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<1>
Accession Number
2014916153
Authors
Sherwood M.W. Peterson E.D.
Institution
(Sherwood, Peterson) Division of Cardiovascular Medicine, Duke University
Medical Center, Duke Clinical Research Institute, 2400 Pratt St, Durham,
NC 27715, United States
Title
Revascularization in stable coronary artery disease.
Source
JAMA - Journal of the American Medical Association. 312 (19) (pp
2028-2030), 2014. Date of Publication: 19 Nov 2014.
Publisher
American Medical Association
Abstract
IMPORTANCE Recent trials of percutaneous coronary intervention (PCI) vs
coronary artery bypass grafting (CABG) for multivessel disease were not
designed to detect a difference in mortality and therefore were
underpowered for this outcome. Consequently, the comparative effects of
these 2 revascularization methods on long-term mortality are still
unclear. In the absence of solid evidence for mortality difference, PCI is
oftentimes preferred over CABG in these patients, given its less invasive
nature. OBJECTIVES To determine the comparative effects of CABG vs PCI on
long-term mortality and morbidity by performing a meta-analysis of all
randomized clinical trials of the current era that compared the 2
treatment techniques in patients with multivessel disease. DATA SOURCES
Asystematic literature searchwas conducted for all randomized clinical
trials directly comparingCABGwith PCI. STUDY SELECTION To reflect current
practice, we included randomized trials with 1 or more arterial grafts
used in at least 90%, and 1 or more stents used in at least 70% of the
cases that reported outcomes in patients with multivessel disease. DATA
EXTRACTION Numbers of events at the longest possible follow-up and sample
sizes were extracted. DATA SYNTHESIS Atotal of 6 randomized trials
enrolling a total of 6055 patientswere included, with aweighted average
follow-up of 4.1 years. Therewas a significant reduction in total
mortality withCABGcompared with PCI (I2 = 0%; risk ratio [RR],0.73
[95%CI,0.62-0.86]) (P >.001). Therewere also significant reductions
inmyocardial infarction (I2 = 8.02%; RR, 0.58 [95%CI,0.48-0.72]) (P >.001)
and repeat revascularization (I2 = 75.6%; RR,0.29 [95%CI,0.21-0.41]) (P
>.001) with CABG. Therewas a trend toward excess strokes withCABG(I2 =
24.9%; RR, 1.36 [95%CI,0.99-1.86]), but thiswas not statistically
significant (P =.06). For reduction in total mortality, therewas no
heterogeneity between trials thatwere limited to and not limited to
patients with diabetes or whether stentswere drug eluting or not. Owing to
lack of individual patient-level data, additional subgroup analyses could
not be performed. CONCLUSIONS AND RELEVANCE In patients with multivessel
coronary disease, compared with PCI, CABG leads to an unequivocal
reduction in long-term mortality andmyocardial infarctions and to
reductions in repeat revascularizations, regardless of whether patients
are diabetic or not. These findings have implications for management of
such patients.

<2>
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Accession Number
2014771741
Authors
Veerasamy M. Edwards R. Ford G. Kirkwood T. Newton J. Jones D. Kunadian V.
Institution
(Veerasamy, Ford, Newton, Jones, Kunadian) Institute of Cellular Medicine,
Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne NE2
4HH, United Kingdom
(Veerasamy, Edwards, Kunadian) Cardiothoracic Centre, Freeman Hospital,
Newcastle upon Tyne, United Kingdom
(Kirkwood, Newton) Institute for Ageing and Health, Newcastle University,
Newcastle upon Tyne, United Kingdom
Title
Acute coronary syndrome among older patients: A review.
Source
Cardiology in Review. 23 (1) (pp 26-32), 2014. Date of Publication: 14 Dec
2015.
Publisher
Lippincott Williams and Wilkins
Abstract
Ischemic heart disease is the leading cause of mortality worldwide. Due to
advances in medicine in the past few decades, life expectancy has
increased resulting in an aging population in developed and developing
countries. Acute coronary syndrome causes greater morbidity and mortality
in this group of older patients, which appears to be due to age-related
comorbidities. This review examines the incidence and prevalence of acute
coronary syndrome among older patients, examines current treatment
strategies, and evaluates the predictors of adverse outcomes. In
particular, the impact of frailty on outcomes and the need for frailty
assessment in developing future research and management strategies among
older patients are discussed.

<3>
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Accession Number
2014786510
Authors
Fleisher L.A. Fleischmann K.E. Auerbach A.D. Barnason S.A. Beckman J.A.
Bozkurt B. Davila-Roman V.G. Gerhard-Herman M.D. Holly T.A. Kane G.C.
Marine J.E. Nelson M.T. Spencer C.C. Thompson A. Ting H.H. Uretsky B.F.
Wijeysundera D.N. Anderson J.L. Halperin J.L. Albert N.M. Brindis R.G.
Curtis L.H. DeMets D. Gidding S. Hochman J.S. Kovacs R.J. Ohman E.M.
Pressler S.J. Sellke F.W. Shen W.-K.
Title
2014 ACC/AHA guideline on perioperative cardiovascular evaluation and
management of patients undergoing noncardiac surgery: Executive summary a
report of the american college of cardiology/american heart association
task force on practice guidelines.
Source
Circulation. 130 (24) (pp 2215-2245), 2014. Date of Publication: 09 Dec
2014.
Publisher
Lippincott Williams and Wilkins

