Results Generated From:
Embase <1980 to 2013 Week 26>
Embase (updates since 2013-06-20)
<1>
Accession Number
2012661383
Authors
Hammoudeh A. Saleh A. Hamam I. Alhaddad I. Bakri M. Nammas A. Alnaquib A.
Izraiq M. Tarawneh H. Harassis A. Tabbalat R. Khader Y. Al-Mousa E.
Institution
(Hammoudeh, Izraiq, Al-Mousa) Cardiology Department, Istishari Hospital,
Amman, Jordan
(Saleh, Hamam) Cardiology Division, Internal Medicine Department, Jordan
University Hospital, Amman, Jordan
(Alhaddad, Bakri) Cardiology Department, Jordan Hospital Medical Center,
Amman, Jordan
(Nammas, Alnaquib) Cardiology Division, Internal Medicine Department,
Islamic Hospital, Amman, Jordan
(Tarawneh, Harassis, Tabbalat) Cardiology Department, Khalidi Hospital
Medical Center, Amman, Jordan
(Khader) Department of Community Medicine, Public Health and Family
Medicine, School of Medicine Jordan University of Science and Technology,
Irbid, Jordan
Title
The prognostic implications of TIMI risk scores in Jordanian patients with
acute coronary syndrome. Results from the glucometabolic abnormalities in
acute coronary syndrome in Jordan (GLORY) study.
Source
Jordan Medical Journal. 46 (3) (pp 237-245), 2012. Date of Publication:
September 2012.
Publisher
University of Jordan (Amman 11942, Jordan)
Abstract
Background and Aims: Western studies have shown that TIMI (Thrombolysis In
Myocardial Infarction) risk scores predict adverse events in patients with
non ST-elevation acute coronary syndrome (NSTEACS) and ST-elevation
myocardial infarction (STEMI). Whether this also applies to Jordanian
patients is largely unknown. Materials and Methods: We prospectively
followed up 656 patients with ACS for total mortality, combined events of
death, nonfatal MI or urgent coronary revascularization up to one year
after admission. Results: Of the whole group, 472 patients (72%) had
NSTEACS, and 184 patients (28%) had STEMI. Among NSTEACS patients, 31.0%
had a low risk score (total points 0-2 of 7), 43.5% had an intermediate
risk score (total points 3-4), and 25.5% had a high risk score (total
points 5-7). In-hospital mortality was not different in the respective
risk score groups (1.4%, 0.5%, and 3.4%, p = 0.123). At 1 year, mortality
was significantly higher in the high risk score group (12.8%) compared
with the intermediate (4%) and low (1.4%) risk groups (p = 0.001). Among
STEMI patients, 58.6% had a low risk score (total points 0-3 of 13-14),
31.0% had a low intermediate risk score (total points 4-6), 8.0% had a
high intermediate score (total points 7-9), and 2.4% had a high risk score
(total points > 10). In-hospital mortality rate was significantly higher
in the two intermediate risk score groups (7.4%, 14.3%, respectively) and
the high risk score group (50%) compared with the low risk score group
(1.0%, p = 0.001). The high risk and the two intermediate risk groups also
had higher one-year mortality (75%, 28.6% and 16.7%, respectively) than
the low risk group (3.9%, p = 0.001). Similarly, composite events occurred
at a significantly higher rate in patients with high risk scores than
intermediate or low risk scores among NSTEACS and STEMI patients.
Conclusions: In Jordanian ACS patients, high TIMI risk scores were
associated with a high risk of cardiovascular events. Such patients are
candidates for early aggressive therapeutic strategies. 2012 DAR
Publishers/University of Jordan. All Rights Reserved.
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Accession Number
2013102178
Authors
Kotwal S. Jun M. Sullivan D. Perkovic V. Neal B.
Institution
(Kotwal, Jun, Perkovic, Neal) George Institute for Global Health,
University of Sydney, PO Box M201, Sydney, NSW 2050, Australia
(Sullivan) University of Sydney, Sydney, Australia
Title
Omega 3 fatty acids and cardiovascular outcomes: Systematic review and
meta-analysis.
Source
Circulation: Cardiovascular Quality and Outcomes. 5 (6) (pp 808-818),
2012. Date of Publication: November 2012.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Background-Early trials evaluating the effect of omega 3 fatty acids (?-3
FA) reported benefits for mortality and cardiovascular events but recent
larger studies trials have variable findings. We assessed the effects of
?-3 FA on cardiovascular and other important clinical outcomes. Methods
and Results-We searched MEDLINE, EMBASE, and the Cochrane Central Register
of Controlled Trials for all randomized studies using dietary supplements,
dietary interventions, or both. The primary outcome was a composite of
cardiovascular events (mostly myocardial infarction, stroke, and
cardiovascular death). Secondary outcomes were arrhythmia, cerebrovascular
events, hemorrhagic stroke, ischemic stroke, coronary revascularization,
heart failure, total mortality, nonvascular mortality, and end-stage
kidney disease. Twenty studies including 63 030 participants were
included. There was no overall effect of ?-3 FA on composite
cardiovascular events (relative risk [RR]=0.96; 95% confidence interval
[CI], 0.90-1.03; P=0.24) or on total mortality (RR=0.95; 95% CI,
0.86-1.04; P=0.28). ?-3 FA did protect against vascular death (RR=0.86;
95% CI, 0.75-0.99; P=0.03) but not coronary events (RR=0.86; 95% CI,
0.67-1.11; P=0.24). There was no effect on arrhythmia (RR=0.99; 95% CI,
0.85-1.16; P=0.92) or cerebrovascular events (RR=1.03; 95% CI, 0.92-1.16;
P=0.59). Adverse events were more common in the treatment group than the
placebo group (RR=1.18, 95% CI, 1.02-1.37; P=0.03), predominantly because
of an excess of gastrointestinal side effects. Conclusions-?-3 FA may
protect against vascular disease, but the evidence is not clear-cut, and
any benefits are almost certainly not as great as previously believed.
2012 American Heart Association, Inc.
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Accession Number
2013102175
Authors
Pettit S.J. Jhund P.S. Hawkins N.M. Gardner R.S. Haj-Yahia S. McMurray
J.J.V. Petrie M.C.
Institution
(Pettit, Gardner, Haj-Yahia, Petrie) Scottish National Advanced Heart
Failure Service, Golden Jubilee National Hospital, Agamemnon St,
Clydebank, Glasgow, G81 4DY, United Kingdom
(Jhund, McMurray) Institute of Cardiovascular and Medical Sciences, BHF
Glasgow Cardiovascular Research Center, University of Glasgow, Glasgow,
United Kingdom
(Hawkins) Institute of Cardiovascular Medicine and Science, Liverpool
Heart and Chest Hospital, Liverpool, United Kingdom
Title
How small is too small? A systematic review of center volume and outcome
after cardiac transplantation.
Source
Circulation: Cardiovascular Quality and Outcomes. 5 (6) (pp 783-790),
2012. Date of Publication: November 2012.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Background-The aim of this study was to assess the relationship between
the volume of cardiac transplantation procedures performed in a center and
the outcome after cardiac transplantation. Methods and Results-PubMed,
Embase, and the Cochrane library were searched for articles on the
volume-outcome relationship in cardiac transplantation. Ten studies were
identified, and all adopted a different approach to data analysis and
varied in adjustment for baseline characteristics. The number of patients
in each study ranged from 798 to 14 401, and observed 1-year mortality
ranged from 12.6% to 34%. There was no association between the continuous
variables of center volume and observed mortality. There was a weak
association between the continuous variables of center volume and adjusted
mortality up to 1 year and a stronger association at 5 years. When centers
were grouped in volume categories, low-volume centers had the highest
adjusted mortality, intermediate-volume centers had lower adjusted
mortality, and high-volume centers had the lowest adjusted mortality but
were not significantly better than intermediate-volume centers. Category
limits were arbitrary and varied between studies. Conclusions-There is a
relationship between center volume and mortality in heart transplantation.
The existence of a minimum acceptable center volume or threshold is
unproven. However, a level of 10 to 12 heart transplants per year
corresponds to the upper limit of low-volume categories that may have
relatively higher mortality. It is not known whether outcomes for patients
treated in low-volume transplant centers would be improved by reorganizing
centers to ensure volumes in excess of 10 to 12 heart transplants per
year. 2012 American Heart Association, Inc.
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Accession Number
2013102171
Authors
Schneider R.H. Grim C.E. Rainforth M.V. Kotchen T. Nidich S.I.
Gaylord-King C. Salerno J.W. Kotchen J.M. Alexander C.N.
Institution
(Schneider, Rainforth, Nidich, Gaylord-King, Salerno, Alexander) Institute
for Natural Medicine and Prevention, Maharishi University of Management,
Fairfield, IA 52556, United States
(Schneider, Rainforth, Nidich, Gaylord-King, Salerno) Center for Natural
Medicine and Prevention, Maharishi University of Management Research
Institute, Maharishi Vedic City, IA, United States
(Grim, Kotchen, Kotchen) Department of Medicine, Medical College of
Wisconsin, Milwaukee, WI, United States
Title
Stress reduction in the secondary prevention of cardiovascular disease:
Randomized, controlled trial of transcendental meditation and health
education in blacks.
