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<1>
Accession Number
2014354727
Authors
Manchikanti L. Cash K.A. McManus C.D. Pampati V. Benyamin R.M.
Institution
(Manchikanti, Cash, McManus, Pampati) Pain Management Center of Paducah,
Paducah, KY, United States
(Manchikanti) University of Louisville, Louisville, KY, United States
(Benyamin) Millennium Pain Center, Bloomington, IL, United States
(Manchikanti) Anesthesiology and Perioperative Medicine, University of
Louisville, Louisville, KY, United States
(Benyamin) College of Medicine, University of Illinois, Urbana-Champaign,
IL, United States
Title
Thoracic interlaminar epidural injections in managing chronic thoracic
pain: A randomized, double-blind, controlled trial with a 2-year
follow-up.
Source
Pain Physician. 17 (3) (pp E327-E338), 2014. Date of Publication: May/June
2014.
Publisher
Association of Pain Management Anesthesiologists
Abstract
Background: Reports of prevalence of spinal pain indicate the prevalence
of thoracic pain in approximately 13% of the general population compared
to 32% of the population with neck pain and 43% of the population with low
back pain during the past year. Even though, thoracic pain is less common
than neck or low back pain, the degree of disability resulting from
thoracic pain disorders seems to be similar to other painful conditions.
Interventions in managing chronic thoracic pain are also less frequent,
leading to the paucity of literature about various interventions in
managing chronic thoracic pain. Thoracic intervertebral discs and thoracic
facet joints have been shown to be pain generators, even though thoracic
radicular pain is very infrequent. Thoracic epidural injections are one of
the commonly performed procedures in managing thoracic pain. The efficacy
of thoracic epidural injections has not been well studied. Study Design: A
randomized, double-blind, active controlled trial. Setting: Private
interventional pain management practice and specialty referral center in
the United States. Objective: The primary objective ws to assess the
effectiveness of thoracic interlaminar epidural injections in providing
effective pain relief and improving function in patients with chronic mid
and/ or upper back pain. Methods: One hundred and ten patients were
randomly assigned into 2 groups with 55 patients in each group receiving
either local anesthetic alone (Group I) or local anesthetic with steroids
(Group II). Randomization was performed by computer-generated random
allocation sequence by simple randomization. Outcomes Assessment: Outcomes
were assessed utilizing Numeric Rating Scale (NRS), the Oswestry
Disability Index (ODI) 2.0, employment status, and opioid intake. The
patients experiencing greater than 3 weeks of significant improvement with
the first 2 procedures were considered as successful. Others were
considered as failed participants. Significant improvement was defined as
a decrease of greater than 50% NRS scores and ODI scores with measurements
performed at baseline, 3, 6, 12, 18, and 24 months post treatment.
Results: Significant improvement was seen in 71% in Group I and 80% in
Group II at the end of 2 years with all participants; however, improvement
was seen in 80% and 86% when only successful patients were considered.
Therapeutic procedural characteristics showed 5 to 6 procedures per 2
years with total average relief of 80 weeks in Group I and 78 weeks in
Group II in the successful patient category; whereas, it was 71 and 72
weeks when all patients were considered. Limitations: Limitations of this
assessment include lack of a placebo group. Conclusions: Based on the
results of this trial, it is concluded that chronic thoracic pain of
non-facet joint origin may be managed conservatively with thoracic
interlaminar epidural injections with or without steroids.

<2>
Accession Number
2014351401
Authors
Caldeira D. David C. Santos A.T. Costa J. Pinto F.J. Ferreira J.J.
Institution
(Caldeira, David, Santos, Costa, Ferreira) Clinical Pharmacology Unit,
Instituto de Medicina Molecular, Lisbon, Portugal
(Caldeira, David, Santos, Costa, Ferreira) Laboratory of Clinical
Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon,
Lisbon, Portugal
(David, Pinto) Cardiology Department, CCUL, CAML, University of Lisbon,
Lisbon, Portugal
(Costa) Evidence Based Medicine Center, Faculty of Medicine, University of
Lisbon, Lisbon, Portugal
(Costa) Faculty of Medicine, Portuguese Collaborating Center of the
Cochrane Iberoamerican Network, University of Lisbon, Lisbon, Portugal
Title
Efficacy and safety of low molecular weight heparin in patients with
mechanical heart valves: Systematic review and meta-analysis.
Source
Journal of Thrombosis and Haemostasis. 12 (5) (pp 650-659), 2014. Date of
Publication: May 2014.
Publisher
Blackwell Publishing Ltd
Abstract
Summary: Background: Low molecular weight heparins (LMWHs) are not
approved for patients with mechanical heart valves (MHVs). However, in
several guidelines, temporary LMWH off-label use in this clinical setting
is considered to be a valid treatment option. Therefore, we reviewed the
efficacy and safety of LMWHs in patients with MHVs. Methods: MEDLINE and
CENTRAL databases were searched from inception to June 2013. Review
articles and references were also searched. We included experimental and
observational studies that compared LMWHs with unfractionated heparin
(UFH) or vitamin K antagonists (VKAs). Data were analyzed and pooled to
estimate odds ratios (ORs) with 95% confidence intervals (CIs) for
thromboembolic and major bleeding events. Statistical heterogeneity was
evaluated with the I²-test. Results: Nine studies were
included: one randomized controlled trial (RCT) and eight observational
studies, with a total of 1042 patients. No differences were found between
LMWHs and UFH/VKAs in the risk of thromboembolic events (OR 0.67; 95% CI
0.27-1.68; I² = 9%) or major bleeding events (OR 0.66; 95% CI
0.36-1.19; I² = 0%). Conclusions: The best evidence available
might support the temporary use of LMWHs as a prophylactic treatment
option in patients with MHVs. However, conclusions are mostly based on
observational data (with large CIs), and an adequately powered RCT is
urgently needed in this clinical setting. 2014 International Society on
Thrombosis and Haemostasis.

