Saturday, March 21, 2015

EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
2014727661
Authors
Besic K.M. Strozzi M. Margetic E. Bulum J. Kolaric B.
Institution
(Besic, Strozzi, Margetic, Bulum) Department of Cardiovascular Medicine,
University Hospital Centre Zagreb, Zagreb, Croatia
(Kolaric) Department for Social Medicine and Epidemiology, Medical School,
University of Rijeka, Rijeka, Croatia
Title
Drug-eluting balloons in patients with non-ST elevation acute coronary
syndrome.
Source
Journal of Cardiology. 65 (3) (pp 203-207), 2015. Date of Publication: 01
Mar 2015.
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: We compared efficacy of bare-metal stent (BMS) and
drug-eluting balloon (DEB) combination vs BMS alone, in patients with
non-ST elevation acute coronary syndrome treated with percutaneous
coronary intervention (PCI). Methods: Patients with non-ST elevation
myocardial infarction (NSTEMI) or unstable angina (UA) were randomized to
BMS only or BMS. +. DEB group. Angiographic follow-up was performed after
6 months. The primary endpoints were binary in-stent restenosis (ISR) and
late lumen loss (LLL) and the secondary endpoints were target lesion
revascularization (TLR), stent thrombosis (ST), and new acute coronary
syndrome (ACS). Results: A total of 85 patients were enrolled, 44 (BMS)
and 41 (BMS. +. DEB). The median age was 67 (36-84) years and 68 (80%)
were male. Fifty-two patients (61.2%) had NSTEMI and 33 patients (38.8%)
UA. There was no difference in patient demographics, risk factors, and
clinical characteristics, except for more smokers in the BMS. +. DEB group
18/41 (43.9%) vs 9/44 (20.5%). At follow-up, no significant difference in
binary ISR was found; p=. 0.593, but LLL was significantly lower in the
BMS. +. DEB group 0.68 (0.00-2.15) mm vs 0.22 (0.00-2.35) mm; p=. 0.002.
The difference in major adverse cardiac events (MACE) rate combining TLR,
ST, and ACS, between the groups was also non-significant, 29.5% (BMS) vs
24.4% (BMS. +. DEB); p=. 0.835. One patient had a subacute ST (BMS. +.
DEB) due to clopidogrel resistance. Conclusion: Patients treated with BMS.
+. DEB combination for non-ST elevation acute coronary syndrome had
significantly less LLL in comparison to patients treated with BMS alone
but without an impact on patient clinical outcomes.

<2>
Accession Number
2015814787
Authors
Gershlick A.H. Khan J.N. Kelly D.J. Greenwood J.P. Sasikaran T. Curzen N.
Blackman D.J. Dalby M. Fairbrother K.L. Banya W. Wang D. Flather M.
Hetherington S.L. Kelion A.D. Talwar S. Gunning M. Hall R. Swanton H.
McCann G.P.