Source
Circulation: Cardiovascular Quality and Outcomes. 5 (6) (pp 750-758),
2012. Date of Publication: November 2012.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Background-Blacks have disproportionately high rates of cardiovascular
disease. Psychosocial stress may contribute to this disparity. Previous
trials on stress reduction with the Transcendental Meditation (TM) program
have reported improvements in cardiovascular disease risk factors,
surrogate end points, and mortality in blacks and other populations.
Methods and Results-This was a randomized, controlled trial of 201 black
men and women with coronary heart disease who were randomized to the TM
program or health education. The primary end point was the composite of
all-cause mortality, myocardial infarction, or stroke. Secondary end
points included the composite of cardiovascular mortality,
revascularizations, and cardiovascular hospitalizations; blood pressure;
psychosocial stress factors; and lifestyle behaviors. During an average
follow-up of 5.4 years, there was a 48% risk reduction in the primary end
point in the TM group (hazard ratio, 0.52; 95% confidence interval,
0.29-0.92; P=0.025). The TM group also showed a 24% risk reduction in the
secondary end point (hazard ratio, 0.76; 95% confidence interval,
0.51-0.1.13; P=0.17). There were reductions of 4.9 mm Hg in systolic blood
pressure (95% confidence interval -8.3 to -1.5 mm Hg; P=0.01) and anger
expression (P<0.05 for all scales). Adherence was associated with
survival. Conclusions-A selected mind-body intervention, the TM program,
significantly reduced risk for mortality, myocardial infarction, and
stroke in coronary heart disease patients. These changes were associated
with lower blood pressure and psychosocial stress factors. Therefore, this
practice may be clinically useful in the secondary prevention of
cardiovascular disease. 2012 American Heart Association, Inc.
<5>
Accession Number
2010134120
Authors
Van Munster B.C. De Rooij S.E.J.A. Yazdanpanah M. Tienari P.J. Pitkala
K.H. Osse R.J. Adamis D. Smit O. Van Der Steen M.S. Van Houten M. Rahkonen
T. Sulkava R. Laurila J.V. Strandberg T.E. Tulen J.H.M. Zwang L. MacDonald
A.J.D. Treloar A. Sijbrands E.J.G. Zwinderman A.H. Korevaar J.C.
Institution
(Van Munster, Zwinderman, Korevaar) Department of Clinical Epidemiology
and Biostatistics, Academic Medical Center, University of Amsterdam,
Amsterdam, Netherlands
(Van Munster, De Rooij) Department of Internal Medicine, Academic Medical
Centre, P.O. Box 22660, 1100 DD Amsterdam, Netherlands
(Yazdanpanah, Sijbrands) Department of Internal Medicine, Erasmus MC,
Rotterdam, Netherlands
(Tienari) Department of Neurology, Helsinki University Central Hospital,
Helsinki, Finland
(Pitkala) Helsinki University Central Hospital, Unit of General Practice,
Helsinki, Finland
(Osse, Tulen) Department of Psychiatry, Erasmus MC, Rotterdam, Netherlands
(Adamis) Psychiatry, Research and Academic Institute of Athens, Athens,
Greece
(Smit) Department of Internal Medicine, VU Medical Center, Amsterdam,
Netherlands
(Van Der Steen) Intensive Care, Gelderse Vallei Hospital, Ede, Netherlands
(Van Houten) Department of Geriatrics, Parnassia, Den Haag, Netherlands
(Rahkonen, Sulkava) Department of Geriatrics, School of Public Health and
Clinical Nutrition, University of Kuopio, Kuopio, Finland
(Laurila) Helsinki University Central Hospital, Clinics of General
Internal Medicine and Geriatrics, Helsinki, Finland
(Strandberg) Oulu University Hospital, Unit of General Practice, Oulu,
Finland
(Zwang) Department of Clinical Chemistry, Erasmus MC, Rotterdam,
Netherlands
(MacDonald) Elderly Care Unit, St. Thomas' Hospital, Westminster, London,
United Kingdom
(Treloar) Memorial Hospital, Shooters Hill, London, United Kingdom
(Tienari) Molecular Neurology Programme, University of Helsinki, Helsinki,
Finland
Title
The association of the dopamine transporter gene and the dopamine receptor
2 gene with delirium, a meta-analysis.
Source
American Journal of Medical Genetics, Part B: Neuropsychiatric Genetics.
153 (2) (pp 648-655), 2010. Date of Publication: March 2010.
Publisher
Wiley-Liss Inc. (111 River Street, Hoboken NJ 07030-5774, United States)
Abstract
Delirium is the most common neuropsychiatric syndrome in elderly ill
patients. Previously, associations between delirium and the dopamine
transporter gene (solute carrier family 6, member 3 (SLC6A3)) and dopamine
receptor 2 gene (DRD2) were found. The aim of this study was to validate
whether markers of the SLC6A3 and DRD2 genes are were associated with
delirium in independent populations. Six European populations collected
DNA of older delirious patients. Associations were determined per
population and results were combined in a meta-analysis. In total 820
medical inpatients, 185 cardiac surgery patients, 134 non-cardiac surgery
patients and 502 population-based elderly subjects were included. Mean age
was 82 years (SD 7.5 years), 598 (36%) were male, 665 (41%) had
pre-existing cognitive impairment, and 558 (34%) experienced delirium. The
SLC6A3 rs393795 homozygous AA genotype was more frequent in patients
without delirium in all populations. The meta-analysis showed an Odds
Ratio (OR) for delirium of 0.4 (95% confidence interval (C.I.) 0.2-0.6,
P=0.0003) for subjects with AA genotype compared to the AG and GG
genotypes. SLC6A3 marker rs1042098 showed no association with delirium. In
meta-analysis the DRD2 rs6276 homozygous GG genotype showed an OR of 0.8
for delirium (95% C.I. 0.6-1.1, P=0.24). When subjects were stratified for
cognitive status the rs6276 GG genotype showed ORs of 0.6 (95% C.I.
0.4-1.0, P=0.06) and 0.8 (95% C.I. 0.5-1.5, P=0.51) for delirium in
patients with and without cognitive impairment, respectively. In
independent cohorts, a variation in the SLC6A3 gene and possibly the DRD2
gene were found to protect for delirium. 2009 Wiley-Liss, Inc.
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Accession Number
2010688765
Authors
Chaitman B.R. Hartigan P.M. Booth D.C. Teo K.K. Mancini J. Kostuk W.J.
Spertus J.A. Maron D.J. Dada M. O'Rourke R.A. Weintraub W.S. Berman D.S.
Shaw L.J. Boden W.E.
Institution
(Chaitman) Department of Internal Medicine, Saint Louis University, School
of Medicine, 1034 S Brentwood Blvd, St. Louis, MO 63117, United States
(Hartigan) VA Connecticut Healthcare System, West Haven, CT, United States
(Booth) Lexington VA Medical Center, Lexington, KY, United States
(Teo) McMaster University, Medical Center, Hamilton, ON, Canada
(Mancini) Department of Medicine, Vancouver Hospital and Health Sciences
Center, Vancouver, BC, Canada
(Kostuk) London Health Sciences Centre, London, ON, Canada
(Spertus) Mid America Heart Institute, UMKC, Kansas City, MO, United
States
(Maron) Vanderbilt University, Medical Center, Nashville, TN, United
States
(Dada) Hartford Hospital, Hartford, CT, United States
(O'Rourke) Audie Murphy VAMC, San Antonio, TX, United States
(Weintraub) Christiana Care Health System, Newark, DE, United States
(Berman) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Shaw) Emory University, Atlanta, GA, United States
(Boden) Western New York VA Healthcare Network and Buffalo General
Hospital, SUNY, Buffalo, NY, United States
Title
Do major cardiovascular outcomes in patients with stable ischemic heart
disease in the Clinical Outcomes Utilizing Revascularization and
Aggressive Drug Evaluation trial differ by healthcare system?.
Source
Circulation: Cardiovascular Quality and Outcomes. 3 (5) (pp 476-483),
2010. Date of Publication: September 2010.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Background: The Clinical Outcomes Utilizing Revascularization and
Aggressive Drug Evaluation (COURAGE) trial enrolled patients from 3
distinct healthcare systems (HCSs) in North America. The primary aim of
this study was to determine whether there is a treatment difference in
cardiovascular outcomes by HCS. Methods and Results: The study population
included 968 patients from the US Department of Veterans Affairs (VA), 386
from the US non-VA, and 931 from Canada with different comorbidities and
prognoses. The primary outcome was all-cause mortality or nonfatal
myocardial infarction (MI) during the median 4.6-year follow-up. Baseline
demographics were similar between percutaneous coronary intervention and
optimal medical therapy treatment groups within each HCS. After follow-up,
the primary end point of total mortality and nonfatal MI was not
statistically significant between percutaneous coronary intervention and
optimal medical therapy, regardless of HCS: VA, 22.3% versus 21.9% (hazard
ratio, 1.05; 95% CI, 0.80-1.38; P=0.95); US non-VA, 15.8% versus 21.8%
(hazard ratio, 0.70; 95% CI, 0.43-1.12; P=0.24); Canadian HCS, 17.3%
versus 13.5% (hazard ratio, 1.30; 95% CI, 0.93-1.83; P=0.17). The
interaction between HCSs and treatment was not statistically significant.
