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<1>
Accession Number
2014025818
Authors
Zhang B. Zhen Y. Tao A. Bao Z. Zhang G.
Institution
(Zhang, Zhen, Tao, Bao, Zhang) Department of Cardiology, The Affiliated
People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
Title
Polyunsaturated fatty acids for the prevention of atrial fibrillation
after cardiac surgery: An updated meta-analysis of randomized controlled
trials.
Source
Journal of Cardiology. 63 (1) (pp 53-59), 2014. Date of Publication:
January 2014.
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai) (Hongo 4-9-22,
Bunkyo-ku, Tokyo 113, Japan)
Abstract
Background: Several clinical trials showed inconsistent results of the
effect of polyunsaturated fatty acids (PUFA) on the incidence of
post-operative atrial fibrillation (POAF). The aim of this meta-analysis
is to investigate the effect of PUFA on the incidence of POAF in patients
undergoing cardiac surgery. Methods and results: PUBMED, EMBASE, Cochrane
Library, and Google Scholar databases were searched for randomized
controlled trials. Statistical heterogeneity was assessed using
I² statistic and Cochran's Q statistic. The effect of PUFA on
the incidence of POAF was presented as risk ratio (RR) with 95% confidence
intervals (CIs) using a fixed effect model or random effect model
depending on statistical heterogeneity. Subgroup analyses were conducted
based on the baseline characteristics of patients, types of surgery, the
ratio of eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA), and the
quality of the studies. Eight trials with 2687 patients were included in
the analysis. Treatment with PUFA had no effect on the incidence of POAF
in patients undergoing cardiac surgery compared to placebo [RR 0.86; 95%
CI 0.71-1.04, p=0.110]. Subgroup analyses showed the quality of the
studies, the ratio of EPA/DHA, accompanied with diabetes might impact the
effect of PUFA on POAF. No evidence of publication bias was detected.
Conclusions: The present analysis suggests that treatment with PUFA
preoperatively has no effect on the incidence of POAF in patients
undergoing open heart surgery. However, patients with diabetes might get
benefits from the treatment with PUFA preoperatively. 2013 Japanese
College of Cardiology.

<2>
Accession Number
2014024576
Authors
Tanaka K.A. Egan K. Szlam F. Ogawa S. Roback J.D. Sreeram G. Guyton R.A.
Chen E.P.
Title
Transfusion and hematologic variables after fibrinogen or platelet
transfusion in valve replacement surgery: Preliminary data of purified
lyophilized human fibrinogen concentrate versus conventional transfusion.
Source
Transfusion. 54 (1) (pp 109-118), 2014. Date of Publication: January 2014.
Publisher
Blackwell Publishing Inc. (350 Main Street, Malden MA 02148, United
States)
Abstract
Background Platelet (PLT) and plasma transfusion remain the mainstay
hemostatic therapy for perioperative bleeding. Several studies have
indicated that acquired fibrinogen (FIB) deficiency can be the primary
cause of bleeding after cardiac surgery. The aim of this study was to
compare hematologic and transfusion profiles between the first-line FIB
replacement and PLT transfusion in post-cardiac surgical bleeding. Study
Design and Methods In this prospective, randomized, open-label study, 20
adult patients who underwent valve replacement or repair and fulfilled
preset visual bleeding scale were randomized to 4 g of FIB or 1 unit of
apheresis PLTs. Primary endpoints included hemostatic condition in the
surgical field and 24-hour hemostatic product usage. Hematologic data,
clinical outcome, and safety data were collected up to the 28th day
postoperative visit. Results In patients who received the first-line FIB
concentrate (n = 10), the visual bleeding scale improved after
intervention, and the incidence of PLT transfusion and total plasma donor
exposure were lower compared to the PLT group (n = 10). Postintervention
FIB level was statistically higher (209 mg/dL vs. 165 mg/dL) in the FIB
group than in the PLT group, but PLT count and prothrombin were lower.
There were no statistical differences in the postoperative blood loss and
red blood cell transfusion between two groups. Conclusions Our preliminary
data indicate that the primary FIB replacement may potentially reduce the
incidence of PLT transfusion and the number of donor exposures. Plasma FIB
level of 200 mg/dL is attainable with a single dose of 4 g, and this level
seems to mitigate bleeding despite moderately decreased thrombin
generation. 2013 American Association of Blood Banks.

<3>
Accession Number
2014021159
Authors
Lucas G.M. Cozzi-Lepri A. Wyatt C.M. Post F.A. Bormann A.M. Crum-Cianflone
N.F. Ross M.J.
Institution
(Lucas) Johns Hopkins University, Baltimore, MD, United States
(Cozzi-Lepri) University College London, London, United Kingdom
(Cozzi-Lepri, Bormann) University of Minnesota, Minneapolis, MN, United
States
(Wyatt, Ross) Mount Sinai School of Medicine, New York, NY, United States
(Post) King's College London School of Medicine, London, United Kingdom
(Crum-Cianflone) Naval Medical Center San Diego, San Diego, CA, United
States
(Crum-Cianflone) Infectious Disease Clinical Research Program, Uniformed
Services University of the Health Sciences, Bethesda, MD, United States
Title
Glomerular filtration rate estimated using creatinine, cystatin C or both
markers and the risk of clinical events in HIV-infected individuals.