<3>
Accession Number
2014344117
Authors
Fletcher D. Martinez V.
Institution
(Fletcher, Martinez) Service d'Anesthesie, Hopital Raymond Poincare,
Garches, Assistance Publique Hopitaux de Paris, Garches F-92380, France
(Fletcher, Martinez) INSERM, Hopital Ambroise Pare, Centre d'Evaluation et
de Traitement de la Douleur, Garches F-92100, France
(Fletcher, Martinez) Universite Versailles Saint-Quentin, Garches F-78035,
France
Title
Opioid-induced hyperalgesia in patients after surgery: A systematic review
and a meta-analysis.
Source
British Journal of Anaesthesia. 112 (6) (pp 991-1004), 2014. Date of
Publication: June 2014.
Publisher
Oxford University Press
Abstract
Background Opioids can increase sensitivity to noxious stimuli and cause
opioid-induced hyperalgesia. We performed a systematic review to evaluate
the clinical consequences of intra-operative doses of opioid. Methods We
identified randomized controlled trials which compared intra-operative
opioid to lower doses or placebo in adult patients undergoing surgery from
MEDLINE, EMBASE, LILAC, Cochrane, and hand searches of trial registries.
We pooled data of postoperative pain intensity, morphine consumption,
incidence of opioid-related side-effects, primary and secondary
hyperalgesia. For dichotomous outcomes relative risks [95% conidence
intervals (CIs)] and for continuous outcomes mean differences (MDs) or
standardized mean difference (SMD; 95% CI) were calculated. Results
Twenty-seven studies involving 1494 patients were included in the
analysis. Patients treated with high intra-operative doses of opioid
reported higher postoperative pain intensity than the reference groups
(MD: 9.4 cm; 95% CI: 4.4, 14.5) at 1 h, (MD: 7.1 cm; 95% CI: 2.8, 11.3) at
4 h, and (MD: 3 cm; 95% CI: 0.4, 5.6) at 24 h on a 100 cm visual analogue
scale. They also showed higher postoperative morphine use after 24 h (SMD:
0.7; 95% CI: 0.37, 1.02). There was no difference in the incidences of
nausea, vomiting, and drowsiness. These results were mainly associated
with the use of remifentanil. The impact of other opioids is less clear
because of limited data. Discussion This review suggests that high
intra-operative doses of remifentanil are associated with small but
significant increases in acute pain after surgery. 2014 The Author.

<4>
Accession Number
2014344793
Authors
El Sabbagh A. Patel V.G. Jeroudi O.M. Michael T.T. Alomar M.E. Mogabgab O.
Fuh E. Roesle M. Rangan B.V. Abdullah S. Hastings J.L. Grodin J. Kumbhani
D.J. Alexopoulos D. Fasseas P. Banerjee S. Brilakis E.S.
Institution
(El Sabbagh, Patel, Jeroudi, Michael, Alomar, Mogabgab, Fuh, Roesle,
Rangan, Abdullah, Hastings, Grodin, Kumbhani, Banerjee, Brilakis) VA North
Texas Health Care System, University of Texas Southwestern Medical School,
Dallas, TX, United States
(Alexopoulos) University of Patras, Patras, Greece
(Fasseas) Medical College of Wisconsin, Milwaukee, WI, United States
Title
Angiographic success and procedural complications in patients undergoing
retrograde percutaneous coronary chronic total occlusion interventions: A
weighted meta-analysis of 3482 patients from 26 studies.
Source
International Journal of Cardiology. 174 (2) (pp 243-248), 2014. Date of
Publication: 15 Jun 2014.
Publisher
Elsevier Ireland Ltd
Abstract
Background The efficacy and safety profile of retrograde chronic total
occlusion (CTO) percutaneous coronary intervention (PCI) has received
limited study. We sought to perform a weighted meta-analysis of the
success and complication rates of retrograde CTO PCI. Methods We conducted
a meta-analysis of 26 studies published between 2006 and April 2013
reporting in-hospital outcomes of retrograde CTO PCI. Data on procedural
success, frequency of death, emergent coronary artery bypass graft surgery
(CABG), stroke, myocardial infarction (MI), perforation, tamponade, stent
thrombosis, major vascular or bleeding events, contrast nephropathy, and
radiation skin injury were collected. Results A total of 26 studies with
3482 patients and 3493 target CTO lesions were included. Primary
retrograde CTO PCI was attempted in 52.4%. Pooled estimates of outcomes
were as follows: procedural success 83.3% [95% confidence interval (CI):
79.0% to 87.7%]; death 0.7% (95% CI: 0.5% to 1.2%); urgent CABG 0.7% (95%
CI: 0.4% to 1.2%); tamponade 1.4% (95% CI: 1.0% to 2.2%); collateral
perforation 6.9% (95% CI: 4.6% to 10.4%); coronary perforation 4.3% (95%
CI: 1.2% to 15.4%); donor vessel dissection 2% (95% CI: 0.9% to 4.5%);
stroke 0.5% (95% CI: 0.2% to 1.0%); MI 3.1% (95% CI: 0.2% to 5.0%); Q wave
MI 0.6% (95% CI: 0.4% to 1.1%); vascular access complications 2% (95% CI:
0.9% to 4.5%); contrast nephropathy 1.8% (95% CI: 0.8% to 3.7%); and wire
fracture and equipment entrapment 1.2% (95% CI: 0.6% to 2.5%). Conclusions
Retrograde CTO PCI is associated with high procedural success rate and
acceptable risk for procedural complications. 2014 Elsevier Ireland Ltd.
All rights reserved.