Long-term mortality was significantly higher in the VA system as a result
of significantly greater comorbidity and worse left ventricular function.
Conclusions: In the COURAGE trial, addition of percutaneous coronary
intervention to optimal medical therapy did not improve 5-year survival or
reduce MI or other major adverse cardiovascular events regardless of
whether patients were Canadian or American or US veterans or nonveterans.
Outcome differences were largely explained by differences in baseline
characteristics known to affect long-term prognosis. Clinical Trial
Registration: URL: http://www.clinicaltrials.gov. Unique identifier:
NCT00007657. 2010 American Heart Association, Inc.
<7>
Accession Number
2010625414
Authors
He J. Li S. Shao W. Wang D. Chen M. Yin W. Wang W. Gu Y. Zhong B.
Institution
(He, Li, Shao, Wang, Chen, Yin, Wang, Zhong) Department of Cardiothoracic
Surgery, First Affiliated Hospital, Guangzhou Medical College, No. 151,
Yanjiang Rd, Guangzhou 510120, Guangdong Province, China
(He, Li, Shao, Wang, Chen, Yin, Wang, Zhong) Guangzhou Research Institute
of Respiratory Disease, China State Key Laboratory of Respiratory Disease,
Guangzhou, China
(Gu) Department of Pathology, First Affiliated Hospital, Guangzhou Medical
College, Guangzhou, China
Title
Activated carbon nanoparticles or methylene blue as tracer during
video-assisted thoracic surgery for lung cancer can help pathologist find
the detected lymph nodes.
Source
Journal of Surgical Oncology. 102 (6) (pp 676-682), 2010. Date of
Publication: 01 Nov 2010.
Publisher
Wiley-Liss Inc. (111 River Street, Hoboken NJ 07030-5774, United States)
Abstract
Background To assess whether using methylene blue (MB) or activated carbon
nanoparticles as tracer can increase the detected number of lymph nodes in
the systematic nodal dissected tissue during Video-Assisted Thoracic
Surgery (VATS) for non-small cell lung cancer. Methods Three groups of 20
patients each were obtained from randomization of 60 patients with NSCLC
requiring VATS with systematic nodal dissection (SND) from February 2007
and December 2008, there were 17, 16, and 17 patients in group A
(injection activated carbon nanoparticles), group B (injection MB), and
group C (controls), respectively. Results There was difference of the
total number of dissected lymph nodes per patient among three groups (P <
0.001). The total number of dissected LNs and mediastinal nodes per
patient in group A and group B was more than in group C (P < 0.001). There
were 20, 18, and 14 metastatic LNs dissected in 6, 6, and 7 patients of
group A, B, and C, respectively. There was difference of total number of
dissected metastatic LNs per patient among three groups (P = 0.002).
Conclusions MB can be as effective as activated carbon nanoparticles being
tracer to increase the detected number of LNs in the systematic nodal
dissected tissue during VATS for NSCLC. 2010 Wiley-Liss, Inc.
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Accession Number
2010293813
Authors
Melsop K. Brooks M.M. Boothroyd D.B. Hlatky M.A.
Institution
(Melsop, Boothroyd, Hlatky) Stanford University School of Medicine,
Stanford, CA, United States
(Brooks) University of Pittsburgh, Graduate School of Public Health,
Pittsburgh, PA, United States
Title
Effect of race on the clinical outcomes in the bypass angioplasty
revascularization investigation trial.
Source
Circulation: Cardiovascular Quality and Outcomes. 2 (3) (pp 186-190),
2009. Date of Publication: May 2009.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Background-In observational studies, clinical outcomes for black patients
with coronary disease have been worse than for white patients. There are
few data from randomized trials comparing the outcomes of coronary
revascularization between black patients and white patients. Methods and
Results-We analyzed data from the Bypass Angioplasty Revascularization
Investigation randomized trial. At study entry, the 113 black patients had
significantly higher rates of diabetes, hypertension, smoking, heart
failure, and abnormal left ventricular function than the 1653 white
patients. Black patients had significantly higher mortality than white
patients (hazard ratio, 2.16; P<0.001), which remained significant after
statistical adjustment for differences in baseline clinical
characteristics (hazard ratio, 1.59; P=0.003). In a substudy of economic
and quality of life outcomes, the 67 black patients had similar frequency
of physician visits and use of evidence-based cardiac medications but
significantly worse physical function scores than the 885 white patients.
The effect of random assignment to either surgery or angioplasty on
clinical outcomes was not significantly modified by race (interaction
probability values >=0.18). Conclusions-Clinical outcomes of black
patients after coronary revascularization were worse than those of white
patients in a clinical trial setting with similar treatment and access to
care. The differences in outcome between black and white patients were not
completely attributable to the greater levels of comorbidity among black
patients at study entry. (Circ Cardiovasc Qual Outcomes. 2009;2:186-190.)
2009 American Heart Association, Inc.
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Accession Number
2010227605
Authors
Orth-Gomer K. Schneiderman N. Wang H.-X. Walldin C. Blom M. Jernberg T.
Institution
(Orth-Gomer) Department of Public Health Sciences, Karolinska Institute,
Stockholm, Sweden
(Schneiderman) Behavioral Medicine Program, Department of Psychology,
University of Miami, Miami, FL, United States
(Wang) Department of Neurobiology, Care Sciences and Society, Aging
Research Center, University of Miami, Miami, FL, United States
(Walldin, Blom, Jernberg) Department of Cardiology, Karolinska University
Clinics, Stockholm, Sweden
(Orth-Gomer) Department of Psychosomatics, Campus Benjamin Franklin,
Charite Universitatsmedizin, Berlin, Germany
Title
Stress reduction prolongs life in women with coronary disease: The
Stockholm women's intervention trial for coronary heart disease (SWITCHD).
Source
Circulation: Cardiovascular Quality and Outcomes. 2 (1) (pp 25-32), 2009.
Date of Publication: January 2009.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Background: Psychosocial stress may increase risk and worsen prognosis of
coronary heart disease in women. Interventions that counteract women's
psychosocial stress have not previously been presented. This study
implemented a stress reduction program for women and investigated its
ability to improve survival in women coronary patients. Methods and
Results: Two hundred thirty-seven consecutive women patients, aged 75
years or younger, hospitalized for acute myocardial infarction, coronary
artery bypass grafting, or percutaneous coronary intervention were
randomized to a group-based psychosocial intervention program or usual
care. Initiated 4 months after hospitalization, intervention groups of 4
to 8 women met for a total of 20 sessions that were spread over a year. We
provided education about risk factors, relaxation training techniques,
methods for self-monitoring and cognitive restructuring, with an emphasis
on coping with stress exposure from family and work, and self-care and
compliance with clinical advice. From randomization until end of follow-up
(mean duration, 7.1 years), 25 women (20%) in the usual care and 8 women
(7%) in the stress reduction died, yielding an almost 3-fold protective
effect of the intervention (odds ratio, 0.33; 95% CI, 0.15 to 0.74;
P=0.007). Introducing baseline measures of clinical prognostic factors,
including use of aspirin, beta-blockers, angiotensin-converting enzyme
inhibitors, calcium-channel blockers, and statins into multivariate models
confirmed the unadjusted results (P=0.009). Conclusions: Although
mechanisms remain unclear, a group-based psychosocial intervention program
for women with coronary heart disease may prolong lives independent of
other prognostic factors. 2009 American Heart Association, Inc.
<10>
Accession Number
2013383913
Authors
Leonardi S. Tricoci P. White H.D. Armstrong P.W. Huang Z. Wallentin L.
Aylward P.E. Moliterno D.J. Van De Werf F. Chen E. Providencia L.
Nordrehaug J.E. Held C. Strony J. Rorick T.L. Harrington R.A. Mahaffey
K.W.