Source
HIV Medicine. 15 (2) (pp 116-123), 2014. Date of Publication: February
2014.
Publisher
Blackwell Publishing Ltd (9600 Garsington Road, Oxford OX4 2XG, United
Kingdom)
Abstract
Objectives: The accuracy and precision of glomerular filtration rate (GFR)
estimating equations based on plasma creatinine (GFR_cr),
cystatin C (GFR_cys) and the combination of these markers
(GFR_cr-cys) have recently been assessed in HIV-infected
individuals. We assessed the associations of GFR, estimated by these three
equations, with clinical events in HIV-infected individuals. Methods: We
compared the associations of baseline GFR_cr, GFR_cys
and GFR_cr-cys [using the Chronic Kidney Disease Epidemiology
Collaboration (CKD-EPI) equations] with mortality, cardiovascular events
(CVEs) and opportunistic diseases (ODs) in the Strategies for the
Management of Antiretroviral Therapy (SMART) study. We used Cox
proportional hazards models to estimate unadjusted and adjusted hazard
ratios per standard deviation (SD) change in GFR. Results: A total of 4614
subjects from the SMART trial with available baseline creatinine and
cystatin C data were included in this analysis. Of these, 99 died, 111 had
a CVE and 121 had an OD. GFR_cys was weakly to moderately
correlated with HIV RNA, CD4 cell count, high-sensitivity C-reactive
protein, interleukin-6, and D-dimer, while GFR_cr had little or
no correlation with these factors. GFR_cys had the strongest
associations with the three clinical outcomes, followed closely by
GFR_cr-cys, with GFR_cr having the weakest
associations with clinical outcomes. In a model adjusting for
demographics, cardiovascular risk factors, HIV-related factors and
inflammation markers, a 1-SD lower GFR_cys was associated with a
55% [95% confidence interval (CI) 27-90%] increased risk of mortality, a
21% (95% CI 0-47%) increased risk of CVE, and a 22% (95% CI 0-48%)
increased risk of OD. Conclusions: Of the three CKD-EPI GFR equations,
GFR_cys had the strongest associations with mortality, CVE and
OD. 2013 British HIV Association.

<4>
Accession Number
2014018921
Authors
Mangukia C.V. Agarwal S. Satyarthy S. Datt V. Satsangi D.
Institution
(Mangukia, Agarwal, Satyarthy, Satsangi) Department of Cardiothoracic and
Vascular Surgery, G.B. Pant Hospital, New Delhi, India
(Datt) Department of Anesthesiology, G.B. Pant Hospital, New Delhi, India
Title
Mediastinitis following pediatric cardiac surgery.
Source
Journal of Cardiac Surgery. 29 (1) (pp 74-82), 2014. Date of Publication:
January 2014.
Publisher
Blackwell Publishing Inc. (350 Main Street, Malden MA 02148, United
States)
Abstract
Background Mediastinitis following pediatric cardiac surgery is associated
with significantly high morbidity and mortality. Method In our review, 21
studies from 1986 to 2011 (12 retrospective studies, eight prospective
studies, and a multi-institutional study) including 44,693 pediatric
cardiac patients were analyzed. Results and Conclusion Younger age,
malnutrition, preoperative respiratory tract infection, high American
anesthesiology score, longer duration of surgery, prolonged ventilation,
and ICU stay were definite risk factors for mediastinitis. Early primary
closure over drains, vacuum-assisted closure, muscle flap, and omental
flap remain the most frequently performed treatments for post-sternotomy
mediastinitis. Vacuum-assisted closure has emerged as the technique of
choice in recent years. 2013 Wiley Periodicals, Inc.

<5>
Accession Number
2014018932
Authors
Bawany F.I. Khan M.S. Khan A. Hussain M.
Institution
(Bawany, Khan, Hussain) Dow University of Health Sciences (DUHS), 109/2,
Main Kha-e-Bane Amirkhusro, Phase 6, DHA, Karachi, Pakistan
(Khan) Cardiac Surgery Department, Civil Hospital, DUHS, Karachi, Pakistan
Title
Skeletonization technique in coronary artery bypass graft surgery reduces
the postoperative pain intensity and disability index.
Source
Journal of Cardiac Surgery. 29 (1) (pp 47-50), 2014. Date of Publication:
January 2014.
