Results Generated From:
Embase <1980 to 2013 Week 30>
Embase (updates since 2013-07-18)
<1>
Accession Number
2013445115
Authors
Whitlock R. Mathew J. Eikelboom J. Al-Saleh A.M. Yuan F. Teoh K.
Institution
(Whitlock, Mathew, Eikelboom, Al-Saleh, Yuan, Teoh) McMaster Univ.,
Canada; the Pop. Hlth. Res. Inst., Canada; and Hamilton Hlth. Sci. Ctr.,
Hamilton, Ontario, Canada
Title
Processed residual pump blood in cardiac surgery: The Processed Residual
Blood in Cardiac surgery trial.
Source
Transfusion. 53 (7) (pp 1487-1492), 2013. Date of Publication: July 2013.
Publisher
Blackwell Publishing Inc. (350 Main Street, Malden MA 02148, United
States)
Abstract
Background Processing residual cardiopulmonary bypass (CPB) volume via
ultrafiltration may improve hemostasis and reduce transfusion through
clearing activated complement, activated coagulation components, and
proinflammatory cytokines. We sought to establish if processing residual
CPB volume with ultrafiltration reduces homologous blood transfusion and
bleeding. Study Design and Methods Adult patients undergoing isolated
coronary artery bypass grafting (CABG) surgery were randomly assigned to
receive processed (n = 99) or unprocessed (control; n = 98) residual CPB
volume in this single-center randomized controlled trial. The intensive
care unit team, patients, and assessors were blinded to treatment
assignment and a transfusion protocol was followed. Surgeons were
permitted to use retrograde autologous priming to minimize crystalloid
pump prime. Results The processed study bag was of a smaller volume (280
[0, 550] mL vs. 590 [215, 726] mL; p < 0.01) but a higher hematocrit (29%
[0%, 34%] vs. 23% [20%, 25%]; p < 0.01) than control. The rate of
transfusion with homologous blood was 39% in both groups (p = 0.92). There
was no difference in the volume transfused (processed 323 +/- 585 mL vs.
control 276 +/- 520 mL; p = 0.56). There was also no difference in the
proportion of patients transfused with any blood product (processed 44%
vs. control 45%; p = 0.95) or in the volume of chest tube output
(processed 600 [500, 940] mL vs. control 670 [490, 932] mL; p = 0.62).
Conclusion Ultrafiltration of residual CPB volume in adults undergoing
isolated CABG surgery does not reduce the need for transfusion or
bleeding. 2012 American Association of Blood Banks.
<2>
Accession Number
22011515
Authors
Wittwer T. Choi Y.H. Neef K. Schink M. Sabashnikov A. Wahlers T.
Institution
(Wittwer) Department of Cardiothoracic Surgery, Heart Center, University
Hospital of Cologne, Germany.
Title
Off-pump or minimized on-pump coronary surgery--initial experience with
Circulating Endothelial Cells (CEC) as a supersensitive marker of tissue
damage.
Source
Journal of cardiothoracic surgery. 6 (pp 142), 2011. Date of Publication:
2011.
Abstract
Off-pump-coronary-artery-bypass-grafting (OPCAB) and
minimized-extracorporeal-circulation (Mini-HLM) have been proposed to
avoid harmful effects of cardiopulmonary-bypass (CPB). Controversies exist
whether OPCAB is still superior in perioperative outcome. Circulating
endothelial cells (CEC) are sensitive markers of endothelial damage and
are significantly elevated in conventional-CPB-procedures as compared to
Mini-HLM-revascularisation. Therefore, CEC might be of specific value in
evaluating effectiveness of Mini-HLM and OPCAB as currently applied
less-invasive coronary procedures. 76 coronary patients were randomly
assigned either to OPCAB (n = 34) or to Mini-HLM (ROCsafe, Terumo Inc., n
= 42) procedures. Perioperative data, clinical and serological outcome and
measurements of CEC-release and parameters of endothelial function
(v.Willebrand-Factor, soluble-thrombomodulin) perioperatively
(pre-operative-baseline, post-Mini-HLM/release of OPCAB-stabilizer, 6 h,
12 h, 24 h and 5 days postoperatively) were obtained and compared by ANOVA
models including repeated-measures-analysis. Mean graft-number was 3.06
+/- 0.72 in Mini-HLM-patients and 1.89 +/- 0.74 in OPCAB-patients (p <
0.001). However, ventilation-, ICU- and total-hospital duration were
comparable between groups as well as chest-tube-drainage, transfusion
requirements, hemodynamics and catecholaminergic support (p > 0.05).
CEC-release did not differ between groups (p = 0.274) and was generally
within normal limits, Troponin-T levels where not significanty different
(p = 0.108). No myocardial infarctions, strokes or deaths occurred, neuron
specific enolase (NSE) did not show any differences between groups (p =
0.194). Conceptional advantages of minimized CPB systems (ROCsafe) result
in morbidity and mortality comparable with OPCAB procedures. Mini-HLM
therefore minimizes CPB-related systemic and organ injury as demonstrated
by low CEC-values which indicates intact endothelial integrity.
Furthermore, Mini-HLM combines OPCAB-benefits with low morbidity in
high-risk patients while facilitating more complete revascularization in
complex patients.
<3>
Accession Number
21992565
Authors
Doss M. Wood J.P. Kiessling A.H. Moritz A.
Institution
(Doss) Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang
Goethe University, Frankfurt am Main, Germany.
Title
Comparative evaluation of left ventricular mass regression after aortic
valve replacement: a prospective randomized analysis.
Source
Journal of cardiothoracic surgery. 6 (pp 136), 2011. Date of Publication:
2011.
Abstract
We assessed the hemodynamic performance of various prostheses and the
clinical outcomes after aortic valve replacement, in different age groups.
One-hundred-and-twenty patients with isolated aortic valve stenosis were
included in this prospective randomized randomised trial and allocated in
three age-groups to receive either pulmonary autograft (PA, n = 20) or
mechanical prosthesis (MP, Edwards Mira n = 20) in group 1 (age < 55
years), either stentless bioprosthesis (CE Prima Plus n = 20) or MP
(Edwards Mira n = 20) in group 2 (age 55-75 years) and either stentless
(CE Prima Plus n = 20) or stented bioprosthesis (CE Perimount n = 20) in
group 3 (age > 75). Clinical outcomes and hemodynamic performance were
evaluated at discharge, six months and one year. In group 1, patients with
PA had significantly lower mean gradients than the MP (2.6 vs. 10.9 mmHg,
p = 0.0005) with comparable left ventricular mass regression (LVMR).
