Results Generated From:
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Embase (updates since 2014-09-25)
<1>
Accession Number
24444192
Authors
Lawley C.M. Lain S.J. Algert C.S. Ford J.B. Figtree G.A. Roberts C.L.
Institution
(Lawley) Clinical Population Perinatal Health Research Group, The Kolling
Institute, University of Sydney at Royal North Shore Hospital, Herbert
Street, St Leonards, New South Wales 2065, Australia.
Title
Prosthetic heart valves in pregnancy: a systematic review and
meta-analysis protocol.
Source
Systematic reviews. 3 (pp 8), 2014. Date of Publication: 2014.
Abstract
Advances in surgical technique, prosthetic heart valve design, and
anticoagulation have contributed to an overall improvement in morbidity
and mortality in women with heart valve prostheses as well as increased
feasibility of pregnancy. Previous work investigating the pregnancies of
women with prosthetic valves has been directed largely toward
understanding the influence of anticoagulation regimen. There has been
little investigation on maternal and infant outcomes. The objective of
this systematic review will be to assess the outcomes of pregnancy in
women with heart valve prostheses in contemporary populations. A
systematic search of Medline, Embase, Cumulative Index to Nursing and
Allied Health Literature (CINAHL), and the Cochrane Library will be
undertaken. Article titles and abstracts will be evaluated by two
reviewers for potential relevance. Studies that include pregnancies
occurring from 1995 onwards and where there are six or more pregnancies in
women with heart valve prostheses included in the study population will be
reviewed for potential inclusion. Primary outcomes of interest will be
mortality (maternal and perinatal). Secondary outcomes will include other
pregnancy outcomes. No language restrictions will be applied.
Methodological quality and heterogeneity of studies will be assessed. Data
extraction from identified articles will be undertaken by two independent
reviewers using a uniform template. Meta-analyses will be performed to
ascertain risk of adverse events and, where numbers are sufficient, by
type of prosthesis and location as well as other subgroup analyses.
Estimates of the risk of adverse events in recent pregnancies of women
with heart valve prosthesis will provide better information for
counselling and decision making. Given the improvements in prognosis of
heart valve prosthesis recipients and the paucity of definitive data
regarding optimal pregnancy management for these women, review of this
topic is pertinent. This protocol has been registered with the
international prospective register of systematic reviews (PROSPERO) as
number CRD42013006187, accessible online at
http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42013006187#.U
tk7qNJ9Lf8.
<2>
Accession Number
24397879
Authors
Kiessling A.H. Dietz J. Reyher C. Stock U.A. Beiras-Fernandez A. Moritz A.
Institution
(Kiessling) Department of Thoracic and Cardiovascular Surgery, Johann
Wolfgang Goethe University, Theodor Stern Kai 7, Frankfurt am Main 60590,
Germany.
Title
Early postoperative serum cystatin C predicts severe acute kidney injury
following cardiac surgery: a post-hoc analysis of a randomized controlled
trial.
Source
Journal of cardiothoracic surgery. 9 (1) (pp 10), 2014. Date of
Publication: 2014.
Abstract
Acute kidney injury (AKI) after cardiac surgery procedures is associated
with poor patient outcomes. Cystatin C as a marker for renal failure has
been shown to be of prognostic value; however, a wide range of its
predictive accuracy has been reported. The aim of the study was to
evaluate whether the measurement of pre- and postoperative serum cystatin
C improves the prediction of AKI. In a single-centre, prospective study of
70 patients (74 + 9 ys; range 47-85 ys; 77% male), cystatin C was measured
six times: (T1=preoperative, T2=start cardiopulmonary bypass (CPB), T3=20
min after CPB, T4=end of operation; T5=24 h postoperatively; T6=7d
postoperatively). Predictive property, in terms of the need for renal
replacement therapy (RRT), was analysed by receiver operating
characteristics (ROC) statistics and described by the area under the curve
(AUC). With respect to RRT (n=8), serum cystatin C was significantly
higher at the end of the operation (T4), 24 h postoperatively at T5 and at
T6. The AUCs for preoperative T1 and intraoperative T2/3 cystatin C were
<0.7 (95% CI, 0.47-0.85). The earliest significant predictive AUCs were
found at the end of the operation (T4: p=0.03 95% CI 0.58-0.88 AUC 0.73)
and 24 h postoperatively (T5: p=0.003 95% CI 0.74-0.96 AUC 0.85). Early
postoperative serum cystatin C increase appears to be a moderate biomarker
in the prediction of AKI, whereas a preoperative and intraoperative
cystatin C increase has only a limited diagnostic and predictive value.
