Results Generated From:
Embase <1980 to 2014 Week 19>
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<1>
Accession Number
2014286369
Authors
Drury N.E. Licari G. Chong C.-R. Howell N.J. Frenneaux M.P. Horowitz J.D.
Pagano D. Sallustio B.C.
Institution
(Drury, Licari, Chong, Horowitz, Sallustio) Departments of Clinical
Pharmacology and Cardiology, Basil Hetzel Institute, Queen Elizabeth
Hospital, 28 Woodville Road, Woodville South, SA 5011, United States
(Drury, Pagano) Discipline of Pharmacology, University of Adelaide,
Adelaide, SA, Australia
(Drury, Howell) Discipline of Medicine, University of Adelaide, Adelaide,
SA, Australia
(Licari, Sallustio) Discipline of Surgery, University of Adelaide,
Adelaide, SA, Australia
(Chong, Horowitz) Department of Cardiothoracic Surgery, Queen Elizabeth
Hospital, Birmingham, United Kingdom
(Frenneaux) School of Clinical and Experimental Medicine, University of
Birmingham, Birmingham, United Kingdom
(Frenneaux) School of Medicine, University of Aberdeen, Aberdeen, United
Kingdom
Title
Relationship between plasma, atrial and ventricular perhexiline
concentrations in humans: Insights into factors affecting myocardial
uptake.
Source
British Journal of Clinical Pharmacology. 77 (5) (pp 789-795), 2014. Date
of Publication: May 2014.
Publisher
Blackwell Publishing Ltd
Abstract
Aim Little is known regarding the steady-state uptake of drugs into the
human myocardium. Perhexiline is a prophylactic anti-anginal drug which is
increasingly also used in the treatment of heart failure and hypertrophic
cardiomyopathy. We explored the relationship between plasma perhexiline
concentrations and its uptake into the myocardium. Methods Blood, right
atrium + left ventricle biopsies were obtained from patients treated with
perhexiline for a median of 8.5 days before undergoing coronary surgery in
the perhexiline arm of a randomized controlled trial. Perhexiline
concentrations in plasma and heart tissue were determined by HPLC. Results
Atrial biopsies were obtained from 94 patients and ventricular biopsies
from 28 patients. The median plasma perhexiline concentration was within
the therapeutic range at 0.24 mg l<sup>-1</sup> (IQR 0.12-0.44), the
median atrial concentration was 6.02 mg kg<sup>-1</sup> (IQR 2.70-9.06)
and median ventricular concentration was 10.0 mg kg<sup>-1</sup> (IQR
5.76-13.1). Atrial (r<sup>2</sup> = 0.76) and ventricular (r<sup>2</sup> =
0.73) perhexiline concentrations were closely and directly correlated with
plasma concentrations (both P < 0.001). The median atrial : plasma ratio
was 21.5 (IQR 18.1-27.1), ventricular : plasma ratio was 34.9 (IQR
24.5-55.2) and ventricular : atrial ratio was 1.67 (IQR 1.39-2.22). Using
multiple regression, the best model for predicting steady-state atrial
concentration included plasma perhexiline, heart rate and age
(r<sup>2</sup> = 0.83). Ventricular concentrations were directly
correlated with plasma perhexiline concentration and length of therapy
(r<sup>2</sup> = 0.84). Conclusions This study demonstrates that plasma
perhexiline concentrations are predictive of myocardial drug
concentrations, a major determinant of drug effect. However, net
myocardial perhexiline uptake is significantly modulated by patient age,
potentially via alteration of myocardial:extracardiac drug uptake. 2013
The British Pharmacological Society.
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Accession Number
2014283073
Authors
Elkayam U. Jalnapurkar S. Barakkat M.N. Khatri N. Kealey A.J. Mehra A.
Roth A.
Institution
(Elkayam, Jalnapurkar, Barakkat, Khatri, Mehra) Keck School of Medicine,
Division of Cardiovascular Diseases, University of Southern California,
2020 Zonal Ave, Los Angeles, CA 90033, United States
(Kealey) Department of Cardiac Sciences, Foothills Medical Centre,
University of Calgary, Calgary, AB, Canada
(Roth) Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel
Aviv University, Tel Aviv, Israel
Title
Pregnancy-associated acute myocardial infarction: A review of contemporary
experience in 150 cases between 2006 and 2011.