Morbidity included 1 stroke in the PA population and 1 gastrointestinal
bleeding in the MP subgroup. In group 2, mean gradients did not differ
significantly between both populations (7.0 vs. 8.9 mmHg, p = 0.81). The
rate of LVMR and EF were comparable at 12 months; each group with one
mortality. Morbidity included 1 stroke and 1 gastrointestinal bleeding in
the stentless and 3 bleeding complications in the MP group. In group 3,
mean gradients did not differ significantly (7.8 vs 6.5 mmHg, p = 0.06).
Postoperative EF and LVMR were comparable. There were 3 deaths in the
stented group and no mortality in the stentless group. Morbidity included
1 endocarditis and 1 stroke in the stentless compared to 1 endocarditis, 1
stroke and one pulmonary embolism in the stented group. Clinical outcomes
justify valve replacement with either valve substitute in the respective
age groups. The PA hemodynamically outperformed the MPs. Stentless valves
however, did not demonstrate significantly superior hemodynamics or
outcomes in comparison to stented bioprosthesis or MPs.
<4>
Accession Number
21854625
Authors
Sun J. Ding Z. Qian Y.
Institution
(Sun) Department of Anesthesiology, First Affiliated Hospital with Nanjing
Medical University/Jiangsu province hospital, Nanjing, P.R.,China.
Title
Effect of short-acting beta blocker on the cardiac recovery after
cardiopulmonary bypass.
Source
Journal of cardiothoracic surgery. 6 (pp 99), 2011. Date of Publication:
2011.
Abstract
The objective of this study was to investigate the effect of beta blocker
on cardiac recovery and rhythm during cardiac surgeries. Sixty surgical
rheumatic heart disease patients were received esmolol 1 mg/kg or the same
volume of saline prior to removal of the aortic clamp. The incidence of
cardiac automatic re-beat, ventricular fibrillation after reperfusion, the
heart rate after steady re-beat, vasoactive drug use during weaning from
bypass, the posterior parallel time and total bypass time were decreased
by esmolol treatment. In conclusion: Esmolol has a positive effect on the
cardiac recovery in cardiopulmonary bypass surgeries.
<5>
Accession Number
2013433721
Authors
Miller C.D. Case L.D. Little W.C. Mahler S.A. Burke G.L. Harper E.N.
Lefebvre C. Hiestand B. Hoekstra J.W. Hamilton C.A. Hundley W.G.
Institution
(Miller, Mahler, Harper, Lefebvre, Hiestand, Hoekstra) Department of
Emergency Medicine, Wake Forest School of Medicine, Medical Center
Boulevard, Winston-Salem, NC 27157, United States
(Case, Hundley) Department of Biostatistical Sciences, Wake Forest School
of Medicine, Winston-Salem, NC, United States
(Little) Department of Internal Medicine/Cardiology, Wake Forest School of
Medicine, Winston-Salem, NC, United States
(Mahler) Department of Epidemiology and Prevention, Wake Forest School of
Medicine, Winston-Salem, NC, United States
(Burke) Division of Public Health Sciences, Wake Forest School of
Medicine, Winston-Salem, NC, United States
(Hamilton) Department of Biomedical Engineering, Wake Forest School of
Medicine, Winston-Salem, NC, United States
(Hundley) Department of Radiology, Wake Forest School of Medicine,
Winston-Salem, NC, United States
Title
Stress CMR reduces revascularization, hospital readmission, and recurrent
cardiac testing in intermediate-risk patients with acute chest pain.
Source
JACC: Cardiovascular Imaging. 6 (7) (pp 785-794), 2013. Date of
Publication: July 2013.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
Objectives The aim of this study was to determine the effect of stress
cardiac magnetic resonance (CMR) imaging in an observation unit (OU) on
revascularization, hospital readmission, and recurrent cardiac testing in
intermediate-risk patients with possible acute coronary syndromes (ACS).
Background Intermediate-risk patients commonly undergo hospital admission
with high rates of coronary revascularization. It is unknown whether
OU-based care with CMR is a more efficient alternative. Methods A total of
105 intermediate-risk participants with symptoms of ACS but without
definite ACS on the basis of the first electrocardiogram and troponin were
randomized to usual care provided by cardiologists and internists (n = 53)
or to OU care with stress CMR (n = 52). The primary composite endpoint of
coronary artery revascularization, hospital readmission, and recurrent
cardiac testing at 90 days was determined. The secondary endpoint was
length of stay from randomization to index visit discharge; safety was
measured as ACS after discharge. Results The median age of participants
was 56 years (range 35 to 91 years), 54% were men, and 20% had
pre-existing coronary disease. Index hospital admission was avoided in 85%
of the OU CMR participants. The primary outcome occurred in 20 usual care
participants (38%) versus 7 OU CMR participants (13%) (hazard ratio: 3.4;
95% confidence interval: 1.4 to 8.0, p = 0.006). The OU CMR group
experienced significant reductions in all components: revascularizations
(15% vs. 2%, p = 0.03), hospital readmissions (23% vs. 8%, p = 0.03), and
recurrent cardiac testing (17% vs. 4%, p = 0.03). Median length of stay
was 26 h (interquartile range: 23 to 45 h) in the usual care group and 21
h (interquartile range: 15 to 25 h) in the OU CMR group (p < 0.001). ACS
after discharge occurred in 3 usual care participants (6%) and no OU CMR
participants. Conclusions In this single-center trial, management of
intermediate-risk patients with possible ACS in an OU with stress CMR
reduced coronary artery revascularization, hospital readmissions, and
recurrent cardiac testing, without an increase in post-discharge ACS at 90
days. (Randomized Investigation of Chest Pain Diagnostic Strategies;
NCT01035047). 2013 by The American College of Cardiology Foundation.
<6>
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Accession Number
2013436737
Authors
Ware J.H. Vetrovec G.W. Miller A.B. Van Tosh A. Gaffney M. Yunis C.
Arteaga C. Borer J.S.
Institution
(Ware) Department of Biostatistics, Harvard School of Public Health,
Boston, MA, United States
(Vetrovec) Division of Cardiology, VCU Medical Center, Richmond, VA,
United States
(Miller) Department of Medicine, Division of Cardiology, University of
Florida-Jacksonville, Jacksonville, FL, United States
(Van Tosh) Division of Cardiovascular Research, St. Francis Hospital,
Roslyn, NY, United States
(Gaffney, Yunis, Arteaga) Pfizer Inc., 235 East 42nd St, New York, NY,
United States
(Borer) Department of Medicine, Division of Cardiovascular Medicine, State
University of New York, Brooklyn and New York, NY, United States
Title
Cardiovascular safety of varenicline: Patient-level meta-analysis of
randomized, blinded, placebo-controlled trials.
