). Stent thrombosis developed
in 0.8% of the patients in the cangrelor group and in 1.4% in the
clopidogrel group (odds ratio, 0.62; 95% CI, 0.43 to 0.90; P = 0.01). The
rates of adverse events related to the study treatment were low in both
groups, though transient dyspnea occurred significantly more frequently
with cangrelor than with clopidogrel (1.2% vs. 0.3%). The benefit from
cangrelor with respect to the primary end point was consistent across
multiple prespecified subgroups. Conclusions: Cangrelor significantly
reduced the rate of ischemic events, including stent thrombosis, during
PCI, with no significant increase in severe bleeding. (Funded by the
Medicines Company; CHAMPION PHOENIX ClinicalTrials.gov number,
NCT01156571.) Copyright 2013 Massachusetts Medical Society. All rights
reserved.
<5>
Accession Number
2013232263
Authors
Gioli-Pereira L. Santos P.C.J.L. Sugaya L.S. Ferreira N.E. Krieger J.E.
Pereira A.C. Hueb W.A.
Institution
(Gioli-Pereira, Santos, Sugaya, Ferreira, Krieger, Pereira, Hueb) Heart
Institute (InCor), Sao Paulo University Medical School, Av. Dr. Eneas de
Carvalho Aguiar 44 Cerqueira Cesar, Sao Paulo - SP 05403-000, Brazil
Title
Association between UCP2 A55V polymorphism and risk of cardiovascular
events in patients with multi-vessel coronary arterial disease.
Source
BMC Medical Genetics. 14 (1) , 2013. Article Number: 40. Date of
Publication: 27 Mar 2013.
Publisher
BioMed Central Ltd. (Floor 6, 236 Gray's Inn Road, London WC1X 8HB, United
Kingdom)
Abstract
Background: UCP2 (uncoupling protein 2) plays an important role in
cardiovascular diseases and recent studies have suggested that the A55V
polymorphism can cause UCP2 dysfunction. The main aim was to investigate
the association of A55V polymorphism with cardiovascular events in a group
of 611 patients enrolled in the Medical, Angioplasty or Surgery Study II
(MASS II), a randomized trial comparing treatments for patients with
coronary artery disease and preserved left ventricular function.Methods:
The participants of the MASS II were genotyped for the A55V polymorphism
using allele-specific PCR assay. Survival curves were calculated with the
Kaplan-Meier method and evaluated with the log-rank statistic. The
relationship between baseline variables and the composite end-point of
cardiac death, acute myocardial infarction (AMI), refractory angina
requiring revascularization and cerebrovascular accident were assessed
using a Cox proportional hazards survival model.Results: There were no
significant differences for baseline variables according genotypes. After
2 years of follow-up, dysglycemic patients harboring the VV genotype had
higher occurrence of AMI (p=0.026), Death+AMI (p=0.033), new
revascularization intervention (p=0.009) and combined events (p=0.037) as
compared with patients carrying other genotypes. This association was not
evident in normoglycemic patients.Conclusions: These findings support the
hypothesis that A55V polymorphism is associated with UCP2 functional
alterations that increase the risk of cardiovascular events in patients
with previous coronary artery disease and dysglycemia. 2013 Gioli-Pereira
et al.; licensee BioMed Central Ltd.
<6>
Accession Number
2013223134
Authors
Lee J.W. Yoo Y.-C. Park H.K. Bang S.-O. Lee K.-Y. Bai S.-J.
Institution
(Lee, Yoo, Bang, Lee, Bai) Department of Anesthesiology and Pain Medicine,
Yonsei University College of Medicine, Seoul, South Korea
(Bang, Lee, Bai) Anesthesia and Pain Research Institute, Yonsei University
College of Medicine, Seoul, South Korea
(Park) Department of Cardiovascular Surgery, Yonsei University College of
Medicine, Seoul, South Korea
Title
Fresh frozen plasma in pump priming for congenital heart surgery:
Evaluation of effects on postoperative coagulation profiles using a
fibrinogen assay and rotational thromboelastometry.
Source
Yonsei Medical Journal. 54 (3) (pp 752-762), 2013. Date of Publication:
May 2013.
Publisher
Yonsei University College of Medicine (Shinchon dong 134, Seodaemoon ku,
Seoul 120-752, South Korea)
Abstract
Purpose: In this prospective study, the effects of fresh frozen plasma
(FFP) included in pump priming for congenital heart surgery in infants and
children on post-bypass coagulation profiles were evaluated. Materials and
Methods: Either 20% albumin (50-100 mL) or FFP (1-2 units) was added to
pump priming for patients randomly allocated into control or treatment
groups, respectively. Hematologic assays, including functional fibrinogen
level, and rotational thromboelastometry (ROTEM) were measured before skin
incision (baseline), after weaning from car-diopulmonary bypass (CPB) and
heparin reversal, and at 24 hours (h) in the intensive care unit (ICU).