Source
Circulation. 129 (16) (pp 1695-1702), 2014. Date of Publication: 22 Apr
2014.
Publisher
Lippincott Williams and Wilkins
<3>
Accession Number
2014279111
Authors
Lupi A. Gabrio Secco G. Rognoni A. Lazzero M. Fattori R. Sheiban I. Sante
Bongo A. Bolognese L. Agostoni P. Porto I.
Institution
(Lupi, Rognoni, Lazzero, Sante Bongo) Hospital Cardiology, Maggiore della
Carita Hospital, Cso Mazzini 18, 28100 Novara, Italy
(Gabrio Secco) Department of Clinical and Experimental Medicine,
University of Eastern Piedmont, Maggiore della Carita Hospital, Novara,
Italy
(Gabrio Secco, Fattori) Division of Interventional Cardiology, Ospedali
Riuniti Marche Nord, Pesaro, Italy
(Sheiban) Interventional Cardiology, Division of Cardiology, University of
Turin, Turin, Italy
(Bolognese, Porto) Cardiology Department, San Donato Hospital, Arezzo,
Italy
(Agostoni) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
Title
Meta-analysis of bioabsorbable versus durable polymer drug-eluting stents
in 20,005 patients with coronary artery disease: An update.
Source
Catheterization and Cardiovascular Interventions. 83 (6) (pp E193-E206),
2014. Date of Publication: 01 May 2014.
Publisher
Wiley-Liss Inc.
Abstract
Objectives To perform an updated meta-analysis comparing biodegradable
polymer drug eluting stents (BP-DES) and durable polymer drug eluting
stents (DP-DES). Background BP-DES have been suggested to reduce late
stent thrombosis (LST) rates as compared to first generation DP-DES.
Recently, second generation DP-DES have replaced older DES, but comparison
of these stents with BP-DES has not yielded consistent results. Methods
Medline/Web databases were searched for studies comparing BP-DES and
DP-DES, and reporting rates of overall/cardiac mortality, myocardial
infarction (MI), LST, target lesion revascularization (TLR) and target
vessel revascularization (TVR) and late lumen loss (LLL), with a follow-up
>6 months. Results Twenty studies (20,005 patients) were included in the
meta-analysis. Median follow-up time was 1 year. Compared with DP-DES,
BP-DES showed lower LLL (in stent: weighted mean difference WMD -0.45 mm,
95% CI -0.66 to -0.24 mm, P=0.00001; in segment: WMD -0.15 mm, 95%
CI=-0.24 to -0.06 mm, P=0.001) and lower rates of LST (OR 0.51, 95%
CI=0.30 to 0.86, P=0.01), although they did not improve mortality, MI,
TLR, and TVR rates. BP-DES coated with sirolimus or novolimus, in
comparison with biolimus or paclitaxel, were associated with reduced LLL
(P<0.0001 for subgroups). Conclusions In comparison with DP-DES, BP-DES
significantly reduce LLL and LST rates, without clear benefits on harder
endpoints. The efficacy of BP-DES in preserving lumen patency seems larger
for sirolimus and novolimus DES. 2014 Wiley Periodicals, Inc.
<4>
Accession Number
2014287646
Authors
Frohlich G.M. Lansky A.J. Webb J. Roffi M. Toggweiler S. Reinthaler M.
Wang D. Hutchinson N. Wendler O. Hildick-Smith D. Meier P.
Institution
(Frohlich, Reinthaler, Meier) The Heart Hospital, University College
London Hospitals, London, United Kingdom
(Lansky, Meier) Division of Cardiology, Yale Medical School, New Haven,
CT, United States
(Webb) Department of Cardiology, St. Paul's Hospital, University of
British Columbia, Vancouver, BC, Canada
(Roffi) Department of Cardiology, University Hospital Geneva HUGE, Geneva,
Switzerland
(Toggweiler) Department of Cardiology, Kantonsspital Luzern, Lucerne,
Switzerland
(Wang) Department of Medical Statistics, London School of Hygiene and
Tropical Medicine London, London, United Kingdom
(Hutchinson) Division of Anesthesiology, Brighton and Sussex University
Hospital, Brighton, United Kingdom
(Wendler) Department of Cardiothoracic Surgery, King's College Hospital,
London, United Kingdom
(Hildick-Smith) Division of Cardiology, Brighton and Sussex University
Hospital, Brighton, United Kingdom
Title
Local versus general anesthesia for transcatheter aortic valve
implantation (TAVR) - systematic review and meta-analysis.