Source
American Journal of Therapeutics. 20 (3) (pp 235-246), 2013. Date of
Publication: May-June 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Smoking is a major modifiable risk factor for cardiovascular (CV) disease.
Varenicline is a pharmacological aid for smoking cessation. To explore the
CV safety of varenicline, we investigated the incidence of CV events in
varenicline-treated subjects across all phase 2-4 randomized
placebo-controlled clinical trials of $12-week treatment duration
conducted in smokers aged $18 years and sponsored by the drug
manufacturer. This manuscript reports a subject-level meta-analysis of
time to major adverse cardiovascular events (MACE; defined as CV-related
death, nonfatal myocardial infarction, nonfatal stroke) and time to MACE+
(defined as MACE plus worsening or any procedure for peripheral vascular
disease, hospitalization for angina, or performance of coronary
revascularization). All events were adjudicated by an independent
adjudication committee, blind to treatment assignment. Events were
assessed during treatment and up to 30 days after the last treatment dose.
The primary analytical method was a stratified logrank time-to-event
analysis; secondary analyses were meta-analyses of incidence rate ratios
and rate differences. Overall, 7002 subjects were included (varenicline:
4190; placebo: 2812) from 15 studies. MACE were reported by 13 varenicline
subjects (0.31%) and 6 placebo subjects (0.21%) [hazard ratio, 1.95; 95%
confidence interval (CI): 0.79-4.82; P = 0.15; risk difference, 0.006
events per subject-year; 95% CI: 20.003, 0.015, P 5 0.19]. MACE+ were
reported by 26 varenicline subjects (0.62%) and 12 placebo subjects
(0.43%) (hazard ratio, 1.74; 95% CI: 0.91-3.34, P = 0.10; risk difference,
0.010; 95% CI: 20.002, 0.022, P = 0.11). This subject-level meta-analysis
of MACE or MACE+ up to 30 days posttreatment in placebo-controlled
clinical trials of varenicline found a trend toward increased incidence of
these events in varenicline-treated patients that did not reach
statistical significance. The overall number of events was low and the
absolute risk of CV events with varenicline was small. 2013 Lippincott
Williams & Wilkins.
<7>
Accession Number
2013437041
Authors
Palmerini T. Biondi-Zoccai G. Riva D.D. Mariani A. Savini C. Di Eusanio M.
Genereux P. Frati G. Marullo A.G.M. Landoni G. Greco T. Branzi A. De Servi
S. Di Credico G. Taglieri N. Williams M.R. Stone G.W.
Institution
(Palmerini, Riva, Mariani, Branzi, Taglieri) Dipartimento Cardiovascolare,
Policlinico S.Orsola, Bologna, Italy
(Biondi-Zoccai, Frati, Marullo) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Savini, Di Eusanio) Department of Cardiac Surgery, Policlinico S.Orsola,
Bologna, Italy
(Genereux, Stone) Columbia University Medical Center and the
Cardiovascular Research Foundation, New York, NY, United States
(Frati) Department of Angiocardioneurology, IRCCS 'Neuromed,' Pozzilli
(IS), Italy
(Marullo) Eleonora Lorillard-Spencer-Cenci Foundation, Rome, Italy
(Landoni, Greco) Department of Anesthesia and Intensive Care, Universita'
Vita-Salute San Raffaele, Milano, Italy
(De Servi) Dipartimento di Malattie Cardiovascolari, Ospedale Civile,
Legnano, Italy
(Di Credico) Dipartimento di Cardiochirurgia, Ospedale Civile, Legnano,
Italy
(Williams) Department of Surgery, Columbia University Medical Center, New
York, NY, United States
(Stone) Columbia University Medical Center, New York- Presbyterian
Hospital, Cardiovascular Research Foundation, 111 E. 59th St, 11th Floor,
New York, NY 10022, United States
Title
Risk of stroke with percutaneous coronary intervention compared with
on-pump and off-pump coronary artery bypass graft surgery: Evidence from a
comprehensive network meta-analysis.
Source
American Heart Journal. 165 (6) (pp 910-917.e14), 2013. Date of
Publication: June 2013.
Publisher
Mosby Inc. (11830 Westline Industrial Drive, St. Louis MO 63146, United
States)
Abstract
Background Although some trials have reported that on-pump coronary artery
bypass graft (CABG) surgery may be associated with higher rates of stroke
than percutaneous coronary intervention (PCI), whether stroke is more
common after offpump CABG compared with PCI is unknown. We therefore
sought to determine whether off-pump CABG is associated with an increased
risk of stroke compared with PCI by means of network meta-analysis.
Methods Randomized controlled trials (RCTs) comparing CABG vs PCI were
searched through MEDLINE, EMBASE, Cochrane databases, and proceedings of
international meetings. Results Eighty-three RCTs with 22,729 patients
randomized to on-pump CABG (n = 10,957), off-pump CABG (n = 7,119), or PCI
(n = 4,653) were analyzed. Thirty-day rates of stroke were significantly
lower in patients treated with PCI compared with either off-pump CABG
(odds ratio [OR]; 0.39, 95% CI, 0.19-0.83) or on-pump CABG (OR, 0.26; 95%
CI, 0.12-0.47). Compared with on-pump CABG, off-pump CABG was associated
with significantly lower 30-day risk of stroke (OR, 0.67; 95% CI,
0.41-0.95). However, in sensitivity analyses restricted to high-quality
studies, studies with more than either 100 or 1,000 patients, or studies
with protocol definition or adjudication of stroke by a clinical events
committee, the precision of the point estimate for the 30-day risk of
stroke between off-pump vs on-pump CABG was markedly reduced. Conclusions
Percutaneous coronary intervention is associated with lower 30-day rates
of stroke than both off-pump and on-pump CABG. Further studies are
required to determine whether the risk of stroke is reduced with off-pump
CABG compared with on-pump CABG. (Am Heart J 2013;165:910-917.e14.). 2013,
Mosby, Inc. All rights reserved.
<8>
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Accession Number
2013438884
Authors
Ghoorah K. De Soyza A. Kunadian V.
Institution
(Ghoorah) Newcastle University Medical School, United Kingdom
(De Soyza) Institute of Cellular Medicine, Faculty of Medical Sciences,
Newcastle University, Newcastle-upon-Tyne NE2 4HH, United Kingdom
(De Soyza) Respiratory Medicine, United Kingdom
(Kunadian) Interventional Cardiology Cardiothoracic Centre, Freeman
Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United
Kingdom
Title
Increased cardiovascular risk in patients with chronic obstructive
pulmonary disease and the potential mechanisms linking the two conditions:
A review.