Institution
(Leonardi, Tricoci, Huang, Rorick, Mahaffey) Duke Clinical Research
Institute, Durham, NC, United States
(Leonardi) Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100
Pavia, Italy
(White) Green Lane Cardiovascular Service, Auckland, New Zealand
(Armstrong) Division of Cardiology, University of Alberta, Edmonton,
Canada
(Wallentin, Held) Department of Medical Sciences, Uppsala Clinical
Research Center, Uppsala University, Uppsala, Sweden
(Aylward) Department of Cardiovascular Medicine, Flinders Medical Centre,
Bedford Park, Australia
(Moliterno) Gill Heart Institute and Division of Cardiovascular Medicine,
University of Kentucky, Lexington, KY, United States
(Van De Werf) Department of Cardiology, University of Leuven, Leuven,
Belgium
(Chen, Strony) Merck, Whitehouse Station, NJ, United States
(Providencia) Division of Cardiology, Hospitais da Universidade de
Coimbra, Coimbra, Portugal
(Nordrehaug) Institute of Medicine, Medical-Odontological Faculty,
University of Bergen, Bergen, Norway
(Harrington) Department of Medicine, Stanford University, Stanford, CA,
United States
Title
Effect of vorapaxar on myocardial infarction in the thrombin receptor
antagonist for clinical event reduction in acute coronary syndrome
(TRACER) trial.
Source
European Heart Journal. 34 (23) (pp 1723-1731), 2013. Date of Publication:
14 Jun 2013.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
AimsThe TRACER trial compared vorapaxar, a novel platelet
protease-activated receptor (PAR)-1 antagonist, with placebo in 12 944
patients with high-risk non-ST-segment elevation acute coronary syndromes
(NSTE ACS). In this analysis, we explored the effect of vorapaxar on
myocardial infarction (MI).Methods and resultsA blinded, independent
central endpoint adjudication committee prospectively defined and
classified MI according to the universal MI definition, including peak
cardiac marker value (creatine kinase-MB [CK-MB] and/or troponin). Because
the trial failed to meet its primary endpoint, these analyses are
considered exploratory. During a median follow-up of 502 days, 1580 MIs
occurred in 1319 patients. The majority (n = 1025, 64.9%) were type 1
(spontaneous) MI, followed by type 4a [percutaneous coronary intervention
(PCI)-related] MI (n = 352; 22.3%). Compared with placebo, vorapaxar
reduced the hazard of a first MI of any type by 12% [hazard ratio (HR),
0.88; 95% confidence interval (CI), 0.79-0.98; P = 0.021] and the hazard
of total number of MIs (first and subsequent) by 14% (HR, 0.86; 95% CI,
0.77-0.97; P = 0.014), an effect that was sustained over time. Vorapaxar
reduced type 1 MI by 17% (HR, 0.83; 95% CI, 0.73-0.95; P = 0.007). Type 4a
MIs were not significantly reduced by vorapaxar (HR, 0.90; 95% CI,
0.73-1.12; P = 0.35). Vorapaxar effect was consistent across MI sizes
defined by peak cardiac marker elevations and across key clinical
subgroups; however, in patients not treated with thienopyridine at
baseline (HR, 0.65; 95% CI, 0.46-0.92) compared with patients who received
thienopyridine (HR, 0.91; 95% CI, 0.81-1.02), there was a trend towards a
higher effect (P<sub>int</sub> = 0.077).ConclusionThe PAR-1 antagonist
vorapaxar was associated with a reduction of MI, including total number of
infarctions. This reduction was sustained over time and was mostly evident
in type 1 MI, the most common type of MI observed. 2013 The Author.
<11>
Accession Number
2013383911
Authors
Ribichini F. Tomai F. Pesarini G. Zivelonghi C. Rognoni A. De Luca G.
Boccuzzi G. Presbitero P. Ferrero V. Ghini A.S. Marino P. Vassanelli C.
Institution
(Ribichini, Pesarini, Zivelonghi, Ferrero, Vassanelli) Department of
Medicine, University of Verona, Verona, Italy
(Ribichini) Cardiovascular Interventional Unit, Universita di Verona,
Piazzale A. Stefani 1, 37126 Verona, Italy
(Tomai, Ghini) Department of Cardiovascular Sciences, European Hospital,
Rome, Italy
(Rognoni, De Luca, Marino) Department of Clinical and Experimental
Medicine, University of Piemonte Orientale, Novara, Italy
(Boccuzzi) Division of Cardiology, Ospedale San Giovanni Bosco, Torino,
Italy
(Presbitero) Interventional Cardiology Unit, Istituto Clinico Humanitas,
Rozzano, Milano, Italy
Title
Long-term clinical follow-up of the multicentre, randomized study to test
immunosuppressive therapy with oral prednisone for the prevention of
restenosis after percutaneous coronary interventions: Cortisone plus BMS
or des veRsus BMS alone to EliminAte Restenosis (CEREA-DES).
Source
European Heart Journal. 34 (23) (pp 1740-1748), 2013. Date of Publication:
14 Jun 2013.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
AimsTo analyse the clinical outcome at 4 years in patients with coronary
artery disease treated with bare metal stents (BMS) vs. BMS and oral
prednisone, or drug-eluting stents (DES), all assuming similar adjunctive
medical treatment.Methods and resultsFive Italian hospitals enrolled 375
non-diabetic, ischaemic patients without contraindications to dual
anti-platelet treatment or corticosteroid therapy in a randomized
controlled study. The primary endpoint was the event-free survival of
cardiovascular death, myocardial infarction, and recurrence of ischaemia
needing repeated target vessel revascularization at 1 year, and this was
significantly lower in the BMS group (80.8%) compared with the prednisone
(88.0%) and DES group (88.8%, P = 0.04 and 0.006, respectively). The
long-term analysis of the primary endpoint was a pre-specified aim of the
trial, and was performed at 1447 days (median, IQ range = 1210-1641).
Patients receiving BMS alone had significantly lower event-free survival
(75.3%) compared with 84.1% in the prednisone group (HR: 0.447; 95% CI:
0.25-0.80, P = 0.007) and 80.6% in DES patients (HR: 0.519; 95% CI:
0.29-0.93, P = 0.03). Prednisone-treated patients did not develop new
treatment-related clinical problems. Drug-eluting stents patients suffered
more very late stent thrombosis as a cause of spontaneous myocardial
infarction. The need for target vessel revascularization remained lower in
the prednisone and DES groups (13.6 and 15.2%, respectively), compared
with BMS (23.2%).ConclusionsThe clinical benefits of prednisone compared
with BMS only persisted almost unchanged at 4 years. Drug-eluting stents
performed better than BMS at long-term, although the advantages observed
at 1 year were in part attenuated because of the occurrence of very late
stent thrombosis and late revascularizations.Clinical Trial NCT 00369356.
2013 The Author.
<12>
Accession Number
2013384202
Authors
Antonelli M. Conti G. Bello G.
Institution
(Antonelli, Conti, Bello) Department of Anesthesiology and Intensive Care,
Agostino Gemelli University Hospital, Universita Cattolica Del Sacro
Cuore, Largo A. Gemelli 8, 00168 Rome, Italy
Title
New niches for NIV: Ahead with caution!.
Source
Intensive Care Medicine. 39 (7) (pp 1325-1327), 2013. Date of Publication:
July 2013.
Publisher
Springer Verlag (Tiergartenstrasse 17, Heidelberg D-69121, Germany)
<13>
Accession Number
2013381304
Authors
Ghisi G.L.M. Polyzotis P. Oh P. Pakosh M. Grace S.L.
Institution
(Ghisi) Exercise Sciences Department, Faculty of Kinesiology and Physical
Education, University of Toronto, Toronto ON, Canada
(Ghisi, Oh, Pakosh, Grace) Cardiac Rehabilitation and Prevention, Toronto
Rehabilitation Institute, University Health Network, Toronto ON, Canada
(Polyzotis, Grace) School of Kinesiology and Health Science, York
University Ontario, Toronto, Canada
Title
Physician factors affecting cardiac rehabilitation referral and patient
enrollment: A systematic review.
Source
Clinical Cardiology. 36 (6) (pp 323-335), 2013. Date of Publication: June
2013.
Publisher
John Wiley and Sons Inc. (111 River Street, Hoboken NJ 07030-5774, United
States)
Abstract
Physicians play an important role in CR referral and enrollment. Despite
established benefits and recommendations, cardiac rehabilitation (CR)
enrollment rates are pervasively low. The reasons cardiac patients are
missing from CR programs are multifactorial and include provider factors.
A number of studies have now investigated physician factors associated
with referral to CR programs and patient enrollment. The objective of this
study was to qualitatively and systematically review this literature. A
literature search of MEDLINE, PsycINFO, CINAHL, Embase, and EBM was
conducted for published articles from database inception to October 2011.
Overall, 17 articles were included following a process of independent
review of each article by 2 authors. Seven (41.2%) were graded as good
quality according to Downs and Black criteria. There were no randomized
controlled trials. Results showed that medical specialty (ie, cardiac
specialists more likely to refer; n = 8 studies) and other
physician-reported reasons (eg, physician report of their reasons for CR
referral and physician sex) were related to referral. Physician factors
related to patient enrollment in CR were physician endorsement, medical
specialty, being referred, and physician attitudes toward CR. Physician
factors are consistently related to CR referral and enrollment. The role
of physician endorsements in promoting patient enrollment should be
optimized and exploited. 2013 The Authors. Clinical Cardiology published
by Wiley Periodicals, Inc.