Institution
(Gershlick, Khan, McCann) Department of Cardiovascular Sciences,
University of Leicester, Glenfield Hospital, Groby Road Site, Leicester
LE3 9QP, United Kingdom
(Kelly) Department of Cardiology, Royal Derby Hospital, Derby, United
Kingdom
(Greenwood) Division of Cardiovascular and Diabetes Research, Leeds
Institute of Cardiovascular and Metabolic Medicine, University of Leeds,
Leeds, United Kingdom
(Greenwood, Blackman) Department of Cardiology, Leeds Teaching Hospitals
NHS Trust, Leeds, United Kingdom
(Sasikaran) Clinical Trials and Evaluation Unit, Royal Brompton and
Harefield NHS Foundation Trust, Imperial College London, London, United
Kingdom
(Curzen) University Hospital Southampton and Faculty of Medicine,
University of Southampton, Southampton, United Kingdom
(Dalby) Royal Brompton and Harefield NHS Trust, London, United Kingdom
(Fairbrother) University Hospitals of Leicester NHS Trust, Leicester,
United Kingdom
(Banya) National Institute for Health Research Cardiovascular Biomedical
Research Unit, Royal Brompton and Harefield NHS Trust, London, United
Kingdom
(Wang) Department of Clinical Sciences, Liverpool School of Tropical
Medicine, Liverpool, United Kingdom
(Flather, Hall) Norfolk and Norwich University Hospitals NHS Foundation
Trust, Norwich Medical School, University of East Anglia, Norwich, United
Kingdom
(Hetherington) Kettering General Hospital, Kettering, United Kingdom
(Kelion) Oxford Heart Centre, John Radcliffe Hospital, Oxford University
Hospitals NHS Trust, Oxford, United Kingdom
(Talwar) Royal Bournemouth Hospital, Bournemouth, United Kingdom
(Gunning) Royal Stoke University Hospital, University Hospitals of North
Midlands NHS Trust, Stoke-on-Trent, Staffordshire, United Kingdom
(Swanton) Heart Hospital, University College London Hospitals, London,
United Kingdom
Title
Randomized trial of complete versus lesion-only revascularization in
patients undergoing primary percutaneous coronary intervention for stemi
and multivessel disease: The CvLPRIT trial.
Source
Journal of the American College of Cardiology. 65 (10) (pp 963-972), 2015.
Date of Publication: 17 Mar 2015.
Publisher
Elsevier USA
Abstract
Background The optimal management of patients found to have multivessel
disease while undergoing primary percutaneous coronary intervention
(P-PCI) for ST-segment elevation myocardial infarction is uncertain.
Objectives CvLPRIT (Complete versus Lesion-only Primary PCI trial) is a
U.K. open-label randomized study comparing complete revascularization at
index admission with treatment of the infarct-related artery (IRA) only.
Methods After they provided verbal assent and underwent coronary
angiography, 296 patients in 7 U.K. centers were randomized through an
interactive voice-response program to either in-hospital complete
revascularization (n = 150) or IRA-only revascularization (n = 146).
Complete revascularization was performed either at the time of P-PCI or
before hospital discharge. Randomization was stratified by infarct
location (anterior/nonanterior) and symptom onset (< 3 h or >3 h). The
primary endpoint was a composite of all-cause death, recurrent myocardial
infarction (MI), heart failure, and ischemia-driven revascularization
within 12 months. Results Patient groups were well matched for baseline
clinical characteristics. The primary endpoint occurred in 10.0% of the
complete revascularization group versus 21.2% in the IRA-only
revascularization group (hazard ratio: 0.45; 95% confidence interval: 0.24
to 0.84; p = 0.009). A trend toward benefit was seen early after complete
revascularization (p = 0.055 at 30 days). Although there was no
significant reduction in death or MI, a nonsignificant reduction in all
primary endpoint components was seen. There was no reduction in ischemic
burden on myocardial perfusion scintigraphy or in the safety endpoints of
major bleeding, contrast-induced nephropathy, or stroke between the
groups. Conclusions In patients presenting for P-PCI with multivessel
disease, index admission complete revascularization significantly lowered
the rate of the composite primary endpoint at 12 months compared with
treating only the IRA. In such patients, inpatient total revascularization
may be considered, but larger clinical trials are required to confirm this
result and specifically address whether this strategy is associated with
improved survival.

<3>
Accession Number
2015814778
Authors
Murphy T.P. Cutlip D.E. Regensteiner J.G. Mohler E.R. Cohen D.J. Reynolds
M.R. Massaro J.M. Lewis B.A. Cerezo J. Oldenburg N.C. Thum C.C. Jaff M.R.
Comerota A.J. Steffes M.W. Abrahamsen I.H. Goldberg S. Hirsch A.T.