<3>
Accession Number
24961148
Authors
Sepehripour A.H. Harling L. Ashrafian H. Casula R. Athanasiou T.
Institution
(Sepehripour) Department of Surgery and Cancer, 10th Floor QEQM Building,
St Mary's Hospital, Imperial College London, London W2 1NY, UK.
Title
Does off-pump coronary revascularization confer superior organ protection
in re-operative coronary artery surgery? A meta-analysis of observational
studies.
Source
Journal of cardiothoracic surgery. 9 (1) (pp 115), 2014. Date of
Publication: 2014.
Abstract
Off-pump coronary artery bypass surgery (OPCAB) has been hypothesised to
be beneficial in the high-risk patient population undergoing re-operative
coronary artery bypass graft surgery (CABG). In addition, this technique
has been demonstrated to provide subtle benefits in end-organ function
including heart, lungs and kidney. The aims of this study were to assess
whether OPCAB is associated with a lower incidence of major adverse
cardiovascular and cerebrovascular events (MACCE) and other adverse
outcomes in re-operative coronary surgery. Twelve studies, incorporating
3471 patients were identified by systematic literature review. These were
meta-analysed using random-effects modelling. Primary endpoints were MACCE
and other adverse outcomes including myocardial infarction, stroke, renal
dysfunction, low cardiac output state, respiratory failure and atrial
fibrillation. A significantly lower incidence of myocardial infarction,
stroke, renal dysfunction, low cardiac output state, respiratory failure
and atrial fibrillation was observed with OPCAB (OR 0.58; 95% CI
(confidence interval) [0.39-0.87]; OR 0.37; 95% CI [0.17-0.79]; OR 0.39;
95% CI [0.24-0.63]; OR 0.14; 95% CI [0.04-0.56]; OR 0.36; 95% CI
[0.24-0.54]; OR 0.41; 95% CI [0.22-0.77] respectively). Sub-group analysis
using sample size, matching score and quality score was consistent with
and reflected these significant findings. Off-pump coronary artery bypass
grafting reduces peri-operative and short-term major adverse outcomes in
patients undergoing re-operative surgery. Consequently we conclude that
OPCAB provides superior organ protection and a safer outcome profile in
re-operative CABG.
<4>
Accession Number
24889138
Authors
Boustany A.N. Ghareeb P. Lee K.
Institution
(Boustany) Department of Surgery, Division of Plastic Surgery, University
of Kentucky, Lexington, USA.
Title
Prospective, randomized, single blinded pilot study of a new FlatWire
based sternal closure system.
Source
Journal of cardiothoracic surgery. 9 (1) (pp 97), 2014. Date of
Publication: 2014.
Abstract
Unstable steel wire cerclage following open heart surgery may result in
increased pain, sternal cut-through, non-union, or dehiscence. These
complications lead to longer hospital stays, increased cost, higher
morbidity, and patient dissatisfaction. The Figure 8 FlatWire Sternal
Closure System is a new construct which is a simple, intuitive, and
inexpensive alternative for primary sternal repair following open heart
surgery. Prior bench-top testing of FlatWire has demonstrated superior
strength and stiffness compared to traditional steel wire. We present our
initial experience in a prospective, randomized, single blinded pilot
study utilizing this FDA approved system. Sixty-three patients undergoing
elective complete sternotomies at a single institution were randomly
assigned to receive either the Figure 8 FlatWire or standard steel wire
cerclage. All surgeries were performed by a single board certified
cardiothoracic surgeon. Data collected included: Age, BMI, pump time, off
pump to surgical stop time, length of hospital stay after surgery, cost
from time of surgery to discharge, and pain on a visual analog pain scale
on the day of discharge, day 30, and day 60. The groups were well matched.