Results: All the baseline measurements were comparable between the control
and treatment groups of infants and children. After heparin reversal,
however, significantly higher fibrinogen levels and less reduced ROTEM
parameters, which reflect clot formation and firmness, were demonstrated
in the treatment groups of infants and children. At 24 h in the ICU,
hematologic assays and ROTEM measurements were comparable between the
control and treatment groups of infants and children. Transfusion
requirements, excluding FFP in pump prime, and postoperative bleeding were
comparable between the control and treatment groups of infants and
children. Conclusion: Although clinical benefits were not clearly found,
the inclusion of FFP in pump priming for congenital heart surgery in
infants and children was shown to improve the hemodilution-related
hemo-static dysfunction immediately after weaning from CPB and heparin
reversal. Yonsei University College of Medicine 2013.
<7>
Accession Number
2013230352
Authors
Temizkan V. Arslan G. Ugur M. Alp I. Yedekci E. Ucak A. Tas D. Yilmaz A.
Institution
(Temizkan, Arslan, Ugur, Alp, Ucak, Yilmaz) Department of Cardiovascular
Surgery, GATA Haydarpasa Training Hospital, Istanbul, Turkey
(Yedekci) Department of Anesthesiology and Reanimation, GATA Haydarpasa
Training Hospital, Istanbul, Turkey
(Tas) Department of Respiratory Disease, GATA Haydarpasa Training
Hospital, Istanbul, Turkey
Title
Reversed C sternotomy versus conventional sternotomy in cardiac surgery.
Source
Thoracic and Cardiovascular Surgeon. 61 (3) (pp 209-214), 2013. Date of
Publication: 2013.
Publisher
Georg Thieme Verlag (Rudigerstrasse 14, Stuttgart D-70469, Germany)
Abstract
Background In this study, cardiac surgery with minimally invasive reversed
C sternotomy was compared with conventional sternotomy in patients
undergoing valve replacement or septal defect repair. Methods In this
prospective randomized study, 35 patients were assigned into one of two
groups for elective cardiac surgery under general anesthesia: Group A
(reversed C sternotomy group) and Group B (conventional sternotomy group).
Intraoperative variables, intubation time, postoperative drainage volume,
pulmonary function tests, sleep quality and quality of life, and
requirement for blood transfusion were compared. Results A significant
difference between the two groups was found in blood transfusion
requirement, extubation time, and drainage volume. Forced expiratory
volume in one second and functional vital capacity were significantly
lower in Group B than in Group A at postoperative Month 1. Total sleep
component score of Pittsburg Sleep Quality Index in Group B patients was
significantly worse at postoperative Month 1. Postoperative assessment of
quality of life (physical and mental) also showed a significant difference
between the two groups. Conclusion These preliminary findings suggest that
creating an access point without compromising the integrity of the sternum
seems to be an advantageous and appropriate technique for suitable
patients undergoing cardiac surgery. 2013 Georg Thieme Verlag KG
Stuttgart - New York.
<8>
Accession Number
2013227395
Authors
Waksman R. Bertrand O. Driesman M. Gruberg L. Rossi J. Mehta S. Swymelar
S. Dvir D. Xue Z. Torguson R.
Institution
(Waksman, Swymelar, Dvir, Xue, Torguson) Interventional Cardiology,
MedStar Washington Hospital Center, Washington, DC, United States
(Bertrand) Laval Hospital, Quebec Heart and Lung Institute, QC, Canada
(Driesman) Bridgeport Hospital, Bridgeport, CT, United States
(Gruberg) Stony Brook University Medical Center, Stony Brook, NY, United
States
(Rossi) University of North Carolina, Chapel Hill, NC, United States
(Mehta) Hamilton General Hospital, ON, Canada
Title
Bivalirudin versus unfractionated heparin during percutaneous coronary
intervention in patients with non-st-segment elevation acute coronary
syndrome initially treated with fondaparinux: Results from an
international, multicenter, randomized pilot study (SWITCH III).
Source
Journal of Interventional Cardiology. 26 (2) (pp 107-113), 2013. Date of
Publication: April 2013.
Publisher
Blackwell Publishing Inc. (350 Main Street, Malden MA 02148, United
States)
Abstract
We aimed to determine the optimal adjunctive anticoagulation regimen for
percutaneous coronary intervention (PCI) in patients presenting with acute
coronary syndrome (ACS) initially treated with fondaparinux. The optimal
adjunctive anticoagulation regimen for PCI in these patients is unclear.