<14>
Accession Number
2013382654
Authors
Battes L. Barendse R. Steyerberg E.W. Simoons M.L. Deckers J.W. Nieboer D.
Bertrand M. Ferrari R. Remme W.J. Fox K. Takkenberg J.J.M. Boersma E.
Kardys I.
Institution
(Battes, Barendse, Simoons, Deckers, Boersma, Kardys) Clinical
Epidemiology Unit, Department of Cardiology, Erasmus Medical Center,
Rotterdam, Netherlands
(Steyerberg, Nieboer) Center for Clinical Decision Sciences, Department of
Public Health, Erasmus Medical Center, Rotterdam, Netherlands
(Bertrand) Lille Heart Institute, Lille, France
(Ferrari) Azienda Ospedalier and University di Ferrara, Ferrara, Italy
(Remme) Sticares Cardiovascular Research Foundation, Rotterdam,
Netherlands
(Fox) Royal Brompton and National Heart Hospital, London, United Kingdom
(Takkenberg) Department of Cardio-Thoracic Surgery, Erasmus Medical
Center, Rotterdam, Netherlands
Title
Development and validation of a cardiovascular risk assessment model in
patients with established coronary artery disease.
Source
American Journal of Cardiology. 112 (1) (pp 27-33), 2013. Date of
Publication: 01 Jul 2013.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
Appropriate risk stratification of patients with established, stable
coronary artery disease could contribute to the prevention of recurrent
cardiovascular events. The purpose of the present study was to develop and
validate risk prediction models for various cardiovascular end points in
the EURopean trial On reduction of cardiac events with Perindopril in
stable coronary Artery disease (EUROPA) database, consisting of 12,218
patients with established coronary artery disease, with a median follow-up
of 4.1 years. Cox proportional hazards models were used for model
development. The end points examined were cardiovascular mortality,
noncardiovascular mortality, nonfatal myocardial infarction, coronary
artery bypass grafting, percutaneous coronary intervention, resuscitated
cardiac arrest, and combinations of these end points. The performance
measures included Nagelkerke's R<sup>2</sup>, time-dependent area under
the receiver operating characteristic curves, and calibration plots.
Backward selection resulted in a prediction model for cardiovascular
mortality (464 events) containing age, current smoking, diabetes mellitus,
total cholesterol, body mass index, previous myocardial infarction,
history of congestive heart failure, peripheral vessel disease, previous
revascularization, and previous stroke. The model performance was adequate
for this end point, with a Nagelkerke R<sup>2</sup> of 12%, and an area
under the receiver operating characteristic curve of 0.73. However, the
performance of models constructed for nonfatal and combined end points was
considerably worse, with an area under the receiver operating
characteristic curve of about 0.6. In conclusion, in patients with
established coronary artery disease, the risk of cardiovascular mortality
during longer term follow-up can be adequately predicted using the
clinical characteristics available at baseline. However, the prediction of
nonfatal outcomes, both separately and combined with fatal outcomes, poses
major challenges for clinicians and model developers. 2013 Elsevier Inc.
All rights reserved.
<15>
Accession Number
2013381658
Authors
Ciszewski P. Tyczka J. Nadolski J. Roszak M. Dyszkiewicz W.
Institution
(Ciszewski, Tyczka, Nadolski) Department of Anesthesiology and Intensive
Care, Poznan University of Medical Sciences, 62 Szamarzewski St, Poznan
61-377, Poland
(Roszak) Department of Computer Science and Statistics, Poznan University
of Medical Sciences, Poznanc, Poland
(Dyszkiewicz) Department of Thoracic Surgery, Poznan University of Medical
Sciences, Poznanc, Poland
Title
Comparative efficacy and usefulness of acebutolol and diltiazem for the
prevention of atrial fibrillation during perioperative time in patients
undergoing pulmonary resection.
Source
Thoracic and Cardiovascular Surgeon. 61 (4) (pp 365-372), 2013. Date of
Publication: 2013.
Publisher
Georg Thieme Verlag (Rudigerstrasse 14, Stuttgart D-70469, Germany)
Abstract
Background Postthoracic surgery atrial fibrillation (AF) is the most
frequently occurring arrhythmia. Strategies for preventing AF have been
amply evaluated, but currently there are no clearly defined guidelines for
treatment of AF after thoracic surgery. Methods The study was prospective
and randomized controlled trial. Acebutolol and diltiazem versus placebo
were compared, among 117 patients postpneumonectomy or lobectomy at the
Thoracosurgery Clinic, Poznan University of Medical Sciences in Poland.
Patients who were enrolled in the study were randomly assigned to one of
the three groups: those who received acebutolol (Group 1) or diltiazem
(Group 2) and compared with patients without antiarrhythmic drugs (Group
0). Each group consisted of 39 patients. The patients were continuously
monitored postoperatively with 24 ECG (Holter monitor) in the intensive
care unit. Results In patients receiving acebutolol AF occurred in 5%
compared with 23% of patients receiving diltiazem and 20% of patients
receiving placebo (difference not statistically significant). Conclusions
Acebutolol and diltiazem appear to have been non-effective for the
treatment or prevention of AF. Side effects were mild. In comparison to
diltiazem, however, acebutolol had a beneficial effect on the circulatory
system. Patients who had received acebutolol proved to have had fewer
tachycardia episodes and supraventricular ectopy during the postoperative
period. It seems that acebutolol can be useful, especially in patients
with sympathetic activity dominance. 2013 Georg Thieme Verlag KG
Stuttgart, New York.
<16>
Accession Number
2013379911
Authors
Faggioli G. Pini R. Mauro R. Freyrie A. Gargiulo M. Stella A.
Institution
(Faggioli, Pini, Mauro, Freyrie, Gargiulo, Stella) Vascular Surgery,
University of Bologna, Policlinico S. Orsola, Via Massarenti 9, 40138
Bologna, Italy
Title
Contralateral carotid occlusion in endovascular and surgical carotid
revascularization: A single centre experience with literature review and
meta-analysis.
Source
European Journal of Vascular and Endovascular Surgery. 46 (1) (pp 10-20),
2013. Date of Publication: July 2013.
Publisher
W.B. Saunders Ltd (32 Jamestown Road, London NW1 7BY, United Kingdom)
Abstract
Objective/background The influence of contralateral carotid occlusion
(CCO) on the outcome of carotid endarterectomy (CEA) and stenting (CAS) is
debated. This study aims to evaluate CEA and CAS results in patients with
CCO. Methods All carotid revascularizations from 2005 to 2011 were
analyzed, focusing on the role of CCO on 30-day cerebral events and death
(CED). A meta-analysis was performed to evaluate the results of the
literature by random effect. Results Of the 1,218 carotid
revascularizations performed in our institution, 706 (57.9%) were CEA and
512 (42.1%) were CAS. CED occurred in 3.6% of the CEAs and 8.2% of the
CASs (p =.001). CCO was present in 37 (5.2%) CEAs and 38 (7.4%) CASs. In
CEA, CCO patients had a higher CED compared with the non-CCO patients
(16.2% vs. 2.9%, p =.001), as confirmed by multiple regression analysis
(OR [odds ratio]: 5.1[1.7-14.5]). In CAS, CED was not significantly
different in the CCO and non-CCO patients (2.6% vs. 8.7%, p = 0.23). The
comparative analysis of the CCO patients showed a higher CED in CEA
compared with that in CAS (16.2% vs. 2.6%, p = 0.04). Meta-analysis of 33
papers (27 on CEA and 6 on CAS) revealed that CCO was associated with a
higher CED in CEA, but not in CAS (OR: 1.82 [1.57-2.11]; OR: 1.22
[0.60-2.49], respectively). Conclusion CCO can be considered as a risk
factor for CED in CEA, but not in CAS. CAS appears to be associated with
lower CED than CEA in CCO patients. 2013 European Society for Vascular
Surgery. Published by Elsevier Ltd. All rights reserved.
<17>
Accession Number
2013377966
Authors
Liu W. Peng Y. Wu B. Li Q. Chai H. Ren X. Wang X. Zhao Z. Chen M. Huang
D.-J.
Institution
(Liu, Peng, Li, Chai, Ren, Wang, Zhao, Chen, Huang) Department of
Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
(Wu) Department of Neurology, West China Hospital, Sichuan University,
Chengdu, China
Title
A meta-analysis of the impact of EPC capture stent on the clinical
outcomes in patients with coronary artery disease.
Source
Journal of Interventional Cardiology. 26 (3) (pp 228-238), 2013. Date of
Publication: June 2013.
Publisher
Blackwell Publishing Inc. (350 Main Street, Malden MA 02148, United
States)
Abstract
Background Damage to the vascular endothelium may be one of the
pathophysiological causes of in-stent thrombosis and restenosis.
