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<1>
Accession Number
2013642667
Authors
Kraal J.J. Peek N. van den Akker-Van Marle M.E. Kemps H.M.C.
Institution
(Kraal, Peek, Kemps) Department of Medical Informatics, Academic Medical
Center, University of Amsterdam, Amsterdam, Netherlands
(van den Akker-Van Marle) Department of Medical Decision Making, Leiden
University Medical Center, Leiden, Netherlands
(Kemps) Department of Cardiology, Maxima Medical Center, Veldhoven,
Netherlands
Title
Effects and costs of home-based training with telemonitoring guidance in
low to moderate risk patients entering cardiac rehabilitation: The
FIT@Home study.
Source
BMC Cardiovascular Disorders. 13 , 2013. Article Number: 82. Date of
Publication: 08 Oct 2013.
Publisher
BioMed Central Ltd. (Floor 6, 236 Gray's Inn Road, London WC1X 8HB, United
Kingdom)
Abstract
Background: Physical training has beneficial effects on exercise capacity,
quality of life and mortality in patients after a cardiac event or
intervention and is therefore a core component of cardiac rehabilitation.
However, cardiac rehabilitation uptake is low and effects tend to decrease
after the initial rehabilitation period. Home-based training has the
potential to increase cardiac rehabilitation uptake, and was shown to be
safe and effective in improving short-term exercise capacity. Long-term
effects on physical fitness and activity, however, are disappointing.
Therefore, we propose a novel strategy using telemonitoring guidance based
on objective training data acquired during exercise at home. In this way,
we aim to improve self-management skills like self-efficacy and action
planning for independent exercise and, consequently, improve long-term
effectiveness with respect to physical fitness and physical activity. In
addition, we aim to compare costs of this strategy with centre-based
cardiac rehabilitation.Methods/design: This randomized controlled trial
compares a 12-week telemonitoring guided home-based training program with
a regular, 12-week centre-based training program of equal duration and
training intensity in low to moderate risk patients entering cardiac
rehabilitation after an acute coronary syndrome or cardiac intervention.
The home-based group receives three supervised training sessions before
they commence training with a heart rate monitor in their home
environment. Participants are instructed to train at 70-85% of their
maximal heart rate for 45-60 minutes, twice a week. Patients receive
individual coaching by telephone once a week, based on measured heart rate
data that are shared through the internet. Primary endpoints are physical
fitness and physical activity, assessed at baseline, after 12 weeks and
after one year. Physical fitness is expressed as peak oxygen uptake,
assessed by symptom limited exercise testing with gas exchange analysis;
physical activity is expressed as physical activity energy expenditure,
assessed by tri-axial accelerometry and heart rate measurements. Secondary
endpoints are training adherence, quality of life, patient satisfaction
and cost-effectiveness.Discussion: This study will increase insight in
long-term effectiveness and costs of home-based cardiac rehabilitation
with telemonitoring guidance. This strategy is in line with the trend to
shift non-complex healthcare services towards patients' home environments.
Trial registration: Dutch Trial Register: NTR3780. Clinicaltrials.gov
register: NCT01732419. 2013 Kraal et al.; licensee BioMed Central Ltd.

<2>
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Accession Number
2013644177
Authors
Munoz P. Valerio M. Palomo J. Giannella M. Yanez J.F. Desco M. Bouza E.
Institution
(Munoz, Valerio, Giannella, Bouza) Department of Clinical Microbiology and
Infectious Diseases, Hospital General Universitario Gregorio Maranon,
Madrid, Spain
(Palomo, Yanez) Department of Cardiology, Hospital General Universitario
Gregorio Maranon, Madrid, Spain
(Desco) Department of Experimental Medicine, Hospital General
Universitario Gregorio Maranon, Madrid, Spain
(Munoz, Bouza) Department of Medicine, Universidad Complutense de Madrid,
Madrid, Spain
(Munoz, Bouza) Red Espanola de Investigacion en Patologia Infecciosa
(REIPI), Madrid, Spain
(Munoz, Bouza) CIBER de Enfermedades Respiratorias (CIBER RES), Palma
deMallorca, Spain
(Munoz, Bouza) Spanish Study Group of Infections in Transplant Recipients
(GESITRA), Madrid, Spain
(Desco) Department of Bioengineering and Aerospace Engineering,
Universidad Carlos III de Madrid, Spain
Title
Targeted antifungal prophylaxis in heart transplant recipients.
Source
Transplantation. 96 (7) (pp 664-669), 2013. Date of Publication: 15 Oct
2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
BACKGROUND: Antifungal prophylaxis after heart transplantation is usually
targeted to high-risk recipients, but the duration is normally fixed and
empirical. Our purpose was to assess the efficacy of a personalized
prophylactic approach based on the duration of the risk factors. METHODS:
In a prospective cohort, from 2003 to 2010, prophylaxis was only
administered to patients with risk factors (13 of 133) and duration was
personalized, starting with the risk factor and continued a median of 20
days after its resolution. RESULTS: Antifungal prophylaxis was prescribed
only in 9.8% of the recipients and was effective in all but one patient
who should have received a higher dose of caspofungin due to his obesity.
Despite suffering an outbreak of invasive aspergillosis (IA) in the
intensive care unit due to extremely high concentration of spores in the
air (three cases with no personal risk factors), there was a reduction in
the incidence of IA (8.6% vs. 2.2%; P=0.01) and Aspergillus-related
mortality (5.75% vs. 1.5%; P=0.06). CONCLUSIONS: Targeted prophylaxis for
IA in heart recipients provided only to patients with risk factors and
maintained for a median of 20 days after their disappearance is effective
and safe. A high environmental load of Aspergillus spores in the intensive
care unit would also indicate the need for antifungal prophylaxis in all
exposed patients. Copyright 2013 by Lippincott Williams & Wilkins.

<3>
Accession Number
2013612654
Authors
Chatterjee S. Ghose A. Sharma A. Guha G. Mukherjee D. Frankel R.
Institution
(Chatterjee, Sharma, Frankel) Maimonides Medical Center, 864 49th Street
Apt C11, Brooklyn NY 11220, United States
(Ghose) University of Toledo, Toledo OH, United States
(Guha) Oregon State University, Corvallis OR, United States
(Mukherjee) Texas Tech University Health Sciences Center, El Paso TX,
United States
Title
Comparing newer oral anti-platelets prasugrel and ticagrelor in reduction
of ischemic events-evidence from a network meta-analysis.
Source
Journal of Thrombosis and Thrombolysis. 36 (3) (pp 223-232), 2013. Date of
Publication: October 2013.
Publisher
Springer Netherlands (Van Godewijckstraat 30, Dordrecht 3311 GZ,
Netherlands)
Abstract
The two newer antiplatelet drugs, prasugrel and ticagrelor have both been
incorporated in various national guidelines and are both under
consideration for approval or have already been approved by various drug
regulatory authorities. Mortality benefits with clopidogrel were
comparable to newer anti-platelets, and prasugrel had great anti-ischemic
potency than ticagrelor. We searched PubMed, EMBASE and Cochrane Central
Register of Controlled Trials' databases for randomized controlled trials
conducted between 1990 and 2012 that assessed clinical outcomes with
prasugrel or ticagrelor. The comparator was standard dosage of
clopidogrel. Outcomes assessed were the risk of all causes mortality, TIMI
non-CABG major bleeding, and a composite of stent thrombosis, recurrent
ischemia and serious recurrent ischemia in the intervention groups versus
the comparator groups. Event rates were compared using a forest plot of
relative risk using a random effects model (Mantel-Haenszel); and Odd's
ratio was calculated in the absence of significant heterogeneity.
Prasugrel was indirectly compared with ticagrelor using network
meta-analysis. Four studies (total N = 34,126) met the inclusion/exclusion
criteria. Both drugs had improved mortality and greater risk of bleeding
compared to clopidogrel; but outcomes were comparable for both (p = NS).
However a composite of recurrent ischemic events, including rates of stent
thrombosis (p = 0.045) was reduced to a modest degree with prasugrel
compared with ticagrelor. This systematic review suggests greater clinical
efficacy of both prasugrel and ticagrelor compared with clopidogrel and an
indirect comparison indicates prasugrel may be more effective than
ticagrelor for preventing stent thrombosis and recurrent ischemic events.
2012 Springer Science+Business Media New York.

<4>
Accession Number
2013639236
Authors
Laiq N. Khan R.A. Malik A.
Institution
(Laiq) Department of Anaesthesia, Lady Reading Hospital Peshawar, Pakistan
(Khan, Malik) Department of Cardiovascular Surgery, Lady Reading Hospital
Peshawar, Pakistan
Title
Non-invasive positive pressure ventilation facilitates early extubation in
post operative cardiac patients.
Source
Journal of Postgraduate Medical Institute. 27 (4) (pp 361-365), 2013. Date
of Publication: 2013.
Publisher
Postgraduate Medical Institute (Lady Reading Hospital, Peshawar, Pakistan)
Abstract
Objectives: To assess the use of NIPPV (non-invasive positive pressure
ventilation) during weaning from mechanical ventilation in post-op
patients in an ICU and compared this procedure with intermittent mandatory
ventilation (IMV) by analyzing cardiac and respiratory parameters and
complications. Methodology: A randomized clinical trial was conducted from
June 2009 to July 2010 on Post-operative surgical patients that were on
IMV for more than 48 hours, who failed at 30 minutes of spontaneous
breathing T-piece trial (SBT). If failure occurred before the 30th minute,
he/she was included in the group previously defined by random assignment.
Patients in the experimental group were extubated and placed on NIPPV,
whereas other patients (the control group) returned to IMV. Daily SBT was
carried out thereafter in order to evaluate the possibility of extubation
in control group. Results: Of 60 patients who failed T-piece trials, 30
patients were placed on NIPPV & 30 on (IMV). The ages of patients in the
NIPPV and IMV groups were 45.7+/- 18.11 and 47.10 +/- 18.45 years
respectively. In both groups, ventilation time before T-piece trial was
2-3 days. Patients of the NIPPV group had a shorter stay in the ICU and in
the hospital i.e., 2.93 +/-0.785 days versus 7.4+1.11 days for IMV group.
No serious complications were observed in both groups. Conclusion: The
results of this study suggest that the combination of early extubation and
NIPPV is a good alternative.

<5>
Accession Number
2013644910
Authors
De Gast-Bakker D.H. De Wilde R.B.P. Hazekamp M.G. Sojak V. Zwaginga J.J.
Wolterbeek R. De Jonge E. Gesink-Van Der Veer B.J.
Institution
(De Gast-Bakker, De Wilde, De Jonge, Gesink-Van Der Veer) Pediatric
Intensive Care Unit, Leiden University Medical Center, Leiden, Netherlands
(Hazekamp, Sojak) Department of Cardiothoracic Surgery, Leiden University
Medical Center, Leiden, Netherlands
(Zwaginga) Center for Clinical Transfusion Research, Sanquin Research,
Leiden, Netherlands
(Zwaginga) Department of Immuno-hematology and Blood Transfusion, Leiden
University Medical Center, Leiden, Netherlands
(Wolterbeek) Department of Medical Statistics and Bioinformatics, Leiden
University Medical Center, Leiden, Netherlands
(De Wilde) Albinusdreef 2, 2300 RC Leiden, Netherlands
Title
Safety and effects of two red blood cell transfusion strategies in
pediatric cardiac surgery patients: A randomized controlled trial.
Source
Intensive Care Medicine. 39 (11) (pp 2011-2019), 2013. Date of
Publication: 2013.
Publisher
Springer Verlag (Tiergartenstrasse 17, Heidelberg D-69121, Germany)
Abstract
Objective: To investigate the safety and effects of a restrictive red
blood cell (RBC) transfusion strategy in pediatric cardiac surgery
patients. Design: Randomized controlled trial. Setting: Pediatric ICU in
an academic tertiary care center, Leiden University Medical Center,
Leiden, The Netherlands. Patients: One hundred seven patients with
non-cyanotic congenital heart defects between 6 weeks and 6 years of age.
One hundred three patients underwent corrective surgery on cardiopulmonary
bypass. Interventions: Prior to surgery patients were randomly assigned to
one of two groups with specific RBC transfusion thresholds: Hb 10.8 g/dl
(6.8 mmol/l) and Hb 8.0 g/dl (5.0 mmol/l). Measurements: Length of stay in
hospital (primary outcome), length of stay in PICU, duration of
ventilation (secondary outcome), incidence of adverse events and
complications related to randomization (intention to treat analysis).
Results: In the restrictive transfusion group, mean volume of transfused
RBC was 186 (+/-70) ml per patient and in the liberal transfusion group
258 (+/-87) ml per patient, (95 % CI 40.6-104.6), p < 0.001. Length of
hospital stay was shorter in patients with a restrictive RBC transfusion
strategy: Median 8 (IQR 7-11) vs. 9 (IQR 7-14) days, p = 0.047. All other
outcome measures and incidence of adverse effects were equal in both RBC
transfusion groups. Cost of blood products for the liberal transfusion
group was 438.35 (+/-203.39) vs. 316.27 (+/-189.96) euros (95 % CI
46.61-197.51) per patient in the restrictive transfusion group, p = 0.002.
Conclusions: For patients with a non-cyanotic congenital heart defect
undergoing elective cardiac surgery, a restrictive RBC transfusion policy
(threshold of Hb 8.0 g/dl) during the entire perioperative period is safe,
leads to a shorter hospital stay and is less expensive. 2013
Springer-Verlag Berlin Heidelberg and ESICM.

<6>
Accession Number
2013644886
Authors
Mesgarpour B. Heidinger B.H. Schwameis M. Kienbacher C. Walsh C. Schmitz
S. Herkner H.
Institution
(Mesgarpour, Heidinger, Schwameis, Kienbacher, Herkner) Department of
Emergency Medicine, General Hospital, Medical University of Vienna,
Wahringer Gurtel 18-20, 1090 Vienna, Austria
(Mesgarpour, Schwameis) Department of Clinical Pharmacology, Medical
University of Vienna, Vienna, Austria
(Walsh) Department of Statistics, Trinity College Dublin, Dublin, Ireland
(Schmitz) Department of Pharmacology and Therapeutics, Trinity College
Dublin, Dublin, Ireland
Title
Safety of off-label erythropoiesis stimulating agents in critically ill
patients: A meta-analysis.
Source
Intensive Care Medicine. 39 (11) (pp 1896-1908), 2013. Date of
Publication: 2013.
Publisher
Springer Verlag (Tiergartenstrasse 17, Heidelberg D-69121, Germany)
Abstract
Purpose: Erythropoiesis stimulating agents (ESAs) are used to treat anemia
in critically ill patients. This indication is off-label, because it is
not licensed by regulatory authorities. Recently ESAs were suspected to
harm critically ill patients. Our objective was to assess the safety of
ESAs in off-label indications in critically ill patients. Methods: Eleven
databases were searched up to April 2012. We considered randomized
controlled trials (RCTs) and controlled observational studies in any
language that compared off-label ESAs treatment with other effective
interventions, placebo or no treatment in critically ill patients. Two
authors independently screened and evaluated retrieved records, extracted
data and assessed risk of bias and quality of reporting. Results: We used
frequentist and Bayesian models to combine studies, and performed
sensitivity and subgroup analyses. From 12,888 citations, we included 48
studies (34 RCTs; 14 observational), involving 944,856 participants. Harm
reporting was of medium to low quality. There was no statistically
significant increased risk of adverse events in general, serious adverse
events, the most frequently reported adverse events, and death in
critically ill patients treated with ESAs. These results were robust
against risk of bias and analysis methods. There is evidence that ESAs
increase the risk of clinically relevant thrombotic vascular events, and
there is some less certain evidence that ESAs might increase the risk for
venous thromboembolism. Conclusions: In critically ill patients,
administration of ESAs is associated with a significant increase in
clinically relevant thrombotic vascular events but not with other
frequently reported adverse events and death. 2013 Springer-Verlag Berlin
Heidelberg and ESICM.