In this open-label, prospective, randomized, multicenter pilot study, we
compared treatment with unfractionated heparin (UFH) versus bivalirudin in
patients with non-ST-segment elevation ACS initially treated with
fondaparinux and undergoing early invasive strategy. The randomized
population consisted of 100 patients (62.7 +/- 12.7 years, 68% men), all
of whom were on clopidogrel. During the angioplasty, patients were
randomized to either bivalirudin or UFH therapy in a 1:1 fashion. Baseline
clinical and angiographic characteristics were similar except for a higher
body mass index in the UFH group (29.4 +/- 4.7 vs. 27.3 +/- 4.2, P =
0.02). Major bleeding was the primary outcome; a major bleeding event was
documented in only 1 patient from the bivalirudin group (2%) and in none
from the UFH group (P = 0.49). There was no death, Q-wave MI, or acute
revascularization in either group. There was no documentation of stent
thrombosis, reinfarction, and catheter thrombus. Data from this
prospective, multicenter pilot study suggest that bivalirudin, compared to
standard-dose UFH, has a similar safety profile in terms of peri-PCI
bleeding and thrombotic events and can be used safely in ACS patients
initially treated with upstream fondaparinux who undergo PCI. (J Interven
Cardiol 2013;26:107-113) 2012, Wiley Periodicals, Inc.
<9>
Accession Number
2013233359
Authors
Weltert L. Nardella S. Rondinelli M.B. Pierelli L. De Paulis R.
Institution
(Weltert, Nardella, Rondinelli, Pierelli, De Paulis) Cardiac Surg. Dept.,
Europ. Hosp.; the Transfus. Med. Dept., S. Camillo Forlanini Hosp.; and
the Dept. of Exp. Med., Sapienza Univ., Rome, Italy
Title
Reduction of allogeneic red blood cell usage during cardiac surgery by an
integrated intra- and postoperative blood salvage strategy: Results of a
randomized comparison.
Source
Transfusion. 53 (4) (pp 790-797), 2013. Date of Publication: April 2013.
Publisher
Blackwell Publishing Inc. (350 Main Street, Malden MA 02148, United
States)
Abstract
BACKGROUND: The amount of allogeneic blood transfusion may relate to worse
outcome in cardiac surgery. The reinfusion of red blood cells (RBCs) lost
by patients, including those of chest drains, is a promising strategy to
minimize allogeneic transfusions. STUDY DESIGN AND METHODS: To verify this
hypotheis, 1047 cardiac surgery patients were randomly assigned to either
traditional intraoperative blood salvage followed by chest drain insertion
or intra- and postoperative strategy with the Haemonetics cardioPAT
system. Allogeneic RBC transfusion rate (primary endpoint) and
postoperative complications (secondary endpoint) were recorded at the time
of discharge from the hospital and at first month follow-up visit,
respectively. RESULTS: The cardioPAT arm received 1.20 units of allogeneic
RBCs per patient, whereas the control group required 2.11 units per
patient, and this difference proved to be highly significant (p = 0.02).
We observed a comparable 45-day mortality rate but a lower rate of deep
vein thrombosis (p = 0.04) and atrial fibrillation (p = 0.04) in the
cardioPAT arm. DISCUSSION: A significant reduction in patient exposure to
allogeneic RBCs was observed in the cardioPAT system arm. Complications
were slightly less frequent in the cardioPAT group. The use of the
cardioPAT is a safe and effective strategy to reduce allogeneic RBC
transfusions in cardiac surgery. 2012 American Association of Blood
Banks.
<10>
Accession Number
2013226995
Authors
Apostolidou E. Kalisetti D. Logani S. McCormick D.J. Goldberg S.
Institution
(Apostolidou, Logani) Hahnemann University Hospital, Philadelphia, PA,
United States
(Kalisetti, McCormick, Goldberg) Department of Cardiovascular Medicine,
Pennsylvania Hospital, University of Pennsylvania Health System, 800
Spruce Street, Philadelphia, PA 19107, United States
Title
Myocardial revascularization in patients with left main coronary disease.
Source
Journal of Invasive Cardiology. 25 (4) (pp 201-207), 2013. Date of
Publication: April 2013.
Publisher
HMP Communications (83 General Warren Blvd. Suite 100, Malven PA 19355,
United States)
Abstract
While coronary artery bypass grafting (CABG) has been the standard of care
for patients with unprotected left main coronary artery disease, advances
in percutaneous coronary intervention (PCI) have made stent placement a
reasonable alternative in selected patients. In this review, we address
the results of studies comparing PCI with CABG, discuss the invasive
evaluation of these patients, and the technical approach to percutaneous
revascularization. Furthermore, we discuss future pivotal trials, which
will help define long-term outcomes comparing PCI with surgery.