Source
Cardiology in Review. 21 (4) (pp 196-202), 2013. Date of Publication:
July-August 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Cardiovascular diseases, especially coronary artery disease (CAD), are the
leading causes of death in patients with chronic obstructive pulmonary
disease (COPD). There is a high prevalence of common risk factors in the
COPD/CAD patient population including smoking, sedentary lifestyle and low
socio-economic status. However, various studies have shown that airflow
limitation is an independent risk factor for cardiovascular diseases.
Chronic low-grade systemic inflammation, oxidative stress and increased
platelet activation have been widely reported to be pathophysiological
links between COPD and atherosclerosis. Statins and inhaled
corticosteroids have been investigated as potential therapeutic
interventions in COPD that may lower cardiovascular risk. The goals of
this review are to examine the evidence for increased cardiovascular risk
in COPD patients, the possible mechanisms linking these two chronic
conditions, to discuss possible predictors or markers of poor outcomes
among patients diagnosed with both COPD and CAD, and the therapeutic
options aimed at reducing cardiovascular risks associated with COPD. 2012
Lippincott Williams & Wilkins.
<9>
Accession Number
22877317
Authors
Durdu S. Sirlak M. Cetintas D. Inan M.B. Eryilmaz S. Ozcinar E. Yazicioglu
L. Elhan A.H. Akar A.R. Uysalel A.
Institution
(Durdu) Department of Cardiovascular Surgery, Heart Center, Ankara
University School of Medicine, Dikimevi-Ankara, Turkey.
Title
The efficacies of modified mechanical post conditioning on myocardial
protection for patients undergoing coronary artery bypass grafting.
Source
Journal of cardiothoracic surgery. 7 (pp 73), 2012. Date of Publication:
2012.
Abstract
Coronary artery bypass grafting (CABG) with cardioplegic cardiac arrest
and cardiopulmonary bypass (CPB) is associated with myocardial injury. The
aim of this study was to investigate whether a modified mechanical
post-conditioning (MMPOC) technique has a myocardial protective effect by
enhancing early metabolic recovery of the heart following
revascularization. A prospective, randomized trial was conducted at a
single-center university hospital performing adult cardiac surgery.
Seventy-nine adult patients undergoing first-time elective isolated
multivessel coronary artery bypass grafting were prospectively randomized
to MMPOC or control group. Anesthetic, cardiopulmonary bypass, myocardial
protection, and surgical techniques were standardized. The post
reperfusion cardiac indices, inotrope use and
biochemical-electrocardiographic evidence of myocardial injury were
recorded. The incidence of postoperative complications was recorded
prospectively. Operative characteristics, including CPB and aortic
cross-clamp time, were similar between the two groups (p>0.05). The MMPOC
group had lower troponin I and other cardiac biomarkers level post CPB and
postoperatively, with greater improvement in cardiac indices (p<0.001).
MMPOC shortened post surgery hospitalization from 9.1 +/- 2.1 to 7.5 +/-
1.6 days (p<0.001). MMPOC technique promotes early metabolic recovery of
the heart during elective CABG, leading to better myocardial protection
and functional recovery.
<10>
Accession Number
20340049
Authors
van Mastrigt G.A. Joore M.A. Nieman F.H. Severens J.L. Maessen J.G.
Institution
(van Mastrigt) Clinical Epidemiology and Medical Technology Assessment,
University Hospital Maastricht, Maastricht, Netherlands.
Title
Health-related quality of life after fast-track treatment results from a
randomized controlled clinical equivalence trial.
Source
Quality of life research : an international journal of quality of life
aspects of treatment, care and rehabilitation. 19 (5) (pp 631-642), 2010.
Date of Publication: Jun 2010.
Abstract
This randomized clinical equivalence trial was designed to evaluate
health-related quality of life (HRQoL) after fast-track treatment for
low-risk coronary artery bypass (CABG) patients. Four hundred and ten CABG
patients were randomly assigned to undergo either short-stay intensive
care treatment (SSIC, 8 h of intensive care stay) or control treatment
(care as usual, overnight intensive care stay). HRQoL was measured at
baseline and 1 month, and one year after surgery using the
multidimensional index of life quality (MILQ), the EQ-5D, the Beck
Depression Inventory and the State-Trait Anxiety Inventory. At one month
after surgery, no statistically significant difference in overall HRQoL
was found (MILQ-score P-value=.508, overall MILQ-index P-value=.543, EQ-5D
VAS P-value=.593). The scores on the MILQ-domains, physical, and social
functioning were significantly higher at one month postoperatively in the
SSIC group compared to the control group (P-value=.049; 95%CI: 0.01-2.50
and P-value=.014, 95% CI: 0.24-2.06, respectively). However, these
differences were no longer observed at long-term follow-up. According to
our definition of clinical equivalence, the HRQoL of SSIC patients is
similar to patients receiving care as usual. Since safety and the
financial benefits of this intervention were demonstrated in a previously
reported analysis, SSIC can be considered as an adequate fast-track
intensive care treatment option for low-risk CABG patients.
<11>
Accession Number
23687144
Authors
Hao X.-Q. Zhang S.-Y. Cheng X.-C. Li M. Sun T.-W. Zhang J.-L. Guo W. Li L.
Institution
(Hao, Zhang, Guo, Li) Department of Pharmacy, College of Animal Science
and Technology, Henan University of Science and Technology, Luoyang
471003, China
(Zhang) Department of Cardiology, Luoyang Central Hospital Affiliated to
Zhengzhou University, Luoyang 471000, China
(Cheng) Department of Animal Science, College of Animal Science and
Technology, Henan University of Science and Technology, Luoyang 471003,
China
(Li) Luoyang Entry-Exit Inspection and Quarantine Bureau, Luoyang 471003,
China
(Sun) Department of Integrated ICU, The First Affiliated Hospital of
Zhengzhou University, Zhengzhou 450052, China
Title
Imidapril inhibits right ventricular remodeling induced by low ambient
temperature in broiler chickens.
Source
Poultry Science. 92 (6) (pp 1492-1497), 2013. Date of Publication: June
2013.
Publisher
Poultry Science Association (1800 South Oak Str.,Str 100, champaign,
Illinois 61820, United States)
Abstract
This study explored the effect of imidapril on the right ventricular
remodeling induced by low ambient temperature in broiler chickens.
Twenty-four broiler chickens were randomly divided into 3 groups (n = 8),
including the control group, low temperature group, and imidapril group.