<7>
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Accession Number
2013640357
Authors
Presutti D.G. D'Ascenzo F. Omede P. Biondi-Zoccai G. Moretti C. Bollati M.
Sciuto F. Lee M.S. Moreno R. Bikkina M. Di Cuia M. Resmini C. Gaita F.
Sheiban I.
Institution
(Presutti, D'Ascenzo, Omede, Moretti, Sciuto, Di Cuia, Resmini, Gaita,
Sheiban) Division of Cardiology, Department of Internal Medicine,
University of Turin, Turin, Italy
(Bikkina) Department of Cardiology, St.Joseph's Regional Medical Center,
Paterson, NJ, United States
(Lee) Division of Cardiology, David Geffen School of Medicine, University
of California, Los Angeles, CA, United States
(Moreno) Division of Interventional Cardiology, Instituto Cardiovascular,
Hospital la Paz, Paseo La Castellana, Madrid, Spain
(Biondi-Zoccai) Department of Medico-Surgical Sciences, Biotechnologies
Sapienza University of Rome, Italy
(Bollati) Invasive Cardiology, Campus Middelheim, Antwerpen, Belgium
(D'Ascenzo, Biondi-Zoccai, Moretti) Meta-analysis and Evidence Based
Medicine Training in Cardiology, Italy
Title
Percutaneous coronary intervention in nonagenarian: A meta-analysis of
observational studies.
Source
Journal of Cardiovascular Medicine. 14 (11) (pp 773-779), 2013. Date of
Publication: November 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
BACKGROUND: Developed countries are facing a sustained increase in life
expectancy. Along with all social and cultural implications of increase
lifespan, very elderly patients are undergoing percutaneous coronary
intervention (PCI) with increasing frequency. However, there is limited
evidence to guide clinicians in evaluating pros and cons of PCI in this
very frail patient population. We, thus, aimed to perform a systematic
review and meta-analysis of clinical studies reporting on PCI with
stenting in nonagenarians. METHODS: Studies reporting on five or more
nonagenarians undergoing PCI were systematically searched in PubMed (last
updated on November 2011). Baseline and clinical characteristics,
in-hospital and long-term outcomes were systematically appraised. End
points of interest were in-hospital and long-term follow-up incidence of
death and Major Adverse Cardiac Events (MACE; i.e. the composite of death
from all causes, myocardial infarction or repeat revascularization).
Events were pooled with a random-effect model, generating summary
estimates of incidence rates [95% confidence intervals (CI)]. RESULTS: A
total of 10 studies were included, reporting on a total of 575
nonagenarians undergoing PCI with stenting who represented 1.99%
(1.34-2.5) of those undergoing revascularization in the cath lab in a mean
period of 5 (3-7) years. Twenty-three percent (13-45) of patients
presented with STEMI (ST Segment Elevation Myocardial Infarction), 10%
(7-12) with cardiogenic shock and in 78% (64-88) of cases a multivessel
disease was diagnosed. Meta-analytic pooling of event rates showed an
in-hospital death risk of 12.61% (9.71-15.50) with MACE in 16.41%
(13.36-19.47). After a follow-up ranging from 6 to 29 months (median 12),
the risk of long-term death was 31.00% (17.10-45.52), with MACE in 37.00%
(19.56-55.95; all CI 95%). CONCLUSION: Our meta-analysis, pooling the
largest cohort ever of nonagenarians undergoing PCI with stents, confirms
the feasibility of percutaneous coronary stenting even in this very frail
patient subset, despite the expected severe event attrition during
follow-up. Thus, nonagenarians with an acceptable risk profile, recent
clinical instability and/or disabling symptoms should not be denied the
possibility of percutaneous coronary revascularization. 2013 Italian
Federation of Cardiology.

<8>
Accession Number
2013615216
Authors
Mier J.M. Chavarin A. Izquierdo-Vidal C. Fibla J.J. Molins L.
Institution
(Mier, Chavarin, Izquierdo-Vidal, Fibla, Molins) Hospital Universitari
Sagrat Cor, c/Viladomat 288, 08029 Barcelona, Spain
Title
A prospective study comparing three-port video-assisted thoracoscopy with
the single-incision laparoscopic surgery (SILS) port and instruments for
the video thoracoscopic approach: A pilot study.
Source
Surgical Endoscopy and Other Interventional Techniques. 27 (7) (pp
2557-2560), 2013. Date of Publication: July 2013.
Publisher
Springer New York (233 Spring Street, New York NY 10013-1578, United
States)
Abstract
Background: Single-incision laparoscopic surgery (SILS) has proved its
advantages in several procedures, mainly a shorter hospital stay, improved
aesthetic results, and less postoperative pain. The authors have used this
approach for several thoracic surgical procedures. Methods: This
prospective study compared 20 cases between standard three-port
video-assisted thoracic surgery (VATS) and the single-incision approach
using a standard abdominal SILS system. In both groups, postsurgical
analgesia was provided with 15 ml of bupivacaine 0.5% at 3 h intervals via
a paravertebral catheter. The hospital length of stay and chest drain
duration (in hours) were recorded as well as postoperative pain using an
analogic visual pain scale (AVPS). A telephone survey was conducted for
all the outpatients. The Mann-Whitney U test was used for statistical
analysis. Results: This study of 20 procedures included 11 lung biopsies,
6 pneumothorax procedures, 2 mediastinic cystectomies, and 1 catamenial
pneumothorax procedure. No statistically significant difference was
reported in hospital length of stay or chest drain duration between the
two groups. However, postoperative pain at 24 h was significantly less in
the SILS group (AVPS, 4.40) than in the VATS group (AVPS, 6.20) (p =
0.035). The SILS group reported two minor surgical wound complications and
one catamenial pneumothorax recurrence that did not require drainage. The
VATS group reported one case of skin rash with no identifiable cause.
Conclusions: The use of the SILS port in thoracic surgery results in less
postoperative pain. This is related to the port's protective effect over
the periostium and the intercostal nerve, relieving them of direct contact
with surgical instruments. However, the findings showed a higher incidence
of surgical wound complications with the SILS port, which can be
attributed to increased pressure on the skin and soft tissues surrounding
the port and to the fact that this same incision was used for chest drain
placement, thus increasing the risk for complications. 2013 Springer
Science+Business Media New York.

<9>
Accession Number
2013644738
Authors
Dwyer N.B. Mikami Y. Hilland D. Aljizeeri A. Friedrich M.G. Traboulsi M.
Anderson T.J.
Institution
(Dwyer, Mikami, Hilland, Friedrich, Traboulsi, Anderson) Department of
Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of
Calgary, Calgary, AB, Canada
(Aljizeeri) Division of Cardiology, University of Ottawa Heart Institute,
Ottawa, ON, Canada
Title
No cardioprotective benefit of ischemic postconditioning in patients with
ST-segment elevation myocardial infarction.
Source
Journal of Interventional Cardiology. 26 (5) (pp 482-490), 2013. Date of
Publication: October 2013.
Publisher
Blackwell Publishing Inc. (350 Main Street, Malden MA 02148, United
States)
Abstract
Background Postconditioning is a potential cardioprotective strategy that
has demonstrated conflicting and variable reductions in infarct size in
human trials. Objectives To determine whether postconditioning could
increase the extent of myocardial salvage in patients with acute
ST-segment elevation myocardial infarction undergoing primary percutaneous
coronary intervention (PPCI). Methods One hundred two patients (aged 57
+/- 11 years; 88% male) were randomly assigned to a postconditioning or
standard protocol. Cardiovascular magnetic resonance imaging was performed
3 days after PPCI to measure the volumetric extent of myocardial necrosis
and the area at risk. Results With similar time-to-reperfusion (170 +/- 84
minutes in the postconditioning group vs. 150 +/- 70 minutes in the
standard group, P = 0.22), the myocardial salvage index was not
significantly different between the postconditioned group and the control
group, averaging 42 +/- 22% vs. 33 +/- 21%, respectively (P = 0.08).
Furthermore, postconditioning was not associated with a smaller infarct
size compared to controls (13 +/- 7 g/m² vs. 15 +/- 8
g/m², respectively, P = 0.18). Conclusions Postconditioning
does not significantly increase myocardial salvage or reduce infarct size
in patients with STEMI undergoing PPCI. However, the possibility of a more
modest impact of postconditioning cannot be excluded with our sample size.
2013, Wiley Periodicals, Inc.

<10>
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Accession Number
2013640366
Authors
Lee T.H. Ouellet J.-F. Cook M. Schreiber M.A. Kortbeek J.B.
Institution
(Lee, Cook, Schreiber) Section of Trauma/Critical Care, Oregon Health,
Science University, Canada
(Kortbeek) Department of Surgery and Critical Care, University of Calagry,
Foothills Medical Centre, 1403-29st NW, Calgary, AB T3C1J5, Canada
(Ouellet) Department of Surgery, Universite Laval, Canada
Title
Pericardiocentesis in trauma: A systematic review.
Source
Journal of Trauma and Acute Care Surgery. 75 (4) (pp 543-549), 2013. Date
of Publication: October 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
BACKGROUND: Pericardiocentesis (PCC) had been taught as a mandatory skill
in the Advanced Trauma Life Support (ATLS) course as a bridge to
definitive surgical therapy for traumatic pericardial tamponade since its
inception in 1978. Immediate thoracotomy for penetrating trauma to the
heart and chest has resulted in the decreased use of PCC in trauma. PCC is
now offered as an optional skill in the ninth edition of the ATLS. A
review of the literature regarding the use and effectiveness of PCC in
traumatic pericardial tamponade in the modern era is necessary to better
define its current role in trauma care. METHODS: Scientific publications
from 1970 to 2010 involving PCC after trauma were identified. The
Preferred Reporting Items for Systematic reviews and Meta-Analyses was
used. Human studies describing acute traumatic tamponade were included.
Publications involving nontraumatic or chronic pericardial tamponade from
effusions caused by inflammatory, infectious, or neoplastic etiology were
excluded. Publications were categorized by level of evidence. RESULTS: Of
the 135 publications identified, 27 were included, composing of 2,094
trauma patients with suspected cardiac tamponade. The reported use of PCC
decreased from 45.9% of patients in the period 1970 to 1979 down to 6.4%
of patients in the period between 2000 and 2010 (p < 0.05). Reported rates
describing the use of PCC as the sole intervention decreased from 13.7% in
the period 1970 to 1979 to 2.1% in the period 2000 to 2010 (p < 0.05).
Survival analysis after PCC was possible for 380 patients. Overall
survival following PCC was 83.4% (n = 317) and 91.8% (n = 145) when used
as the sole intervention. In patients who received PCC then thoracotomy,
survival rate was 79.5% (n = 178). CONCLUSION: Studies on the use of PCC
for trauma are limited and biased toward survivors. The reported survival
rate is high. There remains a limited role for PCC in nontrauma centers
where definitive surgical management is not immediately available and
transport time to a higher level of care facility supports the use of
temporary decompression by PCC. 2013 Lippincott Williams and Wilkins.

<11>
Accession Number
2013637275
Authors
Kuhn E.W. Liakopoulos O.J. Stange S. Deppe A.-C. Slottosch I. Scherner M.
Choi Y.-H. Wahlers T.
Institution
(Kuhn, Liakopoulos, Stange, Deppe, Slottosch, Scherner, Choi, Wahlers)
Department of Cardiothoracic Surgery, Heart Center, University of Cologne,
Kerpener Strasse 62, Cologne 50924, Germany
Title
Meta-Analysis of patients taking statins before revascularization and
aortic valve surgery.
Source
Annals of Thoracic Surgery. 96 (4) (pp 1508-1516), 2013. Date of
Publication: October 2013.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Statin intake before cardiac surgery is associated with favorable
outcomes. We sought to analyze the evidence for statin pretreatment before
isolated coronary artery bypass graft surgery and aortic valve replacement
surgery. In this meta-analysis, we demonstrate beneficial results for the
endpoints mortality, stroke, atrial fibrillation, and length of stay in
hospital in 36,053 statin-pretreated coronary artery bypass graft surgery
patients compared with control subjects retrieved from 32 studies, but
fail to detect relevant advantages through preoperative statin therapy for
3,091 patients undergoing aortic valve replacement from four trials.
Strict adherence to guidelines recommending statin treatment before CABG
surgery is therefore mandatory. 2013 The Society of Thoracic Surgeons.

<12>
Accession Number
2013637249
Authors
Onorati F. D'Errigo P. Barbanti M. Rosato S. Covello D.R. Maraschini A.
Ranucci M. Grossi C. Santoro G. Tamburino C. Santini F. Seccareccia F.
Institution
(Onorati) Division of Cardiac Surgery, University of Verona Medical
School, P.le Scuro, 10, Verona, Italy
(D'Errigo, Barbanti, Rosato, Covello, Maraschini, Ranucci, Grossi,
Santoro, Tamburino, Santini, Seccareccia) National Centre for
Epidemiology, Surveillance and Health Promotion, Istituto Superiore di
Sanita, Rome Italy; Division of Cardiology, Ferrarotto Hospital,
University of Catania, ETNA Foundation, Catania Italy; Department of
Cardiovascular Surgery, S. Croce e Carle Hospital, Cuneo Italy; Division
of Cardiology, Careggi Hospital, Florence Italy; and Division of Cardiac
Surgery, Ospedale San Martino University of Genoa Medical School, Genoa,
Italy
Title
Results differ between transaortic and open surgical aortic valve
replacement in women.
Source
Annals of Thoracic Surgery. 96 (4) (pp 1336-1342), 2013. Date of
Publication: October 2013.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Background Despite the well-known impact of female sex on outcome after
surgical aortic valve replacement (sAVR), few studies investigated its
role after transcatheter aortic valve replacement (TAVR). Methods After
propensity-matching for age, baseline comorbidities, previous
interventions, priority, frailty score, New York Heart Association class,
left ventricular function and associated cardiac diseases, hospital
mortality, and procedure-related morbidities of 388 women (194 TAVR versus
194 sAVR) - of 5,231 patients enrolled in 70 centers participating in this
prospective multicenter national registry - were analyzed at a central
management unit of the Italian National Institute of Health. Results
Although hospital mortality was comparable (4.1% TAVR versus 3.1% sAVR; p
= 0.177), women undergoing sAVR showed a higher rate of transfusion (63.9%
versus 37.1% TAVR; p = 0.0001); higher number of transfusions per patient
(3.6 +/- 0.4 versus 2.3 +/- 0.3 TAVR; p = 0.049); a higher incidence of
low cardiac output state (5.7% versus 3.6% TAVR; p = 0.017) and acute
renal failure (8.8% versus 4.1% TAVR; p = 0.01); and higher mean
transprosthetic gradients (15.7 +/- 12.6 mm Hg versus 11.9 +/- 10.7 mm Hg
TAVR; p = 0.004). In contrast, women undergoing TAVR experienced
significant postprocedural aortic regurgitation (mild, 37.6% versus 7.7%
sAVR; moderate-to-severe, 7.1% versus 1.5% sAVR; p = 0.0001) and a higher
rate of stroke (7.7% versus 2.5% sAVR; p = 0.037), major vascular
complications (9.3% versus 0.5% sAVR; p = 0.0001), pacemaker implantation
(12.4% versus 6.2% sAVR; p = 0.004), need for emergent percutaneous
coronary intervention (1.0% versus 0% sAVR; p = 0.007), and longer
intermediate care unit length of stay (2.5 +/- 4.4 days versus 1.4 +/- 2.6
days sAVR; p = 0.008). Perioperative myocardial infarction and lengths of
intensive care unit stay and hospitalization were comparable (not
significant). Conclusions Women undergoing sAVR and TAVR experienced
different periprocedural morbidities. These data strongly suggest the need
to strictly individualize the indications. 2013 The Society of Thoracic
Surgeons.