<11>
Accession Number
2013224778
Authors
Ebrahim A.J. Mozaffar R. Nadia B.-H. Ali J.
Institution
(Ebrahim, Mozaffar, Nadia, Ali) Department of Anaesthesiology and
Intensive Care, Babol University of Medical Sciences, Babol, Iran, Islamic
Republic of
(Ali) Golestan University of Medical Sciences, Golestan, Iran, Islamic
Republic of
Title
Preoperative prescription of suppository diclofenac for spinal anesthesia.
Source
Annals of African Medicine. 12 (1) (pp 53-54), 2013. Date of Publication:
January-March 2013.
Publisher
Medknow Publications and Media Pvt. Ltd (B9, Kanara Business Centre, off
Link Road, Ghatkopar (E), Mumbai 400 075, India)
<12>
Accession Number
2013232447
Authors
Lin D.M. Murphy L.S. Tran M.-H.
Institution
(Lin) Department of Medicine, University of California, Irvine Medical
Center, Orange, CA, United States
(Murphy) Health Sciences Librarian, Science Library Reference Department,
University of California-Irvine, Libraries, Irvine, CA, United States
(Tran) University of California, Irvine Medical Center, Department of
Pathology and Laboratory Medicine, Orange, CA, United States
Title
Use of prothrombin complex concentrates and fibrinogen concentrates in the
perioperative setting: A systematic review.
Source
Transfusion Medicine Reviews. 27 (2) (pp 91-104), 2013. Date of
Publication: April 2013.
Publisher
W.B. Saunders (Independence Square West, Philadelphia PA 19106-3399,
United States)
Abstract
The use of prothrombin complex concentrates (PCCs) and fibrinogen
concentrates (FIBCs) to achieve hemostasis in the perioperative setting as
alternatives to allogeneic blood products remains controversial. To
examine the efficacy and safety of PCCs and FIBCs, we conducted a
systematic review-in accordance with the Preferred Reporting Items for
Systematic Reviews and Meta-Analysis statement-to compare the use of these
transfusion alternatives in bleeding surgical patients. We performed a
literature search of English articles published between July 1997 and July
2012 in MEDLINE via PubMed, The Cochrane Library, and CINAHL. Five
randomized trials and 15 nonrandomized studies with a comparator group
were included in the final review. Studies were sorted into 1 of the
following 3 clinical settings: cardiac surgery, non-cardiac surgery, and
reversal of warfarin anticoagulation. Risk of bias was assessed using the
Cochrane risk of bias tool. With the exception of 2 randomized controlled
trials, the existing body of literature on the use of PCCs and FIBCs in
the perioperative setting was assessed to have a high degree of
methodological bias. Overall, prospective studies in the cardiac surgery
grouping suggested that patients receiving FIBC and/or PCCs required less
allogeneic blood transfusion and had less chest tube drainage. In studies
of warfarin reversal, PCCs more rapidly corrected the International
Normalized Ratio compared to plasma; however, in the setting of
intracranial hemorrhage, functional outcomes were poor regardless of the
reversal strategy. With regards to safety outcomes, reporting was not
uniform and raises concerns of underreporting. Adequately powered,
methodologically sound trials would be required for more definitive
conclusions to be drawn about the efficacy of PCCs and FIBC over
conventional blood components for the treatment of perioperative
coagulopathy in bleeding patients. 2013 Elsevier Inc.
<13>
Accession Number
2013226068
Authors
Kobashigawa J. Ross H. Bara C. Delgado J.F. Dengler T. Lehmkuhl H.B. Wang
S.-S. Dong G. Witte S. Junge G. Potena L.
Institution
(Kobashigawa) Cedars-Sinai Heart Institute, Los Angeles, CA, United States
(Ross) University Health Network, Toronto, Canada
(Bara) Hannover Medical School, Hannover, Germany
(Delgado) Hospital Universitario 12 de Octubre, Madrid, Spain
(Dengler) Klinikum Bad Friedrichshall, Bad Friedrichshall, Germany
(Lehmkuhl) Deutsches Herzzentrum Berlin, Berlin, Germany
(Wang) National Taiwan University Hospital, Taipei, Taiwan (Republic of
China)
(Dong) Novartis Pharmaceuticals Corporation, East Hanover, NJ, United
States
(Witte, Junge) Novartis Pharma AG, Basel, Switzerland
(Potena) Dipartimento Cardiovascolare, Bologna, Italy
Title
Everolimus is associated with a reduced incidence of cytomegalovirus
infection following de novo cardiac transplantation.
Source
Transplant Infectious Disease. 15 (2) (pp 150-162), 2013. Date of
Publication: April 2013.