Endothelial progenitor cell (EPC) capture stents (ECS) have the ability to
accelerate the damage repair process. However, the clinical outcomes of
ECS remain unknown thus far. Objectives To evaluate the impact of ECS use
on the clinical outcomes of patients with coronary artery disease by
comparing ECS to drug-eluting stent (DES) and/or bare metal stent (BMS).
Methods Studies and abstracts were retrieved from the PubMed, Cochrane
Library, and EMBASE online databases and from the conference compilations
of the American Heart Association (AHA), the American College of
Cardiology (ACC), and Transcatheter Cardiovascular Therapeutics (TCT).
These studies were analyzed to investigate whether there was a difference
in the clinical therapeutic effects between the ECS group and the DES/BMS
group. The primary clinical end-point events were in-stent thrombosis and
target lesion revascularization (TLR). The secondary clinical end-point
events were target lesion failure (TLF), total mortality, cardiac death,
and myocardial infarction (MI). Results A total of 2,024 patients were
enrolled in the analysis of in-stent thrombosis. There was no significant
difference in the incidence of in-stent thrombosis between the ECS group
and the DES/BMS group. A total of 1,745 patients were enrolled in the
analysis of TLR, and there was no significant difference in the TLR
incidence between the ECS group and the DES/BMS group. However, compared
with DES, the TLR incidence for ECS increased 1.73-fold (relative risk
[RR]: 1.73, 95% confidence interval [95% CI]: 1.01-2.94, P = 0.04).
Moreover, the incidence of cardiac death and TLF also increased 3.54-fold
(RR: 3.54, 95% CI: 1.13-11.08, P = 0.03) and 1.90-fold (RR: 1.90, 95% CI:
1.05-3.45, P = 0.03), respectively. But compared with BMS, there is no
significance of the clinical events. Conclusion Compared with DES/BMS use,
ECS use may not reduce the incidence of in-stent thrombosis and TLR. In
addition, the incidence of TLR and cardiac death with ECS is possibly
relatively higher compared with DES and no difference compared with BMS,
but this also needs more large RCTs to guarantee. (J Interven Cardiol
2013;26:228-238) 2013, Wiley Periodicals, Inc.
<18>
Accession Number
2013355697
Authors
Meybohm P. Renner J. Broch O. Caliebe D. Albrecht M. Cremer J. Haake N.
Scholz J. Zacharowski K. Bein B.
Institution
(Meybohm, Zacharowski) Clinic of Anaesthesiology, Intensive Care Medicine
and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main,
Germany
(Meybohm, Renner, Broch, Caliebe, Albrecht, Scholz, Bein) Department of
Anaesthesiology and Intensive Care Medicine, University Hospital
Schleswig-Holstein, Kiel, Germany
(Cremer, Haake) Department of Cardiovascular Surgery, University Hospital
Schleswig-Holstein, Kiel, Germany
Title
Postoperative Neurocognitive Dysfunction in Patients Undergoing Cardiac
Surgery after Remote Ischemic Preconditioning: A Double-Blind Randomized
Controlled Pilot Study.
Source
PLoS ONE. 8 (5) , 2013. Article Number: e64743. Date of Publication: 31
May 2013.
Publisher
Public Library of Science (185 Berry Street, Suite 1300, San Francisco CA
94107, United States)
Abstract
Background:Remote ischemic preconditioning (RIPC) has been shown to
enhance the tolerance of remote organs to cope with a subsequent ischemic
event. We hypothesized that RIPC reduces postoperative neurocognitive
dysfunction (POCD) in patients undergoing complex cardiac
surgery.Methods:We conducted a prospective, randomized, double-blind,
controlled trial including 180 adult patients undergoing elective cardiac
surgery with cardiopulmonary bypass. Patients were randomized either to
RIPC or to control group. Primary endpoint was postoperative
neurocognitive dysfunction 5-7 days after surgery assessed by a
comprehensive test battery. Cognitive change was assumed if the
preoperative to postoperative difference in 2 or more tasks assessing
different cognitive domains exceeded more than one SD (1 SD criterion) or
if the combined Z score was 1.96 or greater (Z score
criterion).Results:According to 1 SD criterion, 52% of control and 46% of
RIPC patients had cognitive deterioration 5-7 days after surgery (p =
0.753). The summarized Z score showed a trend to more cognitive decline in
the control group (2.16+/-5.30) compared to the RIPC group (1.14+/-4.02; p
= 0.228). Three months after surgery, incidence and severity of
neurocognitive dysfunction did not differ between control and RIPC. RIPC
tended to decrease postoperative troponin T release at both 12 hours [0.60
(0.19-1.94) mug/L vs. 0.48 (0.07-1.84) mug/L] and 24 hours after surgery
[0.36 (0.14-1.89) mug/L vs. 0.26 (0.07-0.90) mug/L].Conclusions:We failed
to demonstrate efficacy of a RIPC protocol with respect to incidence and
severity of POCD and secondary outcome variables in patients undergoing a
wide range of cardiac surgery. Therefore, definitive large-scale
multicenter trials are needed.Trial Registration:ClinicalTrials.gov
NCT00877305. 2013 Meybohm et al.
<19>
Accession Number
2013355696
Authors
Falagas M.E. Tansarli G.S. Kapaskelis A. Vardakas K.Z.
Institution
(Falagas, Tansarli, Kapaskelis, Vardakas) Alfa Institute of Biomedical
Sciences (AIBS), Athens, Greece
(Falagas, Kapaskelis, Vardakas) Department of Internal Medicine -
Infectious Diseases, Mitera Hospital, Hygeia Group, Athens, Greece
(Falagas) Department of Medicine, Tufts University School of Medicine,
Boston, MA, United States
Title
Impact of Vacuum-Assisted Closure (VAC) Therapy on Clinical Outcomes of
Patients with Sternal Wound Infections: A Meta-Analysis of Non-Randomized
Studies.
Source
PLoS ONE. 8 (5) , 2013. Article Number: e64741. Date of Publication: 31
May 2013.
Publisher
Public Library of Science (185 Berry Street, Suite 1300, San Francisco CA
94107, United States)
Abstract
Objective:To examine the impact of VAC therapy on mortality of patients
with sternal wound infections after cardiothoracic surgery.Summary
Background Data:Controversial results regarding mortality of patients with
sternal wound infections were published.Methods:We performed a systematic
search in PubMed and Scopus. Mortality was the primary outcome of the
meta-analysis. Recurrences, complications and length of stay were
secondary outcomes.Results:Twenty-two retrospective studies including 2467
patients were eligible for inclusion. Patients treated with VAC had
significantly lower mortality compared to those treated without VAC [2233
patients, RR = 0.40, (95% CI 0.28, 0.57)]. This finding was consistent
regardless of the study design, the exclusion of studies with positive
findings, the criteria for establishment of the compared groups, the time
of mortality assessment or the type of infections under study, provided
that adequate data was available. VAC therapy was associated with fewer
recurrences (RR = 0.34, 95% CI: 0.19-0.59). The meta-analysis did not show
any difference in the length of stay (RR = -2.25, 95% CI:
-7.52-3.02).Conclusions:VAC therapy was associated with lower mortality
than other surgical techniques in retrospective cohorts of patients with
DSWIs following cardiothoracic surgery. 2013 Falagas et al.
<20>
Accession Number
2013359827
Authors
Kato T.S. Jiang J. Schulze P.C. Jorde U. Uriel N. Kitada S. Takayama H.
Naka Y. Mancini D. Gillam L. Homma S. Farr M.
Institution
(Kato, Jiang, Schulze, Jorde, Uriel, Kitada, Mancini, Homma, Farr)
Department of Medicine, Division of Cardiology, Columbia University
Medical Center, New York, New York, United States
(Takayama, Naka) Department of Surgery, Division of Cardiothoracic
Surgery, Columbia University Medical Center, New York, New York, United
States
(Gillam) Division of Cardiology, Morristown Memorial Hospital, Morristown,
NJ, United States
Title
Serial echocardiography using tissue doppler and speckle tracking imaging
to monitor right ventricular failure before and after left ventricular
assist device surgery.