Publisher
Blackwell Publishing Inc. (350 Main Street, Malden MA 02148, United
States)
Abstract
Background and Aim Benefits of the skeletonized internal thoracic artery
(ITA) include increased graft flow, increased graft length, and reduced
incidence of sternal complications. We conducted a randomized,
double-blinded comparison of skeletonized versus pedicled ITA to assess
the differences in pain intensity and extent of disability between the two
types of harvesting procedures at one and three months follow-up. Methods
A total of 50 patients were included in our study. Twenty-five patients
had undergone skeletonized grafting while the other half had undergone
pedicled grafting. The patients were evaluated for their pain at one and
three months postoperatively. Extent of disability was measured via Pain
Disability Index and intensity of pain was measured via Visual Analogue
Scale (VAS). The patients were also questioned about the details of their
pain using Short Form McGill Pain Questionnaire. Results In the first
month, the mean pain intensity measured through VAS was 30.4 + 4.0 and
55.0 + 5.7 mm in skeletonized and pedicle group, respectively. The
pedicled group had significantly higher scores measured by all three
scales at both one- and three-month intervals (p-values < 0.0001).
Conclusions Our results indicate that skeletonization of ITA significantly
reduces postcoronary artery bypass graft surgery pain at both one- and
three-month intervals. Long-term clinical trials involving larger sample
sizes should be conducted to fully confirm the benefits of the
skeletonization technique. 2013 Wiley Periodicals, Inc.

<6>
Accession Number
2013817012
Authors
Walters D.L. Sinhal A. Baron D. Pasupati S. Thambar S. Yong G. Jepson N.
Bhindi R. Bennetts J. Larbalestier R. Clarke A. Brady P. Wolfenden H.
James A. El Gamel A. Jansz P. Chew D.P.
Institution
(Walters, Clarke) Cardiology Program, Prince Charles Hospital, Brisbane
4032, QLD, Australia
(Sinhal, Bennetts, Chew) Flinders Medical Centre, Australia
(Baron, Jansz) St Vincent's Hospital, Sydney, Australia
(Pasupati, El Gamel) Waikato Hospital, New Zealand
(Thambar, James) John Hunter Hospital, Newcastle, Australia
(Yong, Larbalestier) Royal Perth Hospital, Australia
(Jepson, Wolfenden) Prince of Wales Hospital, Sydney, Australia
(Bhindi, Brady) Royal North Shore Hospital, Sydney, Australia
Title
Initial experience with the balloon expandable Edwards-SAPIEN
Transcatheter Heart Valve in Australia and New Zealand: The SOURCE ANZ
registry: Outcomes at 30 days and one year.
Source
International Journal of Cardiology. 170 (3) (pp 406-412), 2014. Date of
Publication: 01 Jan 2014.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Background We report the findings of the SOURCE-ANZ registry of the
clinical outcomes of the Edwards SAPIEN Transcatheter Heart Valve (THV) in
the Australian and New Zealand (ANZ) clinical environment. Methods This
single arm registry of select patients treated in eight centres, represent
the initial experience within ANZ with the balloon expandable Edwards
SAPIEN THV delivered by transfemoral (TF) and transapical (TA) access.
Results The total enrolment for the study was 132 patients, 63 patients
treated by TF, 56 by TA, and 2 patients were withdrawn from the study. The
mean ages: 83.7 (TF) and 81.7 (TA), female: 34.3% (TF) and 61.3% (TA),
logistic EuroSCORE: 26.8% (TF) and 28.8% (TA), and with procedural success
(successful implant without conversion to surgery or death): 92.4% (TF)
and 87.1% (TA) (p = 0.32). Outcomes were not significantly different
between TF and TA implants. These included one year mortality of 13.6%
(TF) and 21.7% (TA) (p = 0.24), MACCE: 16.7% (TF) and 28.3% (TA) (p =
0.12), pacemaker: 4.6% (TF) and 8.3% (TA) (p = 0.39), and VARC major
vascular complication of 4.6% (TF) and 5.0% (TA) (p = 0.91). Conclusion
TAVI in the ANZ clinical environment has demonstrated excellent outcomes
for both the TA and TF approaches in highly selected patients. These
results are consistent with those demonstrated in European, Canadian
registries and the pivotal US clinical trials. ACTRN12611001026910. 2013
The Authors.

<7>
Accession Number
2013803180
Authors
Tomai F. Adorisio R. De Luca L. Pilati M. Petrolini A. Ghini A.S. Parisi
F. Pongiglione G. Gagliardi M.G.
Institution
(Tomai, De Luca, Petrolini, Ghini) Department of Cardiovascular Sciences,
Division of Cardiology, European Hospital, Via Portuense 700, 00149 Rome,
Italy
(Adorisio, Pilati, Parisi, Pongiglione, Gagliardi) Department of
Cardiology, IRCCS Ospedale Pediatrico Bambino Gesu, Rome, Italy
Title
Coronary plaque composition assessed by intravascular ultrasound virtual
histology: Association with long-term clinical outcomes after heart
transplantation in young adult recipients.
Source
Catheterization and Cardiovascular Interventions. 83 (1) (pp 70-77), 2014.
Date of Publication: 01 Jan 2014.