<13>
Accession Number
2013637273
Authors
Sauer A.-M.C. Nathoe H.M. Hendrikse J. Peelen L.M. Regieli J. Veldhuijzen
D.S. Kalkman C.J. Grobbee D.E. Doevendans P.A. Van Dijk D.
Institution
(Sauer, Peelen, Veldhuijzen, Kalkman, Van Dijk) Department of
Anesthesiology, University Medical Center Utrecht, PO Box 85500, 3508 GA
Utrecht, Netherlands
(Nathoe, Regieli, Doevendans) Department of Cardiology, University Medical
Center Utrecht, Utrecht, Netherlands
(Hendrikse) Department of Radiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Peelen, Grobbee) Julius Center for Health Sciences and Primary Care,
University Medical Center Utrecht, Utrecht, Netherlands
Title
Cognitive outcomes 7.5 years after angioplasty compared with off-pump
coronary bypass surgery.
Source
Annals of Thoracic Surgery. 96 (4) (pp 1294-1300), 2013. Date of
Publication: October 2013.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Background: Off-pump coronary artery bypass grafting and percutaneous
coronary intervention are both associated with cognitive decline, but
limited data are available on long-term outcomes. This study compared
long-term cognitive outcomes between patients managed with percutaneous
coronary intervention and off-pump coronary artery bypass grafting.
Methods: A multicenter trial in the Netherlands randomized 280 patients to
percutaneous coronary intervention or off-pump coronary artery bypass
grafting. Cognitive performance 7.5 years after randomization was assessed
through a battery of 9 neuropsychologic tests and summarized into a
combined Z-score. Results: After 7.5 years, cognitive assessment could be
performed in 81% of the 249 surviving patients. Better cognitive
performance was observed in the off-pump coronary artery bypass grafting
group (combined Z-score 0.11 for off-pump coronary artery bypass grafting
versus -0.17 for percutaneous coronary intervention; difference 0.28, 95%
confidence interval 0.08 to 0.47, p < 0.01). However, this difference
became nonsignificant (Z-score difference 0.14, 95% confidence interval
-0.01 to 0.29, p = 0.08) after multivariable adjustment for potential
confounders. Conclusions: At 7.5 years follow-up, off-pump coronary artery
bypass grafting patients had a similar or perhaps even better cognitive
performance compared with percutaneous coronary intervention patients.
2013 The Society of Thoracic Surgeons.

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<1>
Accession Number
2013632384
Authors
Bagai A. Thavendiranathan P. Sharieff W. Al Lawati H.A. Cheema A.N.
Institution
(Bagai, Al Lawati, Cheema) St. Michael's Hospital, 30 Bond Street,
Toronto, ON, M5B 1W8, Canada
(Thavendiranathan) University Health Network, Toronto, Canada
(Sharieff) Hamilton General Hospital, Hamilton, ON, Canada
Title
Non-infarct-related artery revascularization during primary percutaneous
coronary intervention for ST-segment elevation myocardial infarction: A
systematic review and meta-analysis.
Source
American Heart Journal. 166 (4) (pp 684-693.e1), 2013. Date of
Publication: October 2013.
Publisher
Mosby Inc. (11830 Westline Industrial Drive, St. Louis MO 63146, United
States)
Abstract
Background In patients with ST-elevation myocardial infarction (STEMI) and
multivessel disease, guidelines recommend infarct-related artery (IRA)
only intervention during primary percutaneous coronary intervention (PCI)
except in patients with hemodynamic instability. To assess the available
evidence, we performed a systematic review and meta-analysis comparing
outcomes of non-IRA PCI as an adjunct to primary PCI (same sitting PCI
[SS-PCI]) with IRA only PCI (IRA-PCI) in the setting of STEMI. Methods and
Results A comprehensive search identified 14 studies [11 cohort, 3
randomized controlled trials] comprising of 35,239 patients. For cohort
studies, patients undergoing SS-PCI had higher rate of anterior infarction
(48% vs. 45%, P =.04) and cardiogenic shock (11% vs. 9%, P =.0001) at
baseline compared with IRA-PCI. The primary composite end point of death,
myocardial infarction and revascularization was higher in the SS-PCI group
in the short term (OR, 1.63; CI, 1.12-2.37) and long term (OR, 1.60; CI,
1.18-2.16). However, after excluding patients with shock, there was no
difference in primary endpoint for the short (OR, 1.33; CI, 0.67-2.63) and
long term (OR, 1.39; CI, 0.80-2.42) follow-up. In analyses limited to
randomized controlled trials, primary end point was similar during short
term (OR, 0.79; CI, 0.19-3.28) and significantly lower for SS-PCI group in
the long term (OR, 0.55; CI, 0.34-0.91). Conclusions There is paucity of
randomized data to guide management of STEMI patients with multivessel
disease. SS-PCI group in cohort studies has higher baseline risk compared
to IRA-PCI. The primary end point is higher for SS-PCI in observational
cohort studies but this difference did not persist after exclusion of
shock patients and for analysis limited to randomized controlled trials.
These findings underscore the need of a large randomized controlled trial
to guide therapy for a commonly encountered clinical situation. 2013
Mosby, Inc.

<2>
Accession Number
2013632383
Authors
Sambola A. Montoro J.B. Del Blanco B.G. Llavero N. Barrabes J.A. Alfonso
F. Bueno H. Cequier A. Serra A. Zueco J. Sabate M. Rodriguez-Leor O.
Garcia-Dorado D.
Institution
(Sambola, Del Blanco, Llavero, Barrabes, Garcia-Dorado) Cardiology
Department, Hospital Universitari Vall D'Hebron, Universitat Autonoma de
Barcelona, P. Vall d'Hebron 119-129, 08035 Barcelona, Spain
(Montoro) Pharmacy Department, Hospital Universitari Vall D'Hebron,
Universitat Autonoma de Barcelona, Barcelona, Spain
(Alfonso) Cardiology Department, Hospital Universitario Clinico San
Carlos, Madrid, Spain
(Bueno) Cardiology Department, Hospital General Universitario Gregorio
Maranon, Madrid, Spain
(Cequier, Serra) Cardiology Department, Hospital Universitari de
Bellvitge, L'Hospitalet Del Llobregat, Barcelona, Spain
(Zueco, Sabate) Cardiology Department, Hospital Santa Creu i Sant Pau,
Barcelona, Spain
(Rodriguez-Leor) Cardiology Department, Hospital Universitari Germans
Trias i Pujol, Badalona, Barcelona, Spain
Title
Dual antiplatelet therapy versus oral anticoagulation plus dual
antiplatelet therapy in patients with atrial fibrillation and
low-to-moderate thromboembolic risk undergoing coronary stenting: Design
of the MUSICA-2 randomized trial.
Source
American Heart Journal. 166 (4) (pp 669-675), 2013. Date of Publication:
October 2013.
Publisher
Mosby Inc. (11830 Westline Industrial Drive, St. Louis MO 63146, United
States)
Abstract
Background Oral anticoagulation (OAC) is the recommended therapy for
patients with atrial fibrillation (AF) because it reduces the risk of
stroke and other thromboembolic events. Dual antiplatelet therapy (DAPT)
is required after percutaneous coronary intervention and stenting (PCI-S).
In patients with AF requiring PCI-S, the association of DAPT and OAC
carries an increased risk of bleeding, whereas OAC therapy or DAPT alone
may not protect against the risk of developing new ischemic or
thromboembolic events. Objective The MUSICA-2 study will test the
hypothesis that DAPT compared with triple therapy (TT) in patients with
nonvalvular AF at low-to-moderate risk of stroke (CHADS₂ score
<=2) after PCI-S reduces the risk of bleeding and is not inferior to TT
for preventing thromboembolic complications. Design The MUSICA-2 is a
multicenter, open-label randomized trial that will compare TT with DAPT in
patients with AF and CHADS₂ score <=2 undergoing PCI-S. The
primary end point is the incidence of stroke or any systemic embolism or
major adverse cardiac events: death, myocardial infarction, stent
thrombosis, or target vessel revascularization at 1 year of PCI-S. The
secondary end point is the combination of any cardiovascular event with
major or minor bleeding at 1 year of PCI-S. The calculated sample size is
304 patients. Conclusions The MUSICA-2 will attempt to determine the most
effective and safe treatment in patients with nonvalvular AF and
CHADS₂ score <=2 after PCI-S. Restricting TT for AF patients at
high risk for stroke may reduce the incidence of bleeding without
increasing the risk of thromboembolic complications. 2013 Mosby, Inc.

<3>
Accession Number
2013630192
Authors
Zampi J.D. Hirsch J.C. Gurney J.G. Donohue J.E. Yu S. Lapage M.J. Hanauer
D.A. Charpie J.R.
Institution
(Zampi, Donohue, Yu, Lapage, Charpie) Division of Pediatric Cardiology,
Department of Pediatrics, University of Michigan Medical School, Ann Arbor
MI, United States
(Hirsch) Division of Pediatric Cardiac Surgery, Department of Surgery,
University of Michigan Medical School, Ann Arbor MI, United States
(Gurney) St. Jude Children's Research Hospital, Memphis TN, United States
(Hanauer) Department of Pediatrics, University of Michigan Medical School,
Ann Arbor MI, United States
(Zampi) University of Michigan Congenital Heart Center, C.S. Mott
Children's Hospital, 1540 E. Hospital Drive, Ann Arbor MI 48109-4204,
United States
Title
Junctional ectopic tachycardia after infant heart surgery: Incidence and
outcomes.
Source
Pediatric Cardiology. 33 (8) (pp 1362-1369), 2012. Date of Publication:
December 2012.
Publisher
Springer New York (233 Spring Street, New York NY 10013-1578, United
States)
Abstract
Junctional ectopic tachycardia (JET) is an arrhythmia observed almost
exclusively after open heart surgery in children. Current literature on
JET has not focused on patients at the highest risk of both developing and
being negatively impacted by JET. The purpose of this study was to
determine the overall incidence of JET in an infant patient cohort
undergoing open cardiac surgery, to identify patient- and
procedure-related factors associated with developing JET, and to assess
the clinical impact of JET on patient outcomes. We performed a nested
case-control study from the complete cohort of patients at our institution
younger than 1 year of age who underwent open heart surgery between 2005
and 2010. JET patients were compared with an age matched control group
undergoing open heart surgery without JET regarding potential risk factors
and outcomes. The overall incidence of JET in infants after open cardiac
surgery was 14.3 %. From multivariate analyses, complete repair of
tetralogy of Fallot [adjusted odds ratio (AOR) 2.0, 95 % CI 1.12-3.57] and
longer aortic cross clamp times (AOR 1.02, 95 % CI 1.01-1.03) increased
the risk of developing JET. Patients with JET had longer length of
intubation, intensive care unit stays, and total length of
hospitalization, and were more likely to require extracorporeal membrane
oxygenation support (13 vs. 4.3 %). JET is a common postoperative
arrhythmia in infants after open heart operations. Both anatomic substrate
and surgical procedure contribute to the overall risk of developing JET.
Developing JET is associated with worse clinical outcomes. 2012 Springer
Science+Business Media, LLC.

<4>
Accession Number
2013599493
Authors
Eikelboom J.W. Connolly S.J. Brueckmann M. Granger C.B. Kappetein A.P.
Mack M.J. Blatchford J. Devenny K. Friedman J. Guiver K. Harper R. Khder
Y. Lobmeyer M.T. Maas H. Voigt J.-U. Simoons M.L. Van De Werf F.
Institution
(Eikelboom, Connolly) McMaster University, Hamilton Health Sciences,
Hamilton, ON, Canada
(Brueckmann, Lobmeyer, Maas) Boehringer Ingelheim, Ingelheim am Rhein,
Germany
(Brueckmann) Faculty of Medicine Mannheim, University of Heidelberg,
Mannheim, Germany
(Granger) Duke Clinical Research Institute, Durham, NC, United States
(Kappetein) Department of Cardio-Thoracic Surgery, Erasmus University
Medical Center, Rotterdam, Netherlands
(Simoons) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
(Mack) Heart Hospital Baylor, Plano, TX, United States
(Blatchford, Devenny, Guiver, Harper) Boehringer Ingelheim, Bracknell,
United Kingdom
(Friedman) Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT, United
States
(Khder) Boehringer Ingelheim, Paris, France
(Voigt, Van De Werf) Department of Cardiovascular Sciences, KU Leuven,
University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium
Title
Dabigatran versus warfarin in patients with mechanical heart valves.
Source
New England Journal of Medicine. 369 (13) (pp 1206-1214), 2013. Date of
Publication: 2013.
Publisher
Massachussetts Medical Society (860 Winter Street, Waltham MA 02451-1413,
United States)
Abstract
BACKGROUND: Dabigatran is an oral direct thrombin inhibitor that has been
shown to be an effective alternative to warfarin in patients with atrial
fibrillation. We evaluated the use of dabigatran in patients with
mechanical heart valves. METHODS: In this phase 2 dose-validation study,
we studied two populations of patients: those who had undergone aortic- or
mitral-valve replacement within the past 7 days and those who had
undergone such replacement at least 3 months earlier. Patients were
randomly assigned in a 2:1 ratio to receive either dabigatran or warfarin.
The selection of the initial dabigatran dose (150, 220, or 300 mg twice
daily) was based on kidney function. Doses were adjusted to obtain a
trough plasma level of at least 50 ng per milliliter. The warfarin dose
was adjusted to obtain an international normalized ratio of 2 to 3 or 2.5
to 3.5 on the basis of thromboembolic risk. The primary end point was the
trough plasma level of dabigatran. RESULTS: The trial was terminated
prematurely after the enrollment of 252 patients because of an excess of
thromboembolic and bleeding events among patients in the dabigatran group.
In the as-treated analysis, dose adjustment or discontinuation of
dabigatran was required in 52 of 162 patients (32%). Ischemic or
unspecified stroke occurred in 9 patients (5%) in the dabigatran group and
in no patients in the warfarin group; major bleeding occurred in 7
patients (4%) and 2 patients (2%), respectively. All patients with major
bleeding had pericardial bleeding. CONCLUSIONS: The use of dabigatran in
patients with mechanical heart valves was associated with increased rates
of thromboembolic and bleeding complications, as compared with warfarin,
thus showing no benefit and an excess risk. Copyright 2013 Massachusetts
Medical Society.