<4>
Accession Number
2014975831
Authors
Alamoudi A.O. Haque S. Srinivasan S. Mital D.P.
Institution
(Alamoudi, Haque, Srinivasan, Mital) Department of Health Informatics,
School of Health Related Professions, University of Medicine and Dentistry
of New Jersey, Newark, NJ 07107-3001, United States
Title
Diagnostic efficacy value in terms of sensitivity and specificity of
imaging modalities in detecting the abdominal aortic aneurysm: A
systematic review.
Source
International Journal of Medical Engineering and Informatics. 7 (1) (pp
15-35), 2015. Date of Publication: 01 Jan 2015.
Publisher
Inderscience Enterprises Ltd.
Abstract
The purpose of this study was to examine whether duplex ultrasonography
(DUS) or MR angiography (MRA) or CT angiography (CTA) is more applicable
to use as alternative modality in terms of sensitivity and specificity for
detection of abdominal aortic aneurysm (AAA). A search of the medical
databases was performed for describing AAA evaluation and detection.
Twenty eight studies were found and met the selection criteria. Diameter
of aneurysms was categorised by size: < 2.5 cm of the aneurysm diameter.
For aneurisms < 2.5 cm, the mean reported sensitivities and specificities
were DUS: 81% and 91.1%; CTA: 84.3% and 98.4%; MRA: 95.8% and 95.8%,
respectively compared DSA as gold standard. MRA has the highest
sensitivity and CTA has the highest specificity reported diagnostic
accuracy in detecting the aneurysm < 2.5 cm of AAA diameter and they could
be used as a reliable alternative modality to invasive DSA.

<5>
Accession Number
2014975206
Authors
Jiao R. Liu Y. Yang W.-J. Zhu X.-Y. Li J. Tang Q.-Z.
Institution
(Jiao, Liu, Li, Tang) Department of Cardiology, Xiangyang No. 1 People's
Hospital, Affiliated Hospital of Hubei University of Medicine, Hubei,
China
(Jiao, Liu, Li, Tang) Renmin Hospital of Wuhan University, Department of
Cardiology, Xiangyang No. 1 People's Hospital, Affiliated Hospital of
Hubei University of Medicine, Hubei, China
(Zhu) Cardiovascular Research Institute of Wuhan University, Wuhan,
Department of Pediatrics, Xiangyang No. 1 People's Hospital, Affiliated
Hospital of Hubei University of Medicine, Hubei, China
(Yang) The Department of Endocrinology, Xiangyang No. 1 People's Hospital,
Affiliated Hospital of Hubei University of Medicine, Hubei, China
Title
Effects of stem cell therapy on dilated cardiomyopathy.
Source
Saudi Medical Journal. 35 (12) (pp 1463-1468), 2014. Date of Publication:
01 Dec 2014.
Publisher
Saudi Arabian Armed Forces Hospital
Abstract
Objectives: To perform a meta-analysis of clinical trials and investigate
the effect of stem cell therapy on dilated cardiomyopathy.
Methods: A systematic literature search was carried out between May 2012
and July 2013 in PubMed, Medline, Cochrane Library, and Excerpta Medica
Database (EMBASE). The study took place in the Department of Cardiology,
Renmin Hospital of Wuhan University, Wuhan, China. The weighted mean
difference (WMD) was calculated for left Articles ventricular ejection
fraction (LVEF), left ventricular end-diastolic diameter (LVEDD),
mortality and heart transplantation, and the 6-minute walk test (6- MWT)
distance using the RevMan 5.0 software.
Results: Seven trials with 599 participants evaluated the association
between the stem cell therapy and control groups. Compared with the
control group, stem cell therapy group improved the LVEF (WMD: 3.98%, 95%
confidence interval [CI]: 0.55 - 7.41%, p=0.02) and the 6-MWT distance
(WMD: 132.12 m, 95% CI: 88.15-176.09 m, p<0.00001), and reduced mortality
and heart transplantation (odds ratio [OR]: 0.48, 95% CI: 0.29-0.80,
p=0.005). However, the LVEDD showed no significant difference between the
2 groups (WMD: -1.53 mm, 95% CI: -1.15-0.10 mm, p=0.10).
Conclusion: This meta-analysis demonstrated that stem cell therapy
improves cardiac function and reduces mortality in dilated cardiomyopathy
patients, which suggested that stem cell therapy may represent a new
therapy option for dilated cardiomyopathy.

<6>
Accession Number
2014974852
Authors
Zhang Y. Zeng Z. Cao Y. Du X. Wan Z.
Institution
(Zhang, Zeng, Cao, Du, Wan) Department of Emergency, West China School of
Medicine, Sichuan University, Chengdu, Sichuan, China
Title
Effect of urinary protease inhibitor (ulinastatin) on cardiopulmonary
bypass: A meta-analysis for China and Japan.
Source
PLoS ONE. 9 (12) , 2014. Article Number: e113973. Date of Publication: 11
Dec 2014.
Publisher
Public Library of Science
Abstract
Objectives: A meta-analysis was conducted to investigate the effects of
ulinastatin treatment on adult patients undergoing cardiac surgery under
cardiopulmonary bypass (CPB). Methods: Seven electronic databases were
searched for reports of randomized, controlled trials conducted up to
February 2014 in which patients undergoing cardiac surgery with CPB were
administered ulinastatin in the perioperative period. Results: Fifty-two
studies with 2025 patients were retained for analysis. The results showed
that the ulinastatin can attenuate the plasma levels of pro-inflammatory
cytokines and enhance the anti-inflammatory cytokine levels in patients
undergoing cardiac surgery with CPB. Meanwhile, the ulinastatin had a
significant beneficial effect on myocardial injury. The mean differences
(MD) and 95% confidence intervals (95% CI) of biochemical markers were
-63.54 (-79.36, -47.72) for lactate dehydrogenase, -224.99 (-304.83,
-145.14) for creatine kinase, -8.75 (-14.23, -3.28) for creatine
kinase-MB, and -0.14 (-0.20, -0.09] for troponin I (all P<0.01). However,
neither hemodynamics nor cardiac function improved significantly, except
that the MD and 95% CI of mean arterial pressure were 2.50 (0.19, 4.80)
(P=0.03). There were no statistically significant differences in the use
of inotropes, postoperative bleeding, postoperative complications, the
intensive care unit (ICU) stay, and the hospital stay; however, the
frequency of auto resuscitation increased significantly (OR 1.98, 95%CI
1.19 to 3.30, P<0.01), the duration of intubation (MD -1.58, 95%CI -2.84
to -0.32, P<0.01) and the duration of mechanical ventilation (MD -3.29,
95%CI -4.41 to -2.17, P<0.01) shortened significantly in patients who were
treated with ulinastatin. Conclusions: Ulinastatin can reduce the plasma
levels of pro-inflammatory cytokines and elevate anti-inflammatory
cytokine in patients from China and Japan undergoing cardiac surgery with
CPB. Ulinastatin treatment may have protective effects on myocardial
injury, and can increase the frequency of auto resuscitation, shorten the
duration of intubation and mechanical ventilation.