Institution
(Murphy, Cerezo) Department of Diagnostic Imaging, Vascular Disease
Research Center, Rhode Island Hospital, Gerry 337, 593 Eddy Street,
Providence, RI 02903, United States
(Cutlip) Division of Cardiology, Beth Israel Deaconess Medical Center,
Boston, MA, United States
(Cutlip, Reynolds, Massaro, Thum, Abrahamsen) Harvard Clinical Research
Institute, Boston, MA, United States
(Regensteiner) University of Colorado School of Medicine-Aurora, Center
for Women's Health Research, Aurora, CO, United States
(Mohler) Section of Vascular Medicine, Cardiovascular Division at Perelman
School of Medicine, University of Pennsylvania, Philadelphia, PA, United
States
(Cohen) Division of Cardiology, University of Missouri-Kansas City, Kansas
City, MO, United States
(Massaro) Department of Biostatistics, Boston University, Boston, MA,
United States
(Lewis) School of Kinesiology, University of Minnesota, Minneapolis, MN,
United States
(Oldenburg, Steffes, Hirsch) Lillehei Heart Institute, Cardiovascular
Division, University of Minnesota Medical School, Minneapolis, MN, United
States
(Jaff) Division of Cardiology, Massachusetts General Hospital, Boston, MA,
United States
(Comerota) Jobst Vascular Institute, Toledo Hospital, Toledo, OH, United
States
(Goldberg) National Heart Lung and Blood Institute, Bethesda, MD, United
States
Title
Supervised exercise, stent revascularization, or medical therapy for
claudication due to aortoiliac peripheral artery disease: The CLEVER
study.
Source
Journal of the American College of Cardiology. 65 (10) (pp 999-1009),
2015. Date of Publication: 17 Mar 2015.
Publisher
Elsevier USA
Abstract
Background Treatment for claudication that is due to aortoiliac peripheral
artery disease (PAD) often relies on stent revascularization (ST).
However, supervised exercise (SE) is known to provide comparable
short-term (6-month) improvements in functional status and quality of
life. Longer-term outcomes are not known. Objectives The goal of this
study was to report the longer-term (18-month) efficacy of SE compared
with ST and optimal medical care (OMC). Methods Of 111 patients with
aortoiliac PAD randomly assigned to receive OMC, OMC plus SE, or OMC plus
ST, 79 completed the 18-month clinical and treadmill follow-up assessment.
SE consisted of 6 months of SE and an additional year of telephone-based
exercise counseling. Primary clinical outcomes included objective
treadmill-based walking performance and subjective quality of life.
Results Peak walking time improved from baseline to 18 months for both SE
(5.0 +/- 5.4 min) and ST (3.2 +/- 4.7 min) significantly more than for OMC
(0.2 +/- 2.1 min; p < 0.001 and p = 0.04, respectively). The difference
between SE and ST was not significant (p = 0.16). Improvement in
claudication onset time was greater for SE compared with OMC, but not for
ST compared with OMC. Many disease-specific quality-of-life scales
demonstrated durable improvements that were greater for ST compared with
SE or OMC. Conclusions Both SE and ST had better 18-month outcomes than
OMC. SE and ST provided comparable durable improvement in functional
status and in quality of life up to 18 months. The durability of
claudication exercise interventions merits its consideration as a primary
PAD claudication treatment.

<4>
Accession Number
2015810689
Authors
Saner F.H.
Institution
(Saner) Medical Center University of Essen/Germany, Department of General,
Visceral and Transplant Surgery, Hufelandstr. 55, Essen 45147, Germany
Title
Rotational thrombelastometry: A step forward to safer patient care?.
Source
Critical Care. 18 (1) , 2014. Article Number: 706. Date of Publication:
December 26, 2014.
Publisher
BioMed Central Ltd.