<5>
Accession Number
2013618348
Authors
Zhang J.-F. Wu Y.-C. Shen W.-F. Kong Y.
Institution
(Zhang, Kong) Department of Cardiac Surgery Shanghai Chest Hospital,
Shanghai Jiao Tong University, Shanghai 200030, China
(Wu) Department of Cardiac Surgery, Rui Jin Hospital, School of Medicine,
Shanghai Jiao Tong University, Shanghai 200025, China
(Shen) Department of Cardiology, Rui Jin Hospital, School of Medicine,
Shanghai Jiao Tong University, Shanghai 200025, China
Title
Impact of prosthesis-patient mismatch on survival after mitral valve
replacement: A systematic review.
Source
Chinese Medical Journal. 126 (19) (pp 3762-3766), 2013. Date of
Publication: 2013.
Publisher
Chinese Medical Association (42 Dongsi Xidajie, Beijing 100710, China)
Abstract
Objective To determine whether the prosthesis-patient mismatch has a
deleterious impact on survival after mitral valve replacement. Data
sources A comprehensive literature search of PubMed, Embase, and
ScienceDirect was carried out. References and cited papers of relevant
articles were also checked. Study selection All articles published after
January 1980 was initially considered. Non-English and non-human studies,
case reports, and reviews were excluded from the initial search.
References and cited papers of relevant articles were also checked.
Results A total of 8 retrospective cohort studies were identified for this
review. The overall incidence of prosthesis-patient mismatch (<1.3 to <1.2
cm²/m²) after mitral valve replacement ranged from
3.7% to 85.9% (moderate prosthesis-patient mismatch (0.9 to 1.2
cm²/m²) in 37.4% to 69.5%, severe prosthesis-patient
mismatch (<0.9 cm²/m²) in 8.7% to 16.4%). Four
studies demonstrated an association of prosthesis-patient mismatch with
reduced long-term survival, but the other four studies found no
significant deleterious impact of prosthesis-patient mismatch after mitral
valve replacement. No definite conclusion could be derived from these
conflicting results. Conclusions Current evidence is insufficient to
derive a definite conclusion whether mitral prosthesis-patient mismatch
affects long-term survival because of the biases and confounding factors
that interfere with late clinical outcomes. Goodquality prospective
studies are warranted to evaluate the impact of mitral prosthesis-patient
mismatch after mitral valve replacement in the future.

<6>
Accession Number
2013613652
Authors
Sarmento R.A. Silva F.M. Sbruzzi G. Schaan B.D. de Almeida J.C.
Institution
(Sarmento, Sbruzzi, Schaan) Instituto de Cardiologia do Rio Grande do Sul,
Fundacao Universitaria de Cardiologia, Porto Alegre, RS, Brazil
(Sarmento, Silva, Schaan, de Almeida) Servico de Endocrinologia do
Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande
do Sul, Porto Alegre, RS, Brazil
(Schaan, de Almeida) Departamento de Medicina Interna, Universidade
Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
Title
Antioxidant micronutrients and cardiovascular risk in patients with
diabetes: A systematic review.
Source
Arquivos Brasileiros de Cardiologia. 101 (3) (pp 240-248), 2013. Date of
Publication: September 2013.
Publisher
Arquivos Brasileiros de Cardiologia (Rua Beira Rio, 45, 3.o andar, Sao
Paolo SP 04548-050, Brazil)
Abstract
Background: Inverse associations between micronutrient intake and
cardiovascular outcomes have been previously shown, but did not focus on
diabetic patients.Objective: To systematically review the role of
micronutrients in the development/presence of cardiovascular outcomes in
patients with diabetes. Methods: We searched Medline, Embase, and Scopus
(January/1949-March/2012) for observational studies that evaluated
micronutrients and cardiovascular outcomes in patients with diabetes, and
then selected and extracted the data (two independent reviewers).Results:
From the 15 658 studies identified, five were included, comprising three
case-control and two cohorts, with a follow-up of 7-15 years. A
meta-analysis was not performed due to the different antioxidant
micronutrients (types and measurement methods) and outcomes evaluated. The
micronutrients assessed were vitamin C intake in diet and/or
supplementation, chromium and selenium in toenail samples, and
alpha-tocopherol and zinc in serum levels. Intake of > 300 mg of vitamin C
through supplementation was associated with increased risk of
cardiovascular disease, coronary artery disease (CAD), and stroke (RR
1.69-2.37). High levels of alpha-tocopherol in serum were associated with
30% lower CAD risk in another study (HR 0.71; 95%CI 0.53-0.94). Among
minerals (zinc, selenium, and chromium), an inverse association between
zinc and CAD was observed; levels lower than 14.1 mumol/L were associated
with an increased risk for CAD (RR 1.70; 95%CI 1.21-2.38).Conclusion: The
information available on this issue is scarce. Further prospective studies
are needed to elucidate the role of these nutrients in the cardiovascular
risk of patients with diabetes.

<7>
Accession Number
2013627310
Authors
Bjorgvinsdottir L. Arnar D.O. Indridason O.S. Heidarsdottir R. Skogstrand
K. Torfason B. Hougaard D.M. Palsson R. Skuladottir G.V.
Institution
(Bjorgvinsdottir, Arnar, Heidarsdottir, Torfason, Palsson, Skuladottir)
School of Health Sciences, University of Iceland, Reykjavik, Iceland
(Arnar, Indridason, Palsson) Internal Medicine Services, Landspitali - the
National University Hospital of Iceland, Reykjavik, Iceland
(Skogstrand, Hougaard) Surgical Services, Landspitali - the National
University Hospital of Iceland, Reykjavik, Iceland
(Torfason) Department of Clinical Biochemistry, Statens Serum Institut,
Copenhagen, Denmark
Title
Do high levels of n-3 polyunsaturated fatty acids in cell membranes
increase the risk of postoperative atrial fibrillation?.
Source
Cardiology (Switzerland). 126 (2) (pp 107-114), 2013. Date of Publication:
September 2013.
Publisher
S. Karger AG (Allschwilerstrasse 10, P.O. Box, Basel CH-4009, Switzerland)
Abstract
Objectives: Postoperative atrial fibrillation (POAF) has been associated
with an inflammatory response to the surgical procedure. n-3 long-chain
polyunsaturated fatty acids (LC-PUFA) have been proposed for the
prevention of POAF. We investigated the relationship between the plasma
concentration of inflammatory mediators, levels of n-3 LC-PUFA in red
blood cell (RBC) membrane lipids, and the risk of POAF after coronary
artery bypass grafting (CABG). Methods: A total of 125 patients who
underwent CABG were studied. Inflammatory mediators in plasma and the
content of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in
RBC membranes were assessed. Results: Sixty-two patients (49.6%) developed
POAF. The POAF group had higher RBC levels of total n-3 LC-PUFA and DHA
than did patients remaining in sinus rhythm (p < 0.05). Of the
inflammatory mediators, only postoperative interleukin-6 levels differed,
being higher in the POAF group (p < 0.05). Inflammatory mediators were not
independent predictors of POAF by multivariable logistic regression
analysis. Higher levels of DHA and total n-3 LC-PUFA in RBC membranes,
measured immediately prior to CABG and on postoperative day 3, were
linearly associated with an increased risk of POAF (p < 0.05).
Conclusions: Our findings suggest that inflammatory mediators are not
associated with the occurrence of POAF. Interestingly, high n-3 LC-PUFA
levels in RBC membranes appear to increase the risk of POAF. Copyright
2013 S. Karger AG, Basel.

<8>
Accession Number
2013626105
Authors
Xia W.-F. Liu Y. Zhou Q.-S. Tang Q.-Z. Zou H.-D.
Institution
(Xia) Departments of Critic Care Medicine and Cardiology, Renmin Hospital
of Wuhan University, Wuhan 430060, China
(Liu, Tang) Department of Cardiology, Renmin Hospital of Wuhan University,
Wuhan 430060, China
(Liu, Tang) Cardiovascular Research Institute, Wuhan University, Wuhan
430060, China
(Zhou, Zou) Department of Critic Care Medicine, Renmin Hospital of Wuhan
University, Wuhan 430060, China
Title
Protective effect of propofol and its relation to postoperation recovery
in children undergoing cardiac surgery with cardiopulmonary bypass.
Source
Pediatric Cardiology. 32 (7) (pp 940-946), 2011. Date of Publication:
October 2011.
Publisher
Springer New York (233 Spring Street, New York NY 10013-1578, United
States)
Abstract
The aim of this study was to investigate the effect of propofol and its
relation to postoperation recovery in children undergoing cardiac surgery
with cardiopulmonary bypass (CPB). Twenty ASA class I-II children with
congenital heart disease undergoing cardiac surgery were randomly
allocated to a propofol group (n = 10) or a control group (n = 10). Blood
samples were collected at five time points: before operation (T
₀), before the start of CPB (T ₁), 25 min after the
aorta was cross-clamped (T ₂), 30 min after release of the
aortic cross-clamp (T ₃), and 2 h after the cessation of CPB (T
₄). The myocardial samples were collected at the time of
incubation into the right atrium before CPB and at 30 min after
reperfusion. After CPB, propofol significantly suppressed the increase of
the serum lactate dehydrogenase (LDH), creatine phosphokinase (CK), and
interleukin-6 (IL-6) levels and the decrease of the serum superoxide
dismutase (SOD) level. In addition, propofol inhibited the increase of
myocardial nuclear factor-B (NF-B) expression and inflammatory cells
infiltration after CPB. Furthermore, propofol significantly shortened the
tracheal extubation time. In conclusion, propofol exerts a protective
effect and improves postoperation recovery through its antioxidant and
anti-inflammatory actions in children undergoing cardiac surgery with CPB.
2011 Springer Science+Business Media, LLC.

<9>
[Use Link to view the full text]
Accession Number
2013624660
Authors
Friesen R.H. Nichols C.S. Twite M.D. Cardwell K.A. Pan Z. Pietra B.
Miyamoto S.D. Auerbach S.R. Darst J.R. Ivy D.D.
Institution
(Friesen, Nichols, Twite, Cardwell) Department of Anesthesiology,
Children's Hospital Colorado, University of Colorado, 13123 E. 16th Ave.,
Aurora, CO 80045, United States
(Pan) Department of Pediatrics, Research Institute, University of
Colorado, Denver, CO, United States
(Pietra, Miyamoto, Auerbach, Darst, Ivy) Department of Pediatrics
(Cardiology), Children's Hospital Colorado, University of Colorado,
Denver, CO, United States
Title
The hemodynamic response to dexmedetomidine loading dose in children with
and without pulmonary hypertension.
Source
Anesthesia and Analgesia. 117 (4) (pp 953-959), 2013. Date of Publication:
October 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
BACKGROUND:: Dexmedetomidine, an alpha-2 receptor agonist, is widely used
in children with cardiac disease. Significant hemodynamic responses,
including systemic and pulmonary vasoconstriction, have been reported
after dexmedetomidine administration. Our primary goal of this
prospective, observational study was to quantify the effects of
dexmedetomidine initial loading doses on mean pulmonary artery pressure
(PAP) in children with and without pulmonary hypertension. METHODS::
Subjects were children undergoing cardiac catheterization for either
routine surveillance after cardiac transplantation (n = 21) or pulmonary
hypertension studies (n = 21). After anesthetic induction with sevoflurane
and tracheal intubation, sevoflurane was discontinued and anesthesia was
maintained with midazolam 0.1 mg/kg IV (or 0.5 mg/kg orally
preoperatively) and remifentanil IV infusion 0.5 to 0.8 mug/kg/min.
Ventilation was mechanically controlled to maintain PCO2 35 to 40 mm Hg.
When end-tidal sevoflurane was 0% and fraction of inspired oxygen (FIO2)
was 0.21, baseline heart rate, mean arterial blood pressure, PAP, right
atrial pressure, pulmonary artery occlusion pressure, right ventricular
end-diastolic pressure, cardiac output, and arterial blood gases were
measured, and indexed systemic vascular resistance, indexed pulmonary
vascular resistance, and cardiac index were calculated. Each subject then
received a 10-minute infusion of dexmedetomidine of 1 mug/kg, 0.75 mug/kg,
or 0.5 mug/kg. Measurements and calculations were repeated at the
conclusion of the infusion. RESULTS:: Most hemodynamic responses were
similar in children with and without pulmonary hypertension. Heart rate
decreased significantly, and mean arterial blood pressure and indexed
systemic vascular resistance increased significantly. Cardiac index did
not change. A small, statistically significant increase in PAP was
observed in transplant patients but not in subjects with pulmonary
hypertension. Changes in indexed pulmonary vascular resistance were not
significant. CONCLUSION:: Dexmedetomidine initial loading doses were
associated with significant systemic vasoconstriction and hypertension,
but a similar response was not observed in the pulmonary vasculature, even
in children with pulmonary hypertension. Dexmedetomidine does not appear
to be contraindicated in children with pulmonary hypertension. 2013
International Anesthesia Research Society.

<10>
Accession Number
2013592196
Authors
Iida M. Yamamoto M. Ishiguro Y.S. Yamazaki M. Ueda N. Honjo H. Kamiya K.
Institution
(Iida, Yamamoto, Ishiguro, Yamazaki) Department of Cardiology, Mitsubishi
Nagoya Hospital, Nagoya, Japan
(Ueda, Honjo, Kamiya) Department of Cardiovascular Research, Research
Institute of Environmental Medicine, Nagoya University, Nagoya, Japan
Title
Utility of cystatin C as a marker for the severity of aortic regurgitation
in hypertensive patients.
Source
Clinica Chimica Acta. 425 (pp 259-264), 2013. Date of Publication: 21 Oct
2013.
Publisher
Elsevier (P.O. Box 211, Amsterdam 1000 AE, Netherlands)
Abstract
Background: Cystatin C, a cathepsin inhibitor, is involved in the
remodeling of human aortic valve and left ventricle (LV). Objective:
Cystatin C may be related to the severity of aortic regurgitation (AR).
Methods: We measured cystatin C and CRP in hypertensive patients with
mild-to-moderate AR (n = 120) and in those without AR (n = 128).
Echocardiography was performed to assess the vena contracta width (the
narrowest region of regurgitant jet, VCW) as a marker of the severity of
AR, relative wall thickness as a marker of LV concentric remodeling, and
the ratio of early peak mitral flow to early diastolic mitral annular
velocity (E/e') as an index of LV diastolic function. Glomerular
filtration rate (GFR) was estimated using the MDRD methods. Results:
Cystatin C levels were greater in hypertensive patients with AR than in
those without AR. A multiple linear regression analysis indicated cystatin
C levels correlated with the VCW independent of GFR, body mass index, CRP,
relative wall thickness, and E/e' in hypertensive patients with AR.
Conclusions: Cystatin C was associated with the severity of regurgitation
independent of renal function body composition chronic inflammation LV
remodeling and diastolic function in hypertensive patients with
mild-to-moderate AR. 2013 Elsevier B.V.