Publisher
Blackwell Publishing Ltd (9600 Garsington Road, Oxford OX4 2XG, United
Kingdom)
Abstract
Background: Cytomegalovirus (CMV) causes several complications following
cardiac transplantation including cardiac allograft vasculopathy. Previous
studies suggested that immunosuppressive treatment based on everolimus
might reduce CMV infection. Aiming to better characterize the action of
everolimus on CMV and its interplay with patient/recipient serology and
anti-CMV prophylaxis, we analyzed data from 3 large randomized studies
comparing various everolimus regimens with azathioprine (AZA)- and
mycophenolate mofetil (MMF)-based regimens. Methods: CMV data were
analyzed from 1009 patients in 3 trials of de novo cardiac transplant
recipients who were randomized to everolimus 1.5 mg/day, everolimus 3
mg/day, or AZA 1-3 mg/kg/day, plus standard-dose (SD) cyclosporine (CsA;
study B253, n = 634); everolimus 1.5 mg/day plus SD- or reduced-dose
(RD)-CsA (study A2403, n = 199); and everolimus 1.5 mg/day plus RD-CsA or
MMF plus SD-CsA (study A2411, n = 176). Results: In study B253, patients
allocated to everolimus experienced almost a 70% reduction in odds of
experiencing CMV infection compared with AZA (P < 0.001). In study A2403,
CMV infection was low in both everolimus arms, irrespective of CsA dosing,
and in study A2411, patients allocated to everolimus experienced an 80%
reduction in odds of experiencing CMV infection, compared with MMF (P <
0.001). CMV syndrome/disease was rare and less frequent in
everolimus-treated patients. Subgroup analyses showed that the benefit
everolimus provides, in terms of CMV events, is retained in CMV-naive
recipients and is independent of anti-CMV prophylaxis or preemptive
approaches. Conclusions: Everolimus is associated with a lower incidence
of CMV infection compared with AZA and MMF, which combined with its
immunosuppressive efficacy and antiproliferative effects may positively
impact long-term outcomes. 2012 John Wiley & Sons A/S.
<14>
Accession Number
2013223705
Authors
Sinha L.M. Khan A.H. Khan A. Yunus A.
Institution
(Sinha, Khan, Yunus) Department of Cardiac Surgery, King Edward Medical
University, Mayo Hospital, Lahore, Pakistan
(Khan) Department of Anesthesia, King Edward Medical University, Mayo
Hospital, Lahore, Pakistan
Title
Should the duration of antibiotics prophylaxis be prolonged in diabetes
patients with isolated coronary artery bypass grafting?.
Source
Pakistan Journal of Medical and Health Sciences. 6 (2) (pp 495-498), 2012.
Date of Publication: April-June 2012.
Publisher
Lahore Medical And Dental College (Tulspura, North Canal Bank, Lahore,
Pakistan)
Abstract
Objective: To compare the outcome of short-term (<24 hours) versus
longer-term (>24 hours) antibiotic prophylaxis (ABP) in Diabetic patients
undergoing coronary artery bypass graft (CABG) surgery and its impact on
in-hospital incidence of deep Sternal Wound Infection (DSWI) /
Mediastinitis. Patients and method: We performed a cross sectional
comparative study in 160 Diabetic patients undergoing CABG from October
2010 through April 2012. Comparison was made between 80 diabetic patients
receiving less than 24 hours of prophylactic antibiotics with another 80
diabetic patients receiving more than 24 hours of prophylactic antibiotics
undergoing isolated CABG. Surgical Site infection (SSI) was assessed on a
daily basis during the patient's stay in the Department of Cardiac
Surgery, Mayo Hospital/KEMU, Lahore. Diagnosis of identified SSI were
based on fever, pain, redness, secretion, purulent drainage, positive
cultures, clear dehiscence of the sternotomy wound. Results: In-hospital
incidence of Deep Sternal Wound Infection (DSWI)/Mediastinitis was 7.50%
in the group <24h of ABP and 1.25% in the group receiving >24 h of ABP
therapy, and the difference was statistically significant (P=0.042).The
proportion of patients with deep-organ-space involvement (mediastinitis)
and sepsis requiring rewiring were 7 patients (8.75%) for <24 hours and 1
patients (1.25%) in >24 hours of ABP (P=0.030). Similar results were
observed in terms of mortality (8.75% Vs 1.25%). However, the
microorganisms isolated showed a similar distribution in both groups.
Morbidity, infections and the composite outcomes occurred more commonly in
diabetic patients. Conclusions: Diabetes mellitus is an important risk
factor for mortality and morbidity among those undergoing CABG. This study
documents the higher incidence of deep Sternal Wound Infection (DSWI) /
Mediastinitis associated with less than 24h of ABP therapy, suggesting the
need for prolonged ABP in Diabetic patients undergoing CABG.
