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<1>
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Accession Number
2014364681
Authors
Montalescot G. Range G. Silvain J. Bonnet J.-L. Boueri Z. Barthelemy O.
Cayla G. Belle L. Van Belle E. Cuisset T. Elhadad S. Pouillot C. Henry P.
Motreff P. Carrie D. Rousseau H. Aubry P. Monsegu J. Sabouret P. O'Connor
S.A. Abtan J. Kerneis M. Saint-Etienne C. Beygui F. Vicaut E. Collet J.-P.
Institution
(Montalescot, Silvain, Barthelemy, Sabouret, O'Connor, Kerneis, Collet)
ACTION Study Group, Institut de Cardiologie (AP-HP), Universite Paris 6,
Paris, France
(Range) Hopital Louis Pasteur, Le Coudray, France
(Bonnet, Cuisset) Hopital de la Timone, Marseille, France
(Boueri) CH de Bastia, Bastia, France
(Cayla) CHU Caremeau, Nimes, France
(Belle) CH de la Region Annecienne, Annecy, France
(Van Belle) Hopital Cardiologique, Lille, France
(Elhadad) CH de Lagny, Marne-la-Vallee, France
(Pouillot) Clinique Sainte-Clothilde, La-Reunion, France
(Henry) Hopital Lariboisiere, Paris, France
(Motreff) CHU Clermont-Ferrand, Clermont-Ferrand, France
(Carrie) Hopital de Rangueil, Toulouse, France
(Rousseau, Vicaut) Unite de Recherche Clinique, Hopital Lariboisiere,
ACTION Study Group, Paris, France
(Aubry) Hopital Bichat, Paris, France
(Monsegu) HIA du Val-du-Grace, Paris, France
(Abtan) Hopital Bichat, ACTION Study Group, Paris, France
(Saint-Etienne) Hopital Trousseau, Chambray-les-Tours, ACTION Study Group,
Paris, France
(Beygui) CHU Cote de Nacre, Caen, ACTION Study Group, Caen, France
Title
High on-treatment platelet reactivity as a risk factor for secondary
prevention after coronary stent revascularization: A landmark analysis of
the ARCTIC study.
Source
Circulation. 129 (21) (pp 2136-2143), 2014. Date of Publication: 27 May
2014.
Publisher
Lippincott Williams and Wilkins
Abstract
Background - Individualizing antiplatelet therapy after platelet function
testing did not improve outcome after coronary stenting in the Assessment
by a Double Randomization of a Conventional Antiplatelet Strategy Versus a
Monitoring- Guided Strategy for Drug-Eluting Stent Implantation and of
Treatment Interruption Versus Continuation One Year After Stenting
(ARCTIC) study. Whether results are different during the phase of
secondary prevention starting after hospital discharge, when
periprocedural events have been excluded, is unknown. Methods and Results
- In ARCTIC, 2440 patients were randomized before coronary stenting to a
strategy of platelet function monitoring (VerifyNow
P2Y₁₂/aspirin point-of-care assay) with drug adjustment in
suboptimal responders to antiplatelet therapy or to a conventional
strategy without monitoring and without drug or dose changes. We performed
a landmark analysis starting at the time of hospital discharge evaluating
the primary end point of death, myocardial infarction, stent thrombosis,
stroke, or urgent revascularization through 1 year. After discharge, the
primary end point occurred in 8.6% of patients in the monitoring arm and
7.9% in the conventional arm (hazard ratio, 1.105; 95% confidence
interval, 0.835-1.461; P=0.48). Stent thrombosis or urgent
revascularization occurred in 4.4% and 4.5% in the monitoring and
conventional arms, respectively (P=0.99). There was no difference for any
of the other ischemic end points. Major bleeding event rates were 1.8% in
the monitoring arm and 2.8% in the conventional arm (P=0.11), whereas
major or minor bleeding event rates were 2.3% and 3.4%, respectively
(P=0.10). Conclusions - Detection of platelet hyper-reactivity by platelet
function testing in patients undergoing coronary stenting with further
therapeutic adjustment does not reduce ischemic recurrences after
intervention. On-treatment platelet hyperreactivity cannot be considered
as a risk factor requiring intervention for secondary prevention after
percutaneous coronary revascularization. 2014 American Heart Association,
Inc.

<2>
Accession Number
2014364114
Authors
Mathews S.B. Arnold S.E. Epperson C.N.
Institution
(Mathews, Arnold, Epperson) Department of Psychiatry, University of
Pennsylvania School of Medicine, 3535 Market St., Philadelphia, PA 19104,
United States
(Mathews, Epperson) Penn Center for Women's Behavioral Wellness,
University of Pennsylvania, Philadelphia, PA, United States
(Arnold, Epperson) Department of Obstetrics and Gynecology, University of
Pennsylvania School of Medicine, Philadelphia, PA, United States
Title
Hospitalization and cognitive decline: Can the nature of the relationship
be deciphered?.
Source
American Journal of Geriatric Psychiatry. 22 (5) (pp 465-480), 2014. Date
of Publication: May 2014.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Evidence for a relationship between hospitalization and
incident cognitive decline exists mainly in the literature focusing on
critical care hospitalization. Recent studies, however, have also found an
association between noncritical care hospitalization and the development
of cognitive decline. Objective: This article will review the literature
pertaining to hospitalization and cognitive decline, including
hospitalizations for both critical and noncritical care, and in medical
and surgical patients. The article will also explore the various factors
that have been implicated in the development of cognitive decline and
dementia. Methods: Review of the literature was completed using PubMed and
Medline search programs. Results: Several articles supporting evidence for
the association between hospitalization and cognitive decline are
available. Evidence for potential mediating factors also does exist.
Conclusions: There is evidence to support an association between
hospitalization and development of cognitive decline. Factors that could
mediate this association include, but may not be limited to, delirium,
medications, stress, and depression. There is a need for further research
in this area in order to better understand the underlying pathophysiology
involved in the development of cognitive decline and dementia and to
determine if preventive measures might be beneficial in decreasing risk
for cognitive decline for patients who are hospitalized 2014 American
Association for Geriatric Psychiatry.

<3>
Accession Number
2014362421
Authors
Gandhi H. Shah B. Patel R. Toshani R. Pujara J. Kothari J. Shastri N.
Institution
(Gandhi, Shah, Patel, Toshani, Pujara, Shastri) Department of Cardiac
Anesthesia, Uttambhai Nathalal Mehta Institute of Cardiology and Research
Center, Sir Byramjee Jeejeebhoy Medical College, Ahmadabad, Gujarat, India
(Kothari) Department of Cardio Vascular Thoracic Surgery, Uttambhai
Nathalal Mehta Institute of Cardiology and Research Center, Sir Byramjee
Jeejeebhoy Medical College, Ahmadabad, Gujarat, India
Title
Effect of preoperative oral sildenafil on severe pulmonary artery
hypertension in patients undergoing mitral valve replacement.
Source
Indian Journal of Pharmacology. 46 (3) (pp 281-285), 2014. Date of
Publication: May-June 2014.
Publisher
Medknow Publications (B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai 400 075, India)
Abstract
Aim: Long standing mitral valve disease is usually associated with severe
pulmonary hypertension. Perioperative pulmonary hypertension is a risk
factor for right ventricular (RV) failure and a cause for morbidity and
mortality in patients undergoing mitral valve replacement.