<11>
Accession Number
71104808
Authors
Guo Z. Ju W. He M. He X.
Institution
(Guo, Ju, He, He) Organ Transplant Center, 1st Affiliated Hospital of Sun
Yat-sen University, Guangzhou, China
Title
The effects of gender on transplant outcomes: A meta-analysis.
Source
Liver Transplantation. Conference: 19th Annual International Congress of
the International Liver Transplantation Society, ILTS 2013 Sydney, NSW
Australia. Conference Start: 20130612 Conference End: 20130615. Conference
Publication: (var.pagings). 19 (6 SUPPL. 1) (pp S293-S294), 2013. Date of
Publication: June 2013.
Publisher
John Wiley and Sons Ltd
Abstract
Background: There are hot debates on whether and how donor/recipient
gender affects transplant outcomes. Herein, we performed a meta-analysis
to evaluate the effects of donor/recipient gender alone, match and pairing
on major organ transplant outcomes. Methods: PubMed/Medline, Embase, and
Cochrane library databases were researched for studies comparing
transplant outcomes between donor/recipient gender match and mismatch, as
well as four gender pairs. Survival rates were pooled and ranked among
four gender pairs. Results: Twelve studies (174177 patients) for kidney;
four studies (29815 patients) for liver, and four studies (19184 patients)
for heart transplantation were included. Compared with donor/recipient
gender match, gender mismatch was associated with significantly lower 1-,
3-, 5-year kidney graft survivals (1-year OR 0.91 (95% confidence
interval, 0.88-0.94); 3-year: 0.92 (0.90-0.94); 5-year: 0.94 (0.92-0.96)),
liver graft survivals (1-year: 0.81 (0.76-0.86); 3-year: 0.85 (0.81-0.90);
and 5-year: 0.89 (0.85-0.94)) and heart patient survivals (1-year: 0.81
(0.74-0.89); 3-year: 0.83 (0.77-0.89); 5-year; 0.83 (0.78-0.89)). Compared
with female to male pairing, male to male pairing has significant
advantage in kidney graft survival (5-year: 1.22(1.15-1.26)), liver graft
survival (5-year: 1.21(1.11-1.32)) and heart patient survival (5-year:
1.15(1.11-1.32)). Conclusions Gender matching significantly affects
transplant outcomes in major organ transplantation. Female to male pairing
has the worst prognosis in kidney and liver transplantation: while male to
female pairing has long term advantageous potential. Male to male pairing
has the most favorable outcomes in all three types of transplantation.
These results provide important information for allograft
allocation.(Figure presented).

<12>
Accession Number
71191875
Authors
Glass A. Donndorf A.P. Kaminski G. Steinhoff G. Kundt
Institution
(Glass, Kundt) Institute for Biostatistics and Informatics, Medicine and
Ageing Research, University of Rostock, Rostock, Germany
(Donndorf, Kaminski, Steinhoff) Department of Cardiac Surgery, University
of Rostock, Rostock, Germany
Title
Meta-analysis of cardiac surgical trials concerning intramyocardial bone
marrow stem cell transplantation.
Source
Clinical Trials. Conference: 32nd Meeting of the Society of Clinical
Trials Vancouver, BC Canada. Conference Start: 20110515 Conference End:
20110518. Conference Publication: (var.pagings). 8 (4) (pp 523-524), 2011.
Date of Publication: August 2011.
Publisher
SAGE Publications Ltd
Abstract
Objectives Clinical studies have suggested that intramyocardial bone
marrow stem cell (BMSC) transplantation combined with coronary artery
bypass surgery (CABG) might improve left ventricular function, and thus
prove to be a new therapeutic option for patients with endstage ischemic
heart disease. To quantify the overall treatment effect of three
functional parameters we conducted a meta-analysis of relevant studies,
regarding efficacy and safety of BMSC transplantation during CABG. Methods
Database searches (PUBMED, MEDLINE, Cochrane trials register,
ClinicalTrials.gov) revealed 4 RCT's and 2 cohort studies to include. The
analysis (STATA 9.0) was stratified by the difference between BMSC and
control group. Each mean difference was weighted by the inverse of
variance, before being pooled with either the fixed or random effects
model, depending on I-squared and Cochran's Chi-square-test of
homogeneity. In case of heterogeneity a meta-regression analysis was
added. To test significance of the overall effect we performed the z-test.
The presence of publication bias was assessed by funnel plots, Begg's rank
correlation test and Egger's weighted regression method. Results Compared
with control group, the BMSC group showed significant improvement of the
left ventricular ejection fraction from baseline (5.40%, 95%CI: 1.36 to
9.44, p=0.009), and improvement of overall change of left ventricular
end-diastolic volume (9.55 ml, 95%CI: -2.82 to 21.92, p=0.13). Major
adverse cardiovascular events were not significantly different.
Conclusions BMSC transplantation in combination with CABG is associated
with improvements of functional parameters in patients with chronic
ischemic heart disease. Surgical intramyocardial BMSC transplantation
appears to be safe.

<13>
Accession Number
71191779
Authors
Hutton B. Joseph L. Fergusson D. Shapiro S. Mazer D.
Institution
(Hutton, Joseph, Fergusson, Shapiro, Mazer) McGill University, Montreal,
Canada
Title
Risk of death with aprotinin in cardiac surgery: A bayesian evidence
synthesis of randomized and observational studies.
Source
Clinical Trials. Conference: 32nd Meeting of the Society of Clinical
Trials Vancouver, BC Canada. Conference Start: 20110515 Conference End:
20110518. Conference Publication: (var.pagings). 8 (4) (pp 476), 2011.
Date of Publication: August 2011.
Publisher
SAGE Publications Ltd
Abstract
Background: Inclusion of observational studies in meta-analysis with
randomized controlled trials (RCT) is a debated practice. Given past
conflicts regarding the safety of aprotinin in cardiac surgery from
different study designs, an advanced approach to synthesize all evidence
is of interest. Objective: To estimate bias-adjusted meta- analyses of
mortality for aprotinin compared to tranexamic acid (TXA), aminocaproic
acid (ACA), and no treatment using both RCTs and observational studies,
and to assess the comparability of these estimates relative to
meta-analyses of RCTs. Methods: We searched Medline, Embase, and the
Cochrane Database. A three-stage approach to metaanalysis was pursued:
Stage 1- meta-analysis of RCTs only, and RCTs and observational studies
together; Stage 2- meta-regression analyses of RCTs and observational
studies; and Stage 3- meta- regression analyses of RCTs and observational
studies coupled with bias adjustment at the study level. All meta-
analyses used a Bayesian hierarchical approach, and bias adjustments of
observational studies were derived from a clinical expert. Results: Totals
of 77, 26 and 12 studies were available for comparisons of aprotinin with
no therapy, TXA, and ACA, respectively. Using these alternatives as
reference groups for assessments versus aprotinin, comparisons of
mortality based on RCTs alone resulted in estimated odds ratios of 0.92
(95% CrI 0.64- 1.33), 1.45 (0.62-3.54), and 1.68 (0.23- 25.40), while
inclusion of observational evidence modified estimates to 1.16
(0.82-1.59), 1.35 (0.99-1.85), and 1.93 (1.18-3.24). Multivariate
meta-regression further changed estimates to 0.82 (0.33-1.76), 1.28 (0.52-
2.79), and 1.67 (1.07-2.98), while incorporation of bias adjustments
produced final estimates of 0.77 (0.29-1.51), 1.24 (0.47- 2.73), and 1.67
(1.05- 3.06). Conclusions: Pooled estimates suggested that aprotinin is
associated with an increased mortality risk compared to ACA, while
comparisons with TXA and no therapy are inconclusive. Inclusion of
observational studies reduced uncertainty, while bias adjustments had a
minimal impact on point estimates and mildly widened credible intervals.

<14>
Accession Number
71190808
Authors
Piriou N. Sassier J. Valleix-Terruin F. Roy-Giocosa J. Floch F. Gueffet
J.P. Trochu J.N.
Institution
(Piriou, Sassier, Valleix-Terruin, Roy-Giocosa, Floch, Gueffet, Trochu)
Institut du thorax, University Hospital of Nantes, Nantes, France
Title
Dual inhibition of phosophodiesterases type 3 and 5 can reverse reactive
and fixed pulmonary hypertension in advanced heart failure patients.
Source
European Journal of Heart Failure, Supplement. Conference: Heart Failure
2012 Belgrade Serbia. Conference Start: 20120519 Conference End: 20120522.
Conference Publication: (var.pagings). 11 (pp S55), 2012. Date of
Publication: May 2012.
Publisher
Oxford University Press
Abstract
Background: Post-capillary pulmonary hypertension (PH) is highly prevalent
in advanced heart failure (HF) patients. PH can evolve to a reactive
profile, defined by ESC guidelines from right heart catheterization (RHC)
parameters. When reactive PH is fixed despite reversibilty drug testing
(RDT), isolated heart transplantation is contraindicated. This study
reports on a single center's experience of open-label 3 months sildenafil
therapy, a selective inhibitor of type 5 phosphodiesterase (PDE) in HF
patients with reactive PH, focusing on the effects on pulmonary
hemodynamics in basal conditions and during RDT with systematic use of
enoximone, a selective inhibitor of type 3 PDE. Methods: We conducted a
retrospective systematic review of patients addressed in our hospital for
PH RDT before heart transplantation and who secondly received sildenafil
therapy at the dose of 60 mg daily because of reactive PH despite optimal
treatment. We compared trans-pulmonary gradient (TPG), cardiac index (CI)
and pulmonary vascular resistance (PVR) at baseline and after three months
of sildenafil, before and after RDTusing systematically intra-veinous
enoximone. Dobutamine, diuretics, nitrates or inhaled nitric oxide (NO)
could be associated to reach PH reversibility criteria defined by ESC
guidelines. Patients that did not reach those criteria were considered
with fixed PH. Results: 12 patients were treated by sildenafil in this
indication. Basal values of RHC at 3 months showed a 22% decrease in TPG
(18 +/- 4.5 to 14 +/- 3.6 mm Hg), a 16% increase in CI (1.9 +/- 0.5 to 2.2
+/- 0.6 L /mn/m²), and a 26% decrease in PVR (5 +/- 1.7 to 3.7
+/- 1.2 UW). None of these hemodynamic variations reached statistical
significancy because of the small sample size and subsequent heterogeneity
of individual responses to the therapy. However, regarding every
individuals, all had reactive PH at baseline and three of them evolved to
a passive PH at 3 months. Concerning PH RDT, 5 on the 12 patients had a
fixed PH at baseline. At 3 months, 4 evolved to a reversible PH and 3 on
these 4 patients had a successful isolated heart transplantation.
Conclusion: In advanced HF patients with reactive PH, 3 months sildenafil
therapy was associated with an increase in CI and a decrease of TPG and
PVR on basal RHC. Dual inhibition of type 5 and 3 PDE with combined
sildenafil and intra-veinous enoximone during RDT was able to reverse
reactive and fixed PH to a reversible profile which is a crucial point for
therapeutic decision in these patients. These results suggest a strong
implication of NO and PDE pathway in reactive PH secondary to HF.

<15>
Accession Number
71186712
Authors
Shah A. Culligan M. Friedberg J.S. Sterman D.H. Alley E. Stevenson J.P.
Glatstein E. Cengel K. Hahn S.M. Simone C.B.
Institution
(Shah) Columbia University, New York, NY, United States
(Culligan, Friedberg, Sterman, Alley, Glatstein, Cengel, Hahn, Simone)
University of Pennsylvania, Philadelphia, PA, United States
(Stevenson) Cleveland Clinic, Cleveland, OH, United States
Title
Malignant pleural mesothelioma patients' willingness to participate in a
randomized controlled trial of radical pleurectomy with or without
intraoperative photodynamic therapy.
Source
International Journal of Radiation Oncology Biology Physics. Conference:
55th Annual Meeting of the American Society for Radiation Oncology, ASTRO
2013 Atlanta, GA United States. Conference Start: 20130922 Conference End:
20130925. Conference Publication: (var.pagings). 87 (2 SUPPL. 1) (pp
S486), 2013. Date of Publication: 01 Oct 2013.
Publisher
Elsevier Inc.
Abstract
Purpose/Objective(s): Radical pleurectomy (RP) is a lung-sparing
alternative to extrapleural pneumonectomy (EPP) for patients with
malignant pleural mesothelioma (MPM). Adjuvant radiation therapy after RP
is associated with a greater complication rate than after EPP.
Intraoperative photodynamic therapy (PDT) has been delivered as an
alternate to radiation therapy after RP with excellent reported survival.
It is unclear if these outcomes are due to RP, PDT, or both. We therefore
investigated patients' willingness to participate (WTP) in a randomized
controlled trial (RCT) of RP alone versus RP plus PDT. Materials/Methods:
All consecutive patients with histologically confirmed MPM seen in
consultation from March 2012-December 2012 and eligible for RP and PDT
were prospectively enrolled in this IRBapproved study. Immediately after
radiation oncology and thoracic surgery consultations, patients
participated in structured interviews in which they reviewed a written
description of a hypothetical RCT comparing RP alone to RP plus PDT, were
asked open-ended and focused questions regarding their motivations for and
concerns about RCT enrollment, and completed a written questionnaire. WTP
was evaluated using a 6-point Likert scale (1 = definitely not, 6 =
definitely). Interview transcripts were analyzed using qualitative
research methodology, including thematic data analysis and constant
comparison techniques. Results: Twenty-two patients were enrolled, all of
whom were white. Participants had a median age of 67 years and were
predominantly male (73%) and diagnosed with MPM within 3 months of
interview (77%). Many patients had knowledge of RP (52%) or PDT (48%)
prior to consultation. We identified 15 factors that impacted patients'
WTP that largely focused on five major themes: (1) randomization, (2) hope
for cure, (3) desire to compare treatments, (4) altruism, and (5)
physician opinion (Table). Overall, 50% stated they would "definitely" or
"probably" participate, whereas 32% may enroll, and 18% would "probably
not" or "definitely not" participate. Following consultation, 59% elected
to undergo RP plus PDT. Conclusions: A considerable percentage of patients
express a willingness to participate in a RCT comparing RP alone versus RP
plus PDT for MPM. Patients' motivations for and concerns about RCT
enrollment elicited in this study are being used to optimize trial design
and accrual strategies for a planned phase II/III RCT.

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<1>
Accession Number
2013594406
Authors
Namazi M.H. Safi M. Vakili H. Saadat H. Karimi E. Khameneh Bagheri R.
Institution
(Namazi, Safi, Vakili, Saadat, Karimi, Khameneh Bagheri) Cardiovascular
Research Center, Shahid Beheshti University of Medical Sciences, Tehran,
Iran, Islamic Republic of
Title
Comparison between intracoronary abciximab and intravenous eptifibatide
administration during primary percutaneous coronary intervention of acute
ST-segment elevation myocardial infarction.
Source
Journal of Tehran University Heart Center. 8 (3) (pp 132-139), 2013. Date
of Publication: 2013.
Publisher
Tehran Heart Center (North Kargar Street, Tehran 1411713138, Iran, Islamic
Republic of)
Abstract
Background: Administration of glycoprotein IIb/IIIa inhibitors is an
effective adjunctive treatment strategy during primary percutaneous
coronary intervention (PPCI) for ST-segment elevation myocardial
infarction (STEMI). Recent data suggest that an intracoronary
administration of these drugs can increase the efficacy of PPCI. This
study was done to find any potential difference in terms of efficacy of
administering intracoronary Abciximab vs. intravenous Eptifibatide in
primary PPCI. Methods: A total of 40 STEMI patients who underwent PPCI
within 12 hours of symptom onset were randomized to either an
intracoronary Abciximab (0.25 mug/kg) bolus or two boluses of intravenous
Eptifibatide (0.180 mug/kg) each 10 minutes. The primary end points were
enzymatic infarct size, myocardial reperfusion measured as ST-segment
resolution (STR), and post-procedural thrombolysis in myocardial
infarction (TIMI) grade flow of the infarct-related artery. The secondary
end points were intra-procedural adverse effect (arrhythmia) and no-reflow
phenomenon, in-hospital mortality, reinfarction, hemorrhage, and
post-procedural global systolic function. Results: Post-procedural TIMI
grade 3 flow was achieved in 95% and 90% of the intracoronary Abciximab
and intravenous Eptifibatide groups, respectively (p value = 0.61). The
infarct size, as assessed by the area under the curve of creatine
phosphokinase-MB in the first 48 hours after PPCI (mumol/L/hr), was
similar between the intracoronary Abciximab and intravenous Eptifibatide
groups: 6591 (interquartile range [IQR], 3006.0 to 11112.0) versus 7,294
(IQR, 3795.5 to 11803.5); p value = 0.59. Complete STR was achieved in 55%
and 45% of the intracoronary Abciximab and intravenous Eptifibatide
groups, respectively (p value = 0.87). No deaths, urgent
revascularizations, reinfarctions, or TIMI major bleeding events were
observed in either group. Conclusion: The intracoronary administration of
Abciximab was not superior to the intravenous administration of
Eptifibatide in the STEMI patients who underwent primary PCI.