<15>
Accession Number
71039176
Authors
Oto A. Aytemir K. Canpolat U. Yorgun H. Kaya E.B. Sahiner L. Asil S.
Yalcin U. Dural M. Sunman H. Kabakci G. Tokgozotlu L.
Institution
(Oto, Aytemir, Canpolat, Yorgun, Kaya, Sahiner, Asil, Yalcin, Dural,
Sunman, Kabakci, Tokgozotlu) Department of Cardiology, Hacettepe
University, Faculty of Medicine, Ankara, Turkey
Title
Current practice and applications of transvenous lead extraction using
evolution mechanical dilator sheath.
Source
International Journal of Cardiology. Conference: 9th International
Congress of Update in Cardiology and Cardiovascular Surgery Antalya
Turkey. Conference Start: 20130321 Conference End: 20130324. Conference
Publication: (var.pagings). 163 (3 SUPPL. 1) (pp S48-S49), 2013. Date of
Publication: March 2013.
Publisher
Elsevier Ireland Ltd
Abstract
Background: Transvenous lead extraction (TLE) has undergone an explosive
evolution by increasing technology due to incremental problem of lead
infections and malfunctions. We aimed to present our experience in TLE
with Evolution Mechanical Dilator Sheath. Methods: Between June 2009 and
November 2012, Evolution Mechanical Dilator Sheath was used for extraction
of 213 pacemaker (PM) and implantable cardioverter-defibrillator (ICD)
leads in 103 patients in our center. Indications for extraction,
procedural success and complications were defined according to HRS
Guidelines. Results: Indications for TLE were infection in 62 patients
(60.1%), lead malfunction in 40 patients (38.8%) and lead displacement in
1 patient (0.97%). Extracted devices were PM in 40 cases (38.8%), ICD in
42 cases (40.7%) and CRT-D in 21 cases (20.3%). Among 213 leads, 48
(22.5%) were right ventricular, 71 (33.3%) were defibrillator coil, 73
(34.2%) were atrial and 21 (9.8%) were coronary sinus electrodes. Median
time from the preceding procedure was 92 months (18- 264 months). Clinical
success was 99% and complete procedural success with Evolution system
alone was 88.3% (91 patients). Major complications were observed in 1
(0.97%) patients without any mortality. Conclusions: Our experience has
confirmed that the hand powered Evolution system is an effective
extraction tool for chronically implanted pacemaker/ICD leads. Randomized
controlled studies are required to evaluate success and complication rates
in comparison to other techniques. (Figure Presented).
<16>
Accession Number
71037877
Authors
Yim H. Jeong H. Cho Y. Park H. Jeong S. Kim H. Choi J.
Institution
(Yim, Jeong, Cho, Park, Jeong, Kim, Choi) Catholic University of Korea,
Seoul, South Korea
Title
Are selected bone marrow stem cells more effective than unselected ones in
patients with chronic myocardial infarction?.
Source
Cytotherapy. Conference: 19th Annual Meeting of the International Society
for Cellular Therapy, ISCT 2013 Auckland New Zealand. Conference Start:
20130422 Conference End: 20130425. Conference Publication: (var.pagings).
15 (4 SUPPL. 1) (pp S28), 2013. Date of Publication: April 2013.
Publisher
Informa Healthcare
Abstract
Bone marrow derived CD34+ and CD133+ cells, which exhibit endothelial
phenotypes, have been shown to contribute to neovascularization. It has
been shown that selected bone marrow stem cells (BMCs) were more effective
than unselected BMCs in the infarcted myocardium. Therefore we conducted a
systematic review to examine the effectiveness of selected BMCs on
improving LVEF from RCTs to treat CMI. We searched Medline, EMBASE, and
Cochrane database from inception to March 2012. The included studies met
the following criteria: (1) randomized controlled trials (2) CMI patients
who received coronary artery bypass graft (CABG) (3) BMCs were infused
intramuscularly (4) cell injection in periinfarct zone (6) Studies that
had up to 6 month follow-up. The initial search identified 8,433
references, 6 RCTs were met the inclusion criteria. Two of 6 trials
injected selected bone marrow stem cell such as CD34+ and CD133+ and 4 of
6 trials injected unselected BMC to the treatment group. Significant
treatment effect in the studies in which the treatment group injected
CD34+ and CD133+ selected BMC as indicated the LVEF change of 8.61% (95%
CI 6.52 to 10.70) and the studies that infused unselected BMC showed
improvement in LVEF by 4.81% (95% CI, 2.07 to 7.55). The results showed
that selected BMCs were more effective than unselected BMCs. However, the
trials infused selected BMCs tended to use less rigorous study design that
those using unselected BMCs. That is, the trials which were infused
selected stem cell they neither conduct bone marrow aspiration nor sharm
injection in the control group to ascertain blindness. Also they assessed
outcomes with echocardiography instead of MRI that was known to more
precise tool. The intervention effect might be overestimated due to the
study design. Therefore these treatment effects depending on the
difference cell type should be interpreted cautiously.