Phosphodiesterase 5 inhibitor-sildenafil citrate is widely used to treat
primary pulmonary hypertension. There is a lack of evidence of effects of
oral sildenafil on secondary pulmonary hypertension due to mitral valve
disease. The study aims to assess the effectiveness of preoperative oral
sildenafil on severe pulmonary hypertension and incidence of RV failure in
patients undergoing mitral valve replacement surgery. Materials and
Methods: A total of 40 patients scheduled for mitral valve replacement
with severe pulmonary hypertension (RV systolic pressure (RVSP) >60 mmHg)
on preoperative transthoracic echo were randomly treated with oral
sildenafil 25 mg (N = 20) or placebo (N = 20) eight hourly for 24 h before
surgery. Hemodynamic variables were measured 20 min after insertion of
pulmonary artery catheter (PAC) under anesthesia (T1), 20 min at weaning
from cardiopulmonary bypass (CPB) (T2) and after 1,2, and 6 h (T3, T4, T5,
respectively) during the postoperative period. Results: Systolic and mean
pulmonary artery pressure (MPAP) and pulmonary vascular resistance index
(PVRI) were significantly lower (P < 0.0001) in sildenafil group at all
times. Ventilation time and postoperative recovery room stay were
significantly lower (P < 0.001) in sildenafil group. Conclusion:
Sildenafil produces significant pulmonary vasodilatory effect as compared
with placebo in mitral valve replacement patients with severe pulmonary
hypertension. It also reduces ventilation time and intensive care unit
(ICU) stay time as compared with placebo. It is concluded that sildenafil
is effective in reducing pulmonary hypertension when administered
preoperatively in patients with severe pulmonary hypertension undergoing
mitral valve replacement surgery.

<4>
Accession Number
2014359705
Authors
Bergmann N. Ballegaard S. Bech P. Hjalmarson A. Krogh J. Gyntelberg F.
Faber J.
Institution
(Bergmann, Krogh, Faber) Herlev University Hospital, Department of
Endocrinology, Herlev, Denmark
(Ballegaard) Ull Care A/S, Hellerup, Denmark
(Bech) Psychiatric Research Unit, Psychiatric Centre North Zealand,
Hillerod, Denmark
(Hjalmarson) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Gyntelberg) National Research Centre for the Working Environment,
Copenhagen, Denmark
(Faber) Faculty of Health Sciences, Copenhagen University, Copenhagen,
Denmark
Title
The effect of daily self-measurement of pressure pain sensitivity followed
by acupressure on depression and quality of life versus treatment as usual
in ischemic heart disease: A randomized clinical trial.
Source
PLoS ONE. 9 (5) , 2014. Article Number: e97553. Date of Publication: 21
May 2014.
Publisher
Public Library of Science
Abstract
Background: Depressive symptoms and reduced quality of life (QOL) are
parts of the chronic stress syndrome and predictive of adverse outcome in
patients with ischemic heart disease (IHD). Chronic stress is associated
with increased sensitivity for pain, which can be measured by algometry as
Pressure Pain Sensitivity (PPS) on the sternum. Aim: To evaluate if stress
focus by self-measurement of PPS, followed by stress reducing actions
including acupressure, can decrease depressive symptoms and increase
psychological well-being in people with stable IHD. Design: Observer
blinded randomized clinical trial over 3 months of either intervention or
treatment as usual (TAU). Statistical analysis: Intention to treat.
Methods: Two hundred and thirteen participants with IHD were included: 106
to active treatment and 107 to TAU. Dropout: 20 and 12, respectively. The
active intervention included self-measurement of PPS twice daily followed
by acupressure as mandatory action, aiming at a reduction in PPS. Primary
endpoint: change in depressive symptoms as measured by Major depression
inventory (MDI). Other endpoints: changes in PPS, Well-being (WHO-5) and
mental and physical QOL (SF-36). Results: At 3 months PPS decreased 28%,
to 58, in active and 11%, to 72, in TAU, p<0.001. MDI decreased 22%, to
6.5, in active group vs. 12%, to 8.3 in TAU, p = 0.040. WHO-5 increased to
71.0 and 64.8, active group and TAU, p = 0.015. SF-36 mental score sum
increased to 55.3 and 53.3, active and TAU, p = 0.08. Conclusions: PPS
measurements followed by acupressure reduce PPS, depressive symptoms and
increase QOL in patients with stable IHD. Trial Registration:
ClinicalTrials.gov NCT01513824 2014 Bergmann et al.

<5>
Accession Number
2014359444
Authors
Zhang X. Xie J. Li G. Chen Q. Xu B.
Institution
(Zhang, Xie, Li, Chen, Xu) Department of Cardiology, Affiliated Drum Tower
Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
Title
Head-to-head comparison of sirolimus-eluting stents versus
paclitaxel-eluting stents in patients undergoing percutaneous coronary
intervention: A meta-analysis of 76 studies.
Source
PLoS ONE. 9 (5) , 2014. Article Number: e97934. Date of Publication: 20
May 2014.
Publisher
Public Library of Science
Abstract
Background: The relative short-, long- and overall-term efficacy and
safety of sirolimus-eluting stents (SES, Cypher) compared with
paclitaxel-eluting stents (PES, Taxus) in large head-to-head comparisons
still remain to be defined. Methods: We searched Pubmed, EMBASE, and the
Cochrane Central Register of Controlled Trials (CENTRAL) for articles
comparing outcomes of interest between SES and PES without language
restriction. Short- (<1 year), long- (>1 year), and overall-term (the
longest follow-up of each study) outcomes were evaluated. The primary
endpoint was target lesion revascularization (TLR). Other outcomes of
interest were target vessel revascularization (TVR), myocardial
infarction, all-cause death, cardiac death, stent thrombosis, major
adverse cardiac events (MACEs), restenosis and late lumen loss. Results:
Seventy-six studies including more than 15000 patients in randomized
controlled trials and over 70000 patients in adjusted observational
studies were included. At overall-term follow-up, SES significantly
reduced TLR (relative risk [RR]: 0.61; 95% confidence interval [CI]:
0.49-0.76), TVR (RR: 0.67; 95% CI: 0.54-0.83), MACE (RR: 0.79; 95% CI:
0.72-0.87), myocardial infarction (RR: 0.85; 95% CI: 0.73-0.99),
in-segment restenosis (RR: 0.50; 95% CI: 0.38-0.65), and in-segment late
lumen loss (weighted mean difference [WMD]: -0.19; 95% CI: -0.24--0.14) in
randomized controlled trials compared with PES. In addition, lower rates
of death (RR: 0.91; 95% CI: 0.83-1.00), any stent thrombosis (RR: 0.62;
95% CI: 0.45-0.86), definite stent thrombosis (RR: 0.59; 95% CI:
0.45-0.77) were found in patients receiving SES in adjusted observational
studies. Largely similar results were found at short- and long-term
follow-up, and in patients with diabetes, acute myocardial infarction or
long lesions. Conclusions: SES significantly reduced the short-, long- and
overall-term risk of TLR/TVR, MACE, and restenosis, and overallterm risk
of myocardial infarction in randomized controlled trials, as compared with
PES. Lower rates of death and stent thrombosis were also observed in
observational studies in SES-treated patients. 2014 Zhang et al.

<6>
Accession Number
2014366015
Authors
De Ferrari G.M. Fox K.A. White J.A. Giugliano R.P. Tricoci P. Reynolds
H.R. Hochman J.S. Gibson C.M. Theroux P. Harrington R.A. Van De Werf F.
White H.D. Califf R.M. Newby L.K.