<7>
Accession Number
2014975325
Authors
Shammakhi A.A. Sun Z.
Institution
(Shammakhi, Sun) Discipline of Medical Imaging, Department of Imaging and
Applied Physics, Curtin University, Perth, WA 6845, Australia
(Shammakhi) Radiology Department, Armed Forces Hospital, P. O. Box 988
PC612, Oman
Title
Coronary CT angiography with use of iterative reconstruction algorithm in
coronary stenting: A systematic review of image quality, diagnostic value
and radiation dose.
Source
Journal of Medical Imaging and Health Informatics. 5 (1) (pp 103-109),
2015. Date of Publication: 01 Feb 2015.
Publisher
American Scientific Publishers
Abstract
The aim of this study was to perform a systematic review of the image
quality, diagnostic value and radiation dose of coronary CT angiography
with use of iterative reconstruction (IR) in the assessment of coronary
stents when compared to the standard filtered back-projection (FBP)
techniques. A search of medical databases of English literature was
performed to identify studies comparing coronary CT angiography with use
of IR and FBP techniques in coronary stenting. Qualitative and
quantitative assessment of image quality, diagnostic accuracy and
radiation dose associated with coronary CT angiography were analyzed and
compared between the two reconstruction algorithms. Ten studies met
selection criteria and were included in the analysis. In comparison with
FBP, coronary CT angiography with use of IR showed improvement in image
quality through both qualitative and quantitative analysis. The IR
technique resulted in higher diagnostic value than that of FBP with the
mean sensitivity, specificity and accuracy being 98%, 77.4% and 80.1% for
IR technique, and 90.5%, 68.2%, and 68.6% for FBP approach, respectively,
with significant difference reached in the specificity and accuracy (p <
0.05). Furthermore, there was significantly lower dose with use of IR
compared to FBP technique (4.4 mSv vs. 7.0 mSv). Coronary CT angiography
with use of IR algorithm leads to significant improvements in the
assessment of coronary stents with much lower radiation dose.

<8>
Accession Number
2014973496
Authors
Amsterdam E.A. Wenger N.K. Brindis R.G. Casey D.E. Ganiats T.G. Holmes
D.R. Jaffe A.S. Jneid H. Kelly R.F. Kontos M.C. Levine G.N. Liebson P.R.
Mukherjee D. Peterson E.D. Sabatine M.S. Smalling R.W. Zieman S.J.
Title
2014 AHA/ACC guideline for the management of patients with
Non-ST-Elevation acute coronary syndromes: Executive summary: A report of
the American College of Cardiology/American Heart Association Task Force
on Practice Guidelines.
Source
Journal of the American College of Cardiology. 64 (24) (pp 2645-2687),
2014. Date of Publication: 23 Dec 2014.
Publisher
Elsevier USA

<9>
Accession Number
2014973494
Authors
Amsterdam E.A. Wenger N.K. Brindis R.G. Casey D.E. Ganiats T.G. Holmes
D.R. Jaffe A.S. Jneid H. Kelly R.F. Kontos M.C. Levine G.N. Liebson P.R.
Mukherjee D. Peterson E.D. Sabatine M.S. Smalling R.W. Zieman S.J.
Title
2014 AHA/acc guideline for the management of patients with
Non-ST-Elevation acute coronary syndromes: A report of the American
College of Cardiology/American Heart Association Task Force on Practice
Guidelines.
Source
Journal of the American College of Cardiology. 64 (24) (pp e139-e228),
2014. Date of Publication: 23 Dec 2014.
Publisher
Elsevier USA