Source
JACC: Heart Failure. 1 (3) (pp 216-222), 2013. Date of Publication: June
2013.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
Objectives: This study aimed to investigate the utility of serial tissue
Doppler imaging (TDI) and speckle tracking echocardiography (STE) for
monitoring right ventricular failure (RVF) after left ventricular assist
device (LVAD) surgery. Background: RVF post-LVAD is a devastating adverse
event. Methods: The authors prospectively studied 68 patients undergoing
elective LVAD surgery. Echocardiograms were performed within 72 h before
and 72 h after surgery. RVF was pre-specified as: 1) the need for salvage
right ventricular assist device (RVAD); or 2) persistent need for inotrope
and/or pulmonary vasodilator therapy 14 days after surgery. Patients were
classified as Group RVF or Group Non-RVF. Results: A total of 24 patients
(35.3%) met criteria for RVF. Preoperative TDI-derived S' was lower and RV
E/E' ratio was higher (3.7 +/- 0.6 cm/s vs. 4.7 +/- 0.9 cm/s, 12.0 +/- 2.3
vs. 10.0 +/- 2.5, both p < 0.001, respectively), and the absolute value of
RV longitudinal strain (RV-strain) obtained from STE was lower (-12.6 +/-
3.3% vs. -16.2 +/- 4.3%, p < 0.001) in Group RVF vs. Group Non-RVF. Echo
parameters within 72 h after surgery showed higher RV-E/E', (13.9 +/- 4.6
vs. 10.1 +/- 3.0, p < 0.001) and lower RV-strain (-11.8 +/- 3.5% vs. -16.7
+/- 4.4%, p < 0.001) in Group RVF vs. Group Non-RVF. Preoperative S'<4.4
cm/s, RV-E/E'>10 and RV-strain < -14% discriminated patients who developed
RVF at day 14 with a predictive accuracy of 76.5%. When we included
postoperative RV-E/E' and RV-strain, the predictive accuracy increased to
80.9%, with a sensitivity of 66.7% and a specificity of 88.7%.
Conclusions: Serial echocardiograms using TDI and STE before and soon
after LVAD surgery may aid in identifying need to initiate targeted RVF
specific therapy in this population. 2013 American College of Cardiology
Foundation.
<21>
Accession Number
2013358784
Authors
Velders M.A. Hofma S.H. Brouwer J. de Vries C.J. Quere M. van Boven A.J.
Institution
(Velders, Hofma, Brouwer, de Vries, Quere, van Boven) Medical Center
Leeuwarden, Leeuwarden, Netherlands
(Velders) Leiden University Medical Center, Leiden, Netherlands
Title
Two-Year Results of an Open-Label Randomized Comparison of
Everolimus-Eluting Stents and Sirolimus-Eluting Stents.
Source
PLoS ONE. 8 (6) , 2013. Article Number: e64424. Date of Publication: 03
Jun 2013.
Publisher
Public Library of Science (185 Berry Street, Suite 1300, San Francisco CA
94107, United States)
Abstract
Background:Second generation drug-eluting stents were developed to improve
the safety and efficacy of first generation stents. So far, limited long
term randomized data exist comparing the second generation
everolimus-eluting stents (EES) with first generation sirolimus-eluting
stents (SES).Methods:A prospective, open-label, randomized, single center
trial comparing EES and SES in all-comer patients. The primary endpoint
was a composite of cardiac mortality, myocardial infarction and target
vessel revascularization. Secondary endpoints included individual
components of the composite, along with target lesion revascularization
and stent thrombosis.Results:In total, 977 patients were randomized, of
which 498 patients to EES and 479 to SES. Average age was 65.2+/-11.2
years and 71.6% of the population was male. Fifty percent of patients were
treated for acute coronary syndrome, more often for ST-elevation
myocardial infarctions in EES patients (13.7% vs. 9.2% in SES). In
contrast, SES patients more often had prior interventions and showed more
calcified lesions. Two-year follow-up was available in 98% of patients.
The primary endpoint occurred in 10.7% of EES patients compared to 10.6%
of SES patients (HR 1.00, 95% CI 0.68-1.48). Additionally, secondary
endpoints were similar between groups. The rate of stent thrombosis was
low for both stent types.Conclusion:In this all-comer population, there
were no differences in endpoints between EES and SES during two-year
follow-up. Stent thrombosis rates were low, supporting the safety of
drug-eluting stent appliance in clinical practice.Trial
registration:TrialRegister.nl NTR3170. 2013 Velders et al.
<22>
Accession Number
2013362907
Authors
Ruys T.P.E. van der Bosch A.E. Cuypers J.A.A.E. Witsenburg M. Helbing W.A.
Bogers A.J.J.C. van Domburg R. Mcghie J.S. Geleijnse M.L. Henrichs J.
Utens E. Van der Zwaan H.B. Takkenberg J.J.M. Roos-Hesselink J.W.
Institution
(Ruys, van der Bosch, Cuypers, Witsenburg, van Domburg, Mcghie, Geleijnse,
Van der Zwaan, Roos-Hesselink) Department of Cardiology, Erasmus MC,
Rotterdam, Netherlands
(Witsenburg, Helbing) Department of Pediatric Cardiology, Erasmus MC,
Rotterdam, Netherlands
(Helbing) Department of Radiology, Erasmus MC, Rotterdam, Netherlands
(Bogers, Takkenberg) Department of Cardiothoracic Surgery, Erasmus MC,
Rotterdam, Netherlands
(Henrichs, Utens) Department of Child and Adolescent Psychiatry, Erasmus
MC, Rotterdam, Netherlands
Title
Long-term outcome and quality of life after arterial switch operation: A
prospective study with a historical comparison.
Source
Congenital Heart Disease. 8 (3) (pp 203-210), 2013. Date of Publication:
May/June 2013.
Publisher
Blackwell Publishing Ltd (9600 Garsington Road, Oxford OX4 2XG, United
Kingdom)
Abstract
Aim.: The study aims to describe the long-term cardiological and
psychological results of our first surgical cohort of arterial switch
operation (ASO) patients and compare the results with our earlier series
of Mustard patients. Methods.: Twenty-four survivors of ASO operated in
our center (1985-1990) were evaluated by electrocardiography,
echocardiography, magnetic resonance imaging, exercise testing, 24-hour
Holter-monitoring, and health-related quality of life questionnaire. The
results were compared with 58 adult Mustard patients who were evaluated in
2001 using the same study protocol. Results.: Arterial switch operation
was performed at a median age of 13 days and Mustard operation at 2 years.
Median follow-up was 22 years (range 20-25) and 25 years (22-29),
respectively. After ASO, survival was better (P =04). The event-free
survival after 22 years was 77% after ASO vs. 44% after Mustard (P =03).
Good systemic ventricular function was present in 93% after ASO vs. 6%
after Mustard (P <.01). Exercise capacity in ASO was 85% of predicted,
compared with 72% in Mustard patients (P =01). Aortic regurgitation was
found in 21% of ASO patients vs. 16% in Mustard patients. Arterial switch
patients vs. Mustard patients reported significantly better quality of
life and less somatic complaints. Conclusion.: The progression made in
surgical treatment for transposition of the great arteries from Mustard to
ASO has had a positive impact on survival, cardiac function, exercise
capacity, and also self-reported quality of life and somatic complaints.
Longer follow-up is warranted to monitor aortic regurgitation. 2013 Wiley
Periodicals, Inc.
<23>
[Use Link to view the full text]
Accession Number
2013373130
Authors
Herrmann H.C. Pibarot P. Hueter I. Gertz Z.M. Stewart W.J. Kapadia S.
Tuzcu E.M. Babaliaros V. Thourani V. Szeto W.Y. Bavaria J.E. Kodali S.
Hahn R.T. Williams M. Miller D.C. Douglas P.S. Leon M.B.
Institution
(Herrmann, Szeto, Bavaria) University of Pennsylvania, Interventional
Cardiology Program, Hospital of the University of Pennsylvania, 9038 Gates
Pavilion, 3400 Spruce St., Philadelphia, PA 19104, United States
(Pibarot) Quebec Heart and Lung Institute, Laval University, Quebec, QC,
Canada
(Hueter, Kodali, Hahn, Williams, Leon) Cardiovascular Research Foundation
and Columbia University, New York, NY, United States
(Gertz) VCU School of Medicine, Richmond, VA, United States
(Stewart, Kapadia, Tuzcu) Cleveland Clinic, Cleveland, OH, United States
(Babaliaros, Thourani) Emory University, Atlanta, GA, United States
(Miller) Stanford University, Palo Alto, CA, United States
(Douglas) Duke University, Durham, NC, United States
Title
Predictors of mortality and outcomes of therapy in low-flow severe aortic
stenosis: A placement of aortic transcatheter valves (PARTNER) trial
analysis.
Source
Circulation. 127 (23) (pp 2316-2326), 2013. Date of Publication: 11 Jun
2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Background: The prognosis and treatment of patients with low-flow (LF)
severe aortic stenosis are controversial. Methods and Results: The
Placement of Aortic Transcatheter Valves (PARTNER) trial randomized
patients with severe aortic stenosis to medical management versus
transcatheter aortic valve replacement (TAVR; inoperable cohort) and
surgical aortic valve replacement versus TAVR (high-risk cohort). Among
971 patients with evaluable echocardiograms (92%), LF (stroke volume index
<=35 mL/m<sup>2</sup>) was observed in 530 (55%); LF and low ejection
fraction (<50%) in 225 (23%); and LF, low ejection fraction, and low mean
gradient (<40 mm Hg) in 147 (15%). Two-year mortality was significantly
higher in patients with LF compared with those with normal stroke volume
index (47% versus 34%; hazard ratio, 1.5; 95% confidence interval,
1.25-1.89; P=0.006). In the inoperable cohort, patients with LF had higher
mortality than those with normal flow, but both groups improved with TAVR
(46% versus 76% with LF and 38% versus 53% with normal flow; P<0.001). In
the high-risk cohort, there was no difference between TAVR and surgical
aortic valve replacement. In patients with paradoxical LF and low gradient
(preserved ejection fraction), TAVR reduced 1-year mortality from 66% to
35% (hazard ratio, 0.38; P=0.02). LF was an independent predictor of
mortality in all patient cohorts (hazard ratio, 1.5), whereas ejection
fraction and gradient were not. Conclusions: LF is common in severe aortic
stenosis and independently predicts mortality. Survival is improved with
TAVR compared with medical management and similar with TAVR and surgical
aortic valve replacement. A measure of flow (stroke volume index) should
be included in the evaluation and therapeutic decision making of patients
with severe aortic stenosis. 2013 American Heart Association, Inc.