<5>
Accession Number
2014350084
Authors
Patila T. Lehtinen M. Vento A. Schildt J. Sinisalo J. Laine M. Hammainen
P. Nihtinen A. Alitalo R. Nikkinen P. Ahonen A. Holmstrom M. Lauerma K.
Poyhia R. Kupari M. Kankuri E. Harjula A.
Institution
(Patila, Lehtinen, Vento, Hammainen, Harjula) Department of Cardiothoracic
Surgery, United States
(Schildt, Nikkinen, Ahonen) Division of Nuclear Medicine, Department of
Clinical Physiology, United States
(Sinisalo, Laine, Kupari) Division of Cardiology, Department of Medicine,
United States
(Nihtinen) Department of Hematology, United States
(Alitalo) Stem Cell Laboratory, Department of Clinical Chemistry and
Hematology, HUSLAB, United States
(Holmstrom, Lauerma) Department of Radiology, United States
(Poyhia) Department of Anesthesiology and Intensive Care, Helsinki
University Central Hospital, Helsinki, Finland
(Kankuri, Harjula) Institute of Biomedicine, Pharmacology, University of
Helsinki, Helsinki, Finland
Title
Autologous bone marrow mononuclear cell transplantation in ischemic heart
failure: A prospective, controlled, randomized, double-blind study of cell
transplantation combined with coronary bypass.
Source
Journal of Heart and Lung Transplantation. 33 (6) (pp 567-574), 2014. Date
of Publication: June 2014.
Publisher
Elsevier USA
Abstract
Background Bone marrow mononuclear cell (BMMC) transplantation for heart
failure has shown inconsistent therapeutic efficacy. Methods We enrolled
104 ischemic heart failure patients scheduled for coronary artery bypass
surgery (CABG). After 4- to 12-week pharmacotherapy optimization, 39
patients with left ventricular ejection fraction (LVEF) of <45% received
injections of BMMC or vehicle intra-operatively into the myocardial
infarction border area in a randomized, double-blind manner. Results The
median number of cells injected was 8.4 ;times& 10;bsupesup&
(interquartile range [IQR]: 5.2 ;times& 10;bsupesup& to 13.5 ;times&
10;bsupesup). We measured LV function and myocardial scar size by magnetic
resonance imaging (MRI), and viability by positron emission tomography
(PET) and single-photon emission computed tomography (SPECT),
pre-operatively and after 1-year follow-up. LVEF, the pre-defined primary
end-point measure, improved by a median of 5.6% in the control group (IQR
0.2 to 10.1) and by 4.8% in the BMMC group (IQR -0.5 to 8.2) (p = 0.59).
Wall thickening in injected segments rose by a median of 4.5% among
controls (IQR -18.1 to 23.9) and by 5.5% in the BMMC group (IQR -6.6 to
26.5) (p = 0.68). Changes in viability by PET and SPECT did not differ
between groups. Myocardial scar size by MRI in injected segments rose by a
median of 5.1% among controls (IQR -3.3 to 10.8), but fell by 13.1% in the
BMMC group (IQR -21.4 to -6.5) (p = 0.0002). Conclusions BMMC therapy
combined with CABG failed to improve LV systolic function, or viability,
despite reducing myocardial scar size. 2014 International Society for
Heart and Lung Transplantation.