<17>
Accession Number
71035603
Authors
Phan A. Kittleson M. Patel J. Rafiei M. Osborne A. Chang D. Czer L. Ramzy
D. Esmailian F. Kobashigawa J.
Institution
(Phan, Kittleson, Patel, Rafiei, Osborne, Chang, Czer, Ramzy, Esmailian,
Kobashigawa) Cedars-Sinai Heart Institute, Los Angeles, CA, United States
Title
Atg induction improves outcome for sensitized patients who have undergone
heart transplantation.
Source
Journal of Heart and Lung Transplantation. Conference: 33rd Annual Meeting
and Scientific Sessions of the International Society for Heart and Lung
Transplantation, ISHLT 2013 Montreal, QC Canada. Conference Start:
20130424 Conference End: 20130427. Conference Publication: (var.pagings).
32 (4 SUPPL. 1) (pp S200), 2013. Date of Publication: April 2013.
Publisher
Elsevier USA
Abstract
Purpose: Heart transplant recipients who are sensitized pre transplant are
at increased risk for the development of antibody mediated and cellular
rejection post transplantation. The use of induction therapy with
anti-thymocyte globulin (ATG) may reduce the incidence of antibody
mediated rejection (AMR), but this has not been formally studied in a
randomized controlled trial. The purpose of this study was to determine
the impact of ATG induction on the incidence of AMR in a large
single-center experience. Methods and Materials: We identified 170 heart
transplant (HTx) patients transplanted between January 1994 and October
2011, with pre-transplant panel reactive antibodies (PRA) > 10%. Induction
therapy was given based on the treating physician's preference. One-year
outcomes were assessed, including the incidence of treated rejection and
pathology-defined AMR. Results: Of the 170 HTx, 91 received ATG induction
and 79 did not. The mean pre-transplant PRA was significantly higher in
the ATG group (59 +/- 31% vs 43 +/- 32%>,p=0.0015). In the ATG induction
group, there were fewer treated rejection episodes (14% vs 30%,p= 0.01)
and fewer pathology-defined AMR episodes (12% vs 26%, p=0.016). There was
no difference in the incidence of cellular rejection (12% in both groups).
(Table presented) Conclusions: ATG induction therapy for sensitized
patients results in fewer treated rejection epiosdes and a decreased
incidence of pathology-defined AMR. This suggests that ATG induction is
beneficial in sensitized patients, and the results should be confirmed
with a randomized trial.
<18>
Accession Number
71035344
Authors
Khuu T. Cheng R.K. Cadeiras M. Allareddy M. Baas A. Cruz D. Depasquale E.
Rickey A. Kubak B. Nsair A. Holt C. Fishbein M.C. Kwon M.H. Ardehali A.
Shemin R.J. Reed E.F. Deng M.C.
Institution
(Cheng, Cadeiras, Allareddy, Baas, Cruz, Depasquale, Rickey, Kubak, Nsair,
Deng) Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA, United
States
(Khuu) Heart and Lung Transplant, Ronald Reagan UCLA Medical Center, Los
Angeles, CA, United States
(Holt, Kwon, Ardehali, Shemin) Surgery, Ronald Reagan UCLA Medical Center,
Los Angeles, CA, United States
(Fishbein) Pathology and Lab Med, Ronald Reagan UCLA Medical Center, Los
Angeles, CA, United States
(Reed) Pathology-Immunogenetics Center, Ronald Reagan UCLA Medical Center,
Los Angeles, CA, United States
Title
Comparing bortezomib to traditional therapies for antibody-mediated
rejection (AMR): Out with the old?.
Source
Journal of Heart and Lung Transplantation. Conference: 33rd Annual Meeting
and Scientific Sessions of the International Society for Heart and Lung
Transplantation, ISHLT 2013 Montreal, QC Canada. Conference Start:
20130424 Conference End: 20130427. Conference Publication: (var.pagings).
32 (4 SUPPL. 1) (pp S110), 2013. Date of Publication: April 2013.