Source
BMC Medicine. 12 (1) , 2014. Article Number: 41. Date of Publication: 10
Mar 2014.
Publisher
BioMed Central Ltd. (34 - 42 Cleveland Street, London W1T 4LB, United
Kingdom)
Abstract
Background: The hypothesis of this study was that local anesthesia with
monitored anesthesia care (MAC) is not harmful in comparison to general
anesthesia (GA) for patients undergoing Transcatheter Aortic Valve
Implantation (TAVR).TAVR is a rapidly spreading treatment option for
severe aortic valve stenosis. Traditionally, in most centers, this
procedure is done under GA, but more recently procedures with MAC have
been reported. Methods: This is a systematic review and meta-analysis
comparing MAC versus GA in patients undergoing transfemoral TAVR. Trials
were identified through a literature search covering publications from 1
January 2005 through 31 January 2013. The main outcomes of interest of
this literature meta-analysis were 30-day overall mortality,
cardiac-/procedure-related mortality, stroke, myocardial infarction,
sepsis, acute kidney injury, procedure time and duration of hospital stay.
A random effects model was used to calculate the pooled relative risks
(RR) with 95% confidence intervals. Results: Seven observational studies
and a total of 1,542 patients were included in this analysis. None of the
studies were randomized. Compared to GA, MAC was associated with a shorter
hospital stay (-3.0 days (-5.0 to -1.0); P = 0.004) and a shorter
procedure time (MD -36.3 minutes (-58.0 to -15.0 minutes); P <0.001).
Overall 30-day mortality was not significantly different between MAC and
GA (RR 0.77 (0.38 to 1.56); P = 0.460), also cardiac- and
procedure-related mortality was similar between both groups (RR 0.90 (0.34
to 2.39); P = 0.830). Conclusion: These data did not show a significant
difference in short-term outcomes for MAC or GA in TAVR. MAC may be
associated with reduced procedural time and shorter hospital stay. Now
randomized trials are needed for further evaluation of MAC in the setting
of TAVR. 2014 Frohlich et al.; licensee BioMed Central Ltd.
<5>
Accession Number
2014268725
Authors
Lee G.R. Jhanji S. Tarrant H. James S. Pearse R.M. Fitzgibbon M.
Institution
(Lee, Tarrant, Fitzgibbon) Department of Clinical Biochemistry and
Diagnostic Endocrinology, Mater Misericordiae University Hospital, Dublin,
Ireland
(Jhanji) Critical Care Unit, Royal Marsden NHS Trust, London, United
Kingdom
(James, Pearse) Barts and the London NHS Trust Royal, London, United
Kingdom
Title
Peri-operative troponin monitoring using a prototype high-sensitivity
cardiac troponin I (hs-cTnI) assay: Comparisons with hs-cTnT and
contemporary cTnI assays.
Source
Annals of Clinical Biochemistry. 51 (2) (pp 258-268), 2014. Date of
Publication: March 2014.
Publisher
Royal Society of Medicine Press Ltd
Abstract
Background: Non-cardiac surgery is associated with major vascular
complications and higher incidences of elevated plasma troponin (cTn)
concentration. Goal-directed therapy (GDT) is a stroke volume (SV)-guided
approach to intravenous (IV) fluid therapy that improves tissue perfusion,
oxygenation and reduces post-operative complications. In patients
undergoing major gastro-intestinal surgery, we compared high sensitive and
contemporary troponin assays and correlated results with patient outcome.