Institution
(De Ferrari) Department of Cardiology, Fondazione IRCCS Policlinico San
Matteo, Pavia, Italy
(Fox) Centre for Cardiovascular Science, University of Edinburgh, United
Kingdom
(White, Tricoci, Califf, Newby) Duke Clinical Research Institute, Duke
University Medical Center, Durham, United States
(Giugliano) TIMI Study Group, Brigham and Women's Hospital, Boston, United
States
(Reynolds, Hochman) Cardiovascular Clinical Research Center, NYU School of
Medicine, New York, United States
(Gibson) Interventional Cardiology, Beth Israel Deaconess Medical Center,
Boston, United States
(Theroux) Institut de Cardiologie de Montreal, Universite de Montreal,
Quebec, Canada
(Harrington) Department of Medicine, Stanford University, United States
(Van De Werf) University Hospital Gasthuisberg and Leuven Coordinating
Center, Belgium
(White) Green Lane Cardiovascular Service, Auckland City Hospital, New
Zealand
Title
Outcomes among non-ST-segment elevation acute coronary syndromes patients
with no angiographically obstructive coronary artery disease: Observations
from 37,101 patients.
Source
European Heart Journal: Acute Cardiovascular Care. 3 (1) (pp 37-45), 2014.
Date of Publication: 2014.
Publisher
SAGE Publications Inc.
Abstract
Aims: Limited data exist concerning outcomes of patients with
non-ST-segment elevation acute coronary syndromes (NSTE ACS) with no
angiographically obstructive coronary artery disease (non-obstructive
CAD). We assessed the frequency of clinical outcomes among patients with
non-obstructive CAD compared with obstructive CAD. Methods and results: We
pooled data from eight NSTE ACS randomized clinical trials from 1994 to
2008, including 37,101 patients who underwent coronary angiography. The
primary outcome was 30-day death or myocardial infarction (MI). Adjusted
odds ratios (ORs) and 95% confidence intervals (CIs) for 30-day death or
MI for non-obstructive versus obstructive CAD were generated for each
trial. Summary ORs (95% CIs) across trials were generated using random
effects models. Overall, 3550 patients (9.6%) had non-obstructive CAD.
They were younger, more were female, and fewer had diabetes mellitus,
previous MI or prior percutaneous coronary intervention than patients with
obstructive CAD. Thirty-day death or MI was less frequent among patients
with non-obstructive CAD (2.2%) versus obstructive CAD (13.3%) (ORadj
0.15; 95% CI, 0.11-0.20); 30-day death or spontaneous MI and six-month
mortality were also less frequent among patients with non-obstructive CAD
(ORadj 0.19 (0.14-0.25) and 0.37 (0.28-0.49), respectively). Conclusion:
Among patients with NSTE ACS, one in 10 had non-obstructive CAD. Death or
MI occurred in 2.2% of these patients by 30 days. Compared with patients
with obstructive CAD, the rate of major cardiac events was lower in
patients with non-obstructive CAD but was not negligible, prompting the
need to better understand management strategies for this group. The
European Society of Cardiology 2013.

<7>
Accession Number
2014362538
Authors
Benhamed L. Woelffle D.
Institution
(Benhamed, Woelffle) Department of Thoracic and Vascular Surgery,
Valenciennes Hospital, Centre Hospitalier de Valenciennes, Avenue
Desandrouin, 59322 Valenciennes cedex, France
Title
Adjuvant antifungal therapy after pulmonary surgery for aspergilloma: Is
it useful?.
Source
Interactive Cardiovascular and Thoracic Surgery. 18 (6) (pp 835-837),
2014. Date of Publication: June 2014.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was whether adjuvant
antifungal therapy is useful after pulmonary surgery for aspergilloma. One
hundred and sixteen papers were identified using the search described
below, of which 5 papers presented the best evidence to answer the
clinical question. The authors, journal, date and country of publication,
patient group studied, study type, relevant outcomes and results of these
papers are tabulated. No paper was greater than level-three evidence. One
study compared the outcomes of 72 patients treated for pulmonary
aspergilloma (PA) during a 23-year period. Despite no difference being
found in outcomes, more complications were seen in the surgery-alone
group. Another study included 14 patients treated with amphotericin B
alone or with flucytocine. They found no benefit in the treatment of PA by
systemic antifungal therapy. One retrospective study reported complete
eradication of PA in patients treated with preoperative and postoperative
oral itraconazole. One large cohort study reported their outcomes in 256
patients with PA, divided into two groups: Group A (simple aspergilloma, n
= 96) and Group B (complex aspergilloma, n = 160) after aggressive
surgical treatment and antifungal therapy. They found no difference in the
postoperative morbidity between two groups (P = 0.27). A postoperative
fungal relapse was found in 2 patients. One retrospective study reported
the outcomes and mortality in 61 cases with PA. Thirty-five (60%) patients
were treated with antifungal agents, and 15 (25%) patients were treated
surgically. Many cases did not respond to antifungal therapy. Nineteen
(31%) patients died. We did not find evidence to support the role of
adjuvant antifungal therapy following definitive surgical removal of the
fungus ball in immunocompetent patients; however, randomized control
studies in multiple centres, with new antifungal therapy, are necessary to
confirm these preliminary results. 2014 The Author 2014. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<8>
Accession Number
2014362535
Authors
Kiessling A.-H. Guo F.W. Gokdemir Y. Thudt M. Reyher C. Scherer M.
Beiras-Fernandez A. Moritz A.
Institution
(Kiessling, Guo, Gokdemir, Thudt, Beiras-Fernandez, Moritz) Department of
Thoracic and Cardiovascular Surgery, Goethe University Hospital Frankfurt
Am Main, Theodor Stern Kai 7, 60590 Frankfurt am Main, Germany
(Reyher) Department of Anaesthesiology and Intensive Care, Goethe
University Hospital Frankfurt Am Main, Frankfurt am Main, Germany
(Scherer) Department for Cardiac Surgery, UKM University Clinic, Munster,
Germany
Title
The influence of selective pulmonary perfusion on the inflammatory
response and clinical outcome of patients with chronic obstructive
pulmonary disease undergoing cardiopulmonary bypass.
Source
Interactive Cardiovascular and Thoracic Surgery. 18 (6) (pp 732-739),
2014. Date of Publication: June 2014.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES Patients undergoing cardiac surgery presenting with chronic
obstructive pulmonary disease (COPD) have a higher 30-day mortality risk.
In these patients, pulmonary dysfunction linked to an inflammatory
response is frequent after cardiac operations using cardiopulmonary bypass
(CPB), which causes pulmonary hypoperfusion. We hypothesize that selective
pulmonary perfusion (sPP) of the lungs leads to a reduction of pulmonary
inflammation and a better clinical outcome. METHODS Fifty-nine COPD
patients (forced expiratory volume in 1 s/vital capacity <70%) undergoing
cardiac surgery procedures (coronary artery bypass grafting 64%, valve
14%) were block-randomized to sPP (venous blood, temperature 2degreeC, 4
l) or standard CPB (28/28). The primary end-point of the study was to
evaluate the effect of pulmonary perfusion on gas exchange by measuring
alveolar-arterial oxygen gradient. The surrogate end-points were
inflammatory response, intensive care unit (ICU) stay, time on respirator
(TOR) and major adverse cardiac and cerebrovascular events. A cytokine
assay for interleukin-1beta, IL-6, IL-10, tumour necrosis factor-alpha
(TNF-alpha) and polymorphonuclear elastase was performed with peripheral
blood at different time-points [(t1) pre-CPB, (t2) end of CPB, (t3) 3 h,
(t4) 24 h, (t5) 48 h postoperatively]. Repeated-measure analysis of
variance and non-parametric statistics were used to assess the
between-group and during time differences. RESULTS The two groups proved
comparable for perioperative variables. Serum cytokines were not different
in the two groups throughout the study (P > 0.05 at single time-points),
but as a function of time, the markers of the inflammatory response
increased after CBP (P < 0.05 pre-CPB to 24 h). Clinical end-points were
statistically comparable in both groups, but with a trend towards a
shorter TOR (72 + 159 h/106 + 193 h) and ICU stay (3.9 + 7.2 days/5.5 +
9.2 days) in the sPP group despite a slightly longer time on
extracorporeal circulation (120 vs 158 min). CONCLUSIONS These results
indicate a non-significant trend that repeated hypothermic lung perfusion
with venous blood during CPB may have a protective effect on the lungs. A
multicentre study design and larger cohort seem necessary to demonstrate
the benefits of sPP more clearly. 2014 The Author 2014. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<9>
Accession Number
2014362534
Authors
Wang S. Huang D. Ma Q. Chen X.