Chickens in the control group were raised at normal temperature, whereas
chickens in the low temperature group and imidapril group were exposed to
low ambient temperature (12 to 18degreeC) from 14 d of age until 45 d of
age. At the same time, chickens in the imidapril group were gavaged with
imidapril at 3 mg/kg once daily for 30 d. The thickness of the right
ventricular wall was observed with echocardiography. The BW and wet lung
weight as well as weight of right and left ventricles and ventricular
septum were measured. Both wet lung weight index and right ventricular
hypertrophy index were calculated. Pulmonary arterial systolic pressure
was assessed according to echocardiography. The expression of ACE and ACE2
mRNA in the right ventricular myocardial tissue was quantified by
real-time PCR. Proliferating cell nuclear antigen-positive cells were
detected by immunohistostaining. The concentration of angiotensin (Ang) II
and Ang (1-7) in the right ventricular myocardial tissue was measured with
ELISA. The results showed that right ventricular hypertrophy index, wet
lung weight index, pulmonary arterial systolic pressure, expression of ACE
mRNA in the right ventricular tissue, Ang II concentration, and the
thickness of the right ventricular wall in the low temperature group
increased significantly compared with those in the control group and
imidapril group. The ACE2 mRNA expression increased 36%, whereas Ang (1-7)
concentration decreased significantly in the low temperature group
compared with that in the control group and imidapril group. In
conclusion, imidapril inhibits right ventricular remodeling induced by low
ambient temperature in broiler chickens. 2013 Poultry Science Association
Inc.
<12>
Accession Number
23241361
Authors
Martorella G. Cote J. Racine M. Choiniere M.
Institution
(Martorella) Faculty of Nursing, University of Montreal, Montreal, QC,
Canada.
Title
Web-based nursing intervention for self-management of pain after cardiac
surgery: pilot randomized controlled trial.
Source
Journal of medical Internet research. 14 (6) (pp e177), 2012. Date of
Publication: 2012.
Abstract
Most adults undergoing cardiac surgery suffer from moderate to severe pain
for up to 6 days after surgery. Individual barriers and attitudes
regarding pain and its relief make patients reluctant to report their pain
and ask for analgesic medication, which results in inadequate pain
management. More innovative educational interventions for postoperative
pain relief are needed. We developed a Web-based nursing intervention to
influence patient's involvement in postoperative pain management. The
intervention (SOULAGE-TAVIE) includes a preoperative 30-minute Web-based
session and 2 brief face-to-face postoperative booster sessions. The Web
application generates reflective activities and tailored educational
messages according to patients' beliefs and attitudes. The messages are
transmitted through videos of a virtual nurse, animations, stories, and
texts. The aim of this single-blinded pilot randomized trial was to
investigate the preliminary effects of a virtual nursing intervention
(SOULAGE-TAVIE) to improve pain relief in patients undergoing cardiac
surgery. Participants (N = 60) were adults scheduled for their first
cardiac surgery. They were randomly assigned to the experimental group
using SOULAGE-TAVIE (n = 30) or the control group using usual care,
including an educational pamphlet and postoperative follow-up (n = 30).
Data were collected through questionnaires at the time of admission and
from day 1 to day 7 after surgery with the help of a blinded research
assistant. Outcomes were pain intensity, pain interference with daily
activities, patients' pain barriers, tendency to catastrophize in face of
pain, and analgesic consumption. The two groups were comparable at
baseline across all demographic measures. Results revealed that patients
in the experimental group did not experience less intense pain, but they
reported significantly less pain interference when breathing/coughing (P =
.04). A severe pain interference with breathing/coughing (pain ranked >=
7/10) was reported on day 3 after surgery by 15% of the patients in the
experimental group (4/27), as compared to 44% (7/16) in the control group.
On day 7 after surgery, participants in the experimental group also
exhibited fewer pain-related barriers as measured by the Barriers
Questionnaire-II (mean 10.6, SD 8.3) than patients in the control group
(mean 15.8, SD 7.3, P = .02). No difference was found for pain
catastrophizing. However, in both groups, means revealed a lower tendency
to catastrophize pain before surgery as measured by the Pain
Catastrophizing Scale (control group mean 1.04, SD 0.74; experimental
group mean 1.10, SD 0.95) and after surgery (control group mean score
1.19, SD 0.94; experimental group mean score 1.08, SD 0.99). Finally, the
experimental group consumed more opioid medication (mean 31.2 mg, SD 23.2)
than the control group (mean 18.8 mg, SD 15.3, P = .001). This pilot study
provides promising results to support the benefits of this new
Web-tailored approach that can increase accessibility to health education
and promote pain relief without generating more costs. Clinicaltrials.gov
NCT01084018; http://www.clinicaltrials.gov/ct2/show/NCT01084018 (Archived
by WebCite at http://www.webcitation.org/6CoTBkIoT).
<13>
Accession Number
21943128
Authors
Krzych L.J. Lees B. Nugara F. Banya W. Bochenek A. Cook J. Taggart D.
Flather M.D.
Institution
(Krzych) Clinical Trials and Evaluation Unit, Royal Brompton and Harefield
NHS Foundation Trust, London, UK.
Title
Assessment of data quality in an international multi-centre randomised
trial of coronary artery surgery.
Source
Trials. 12 (pp 212), 2011. Date of Publication: 2011.
Abstract
ART is a multi-centre randomised trial of cardiac surgery which provided a
unique opportunity to evaluate the data from a large number of centres
from a variety of countries. We attempted to assess data quality,
including recruitment rates, timeliness and completeness of the data
obtained from the centres in different socio-economic strata. The analysis
was based on the 2-page CRF completed at the 6 week follow-up. CRF pages
were categorised into "clean" (no edit query) and "dirty" (any incomplete,
inconsistent or illegible data). The timelines were assessed on the basis
of the time interval from the visit and receipt of complete CRF. Data
quality was defined as the number of data queries (in percent) and time
delay (in days) between visit and receipt of correct data. Analyses were
stratified according to the World Bank definitions into: "Developing"
countries (Poland, Brazil and India) and "Developed" (Italy, UK, Austria
and Australia). There were 18 centres in the "Developed" and 10 centres in
the "Developing" countries. The rate of enrolment did not differ
significantly by economic level ("Developing":4.1 persons/month,
"Developed":3.7 persons/month). The time interval for the receipt of data
was longer for "Developing" countries (median:37 days) compared to
"Developed" ones (median:11 days) (p < 0.001). The median number of data
queries was 23% in "Developed" countries compared to 19% in "Developing"
ones (p = ns). In this study we showed that data quality was comparable
between centres from "Developed" and "Developing" countries. Data was
received in a less timely fashion from Developing countries and
appropriate systems should be instigated to minimize any delays. Close
attention should be paid to the training of centres and to the central
management of data quality. ISRCTN46552265.
<14>
Accession Number
21918956
Authors
Hirao M. Ando N. Tsujinaka T. Udagawa H. Yano M. Yamana H. Nagai K.