<10>
Accession Number
2014973476
Authors
Montalescot G. Collet J.-P. Ecollan P. Bolognese L. Ten Berg J. Dudek D.
Hamm C. Widimsky P. Tanguay J.-F. Goldstein P. Brown E. Miller D.L. Lenarz
L. Vicaut E.
Institution
(Montalescot, Collet) ACTION Study Group, Institut de Cardiologie, Centre
Hospitalier Universitaire Pitie-Salpetriere (AP-HP), Paris, France
(Ecollan) ACTION Study Group, SMUR, Centre Hospitalier Universitaire
Pitie-Salpetriere (AP-HP), Paris, France
(Bolognese) Cardiovascular and Neurological Department, Azienda
Ospedaliera, Arezzo, Italy
(Ten Berg) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(Dudek) Institute of Cardiology, Jagiellonian University Medical College,
University Hospital, Krakow, Poland
(Hamm) Kerckhoff Heart and Thoraxcenter, Bad Nauheim and Medical Clinic i,
University of Giessen, Giessen, Germany
(Widimsky) Third Medical Faculty, Charles University, University Hospital
Royal Vineyards, Prague, Czech Republic
(Tanguay) Montreal Heart Institute, Montreal, QC, Canada
(Goldstein) SAMU and Emergency Department, Lille University Hospital,
Lille, France
(Brown, Miller, Lenarz) Eli Lilly and Company, Lilly Corporate Center,
Indianapolis, United States
(Vicaut) ACTION Study Group, Methodology and Statistical Unit, Universite
Paris 7, Paris, France
(Montalescot) Institut de Cardiologie, Pitie- Salpetriere, University
Hospital, 47, Boulevard de l'Hopital, Paris 75013, France
Title
Effect of prasugrel pre-treatment strategy in patients undergoing
percutaneous coronary intervention for NSTEMI: The ACCOAST-PCI study.
Source
Journal of the American College of Cardiology. 64 (24) (pp 2563-2571),
2014. Date of Publication: 23 Dec 2014.
Publisher
Elsevier USA
Abstract
Background After percutaneous coronary intervention (PCI) for
non-ST-segment elevation myocardial infarction (NSTEMI), treatment with a
P2Y₁₂ antagonist with aspirin is recommended for 1 year.
Objectives The oral P2Y₁₂ antagonists ticagrelor and prasugrel
have higher recommendations than clopidogrel, but it is unknown if
administration before the start of PCI is beneficial.
Methods In the randomized, double-blind ACCOAST (A Comparison of prasugrel
at the time of percutaneous Coronary intervention Or as pre-treatment At
the time of diagnosis in patients with non-ST-segment elevation myocardial
infarction) trial, 4,033 patients were diagnosed with NSTEMI and 68.7%
underwent PCI; 1,394 received pre-treatment with prasugrel (30-mg loading
dose), and 1,376 received placebo. At the time of PCI, patients who
received pre-treatment with prasugrel received an additional 30-mg dose of
prasugrel, and those who received placebo received a 60-mg loading dose of
prasugrel. Primary efficacy was a composite of cardiovascular death,
myocardial infarction, stroke, urgent revascularization, or glycoprotein
IIb/IIIa bailout through 7 days from randomization. Investigators captured
the presence of thrombus on initial angiography and during PCI.
Results The incidence of the primary endpoint through 7 days from
randomization in the pre-treatment group versus the no pre-treatment group
was 13.1% versus 13.1% (p = 0.93). Pre-treatment with prasugrel was not
associated with decreases in any ischemic event, including total
mortality. Patients with thrombus on angiography had a 3-fold higher
incidence of the primary endpoint than patients without thrombus. There
was no impact of pre-treatment with prasugrel on the presence of thrombus
before PCI or on occurrence of stent thrombosis after PCI. There was a
3-fold increase in all non-coronary artery bypass graft Thrombolysis In
Myocardial Infarction (TIMI) major bleeding and a 6-fold increase in
non-coronary artery bypass graft life-threatening bleeding with
pre-treatment with prasugrel; the same trends persisted in patients who
had radial or femoral access even with use of a closure device.
Conclusions These findings support deferring treatment with prasugrel
until a decision is made about revascularization in patients with NSTEMI
undergoing angiography within 48 h of admission. (A Comparison of
prasugrel at the time of percutaneous Coronary intervention Or as
pre-treatment At the time of diagnosis in patients with non - ST-segment
elevation myocardial infarction [ACCOAST]; NCT01015287).

<11>
Accession Number
2014968810
Authors
Pilgrim T. Heg D. Roffi M. Tuller D. Muller O. Vuilliomenet A. Cook S.
Weilenmann D. Kaiser C. Jamshidi P. Fahrni T. Moschovitis A. Noble S.
Eberli F.R. Wenaweser P. Juni P. Windecker S.
Institution
(Pilgrim, Fahrni, Moschovitis, Wenaweser, Windecker) Department of
Cardiology, Swiss Cardiovascular Center, University Hospital, Bern 3010,
Switzerland
(Roffi, Noble) Department of Cardiology, University Hospital, Geneva,
Switzerland
(Tuller, Eberli) Department of Cardiology, Triemlispital, Zurich,
Switzerland
(Muller) Department of Cardiology, University Hospital, Lausanne,
Switzerland
(Vuilliomenet) Department of Cardiology, Kantonsspital, Aarau, Switzerland
(Cook) Department of Cardiology, University Hospital, Fribourg,
Switzerland
(Weilenmann) Department of Cardiology, Kantonsspital, St Gallen,
Switzerland
(Kaiser) Department of Cardiology, University Hospital, Basel, Switzerland
(Jamshidi) Department of Cardiology, Kantonsspital, Luzern, Switzerland
(Heg, Juni) Institute of Social and Preventive Medicine, Clinical Trials
Unit, Bern University Hospital, Bern, Switzerland
Title
Ultrathin strut biodegradable polymer sirolimus-eluting stent versus
durable polymer everolimus-eluting stent for percutaneous coronary
revascularisation (BIOSCIENCE): A randomised, single-blind,
non-inferiority trial.
Source
The Lancet. 384 (9960) (pp 2111-2122), 2014. Date of Publication: 13 Dec
2014.
Publisher
Lancet Publishing Group
Abstract
Background Refinements in stent design affecting strut thickness, surface
polymer, and drug release have improved clinical outcomes of drug-eluting
stents. We aimed to compare the safety and efficacy of a novel, ultrathin
strut cobalt-chromium stent releasing sirolimus from a biodegradable
polymer with a thin strut durable polymer everolimus-eluting stent.
Methods We did a randomised, single-blind, non-inferiority trial with
minimum exclusion criteria at nine hospitals in Switzerland. We randomly
assigned (1:1) patients aged 18 years or older with chronic stable
coronary artery disease or acute coronary syndromes undergoing
percutaneous coronary intervention to treatment with biodegradable polymer
sirolimus-eluting stents or durable polymer everolimus-eluting stents.
Randomisation was via a central web-based system and stratified by centre
and presence of ST segment elevation myocardial infarction. Patients and
outcome assessors were masked to treatment allocation, but treating
physicians were not. The primary endpoint, target lesion failure, was a
composite of cardiac death, target vessel myocardial infarction, and
clinically-indicated target lesion revascularisation at 12 months. A
margin of 35% was defined for non-inferiority of the biodegradable polymer
sirolimus-eluting stent compared with the durable polymer
everolimus-eluting stent. Analysis was by intention to treat. The trial is
registered with ClinicalTrials.gov, number NCT01443104.
Findings Between Feb 24, 2012, and May 22, 2013, we randomly assigned 2119
patients with 3139 lesions to treatment with sirolimus-eluting stents
(1063 patients, 1594 lesions) or everolimus-eluting stents (1056 patients,
1545 lesions). 407 (19%) patients presented with ST-segment elevation
myocardial infarction. Target lesion failure with biodegradable polymer
sirolimus-eluting stents (69 cases; 65%) was non-inferior to durable
polymer everolimus-eluting stents (70 cases; 66%) at 12 months (absolute
risk difference -014%, upper limit of one-sided 95% CI 197%, p for
non-inferiority <00004). No significant differences were noted in rates of
definite stent thrombosis (9 [09%] vs 4 [04%], rate ratio [RR] 226, 95% CI
070-733, p=016). In pre-specified stratified analyses of the primary
endpoint, biodegradable polymer sirolimus-eluting stents were associated
with improved outcome compared with durable polymer everolimus-eluting
stents in the subgroup of patients with ST-segment elevation myocardial
infarction (7 [33%] vs 17 [87%], RR 038, 95% CI 016-091, p=0024, p for
interaction=0014).
Interpretation In a patient population with minimum exclusion criteria and
high adherence to dual antiplatelet therapy, biodegradable polymer
sirolimus-eluting stents were non-inferior to durable polymer
everolimus-eluting stents for the combined safety and efficacy outcome
target lesion failure at 12 months. The noted benefit in the subgroup of
patients with ST-segment elevation myocardial infarction needs further
study.
Funding Clinical Trials Unit, University of Bern, and Biotronik, Bulach,
Switzerland.