Methods: Patients (n = 135) were randomized to receive IV fluid, guided by
either the central venous pressure (CVP group, n = 45) or SV (+ dopexamine
inotrope, n = 45 per group). Serum was obtained pre- and post-operatively
(0, 8 and 24 h) for troponin analysis by a prototype hs-cTnI assay (Abbott
Laboratories), hs-cTnT (Roche Diagnostics) and contemporary cTnI (Beckman
Coulter) assays. Results: All troponin measurements were increased (P <
0.05) post-operatively but there was no difference (P > 0.05) amongst
treatments. Post-operative increases were reported more frequently (P <
0.05) and earlier with hs-cTnI. Temporal increases (P < 0.05) were
reported in patients with and without complications for hs-cTnI/T assays
but only in the complications group for cTnI measurements. Elevations
>99th centile occurred most often (P < 0.05) for hs-cTnT measurements but
with similar frequency for both outcome groups (all assays). Only the
hs-cTnI assay showed an increased relative risk of mortality (P < 0.05)
for elevations >99th centile Conclusions: Our study may suggest a possible
preference for the hs-cTnI assay in the peri-operative setting; however,
our findings should be verified for larger cohort studies where emerging
reference range data is incorporated for improving risk prediction with
hs-cTn assays. The Author(s) 2013 Reprints and permissions:
sagepub.co.uk/journalsPermissions.nav.
<6>
Accession Number
2014264628
Authors
Mahaffey K.W. Held C. Wojdyla D.M. James S.K. Katus H.A. Husted S. Steg
P.G. Cannon C.P. Becker R.C. Storey R.F. Khurmi N.S. Nicolau J.C. Yu C.-M.
Ardissino D. Budaj A. Morais J. Montgomery D. Himmelmann A. Harrington
R.A. Wallentin L.
Institution
(Mahaffey, Wojdyla, Becker, Montgomery) Duke Clinical Research Institute,
Duke University, Durham, NC, United States
(Mahaffey, Harrington) Department of Medicine, Stanford University, 300
Pasteur Drive, Grant S-102, Stanford, CA 94305, United States
(Held, James, Wallentin) Department of Medical Sciences, Cardiology,
Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
(Katus) Medizinishe Klinik, University of Heidelberg, Heidelberg, Germany
(Husted) Medical Department, Hospital Unit West, Herning/Holstbro, Denmark
(Steg) INSERM-Unite 698, Paris, France
(Steg) Assistance Publique-Hopitaux de Paris, Departement
Hospitalo-Universitaire FIRE, Hopital Bichat, Paris, France
(Steg) Universite Paris-Diderot, Sorbonne-Paris Cite, Paris, France
(Cannon) TIMI Study Group, Brigham and Women's Hospital, Boston, MA,
United States
(Storey) Department of Cardiovascular Science, University of Sheffield,
Sheffield, United Kingdom
(Khurmi) AstraZeneca Research and Development, Wilmington, DE, United
States
(Nicolau) Heart Institute (InCor), University of Sao Paulo, Medical
School, Sao Paulo, Brazil
(Yu) Prince of Wales Hospital, Institute of Vascular Medicine, Chinese
University of Hong Kong, Hong Kong, Hong Kong
(Ardissino) Azienda Ospedaliero Universitaria di Parma, Parma, Italy
(Budaj) Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland
(Morais) Santo Andres Hospital, Leiria, Portugal
(Himmelmann) AstraZeneca Research and Development, Molndal, Sweden
Title
Ticagrelor effects on myocardial infarction and the impact of event
adjudication in the PLATO (platelet inhibition and patient outcomes)
trial.
Source
Journal of the American College of Cardiology. 63 (15) (pp 1493-1499),
2014. Date of Publication: 22 Apr 2014.
Publisher
Elsevier USA
Abstract
Objectives: This study sought to report the treatment effect of ticagrelor
on myocardial infarction (MI) and the strategy for and impact of event
adjudication in the PLATO (Platelet Inhibition and Patient Outcomes)
trial. Background: In PLATO, ticagrelor reduced cardiovascular death, MI,
or stroke in patients with acute coronary syndromes (ACS). Methods: A
clinical events committee (CEC) prospectively defined and adjudicated all
suspected MI events, on the basis of events reported by investigators and
by triggers on biomarkers. Treatment comparisons used CEC-adjudicated
data, and per protocol, excluded silent MI. Results: Overall, 1,299 (610
ticagrelor, 689 clopidogrel) MIs reported by the CEC occurred during the
trial. Of these, 1,097 (504 ticagrelor, 593 clopidogrel) contributed to
the primary composite endpoint. Site investigators reported 1,198 (580
ticagrelor, 618 clopidogrel) MIs. Ticagrelor significantly reduced overall
MI rates (12-month CEC-adjudicated Kaplan-Meier rates: 5.8% ticagrelor,
6.9% clopidogrel; hazard ratio [HR]: 0.84; 95% confidence interval [CI]:
0.75 to 0.95). Nonprocedural MI (HR: 0.86; 95% CI: 0.74 to 1.01) and MI
related to percutaneous coronary intervention or stent thrombosis tended
to be lower with ticagrelor. MIs related to coronary artery bypass graft
surgery were few, but numerical excess was observed in patients assigned
ticagrelor. Analyses of overall MIs using investigator-reported data
showed similar results but did not reach statistical significance (HR:
0.88; 95% CI: 0.78 to 1.00). Conclusions: In patients with ACS, ticagrelor
significantly reduced the incidence of MI compared with clopidogrel, with
consistent results across most MI subtypes. CEC procedures identified more
MI endpoints compared with site investigators. 2014 by the American
College of Cardiology Foundation.