Institution
(Wang, Huang, Ma, Chen) Department of Thoracic Surgery, Huashan Hospital,
Fudan University, Shanghai, China
Title
Does ambroxol confer a protective effect on the lungs in patients
undergoing cardiac surgery or having lung resection?.
Source
Interactive Cardiovascular and Thoracic Surgery. 18 (6) (pp 830-834),
2014. Date of Publication: June 2014.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
A best evidence topic in perioperative care was written according to a
structured protocol. The question addressed was 'Does ambroxol confer a
protective effect on the lung in patients undergoing cardiac surgery or
having lung resection?' A total of 247 papers were found using the
reported search, of which 7 represented the best evidence to answer the
clinical question. The authors, journal, date and country of publication,
patient group studied, study type, relevant outcomes and results of these
papers were tabulated. Several studies indicate that for patients with
chronic obstructive pulmonary disease (COPD) who undergo cardiac surgery
or upper abdominal surgery, perioperative ambroxol administration is
associated with improved pulmonary function and reduced postoperative
pulmonary complications (PPCs). In patients with pulmonary lobectomy,
large-dose ambroxol treatment (1000 mg/day for 3 days) is correlated with
reduced PPCs (6 vs 19%, P = 0.02), decreased postoperative hospital stay
(5.6 vs 8.1 days, P = 0.02) and lower postoperative cost (2499 vs 5254 , P
= 0.04) compared with low-dose ambroxol treatment. Ambroxol also has a
protective effect on the lungs during extracorporeal bypass, ameliorating
inflammatory reaction and oxygen stress and preserving pulmonary
surfactant. However, there is no evidence for any advantage of reducing
PPCs after extracorporeal circulation. We conclude that perioperative
application of ambroxol, a versatile mucoactive drug, particularly in high
doses, is associated with lower PPCs, especially in high-risk patients
with fundamental lung disease such as COPD. Large doses of ambroxol are
correlated with even lower PPCs after lung resection. We recommend that
routine intravenous ambroxol should be used in large doses in high-risk
patients in the perioperative period to reduce the risk of PPCs. 2014 The
Author 2014. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<10>
Accession Number
2014362528
Authors
Kouvelos G.N. Koutsoumpelis A. Peroulis M. Matsagkas M.
Institution
(Kouvelos, Koutsoumpelis, Peroulis, Matsagkas) Department of Surgery,
Medical School, University of Ioannina, S. Niarchos Avenue, 45110
Ioannina, Greece
Title
In endovascular aneurysm repair cases, when should you consider internal
iliac artery embolization when extending a stent into the external iliac
artery?.
Source
Interactive Cardiovascular and Thoracic Surgery. 18 (6) (pp 821-824),
2014. Date of Publication: June 2014.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
A best evidence topic was constructed according to a structured protocol.
The question addressed was whether internal iliac artery (IIA)
embolization is necessary for achieving the best clinical outcome in all
patients when extension of the stent graft to the external iliac artery is
required. Altogether more than 400 papers were found using the reported
search, of which 5 represented the best evidence to answer the clinical
question. The authors, journal, date and country of publication, patient
group studied, study type, relevant outcomes and results of these papers
are tabulated. There is a significant gap in the current literature
regarding the subset of patients that may benefit from an IIA embolization
during endovascular aneurysm repair (EVAR) as indications have not been
clearly defined. There are several situations concerning a small number of
patients, that IIA embolization might be beneficial in preventing endoleak
not only to the common iliac artery but also to the aortic aneurysmal sac.
For the majority of patients requiring extension of the stent graft to the
external iliac artery, the current evidence, even retrospective in nature
and reporting on small numbers of patients, shows that IIA embolization
seems to be associated with worse clinical outcome, mostly raising the
risk for new-onset buttock claudication. It seems that not all patients
require embolization, as IIA coverage solely by the stent graft was not
associated with a significant higher rate of type II endoleak in either
study. Furthermore, coil embolization in the largest study so far was
associated with higher procedure and fluoroscopy time and amount of
contrast media, facts that should not be neglected. However the
above-mentioned results should be taken into account with caution, as all
studies were retrospective and reported on small number of patients. 2014
The Author 2014. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<11>
Accession Number
2014362519
Authors
Ahmed N. Gollop N.D. Ellis J. Khan O.A.
Institution
(Ahmed) Institute of Cardiovascular and Medical Sciences, University of
Glasgow, Glasgow, United Kingdom
(Gollop) Norfolk and Norwich University Hospital, Colney Lane, Norwich,
NR4 7UY Norfolk, United Kingdom
(Ellis) Queen Elizabeth Hospital Norfolk, United Kingdom
(Khan) Department of Upper GI Surgery, St Georges Hospital, London, United
Kingdom
Title
How does elective laparoscopic abdominal aortic aneurysm repair compare to
endovascular aneurysm repair?.
Source
Interactive Cardiovascular and Thoracic Surgery. 18 (6) (pp 814-820),
2014. Date of Publication: June 2014.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
A best evidence topic in surgery was written according to a structured
protocol. The question addressed was how elective laparoscopic abdominal
aortic aneurysm (AAA) repair compared to endovascular aneurysm repair
(EVAR) in terms of survival. There were 229 papers found using the
reported search, with 8 papers (5 prospective studies, 1 retrospective
study, 1 randomized trial and 1 systematic review) representing the best
evidence to answer the question proposed. Current evidence suggests that
EVAR is the preferred surgical approach for AAA repair, due to shorter
hospital stay and lower perioperative morbidity and mortality rates, as
opposed to an open surgical approach. Despite this, EVAR is subject to a
number of limitations, including device restrictions in patients with
anatomical variations as well as increased risk of future complications
stemming from device implantation. We discuss a key study that showed that
complications in the EVAR group commonly included endoleak type II and
graft thrombosis. More importantly, there were similar rates of
complications between those patients receiving EVAR and those receiving
minimally invasive aortic surgery. The evidence suggests that elective
laparoscopic AAA repair has a favourable safety profile comparable with
that of EVAR, with low conversion rates as well as similar mortality and
morbidity rates. This has been illustrated in several studies. We discuss
a prospective randomized trial of 100 patients, which compared EVAR with
hand-assisted laparoscopic surgery. This study showed no deaths in either
group after the procedure or at follow-up after 12 months, with similar
complication rates between the groups. While the evidence suggests that
EVAR is less invasive, it does not always significantly alter the
postoperative course or length of hospital stay for patients. We conclude
from the evidence available that elective laparoscopic AAA repair may have
a role in those patients who are unsuitable for EVAR. Unfortunately, few
studies exist directly comparing these two techniques, and those that do
are subject to limitations, for example, study population bias, small
sample sizes and a lack of comparison in the literature between the common
AAA repair techniques. 2014 The Author 2014. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<12>
Accession Number
2014362516
Authors
Talwar S. Kumar M.V. Choudhary S.K. Airan B.