<2>
Accession Number
2013594405
Authors
Forouzannia S.K. Abdollahi M.H. Mirhosseini S.J. Hadadzadeh M. Zarepur R.
Zarepur E. Beiki O. Sarebanhassanabadi M.
Institution
(Forouzannia, Abdollahi, Mirhosseini, Hadadzadeh, Zarepur, Zarepur,
Sarebanhassanabadi) Yazd Cardiovascular Research Center, Shahid Sadoughi
University of Medical Sciences, Yazd, Iran, Islamic Republic of
(Beiki) Kermanshah University of Medical Sciences, Kermanshah, Iran,
Islamic Republic of
Title
Adenosine preconditioning versus ischemic preconditioning in patients
undergoing off-pump coronary artery bypass (OPCAB).
Source
Journal of Tehran University Heart Center. 8 (3) (pp 127-131), 2013. Date
of Publication: 2013.
Publisher
Tehran Heart Center (North Kargar Street, Tehran 1411713138, Iran, Islamic
Republic of)
Abstract
Background: During off-pump coronary artery bypass (OPCAB), the heart is
subjected to ischemic and reperfusion injury. Preconditioning is a
mechanism that permits the heart to tolerate myocardial ischemia. The aim
of this study was to compare the effects of Adenosine preconditioning with
ischemic preconditioning on the global ejection fraction (EF) in patients
undergoing OPCAB. Methods: In this single-blind, randomized controlled
trial, sixty patients undergoing OPCAB were allocated into three
equally-numbered groups through simple randomization: Adenosine group,
ischemic group, and control group. The patients in the Adenosine group
received an infusion of Adenosine. In the ischemic group, ischemic
preconditioning was induced by the temporary occlusion of the left
anterior descending coronary artery twice for a 2-minute period, followed
by 3-minute reperfusion before bypass grafting of the first coronary
vessel. The control group received an intravenous infusion of 0.9% saline.
Blood samples at different times were sent for the measurement of creatine
kinase isoenzyme MB (CK-MB) and cardiac troponin I (cTnI). We also
recorded electrocardiographic indices and clinical parameters, including
postoperative use of inotropic drugs and preoperative and postoperative
EF. Results: History of myocardial infarction, hyperlipidemia, diabetes
mellitus, kidney disease, preoperative arrhythmias, and utilization of
postoperative inotrope was the same between the three groups. The
incidence of postoperative arrhythmias was not significant between the
three groups. Also, there were no significant differences in preoperative
and postoperative EF and the serum levels of enzymes (cTnI and CK-MB)
between the groups. Conclusion: Based on the findings of this study, there
was no significant difference in the postoperative EF between the groups.
Although the incidence of arrhythmias was higher in the ischemic
preconditioning group than in the other groups, the difference between the
groups did not constitute statistical significance.

<3>
[Use Link to view the full text]
Accession Number
2013617717
Authors
Bragadottir G. Redfors B. Ricksten S.-E.
Institution
(Bragadottir, Redfors, Ricksten) Department of Anesthesiology and
Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg,
Sahlgrenska University Hospital, S-413 45 Goteborg, Sweden
Title
Effects of levosimendan on glomerular filtration rate, renal blood flow,
and renal oxygenation after cardiac surgery with cardiopulmonary bypass: A
randomized placebo-controlled study.
Source
Critical Care Medicine. 41 (10) (pp 2328-2335), 2013. Date of Publication:
October 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Objectives: Acute kidney injury develops in a large proportion of patients
after cardiac surgery because of the low cardiac output syndrome. The
inodilator levosimendan increases cardiac output after cardiac surgery
with cardiopulmonary bypass, but a detailed analysis of its effects on
renal perfusion, glomerular filtration, and renal oxygenation in this
group of patients is lacking. We therefore evaluated the effects of
levosimendan on renal blood flow, glomerular filtration rate, renal oxygen
consumption, and renal oxygen demand/supply relationship, i.e., renal
oxygen extraction, early after cardiac surgery with cardiopulmonary
bypass. Design: Prospective, placebo-controlled, and randomized trial.
Setting: Cardiothoracic ICU of a tertiary center. Patients: Postcardiac
surgery patients (n = 30). INTERVENTIONS: The patients were randomized to
receive levosimendan, 0.1 mug/kg/min after a loading dose of 12 mug/kg (n
= 15), or placebo (n = 15). Measurements and Main Results: The
experimental procedure started 4-6 hours after surgery in the ICU during
propofol sedation and mechanical ventilation. Systemic hemodynamic were
evaluated by a pulmonary artery thermodilution catheter. Renal blood flow
and glomerular filtration rate were measured by the renal vein retrograde
thermodilution technique and by renal extraction of Cr-EDTA, respectively.
Central venous pressure was kept constant by colloid/crystalloid infusion.
Compared to placebo, levosimendan increased cardiac index (22%), stroke
volume index (15%), and heart rate (7%) and decreased systemic vascular
resistance index (21%), whereas mean arterial pressure was not affected.
Levosimendan induced significant increases in renal blood flow (12%, p <
0.05) and glomerular filtration rate (21%, p < 0.05), decreased renal
vascular resistance (18%, p < 0.05) but caused no significant changes in
filtration fraction, renal oxygen consumption, or renal oxygen extraction,
compared to placebo. Conclusions: After cardiac surgery with
cardiopulmonary bypass, levosimendan induces a vasodilation,
preferentially of preglomerular resistance vessels, increasing both renal
blood flow and glomerular filtration rate without jeopardizing renal
oxygenation. Due to its pharmacodynamic profile, levosimendan might be an
interesting alternative for treatment of postoperative heart failure
complicated by acute kidney injury in postcardiac surgery patients.
Copyright 2013 by the Society of Critical Care Medicine and Lippincott
Williams & Wilkins.

<4>
Accession Number
2013617165
Authors
Florescu D.F. Kalil A.C. Qiu F. Schmidt C.M. Sandkovsky U.
Institution
(Florescu, Kalil, Sandkovsky) Infectious Diseases Division, University of
Nebraska Medical Center, Omaha, NE, United States
(Florescu) Transplant Surgery Division, University of Nebraska Medical
Center, Omaha, NE, United States
(Qiu) Biostatistics Department, University of Nebraska Medical Center,
Omaha, NE, United States
(Schmidt) McGoogan Library of Medicine, Nebraska Medical Center, Omaha,
NE, United States
Title
What is the impact of hypogammaglobulinemia on the rate of infections and
survival in solid organ transplantation? A meta-analysis.
Source
American Journal of Transplantation. 13 (10) (pp 2601-2610), 2013. Date of
Publication: October 2013.
Publisher
Blackwell Publishing Ltd (9600 Garsington Road, Oxford OX4 2XG, United
Kingdom)
Abstract
Hypogammaglobulinemia has been described after solid organ transplantation
and has been associated with increased risk of infections. The aim of the
study was to evaluate the rate of severe hypogammaglobulinemia and its
relationship with the risk of infections during the first year
posttransplantation. Eighteen studies (1756 patients) that evaluated
hypogammaglobulinemia and posttransplant infections were included. The
data were pooled using the DerSimonian and Laird random-effects model. Q
statistic method was used to assess statistical heterogeneity. Within the
first year posttransplantation, the rate of hypogammaglobulinemia (IgG <
700 mg/dL) was 45% (95% CI: 0.34-0.55; Q = 330.1, p < 0.0001), the rate of
mild hypogammaglobulinemia (IgG = 400-700 mg/dL) was 39% (95% CI:
0.22-0.56; Q = 210.09, p < 0.0001) and the rate of severe
hypogammaglobulinemia (IgG < 400 mg/dL) was 15% (95% CI: 0.08-0.22; Q =
50.15, p < 0.0001). The rate of hypogammaglobulinemia by allograft type:
heart 49% (21%-78%; Q = 131.16, p < 0.0001); kidney 40% (30%-49%; Q =
24.55, p = 0.0002); liver 16% (0.001%-35%; Q = 14.31, p = 0.0002) and lung
63% (53%-74%; Q = 6.85, p = 0.08). The odds of respiratory infection (OR =
4.83; 95% CI: 1.66-14.05; p = 0.004; I² = 0%), CMV (OR = 2.40;
95% CI: 1.16-4.96; p = 0.02; I² = 26.66%), Aspergillus (OR =
8.19; 95% CI: 2.38-28.21; p = 0.0009; I² = 17.02%) and other
fungal infections (OR = 3.69; 95% CI: 1.11-12.33; p = 0.03; I²
= 0%) for patients with IgG <400 mg/dL were higher than the odds for
patients with IgG >400 mg/dL. The odds for 1-year all-cause mortality for
severe hypogammaglobulinemia group was 21.91 times higher than those for
IgG >400 mg/dL group (95% CI: 2.49-192.55; p = 0.005; I² = 0%).
Severe hypogammaglobulinemia during the first year posttransplantation
significantly increased the risk of CMV, fungal and respiratory
infections, and was associated with higher 1-year all-cause mortality.
Severe hypogammaglobulinemia during the first year posttransplantation
increases the risk of CMV, fungal and respiratory infections, and it is
associated with higher one-year all-cause mortality. See editorial by
Avery and Blumberg on page 2517. 2013 The American Society of
Transplantation and the American Society of Transplant Surgeons.

<5>
Accession Number
2013611716
Authors
Munipalle P.C. Garud T. Light D.
Institution
(Munipalle, Garud, Light) Department of General Surgery, Friarage
Hospital, Northallerton, North Yorks, United Kingdom
Title
Diaphragmatic disease of the colon: Systematic review.
Source
Colorectal Disease. 15 (9) (pp 1063-1069), 2013. Date of Publication:
September 2013.
Publisher
Blackwell Publishing Ltd (9600 Garsington Road, Oxford OX4 2XG, United
Kingdom)
Abstract
Aim: Diaphragmatic disease is rare. This review aims to increase awareness
of this condition and its management. Method: A literature search was
conducted using the key terms 'colon' or 'colonic' in combination with
'diaphragm' or 'diaphragm disease' for publications until August 2012. All
cases of colonic diaphragm syndrome were identified and the required data
were collected. Results: Forty-five cases of colon diaphragm disease were
included. The highest incidence was in the seventh decade of life, with a
female preponderance (40F:5M). Most patients presented with chronic
(median 3 months) and multiple symptoms. The median use of nonsteroidal
anti-inflammatory drugs (NSAIDs) was 5 years including diclofenac as the
most commonly used NSAID. Colonoscopy was the most informative
investigation and the ascending colon was the most common site of
diaphragm disease. Nearly two-thirds of the patients were treated by
discontinuing NSAID treatment combined with other forms of treatment,
mostly surgery. Conclusion: Diaphragm disease of the colon is a rare
condition associated with long-term use of NSAIDs with a range of
presentations and symptoms. Based on this review, when colon diaphragm
disease is diagnosed we would recommend a trial cessation of NSAIDs.
Therapeutic endoscopic techniques should be considered but surgery may be
required for definitive treatment. 2013 The Association of Coloproctology
of Great Britain and Ireland.

<6>
Accession Number
2013604384
Authors
Nozue T. Fukui K. Yamamoto S. Kunishima T. Umezawa S. Onishi Y. Tohyama S.
Takeyama Y. Morino Y. Yamauchi T. Hibi K. Sozu T. Terashima M. Michishita
I.
Institution
(Nozue, Michishita) Division of Cardiology, Department of Internal
Medicine, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
(Fukui) Department of Cardiology, Kanagawa Cardiovascular and Respiratory
Center, Yokohama, Japan
(Yamamoto) Department of Cardiology, Tsurumi Nishiguchi Hospital,
Yokohama, Japan
(Kunishima) Fourth Department of Internal Medicine, Mizonokuchi Hospital,
Teikyo University School of Medicine, Kawasaki, Japan
(Umezawa, Onishi) Department of Cardiology, Hiratsuka Kyosai Hospital,
Hiratsuka, Japan
(Tohyama) Department of Cardiology, Yokohama Seamen's Insurance Hospital,
Yokohama, Japan
(Takeyama) Division of Cardiology, Showa University Fujigaoka
Rehabilitation Hospital, Yokohama, Japan
(Morino) Department of Cardiology, Iwate Medical University, Morioka,
Japan
(Yamauchi) Department of Cardiology, Tokyo Women's Medical University,
Tokyo, Japan
(Hibi) Division of Cardiology, Yokohama City University Medical Center,
Yokohama, Japan
(Sozu) Department of Biostatistics, Kyoto University School of Public
Health, Kyoto, Japan
(Terashima) Cardiovascular Imaging Center, Toyohashi, Japan
Title
C-reactive protein and future cardiovascular events in statin- treated
patients with angina pectoris: The extended TRUTH study.
Source
Journal of Atherosclerosis and Thrombosis. 20 (9) (pp 717-725), 2013. Date
of Publication: 2013.
Publisher
Japan Atherosclerosis Society (2-20-15 Shinbashi, Minato-ku, Tokyo
105-0004, Japan)
Abstract
The TRUTH trial demonstrated that 8-month statin therapy alters the
composition of coronary artery plaque using virtual histology
(VH)-intravascular ultrasound (IVUS). The extended TRUTH study was
conducted to evaluate the relationship between changes in coronary
atherosclerosis and mid-term clinical outcomes and identify the factors
associated with cardiovascular events. Methods: Of 164 patients with
angina pectoris who participated in the TRUTH trial, 119 subjects with
analyzable IVUS data at both enrollment and the 8-month follow-up were
enrolled and observed for at least two years. The primary end point was
the time to first occurrence of cardiovascular composite events, including
cardiovascular death, nonfatal myocardial infarction, nonfatal cerebral
infarction, unstable angina and ischemic-driven revascularization, except
for target lesion revascularization. Results: The frequency of reaching
the primary end point was 13% (16/119), with a mean follow-up period of
41.9+/-9.4 months. Although plaque regression and changes in plaque
composition were not associated with future cardiovascular events, the
serum high-sensitivity C-reactive protein (hs- CRP) levels at the start of
the extended TRUTH study were significantly higher in the event group than
in the event-free group (1.43 mg/L vs. 0.58 mg/L, p= 0.01). A multivariate
logistic regression analysis showed that the hs-CRP level was an
independent significant predictor of cardiovascular events (odds ratio:
1.69; 95% confidence interval: 1.14-2.50, p= 0.01). Conclusions: Coronary
artery plaque regression and changes in plaque composition during statin
therapy do not predict future cardiovascular events in patients with
angina pectoris. Instead, the serum hs-CRP level can be used as a
predictor of cardiovascular events.