Publisher
Wiley-Liss Inc. (111 River Street, Hoboken NJ 07030-5774, United States)
Abstract
Objectives To assess coronary plaque composition by virtual histology
intravascular ultrasound (VH-IVUS) analysis in young adult recipients and
to correlate these findings with time from heart transplant (HTx) and
long-term outcomes. Background Rapid progression of coronary allograft
vasculopathy after heart transplantation is a powerful predictor of
mortality and clinical events at long-term. Methods Forty consecutive
young adult recipients transplanted during childhood undergoing VH-IVUS
during coronary surveillance have been prospectively included in this
study. According to the time interval from HTx to VH-IVUS assessment, our
cohort was divided into two groups (group A: <5 years, n = 13; group B: >5
years, n = 27). Results Group B showed an higher percentage of necrotic
core and dense calcium (12 + 2 vs. 5 + 1%, P = 0.04; 8.2 vs. 2.1%, P =
0.03; respectively). An "inflammatory plaque" (necrotic core and dense
calcium >30%) was detected in 34.8% of patients in group B and in none
among group A patients (P = 0.03). Patients in group B had a number of
adverse clinical events significantly higher than group A patients (53.8
vs. 14.3%; HR 4.45; 95% CI 1.62-12.16; P = 0.029) at long-term follow-up
(4.2 years). The multivariate regression analysis showed that age (HR 1.5;
95% CI 1.1-2.0; P = 0.007), time from HTx (HR 1.8; 95% CI 1.6-4.8; P =
0.02), and inflammatory plaque (HR 2.4; 95% CI 1.1-5.3; P = 0.03) were
independent predictors of adverse clinical events. Conclusions This study
supports the hypothesis that time-dependent differences in plaque
composition, as assessed by VH-IVUS, occur after HTx in young adult
recipients, probably determining an increased risk of long-term clinical
events. 2013 Wiley Periodicals, Inc. Copyright 2013 Wiley Periodicals,
Inc.

<8>
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Accession Number
2014023074
Authors
Stazi A. Scalone G. Laurito M. Milo M. Pelargonio G. Narducci M.L.
Parrinello R. Figliozzi S. Bencardino G. Perna F. Lanza G.A. Crea F.
Institution
(Stazi, Scalone, Laurito, Milo, Pelargonio, Narducci, Parrinello,
Figliozzi, Bencardino, Perna, Lanza, Crea) Istituto di Cardiologia,
Universita Cattolica Del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome,
Italy
Title
Effect of remote ischemic preconditioning on platelet activation and
reactivity induced by ablation for atrial fibrillation.
Source
Circulation. 129 (1) (pp 11-17), 2014. Date of Publication: 2014.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
BACKGROUND-: Radiofrequency ablation of atrial fibrillation has been
associated with some risk of thromboembolic events. Previous studies
showed that preventive short episodes of forearm ischemia (remote ischemic
preconditioning [IPC]) reduce exercise-induced platelet reactivity. In
this study, we assessed whether remote IPC has any effect on platelet
activation induced by radiofrequency ablation of atrial fibrillation.
METHODS AND RESULTS-: We randomized 19 patients (age, 54.7+11 years; 17
male) undergoing radiofrequency catheter ablation of paroxysmal atrial
fibrillation to receive remote IPC or sham intermittent forearm ischemia
(control subjects) before the procedure. Blood venous samples were
collected before and after remote IPC/sham ischemia, at the end of the
ablation procedure, and 24 hours later. Platelet activation and reactivity
were assessed by flow cytometry by measuring monocyte-platelet aggregate
formation, platelet CD41 in the monocyte-platelet aggregate gate, and
platelet CD41 and CD62 in the platelet gate in the absence and presence of
ADP stimulation. At baseline, there were no differences between groups in
platelet variables. Radiofrequency ablation induced platelet activation in
both groups, which persisted after 24 hours. However, compared with
control subjects, remote IPC patients showed a lower increase in all
platelet variables, including monocyte-platelet aggregate formation
(P<0.0001), CD41 in the monocyte-platelet aggregate gate (P=0.002), and
CD41 (P<0.0001) and CD62 (P=0.002) in the platelet gate. Compared with
control subjects, remote IPC was also associated with a significantly
lower ADP-induced increase in all platelet markers. CONCLUSIONS-: Our data
show that remote IPC before radiofrequency catheter ablation for
paroxysmal atrial fibrillation significantly reduces the increased
platelet activation and reactivity associated with the procedure. 2013
American Heart Association, Inc.

<9>
Accession Number
2014016889
Authors
Wong J.J.-M. Ong C. Han W.M. Lee J.H.
Institution
(Wong) Department of Pediatric Medicine, KK Women's and Children's
Hospital, 100, Bukit Timah Road, Singapore 229899, Singapore
(Ong, Han) Department of Nutrition and Dietetics, KK Women's and
Children's Hospital, Singapore, Singapore
(Lee) Children's Intensive Care Unit, Department of Pediatric
Subspecialties, KK Women's and Children's Hospital, Singapore, Singapore
(Lee) Office of Clinical Sciences, Duke-NUS Graduate School of Medicine,
Singapore, Singapore
Title
Protocol-driven enteral nutrition in critically ill children: A systematic
review.