Publisher
Elsevier USA
Abstract
Purpose: Novel therapies are emerging for treatment of AMR, but minimal
data is available comparing efficacy and safety with prevailing
treatments. We tested whether the efficacy of bortezomib (Bzb) in lowering
donor antibody antibodies (DSA) was improved over standard plasmapheresis
(PP)/ IVIG or rituximab therapy for AMR. Methods and Materials: Ten adult
heart transplant recipients with DSA mean fluorescence intensity (MFI)
>1000, biopsy-proven, and/or clinically suspicious AMR were treated for 20
episodes between February 2010 to August 2012. Treatment consisted of PP
(5 days) with IVIG (2 g/kg), rituximab (375 mg/m2), and/or Bzb (0.7-1
mg/m2 x 4) at least 30 days apart. Antibody titers were measured via
single antigen Luminex assay before and after therapy. Parametric and
non-parametric comparisons, linear and logistic regression were used as
appropriate to assess outcomes. Results: There was a greater reduction in
DSA with Bzb therapy (beta-0.58, 95% CI 0.16-0.90, p-0.01) when adjusting
for time to AMR. In those with compromised ejection fraction, there was
improvement after Bzb therapy (p-0.03). Patient survival in both groups
was 100% at 60 days. Conclusions: Compared to PP/IVIG or rituximab, Bzb
was more effective in reducing DSA without a significant effect on the
incidence of infection or survival in this limited data set. There is
indication for a randomized controlled trial comparing Bzb to standard AMR
therapies to help determine clinical and survival benefit. (Table
presented).
<19>
Accession Number
71035283
Authors
Nytreen K. Lene Annette R. Ingrid E. Pail A. Thor U. Tove L. Einar G. Nils
W.E. Anders H. Svend A. Lars G. Satish A.
Institution
(Nytreen, Lene Annette, Ingrid, Pail, Einar, Nils, Anders, Svend, Lars,
Satish) Department of Cardiology, Oslo University Hospital,
Rikshospitalet, Oslo, Norway
(Thor, Tove) Research Institute for Internal Medicine, Oslo University
Hospital, Rikshospitalet, Oslo, Norway
(Lene Annette) Department of Circulation and Medical Imaging, Norwegian
University of Science and Technology, Trondheim, Norway
(Pail, Lars) Faculty of Medicine, University of Oslo, Oslo, Norway
Title
High intensity interval training reduces progression of cardiac allograft
vasculopathy among heart transplant recipients - Results from a randomized
controlled trial.
Source
Journal of Heart and Lung Transplantation. Conference: 33rd Annual Meeting
and Scientific Sessions of the International Society for Heart and Lung
Transplantation, ISHLT 2013 Montreal, QC Canada. Conference Start:
20130424 Conference End: 20130427. Conference Publication: (var.pagings).
32 (4 SUPPL. 1) (pp S27), 2013. Date of Publication: April 2013.
Publisher
Elsevier USA
Abstract
Purpose: Cardiac allograft vasculopathy (CAV) is a progressive form of
atherosclerosis occurring in heart transplant (HTx) recipients,
contributing to increased morbidity and mortality. High intensity interval
training (HIIT) is effective in patients with coronary artery disease,
resulting in reduced progression of atherosclerosis, but its effect in HTx
has not been investigated. We hypothesized that HIIT also would reduce the
progression of CAV in HTx patients. Methods and Materials: Forty-three
clinically stable HTx recipients > 18 years old, were randomized to either
HIIT or control group (standard care) for one year. Baseline and one year
maximal exercise testing on a treadmill, together with measurement of
inflammatory biomarkers and intravascular ultrasound (IVUS), were
performed. Results: The mean+/-SD age was 51 +/-16 years, 67% were male
and time post HTx was 4.0 +/-2.2 years. VO2peak (mL/kg/min) improvement
was 2.9+/-2.9 in the HIIT group as compared to -0.3+/-2.9 in the control
group (p<0.001), corresponding to 89% and 82% of expected VO2peak level,
respectively. IVUS analysis revealed a mean increase [95% CI] in percent
atheroma volume (PAV) of 0.9 [-0.3, 1.9]% in the HIIT group, as compared
to 2.5 [1.6, 3.5]% in the control group (p=0.021). Similarly, mean
increase [95%CI] in maximal intimal thickness (MIT) was 0.02 [0.01, 0.04]
mm in the HIIT group as compared to 0.05 [0.03, 0.08] mm in the control
group (p=0.054). Qualitative plaque progression (virtual histology
parameters) and inflammatory activity (biomarkers) were similar between
the two groups during the study period. Conclusions: High intensity
interval training among maintenance HTx recipients resulted in a
significantly slower rate of CAV progression as assessed by PAV, and
borderline significant by MIT. Furthermore, improvement in VO2peak was
significantly greater in patients treated with HIIT, suggesting that
routine implementation of exercise protocols could help reduce morbidity
and mortality among HTx recipients.
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