Patients receiving the Figure 8 FlatWire (33) had a reduction in length of
stay compared to patients receiving steel wire circlage (30), but it was
not statistically significant (6.8 vs. 7.8 days respectively, p < 0.093).
Additionally those with the FlatWire reported significantly decreased pain
at day of discharge (3.07 vs. 4.92 points on pain scale, p < 0.0066), with
similar pain scores at 30 and 60 days. Off pump to surgery stop time was
increased by 15.9 minutes in patients receiving the FlatWire vs. steel
wires (55.7 vs. 71.6 minutes, p = 0.00025). Mean cost from surgery until
discharge was $87,820.98 in the FlatWire group vs. $91,930.29 in the steel
wire group (p < 0.3082). Early clinical results suggest that Figure 8
FlatWire provides excellent stability, which resulted in significantly
diminished postoperative pain at discharge. Although not significant there
was a trend toward decreased length of stay, and reduced cost. Further
clinical research is warranted to expand upon these initial trends and
validate long term outcomes.
<5>
Accession Number
25121931
Authors
Smith M.D. McCall J. Plank L. Herbison G.P. Soop M. Nygren J.
Institution
(Smith) Department of General Surgery, Southland Hospital, Kew Road,
Invercargill, New Zealand, 9840.
Title
Preoperative carbohydrate treatment for enhancing recovery after elective
surgery.
Source
The Cochrane database of systematic reviews. 8 (pp CD009161), 2014. Date
of Publication: 2014.
Abstract
Preoperative carbohydrate treatments have been widely adopted as part of
enhanced recovery after surgery (ERAS) or fast-track surgery protocols.
Although fast-track surgery protocols have been widely investigated and
have been shown to be associated with improved postoperative outcomes,
some individual constituents of these protocols, including preoperative
carbohydrate treatment, have not been subject to such robust analysis. To
assess the effects of preoperative carbohydrate treatment, compared with
placebo or preoperative fasting, on postoperative recovery and insulin
resistance in adult patients undergoing elective surgery. We searched the
Cochrane Central Register of Controlled Trials (CENTRAL) (2014, Issue 3),
MEDLINE (January 1946 to March 2014), EMBASE (January 1947 to March 2014),
the Cumulative Index to Nursing and Allied Health Literature (CINAHL)
(January 1980 to March 2014) and Web of Science (January 1900 to March
2014) databases. We did not apply language restrictions in the literature
search. We searched reference lists of relevant articles and contacted
known authors in the field to identify unpublished data. We included all
randomized controlled trials of preoperative carbohydrate treatment
compared with placebo or traditional preoperative fasting in adult study
participants undergoing elective surgery. Treatment groups needed to
receive at least 45 g of carbohydrates within four hours before surgery or
anaesthesia start time. Data were abstracted independently by at least two
review authors, with discrepancies resolved by consensus. Data were
abstracted and documented pro forma and were entered into RevMan 5.2 for
analysis. Quality assessment was performed independently by two review
authors according to the standard methodological procedures expected by
The Cochrane Collaboration. When available data were insufficient for
quality assessment or data analysis, trial authors were contacted to
request needed information. We collected trial data on complication rates
and aspiration pneumonitis. We included 27 trials involving 1976
participants Trials were conducted in Europe, China, Brazil, Canada and
New Zealand and involved patients undergoing elective abdominal surgery
(18), orthopaedic surgery (4), cardiac surgery (4) and thyroidectomy (1).