Source
Journal of Parenteral and Enteral Nutrition. 38 (1) (pp 29-39), 2014. Date
of Publication: January 2014.
Publisher
SAGE Publications Inc. (2455 Teller Road, Thousand Oaks CA 91320, United
States)
Abstract
Enteral nutrition (EN) protocols are thought to improve clinical outcomes
in the pediatric intensive care unit (PICU); however, critical evaluation
of their efficacy is limited. We conducted a systematic review with the
aim of assessing the effect of EN protocols on important clinical outcomes
in these children. We searched MEDLINE, Cochrane Database for Reviews,
Embase, and CINAHL using predetermined keywords and MESH terms. We
included randomized controlled trials (RCTs) and observational studies
that involved EN protocols in children admitted to the PICU for >24 hours.
We included studies that reported at least 1 of our outcomes of interest.
Studies that exclusively studied premature neonates or adults were
excluded. Primary outcomes were PICU or hospital mortality, PICU or
hospital length of stay (LOS), duration of mechanical ventilation,
gastrointestinal (GI) complications, and infective complications.
Secondary outcomes were time to initiate feeds and time to achieve goal
feeds. In total, we included 9 studies (total 1564 children) in our
systematic review (1 RCT, 4 before-and-after studies, 1 single-arm cohort
study, 1 prospective descriptive study, and 2 audits). There is low-level
evidence that the use of EN protocols is associated with a reduction in GI
and infective complications and improved timeliness of feed initiation and
achievement of goal feeds. Current medical literature does not have
compelling data on the effects of an EN protocol on clinical outcomes
among critically ill children. Future clinical trials should look into
using standardized interventions and outcome measures to strengthen the
existing evidence. 2013 American Society for Parenteral and Enteral
Nutrition.

<10>
Accession Number
2014017067
Authors
Kaushal S. Matthews K.L. Garcia X. Wehman B. Riddle E. Ying Z. Nubani R.
Canter C.E. Morrow W.R. Huddleston C.B. Backer C.L. Pahl E.
Institution
(Kaushal, Wehman) Division of Cardiac Surgery, University of Maryland
Medical Center, Chicago, IL, United States
(Matthews, Ying, Pahl) Division of Cardiology, Northwestern University,
Ann and Robert H. Lurie Children's Hospital, Chicago, IL, United States
(Garcia, Nubani, Morrow) Division of Cardiology, Arkansas Children's
Hospital, Little Rock, AR, United States
(Riddle, Canter) Division of Cardiology, St. Louis Children's Hospital,
St. Louis, MO, United States
(Huddleston) Cardiovascular-Thoracic Surgery, St. Louis Children's
Hospital, St. Louis, MO, United States
(Backer) Department of Cardiovascular Surgery, Northwestern University,
Ann and Robert H. Lurie Children's Hospital, Chicago, IL, United States
(Pahl) Division of Cardiology, Lurie Children's Hospital, 225 E. Chicago
Avenue, Chicago, IL 60611, United States
Title
A multicenter study of primary graft failure after infant heart
transplantation: Impact of extracorporeal membrane oxygenation on
outcomes.
Source
Pediatric Transplantation. 18 (1) (pp 72-78), 2014. Date of Publication:
February 2014.
Publisher
Blackwell Publishing Ltd (9600 Garsington Road, Oxford OX4 2XG, United
Kingdom)
Abstract
Primary graft failure is the major cause of mortality in infant HTx. The
aim of this study was to characterize the indication and outcomes of
infants requiring ECMO support due to primary graft failure after HTx. We
performed a retrospective review of all infants (<1 yr) who underwent Htx
from three institutions. From 1999 to 2008, 92 infants (<1 yr) received
Htx. Sixteen children (17%) required ECMO after Htx due to low cardiac
output syndrome. Eleven (69%) infants were successfully weaned off ECMO,
and 9 (56%) infants were discharged with a mean follow-up of 2.3 + 2.5 yr.
Mean duration of ECMO in survivors was 5.4 days (2-7 days) compared with
eight days (2-10 days) in non-survivors (p = NS). The five-yr survival
rate for all patients was 75%; however, the five-yr survival rate was 40%
in the ECMO cohort vs. 80% in the non-ECMO cohort (p = 0.0001). Graft
function within one month post-Htx was similar and normal between ECMO and
non-ECMO groups (shortening fraction = 42 + 3 vs. 40 + 2, p = NS). For
infants, ECMO support for primary graft failure had a lower short-term and
long-term survival rate vs. non-ECMO patients. Duration of ECMO did not
adversely impact graft function and is an acceptable therapy for infants
after HTx for low cardiac output syndrome. 2013 John Wiley & Sons A/S.
Published by John Wiley & Sons Ltd.