Abstract
The study by Hincker and colleagues indicated that the perioperative use
of rotational thrombelastometry (ROTEM) could predict thromboembolic
events in 90% of the cases in non-cardiac surgery. Viscoelastic tests
(VETs) - ROTEM and thrombelastography (TEG) - are used mainly to predict
bleeding complications. Most conventional coagulation tests, like
prothrombin time and activated partial thromboplastin time, can identify a
disturbance in plasmatic hemostasis. However, the relevance of these
assays is limited to the initiation phase of coagulation, whereas VETs are
designed to assess the whole clotting kinetics and strength of the whole
blood clot and reflect more the interaction between procoagulants,
anticoagulants, and platelets. The first reports about VET and
hypercoagulable state were published more than 25 years ago. Since then,
several studies with different quality and sample size have been
published, sometimes with conflicting results. A systematic review about
hypercoagulable state and TEG indicated that further studies are needed to
recommend VETs as a screening tool to predict postoperative thrombosis.

<5>
Accession Number
2015810429
Authors
Greenberg J.H. Coca S. Parikh C.R.
Institution
(Greenberg) Department of Pediatrics, Section of Nephrology, Yale
University School of Medicine, New Haven, CT, United States
(Coca, Parikh) Department of Internal Medicine, Section of Nephrology, New
Haven, CT, United States
(Coca, Parikh) VA Medical Center, Yale University School of Medicine, West
Haven, CT, United States
(Greenberg, Coca, Parikh) Yale Program of Applied Translational Research,
Yale University School of Medicine, 60 Temple Street, 6th Floor, Suite 6C,
New Haven, CT 06510, United States
Title
Long-term risk of chronic kidney disease and mortality in children after
acute kidney injury: A systematic review.
Source
BMC Nephrology. 15 (1) , 2014. Article Number: 184. Date of Publication:
21 Nov 2014.
Publisher
BioMed Central Ltd.
Abstract
Background: Acute kidney injury (AKI) is associated with significant
short-term morbidity and mortality in children. However, the risk for
long-term outcomes after AKI is largely unknown. Methods: We performed a
systematic review and meta-analysis to determine the cumulative incidence
rate of proteinuria, hypertension, decline in glomerular filtration rate
(GFR), and mortality after an episode of AKI. After screening 1934
published articles from 1985-2013, we included 10 cohort studies that
reported long-term outcomes after AKI in children. Results: A total of 346
patients were included in these studies with a mean follow-up of 6.5 years
(range 2-16) after AKI. The studies were of variable quality and had
differing definitions of AKI with five studies only including patients who
required dialysis during an AKI episode. There was a substantial
discrepancy in the outcomes across these studies, most likely due to study
size, disparate outcome definitions, and methodological differences. In
addition, there was no non-AKI comparator group in any of the published
studies. The cumulative incidence rates for proteinuria, hypertension,
abnormal GFR (<90 ml/min/1.73 m<sup>2</sup>), GFR < 60 ml/min/1.73
m<sup>2</sup>, end stage renal disease, and mortality per 100
patient-years were 3.1 (95% CI 2.1-4.1), 1.4 (0.9-2.1), 6.3 (5.1-7.5), 0.8
(0.4-1.4), 0.9 (0.6-1.4), and 3.7 (2.8-4.5) respectively. Conclusions: AKI
appears to be associated with a high risk of long-term renal outcomes in
children. These findings may have implications for care after an episode
of AKI in children. Future prospective studies with appropriate non-AKI
comparator groups will be required to confirm these results.

<6>
Accession Number
2015808751
Authors
Ozcan O.U. Tutar E. Candemir B. Ustun E.E. Erol C.
Institution
(Ozcan, Tutar, Candemir, Ustun, Erol) Department of Cardiology, Ankara
University, School of Medicine, Ankara 06230, Turkey
Title
Overcoming aspirin resistance with loading clopidogrel earlier in elective
percutaneous coronary intervention.
Source
International Journal of Angiology. 24 (1) (pp 19-24), 2015. Date of
Publication: 17 Feb 2014.
Publisher
Thieme Medical Publishers, Inc.
Abstract
We aimed to analyze the clinical effect of clopidogrel loading time on
adverse cardiovascular events among patients with aspirin resistance.