<7>
Accession Number
2013604343
Authors
Lv J.-Y. Li X. Wang L. Xin S.-J.
Institution
(Lv, Wang, Li, Wang, Xin) Department of Vascular and Thyroid Surgery, The
First Affiliated Hospital of China Medical University, Shenyang 110001,
China
Title
Amiodarone for repurfusion arrhythmia after thrombolytic therapy for acute
myocardial infarction: A meta-analysis.
Source
Chinese Journal of Evidence-Based Medicine. 13 (9) (pp 1110-1115), 2013.
Date of Publication: 2013.
Publisher
West China University of Medical Science (37 Wainan Guoxue Xiang, Chengdu,
Sichuan 610041, China)
Abstract
Objective To systematically review the effectiveness of amiodarone in
treating repurfusion arrhythmia (RA) after thrombolytic therapy for acute
myocardial infarction (AMI), so as to provide high quality evidence for
formulating the rational thrombolytic therapy for AMI. Methods Randomized
controlled trails (RCTs) on amiodarone in treating RA after thrombolytic
therapy for AMI were electronically retrieved in PubMed, EMbase, The
Cochrane Library (Issue 3, 2012), CBM, CNKI, VIP and WanFang Data from
inception to January, 2013. According to the inclusion and exclusion
criteria, two reviewers independently screened literature, extracted data,
and assessed quality. Then RevMan 5.1 software was used for meta-analysis.
Results A total of 5 RCTs involving 440 patients were included. The
results of meta- analysis suggested that, compared with the blank control,
amiodarone reduced the incidence of RA after thrombolytic therapy in
treating AMI (RR=0.60, 95%CI 0.48 to 0.74, P<0.000 01) and the incidence
of ventricular fibrillation (RR=0.47, 95%CI 0.26 to 0.85, P=0.01). It
neither affected the recanalization rate of occluded arteries after
thrombolytic therapy (RR=1.00, 95%CI 0.88 to 1.15, P=0.94) nor decreased
the mortality after surgery (RR=0.33, 95%CI 0.10 to 1.09, P=0.07).
Conclusion Current evidence indicated that, amiodarone can decrease the
incidence of RA. Unfortunately, the mortality rate can't be reduced by
amiodarone. Due to the limited quality and quantity of the included
studies, more high quality studies are needed to verify the above
conclusion. 2013 Editorial Board of Chin J Evid-based Med.

<8>
Accession Number
2013604342
Authors
Yin Q. Zhang Z.-G. Ma Y.-P. Li B.-F.
Institution
(Yin) The First Affiliated Hospital, Sun Yat-sen University, Guangzhou
510080, China
(Yin, Zhang, Li) Department of Anesthesiology, Zhongshan People's
Hospital, Zhongshan 528403, China
(Ma) Hybio Pharmaceutical Co.Ltd., Shenzhen 518057, China
Title
Intracoronary glycoprotein IIb/IIIa inhibitor for patients with acute
coronary syndrome undergoing percutaneous coronary intervention: A
meta-analysis.
Source
Chinese Journal of Evidence-Based Medicine. 13 (9) (pp 1102-1109), 2013.
Date of Publication: 2013.
Publisher
West China University of Medical Science (37 Wainan Guoxue Xiang, Chengdu,
Sichuan 610041, China)
Abstract
Objective To systematically review the effectiveness and safety of
intracoronary glycoprotein IIb/IIIa inhibitors (GPIs) undergoing
percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS)
compared with intravenous administration. Methods Databases including
PubMed, EMbase, The Cochrane Library (Issue 9, 2012), Ovid, CBM, CNKI and
VIP were electronically searched for randomized controlled trials (RCTs)
about intracoronary GPIs administration versus intravenous administration
undergoing PCI for ACS from inception to September 30th, 2012. Meanwhile,
domestic relevant papers published in recent 1 year were also retrieved
manually. References of the included studies were retrieved, too.
According to the inclusion and exclusion criteria, two reviewers
independently screened literature, extracted data, and assessed the
methodologically quality of the included studies. Then, meta-analysis was
performed using RevMan 5.1 software. Results 10 RCTs involving 3 553 ACS
patients were finally included. The results of meta-analysis showed that:
compared with intravenous administration, intracoronary GPIs
administration decreased the major adverse cardiovascular event (MACE)
(OR=0.54, 95%CI 0.34 to 0.85, P=0.008). The incidences of reinfarction
(MI), revascularization (TVR) and heart failure were (OR=0.62, 95%CI 0.39
to 0.97, P=0.04), (OR=0.59, 95%CI 0.36 to 0.97, P=0.04), (OR=0.52, 95%CI
0.32 to 0.84, P=0.008), respectively. But for the mortality, there were no
significant differences between the two groups (OR=0.81, 95%CI 0.58 to
1.14, P=0.23). Intravenous administration and intracoronary administration
were alike in the incidences of mild/serious bleeding (mild: OR=0.94,
95%CI 0.75 to 1.19, P=0.63; serious: OR=1.18, 95%CI 0.76, 1.84, P=0.47).
Conclusion Compared with routine GPIs regimen of intravenous bolus,
intracoronary administration with initial dosage showed significant
benefits in clinical outcomes in ACS patients undergoing PCI, which could
not increase the incidence of bleeding. 2013 Editorial Board of Chin J
Evid-based Med.

<9>
Accession Number
2013604341
Authors
Li J.-H. Aikebaer Mula T. Inamdar K.Y.
Institution
(Li, Aikebaer, Mula, Inamdar) The First Department of Cardiac Surgery
Division, First Affiliated Hospital of Xinjiang Medical University, Urumqi
830054, China
Title
Effectiveness and safety of coronary artery bypass grafting for
unprotected left main coronary artery: A systematic review.
Source
Chinese Journal of Evidence-Based Medicine. 13 (9) (pp 1096-1101), 2013.
Date of Publication: 2013.
Publisher
West China University of Medical Science (37 Wainan Guoxue Xiang, Chengdu,
Sichuan 610041, China)
Abstract
Objective To systematically review the effectiveness and safety of
coronary artery bypass grafting (CABG) versus percutaneous coronary stent
implantation (PCI) in the treatment of patients with unprotected left main
coronary artery disease (ULMCA). Methods Databases including The Cochrane
Library (Issue 2, 2012), PubMed, EMbase, CBM, CNKI, WanFang Data and VIP
were electronically searched from inception to September 2012 for
randomized controlled trials on the effectiveness and safety of coronary
artery bypass grafting (CABG) versus percutaneous coronary stent
implantation (PCI) for ULMCA; References of the included studies were also
retrieved. Two reviewers independently screened literature according to
the inclusion and exclusion criteria, extracted data, and assessed the
methodological quality of the included studies. Then, meta-analysis was
performed using RevMan 5.0. Results Four studies were included involving 1
611 cases, of which, 802 cases are in the CABG group, while 809 cases were
in the PCI group. The results of meta-analysis showed that: comparing with
PCI, CABG significantly reduced the postoperative repeat revascularization
rate (OR=0.45, 95%CI 0.31 to 0.66, P<0.000 1), but there was no
significant difference between the two groups in reducing the myocardial
infarction incidence (OR=1.28, 95%CI 0.47 to 3.48, P=0.63), mortality rate
(OR=1.36, 95%CI 0.80 to 2.34, P=0.26), and the incidence of major adverse
cardio-cerebral vascular events (OR=0.92, 95%CI 0.66 to 1.28, P=0.61).
Conclusion This study indicates that CABG is superior to PCI in reducing
postoperative rate of target vessel revascularization. But CABG and PCI
are alike in reducing myocardial infarction incidence, mortality rate, and
the incidence of major adverse cardio-cerebral vascular events. Due to the
limited quantity and quality of the included studies, the above conclusion
needs to be verified by more high quality RCTs. 2013 Editorial Board of
Chin J Evid-based Med.

<10>
Accession Number
2013581682
Authors
Qin S.-Y. Zhou Y. Jiang H.-X. Hu B.-L. Tao L. Xie M.-z.
Institution
(Qin, Jiang, Hu, Tao, Xie) The First Affiliated Hospital of Guangxi
Medical University, Nanning, Guangxi, China
(Zhou) Minerva Foundation Institute for Medical Research, Helsinki,
Finland
Title
The Association of Diabetes Mellitus with Clinical Outcomes after Coronary
Stenting: A Meta-Analysis.
Source
PLoS ONE. 8 (9) , 2013. Article Number: e72710. Date of Publication: 16
Sep 2013.
Publisher
Public Library of Science (185 Berry Street, Suite 1300, San Francisco CA
94107, United States)
Abstract
Background:Previous studies have shown inconsistent results on the
association between diabetes mellitus (DM) and some clinical outcomes. We
conducted a meta-analysis of observational studies to assess effect of DM
on clinical outcomes after coronary stenting.Methods:We searched for
studies without language restriction in PubMed, Embase and Cochrane
library prior to 2012. The clinical outcomes including in-stent restenosis
(ISR), major adverse cardiac events (MACE), stent thrombosis (ST), target
lesion revascularization (TLR) and target vessel revascularization (TVR).
Adjusted odds ratio (OR), and the corresponding 95% confidence interval
(95% CI) was summarized.Results:55 studies involving 128,084 total
patients (38,416 DM patients and 89,668 controls) were eligible for our
analysis. Overall, there were significant associations between DM and ISR
(OR = 1.70, 95% CI: 1.53-1.89, I² = 0.0%), MACE (OR = 1.54, 95%
CI: 1.36-1.73, I² = 29.0%), ST (OR = 2.01, 95% CI: 1.36-2.97,
I² = 47.7%), TLR (OR = 1.46, 95% CI: 1.26-1.68, I² =
43.3%) as well as TVR (OR = 1.33, 95% CI: 1.17-1.51, I² =
48.3). Subgroup analysis showed that the associations were similar between
BMS and DES implantation. Moreover, there was no significant association
in the ST subgroup after 1-3 years follow-up.Conclusions:Our meta-analysis
suggests that after coronary stent implantation, DM is associated with
ISR, MACE, ST, TLR and TVR. DM appears to be a vital risk factor of these
clinical outcomes. 2013 Qin et al.

<11>
Accession Number
2013570185
Authors
Yu C.-M. Kwong J.S.W. Sanderson J.E.
Institution
(Yu, Kwong, Sanderson) Department of Medicine and Therapeutics, Chinese
University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong
Title
Drug-eluting balloons for coronary artery disease: A meta-analysis of
randomized controlled trials.
Source
International Journal of Cardiology. 168 (1) (pp 197-206), 2013. Date of
Publication: 20 Sep 2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Background: Drug-eluting balloons (DEB) are attractive new alternatives to
drug-eluting stents (DES) for percutaneous coronary interventions. We
aimed to systematically review the efficacy and safety of DEB in the
treatment of coronary artery disease (CAD). Methods: MEDLINE, EMBASE and
the Cochrane Central Register of Controlled Trials (CENTRAL) were searched
in December 2011 for eligible randomized controlled trials. Primary
outcomes were target lesion revascularization (TLR), major adverse cardiac
events (MACE) and mortality. Secondary outcomes were late lumen loss,
minimal lumen diameter and binary restenosis. Results: Five studies
involving 349 patients were included. Compared to controls, DEB improved
angiographic measures with no significant effect on clinical outcomes in
the overall CAD population. There is clear superiority of DEB in patients
with in-stent restenosis in TLR (OR 0.17, 95% CI 0.07 to 0.38, p < 0.0001,
I² = 0%), MACE (OR 0.22, 95% CI 0.10 to 0.51, p = 0.0005,
I² = 13%), late lumen loss (in-stent: MD - 0.51, 95% CI - 0.73
to - 0.28, p < 0.00001, I² = 60%; in-segment: MD - 0.51, 95% CI
- 0.77 to - 0.24, p = 0.0002, I² = 72%;), minimal lumen
diameter (in-stent: MD 0.49, 95% CI 0.05 to 0.93, p = 0.03, I²
= 85%; in-segment: MD 0.49, 95% CI 0.13 to 0.86, p = 0.008, I²
= 79%) and binary restenosis (in-stent: OR 0.15, 95% CI 0.05 to 0.47, p =
0.001, I ² = 37%; in-segment: OR 0.11, 95% CI 0.05 to 0.27, p <
0.00001, I² = 17%). Conclusions: Our findings support the
current recommendation of using DEB in in-stent restenosis. Large,
well-conducted trials are essential in determining the application of DEB
in other lesion types as well as exploring device-specific efficacy and
safety profiles. 2012 Elsevier Ireland Ltd. All rights reserved.

<12>
Accession Number
23599353
Authors
Scalvini S. Zanelli E. Comini L. Dalla Tomba M. Troise G. Febo O. Giordano
A.
Institution
(Scalvini) Telemedicine Service, Fondazione Salvatore Maugeri, Institute
for Care and Scientific Research (IRCCS), Via Giuseppe Mazzini, 129-25065
Lumezzane, Brescia, Italy.
Title
Home-based versus in-hospital cardiac rehabilitation after cardiac
surgery: a nonrandomized controlled study.
Source
Physical therapy. 93 (8) (pp 1073-1083), 2013. Date of Publication: Aug
2013.
Abstract
Exercise rehabilitation after cardiac surgery has beneficial effects,
especially on a long-term basis. Rehabilitative programs with telemedicine
plus appropriate technology might satisfy the needs of performing
rehabilitation at home. The purpose of this study was to compare exercise
capacity after home-based cardiac rehabilitation (HBCR) or in-hospital
rehabilitation in patients at low to medium risk for early mortality
(EuroSCORE 0-5) following cardiac surgery. A quasi-experimental study was
conducted. At hospital discharge, patients were given the option to decide
whether to enroll in the HBCR program. Clinical examinations
(electrocardiography, cardiac echo color Doppler, chest radiography, blood
samples) of patients in the HBCR group were collected during 4 weeks of
rehabilitation, and exercise capacity (assessed using the Six-Minute Walk
Test [6MWT]) was assessed before and after rehabilitation. A group of
patients admitted to the in-hospital rehabilitation program was used as a
comparison group. Patients in the HBCR group were supervised at home by a
medical doctor and telemonitored daily by a nurse and physical therapist
by video conference. Periodic home visits by health staff also were
performed. One hundred patients were recruited into the HBCR group. An
equal number of patients was selected for the comparison group. At the end
of the 4-week study, the 2 groups showed improvement from their respective
baseline values only in the 6MWT. No difference was found in time x group
interaction. Because patients self-selected to enroll in the HBCR program
and because they were enrolled from a single clinical center, the results
of the study cannot be generalized. In patients who self-selected HBCR,
the program was found to be effective and comparable to the standard
in-hospital rehabilitative approach, indicating that rehabilitation
following cardiac surgery can be implemented effectively at home when
coadministered with an integrated telemedicine service.