<11>
Accession Number
24242195
Authors
Keeping-Burke L. Purden M. Frasure-Smith N. Cossette S. Mccarthy F. Amsel
R.
Institution
(Keeping-Burke) Department of Nursing and Health Sciences, University of
New Brunswick, PO Box 5050, Saint John, NB E2L 4L5, Canada
(Keeping-Burke) Faculty of Health Sciences, Queen's University, Kingston,
ON, Canada
(Purden) School of Nursing, McGill University, Montreal, QC, Canada
(Purden) Centre for Nursing Research, Jewish General Hospital, Montreal,
QC, Canada
(Frasure-Smith) Department of Psychiatry and School of Nursing, McGill
University, Montreal, QC, Canada
(Frasure-Smith, Cossette) Montreal Heart Institute and Research Centre,
Montreal, QC, Canada
(Frasure-Smith, Cossette) Centre Hospitalier Universite de Montreal,
Montreal, QC, Canada
(Cossette) Faculty of Nursing, Universite de Montreal, Montreal, QC,
Canada
(Cossette) Research Network Nursing Intervention Quebec (RRISIQ),
Montreal, QC, Canada
(Mccarthy) Department of Anatomy and Neurobiology, Dalhousie University
Medical Program, Saint John, NB, Canada
(Amsel) Department of Psychology, McGill University, Montreal, QC, Canada
(Keeping-Burke) Department of Nursing and Health Sciences, UNB, Canada
(Purden) School of Nursing, McGill University, Canada
(Frasure-Smith) Department of Psychiatry and School of Nursing, McGill
University, Canada
(Cossette) School of Nursing, Universite de Montreal., Canada
(Amsel) Department of Psychology, McGill University, Canada
Title
Bridging the transition from hospital to home: Effects of the VITAL
telehealth program on recovery for CABG surgery patients and their
caregivers.
Source
Research in Nursing and Health. 36 (6) (pp 540-553), 2013. Date of
Publication: December 2013.
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
The purpose of this randomized trial was to determine whether coronary
artery bypass graft surgery patients and their caregivers who received
telehealth follow-up had greater improvements in anxiety levels from
pre-surgery to 3 weeks after discharge than did those who received
standard care. Secondary outcomes included changes in depressive symptoms
and patients' contacts with physicians. No group differences were noted in
changes in patients' anxiety and depressive symptoms, but patients in the
telehealth group had fewer physician contacts (p=.04). Female caregivers
in the telehealth group had greater decreases in anxiety than those in
standard care (p < .001), and caregivers of both genders in the telehealth
group had greater decreases in depressive symptoms (p=.03). 2013 Wiley
Periodicals, Inc.

<12>
Accession Number
2013807038
Authors
Farooq V. Serruys P.W. Zhang Y. Mack M. Stahle E. Holmes D.R. Feldman T.
Morice M.-C. Colombo A. Bourantas C.V. De Vries T. Morel M.-A. Dawkins
K.D. Kappetein A.P. Mohr F.W.
Institution
(Farooq, Serruys, Zhang, Bourantas) Department of Interventional
Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam,
Netherlands
(Mack) Medical City Dallas Hospital, Dallas, TX, United States
(Stahle) University Hospital Uppsala, Uppsala, Sweden
(Holmes) Mayo Clinic, Rochester, MN, United States
(Feldman) Evanston Hospital, Evanston, IL, United States
(Morice) Institut Jacques Cartier, Massy, France
(Colombo) San Raffaele Scientific Institute, Milan, Italy
(De Vries, Morel) Cardialysis BV, Rotterdam, Netherlands
(Dawkins) Boston Scientific Corporation, Natick, MA, United States
(Kappetein) Department of Cardiothoracic Surgery, Erasmus University
Medical Centre, Thoraxcenter, Rotterdam, Netherlands
(Mohr) Herzzentrum, Leipzig, Germany
Title
Short-term and long-term clinical impact of stent thrombosis and graft
occlusion in the SYNTAX trial at 5 years: Synergy between percutaneous
coronary intervention with taxus and cardiac surgery trial.