<7>
Accession Number
2014265017
Authors
Xu X. Zhang W. Zhou Y. Zhao Y. Liu Y. Shi D. Zhou Z. Ma H. Wang Z. Yu M.
Ma Q. Gao F. Shen H. Zhang J.
Institution
(Xu, Zhang, Zhou, Zhao, Liu, Shi, Zhou, Ma, Wang, Yu, Ma, Gao, Shen,
Zhang) Department of Cardiology, Beijing An Zhen Hospital, Capital Medical
University, Anzhenli Avenue, Chao Yang District, Beijing 100029, China
Title
Effect of trimetazidine on recurrent angina pectoris and left ventricular
structure in elderly multivessel coronary heart disease patients with
diabetes mellitus after drug-eluting stent implantation: A single-centre,
prospective, randomized, double-blind study at 2-year follow-up.
Source
Clinical Drug Investigation. 34 (4) (pp 251-258), 2014. Date of
Publication: 2014.
Publisher
Adis International Ltd
Abstract
Background and Objective: Trimetazidine has been shown to improve angina
pectoris and left ventricular (LV) function in diabetic patients with
ischaemic cardiomyopathy. The objective of this study was to evaluate the
effects of trimetazidine on recurrent angina pectoris and LV structure
after drug-eluting stent (DES) implantation in elderly multivessel
coronary heart disease (CHD) patients with diabetes mellitus (DM) and a
left ventricular ejection fraction (LVEF) of >50 %. Methods: This was a
single-centre, prospective, randomized, double-blind evaluation study.
Between January 2010 and September 2010, 700 CHD patients with DM who were
aged >65 years and undergoing coronary angiography at An Zhen Hospital
(Beijing, China) were recruited and prospectively randomized to receive
trimetazidine (20 mg three times daily) or placebo after DES implantation
as an addition to conventional CHD treatment. The primary end points were
the incidence of recurrent angina pectoris and measures of various
echocardiographic parameters, which included LVEF. Results: At 2-year
follow-up, patients in the trimetazidine group (n = 255) showed
significant improvements in the incidence (P = 0.024) and severity of
angina pectoris, compared with the control group, as well as silent
myocardial ischaemia (P = 0.009) and angina pectoris-free survival (P =
0.011). LV function and structure in trimetazidine-treated patients were
relatively stable at 2-year follow-up, while they deteriorated in the
control group (n = 255) with a significant difference between groups (all
P < 0.01). The E peak to A peak (E/A) ratio in trimetazidine-treated
patients and in the control group decreased after 2 years; the E/A ratio
in trimetazidine-treated patients was slightly better than that in the
control group, without a significant difference (P = 0.170). There was no
significant difference in event-free survival for the composite end point
including death, myocardial infarction, cerebrovascular accident (P =
0.422) and subsequent revascularization (P = 0.073). Conclusion:
Adjunctive therapy with trimetazidine after DES implantation can have a
beneficial effect on recurrent angina pectoris as well as LV function and
structure in elderly multivessel CHD patients with DM. 2014 Springer
International Publishing Switzerland.