Twelve studies were limited to participants with an American Society of
Anaesthesiologists grade of I-II or I-III.A total of 17 trials contained
at least one domain judged to be at high risk of bias, and only two
studies were judged to be at low risk of bias across all domains. Of
greatest concern was the risk of bias associated with inadequate blinding,
as most of the outcomes assessed by this review were subjective. Only six
trials were judged to be at low risk of bias because of blinding.In 19
trials including 1351 participants, preoperative carbohydrate treatment
was associated with shortened length of hospital stay compared with
placebo or fasting (by 0.30 days; 95% confidence interval (CI) 0.56 to
0.04; very low-quality evidence). No significant effect on length of stay
was noted when preoperative carbohydrate treatment was compared with
placebo (14 trials including 867 participants; mean difference -0.13 days;
95% CI -0.38 to 0.12). Based on two trials including 86 participants,
preoperative carbohydrate treatment was also associated with shortened
time to passage of flatus when compared with placebo or fasting (by 0.39
days; 95% CI 0.70 to 0.07), as well as increased postoperative peripheral
insulin sensitivity (three trials including 41 participants; mean increase
in glucose infusion rate measured by hyperinsulinaemic euglycaemic clamp
of 0.76 mg/kg/min; 95% CI 0.24 to 1.29; high-quality evidence).As reported
by 14 trials involving 913 participants, preoperative carbohydrate
treatment was not associated with an increase or a decrease in the risk of
postoperative complications compared with placebo or fasting (risk ratio
of complications 0.98, 95% CI 0.86 to 1.11; low-quality evidence).
Aspiration pneumonitis was not reported in any patients, regardless of
treatment group allocation. Preoperative carbohydrate treatment was
associated with a small reduction in length of hospital stay when compared
with placebo or fasting in adult patients undergoing elective surgery. It
was found that preoperative carbohydrate treatment did not increase or
decrease postoperative complication rates when compared with placebo or
fasting. Lack of adequate blinding in many studies may have contributed to
observed treatment effects for these subjective outcomes, which are
subject to possible biases.
<6>
Accession Number
24453831
Authors
Gianetti J. Parri M.S. Della Pina F. Marchi F. Koni E. De Caterina A.
Maffei S. Berti S.
Institution
(Gianetti, Parri, Della Pina, Marchi, Koni, De Caterina, Maffei, Berti)
Operative Unit of Cardiology, Fondazione Gabriele Monasterio, Ospedale del
Cuore "G. Pasquinucci", Via Aurelia Sud, 54100 Massa, Italy.
Title
Von Willebrand factor antigen predicts response to double dose of aspirin
and clopidogrel by PFA-100 in patients undergoing primary angioplasty for
ST elevation myocardial infarction.
Source
TheScientificWorldJournal. 2013 (pp 313492), 2013. Date of Publication:
2013.
Abstract
Von Willebrand factor (VWF) is an emerging risk factor in acute coronary
syndromes. Platelet Function Analyzer (PFA-100) with Collagen/Epinephrine
(CEPI) is sensitive to functional alterations of VWF and also identifies
patients with high on-treatment platelet reactivity (HPR). The objective
of this study was to verify the effect of double dose (DD) of aspirin and
clopidogrel on HPR detected by PFA-100 and its relation to VWF and to its
regulatory metalloprotease ADAMTS-13. Between 2009 and 2011 we enrolled
116 consecutive patients with ST elevation myocardial infarction
undergoing primary PCI with HPR at day 5 after PCI. Patients recruited
were then randomized between a standard dose (SD, n = 58) or DD of aspirin
and clopidogrel (DD, n = 58), maintained for 6 months follow-up. Blood
samples for PFA-100, light transmittance aggregometry, and VWF/ADAMTS-13
analysis were collected after 5, 30, and 180 days (Times 0, 1, and 2). At
Times 1 and 2 we observed a significantly higher CEPI closure times (CT)
in DD as compared to SD (P < 0.001). Delta of CEPI-CT (T1 - T0) was
significantly related to VWF (P < 0.001) and inversely related to
ADAMTS-13 (0.01). Responders had a significantly higher level of VWF at
T0. Finally, in a multivariate model analysis, VWF and ADAMTS-13 in
resulted significant predictors of CEPI-CT response (P = 0.02). HRP
detected by PFA-100 in acute myocardial infarction is reversible by DD of
aspirin and clopidogrel; the response is predicted by basal levels of VWF
and ADAMTS-13. PFA-100 may be a useful tool to risk stratification in
acute coronary syndromes given its sensitivity to VWF.