<6>
[Use Link to view the full text]
Accession Number
2014346076
Authors
Newburger J.W. Sleeper L.A. Frommelt P.C. Pearson G.D. Mahle W.T. Chen S.
Dunbar-Masterson C. Mital S. Williams I.A. Ghanayem N.S. Goldberg C.S.
Jacobs J.P. Krawczeski C.D. Lewis A.B. Pasquali S.K. Pizarro C. Gruber
P.J. Atz A.M. Khaikin S. Gaynor J.W. Ohye R.G.
Institution
(Newburger, Dunbar-Masterson) Boston Children's Hospital and Harvard
Medical School, Boston, MA, United States
(Sleeper, Chen) New England Research Institutes, Watertown, MA, United
States
(Frommelt) Children's Hospital of Wisconsin and Medical College of
Wisconsin, Milwaukee, United States
(Pearson) National Heart, Lung, and Blood Institute, National Institutes
of Health, Bethesda, MD, United States
(Mahle) Emory University, Atlanta, GA, United States
(Mital, Khaikin) Hospital for Sick Children, Toronto, Canada
(Williams) Morgan Stanley Children's Hospital of New York-Presbyterian,
NY, United States
(Goldberg, Ohye) University of Michigan Medical School, Ann Arbor, United
States
(Jacobs) Congenital Heart Institute of Florida, St. Petersburg, United
States
(Krawczeski) Cincinnati Children's Medical Center, Cincinnati, OH, United
States
(Lewis) Children's Hospital Los Angeles, Los Angeles, CA, United States
(Pasquali) North Carolina Consortium: Duke University, Durham, East
Carolina University, Greenville, Wake Forest University, Winston-Salem,
United States
(Pizarro) Nemours Cardiac Center, Wilmington, DE, United States
(Gruber) Primary Children's Medical Center and University of Utah, Salt
Lake City, United States
(Atz) Medical University of South Carolina, Charleston, United States
(Gaynor) Children's Hospital of Philadelphia, University of Pennsylvania
Medical School, Philadelphia, ON, United States
Title
Transplantation-free survival and interventions at 3 years in the single
ventricle reconstruction trial.
Source
Circulation. 129 (20) (pp 2013-2020), 2014. Date of Publication: 20 May
2014.
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND - : In the Single Ventricle Reconstruction (SVR) trial, 1-year
transplantation-free survival was better for the Norwood procedure with
right ventricle-to-pulmonary artery shunt (RVPAS) compared with a modified
Blalock-Taussig shunt (MBTS). At 3 years, we compared transplantation-free
survival, echocardiographic right ventricular ejection fraction, and
unplanned interventions in the treatment groups. METHODS AND RESULTS - :
Vital status and medical history were ascertained from annual medical
records, death indexes, and phone interviews. The cohort included 549
patients randomized and treated in the SVR trial. Transplantation-free
survival for the RVPAS versus MBTS groups did not differ at 3 years (67%
versus 61%; P=0.15) or with all available follow-up of 4.8+1.1 years
(log-rank P=0.14). Pre-Fontan right ventricular ejection fraction was
lower in the RVPAS group than in the MBTS group (41.7+5.1% versus
44.7+6.0%; P=0.007), and right ventricular ejection fraction deteriorated
in RVPAS (P=0.004) but not MBTS (P=0.40) subjects (pre-Fontan minus
14-month mean, -3.25+8.24% versus 0.99+8.80%; P=0.009). The RVPAS versus
MBTS treatment effect had nonproportional hazards (P=0.004); the hazard
ratio favored the RVPAS before 5 months (hazard ratio=0.63; 95% confidence
interval, 0.45-0.88) but the MBTS beyond 1 year (hazard ratio=2.22; 95%
confidence interval, 1.07-4.62). By 3 years, RVPAS subjects had a higher
incidence of catheter interventions (P<0.001) with an increasing HR over
time (P=0.005): <5 months, 1.14 (95% confidence interval, 0.81-1.60); from
5 months to 1 year, 1.94 (95% confidence interval, 1.02-3.69); and >1
year, 2.48 (95% confidence interval, 1.28-4.80). CONCLUSIONS - : By 3
years, the Norwood procedure with RVPAS compared with MBTS was no longer
associated with superior transplantation-free survival. Moreover, RVPAS
subjects had slightly worse right ventricular ejection fraction and
underwent more catheter interventions with increasing hazard ratio over
time. 2014 American Heart Association, Inc.

<7>
Accession Number
2014344145
Authors
Nasseri B.A. Ebell W. Dandel M. Kukucka M. Gebker R. Doltra A. Knosalla C.
Choi Y.-H. Hetzer R. Stamm C.
Institution
(Nasseri, Dandel, Knosalla, Hetzer, Stamm) Department of Cardiothoracic
and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz
1, Berlin 13353, Germany
(Ebell) Pediatric Bone Marrow Transplant Program Charite',
Universita'tsmedizin Berlin, Berlin 10117, Germany
(Kukucka) Department of Anesthesiology, Deutsches Herzzentrum Berlin,
Berlin 13353, Germany
(Gebker, Doltra) Department of Internal Medicine/Cardiology, Deutsches
Herzzentrum Berlin, Berlin 13353, Germany
(Choi, Stamm) Berlin-Brandenburg Center for Regenerative Therapies, Berlin
13353, Germany
Title
Autologous CD133+ bone marrow cells and bypass grafting for regeneration
of ischaemic myocardium: The Cardio133 trial.
Source
European Heart Journal. 35 (19) (pp 1263-1274), 2014. Date of Publication:
14 May 2014.
Publisher
Oxford University Press
Abstract
Aims Intra-myocardial transplantation of CD133⁺ bone marrow
stem cells (BMC) yielded promising results in clinical pilot trials. We
now performed the double-blinded, randomized, placebo-controlled CARDIO133
trial to determine its impact on left ventricular (LV) function and
clinical symptoms. Methods and results Sixty patients with chronic
ischaemic heart disease and impaired LV function (left ventricular
ejection fraction, LVEF <35%) were randomized to undergo either coronary
artery bypass grafting (CABG) and injection of CD133⁺ BMC in
the non-transmural, hypokinetic infarct border zone (CD133), or CABG and
placebo injection (placebo). Pre-operative LVEF was 27 + 6% in CD133
patients and 26 + 6% in placebo patients. Outcome was assessed after 6
months, and the primary endpoint was LVEF measured by cardiac magnetic
resonance imaging (MRI) at rest. The incidence of adverse events was
similar in both groups. There was no difference in 6-min walking distance,
Minnesota Living with Heart Failure score, or Canadian Cardiovascular
Society (CCS) class between groups at follow-up, and New York Heart
Association class improved more in the placebo group (P = 0.004). By
cardiac MRI, LVEF at 6 months was 33 + 8% in the placebo group and 31 + 7%
in verum patients (P = 0.3), with an average inter-group difference of
-2.1% (95% CI -6.3 to 2.1). Systolic or diastolic LV dimensions at 6
months were not different, either. In the CD133 group, myocardial
perfusion at rest recovered in more LV segments than in the placebo group
(9 vs. 2%, P < 0.001). Scar mass decreased by 2.2 + 5 g in
CD133⁺ patients (P = 0.05), but was unchanged in the placebo
group (0.3 + 4 g, P = 0.7; inter-group difference in change = 2 g (95% CI
-1.1 to 5)). By speckle-tracking echocardiography, cell-treated patients
showed a better recovery of regional wall motion when the target area was
posterior. Conclusion Although there may be some improvements in scar size
and regional perfusion, intra-myocardial injection of CD133 ⁺
BMC has no effect on global LV function and clinical symptoms.
Improvements in regional myocardial function are only detectable in
patients with posterior infarction, probably because the interventricular
septum after anterior infarction is not accessible by trans-epicardial
injection. Clinical Trial Registration This trial was registered at
http://www.clinicaltrials.gov under NCT00462774. 2014 The Author.