<13>
Accession Number
2013571480
Authors
Xin W. Wei W. Lin Z. Zhang X. Yang H. Zhang T. Li B. Mi S.
Institution
(Xin, Zhang, Yang, Zhang, Li, Mi) Department of Cardiology, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
(Wei) Department of Pathophysiology, School of Medicine, Nankai
University, Tianjin, China
(Lin) Department of Cardiovascular Medicine, Affiliated Hospital of
Guiyang Medical College, Guizhou, China
Title
Fish Oil and Atrial Fibrillation after Cardiac Surgery: A Meta-Analysis of
Randomized Controlled Trials.
Source
PLoS ONE. 8 (9) , 2013. Article Number: e72913. Date of Publication: 10
Sep 2013.
Publisher
Public Library of Science (185 Berry Street, Suite 1300, San Francisco CA
94107, United States)
Abstract
Background:Influence of fish oil supplementation on postoperative atrial
fibrillation (POAF) was inconsistent according to published clinical
trials. The aim of the meta-analysis was to evaluate the effects of
perioperative fish oil supplementation on the incidence of POAF after
cardiac surgery.Methods:Pubmed, Embase and the Cochrane Library databases
were searched. Randomized controlled trials (RCTs) assessing perioperative
fish oil supplementation for patients undergoing cardiac surgery were
identified. Data concerning study design, patient characteristics, and
outcomes were extracted. Risk ratio (RR) and weighted mean differences
(WMD) were calculated using fixed or random effects models.Results:Eight
RCTs involving 2687 patients were included. Perioperative supplementation
of fish oil did not significantly reduce the incidence of POAF (RR = 0.86,
95%CI 0.71 to 1.03, p = 0.11) or length of hospitalization after surgery
(WMD = 0.10 days, 95% CI: 0.48 to 0.67 days, p = 0.75). Fish oil
supplementation also did not affect the perioperative mortality, incidence
of major bleeding or the length of stay in the intensive care unit.
Meta-regression and subgroup analyses indicated mean DHA dose in the
supplements may be a potential modifier for the effects of fish oil for
POAF. For supplements with DHA >1 g/d, fish oil significantly reduced the
incidence of POAF; while it did not for the supplements with a lower dose
of DHA.Conclusions:Current evidence did not support a preventative role of
fish oil for POAF. However, relative amounts of DHA and EPA in fish oil
may be important for the prevention of POAF. 2013 Xin et al.

<14>
Accession Number
2013569712
Authors
Maisano F. Franzen O. Baldus S. Schafer U. Hausleiter J. Butter C. Ussia
G.P. Sievert H. Richardt G. Widder J.D. Moccetti T. Schillinger W.
Institution
(Maisano) Scientific Institute San Raffaele, Department of Cardiac
Surgery, Hospital San Raffaele, Via Olgettina 60, 20132 Milan, Italy
(Franzen) Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
(Baldus) Department of General and Interventional Cardiology, University
Heart Centre, Hamburg, Germany
(Schafer) Department of Cardiology, Asklepios Klinik St. Georg, Hamburg,
Germany
(Hausleiter) Deutsches Herzzentrum Munchen, Munich, Germany
(Butter) Heart Centre Brandenburg, Bernau/Berlin, Germany
(Ussia) Interventional Structural and Congenital Heart Disease Programme,
Ferrarotto Hospital, University of Catania, Catania, Italy
(Ussia) ETNA Foundation, Catania, Italy
(Sievert) CardioVascular Center Frankfurt, Frankfurt, Germany
(Richardt) Heart Center, Segeberger Kliniken GmbH (Academic Teaching
Hospital of the Universities of Kiel and Hamburg), Bad Segeberg, Germany
(Widder) Medizinische Hochschule, Hannover, Germany
(Moccetti) Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano,
Switzerland
(Schillinger) Heart Centre, Georg-August University, Gottingen, Germany
Title
Percutaneous mitral valve interventions in the real world: Early and
1-year results from the ACCESS-EU, A prospective, multicenter,
nonrandomized post-approval study of the Mitraclip therapy in Europe.
Source
Journal of the American College of Cardiology. 62 (12) (pp 1052-1061),
2013. Date of Publication: 17 Sep 2013.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Objectives The purpose of this article is to report early and mid-term
outcomes of the ACCESS-EU study (ACCESS-Europe A Two-Phase Observational
Study of the MitraClip System in Europe), a European prospective,
multicenter, nonrandomized post-approval study of MitraClip therapy
(Abbott Vascular, Inc., Santa Clara, California). Background MitraClip has
been increasingly performed in Europe after approval; the ACCESS-EU
registry provides a snapshot of the real-world clinical demographic data
and outcomes. Methods A total of 567 patients with significant mitral
valve regurgitation (MR) underwent MitraClip therapy at 14 European sites.
Mean logistic European System for Cardiac Operative Risk Evaluation at
baseline was 23.0 +/- 18.3; 84.9% patients were in New York Heart
Association functional class III or IV, and 52.7% of patients had an
ejection fraction <=40%. Results The MitraClip implant rate was 99.6%. A
total of 19 patients (3.4%) died within 30 days after the MitraClip
procedure. The Kaplan-Meier survival at 1 year was 81.8%. Intensive care
unit and hospital length of stay was 2.5 +/- 6.5 days and 7.7 +/- 8.2
days, respectively. Single leaflet device attachment was reported in 27
patients (4.8%). There were no MitraClip device embolizations. Thirty-six
subjects (6.3%) required mitral valve surgery within 12 months after the
MitraClip implant procedure. There was improvement in the severity of MR
at 12 months, compared with baseline (p < 0.0001), with 78.9% of patients
free from MR, severity of >2+ at 12 months. At 12 months, 71.4% of
patients had New York Heart Association functional class II or class I.
Six-min-walk-test improved 59.5 +/- 112.4 m, and
Minnesota-living-with-heart-failure score improved 13.5 +/- 20.5 points.
Conclusions In the real-world, post-approval experience in Europe,
patients undergoing the MitraClip therapy are high-risk, elderly patients,
mainly affected by functional MR. In this patient population, the
MitraClip procedure is effective with low rates of hospital mortality and
adverse events. 2013 by the American College of Cardiology Foundation
Published by Elsevier Inc.

<15>
Accession Number
2013570180
Authors
Qarawani D. Cohen A. Nahir M. Hasin Y.
Institution
(Qarawani, Nahir, Hasin) Cardiovascular Institute Bruch Padea Medical
Center, Tiberias, Israel
(Cohen) Department of Statistics, Technion, Haifa, Israel
Title
Facilitation of left ventricular function recovery post percutaneous
coronary intervention by levosimendan.
Source
International Journal of Cardiology. 168 (1) (pp 237-242), 2013. Date of
Publication: 20 Sep 2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Background: Efficiency of percutaneous revascularization and the utility
of levosimendan for advanced ischemic heart failure (HF) is unclear. We
examined the efficacy of revascularization and levosimendan on left
ventricular ejection fraction (LVEF) and mortality of patients admitted
with acute decompensated HF and severe left ventricular dysfunction.
Methods: A prospective case control study that enrolled 84 patients with
ischemic decompensated HF with LVEF < 35% and preserved LV wall thickness.
Group A: 42 patients whose LVEF improved post percutaneous coronary
intervention (PCI). Group B1: 22 patients whose LVEF did not improve
post-PCI alone but improved after levosimendan. Group B2: 20 patients
whose LVEF did not improve neither post-PCI nor post levosimendan.
Results: LVEF increased in group A from 22 +/- 5 to 29 +/- 5% post PCI and
continued to improve at the 6 month follow-up (36 +/- 4%). In group B1
LVEF did not improve after PCI, but increased after levosimendan from 23
+/- 4% to 32 +/- 4% and remained constant at 6 months. In group B2 LVEF 26
+/- 4% did not change following both interventions. Reverse remodeling
with a decrease in end-diastolic and end-systolic diameters was observed
only in groups A and B1. Group B2 had a dismal prognosis with 36%
in-hospital and 43% six month mortality. Groups A and B1 had a lower in
hospital (4.7%, 4.5%) and mid term (11%, 11%) mortality. Conclusion:
Improvement of LV size and function with better prognosis can be expected
in the majority of patients undergoing PCI for decompensated ischemic HF.
Levosimendan enhanced the recovery of LV function post PCI. 2012 Elsevier
Ireland Ltd. All rights reserved.

<16>
Accession Number
2013568524
Authors
Leibowitz D. Weiss A.T. Rott D. Durst R. Lotan C.
Institution
(Leibowitz, Weiss, Rott, Durst, Lotan) Heart Institute, Hadassah Hebrew
University Medical Center, Mount Scopus, Jerusalem, Israel
Title
The efficacy of cardiac shock wave therapy in the treatment of refractory
angina: A pilot prospective, randomized, double-blind trial.
Source
International Journal of Cardiology. 167 (6) (pp 3033-3034), 2013. Date of
Publication: 2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)

<17>
Accession Number
2013570148
Authors
Guaricci A.I. Maffei E. Brunetti N.D. Montrone D. Di Biase L. Tedeschi C.
Gentile G. Macarini L. Midiri M. Cademartiri F. Di Biase M.
Institution
(Guaricci, Brunetti, Montrone, Di Biase, Tedeschi, Di Biase) Cardiology
Department, University of Foggia, Ospedali Riuniti Hospital, Foggia, Italy
(Maffei, Cademartiri) Cardiovascular Radiology Unit, Giovanni XXIII
Hospital, Monastier di Treviso, Italy
(Di Biase) Texas Cardiac Arrhythmia Institute, St. David's Medical Center,
Austin, TX, United States
(Gentile, Midiri) Department of Radiology, University Hospital P.
Giaccone, University of Palermo, Italy
(Macarini) Department of Diagnostic Imaging, University of Foggia,
Ospedali Riuniti Hospital, Foggia, Italy
(Cademartiri) Department of Radiology, Erasmus Medical Center University,
Rotterdam, Netherlands
Title
Heart rate control with oral ivabradine in computed tomography coronary
angiography: A randomized comparison of 7.5 mg vs 5 mg regimen.
Source
International Journal of Cardiology. 168 (1) (pp 362-368), 2013. Date of
Publication: 20 Sep 2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Background: Heart rate (HR) reduction is essential to achieve optimal
image quality and diagnostic accuracy with computed tomography coronary
angiography (CTCA). Administration of oral ivabradine seems to be more
effective than beta-blockade in reducing HR in patients referred for CTCA.
Methods: Two-hundred-fifty-nine consecutive patients referred for CTCA
were prospectively enrolled. Patients not receiving beta-blocker at
baseline (group 1) and those with beta-blocker therapy (group 2) were
enrolled in the study. Each group was randomized into 3 parallel arms with
1:1:1 allocation. Patients who did not receive beta-blocker at baseline:
underwent CTCA without beta blocker (n = 49), and received ivabradine 5 mg
(n = 48), or 7.5 mg ivabradine (n = 48). Patients with beta-blocker
therapy: continued with the prior beta-blocker without any dose
modification (n = 38), and received ivabradine 5 mg (n = 38), or
ivabradine 7.5 mg (n = 38). Results: HR and blood pressure were assessed
at admission (T0), immediately before CTCA (T1) and during CTCA (T2).
Administration of ivabradine 7.5 mg significantly reduced mean relative HR
at T1 and T2 (p < 0.01), the rate of patients not achieving target HR at
T1 (p < 0.001) and T2 (p < 0.01), and the percentage of patients needing
additional IV beta-blockade prior to CTCA (p < 0.01). Results remained
statistically significant even after correction for age, gender, ejection
fraction, risk factors and HR at T0, in a multivariable analysis.
Conclusions: Ivabradine 7.5 mg is more effective than ivabradine 5 mg in
increasing the rate of patients at target HR in patients referred for
CTCA. 2012 Elsevier Ireland Ltd. All rights reserved.

<18>
Accession Number
2013568592
Authors
Barthelemy O. Cayla G. Silvain J. O'Connor S.A. Bellemain-Appaix A. Beygui
F. Sideris G. Varenne O. Collet J.P. Vicaut E. Montalescot G.
Institution
(Barthelemy, Silvain, O'Connor, Bellemain-Appaix, Beygui, Collet,
Montalescot) Institut de Cardiologie, Centre Hospitalier Universitaire
Pitie-Salpetriere (AP-HP), INSERM CMR 937, Paris, France
(Cayla) Service de Cardiologie, Centre Hospitalier Universitaire Caremeau,
Nimes, France
(Sideris) Service de Cardiologie, Centre Hospitalier Universitaire
Lariboisiere (AP-HP), Paris, France
(Varenne) Service de Cardiologie, Centre Hospitalier Cochin (AP-HP),
Universite Paris Descartes, Paris, France
(Vicaut) Unite de Recherche Clinique, Centre Hospitalier Universitaire
Lariboisiere (AP-HP), France
Title
Optimal time for catheterization in NSTE-ACS patients with impaired renal
function: Insights from the ABOARD Study.
Source
International Journal of Cardiology. 167 (6) (pp 2646-2652), 2013. Date of
Publication: 2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Background: To assess the impact of impaired renal function (IRF) and
timing of catheterization (immediate versus delayed intervention) on
outcomes in intermediate/high risk NSTE-ACS patients. Methods: We
performed a post-hoc analysis of the randomized ABOARD population to
compare 1) patients with vs. without IRF and 2) the two intervention
strategies in patients with IRF. A creatinine clearance < 60 mL/min
defined IRF. The primary endpoint was the in-hospital peak troponin I
value; the secondary endpoints were a) the composite of death, myocardial
infarction, urgent revascularization or recurrent ischemia
(death/MI/UR/RI) and b) STEEPLE major bleeding (MB) at 1-month follow-up.
Results: Among the 345 patients, 75 (21.7%) had IRF. Patients with IRF
were older, had more comorbidities and were at higher cardiovascular risk.
Radial catheterization was predominant (84%). Among IRF patients, 37 (49%)
and 38 (51%) patients were randomized to an immediate and delayed
strategy, respectively. The primary and secondary endpoints rates were not
different for the two comparisons. IRF was associated with more death
(5.3% vs. 1.1%, p = 0.043) and non-CABG MB (9.3% vs. 2.2%, p = 0.001). In
patients with IRF, a delayed strategy was associated with more recurrent
ischemia (28.9% vs. 8.1%, p = 0.021). Absence of clopidogrel pretreatment,
insulin therapy and left main culprit lesion were independently associated
with death/MI/UR/RI, while age and CABG surgery were related with MB.
Conclusion: IRF is associated with worse outcomes in NSTE-ACS patients.
The primary results of the ABOARD study apply also to patients with IRF in
which the timing of catheterization does not impact hard outcomes. 2012
Elsevier Ireland Ltd.

<19>
Accession Number
2013603552
Authors
Yu G.-P. Shen Z.-Y.
Institution
(Yu, Shen) Department of Cardiothoracic Vascular Surgery, Affiliated
Jiangyin Hospital of Medical School, Southeast University, Jiangyin
214400, Jiangsu Province, China
Title
Research advances in mechanisms by which bone marrow stem cells improve
myocardial function.
Source
Chinese Journal of Tissue Engineering Research. 16 (41) (pp 7747-7751),
2012. Date of Publication: 2012.
Publisher
Journal of Clinical Rehabilitative (P.O. Box 1200, Shenyang 110004, China)
Abstract
Background: Bone marrow mesenchymal stem cells transplantation can
significantly improve the cardiac structure reconfiguration and cardiac
function through affecting the myocardial cell formation and myocardial
angiogenesis. Objective: To summarize the theoretical basis of bone marrow
mesenchymal stem cells transplantation for the treatment of ischemic
cardomyopathy through researching the effect of bone marrow mesenchymal
stem cells transplantation on myocardial function. Methods: The Chinese
Biomedical Literature database and Medline database from 1994 to 2011 were
used to search the reviews and reports that relate to the application of
bone marrow mesenchymal stem cells transplantation for the treatment of
ischemic cardomyopathy, and the research progress was analyzed. Results
and Conclusion: A total of 37 articles were included for the review.
Autologous application of bone marrow mesenchmal stem cells
transplantation can be amplified in vitro without immune rejection and can
avoid the ethical controversy. Research of bone marrow stem cells for the
treatment of acute myocardial infarction is still in the early stage. With
the development of the research, bone marrow mesenchymal stem cells become
a new method for the treatment of ischemic cardiomyopathy if we can find
an effective and safe dosage.