Institution
(Talwar, Kumar, Choudhary, Airan) Cardiothoracic Centre, All India
Institute of Medical Sciences, New Delhi 110029, India
Title
Conventional versus adjustable pulmonary artery banding: Which is
preferable?.
Source
Interactive Cardiovascular and Thoracic Surgery. 18 (6) (pp 838-841),
2014. Date of Publication: June 2014.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was 'whether conventional
pulmonary artery banding (PAB) or adjustable PAB might be the superior
intervention?' Using the PubMed search, 51 papers were found, of which
seven papers represented the best evidence to answer the clinical
question. We included only those papers that actually compared
conventional PAB with adjustable PAB, and excluded those that studied only
one of these interventions. Four studies qualified (one prospective and
three retrospective) and analysed data in human patients, while three were
experimental studies in animals. The end points in the prospective human
study were death, debanding and follow-up to intracardiac repair. The
three retrospective studies compared the incidence of early deaths,
inotropic support, need for mechanical ventilatory support, reoperations
and intensive care unit and hospital stay. Out of the four studies in
humans, three studies noted a significant reduction in early deaths from
23 to 1.8%, 77 to 0% and 15 to 0% in conventional vs adjustable PAB. Need
for early reoperations reduced from 18 to 3.5% and from 35 to 0% in 2
studies. Similarly, there was a reduction in the ventilatory times and the
intensive care unit and hospital stay. The three experimental animal
studies demonstrated that a much more reliable preparation of the
ventricle was achieved with the use of an adjustable PAB. The results of
all the seven studies led us to conclude that adjustable PAB provides
superior early outcomes; reduces early mortality, need for inotropes and
need for reintervention; and provides equivalent or superior band
gradients when compared to conventional PAB. The use of the adjustable PAB
was found to result in significant haemodynamic improvement by
progressively reducing the pulmonary artery pressures and left-to-right
shunt. The adjustable PAB was found to improve early survival and also
made delayed repair feasible in a better clinical state, with reduced
mortality and morbidity. 2014 The Author 2014. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<13>
Accession Number
2014362514
Authors
Takagi H. Watanabe T. Mizuno Y. Kawai N. Umemoto T.
Institution
(Takagi, Watanabe, Mizuno, Kawai, Umemoto) Department of Cardiovascular
Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun,
Shizuoka 411-8611, Japan
Title
A review with meta-analysis of observational studies for survival
following off-pump coronary artery bypass versus drug-eluting stent
implantation.
Source
Interactive Cardiovascular and Thoracic Surgery. 18 (6) (pp 807-813),
2014. Date of Publication: June 2014.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
To determine whether off-pump coronary artery bypass (OPCAB) improves
survival over drug-eluting stent (DES) implantation, we performed a review
with meta-analysis of exclusive OPCAB versus DES. Databases including
MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials
were searched through October 2013 using Web-based search engines (PubMed
and OVID). Studies that met the following criteria were considered for
inclusion: the design was a randomized controlled trial or observational
comparative study; the study population was patients with any coronary
artery disease; patients were assigned to OPCAB versus DES and outcomes
included all-cause mortality at >1 years. Our exhaustive search identified
no randomized trial and 10 observational studies of OPCAB versus DES. A
pooled analysis demonstrated no statistically significant difference in
all-cause mortality between OPCAB and DES (hazard ratio, 0.94; 95%
confidence interval, 0.76-1.15; P = 0.55). In general, exclusion of any
single study from the analysis did not substantially alter the overall
result of our analysis. There was no evidence of significant publication
bias. In conclusion, OPCAB may not improve survival over DES despite
greater number of treated vessels in OPCAB than in DES or greater number
of distal anastomosis in OPCAB than that of implanted stents in DES. 2014
The Author 2014. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<14>
Accession Number
2014362511
Authors
Cherniavsky A. Kareva Y. Pak I. Rakhmonov S. Pokushalov E. Romanov A.
Karaskov A.
Institution
(Cherniavsky, Kareva, Pak, Rakhmonov) Department of Surgery, Aorta,
Coronary and Peripheral Arteries, Novosibirsk Research Institute of
Circulation Pathology, Stroiteley Street 9, 46, Novosibirsk, Russian
Federation
(Pokushalov, Romanov) Department of Rhythm Disorders of the Heart,
Novosibirsk Research Institute of Circulation Pathology, Novosibirsk,
Russian Federation
(Karaskov) Novosibirsk Research Institute of Circulation Pathology,
Novosibirsk, Russian Federation
Title
Assessment of results of surgical treatment for persistent atrial
fibrillation during coronary artery bypass grafting using implantable loop
recorders.
Source
Interactive Cardiovascular and Thoracic Surgery. 18 (6) (pp 727-731),
2014. Date of Publication: June 2014.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES We report our experience with a modified mini-maze procedure
and pulmonary vein isolation using radiofrequency energy for treating
persistent atrial fibrillation during coronary artery bypass grafting
(CABG). METHODS Ninety-five patients with persistent atrial fibrillation
and coronary heart disease underwent open heart surgery combined with
intraoperative irrigated radiofrequency ablation. Patients were randomized
into the following three groups: CABG and irrigated radiofrequency
pulmonary vein isolation (CABG+PVI, n = 31); CABG and an irrigated
radiofrequency modified mini-maze procedure (CABG+MM, n = 30); and
isolated CABG (CABG alone, n = 34). All patients received implantable loop
recorders. RESULTS No reoperation and no hospital mortality were recorded.
Mean follow-up was 14.4 + 9.7 months. The implantable loop
recorder-determined freedom from atrial fibrillation was 80% in the
CABG+PVI group, 86.2% in the CABG+MM group and 44.1% in the CABG alone
group. CONCLUSIONS Patients with concomitant atrial fibrillation and
coronary heart disease may benefit from intraoperative ablation to prevent
relapse of arrhythmia. 2014 The Author 2014. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<15>
Accession Number
2014362509
Authors
Hassouna A. Allam H.