Mizusawa J. Nakamura K. Japan Esophageal Oncology Group - Japan Clinical
Oncology Group
Institution
(Hirao) Department of Surgery, National Hospital Organization, Osaka
National Hospital, Osaka, Japan.
Title
Influence of preoperative chemotherapy for advanced thoracic oesophageal
squamous cell carcinoma on perioperative complications.
Source
The British journal of surgery. 98 (12) (pp 1735-1741), 2011. Date of
Publication: Dec 2011.
Abstract
The Japan Clinical Oncology Group (JCOG) 9907 trial has changed the
standard of care for advanced thoracic oesophageal cancer in Japan from
postoperative chemotherapy to preoperative chemotherapy. The impact of
preoperative chemotherapy on the risk of developing postoperative
complications remains controversial. This article reports the safety
analysis of JCOG9907, focusing on risk factors for postoperative
complications. Patients with potentially resectable advanced thoracic
oesophageal squamous cell carcinoma were randomized to either
postoperative or preoperative chemotherapy followed by transthoracic
oesophagectomy with D2-3 lymphadenectomy. Chemotherapy consisted of two
cycles of cisplatin and 5-fluorouracil. Clinical baseline data,
intraoperative complications, postoperative complications and in-hospital
mortality, collected on the case report forms in a predetermined format,
were analysed. Univariable and multivariable analyses were used to explore
the risk of postoperative complications in relation to treatment group,
age, sex, tumour depth, nodal metastasis, stage and location. Of 330
patients randomized, 166 were assigned to receive postoperative
chemotherapy and 164 preoperative chemotherapy; 162 and 154 patients
respectively underwent surgery. The incidence of intraoperative
complications, postoperative complications and in-hospital mortality was
similarly low in both groups. Multivariable analysis showed that age, sex
and tumour location were independently associated with an increase in
postoperative complications, but preoperative chemotherapy was not.
Preoperative chemotherapy does not increase the risk of complications or
hospital mortality after surgery for advanced thoracic oesophageal cancer.
Copyright 2011 British Journal of Surgery Society Ltd. Published by John
Wiley & Sons, Ltd.
<15>
Accession Number
20702510
Authors
Pluss C.E. Billing E. Held C. Henriksson P. Kiessling A. Karlsson M.R.
Wallen H.N.
Institution
(Pluss) Karolinska Institute, Department of Clinical Sciences, Division of
Cardiovascular Medicine, Danderyd Hospital, Stockholm, Sweden.
Title
Long-term effects of an expanded cardiac rehabilitation programme after
myocardial infarction or coronary artery bypass surgery: a five-year
follow-up of a randomized controlled study.
Source
Clinical rehabilitation. 25 (1) (pp 79-87), 2011. Date of Publication: Jan
2011.
Abstract
To investigate the long-term effect of expanded cardiac rehabilitation on
a composite end-point, consisting of cardiovascular death, myocardial
infarction or readmission for cardiovascular disease, in patients with
coronary artery disease. Single-centre prospective randomized controlled
trial. University hospital. Two hundred and twenty-four patients with
acute myocardial infarction or undergoing coronary artery by-pass
grafting. Patients were randomized to expanded cardiac rehabilitation (a
one-year stress management programme, increased physical training, staying
at a 'patient hotel' for five days after the event, and cooking sessions),
or to standard cardiac rehabilitation. Data on cardiovascular death,
myocardial infarction, readmission for cardiovascular disease and days at
hospital for cardiovascular reasons were obtained from national registries
of the Swedish National Board of Health and Welfare. The primary end-point
occurred in 121 patients altogether (54%). The number of cardiovascular
events were reduced in the expanded rehabilitation group compared with the
standard cardiac rehabilitation (53 patients (47.7%) versus 68 patients
(60.2%); hazard ratio 0.69; P =0.049). This was mainly because of a
reduction of myocardial infarctions in the expanded rehabilitation group.
During the five years 12 patients (10.8%) versus 23 patients (20.3%);
hazard ratio 0.47; P =0.047 had a myocardial infarction. Days at hospital
for cardiovascular reasons were significantly reduced in patients who
received expanded cardiac rehabilitation (median 6 days) compared with
standard cardiac rehabilitation (median 10 days; P =0.02). Expanded
cardiac rehabilitation after acute myocardial infarction or coronary
artery bypass grafting reduces cardiovascular morbidity and days at
hospital for cardiovascular reasons.
<16>
Accession Number
20524462
Authors
Bakhsh M. Abbas S. Hussain R.M. Ali Khan S. Naqvi S.M.
Institution
(Bakhsh) Department of Anaesthesia, Armed Forces Institute of Cardiology,
Rawalpindi, Pakistan.
Title
Role of magnesium in preventing post-operative atrial fibrillation after
coronary artery bypass surgery.
Source
Journal of Ayub Medical College, Abbottabad : JAMC. 21 (2) (pp 27-29),
2009. Date of Publication: 2009 Apr-Jun.
Abstract
To assess the role of 3 days of magnesium infusion after coronary artery
bypass graft (CABG) surgery in preventing postoperative atrial
fibrillation (AF). Place and Duration of Study: Armed Forces Institute of
Cardiology (AFIC) & National Institute of Heart Diseases (NIHD),
Rawalpindi, from July 2006 to June 2007. Prospective, randomized,
non-blinded. All patients undergoing isolated, initial CABG surgery, and
having sinus rhythm before surgery were alternatively randomized into the
study or the control group. The exclusion criteria included: history of
AF, implanted pacemaker, myocardial infarction postoperatively, use of
left ventricular assist devices and renal failure. The patients in the
study group received 10 mmol of magnesium sulphate (2.47 gm) dissolved in
100 ml of saline solution infused intravenously over 4 hours, for 3 days.
The end point was development of AF for at least 15 minutes or more, or if
an episode of AF had to be treated because of symptoms. A total of 220
patients were included in the study, 110 in each group. The incidence of
AF was 9% in patients who received the three days of magnesium infusion.
The patients without magnesium had an AF incidence of 23% (p < 0.001). The
hospital stay was also less in the treated group (p = 0.055). A 3-days
postoperative infusion of magnesium is safe and effective in reduction of
possibly life-threatening AF, in patients undergoing primary coronary
artery bypass surgery.
<17>
Accession Number
2013425904
Authors
Farkouh M.E. Domanski M. Sleeper L.A. Fuster V.
Institution
(Fuster) Mount Sinai School of Medicine, New York, NY, United States
Title
PCI using drug-eluting stents had higher mortality than CABG in diabetes
and multivessel CAD.
Source
Annals of Internal Medicine. 158 (6) (pp JC8), 2013. Date of Publication:
2013.