<12>
Accession Number
2014957271
Authors
Abbate A. Van Tassell B.W. Christopher S. Abouzaki N.A. Sonnino C. Oddi C.
Carbone S. Melchior R.D. Gambill M.L. Roberts C.S. Kontos M.C. Peberdy
M.A. Toldo S. Vetrovec G.W. Biondi-Zoccai G. Dinarello C.A.
Institution
(Abbate, Christopher, Abouzaki, Sonnino, Oddi, Carbone, Melchior, Gambill,
Roberts, Kontos, Peberdy, Toldo, Vetrovec) VCU Pauley Heart Center,
Virginia Commonwealth University, Richmond, VA, United States
(Van Tassell, Sonnino, Oddi, Carbone, Melchior, Gambill, Peberdy)
Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth
University, Richmond, VA, United States
(Biondi-Zoccai) Sapienza University of Rome, Latina, Italy
(Dinarello) Department of Medicine, University of Colorado, Aurora, CO,
United States
Title
Effects of Prolastin C (plasma-derived alpha-1 antitrypsin) on the acute
inflammatory response in patients with ST-segment elevation myocardial
infarction (from the VCU-alpha 1-RT pilot study).
Source
American Journal of Cardiology. 115 (1) (pp 8-12), 2015. Date of
Publication: 01 Jan 2015.
Publisher
Elsevier Inc.
Abstract
Alpha-1 antitrypsin (AAT) has broad anti-inflammatory and immunomodulating
properties in addition to inhibiting serine proteases. Administration of
human plasma-derived AAT is protective in models of acute myocardial
infarction in mice. The objective of this study was to determine the
safety and tolerability of human plasma-derived AAT and its effects on the
acute inflammatory response in non-AAT deficient patients with ST-segment
elevation myocardial infarction (STEMI). Ten patients with acute STEMI
were enrolled in an open-label, single-arm treatment study of AAT at 60
mg/kg infused intravenously within 12 hours of admission and following
standard of care treatment. C-reactive protein (CRP) and plasma AAT levels
were determined at admission, 72 hours, and 14 days, and patients were
followed clinically for 12 weeks for the occurrence of new onset heart
failure, recurrent myocardial infarction, or death. Twenty patients with
STEMI enrolled in previous randomized trials with identical inclusion
and/or exclusion criteria, but who received placebo, served as historical
controls. Prolastin C was well tolerated and there were no in-hospital
adverse events. Compared with historical controls, the area under the
curve of CRP levels was significantly lower 14 days after admission in the
Prolastin C group (75.9 [31.4 to 147.8] vs 205.6 [78.8 to 410.9] mg/l, p =
0.048), primarily due to a significant blunting of the increase occurring
between admission and 72 hours (delta CRP +1.7 [0.2 to 9.4] vs +21.1 [3.1
to 38.0] mg/l, p = 0.007). Plasma AAT levels increased from admission (149
[116 to 189]) to 203 ([185 to 225] mg/dl) to 72 hours (p = 0.005). In
conclusion, a single administration of Prolastin C in patients with STEMI
is well tolerated and is associated with a blunted acute inflammatory
response.