Source
Journal of the American College of Cardiology. 62 (25) (pp 2360-2369),
2013. Date of Publication: 24 Dec 2013.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Objectives The aim of this study was to report the short-term and
long-term clinical impact of stent thrombosis (ST) and graft occlusion
(GO) in the final 5-year outcomes of the SYNTAX (SYNergy Between PCI With
TAXUS and Cardiac Surgery) trial. Background The clinical effect of
newer-generation drug-eluting stents and operative factors in complex
coronary artery disease is uncertain. Methods The incidence of 5-year ST
and GO, and their association with clinical outcomes, were analyzed in the
randomized percutaneous coronary intervention and coronary artery bypass
graft cohorts. ST and GO were defined by the SYNTAX protocol definitions
(clinical presentation with acute coronary syndrome and
angiographic/pathological evidence), the Academic Research Consortium
(ARC) definition for ST, and the newly devised "ARC-like" definition of GO
(i.e., definite, probable, or possible GO). Results At 5 years, 871 of 903
patients (96.5%) in the percutaneous coronary intervention cohort and 805
of 897 patients (89.7%) in the coronary artery bypass graft cohort
completed follow-up. As compared with other vessel locations, protocol ST
(72 lesions) occurred more frequently in the left main (14 of 72; 19%) and
proximal coronary vasculature (37 of 72; 51%) and protocol GO (41 lesions)
with grafts anastomosed to the distal right coronary artery (17 of 41;
42%). The incidence of 5-year ARC definite ST and ARC-like definite GO did
not significantly differ (7% [n = 48] vs. 6% [n = 32], log rank p = 0.34);
landmark analyses indicated significantly increased ARC definite ST within
30 days (3% [n = 19] vs. 1% [n = 6], log rank p = 0.033) but not >30 days
to 5 years (4.2% [n = 29] vs. 4.5% [n = 26], log rank p = 0.78). At
presentation, ARC definite ST (n = 48) and ARC-like definite GO (n = 32)
were adjudicated to be linked to 4 (8%) and 0 deaths, respectively. At 5
years, ARC definite ST (n = 48) and ARC definite/probable ST (n = 75) were
associated with 17 (17 of 48, 35.4%; median days to death: 0 days;
interquartile range: 0 to 16 days; maximum: 321 days) and 31 (31 of 75,
41.3%; median: 0 days; interquartile range: 0 to 9 days; maximum: 721
days) cardiac deaths, respectively. At 5 years, ARC-like definite GO (n =
32) and ARC-like definite/probable GO (n = 53) were associated with 0 and
12 (12 of 52, 23.1%; median: 0 days; interquartile range: 0 to 14 days;
maximum: 257 days) cardiac deaths, respectively. Conclusions Although the
incidence of ST and GO was similar at 5 years, the clinical impact of ST
appeared greater, with a negative impact on short-term to long-term
mortality. 2013 by the American College of Cardiology Foundation.

<13>
Accession Number
23739937
Authors
de Oliveira Sa M.P.B. Ferraz P.E. Escobar R.R. Nunes E.O. Soares A.M.M.N.
de Araujoe Sa F.B.C. Vasconcelos F.P. Lima R.C.
Institution
(de Oliveira Sa, Ferraz, Escobar, Nunes, Soares, de Araujoe Sa,
Vasconcelos, Lima) Division of Cardiovascular Surgery of Pronto Socorro
Cardiologico de Pernambuco (PROCAPE), University of Pernambuco (UPE),
Recife, PE, Brazil
Title
Five-year outcomes following PCI with DES versus CABG for unprotected LM
coronary lesions: Meta-analysis and meta-regression of 2914 patients.
Source
Brazilian Journal of Cardiovascular Surgery. 28 (1) (pp 83-92), 2013. Date
of Publication: January-March 2013.
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular (Av. Juscelino Kubitschek
de Oliviera 1505, Sao Jose do Rio Preto 15091-450, Brazil)
Abstract
Objective: To compare the safety and efficacy at long-term follow-up of
coronary artery bypass grafting (CABG) with percutaneous coronary
intervention (PCI) using drug-eluting stents (DES) in patients with
unprotected left main coronary artery (ULMCA) disease. Methods: MEDLINE,
EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists
of relevant articles were searched for clinical studies that reported
outcomes at 5-year follow-up after PCI with DES and CABG for the treatment
of ULMCA stenosis. Five studies (1 randomized controlled trial and 4
observational studies) were identified and included a total of 2914
patients (1300 for CABG and 1614 for PCI with DES). Results: At 5-year
follow-up, there was no significant difference between the CABG and
PCI-DES groups in the risk for death (odds ratio [OR] 1.159, P=0.168 for
random effect) or the composite endpoint of death, myocardial infarction,
or stroke (OR 1.214, P=0.083). The risk for target vessel
revascularization (TVR) was significantly lower in the CABG group compared
to the PCI-DES group (OR 0.212, P;0.001). The risk of major adverse
cardiac and cerebrovascular events (MACCE) was significantly lower in the
CABG group compared to the PCI-DES group (OR 0.526, P;0.001). It was
observed no publication bias about outcomes and considerably heterogeneity
effect about MACCE. Conclusion: CABG surgery remains the best option of
treatment for patients with ULMCA disease, with less need of TVR and MACCE
rates at long-term follow-up.

<14>
Accession Number
23489530
Authors
Capoulade R. Clavel M.A. Dumesnil J.G. Chan K.L. Teo K.K. Tam J.W. Cote N.
Mathieu P. Despres J.P. Pibarot P. TRONOMER Investigators
Institution
(Capoulade) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec/Quebec Heart & Lung Institute, Laval University, Quebec, Quebec,
Canada.
Title
Insulin resistance and LVH progression in patients with calcific aortic
stenosis: a substudy of the ASTRONOMER trial.