Publisher
American College of Physicians (190 N. Indenpence Mall West, Philadelphia
PA 19106-1572, United States)
<18>
[Use Link to view the full text]
Accession Number
2013436689
Authors
De Vecchis R. Di Biase G. Esposito C. Ciccarelli A. Cioppa C. Giasi A.
Ariano C. Cantatrione S.
Institution
(De Vecchis, Cioppa, Giasi, Cantatrione) Cardiology Unit, Presidio
Sanitario Intermedio Elena d'Aosta, Napoli, Italy
(Di Biase, Ariano) Neurorehabilitation Unit, Clinica S. Maria Del Pozzo,
Somma Vesuviana, Italy
(Esposito) Institute of Hygiene and Preventive Medicine, Second University
of Napoli, Napoli, Italy
(Ciccarelli) Italian College of General Practitioners, ASL NA 2 Nord
Public Health Company, Monterusciello Pozzuoli, Italy
Title
Statin use for nonrheumatic calcific aortic valve stenosis: A review with
meta-analysis.
Source
Journal of Cardiovascular Medicine. 14 (8) (pp 559-567), 2013. Date of
Publication: August 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
AIMS: To synthesize by meta-analysis the findings of recent experimental
studies focusing on possible therapeutic effectiveness of statins for
nonrheumatic calcific aortic stenosis METHODS: Observational studies and
randomized controlled trials (RCTs) were selected from the Pubmed database
to evaluate the hemodynamic progression of aortic stenosis in
statin-treated patients compared with controls (i.e. patients with aortic
stenosis taking placebo or no treatment). The endpoints were the
annualized changes in one or more of the following ultrasonographic
measurements: peak aortic valve jet velocity, peak aortic valve pressure
gradient, mean aortic valve pressure gradient aortic valve area (AVA). For
estimating the overall effect of statin therapy on each of the
above-mentioned continuous variables across the considered studies, we
used the weighted mean difference (WMD) as effect size measure. In
addition, we calculated the odds of aortic valve replacement surgery and
cardiovascular death in both statin-treated patients and controls for
subsequently estimating the appropriate odds ratios. RESULTS: Nine studies
were selected. A lower annualized increase in peak aortic valve jet
velocity was found in statin-treated patients compared with controls
(overall WMD: -0.09m/s per year, 95% CI -0.16, -0.01 P=0.018). Similarly,
a smaller annualized increase in peak aortic valve pressure gradient was
found in the statin group (overall WMD: -2.04mmHg/year 95% CI: -3.56,
-0.52, P=0.0085).However, the overall effects in statin-treated patients
on both annualized increases in mean aortic valve pressure gradient and
decreases in AVA were not significantly different from those found in
controls. Moreover, there was no significant difference in cardiovascular
outcomes in the statin groups compared with placebo groups in each of the
three analyzed RCTs and overall. CONCLUSION: Significant benefit of statin
therapy in retarding hemodynamic deterioration was identified by favorable
effects concerning annualized changes in peak aortic valve jet velocity
and peak aortic valve pressure gradient; on the contrary, in
statin-treated patients with aortic stenosis, no significant improvement
was found for annualized changes in mean aortic valve pressure gradient
and AVA and clinical outcomes. 2013 Italian Federation of Cardiology.
<19>
Accession Number
22412081
Authors
de Macedo R.M. Neto J.R. Costantini C.O. Olandoski M. Casali D. de Macedo
A.C. Muller A. Costantini C.R. do Amaral V.F. de Carvalho K.A.
Guarita-Souza L.C.
Institution
(de Macedo) Pontificia Universidade Catolica do Parana, Brazil.
Title
A periodized model for exercise improves the intra-hospital evolution of
patients after myocardial revascularization: a pilot randomized controlled
trial.
Source
Clinical rehabilitation. 26 (11) (pp 982-989), 2012. Date of Publication:
Nov 2012.
Abstract
To compare models of the postoperative hospital treatment phase after
myocardial revascularization. Design: A pilot randomized controlled trial.
Setting: Hospital patients in a hospital setting. Thirty-two patients with
indications for myocardial revascularization were included between January
2008 and December 2009, with a left ventricular ejection fraction (LVEF)
>=50%, 1-second forced expiratory volume (FEV(1)) >=60 and forced vital
capacity (FVC) >=60% of predicted value. Patients were randomly placed
into two groups: one performed prescribed exercises according to the model
proposed by the American College of Sports Medicine (ACSM) and the other
according to a periodized model. Main measures: Partial pressure of O(2)
(P o (2)) and arterial O(2) saturation (Sao (2)), percentage of predicted
FVC and total distance on the six-minute walking test (6MWT). Twenty-seven
patients were re-evaluated upon release from the hospital (ACSM = 14 and
PP = 13). Five patients extubated for more than 6 hours in the
postoperative period were excluded from the sample. In the preoperative
period the variables P o (2), Sao (2), % FVC and 6MWT were similar. In the
postoperative period, a reduction was observed for all parameters in both
groups. Upon comparison of the groups, a difference was observed in P o
(2) (ACSM = 68.0 +/- 4.3 vs. PP = 75.9 +/- 4.8 mmHg; P < 0.001), Sao (2)
(ACSM = 93.5 +/- 1.4 vs. PP = 94.8 +/- 1.2%; P = 0.018) and 6MWT (ACSM =
339.3 +/- 41.7 vs. PP = 393.8 +/- 25.7 m; P < 0.001). There was no
difference in % FVC. Patients after myocardial revascularization following
a periodized model of exercise presented a better intra-hospital evolution
when compared to those using the ACSM model.
<20>
Accession Number
21169142
Authors
Adluri R.K. Singh A.V. Skoyles J. Robins A. Parton J. Baker M. Mitchell
I.M.
Institution
(Adluri) Department of Cardiac Surgery, Nottingham City Hospital,
Nottingham, UK.
Title
The effect of fenoldopam and dopexamine on cytokine and endotoxin release
following on-pump coronary artery bypass grafting: a prospective
randomized double-blind trial.
Source
The heart surgery forum. 13 (6) (pp E353-361), 2010. Date of Publication:
1 Dec 2010.
Abstract
Surgical trauma, exposure to an external circuit, and reduced organ
perfusion contribute to the systemic inflammatory response following
cardiopulmonary bypass (CPB). Reduced splanchnic perfusion causes
disruption of the gastrointestinal mucosal barrier and the release of
endotoxins. Fenoldopam (a new dopamine 1 receptor agonist) has been shown
to be a specific renosplanchnic vasodilator in animal and human studies.