Institution
(Hassouna) Department of Cardiothoracic Surgery, Faculty of Medicine, Ain
Shams University Hospitals, PO Box 93, Elmukattam, 11571 Cairo, Egypt
(Allam) Department of Complementary Medicine, National Research Center,
Giza, Egypt
Title
Limited dose warfarin throughout pregnancy in patients with mechanical
heart valve prosthesis: A meta-analysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 18 (6) (pp 797-806),
2014. Date of Publication: June 2014.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
The continuation of warfarin throughout pregnancy in patients with a
mechanical valve prosthesis is a valid anticoagulation regimen, provided
that warfarin dose does not exceed 5 mg/day. Two decades after being
introduced, the efficacy and safety of this regimen merit evaluation. We
performed a systematic review for cases published between January 1991 and
January 2013. We compiled our prospective data on 55 pregnancies and
calculated pooled estimates (95% confidence interval) of adverse foetal
and maternal outcomes. Events were expressed as proportions of total
pregnancies, except embryopathy and maternal death, which were related to
the number of live births and number of patients, respectively. There were
494 eligible pregnancies reported in 11 studies. The rate of embryopathy
was 0.9% (0.4-2.4%) and most of the 13.4% (8.4-24.7%) foetal losses were
due to the 12.8% (7.7-22.7%) rate of spontaneous abortion. No maternal
mortality was encountered (0-1.3%) but 0.6% (0.3-2%) prosthetic valve
thrombosis, 1.8% (1.1-3.6%) total thromboembolic events and 3.4% (2-5.1%)
major maternal bleeding events were recorded. Foetal loss, spontaneous
abortions and foetal embryopathy dropped to 8.1% (2.9-13.7%), 7.3%
(3.1-11.8%) and 0.6% (0.1-2.1%) among the 344 pregnancies (69.6%) observed
in the 6 prospective studies (54.5%). Prosthetic valve thrombosis (0.6%;
01-2%), total thromboembolic (2.3%; 1.2-4.6%) and major bleeding events
(2.9%; 1.8-6%) remained comparable with overall results. Foetal
embryopathy and prosthetic valve thrombosis were not robust on sensitivity
analysis, regardless of the study design. A prospective subgroup of 96
patients (19.4%) received smaller warfarin dose, through targeting a lower
international normalized ratio (INR) between 1.5 and 2.5. The associated
rate of foetal loss (2.1%; 0.5-6.9%) was significantly lower than that
observed in the remaining patients targeting a higher INR between 2.5 and
3.5 (16.1%; 13.1-34.4%). Adverse maternal outcomes were also fewer but
rates remained comparable. Limited dose warfarin throughout pregnancy was
associated with improved foetal outcomes, without jeopardizing maternal
safety. Foetal outcomes were better when patients were followed up
prospectively or receiving smaller warfarin doses through targeting a
lower INR than recommended (1.5-2.5). Large randomized controlled trials
are mandatory to evaluate our findings. 2014 The Author 2014. Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<16>
Accession Number
2014358690
Authors
Zhang X.-D. Gu J. Jiang W.-F. Zhao L. Zhou L. Wang Y.-L. Liu Y.-G. Liu X.
Institution
(Zhang, Gu, Jiang, Zhao, Zhou, Wang, Liu, Liu) Department of Cardiology,
Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, 241
West Huaihai Road, Shanghai 200030, China
Title
Optimal rhythm-control strategy for recurrent atrial tachycardia after
catheter ablation of persistent atrial fibrillation: A randomized clinical
trial.
Source
European Heart Journal. 35 (20) (pp 1327-1334), 2014. Date of Publication:
21 May 2014.
Publisher
Oxford University Press
Abstract
Aim: Although catheter ablation (CA) has replaced antiarrhythmic drugs
(AAD) as first-line treatment in selected patients with atrial
fibrillation (AF), optimal treatment of recurrent atrial tachycardia (AT)
after AF ablation remains unclear. This parallel randomized controlled
study compared CA vs. AAD for recurrent AT after persistent AF ablation.
Methods and results: Two-hundred and one patients (aged 59.1 + 10.9 years,
68.7% male) with recurrent AT after persistent AF ablation were enrolled
and randomized to either CA (n = 101) or AAD (n = 100) treatment. Primary
endpoint was freedom from recurrent atrial tachyarrhythmia (ATa, including
AT and AF) at 24-month follow-up. Composite secondary endpoints comprised
procedural complications, long-term morbidity and improvement in quality
of life (QoL). On an intention-to-treat basis, the CA group had a higher
rate of freedom from recurrent ATa (56.4 vs. 34.0%; P = 0.001). Adjusted
Cox regression analysis showed a significant treatment effect with a
hazard ratio of 0.538 (95% CI: 0.355-0.816) in favour of CA. There was a
higher proportion of periprocedural complications in the CA group (7.9 vs.
0; P = 0.012), and of long-term adverse events in the AAD group (10.9 vs.
24.0%; P = 0.014). Quality of life was significantly higher for CA.
Conclusions: This study demonstrates superiority of CA over AAD for
recurrent AT after persistent AF ablation with regard to SR maintenance,
long-term safety and QoL improvement. However, CA use might be limited by
a higher risk for periprocedural complications. The Author 2014.

<17>
Accession Number
2014355323
Authors
Mahdanian A.A. Rej S. Bacon S.L. Ozdin D. Lavoie K.L. Looper K.
Institution
(Mahdanian, Rej, Ozdin, Looper) McGill University, Jewish General
Hospital, Department of Psychiatry, 1033 Pine Avenue West Montreal,
Montreal, QC H3A 1A1, Canada
(Mahdanian, Bacon, Lavoie) Hopital du Sacre-Coeur de Montreal, Montreal
Behavioural Medicine Centre, Montreal, Canada
(Mahdanian) McGill University Health Centre, Department of Surgery, Cedars
Clinic, Montreal, Canada
(Bacon) Concordia University, Department of Exercise Sciences, Montreal,
Canada
(Lavoie) University of Quebec at Montreal (UQAM), Department of
Psychology, Montreal, Canada
Title
Serotonergic antidepressants and perioperative bleeding risk: A systematic
review.
Source
Expert Opinion on Drug Safety. 13 (6) (pp 695-704), 2014. Date of
Publication: June 2014.
Publisher
Informa Healthcare
Abstract
Introduction: Serotonergic antidepressants (SAds) are known to increase
bleeding events, with a number of recent studies investigating this risk
in surgical settings. Our main objective was to synthesize the current
evidence to evaluate the clinical importance of SAd-related bleeding risk
in the perioperative period. Methods: A systematic review of MEDLINE,
Embase and PsychINFO until November 2013 was conducted in compliance with
the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
statement. We examined the risk of perioperative bleeding adverse events
in SAd users in comparison to controls. Results: A total of 13 relevant
studies were identified across a broad variety of surgical procedures.
SAds were associated with an increased risk of perioperative bleeding
(odds ratios [ORs] = 1.21-4.14) and blood transfusions (ORs = 0.93-3.71).
Conclusions: SAds are associated with increased perioperative bleeding
events, particularly abnormal bleeding and blood transfusions. From a
clinical perspective, the potential bleeding risks of SAds in surgical
settings need to be carefully weighed against their psychiatric benefits.
Future research will need to investigate potential strategies to mitigate
SAd-related bleeding risk in the surgical context. Informa UK, Ltd.

<18>
Accession Number
2014366588
Authors
Sarzaeem M. Shayan N. Bagheri J. Jebelli M. Mandegar M.
Institution
(Sarzaeem, Bagheri, Jebelli, Mandegar) Department of Cardiovascular
Surgery, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Shayan) Cardiac Surgery and Transplantation Research Center, Dr. Shariati
Hospital, Tehran, Iran, Islamic Republic of
Title
Low dose Colchicine in prevention of atrial fibrillation after coronary
artery bypass graft: A double blind clinical trial.
Source
Tehran University Medical Journal. 72 (3) (pp 147-154), 2014. Date of
Publication: 2014.