Recurrent adverse events may still occur despite dual antiplatelet therapy
after coronary stenting. Aspirin resistance is one of the possible reasons
of this trouble. Optimal antiplatelet strategy for coronary stenting is
unknown among patients with aspirin resistance. A total of 980 patients
scheduled for elective coronary stenting were enrolled and allocated into
two groups according to the loading time of clopidogrel more or less than
6 hours before coronary intervention (early- or late-loaded groups,
respectively). Aspirin resistance was determined according to the urinary
levels of 11-dehydrothromboxane B2. Overall 240 patients who were
allocated to early- and late-loaded groups were identified as aspirin
resistant according to the urinary levels of 11-dehydrothromboxane B2.
After a follow-up period of 12 months major adverse cardiac events were
observed among 16 patients (13.9%) in the early-loaded group and 30
patients (25.8%) in the late-loaded group (p = 0.02). Early loading of
clopidogrel was an independent predictor of lower rate of cardiac events
(hazard ratio = 0.46 [0.32-0.76, 95% confidence interval], p = 0.001). The
rates of bleeding events and periprocedural myocardial infarction were
similar in early- and late-loaded groups. The current study demonstrated
that loading of clopidogrel earlier than 6 hours before elective coronary
stenting among aspirin-resistant patients was associated with increased
benefits for ischemic events with similar bleeding rates.

<7>
Accession Number
2015812637
Authors
Imazio M.
Institution
(Imazio) Cardiology Department, Maria Vittoria Hospital and University of
Torino, Via Luigi Cibrario 72, Torino 10141, Italy
Title
New Clinical Trials in Acute and Recurrent Pericarditis.
Source
Current Cardiology Reports. 17 (4) (pp 1-7), 2015. Date of Publication:
2015.
Publisher
Current Medicine Group LLC 1
Abstract
Clinical trials in the last decade have improved the quality of evidence
to support preventive medical strategies to reduce the risk of recurrences
after pericarditis. There are essentially three main strategies: (1) to
use full anti-inflammatory doses for the treatment of each attack of
pericarditis till symptoms resolution and normalization of markers of
inflammation (i.e., C-reactive protein); (2) to limit the use of
corticosteroids and, if used, to use low to moderate doses (i.e.,
prednisone 0.2 to 0.5 mg/kg/day or equivalent) followed by slow tapering;
and (3) to add colchicine to improve the response to conventional
anti-inflammatory therapies and reduce the risk of recurrences.
Recommended regimens include weight-adjusted doses (i.e., 0.5-0.6 mg twice
daily for patients weighing >70 kg or 0.5-0.6 mg once daily for patients
weighing <70 kg for 3 months for acute pericarditis and 6 months for
recurrences) without a loading dose to improve patients' compliance. Using
these doses and appropriate selection of patients (e.g. to avoid severe
renal impairment or adjust doses according to comorbid conditions and
concomitant therapies), the drug is well tolerated, may cause reversible
gastrointestinal intolerance (mainly diarrhea) in about 8 to 10 % of cases
but has no severe side effects.

<8>
Accession Number
2014833753
Authors
Wu Y.-C. Su T.-W. Zhang J.-F. Shen W.-F. Ning G. Kong Y.
Institution
(Wu, Zhang, Kong) Department of Cardiovascular Surgery, Shanghai Chest
Hospital, Shanghai Jiao Tong University, Shanghai, China
(Su, Ning) Shanghai Institute of Endocrine and Metabolic Diseases,
Shanghai, China
(Su, Ning) Department of Endocrinology and Metabolism, Shanghai Jiao Tong
University, Shanghai, China
(Shen) Department of Cardiology, Rui Jin Hospital, School of Medicine,
Shanghai Jiao Tong University, Shanghai, China
Title
Coronary artery bypass grafting versus drug-eluting stents in patients
with severe coronary artery disease and diabetes mellitus: Systematic
review and meta-analysis.