<8>
Accession Number
2014350730
Authors
Wijeysundera H.C. Farshchi-Zarabi S. Witteman W. Bennell M.C.
Institution
(Wijeysundera, Farshchi-Zarabi, Bennell) Schulich Heart Centre, Division
of Cardiology, Sunnybrook Health Sciences Centre, Canada
(Wijeysundera) Institute of Health Policy, Management and Evaluation,
University of Toronto, Canada
(Wijeysundera) Institute for Clinical Evaluative Sciences, Canada
(Wijeysundera) Li Ka Shing Knowledge Institute of St Michael's Hospital,
Toronto, ON, Canada
(Witteman) Centre Hospitalier Universitaire du Quebec, Charlesbourg, QC,
Canada
Title
Conversion of the Seattle Angina questionnaire into EQ-5D utilities for
ischemic heart disease: A systematic review and catalog of the literature.
Source
ClinicoEconomics and Outcomes Research. 6 (1) (pp 253-268), 2014. Date of
Publication: 19 May 2014.
Publisher
Dove Medical Press Ltd (PO Box 300-008, Albany, 44 Corinthian Drive,
Albany,Auckland 0752, New Zealand. E-mail: angela@dovepress.com)
Abstract
Background: There is a paucity of preference-based (utility) measures of
health-related quality of life for patients with ischemic heart disease
(IHD); in contrast, the Seattle Angina Questionnaire (SAQ) is a widely
used descriptive measure. Our objective was to perform a systematic review
of the literature to identify IHD studies reporting SAQ scores in order to
apply a mapping algorithm to convert these to preference-based scores for
secondary use in economic evaluations. Methods: Relevant articles were
identified in MEDLINE (Ovid), EMBASE (Ovid), Cochrane Library (Wiley),
HealthStar (Ovid), and PubMed from inception to 2012. We previously
developed and validated a mapping algorithm that converts SAQ descriptive
scores to European Quality of Life-5 Dimensions (EQ-5D) utility scores. In
the current study, this mapping algorithm was used to estimate EQ-5D
utility scores from SAQ scores. Results: Thirty-six studies met the
inclusion criteria. The studies were categorized into three groups, ie,
general IHD (n=13), acute coronary syndromes (n=4), and revascularization
(n=19). EQ-5D scores for patients with general IHD were in the range of
0.605-0.843 at baseline, and increased to 0.649-0.877 post follow-up.
EQ-5D scores for studies of patients with recent acute coronary syndromes
increased from 0.706-0.796 at baseline to 0.795-0.942 post follow-up. The
revascularization studies had EQ-5D scores in the range of 0.616-0.790 at
baseline, and increased to 0.653-0.928 after treatment; studies that
focused only on coronary artery bypass grafting increased from 0.643-0.788
at baseline to 0.653-0.928 after grafting, and studies that focused only
on percutaneous coronary intervention increased in score from 0.616-0.790
at baseline to 0.668-0.897 after treatment. Conclusion: In this review, we
provide a catalog of estimated health utility scores across a wide range
of disease severity and following various interventions in patients with
IHD. Our catalog of EQ-5D scores can be used in IHD-related economic
evaluations. 2014 Wijeysundera et al.