Publisher
Tehran University of Medical Sciences (TUMS) (No.59, Enayat Alley,
Poursina Ave., Ghods St.,Keshavarz Blv, Tehran, Iran, Islamic Republic of)
Abstract
Background: The occurrence of Atrial Fibrillation (AF) is linked to an
increased inflammatory response after cardiac surgery that is
significantly decreased by anti-inflammatory treatments. The present study
aimed at administrating Colchicine as a way to reduce the incidence of
post- Coronary Artery Bypass Graft (CABG) atrial fibrillation. Methods: In
this double-blind, parallel clinical trial, 216 patients with coronary
artery disease who underwent CABG surgery, by using a table of random
numbers are divided into intervention and control groups to receive
placebo or Colchicine. The clinical and surgical characteristics of the
patients in two groups were similar. The intervention group received 1.0
mg of Colchicine tab, the night before surgery and on the morning of
surgery. This drug followed by 0.5 mg twice a day for five days after
surgery. On the other hand patients in the control group received only
placebo (ineffective pill with similar size to Colchicine). After
operation two groups were compared regarding important outcomes such as
postoperative arrhythmia, ICU stay and hospital stay. The data were
assessed using SPSS software (version 17) and t-test and chi²
statistical tests. Results: One hundred fifty six men and sixty women with
a mean age of 59.9+9.3 years were enrolled in the study in two Colchicine
and placebo groups (each consisting of 108 patients). The incidence of
postoperative atrial fibrillation was 14.8% in the Colchicine group and
30.6% in the control group (P= 0.006). ICU stay in the Colchicine group
were 2.4+1.3 days versus 3.1+1.5 days in controls (P< 0.001) and hospital
stay in the Colchicine group were 6.6+1.5 days versus 8.1+2.0 days in
controls (P< 0.001). Conclusion: Colchicine is an anti-inflammatory
medication and has very few side effects at low doses. According to the
48% reduction in the incidence of atrial fibrillation in Colchicine
patients undergoing coronary artery bypass grafting surgery, this drug can
be prescribed as a prophylaxis for prevention of post-CABG atrial
fibrillation.

<19>
Accession Number
2014360236
Authors
Kim H.-L. Suh J.-W. Lee S.-P. Kang H.-J. Koo B.-K. Cho Y.-S. Youn T.-J.
Chae I.-H. Choi D.-J. Rha S.-W. Bae J.-H. Kwon T.-G. Bae J.-W. Cho M.-C.
Kim H.-S.
Institution
(Kim, Lee, Kang, Koo, Kim) Cardiovascular Center, Seoul National
University Hospital, Seoul, South Korea
(Rha) Cardiovascular Center, Korea University Guro Hospital, Seoul, South
Korea
(Kim) Department of Molecular Medicine and Biopharmaceutical Sciences,
Graduate School of Convergence Science and Technology, Seoul National
University, Seoul, South Korea
(Suh, Cho, Youn, Chae, Choi) Cardiovascular Center, Seoul National
University Bundang Hospital, Seongnam, South Korea
(Bae, Kwon) Heart Center, Konyang University Hospital, Daejon, South Korea
(Bae, Cho) Department of Internal Medicine, College of Medicine, Chungbuk
National University, Cheongju, South Korea
Title
Cilostazol eliminates adverse smoking outcome in patients with
drug-eluting stent implantation - Analysis of longer-term follow-up of the
CILON-T randomized trial -.
Source
Circulation Journal. 78 (6) (pp 1420-1427), 2014. Date of Publication:
2014.
Publisher
Japanese Circulation Society
Abstract
Background: The present study investigated whether cilostazol can
eliminate adverse smoking outcome after percutaneous coronary intervention
(PCI). Methods and Results: A total of 914 patients with successful
drug-eluting stent (DES) implantation were randomly assigned to dual
antiplatelet therapy (DAT; aspirin and clopidogrel, n=457) or to triple
antiplatelet therapy (TAT; DAT with cilostazol, n=457). The effect of
smoking on 2-year major adverse cardio/cerebrovascular events (MACCE) in
both the TAT and DAT groups was evaluated. Total MACCE were not
significantly different between the 2 anti-platelet regimens (9.8% in TAT
vs. 11.4% in DAT groups, P=0.45), but the adverse effects of smoking on
clinical outcome were different between DAT vs. TAT. Current smokers had a
higher prevalence of MACCE than non-smokers in the DAT group (16.7% vs.
9.5%, P=0.04). In the TAT group, however, the adverse effect of smoking
was abolished (9.2% vs. 10.1%, P=0.85). Regarding the effects of smoking
on the antiplatelet effects of DAT or TAT, post-treatment platelet
reactivity (in P2Y₁₂ reaction units; PRU) in current smokers
was not significantly lower than that in non-smokers in the DAT group,
whereas, in the TAT group, it was significantly lower than that of
non-smokers (189+88 vs. 216+89 PRU, P=0.01). Conclusions: Adverse clinical
effects of smoking may be eliminated by the addition of cilostazol to DAT
after DES implantation. This may be due to the stimulation of cilostazol's
antiplatelet effects by smoking.

<20>
Accession Number
2014363726
Authors
Gripari P. Muratori M. Fusini L. Tamborini G. Pepi M.
Institution
(Gripari, Muratori, Fusini, Tamborini, Pepi) Centro Cardiologico Monzino,
Istituto di ricovero e cura a carattere scientifico, Via Parea, 4, 20138
Milan, Italy
Title
Three-dimensional echocardiography: Advancements in qualitative and
quantitative analyses of mitral valve morphology in mitral valve prolapse.
Source
Journal of Cardiovascular Echography. 24 (1) (pp 1-9), 2014. Date of
Publication: January-March 2014.
Publisher
Masson SpA
Abstract
Degenerative mitral valve disease (MVD) is the leading cause of organic
mitral regurgitation (MR), one of the most common valvular heart disease
in western countries. Substantial progresses in the surgical treatment of
degenerative MVD have improved life expectancy of patients with
significant MR. However, prognosis, surgical decision and timing of
surgery strongly depend on the accurate characterization of mitral valve
(MV) anatomy and pathology and on the precise quantification of MR.
Three-dimensional (3D) echocardiography, a major technological
breakthrough in the field of cardiovascular imaging, provides several
advantages over two-dimensional (2D) imaging in the qualitative and
quantitative evaluations of MV apparatus. In this review, we focus on the
contribution of this new modality to the diagnosis of degenerative MVD,
the quantitative assessment of MR severity, the selection and monitoring
of surgical and percutaneous procedures, the evaluation of procedural
outcomes. The results of a systematic and exhaustive search of the
existing literature, restricted to real-time 3D echocardiography in
adults, are here reported.

<21>
Accession Number
2014362753
Authors
Long G.H. Cooper A.J.M. Wareham N.J. Griffin S.J. Simmons R.K.
Institution
(Long, Cooper, Wareham, Griffin, Simmons) MRC Epidemiology Unit,
University of Cambridge, School of Clinical Medicine, Cambridge, United
Kingdom
Title
Healthy behavior change and cardiovascularoutcomes innewly diagnosed type
2 diabetic patients: A cohort analysis of the addition-cambridge study.
Source
Diabetes Care. 37 (6) (pp 1712-1720), 2014. Date of Publication: June
2014.
Publisher
American Diabetes Association Inc.
Abstract
OBJECTIVE To examine whether improvements in health behaviors are
associated with reduced risk of cardiovascular disease (CVD) in
individuals with newly diagnosed type 2 diabetes. RESEARCH DESIGN AND
METHODS Population-based prospective cohort study of 867 newly diagnosed
diabetic patients aged between 40 and 69 years from the treatment phase of
the ADDITION-Cambridge study. Because the results for all analyses were
similar by trial arm, data were pooled, and results were presented for the
whole cohort. Participants were identified via population-based stepwise
screening between 2002 and 2006, and underwent assessment of physical
activity (European Prospective Investigation into Cancer-Norfolk Physical
Activity Questionnaire), diet (plasma vitamin C and self-report), and
alcohol consumption (self-report) at baseline and 1 year. A composite
primary CVD outcome was examined, comprised of cardiovascular mortality,
nonfatal myocardial infarction, nonfatal stroke, and revascularization.