<13>
Accession Number
2014950784
Authors
Steinvil A. Leshem-Rubinow E. Halkin A. Abramowitz Y. Ben-Assa E. Shacham
Y. Bar-Dayan A. Keren G. Banai S. Finkelstein A.
Institution
(Steinvil, Leshem-Rubinow, Halkin, Abramowitz, Ben-Assa, Shacham, Keren,
Banai, Finkelstein) Department of Cardiology, Tel-Aviv Medical Center,
Tel-Aviv University, Tel Aviv, Israel
(Bar-Dayan) Department of Vascular Surgery, Tel-Aviv Medical Center,
Tel-Aviv University, Tel Aviv, Israel
Title
Vascular complications after transcatheter aortic valve implantation and
their association with mortality reevaluated by the valve academic
research consortium definitions.
Source
American Journal of Cardiology. 115 (1) (pp 100-106), 2015. Date of
Publication: 01 Jan 2015.
Publisher
Elsevier Inc.
Abstract
Vascular complications (VC) after transcatheter aortic valve implantation
(TAVI) are reported using various criteria and several access site
approaches. We aimed to describe them in a solely percutaneous
transfemoral TAVI approach and their association with survival using both
the updated Valve Academic Research Consortium (VARC)-2 criteria and the
former VARC-1 criteria. From March 2009 to September 2013, 403 consecutive
patients at a mean age (+SD) of 83 + 6 years underwent percutaneous
transfemoral TAVI. VC were defined by both VARC-1 and VARC-2 criteria and
analyzed separately. Cox proportional hazard ratio models for all-cause
mortality were adjusted separately as defined by each criteria.
VARC-1-defined and VARC-2-defined VC occurred in 71 (18%) and 78 (19%)
patients, respectively, with 15 (4%) and 33 (8%) defined as major VC. The
difference in frequency of major and minor VC was mainly driven by VARC-2
implementation of major bleeding events. With either VARC definition,
patients with minor VC had similar mortality and complications rates as
those patients without VC. In multivariate analyses, referenced to
patients with minor or no VC, only VARC-1-defined major VC were
significantly associated with increased mortality (hazard ratio 3.52;
confidence interval 1.5 to 8.4; p = 0.005), whereas VARC-2-defined major
VC were found to be only marginally significant (hazard ratio 1.9;
confidence interval 0.9 to 3.9; p = 0.08). In conclusion, the
implementation of the VARC-2 criteria resulted in a higher rate of
reported major VC after TAVI compared with VARC-1 criteria, mainly by the
inclusion of major bleeding events and a reduced association with patient
mortality.

<14>
Accession Number
2014962397
Authors
Jashari H. Rydberg A. Ibrahimi P. Bajraktari G. Henein M.Y.
Institution
(Jashari, Ibrahimi, Bajraktari, Henein) Department of Public Health and
Clinical Medicine, Umea University, Sweden
(Rydberg) Department of Clinical Sciences, Umea University, Sweden
Title
Left ventricular response to pressure afterload in children: Aortic
stenosis and coarctation: A systematic review of the current evidence.
Source
International Journal of Cardiology. 178 (pp 203-209), 2014. Date of
Publication: 15 Jan 2015.
Publisher
Elsevier Ireland Ltd
Abstract
Congenital aortic stenosis (CAS) and Coarctation of Aorta (CoA) represent
two forms of pressure afterload that affect the left ventricle (LV), hence
require regular echocardiographic monitoring. Subclinical dysfunction of
the LV exists even in asymptomatic patients with preserved left
ventricular ejection fraction (EF), implying low sensitivity of EF in
predicting optimum time for intervention. In this article we review
patterns of LV myocardial deformation before and after correction of CAS
and CoA in infants, children and adolescents, showing their important role
in monitoring the course of LV dysfunction. A systematic search using
PubMed was performed and suitable studies are presented on a narrative
form. Normal EF and/or fractional shortening (FS), with subclinical
myocardial dysfunction are reported in all studies before intervention.
The short-term results, after intervention, were related to the type of
procedure, with no improvement or further deterioration related to surgery
but immediate improvement after balloon intervention. Long term follow-up
showed further improvement but still subnormal function. Thus correction
of CAS and CoA before irreversible LV dysfunction is vital, and requires
longitudinal studies in order to identify the most accurate parameter for
function prognostication. Until then, conventional echocardiographic
parameters together with myocardial velocities and deformation parameters
should continue to provide follow-up reproducible measures of ventricular
function.

<15>
Accession Number
2014962375
Authors
Briasoulis A. Afonso L. Palla M. Sharma S. Panaich S. Papageorgiou N.
Tousoulis D.
Institution
(Briasoulis, Afonso, Palla, Sharma, Panaich) Wayne State
University/DetroitMedical Center, Department of Cardiology, Detroit, IL
48226, United States
(Papageorgiou, Tousoulis) University of Athens Medical School, 1st
Department of Cardiology, Greece
Title
Culprit-vessel versus complete revascularization during primary
angioplasty in ST-elevation myocardial infarction: An updated
meta-analysis.
Source
International Journal of Cardiology. 178 (pp 171-174), 2014. Date of
Publication: 15 Jan 2015.
Publisher
Elsevier Ireland Ltd

<16>
Accession Number
2014962079
Authors
Shao Y. Fan Y. Li J. Cao H. Liu B. Wang J. Yang J. Zhang Q. Hu X.
Institution
(Shao, Fan, Li, Cao, Liu, Wang, Yang, Zhang, Hu) Department of Surgery,
First Affiliated Hospital of China Medical University, Shenyang 110001,
China
Title
Does elevated asymmetrical dimethylarginine predict major adverse cardiac
events and mortality in patients after percutaneous coronary
intervention?.
Source
International Journal of Cardiology. 178 (pp 188-190), 2014. Date of
Publication: 15 Jan 2015.
Publisher
Elsevier Ireland Ltd