<7>
Accession Number
2014804849
Authors
Mark D.B. Knight J.D. Velazquez E.J. Wasilewski J. Howlett J.G. Smith P.K.
Spertus J.A. Rajda M. Yadav R. Hamman B.L. Malinowski M. Naik A. Rankin G.
Harding T.M. Drew L.A. Desvigne-Nickens P. Anstrom K.J.
Institution
(Mark, Knight, Velazquez, Rankin, Harding, Drew, Anstrom) Duke Clinical
Research Institute, PO Box 17969, Durham, NC 27715, United States
(Wasilewski) Silesian Center for Heart Diseases, M. Curie-Sklodowskiej 9,
Zabrze 41-800, Poland
(Howlett) Foothills Medical Center, University of Calgary, 1403 29th
Street NW, Calgary, AB T2N 2T9, Canada
(Smith) Duke University Medical Center, Box 3442, Durham, NC 27710, United
States
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri-Kansas City, 4401 Wornall Road, Kansas City, MO 64111, United
States
(Rajda) Queen Elizabeth II Health Sciences Centre, Halifax Infimary Site
2261, 1796 Summer Street, Halifax, NS B3H 3A7, Canada
(Yadav) All India Institute of Medical Sciences, Ansari Nagar, New Dehli
110029, India
(Hamman) Baylor Soltero Cardiovascular Research Center, 621 North Hall
Street, Dallas, TX 75226, United States
(Malinowski) 2nd Department of Cardiac Surgery, Medical University of
Silesia, Ziolowa 47, Katowice 40-635, Poland
(Naik) Care Institute of Medical Sciences, Science City Road, Sola,
Ahmedabad Gujarat 380060, India
(Desvigne-Nickens) Division of Cardiovascular Sciences, National Heart,
Lung, and Blood Institute, National Institutes of Health, 6701 Rockledge
Drive, Bethesda, MD 20892, United States
Title
Quality-of-life outcomes with coronary artery bypass graft surgery in
ischemic left ventricular dysfunction: A randomized trial.
Source
Annals of Internal Medicine. 161 (6) (pp 392-399), 2014. Date of
Publication: 16 Sep 2014.
Publisher
American College of Physicians (190 N. Indenpence Mall West, Philadelphia
PA 19106-1572, United States)
Abstract
Intervention: Random assignment to medical therapy alone (602 patients) or
medical therapy plus CABG (610 patients).
<8>
Accession Number
2014797471
Authors
Christopoulos G. Menon R.V. Karmpaliotis D. Alaswad K. Lombardi W.
Grantham A. Patel V.G. Rangan B.V. Kotsia A.P. Lembo N. Kandzari D.
Carlson H. Garcia S. Banerjee S. Thompson C.A. Brilakis E.S.
Institution
(Christopoulos, Menon, Patel, Rangan, Kotsia, Banerjee, Brilakis) VA North
Texas Healthcare System, UT Southwestern Medical Center, Dallas VA Medical
Center (111A), 4500 South Lancaster Road, Dallas, TX 75216, United States
(Karmpaliotis) Columbia University, New York, NY, United States
(Alaswad) Appleton Cardiology, Appleton, WI, United States
(Lombardi) PeaceHealth Cardiology, Bellingham, WA, United States
(Grantham) Mid America Heart Institute, Kansas City, MO, United States
(Lembo, Kandzari, Carlson) Piedmont Hospital, Atlanta, GA, United States
(Garcia) Minneapolis VA Healthcare System, University of Minnesota,
Minneapolis, MN, United States
(Thompson) Yale University School of Medicine, New Haven, CT, United
States
Title
The efficacy and safety of the "hybrid" approach to coronary chronic total
occlusions: Insights from a contemporary multicenter US registry and
comparison with prior studies.
Source
Journal of Invasive Cardiology. 26 (9) (pp 427-432), 2014. Date of
Publication: 01 Sep 2014.