RESULTS After a median (interquartile range) follow-up period of 5.0 years
(1.3 years), 6% of the cohort experienced a CVD event (12.2 per 1,000
person-years; 95% CI 9.3- 15.9). CVD risk was inversely related to the
number of positive health behaviors changed in the year after diabetes
diagnosis. The relative risk for primary CVD event in individuals who did
not change any health behavior compared with those who adopted three/four
healthy behaviors was 4.17 (95% CI 1.02-17.09), adjusting for age, sex,
study group, social class, occupation, and prescription of
cardioprotective medication (P for trend = 0.005). CONCLUSIONS CVD risk
was inversely associated with the number of healthy behavior changes
adopted in the year after the diagnosis of diabetes. Interventions that
promote early achievement of these goals in patients with newly diagnosed
diabetes could help reduce the burden of diabetes-related morbidity and
mortality. 2014 by the American Diabetes Association.

<22>
Accession Number
2014353429
Authors
Al Ali J. Franck C. Filion K.B. Eisenberg M.J.
Institution
(Al Ali) Division of Cardiology, McGill University Health Center,
Montreal, QC, Canada
(Franck, Filion, Eisenberg) Center for Clinical Epidemiology, Lady Davis
Institute for Medical Research, Jewish General Hospital, Montreal, QC,
Canada
(Filion) Division of Clinical Epidemiology, McGill University, Montreal,
QC, Canada
(Filion, Eisenberg) Department of Epidemiology, Biostatistics and
Occupational Health, McGill University, Montreal, QC, Canada
(Eisenberg) Divisions of Cardiology and Clinical Epidemiology, Jewish
General Hospital, McGill University, 3755 Cote Ste. Catherine Road,
Montreal, QC H3T 1E2, Canada
Title
Coronary artery bypass graft surgery versus percutaneous coronary
intervention with first-generation drug-eluting stents: A meta-analysis of
randomized controlled trials.
Source
JACC: Cardiovascular Interventions. 7 (5) (pp 497-506), 2014. Date of
Publication: May 2014.
Publisher
Elsevier Inc.
Abstract
Objectives This study sought to compare the efficacy of coronary artery
bypass graft surgery (CABG) to that of percutaneous coronary intervention
(PCI) with first-generation drug-eluting stents among patients with
multivessel disease (MVD), unprotected left main (LM) disease, and
single-vessel proximal left anterior descending (LAD) disease. Background
The efficacy and safety of CABG versus PCI with drug-eluting stents in
patient subgroups remains controversial. Methods We systematically
searched Cardiosource, Circulation, Clinicaltrials.gov, the Cochrane
Library, EMBASE, and Medline for articles published through June 2013 for
randomized controlled trials comparing CABG with PCI. Primary endpoints
included mortality, myocardial infarction, revascularization, and stroke.
Data were meta-analyzed with random-effects models. Results We identified
7 randomized controlled trials (N = 5,835): 2 of MVD (n = 2,410, 100%
diabetic), 2 of LM disease (n = 1,206, 29.0% diabetic), 1 of 3-vessel or
LM disease (n = 1,900, 25.5% diabetic), and 2 of single-vessel proximal
LAD disease (n = 319, 36.3% diabetic). In MVD patients, CABG reduced the
risk of mortality (risk ratio [RR]: 0.70, 95% confidence interval [CI]:
0.57 to 0.87), myocardial infarction (RR: 0.47, 95% CI: 0.36 to 0.61), and
repeat revascularization (RR: 0.36, 95% CI: 0.24 to 0.52), but increased
stroke risk (RR: 1.72, 95% CI: 1.02 to 2.90). In patients with LM disease,
CABG reduced revascularization risk (RR: 0.60, 95% CI: 0.46 to 0.78) and
increased stroke risk (RR: 2.89, 95% CI: 1.15 to 7.27). Data for patients
with single-vessel proximal LAD disease were inconclusive. Conclusions
CABG is more efficacious than is PCI with first-generation drug-eluting
stents in patients with LM and MVD, at the cost of increased rates of
stroke. No conclusion can be drawn for patients with single-vessel
proximal LAD disease. 2014 by The American College of Cardiology
Foundation Published by Elsevier Inc.

<23>
Accession Number
71484180
Title
Association for Academic Surgery and Society of University Surgeons 5th
Annual Academic Surgical Congress.
Source
Journal of Surgical Research. Conference: 5th Annual Academic Surgical
Congress of the Association for Academic Surgery, AAS and the Society of
University Surgeons, SUS San Antonio, TX United States. Conference Start:
20100203 Conference End: 20100205. Conference Publication: (var.pagings).
158 (2) , 2010. Date of Publication: February 2010.
Publisher
Academic Press Inc.
Abstract
The proceedings contain 636 papers. The topics discussed include: a novel
ex vivo pressure-induced model for the examination of human thoracic
aortic aneurysms; successful introduction of video-assisted thoracic
surgery (VATS) lobectomy to general surgery residents: analysis of 235
consecutive cases; autophagy protects mesothelioma from HDAC inhibitor
induced apoptosis by targeting mitochondria; are drowning victims good
donors for lung transplantation? analysis of over 18,000 lung transplants;
synchronous non small cell lung cancers should not be classified as stage
IV - a seer database analysis; listing pediatric patients on the heart
transplant waiting list with weight ranges limits donor pool
unnecessarily; and warming and humidification of insufflation
CO₂ in laparoscopic colonic surgery - a double-blinded
randomized controlled trial.

<24>
Accession Number
71483670
Authors
Haddad M. Nair R. Hendry P. Coyle D. Mesana T.
Institution
(Haddad) Thomas Jefferson University Hospital, Philadelphia, PA, United
States
(Nair, Hendry, Coyle, Mesana) University of Ottawa, Ottawa, ON, Canada
Title
Peri-operative amiodarone for post-operative atrial fibrillation
prophylaxis in valve surgery patients.
Source
Journal of Surgical Research. Conference: 5th Annual Academic Surgical
Congress of the Association for Academic Surgery, AAS and the Society of
University Surgeons, SUS San Antonio, TX United States. Conference Start:
20100203 Conference End: 20100205. Conference Publication: (var.pagings).
158 (2) (pp 226), 2010. Date of Publication: February 2010.
Publisher
Academic Press Inc.
Abstract
Purpose: Post-operative Atrial Fibrillation (AF) affects approximately 40%
of patients undergoing heart valves surgery. Peri-operative Amiodarone has
been shown to reduce the risk of post-operative AF in patients undergoing
mostly coronary artery bypass grafting (CABG) procedures. The purpose of
this study is to evaluate the benefit of per-operative Amiodarone in
reducing the risk of post-operative AF in valve patients. Methods: A
double-blinded randomized controlled trial using peri-operative Amiodarone
in patients undergoing valve surgery (isolated or concomitant with CABG).
A total of 47 patients were randomized to receive either Amiodarone (22
patients) or placebo (25 patients) for 5 days pre and 5 days post-valve
surgery. All patients had in-hospital continuous cardiac monitoring and
outpatient follow-up to 6 weeks. Results: There was no difference in the
incidence of post-operative AF between the Amiodarone and placebo groups
(8 of 22 patients, 36%, vs. 10 of 25 patients, 40% respectively; P = 0.8).
Also, there was no difference in the average duration of AF between the
two groups or the incidence of post-operative strokes myocardial
infarctions, or hemorrhagic complications. None of the patients died and
the length of hospital stay was similar between the Amiodarone and Placebo
groups (7.8166.68 days vs 7.6465.44 days respectively; P = 0.93).
Conclusions: Peri-operative Amiodarone utilization in valve patients does
not reduce the incidence of post-operative AF despite existing evidence
for such benefit in CABG patients.