<17>
Accession Number
2014960875
Authors
Trivedi C. Sadadia M.
Institution
(Trivedi) St. Davids Medical Center, Austin, TX 78705, United States
(Sadadia) Department of Pharmacology, Smt. B K Shah Medical Institute and
Research Centre, Piparia, Vadodara, Gujarat, India
Title
Colchicine in prevention of atrial fibrillation following cardiac surgery:
Systematic review and meta-analysis.
Source
Indian Journal of Pharmacology. 46 (6) (pp 590-595), 2014. Date of
Publication: 01 Nov 2014.
Publisher
Medknow Publications (B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai 400 075, India)
Abstract
Objectives: Inflammation is one of the predictors of atrial fibrillation
(AF) following surgical or interventional cardiac procedures. Recent
evidence suggests that colchicine may represent a new strategy to prevent
AF following cardiac procedures. This study aims to assess the
antiinflammatory efficacy of colchicine in prevention of early AF event
(EAFE). Materials and Methods: We reviewed all available studies that
assessed the effectiveness of colchicine therapy on the occurrence of AF
in patients undergoing cardiac procedures. Meta-analysis was performed by
random effect inverse variance-weighted method by entering AF events and
the total population from each study. Results: After thorough review of
the databases, we found three studies comparing colchicine and placebo
which had EAFE as the outcome. Of 584 patients, 286 patients were on
colchicine and 298 on placebo. All the three studies were randomized.
After pooled analysis, colchicine was associated with significant
reduction in AF events compared to placebo (odds ratio = 0.44 [0.29,
0.66], P < 0.001). There was no statistical heterogeneity between included
studies (chi² = 0.45, P = 0.80, I² = 0%).
Conclusion: Colchicine may prove beneficial in the prevention of AF
following cardiac surgery. Further research is warranted.

<18>
[Use Link to view the full text]
Accession Number
2014750219
Authors
Cantinotti M. Spadoni I. Assanta N. Crocetti M. Marotta M. Arcieri L.
Murzi B. Imazio M.
Institution
(Cantinotti, Spadoni, Assanta, Crocetti, Marotta, Arcieri, Murzi)
Fondazione Toscana G. Monasterio, Via Aurelia Sud, Massa 54100, Italy
(Imazio) Cardiology Department, Maria Vittoria Hospital, Torino, Italy
Title
Controversies in the prophylaxis and treatment of postsurgical pericardial
syndromes: A critical review with a special emphasis on paediatric age.
Source
Journal of Cardiovascular Medicine. 15 (12) (pp 847-854), 2014. Date of
Publication: 10 Dec 2014.
Publisher
Lippincott Williams and Wilkins
Abstract
Postsurgical pericardial syndromes are common complications after cardiac
surgery; however, their treatment is not well established yet. We reviewed
the accuracy and limits of clinical trials of prophylaxis and treatment of
these diseases to identify an evidence-based therapeutic approach. We
performed a literature search in the National Library of Medicine using
the keywords pericardial effusion, cardiac surgery and paediatric /
congenital. The research was then redefined adding separately the keywords
postpericardiotomy syndrome, NSAIDs, steroids and colchicine. We found 12
clinical trials (eight for the prophylaxis and four regarding treatment),
testing three major agent classes: NSAIDs, corticosteroids and colchicine.
Therapy is generally based on NSAID with or without steroids with the
adjunct of colchicine for recurrences. Only a few randomized controlled
trials (RCTs) in adults support NSAID therapy. Efficacy of steroids has
been proved only in small paediatric works, whereas no studies are
available for colchicine. Studies furthermore presented some limitations:
not univocal endpoints (not allowing for a meta-analysis), a limited
sample size, scarce attention to confounders (such as the underlying
cardiac disease and diuretic/analgesic regimen). Moreover, different
agents were not assessed, nor when to start therapy. More evidence (two
wide RCT plus a meta-analysis) supports the role of colchicine for
prophylaxis in adults. Prophylaxis with NSAID/corticosteroids instead
failed to have significant advantage in children, whereas a few data are
available for adults. Evidence for the treatment of postsurgical
pericardial syndromes is incomplete, making it difficult to understand
when to treat and which agent to employ, especially in children.

<19>
Accession Number
2014962637
Authors
Juhl-Olsen P. Jakobsen C.-J. Rasmussen L.A. Bhavsar R. Klaaborg K.-E.
Frederiksen C.A. Sloth E.
Institution
(Juhl-Olsen, Jakobsen, Rasmussen, Bhavsar, Frederiksen, Sloth) Department
of Anaesthesiology and Intensive Care, Aarhus University Hospital,
Brendstrupgaardsvej 100, Aarhus 8200, Denmark
(Juhl-Olsen, Frederiksen) Department of Clinical Medicine, Aarhus
University, Aarhus, Denmark
(Klaaborg) Department of Thoracic and Vascular Surgery, Aarhus University
Hospital, Aarhus, Denmark
Title
Effects of levosimendan in patients with left ventricular hypertrophy
undergoing aortic valve replacement.
Source
Acta Anaesthesiologica Scandinavica. 59 (1) (pp 65-77), 2015. Date of
Publication: 01 Jan 2015.
Publisher
Blackwell Munksgaard
Abstract
Background: Left ventricular hypertrophy is associated with adverse
outcomes, including death, during cardiac surgery. This may be facilitated
by an increased oxygen demand and diastolic dysfunction. Levosimendan
augments haemodynamics without further oxygen consumption and improves
echocardiographic indices of diastolic dysfunction. This study aimed to
describe the haemodynamic effects of short-term pre- and intra-operative
levosimendan infusion including advanced echocardiographic measures of
diastolic and systolic heart function.
Methods: The study was randomised, double-blinded and placebo-controlled
performed at a single-centre university hospital. Patients with left
ventricular hypertrophy and ejection fraction > 45% scheduled for single
procedure aortic valve replacement were included and randomised to
infusion of either levosimendan 0.1 mug/kg/min or placebo from 4 h before
anaesthesia to the end of surgery. Outcome measures were echocardiographic
indices of left ventricular diastolic function: E/e (primary endpoint), e,
e/a and indices of systolic function: longitudinal strain, ejection
fraction and s. Patients were followed until 6 months after surgery. In
addition, invasive haemodynamic measures were obtained perioperatively.
Results: The trial was prematurely terminated due to an overall high
incidence of post-operative atrial fibrillation (15/20, P = 0.002) after
inclusion of 20 patients. The relative decrease in perioperative cardiac
index was lower (P = 0.016) in the levosimendan group. There was no
difference in E/e, and similar results were found for all measures of
systolic function.
Conclusion: Short-term levosimendan caused a transient relative increase
in cardiac index, but no effect was seen on the first post-operative day
and up to 6 months post-operatively with indices of systolic and diastolic
heart function.