<8>
Accession Number
2014271568
Authors
Ohkubo K. Fujimoto Y. Iwata Y. Kitahara H. Kadohira T. Sugimoto K. Morino
T. Kobayashi Y.
Institution
(Ohkubo, Fujimoto, Iwata, Kitahara, Kadohira, Sugimoto, Morino, Kobayashi)
Department of Cardiovascular Medicine, Chiba University Graduate School of
Medicine, 1-7-1 Inohana, Chuo-ku, Chiba, Chiba 260-8677, Japan
Title
Efficacy and safety of low-dose clopidogrel in Japanese patients after
drug-eluting stent implantation: A randomized pilot trial.
Source
Heart and Vessels. 29 (1) (pp 1-5), 2014. Date of Publication: January
2014.
Publisher
Springer-Verlag Tokyo
Abstract
In Japan, a lower maintenance dose of ticlopidine is used than in the
United States and Europe. Therefore a lower maintenance dose of
clopidogrel may also be considered appropriate in Japanese patients. The
present randomized pilot study evaluated the efficacy and safety of 50 mg
clopidogrel in Japanese patients who underwent drug-eluting stent (DES)
implantation. A total of 200 patients with 277 lesions who underwent
intravascular ultrasound-guided DES implantation were enrolled. The
subjects were allocated to the 50- or 75-mg clopidogrel group. All
patients received 100 mg aspirin daily before the procedure, and this
continued indefinitely. The duration of clinical follow-up was 21.8 + 5.7
months in the 75-mg group and 21.9 + 6.1 months in the 50-mg group (P =
0.96). During follow-up, no cardiac death, myocardial infarction, or stent
thrombosis was observed in either group. Side effects of clopidogrel were
observed in 4 patients (4.0%) in the 75-mg group and in 4 patients (4.0%)
in the 50-mg group. Following this randomized pilot study, it may be
justified to perform a large-scale randomized study comparing 50- and
75-mg dosing of clopidogrel in Japanese patients undergoing coronary stent
implantation. Springer 2012.
<9>
Accession Number
2014283772
Authors
Yurtdas M. Yaylali Y.T. Kaya Y. Ozdemir M. Aladag N. Arin C.B. Ceylan Y.
Institution
(Yurtdas, Ozdemir, Aladag, Arin, Ceylan) Van Region Training and Research
Hospital, Department of Cardiology, Van, Turkey
(Yaylali) Pamukkale University, School of Medicine, Department of
Cardiology, Denizli, Turkey
(Kaya) Kafkas University, School of Medicine, Department of Cardiology,
Kars, Turkey
Title
The relationship of the degree of coronary stenosis and percutaneous
coronary revascularization with heart rate recovery index.
Source
Experimental and Clinical Cardiology. 20 (1) (pp 1306-1327), 2014. Date of
Publication: 2014.
Publisher
Pulsus Group Inc.
Abstract
OBJECTIVES: Heart rate recovery (HRR) is influenced by autonomic function.
We aimed to investigate the effect of percutaneous coronary intervention
(PCI) on HRR with respect to the degree of coronary stenosis (DCS) in
severe coronary artery disease (CAD). METHODS: The treatment group (TG)
consisted of 70 severe stable CAD patients treated with PCI and the
control group (CG), 62 non-critical CAD patients, who were not treated
with PCI. All participants underwent exercise test both at baseline and 3
months after coronary angiography (CAG)/PCI. HRR was defined as a change
in heart rate from peak exercise to 1 minute after exercise. HRR index was
described as the percentage change in HRR from 3 months after CAG/PCI to
baseline. RESULTS: The TG had lower HRR than the CG (p<0.001). In the TG,
HRR was inversely correlated with the number of diseased vessels at
baseline (r=-0.418, p<0.001). HRR index was higher in TG than CG
(p<0.001). No associations were found between HRR (p=0.136), HRR index
(p=0.703) and the DCS. Patients who had multiple vessels treated, had the
highest HRR index. CONCLUSION: HRR is not associated with the DCS of 70%
to 99%, and PCI improves HRR in proportion to the number of coronary
vessels treated in severe stable CAD.
<10>
Accession Number
2014283764
Authors
Battes L. Akkerhuis K.M. Van Boven N. Boersma E. Kardys I.
Institution
(Battes, Akkerhuis, Boersma, Kardys) Clinical Epidemiology Unit,
Department of Cardiology, Erasmus MC, Rotterdam, Netherlands
(Van Boven) Department of Cardiology, Medical Center Alkmaar, Alkmaar,
Netherlands
Title
Cardiovascular risk prediction models in patients with stable coronary
artery disease.