<9>
Accession Number
2014347084
Authors
Athappan G. Gajulapalli R.D. Sengodan P. Bhardwaj A. Ellis S.G. Svensson
L. Tuzcu E.M. Kapadia S.R.
Institution
(Athappan, Sengodan, Bhardwaj) Department of Cardiovascular Medicine,
Heart and Vascular Institute, Case Western Reserve University, Cleveland,
OH, United States
(Gajulapalli, Ellis, Svensson, Tuzcu, Kapadia) Department of
Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic,
Cleveland, OH, United States
Title
Influence of transcatheter aortic valve replacement strategy and valve
design on stroke after transcatheter aortic valve replacement: A
meta-analysis and systematic review of literature.
Source
Journal of the American College of Cardiology. 63 (20) (pp 2101-2110),
2014. Date of Publication: 27 May 2014.
Publisher
Elsevier USA
Abstract
Objectives The study undertook a systematic review to establish and
compare the risk of stroke between the 2 widely used approaches
(transfemoral [TF] vs. transapical [TA]) and valve designs (CoreValve,
Medtronic, Minneapolis, Minnesota vs. Edwards Valve, Edwards Lifesciences,
Irvine, California) for transcatheter aortic valve replacement (TAVR).
Background There has been a rapid adoption and expansion in the use of
TAVR. The technique is however far from perfect and requires further
refinement to alleviate safety concerns that include stroke. Methods All
studies reporting on the risk of stroke after TAVR were identified using
an electronic search and pooled using established meta-analytical
guidelines. Results 25 multicenter registries and 33 single-center studies
were included in the analysis. There was no difference in pooled 30-day
stroke post-TAVR between the TF and TA approach in multicenter (2.8% [95%
confidence interval (CI): 2.4 to 3.4] vs. 2.8% [95% CI: 2.0 to 3.9]) and
single-center studies (3.8% [95% CI: 3.1 to 4.6] vs. 3.4% [95% CI: 2.5 to
4.5]). Similarly, there was no difference in pooled 30-day stroke post
TAVR between the CoreValve and Edwards Valve in multicenter (2.4% [95% CI:
1.9 to 3.2] vs. 3.0% [95% CI: 2.4 to 3.7]) and single-center studies (3.8%
[95% CI: 2.8 to 4.9] vs. 3.2% [95% CI: 2.4 to 4.3]). There was a decline
in stroke risk with experience and technological advancement. There was no
difference in the outcome of 30-day stroke between TAVR and surgical
aortic valve replacement. Conclusions Our findings suggest that the risk
of 30-day stroke after TAVR is similar between the approaches and valve
types. There has been a decline in stroke risk after TAVR with
improvements in valve technology, patient selection, and operator
experience. 2014 by the American College of Cardiology Foundation
Published by Elsevier Inc.

<10>
Accession Number
2014344659
Authors
Escarcega R.O. Magalhaes M.A. Lipinski M.J. Baker N.C. Minha S. Torguson
R. Waksman R.
Institution
(Escarcega, Magalhaes, Lipinski, Baker, Minha, Torguson, Waksman) MedStar
Washington Hospital Center, 110 Irving St. NW, Washington, DC 20010,
United States
Title
Mortality in patients requiring pacemaker implantation following
transcatheter aortic valve replacement: Insights from a systematic review
and meta-analysis.
Source
International Journal of Cardiology. 174 (1) (pp 207-208), 2014. Date of
Publication: 01 Jun 2014.
Publisher
Elsevier Ireland Ltd

<11>
Accession Number
2014342867
Authors
Baik J.S. Oh A.-Y. Cho C.W. Shin H.-J. Han S.H. Ryu J.H.
Institution
(Baik, Oh, Cho, Shin, Han, Ryu) Department of Anesthesiology and Pain
Medicine, Seoul National University Bundang Hospital, Seongnam-si,
Gyeonggi-do, South Korea
Title
Thoracic paravertebral block for nephrectomy: A randomized, controlled,
observer-blinded study.
Source
Pain Medicine (United States). 15 (5) (pp 850-856), 2014. Date of
Publication: May 2014.
Publisher
Blackwell Publishing Inc.
Abstract
Objective: This study evaluated whether adding a preoperative single
thoracic paravertebral block (TPVB) to intravenous patient-controlled
analgesia (IV PCA) would improve postoperative analgesia compared with
using IV PCA alone in patients undergoing nephrectomy. Design:
Prospective, randomized, controlled, observer-blinded trial. Setting:
University hospital. Subjects: Thirty-four adult patients undergoing
elective open nephrectomy. Methods: The patients were randomized to
receive a TPVB plus IV PCA (group T) or IV PCA alone (group C). A single
18-mL injection of 0.75% ropivacaine was administered preoperatively under
ultrasound guidance; fentanyl was used for IV PCA. Each patient's
postoperative pain score based on a verbal numerical rating scale,
postoperative fentanyl consumption, inspiratory volume by incentive
spirometry, and complications were evaluated at 1, 3, 6, 12, and 24 hours
after surgery. Changes in heart rate (HR), systolic arterial pressure
(SAP), and mean arterial pressure (MAP) were evaluated following skin
incision. Results: The postoperative pain score and fentanyl consumption
were significantly lower in group T than in group C at all time points up
to 24 hours after surgery. The postoperative inspiratory volumes were not
significantly different. The changes in HR were similar, while the
increases in SAP and MAP after skin incision were lower in group T than in
group C. Conclusions: A preoperative single TPVB improved postoperative
analgesia by reducing the postoperative pain score and fentanyl
consumption in patients undergoing nephrectomy. 2014 American Academy of
Pain Medicine.

<12>
Accession Number
2014339913
Authors
Armstrong E.J. Waltenberger J. Rogers J.H.
Institution
(Armstrong, Rogers) Davis Medical Center, Division of Cardiovascular
Medicine, University of California, 4860 Y St, Sacramento, CA 95817,
United States
(Waltenberger) Department of Cardiovascular Medicine, Division of
Cardiology, University Hospital Munster, Munster, Germany
Title
Percutaneous coronary intervention in patients with diabetes: Current
concepts and future directions.
Source
Journal of Diabetes Science and Technology. 8 (3) (pp 581-589), 2014. Date
of Publication: May 2014.
Publisher
Diabetes Technology Society
Abstract
Patients with diabetes and coronary artery disease represent a challenging
and growing subset of the population. Although surgical revascularization
is the preferred treatment for patients with diabetes and multivessel
coronary artery disease with stable angina, a significant proportion of
diabetic patients undergo percutaneous revascularization due to
comorbidities, presence of single-vessel disease, or presentation with
myocardial infarction. The development of drug-eluting stents has
significantly improved the results of percutaneous revascularization among
diabetic patients, but a number of challenges remain, including higher
rates of restenosis and stent thrombosis among diabetic patients. With
current technologies, the outcomes of diabetic patients treated with
noninsulin agents have approached that of nondiabetic patients. In
comparison, patients with diabetes who require insulin therapy represent a
high-risk cohort with increased rates of target vessel failure after
coronary revascularization. The development of bioresorbable stents and
new drug elution systems may provide additional future benefit among
patients with diabetes undergoing percutaneous coronary artery
revascularization. 2014 Diabetes Technology Society.