Source
Journal of Diabetes. 7 (2) (pp 192-201), 2015. Date of Publication: 01 Mar
2015.
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Background: A comprehensive meta-analysis was performed to evaluate the
comparative benefits of coronary artery bypass grafting (CABG) versus
drug-eluting stents (DES) in patients with diabetes mellitus and severe
coronary artery disease (CAD). Methods: A comprehensive literature search
of PubMed, Embase, and ScienceDirect was undertaken. References cited with
the papers were also checked to identify relevant articles. Results: In
all, four randomized controlled trials, two prospective registries, and 11
retrospective studies were identified for review. Pooled analysis
demonstrated that DES was associated with lower all-cause mortality at Day
30. However, there was no significant difference between CABG and DES in
mortality at 12 months and at maximum follow-up. Furthermore, DES was
associated with lower overall and major adverse cardiac and
cerebrovascular events (MACCE)-free survival, as well as a higher
incidence of myocardial infarction and repeat revascularization. In
contrast, CABG was associated with an increased risk of stroke.
Conclusions: For patients with diabetes mellitus and severe CAD, CABG is
superior to DES in that it significantly improves overall and MACCE-free
survival and reduces the incidence of myocardial infarction and repeat
revascularization in the long term, although it is associated with greater
perioperative risk and a higher incidence of stroke. Therefore, CABG
should remain the gold standard for these patients.

<9>
Accession Number
2015801783
Authors
Mohanty S. Di Biase L. Mohanty P. Trivedi C. Santangeli P. Bai R.
Burkhardt J.D. Gallinghouse J.G. Horton R. Sanchez J.E. Hranitzky P.M.
Zagrodzky J. Al-Ahmad A. Pelargonio G. Lakkireddy D. Reddy M. Forleo G.
Rossillo A. Themistoclakis S. Hongo R. Beheiry S. Casella M. Dello Russo
A. Tondo C. Natale A.
Institution
(Mohanty, Di Biase, Mohanty, Trivedi, Santangeli, Bai, Burkhardt,
Gallinghouse, Horton, Sanchez, Hranitzky, Zagrodzky, Al-Ahmad, Natale)
Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 N.,
Austin, TX 78705, United States
(Di Biase, Horton, Natale) Department of Biomedical Engineering,
University of Texas at Austin, Austin, TX, United States
(Di Biase) Albert Einstein College of Medicine, Montefiore Hospital,
Bronx, NY, United States
(Di Biase, Santangeli) University of Foggia, Foggia, Italy
(Santangeli) University of Pennsylvania, Philadelphia, PA, United States
(Bai) Beijing Anzhen Hospital, Capital Medical University, Beijing, China
(Pelargonio) Catholic University, Rome, Italy
(Lakkireddy, Reddy) University of Kansas, Kansas City, KS, United States
(Forleo) University Tor Vergata, Rome, Italy
(Rossillo, Themistoclakis) Ospedale dell'Angelo, Mestre/Venice, United
States
(Hongo, Beheiry, Natale) California Pacific Medical Center, San Francisco,
CA, United States
(Casella, Dello Russo, Tondo) RCCS Monzino Hospital, Milan, Italy
(Natale) Division of Cardiology, Stanford University, Palo Alto, CA,
United States
(Natale) Interventional Electrophysiology, Scripps Clinic, San Diego, CA,
United States
(Natale) Department of Internal Medicine, Dell Medical School, Austin, TX,
United States
Title
Effect of periprocedural amiodarone on procedure outcome in patients with
longstanding persistent atrial fibrillation undergoing extended pulmonary
vein antrum isolation: Results from a randomized study (SPECULATE).
Source
Heart Rhythm. 12 (3) (pp 477-483), 2015. Date of Publication: 01 Mar 2015.
Publisher
Elsevier
Abstract
Background The impact of amiodarone on ablation outcome in longstanding
persistent atrial fibrillation (LSPAF) patients is not known yet.