Source
Experimental and Clinical Cardiology. 20 (1) (pp 117-130), 2014. Date of
Publication: 2014.
Publisher
Pulsus Group Inc.
Abstract
Background: Installment of appropriate measures to prevent adverse events
in patients with established, stable coronary artery disease (CAD) may
contribute to efficient healthcare. This review gives an overview of
existing models for prediction of cardiovascular adverse events in such
patients and discusses model performance. Methods: We used a computerized
literature search in the EMBASE, PubMed publisher, MEDLINE, Google Scolar,
Web of Science and Cochrane databases. Studies were selected if they
included patients with stable CAD (stable angina pectoris, myocardial
infarction more than 3 months ago or coronary intervention more than 6
months ago) and if they presented a model that included mortality as the
endpoint. Results: Sixteen studies met our inclusion criteria. Clinical
variables that were included in the models differed highly between the
studies. Still, age, smoking status, hypertension, diabetes, cholesterol
and heart failure were present in a large part of the models. Several
studies examined model discrimination, but the majority paid insufficient
attention to calibration and validation. Conclusions: Although multiple
prediction models for adverse events have been developed in patients with
stable CAD, variables included in these models display large
heterogeneity, and model performance is often insufficiently addressed.
<11>
Accession Number
2014268790
Authors
Zhao J. Cheng Z. Quan X. Zhao Z.
Institution
(Zhao, Cheng, Quan, Zhao) Cardiovascular Surgery Department, Zhengzhou
University People's Hospital and Henan Provincial People's Hospital,
Zhengzhou, China
Title
Does posterior pericardial window technique prevent pericardial tamponade
after cardiac surgery?.
Source
Journal of International Medical Research. 42 (2) (pp 416-426), 2014. Date
of Publication: April 2014.
Publisher
Field House Publishing LLP
Abstract
Objective: To investigate the efficacy of the intraoperative posterior
pericardial window technique in preventing pericardial tamponade following
open heart surgery. Patients and methods: Adult patients undergoing
coronary and/or valve surgery were randomly divided into a control
(traditional) or a pericardial window (PW) technique group. Pre-, intra-,
peri- and postoperative clinical data were collected prospectively,
including incidence of pericardial tamponade, cardiac arrest, drainage
volume, ventilation assistance time and moderateto-large pericardial
effusion. Results: In total, 458 patients were included: 230 controls and
228 in the PW group. The incidence of pericardial tamponade in the PW
group was significantly lower than in controls. Cardiac arrest occurred in
one patient (0.4%) in the PW group and five (2.2%) controls; this
difference was not statistically significant. Moderate-to-large
pericardial effusion after drainage extubation and newonset atrial
fibrillation were significantly more common in controls than in the PW
group. After stratification by age (<70 versus >70 years), there was no
between-group difference in duration of endotracheal intubation, although
in the PW group, after removal of the tracheal cannula, duration of
noninvasive positive pressure ventilation was significantly longer in
older patients. Conclusions: The pericardial window procedure did not
increase the rate or severity of procedure-related complications. This
simple technique significantly decreased the incidence of postoperative
pericardial tamponade and new-onset atrial fibrillation. The Author(s)
2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
<12>
Accession Number
2014264662
Authors
Robertson J.O. Ebrahimi R. Lansky A.J. Mehran R. Stone G.W. Lincoff A.M.
Institution
(Robertson, Lincoff) Department of Cardiovascular Medicine/F25, Cleveland
Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States
(Ebrahimi) University of California Los Angeles, Greater Los Angeles VA
Medical Center, Los Angeles, CA, United States
(Lansky) Yale University School of Medicine, New Haven, CT, United States
(Mehran) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Mehran, Stone) Cardiovascular Research Foundation, New York, NY, United
States
(Stone) Columbia University Medical Center, New York, NY, United States
Title
Impact of cigarette smoking on extent of coronary artery disease and
prognosis of patients with non-ST-segment elevation acute coronary
syndromes: An analysis from the ACUITY trial (acute catheterization and
urgent intervention triage strategy).
Source
JACC: Cardiovascular Interventions. 7 (4) (pp 372-379), 2014. Date of
Publication: April 2014.