<24>
Accession Number
2013369168
Authors
Karthikeyan G. Senguttuvan N.B. Joseph J. Devasenapathy N. Bahl V.K. Airan
B.
Institution
(Karthikeyan, Senguttuvan, Joseph, Bahl) Department of Cardiology,
Cardiothoracic Sciences Centre, All India Institute of Medical Sciences,
Ansari Nagar, New Delhi 110029, India
(Devasenapathy) Indian Institute of Public Health-Delhi, Gurgaon, Haryana,
India
(Airan) Department of Cardiothoracic Surgery, All India Institute of
Medical Sciences, New Delhi, India
Title
Urgent surgery compared with fibrinolytic therapy for the treatment of
left-sided prosthetic heart valve thrombosis: A systematic review and
meta-analysis of observational studies.
Source
European Heart Journal. 34 (21) (pp 1557-1566), 2013. Date of Publication:
01 Jun 2013.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
AimsLeft-sided prosthetic valve thrombosis (PVT) occurs frequently in
developing countries and causes major morbidity and mortality.
Fibrinolytic therapy (FT) is most commonly used as treatment, but
increases the risk of stroke and bleeding. Urgent surgery may be more
efficacious and cause fewer complications. Our aim was to compare the
efficacy and safety of urgent surgery and FT for the treatment of
left-sided PVT.Methods and resultsWe searched EMBASE and MEDLINE for
articles which included at least five patients each treated with surgery
and FT. The primary outcome was complete restoration of valve function.
Other outcomes were in-hospital death, thrombo-embolism (stroke, transient
ischaemic attack, or non-CNS systemic embolism), major bleeding, and
recurrence of PVT on follow-up. We calculated odds ratios (ORs) for each
outcome and pooled them using a random effects model. We included seven
eligible studies with 690 episodes of PVT, 446 treated with surgery, and
244 with FT. There was no significant difference in the occurrence of the
primary outcome (86.5 vs. 69.7%, OR 2.53, 95% CI 0.94-6.78, P = 0.066,
I<sup>2</sup> = 74%) or death (13.5 vs. 9%, OR 1.95, 95% CI 0.63-5.98, P =
0.244, I<sup>2</sup> = 59%) between the two treatments. However, compared
with FT, urgent surgery was associated with significant reductions in
thrombo-embolism (1.6 vs. 16%, OR 0.10, 95% CI 0.04-0.24, P < 0.001,
I<sup>2</sup> = 0%), major bleeding (1.4 vs. 5%; OR 0.27, 95% CI
0.08-0.98, P = 0.046, I<sup>2</sup> = 0%), and recurrent PVT (7.1 vs.
25.4%; OR 0.25, 95% CI 0.08-0.74, P = 0.013, I<sup>2</sup> =
59%).ConclusionUrgent surgery was not superior to FT at restoring valve
function, but substantially reduced the occurrence of thrombo-embolic
events, major bleeding, and recurrent PVT. In experienced centres, urgent
surgery should probably be preferred over FT for treating left-sided PVT,
pending the results of randomized controlled trials. 2012 The Author.
<25>
Accession Number
2013353180
Authors
Sakurai R. Inajima T. Kaneda H. Nagai R. Hashimoto H.
Institution
(Sakurai) Department of Planning, Information and Management, University
of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
(Sakurai, Inajima, Nagai) Department of Cardiovascular Medicine,
University of Tokyo Hospital, Tokyo, Japan
(Kaneda) Okinaka Memorial Institute for Medical Research, Tokyo, Japan
(Hashimoto) Department of Health Economics and Epidemiology Research,
School of Public Health, University of Tokyo, Tokyo, Japan
Title
Sirolimus-eluting stents reduce long-term mortality compared with bare
metal stents in ST-segment elevation myocardial infarction: A
meta-analysis of randomized controlled trials.
Source
International Journal of Cardiology. 167 (1) (pp 162-167), 2013. Date of
Publication: 15 Jul 2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Background: Sirolimus-eluting stents (SES) have demonstrated more
favorable outcomes compared with bare metal stents (BMS) for ST-segment
elevation myocardial infarction (STEMI) within medium term follow up in
randomized controlled trials (RCT). However, long-term outcomes remain
unknown. Methods: We conducted a meta-analysis of RCT comparing SES with
BMS in STEMI patients at long-term follow up, defined as 2 years or more
after primary percutaneous coronary intervention (PCI). The clinical end
points of our interest were death, recurrent myocardial infarction (MI),
definite stent thrombosis (ST), and target lesion revascularization (TLR).
We calculated the pooled estimate based on a fixed-effects model using
Peto odds ratio (OR) for rare events. If heterogeneity was observed across
an individual RCT, an analysis based on a random-effects model was
performed. Results: Four RCT were included in this study, involving 1304
patients (656 patients randomized to SES and 648 patients to BMS). Up to 4
years, SES showed a significant reduction in not only TLR (OR: 0.44, 95%
confidence interval (CI): 0.31 to 0.62, p < 0.001) but also mortality (OR:
0.62, 95% CI: 0.39 to 1.00, p = 0.049) compared with BMS. In contrast, the
proportions of recurrent MI (OR: 0.82, 95% CI: 0.52 to 1.28, p = 0.378)
and definite ST (OR: 1.13, 95% CI: 0.56 to 2.27, p = 0.740) were
comparable between the 2 groups. Conclusions: In this meta-analysis of
long-term RCT, primary PCI for STEMI patients with SES was associated with
a decrease in mortality as well as TLR without an increase in recurrent MI
or definite ST compared with BMS. 2011 Elsevier Ireland Ltd.
<26>
Accession Number
2013353186
Authors
Simard T. Hibbert B. Pourdjabbar A. Ramirez F.D. Wilson K.R. Hawken S.
O'Brien E.R.
Institution
(Simard, Hibbert, Pourdjabbar, Ramirez, O'Brien) Division of Cardiology,
University of Ottawa Heart Institute, Ottawa, ON, Canada
(Wilson) Department of Medicine, University of Ottawa, Ottawa, ON, Canada
(Hawken) Institute for Clinical Evaluative Sciences, University of Ottawa,
Canada
Title
Percutaneous coronary intervention with or without on-site coronary artery
bypass surgery: A systematic review and meta-analysis.
Source
International Journal of Cardiology. 167 (1) (pp 197-204), 2013. Date of
Publication: 15 Jul 2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Background: Current American Heart Association guidelines recommend
against the performance of elective or primary percutaneous coronary
intervention (PCI) without on-site surgical backup (i.e. a class III and
IIb recommendation respectively). Despite this, numerous centers have
already implemented PCI programs with no on-site surgery backup (NSOS).
Methods: To evaluate the necessity for on-site surgical backup (SOS) when
performing PCI we performed a systematic review and meta-analysis.
English-language articles published from 1966 through December 2010 were
retrieved using keyword searches of Medline and Scopus, supplemented by
letters to authors and reviews of all bibliographies. Article inclusion
and data extraction was performed by two independent reviewers. We
identified 18 articles published between 1992 and 2009 which contained
reported events on 1,150,200 patients. Results: The combined odds ratio
calculated using a random effects model for death with NSOS was 0.93 (95%
CI, 0.80-1.09). In studies with data reported for primary PCI and elective
PCI the OR for death was 0.91 (95% CI, 0.84-1.00) and 1.04 (95% CI,
0.67-1.63). A lack of effect of SOS was maintained when analysis was
performed by study type or by either primary or elective PCI. No
differences in rates of emergency coronary artery bypass grafting, post
procedural myocardial infarction, target vessel revascularization, or
cerebrovascular accidents were observed between SOS and NSOS centers.
Conclusion: Both primary and elective PCI can safely be performed at NSOS
centers without an increase in mortality or PCI related complications.
AHA/ACC guidelines should reflect the lack of benefit conferred by on-site
surgical backup. In establishing PCI programs, adequate operator/center
volumes, patient selection, and geographic/population considerations
should take precedence rather than the availability of on-site surgical
backup during PCI. 2011 Elsevier Ireland Ltd.