Publisher
HMP Communications
Abstract
BACKGROUND: Percutaneous coronary intervention (PCI) for chronic total
occlusion (CTO) is challenging and has been associated with low success
rates. However, recent advancements in equipment and the flexibility to
switch between multiple technical approaches during the same procedure
("hybrid" percutaneous algorithm) have dramatically increased the success
of CTO-PCI. We sought to compare the contemporary procedural outcomes of
hybrid CTO-PCI with previously published CTO-PCI studies. METHODS: The
procedural outcomes of 497 consecutive CTO-PCIs performed between January
2012 and August 2013 at five high-volume centers in the United States were
compared with the pooled success and complication rates reported in 39
prior CTO-PCI series that included >100 patients and were published after
2000. RESULTS: The baseline clinical and angiographic characteristics of
the study patients were comparable to those of previous studies. Technical
and procedural success was achieved in 455 cases (91.5%) and 451 cases
(90.7%), respectively, and were significantly higher than the pooled
technical and procedural success rates from prior studies (76.5%, P<.001
and 75.2%, P<.001, respectively). Major procedural complications occurred
in 9/497 patients (1.8%) overall and included death (2 patients), acute
myocardial infarction (5 patients), repeat target vessel PCI (1 patient),
and tamponade requiring pericardiocentesis (2 patients). The incidence of
major complications was similar to that of prior studies (pooled rate
2.0%; P<.72). CONCLUSION: Use of the hybrid approach to CTO-PCI is
associated with higher success and similar complication rates compared to
prior studies, supporting its expanded use for treating these challenging
lesions.
<9>
Accession Number
2014596461
Authors
Wu G. Sun G. Zhao R. Sun M.
Institution
(Wu, Sun) Department of Cardiology, First Hospital, Jilin University,
Changchun, China
(Zhao) Department of Endoscopy and Gastroenterology, First Hospital, Jilin
University, Changchun, China
(Sun) Emergency Department, First Hospital, Jilin University, Ji'lin Road
3302, Changchun 130031, China
Title
Clinical outcomes of second- Versus first-generation drug-eluting stents
in patients with acute myocardial infarction: A meta-analysis of
randomized controlled trials.
Source
Archives of Medical Science. 10 (4) (pp 643-650), 2014. Date of
Publication: August 2014.
Publisher
Termedia Publishing House Ltd. (Kleeberqa St.2, Poznan 61-615, Poland)
Abstract
Introduction: It remains unclear whether the clinical outcomes of patients
with acute myocardial infarction (AMI) receiving second- and
first-generation drug-eluting stents (DES) are identical. The study aimed
to investigate the differences in clinical utility between the two
generations of DES in these specific subjects by a meta-analysis. Material
and methods: We systemically searched PubMed and EMBASE databases and the
Cochrane Library up until January 2013. Randomized trials, which compared
clinical outcomes of second-generation DES (everolimus- (EES) or
zotarolimus-eluting stents (ZES)) with first-generation DES (sirolimus- or
paclitaxel-eluting stents) in patients with AMI were included. Results:
Five trials with 1720 AMI subjects were included in the meta-analysis.
Pooled analysis demonstrated a trend toward lower incidence of stent
thrombosis with the second-generation DES relative to the first-generation
one (risk ratio (RR), 0.53; 95% confidence intervals (CI): 0.25-1.13; p =
0.10). However, the second-generation DES did not offer a significant
advantage over the first-generation DES in reducing the incidence of
target lesion revascularization (TLR) (RR = 1.73; 95% CI: 0.83-3.64; p =
0.15), major adverse cardiac events (MACEs) (RR = 0.97; p = 0.90), or
all-cause death (RR = 1.00; p = 1.0). In addition, in elderly patients the
second-generation DES seemed to reduce the occurrence of MACEs (RR = 0.65;
p = 0.10) and stent thrombosis (RR = 0.40; p = 0.08), and the
second-generation EES showed a potential benefit in lowering the MACE rate
(RR = 0.55; p = 0.06). Conclusions: The second-generation DES appeared to
lower the risk of stent thrombosis in AMI patients. There might be a lower
incidence of MACEs associated with the second-generation EES. Copyright
2014 Termedia & Banach.
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