We studied the effects of fenoldopam on the systemic inflammatory response
and the release of endotoxins after CPB and compared the results with
those for dopexamine. Our prospective randomized study included 42
consecutive patients with good to moderate left ventricular function who
were to undergo elective or inpatient coronary artery bypass grafting. We
used closed envelope method to randomize patients to receive 0.2 mug/kg
per minute of fenoldopam (n = 14), 2 mug/kg per minute of dopexamine (n =
14), or normal saline (n = 14). Patients received their respective
treatments continuously from anesthesia induction until the end of the
first 24 postoperative hours. Interleukin 1beta (IL-1beta), IL-6, IL-8,
IL-10, IL-12, tumor necrosis factor alpha, complement 3a (C3a), C4a, C5a,
and endotoxins were measured during the perioperative period.
Repeated-measures analysis of variance was used to evaluate the results
for the timed samples. There were no statistical differences between the
groups with respect to pre- and intraoperative variables. Release of C3a
was attenuated in the fenoldopam group (P = .002), and release of IL-6 and
IL-8 was attenuated in the postoperative period in the fenoldopam group (P
= .012 and .015, respectively). The other interleukins showed no uniform
release in any of the 3 groups. There were no statistically significant
differences in serum endotoxin elevation between the 3 groups. A partial
attenuation in the inflammatory response is possible with fenoldopam
infusion. The elevation in serum endotoxin levels was not affected by
dopexamine or fenoldopam infusion.
<21>
Accession Number
2013426385
Authors
Zhong H. Gao Z. Chen M. Zhao J. Wang F. Li L. Dong H. Liu L. Wang Q. Xiong
L.
Institution
(Zhong, Gao, Chen, Zhao, Wang, Li, Dong, Wang, Xiong) Department of
Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an
710032, Shaanxi, China
(Liu) Department of Anesthesiology, Stony Brook University, School of
Medicine, Stony Brook NY, United States
Title
Cardioprotective effect of remote ischemic postconditioning on children
undergoing cardiac surgery: A randomized controlled trial.
Source
Paediatric Anaesthesia. 23 (8) (pp 726-733), 2013. Date of Publication:
August 2013.
Publisher
Blackwell Publishing Ltd (9600 Garsington Road, Oxford OX4 2XG, United
Kingdom)
Abstract
Background: Remote ischemic postconditioning (RPostC) is a noninvasive
intervention that has demonstrated cardioprotection and neuroprotection in
animal studies. Objective: Our goal was to investigate the cardio-cerebral
protective effects of RPostC on children undergoing open-heart surgery for
repair of congenital heart defects (CHD). Methods: Children undergoing
open-heart repair of CHD were randomly assigned to a RPostC or control
group. RPostC was induced by three 5-min cycles of lower limb ischemia and
reperfusion using a blood pressure cuff (200 mmHg) at the onset of aortic
unclamping. Serum cardiac troponin I (cTnI), creatine kinase-MB (CK-MB),
neuron-specific enolase (NSE), S100beta, cytokines, and clinical outcomes
were assessed. Results: There were 35 children in the control group and 34
in the RPostC group. The mean age (3.64 +/- 1.95 years vs. 3.45 +/- 3.02
years, P = 0.80), weight (15.11 +/- 6.91 kg vs. 13.40 +/- 6.33 kg, P =
0.37), surgical time (144.82 +/- 38.51 min vs. 129.92 +/- 30.76 min, P =
0.15), and bypass time (78.01 +/- 27.22 min vs. 72.52 +/- 26.05 min, P =
0.49) were not different. Compared with the control group, the
postoperative levels of cTnI (P = 0.037) and CK-MB (P = 0.046) were
significantly reduced in the RPostC group. Furthermore, the MAP was higher
(P = 0.008), and ICU stay (36.87 +/- 3.30 h vs. 60.57 +/- 7.35 h, P =
0.006) and postoperative hospital stay (8.56 +/- 1.50 days vs. 10.06 +/-
2.41 days, P = 0.048) were shorter in the RPostC group than in the control
group. However, the postoperative CVP and the concentrations of NSE,
S100beta, CRP, TNF-alpha, IL-1beta, IL-6, and IL-10 were not significantly
different. Conclusion: RPostC significantly alleviates cardiac injury in
children undergoing open-heart repair of CHD and may also reduce cerebral
injury. 2013 John Wiley & Sons Ltd.
<22>
Accession Number
22090660
Authors
Becker R.C. Bassand J.P. Budaj A. Wojdyla D.M. James S.K. Cornel J.H.
French J. Held C. Horrow J. Husted S. Lopez-Sendon J. Lassila R. Mahaffey
K.W. Storey R.F. Harrington R.A. Wallentin L.
Institution
(Becker) Duke University School of Medicine, Duke Clinical Research
Institute, Durham, NC 27715, USA.
Title
Bleeding complications with the P2Y12 receptor antagonists clopidogrel and
ticagrelor in the PLATelet inhibition and patient Outcomes (PLATO) trial.
Source
European heart journal. 32 (23) (pp 2933-2944), 2011. Date of Publication:
Dec 2011.
Abstract
AIMS More intense platelet-directed therapy for acute coronary syndrome
(ACS) may increase bleeding risk. The aim of the current analysis was to
determine the rate, clinical impact, and predictors of major and fatal
bleeding complications in the PLATO study. METHODS AND RESULTS PLATO was a
randomized, double-blind, active control international, phase 3 clinical
trial in patients with acute ST elevation and non-ST-segment elevation
ACS. A total of 18 624 patients were randomized to either ticagrelor, a
non-thienopyridine, reversibly binding platelet P2Y(12) receptor
antagonist, or clopidogrel in addition to aspirin. Patients randomized to
ticagrelor and clopidogrel had similar rates of PLATO major bleeding (11.6
vs. 11.2%; P = 0.43), TIMI major bleeding (7.9 vs. 7.7%, P = 0.56) and
GUSTO severe bleeding (2.9 vs. 3.1%, P = 0.22). Procedure-related bleeding
rates were also similar. Non-CABG major bleeding (4.5 vs. 3.8%, P = 0.02)
and non-procedure-related major bleeding (3.1 vs. 2.3%, P = 0.05) were
more common in ticagrelor-treated patients, primarily after 30 days on
treatment. Fatal bleeding and transfusion rates did not differ between
groups. There were no significant interactions for major bleeding or
combined minor plus major bleeding between treatment groups and age >=75
years, weight <60 kg, region, chronic kidney disease, creatinine clearance
<60 mL/min, aspirin dose >325 mg on the day of randomization,
pre-randomization clopidogrel administration, or clopidogrel loading dose.
CONCLUSION Ticagrelor compared with clopidogrel was associated with
similar total major bleeding but increased non-CABG and
non-procedure-related major bleeding, primarily after 30 days on study
drug treatment. Fatal bleeding was low and did not differ between groups.
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