Source
JACC. Cardiovascular imaging. 6 (2) (pp 165-174), 2013. Date of
Publication: Feb 2013.
Abstract
The objective of this substudy of the ASTRONOMER (Aortic Stenosis
Progression Observation: Measuring Effects of Rosuvastatin) trial was to
examine the association between insulin resistance and progression of left
ventricular hypertrophy (LVH) in patients with aortic stenosis (AS). In a
recent cross-sectional study, the authors reported that the metabolic
syndrome was associated with an increased prevalence of concentric LVH in
patients with AS. As a central feature of the metabolic syndrome, insulin
resistance could be an important mediator of this association. This
substudy included 250 of 269 patients enrolled in ASTRONOMER. Follow-up
was 3.4 + 1.3 years. Insulin resistance was evaluated using the
homeostatic assessment model (HOMA) index, and patients were dichotomized
using the median HOMA index value (1.24). The rate of LVH progression was
estimated by calculating the annualized change in LV mass index (LVMi),
measured on echocardiography. The presence of LVH was defined as an LVMi
>47 g/m(2.7) in women and >49 g/m(2.7) in men. There was a significant
progression of LVH among the patients without LVH at baseline (n = 134; p
< 0.0001) but not in those with it (n = 116; p = NS). In those without LVH
at baseline, the annualized progression rate of LVMi was significantly
faster in the subset with HOMA >1.24 compared to that in the subset with
HOMA <1.24 (2.49 + 4.38 g/m(2.7)/year vs. -0.03 + 3.90 g/m(2.7)/year; p =
0.001). During follow-up, LVH developed in 46% of patients with HOMA >1.24
compared to 11% of those with HOMA <1.24 (p = 0.0005). Independent
predictors of faster LVH progression identified on multivariate analysis
were history of hypertension (p = 0.048), degree of aortic valve
calcification (p = 0.035), and HOMA index (p = 0.02). In this ASTRONOMER
substudy, insulin resistance was a powerful independent predictor of
progression to LVH in patients with AS. Visceral obesity and ensuing
insulin resistance may thus present novel therapeutic targets in AS
patients. Copyright 2013 American College of Cardiology Foundation.
Published by Elsevier Inc. All rights reserved.

<15>
Accession Number
71286753
Authors
Kopecky P. Mraz M. Lips M. Lindner J. Svacina S. Blaha J. Haluzik M.
Institution
(Kopecky, Mraz, Lips, Lindner, Svacina, Blaha, Haluzik) PragueCzech
Republic
Title
Perioperative initiation of tight glucose control reduces postoperative
adverse events in elective cardiac surgery patients: A randomized
controlled trial.
Source
Diabetes. Conference: 73rd Scientific Sessions of the American Diabetes
Association Chicago, IL United States. Conference Start: 20130621
Conference End: 20130625. Conference Publication: (var.pagings). 62 (pp
A80), 2013. Date of Publication: July 2013.
Publisher
American Diabetes Association Inc.
Abstract
Tight glucose control (TGC) reduced morbidity and mortality in patients
undergoing elective cardiac surgery. However, the optimal time for its
initiation has not been studied yet. We performed a randomized controlled
trial comparing the effects of perioperative (PERI) versus postoperative
(POST) initiation of TGC on postoperative adverse events and the length of
hospitalization in elective cardiac surgery patients. 2393 patients (age
18-90 years, 28.1% diabetics) undergoing elective cardiac surgery were
randomized into either PERI (1242 subjects, 26.9% diabetics) or POST (1151
subjects, 29.4% diabetics) group according to the time of initiation of
intravenous insulin infusion therapy. Target glucose range was set at
4.4-6.1 mmol/l. Adverse events from any cause during hospital stay after
cardiac surgery were set up as primary and the length of hospitalization
as secondary endpoints. In the whole cohort, perioperatively-initiated TGC
markedly reduced the number of patients with postoperative complications
(23.8 vs. 31.4%, p<0.001) in spite of only modest improvement of glucose
control (blood glucose 6.6+0.7 vs. 6.7+0.7 mmol/l, p<0.001; time in target
range 42.1+13.7 vs. 40.0+13.8%, p<0.001). The positive effect of TGC on
postoperative complication was driven by non-diabetic patients (20.3 vs.
31.7%, p<0.001; blood glucose 6.6+0.7 vs. 6.5+0.6 mmol/, p<0.05; time in
target range 43.2+14.3 vs. 43.0+13.3%, n.s.) while no significant effect
was seen in diabetic patients subgroup (33.2 vs. 30.5%, n.s.) despite
significantly better glucose control in the PERI diabetic group (blood
glucose 6.6+0.7 vs. 7.1+0.8 mmol/l, p<0.001; time in target range
39.2+11.7 vs. 32.9+12.5%, p<0.001). We conclude that perioperative
initiation of intensive insulin therapy during elective cardiac surgery
reduces postoperative morbidity only in nondiabetic patients without
affecting the length of their stay in the hospital.