<13>
Accession Number
2014331310
Authors
Gedik N. Thielmann M. Kottenberg E. Peters J. Jakob H. Heusch G.
Kleinbongard P.
Institution
(Gedik, Heusch, Kleinbongard) Institut fur Pathophysiologie,
Universitatsklinikum Essen, Universitat Duisburg-Essen, Essen, Germany
(Thielmann, Jakob) Klinik fur Thorax- und Kardiovaskulare Chirurgie,
Universitatsklinikum Essen, Universitat Duisburg-Essen, Essen, Germany
(Kottenberg, Peters) Klinik fur Anasthesiologie und Intensivmedizin,
Universitatsklinikum Essen, Universitat Duisburg-Essen, Essen, Germany
Title
No evidence for activated autophagy in left ventricular myocardium at
early reperfusion with protection by remote ischemic preconditioning in
patients undergoing coronary artery bypass grafting.
Source
PLoS ONE. 9 (5) , 2014. Article Number: e96567. Date of Publication: 05
May 2014.
Publisher
Public Library of Science
Abstract
Objective: Remote ischemic preconditioning (RIPC) by repeated brief limb
ischemia/reperfusion reduces myocardial injury in patients undergoing
coronary artery bypass grafting (CABG). Activation of signal transducer
and activator of transcription 5 (STAT5) in left ventricular (LV)
myocardium at early reperfusion is associated with such protection.
Autophagy, i.e., removal of dysfunctional cellular components through
lysosomes, has been proposed as one mechanism of cardioprotection.
Therefore, we analyzed whether or not the protection by RIPC is associated
with activated autophagy. Methods: CABG patients were randomized to
undergo RIPC (3x5 min blood pressure cuff inflation/5 min deflation) or
placebo (cuff deflated) before skin incision (n = 10/10). Transmural
myocardial biopsies were taken from the LV before cardioplegia (baseline)
and at early (5-10 min) reperfusion. RIPC-induced protection was reflected
by decreased serum troponin I concentration area under the curve (194+17
versus 709+129 ng/ml x 72 h, p = 0.002). Western blotting for
beclin-1-phosphorylation and protein expression of autophagy-related gene
5-12 (ATG5-12) complex, light chain 3 (LC3), parkin, and p62 was
performed. STAT3-, STAT5- and extracellular signal-regulated protein
kinase 1/2 (ERK1/2)-phosphorylation was used as positive control to
confirm signal activation by ischemia/reperfusion. Results: Signals of all
analyzed autophagy proteins did not differ between baseline and early
reperfusion and not between RIPC and placebo. STAT5-phosphorylation was
greater at early reperfusion only with RIPC (2.2-fold, p = 0.02). STAT3-
and ERK1/2-phosphorylation were greater at early reperfusion with placebo
and RIPC (>2.7-fold versus baseline, p<0.05). Conclusion: Protection
through RIPC in patients undergoing CABG surgery does not appear to be
associated with enhanced autophagy in LV myocardium at early reperfusion.
2014 Gedik et al.

<14>
Accession Number
2014331264
Authors
Ding X. Jin S. Niu X. Ren H. Fu S. Li Q.
Institution
(Ding, Jin, Fu, Li) Department of Anesthesiology, Shanghai Tenth People's
Hospital, Tongji University School of Medicine, Shanghai, China
(Ding, Jin, Niu, Ren, Li) Department of Anesthesiology, East Hospital,
Tongji University School of Medicine, Shanghai, China
Title
A comparison of the analgesia efficacy and side effects of paravertebral
compared with epidural blockade for thoracotomy: An updated meta-analysis.
Source
PLoS ONE. 9 (5) , 2014. Article Number: e96233. Date of Publication: 05
May 2014.
Publisher
Public Library of Science
Abstract
Objective: The most recent systematic review and meta-analysis comparing
the analgesic efficacy and side effects of paravertebral and epidural
blockade for thoracotomy was published in 2006. Nine well-designed
randomized trials with controversial results have been published since
then. The present report constitutes an updated meta-analysis of this
issue. Summary of Background: Thoracotomy is a major surgical procedure
and is associated with severe postoperative pain. Epidural analgesia is
the gold standard for post-thoracotomy pain management, but has its
limitations and contraindications, and paravertebral blockade is
increasingly popular. However, it has not been decided whether the
analgesic effect of the two methods is comparable, or whether
paravertebral blockade leads to a lower incidence of adverse side effects
after thoracotomy. Methods: Two reviewers independently searched the
databases PubMed, EMBASE, and the Cochrane Library (last performed on 1
February, 2013) for reports of studies comparing post-thoracotomy epidural
analgesia and paravertebral blockade. The same individuals independently
extracted data from the appropriate studies. Result: Eighteen trials
involving 777 patients were included in the current analysis. There was no
significant difference in pain scores between paravertebral blockade and
epidural analgesia at 4-8, 24, 48 hours, and the rates of pulmonary
complications and morphine usage during the first 24 hours were also
similar. However, paravertebral blockade was better than epidural
analgesia in reducing the incidence of urinary retention (p<0.0001),
nausea and vomiting (p = 0.01), hypotension (p<0.00001), and rates of
failed block were lower in the paravertebral blockade group (p = 0.01).
Conclusions: This meta-analysis showed that PVB can provide comparable
pain relief to traditional EPI, and may have a better side-effect profile
for pain relief after thoracic surgery. Further high-powered randomized
trials are to need to determine whether PVB truly offers any advantages
over EPI. 2014 Ding et al.