<20>
Accession Number
2014912896
Authors
Pasin L. Landoni G. Cabrini L. Borghi G. Taddeo D. Saleh O. Greco T. Monti
G. Chiesa R. Zangrillo A.
Institution
(Pasin, Landoni, Cabrini, Borghi, Taddeo, Saleh, Greco, Monti, Zangrillo)
Department of Anaesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Via Olgettina 60, Milano 20132, Italy
(Landoni, Zangrillo) Vita-Salute San Raffaele University, Milano, Italy
(Chiesa) Department of Vascular Surgery, IRCCS San Raffaele Scientific
Institute, Milano, Italy
Title
Propofol and survival: A meta-analysis of randomized clinical trials.
Source
Acta Anaesthesiologica Scandinavica. 59 (1) (pp 17-24), 2015. Date of
Publication: 01 Jan 2015.
Publisher
Blackwell Munksgaard
Abstract
Background: One of the most commonly used hypnotics is propofol. Several
studies performed in cardiac surgery suggested an increased mortality in
patients receiving a propofol-based total intravenous anaesthesia.
Furthermore, the possibility of infections and the 'propofol syndrome'
have suggested that propofol might be dangerous. Nonetheless, propofol is
widely used in different settings because of its characteristics: fast
induction, rapid elimination, short duration of action, smooth recovery
from anaesthesia, few adverse effects, no teratogenic effects,
characteristics that have undoubtedly contributed to its popularity. The
effect of propofol on survival is unknown. We decided to carry out a
meta-analysis of all randomized controlled studies ever performed on
propofol vs. any comparator in any clinical setting.
Methods: Pertinent studies were independently searched in BioMedCentral,
PubMed, Embase, Clinicaltrial.gov, and Cochrane Central Register of
Clinical Trials by expert investigators. The following inclusion criteria
were used: random allocation to treatment, comparison between propofol and
any comparator in any clinical setting.
Results: One hundred thirty-three studies randomizing 14,516 patients were
included. No differences in mortality between patients receiving propofol
[349/6957 (5.0%)] vs. any comparator [340/7559 (4.5%)] were observed in
the overall population [risk ratio = 1.05, 95% confidence interval (0.93
to 1.18), P = 0.5] and in several sub-analyses.
Conclusion: Inspite of theoretical concerns, propofol has no detrimental
effect on survival according to the largest meta-analysis of randomized
trials ever performed on hypnotic drug.

<21>
Accession Number
2014960958
Authors
Pezawas T. Grimm M. Ristl R. Kivaranovic D. Moser F.T. Laufer G.
Schmidinger H.
Institution
(Pezawas, Moser, Schmidinger) Department of Internal Medicine II, Devision
of Cardiology, Medical University of Vienna, Wahringer Gurtel 18-20,
Vienna 1090, Austria
(Grimm, Laufer) Department of Cardiothoracic Surgery, Medical University
of Vienna, Vienna, Austria
(Ristl, Kivaranovic) Center for Medical Statistics Informatics and
Intelligent Systems, Medical University of Vienna, Vienna, Austria
Title
Primary preventive cardioverter-defibrillator implantation (Pro-ICD) in
patients awaiting heart transplantation. A prospective, randomized,
controlled 12-year follow-up study.
Source
Transplant International. 28 (1) (pp 34-41), 2014. Date of Publication: 01
Jan 2015.
Publisher
Blackwell Publishing Ltd
Abstract
Summary The aim of this study was to evaluate whether short-term primary
preventive cardioverter-defibrillator (ICD) implantation as bridge to
heart transplantation (HTX) provides any survival benefit. Thirty-three
patients awaiting HTX were randomized to either conventional therapy
(control group) or primary preventive ICD implantation (ICD group).
Fourteen patients had ischemic cardiomyopathy (ICM) and 19 patients had
dilated cardiomyopathy (DCM). Sixteen patients were randomized to the ICD
group and 17 patients were randomized to the control group. Twenty
patients (61%) were transplanted after a waiting time of 10 + 9 months.
The remaining 13 patients (39%) were not transplanted because of clinical
improvement (n = 5), cerebral hemorrhage (n = 3), or death (n = 5). On the
waiting list, 3 ICD patients with DCM developed slow VTs without ICD
intervention, two patients with ICM (6%) had fast VT terminated by the
ICD, and no arrhythmic death was observed. After 11.9 years (median), 13
of 20 HTX patients (65%) and 5 of 13 non-HTX patients (38%) were alive.
Survivors had a higher LVEF (22 + 6 vs. 17 + 4%, P = 0.0092) and a better
exercise capacity (75 + 29 vs. 57 + 24 Watt, P = 0.0566) at baseline as
compared to nonsurvivors. This study may not support the general use of
primary preventive ICDs as a short-term bridge to heart transplantation.