Publisher
Elsevier Inc.
Abstract
Objectives: This study sought to evaluate the short- and long-term
outcomes for smokers with non-ST-segment elevation acute coronary
syndromes (NSTE-ACS). Background: Smoking has been associated with the
"paradox" of reduced mortality after acute myocardial infarction (MI).
This is thought to be due to favorable baseline characteristics and less
diffuse coronary artery disease (CAD) among smokers. Methods: In the
ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy)
trial, 13,819 patients (29.1% smokers) with moderate- to high-risk
NSTE-ACS underwent angiography and, if indicated, revascularization.
Results: Smokers were significantly younger and had fewer comorbidities
than nonsmokers. Incidence of death and MI were comparable at 30 days,
although smokers had significantly reduced risks of 30-day major bleeding
(hazard ratio [HR]: 0.80, 95% confidence interval [CI]: 0.67 to 0.96; p =
0.016) and 1-year mortality (HR: 0.797, 95% CI: 0.65 to 0.97; p = 0.027).
After correction for baseline and clinical differences, smoking was no
longer predictive of major bleeding (odds ratio: 1.06, 95% CI: 0.86 to
1.32; p = 0.56) and was associated with higher 1-year mortality (HR: 1.37,
95% CI: 1.07 to 1.7; p = 0.013). This pattern of reversed risk after
multivariable correction held true for those smokers requiring
percutaneous coronary intervention. Core laboratory angiographic analysis
showed that smokers and nonsmokers were comparable in terms of the extent
of CAD, Thrombolysis In Myocardial Infarction flow, myocardial blush, and
the presence of thrombi. Conclusions: In contrast to the paradox
previously described in ST-segment elevation MI, our analysis finds
smoking to be an independent predictor of higher 1-year mortality in
patients presenting with NSTE-ACS, and our angiographic study demonstrates
CAD in smokers that is comparable to that in nonsmokers but evident ~1
decade earlier. (Acute Catheterization and Urgent Intervention Triage
Strategy [ACUITY]; NCT00093158). 2014 by the American College of
Cardiology Foundation.
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Accession Number
2014265009
Authors
Sadat K. Ather S. Aljaroudi W. Heo J. Iskandrian A.E. Hage F.G.
Institution
(Sadat, Ather, Heo, Iskandrian, Hage) Division of Cardiovascular Disease,
University of Alabama, Birmingham Lyons-Harrison Research, 1900 University
Blvd, Birmingham, AL 35294, United States
(Aljaroudi) Division of Cardiovascular Disease, American University,
Beirut Medical Center, Beirut, Lebanon
(Hage) Section of Cardiology, Birmingham Veterans Affairs Medical Center,
Birmingham, AL, United States
Title
The effect of bone marrow mononuclear stem cell therapy on left
ventricular function and myocardial perfusion.
Source
Journal of Nuclear Cardiology. 21 (2) (pp 351-367), 2014. Date of
Publication: 2014.
Publisher
Springer New York LLC
Abstract
Background: Bone morrow stem cell (BMC) transfer is an emerging therapy
with potential to salvage cardiomyocytes during acute myocardial
infarction and promote regeneration and endogenous repair of damaged
myocardium in patients with left ventricular (LV) dysfunction. We
performed a meta-analysis to examine the association between
administration of BMC and LV functional recovery as assessed by imaging.
Methods and Results: Our meta-analysis included data from 32 trials
comprising information on 1,300 patients in the treatment arm and 1,006
patients in the control arm. Overall, BMC therapy was associated with a
significant increase in LV ejection fraction by 4.6% + 0.7% (P <.001)
(control-adjusted increase of 2.8% + 0.9%, P =.001), and a significant
decrease in perfusion defect size by 9.5% + 1.4% (P <.001)
(control-adjusted decrease of 3.8% + 1.2%, P =.002). The effect of BMC
therapy was similar whether the cells were administered via intra-coronary
or intra-myocardial routes and was not influenced by baseline ejection
fraction or perfusion defect size. Conclusions: BMC transfer appears to
have a positive impact on LV recovery in patients with acute coronary
syndrome and those with stable coronary disease with or without heart
failure. Most studies were small and a minority used a core laboratory for
image analysis. 2013 American Society of Nuclear Cardiology.
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