<15>
Accession Number
2014335813
Authors
Mosleh S.M. Bond C.M. Lee A.J. Kiger A. Campbell N.C.
Institution
(Mosleh) Mutah University, Faculty of Nursing, PO BOX (7), Karak, 61710,
Jordan
(Bond, Campbell) Centre of Academic Primary Care, University of Aberdeen,
United Kingdom
(Lee) Division of Applied Health Sciences, University of Aberdeen, United
Kingdom
(Kiger) Centre for Advanced Studies in Nursing, University of Aberdeen,
United Kingdom
Title
Effectiveness of theory-based invitations to improve attendance at cardiac
rehabilitation: A randomized controlled trial.
Source
European Journal of Cardiovascular Nursing. 13 (3) (pp 201-210), 2014.
Date of Publication: June 2014.
Publisher
Elsevier
Abstract
Background: Despite well-established evidence of benefit from cardiac
rehabilitation, typically fewer than 35% of eligible patients attend.
Objective: The purpose of this study was to evaluate whether theory-based
invitations increase attendance at cardiac rehabilitation. Method: The
study was a randomized controlled trial (RCT) with two by two factorial
design. A total of 375 participants with acute myocardial infarction or
coronary revascularization was recruited from medical and surgical cardiac
wards at Aberdeen Royal Infirmary (ARI). They were randomly assigned to
receive either the standard invitation letter or a letter with wording
based on the theory of planned behavior (TPB) and the common sense model
of illness perception, and either a supportive leaflet with motivational
messages or not. The primary outcome was one or more attendances at
cardiac rehabilitation. Results: The theory-based letter increased
attendance at cardiac rehabilitation compared to the standard letter (84%
versus 74%, odds ratio (OR) 2.93, 95% confidence interval (CI) 1.545.56),
independent of age, gender, working status, hypertension, identity and TPB
constructs. The number needed to treat (NNT) was 9 (95% CI 712). The
motivational leaflet had no significant effect on attendance at
rehabilitation (OR 1.02, 95% CI 0.571.83). Conclusions: The use of
theory-based wording in invitation letters is a simple method to improve
attendance at cardiac rehabilitation. Our letter, reproduced in this
paper, could provide a template for practitioners and researchers. 2013
The European Society of Cardiology.

<16>
Accession Number
2014343201
Authors
Zeb I. Abbas N. Nasir K. Budoff M.J.
Institution
(Zeb, Abbas) Bronx-Lebanon Hospital Center, 1650 Grand Concourse, Bronx,
NY, United States
(Nasir) Center for Prevention and Wellness Research, Baptist Health
Medical Group, Miami Beach, FL, United States
(Nasir) Department of Epidemiology, Robert Stempel College of Public
Health, Florida International University, Miami, FL, United States
(Nasir) Department of Medicine, Herbert Wertheim College of Medicine,
Florida International University, Miami, FL, United States
(Nasir) The Johns Hopkins Ciccarone Center for the Prevention of Heart
Disease, Baltimore, MD, United States
(Budoff) Los Angeles Biomedical Research Institute at Harbor-UCLA Medical
Center, Torrance, CA 90502, United States
Title
Coronary computed tomography as a cost-effective test strategy for
coronary artery disease assessment - A systematic review.
Source
Atherosclerosis. 234 (2) (pp 426-435), 2014. Date of Publication: June
2014.
Publisher
Elsevier Ireland Ltd
Abstract
Cardiovascular imaging imparts a huge burden on healthcare spending.
Coronary CT angiography (CCTA) may provide a cost effective means of
diagnosing coronary artery disease (CAD) and reducing downstream cost of
testing. We performed a systematic search of literature for randomized
controlled trials or prospective or retrospective non-randomized
comparative studies or case series, decision analytic models and
technology reports in which some or all of the patients underwent CCTA and
looking at the cost effectiveness, comparative effectiveness and
downstream test utilization associated with the use of CCTA. We found 42
articles matching our criteria. CCTA either as first line or as a layering
test may represent a cost effective strategy for initial evaluation of
patients with CAD prevalence of 10%-50% in both near-term and long-term
diagnostic periods. For CAD prevalence >70%, ICA as initial test may
represent cost effective strategy for diagnosis of stable chest pain. CCTA
may represent cost-effective strategy when performed as a layering test to
equivocal initial stress imaging before performing ICA. Use of CCTA is
cost- and time-effective strategy for evaluation of low risk (<30% CAD
prevalence) acute chest pain patients in emergency department and can be
used for safe exclusion of acute coronary syndrome (ACS). Use of coronary
calcium score as an initial test may require further evidence to be deemed
cost-effective strategy. CCTA may represent a cost effective and may be
associated with less downstream testing for diagnosis of stable chest pain
patients in low to intermediate risk patients whereas for low risk acute
chest pain patients, use of CCTA is associated with expedited patient
management, less cost and safe exclusion of ACS. 2014 Elsevier Ireland
Ltd.