Objective The purpose of this study was to assess the effect of amiodarone
on procedural-outcomes in LSPAF patients undergoing catheter ablation.
Methods We enrolled 112 LSPAF patients on amiodarone and scheduled to
undergo atrial fibrillation (AF) ablation. Patients were randomized to
amiodarone discontinuation 4 months before ablation (group 1, n = 56) and
a control group (group 2, n = 56) in which ablation was performed without
amiodarone discontinuation. All patients underwent pulmonary vein (PV)
antrum and posterior wall isolation, defragmentation and extra PV triggers
ablation. Patients were followed up for recurrence for 32 +/- 8 months
post-ablation. Repeat procedures in all recurrent patients were performed
off amiodarone. Results During ablation, AF termination was more frequent
in group 2 compared to group 1 [44 (79%) vs 32 (57%), P =.015]. After
high-dosage isoproterenol, more non-PV triggers were disclosed in group 1
compared to group 2 (42 [75%] vs 24 [43%] respectively, P <.001). Group 2
had lower procedure, radiofrequency and fluoroscopy times compared to
group 1 (2.7 +/- 1 vs 3.1 +/- 1 h, 69 +/- 13 min vs 87 +/- 11 min and 64
+/- 14 min vs 85 +/- 18 min respectively, p <.05). At 32 +/- 8 month
follow-up, on or off antiarrhythmic drug success rate was 37 (66%) in
group 1 and 27 (48%) in group 2 (P =.04). During redo, new non-PV trigger
sites were identified in group 2 patients. Conclusion Periprocedural
continuous amiodarone was associated with higher organization rate and
lower radiofrequency ablation rate. However, masking non-PV triggers
increased the late recurrence rate.

<10>
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Accession Number
2015800435
Authors
Gosain P. Yamani N. Santana O. Mihos C.G. Lamelas J.
Institution
(Gosain, Santana, Mihos) Division of Cardiology, Columbia University,
Mount Sinai Heart Institute, Miami Beach, FL, United States
(Yamani) Department of Internal Medicine, John H. Stroger Hospital of Cook
County, Chicago, IL, United States
(Lamelas) Division of Cardiac Surgery, Mount Sinai Medical Center, Miami
Beach, FL, United States
(Santana) Echocardiography Laboratory, Columbia University Division of
Cardiology, Mount Sinai Heart Institute, 4300 Alton Road, Miami Beach, FL
33140, United States
Title
Hybrid coronary revascularization: A systematic review.
Source
Cardiology in Review. 23 (2 Supplement 3) (pp 87-93), 2015. Date of
Publication: 04 Mar 2015.
Publisher
Lippincott Williams and Wilkins
Abstract
The hybrid approach to coronary revascularization is an evolving technique
that is being used as an alternative to the traditional median sternotomy
coronary artery bypass graft surgery. It combines a minimally invasive
approach to bypass the left anterior descending coronary artery with a
percutaneous approach to revascularize the other coronary arteries. A
systematic review of the available literature was conducted to evaluate
the benefits, and the short-and long-term outcomes of this procedure.

<11>
Accession Number
2015796339
Authors
Millan X. Skaf S. Joseph L. Ruiz C. Garcia E. Smolka G. Noble S.
Cruz-Gonzalez I. Arzamendi D. Serra A. Kliger C. Sia Y.T. Asgar A. Ibrahim
R. Jolicoeur E.M.
Institution
(Millan, Skaf, Asgar, Ibrahim, Jolicoeur) Department of Medicine, Montreal
Heart Institute, Universite de Montreal, Montreal, QC, Canada
(Joseph) Division of Clinical Epidemiology, McGill University Health
Centre, Montreal, QC, Canada
(Ruiz, Kliger) Division of Structural and Congenital Heart Disease, Lenox
Hill Heart and Vascular Institute-North Shore LIJ Health System, New York,
NY, United States
(Garcia) Division of Interventional Cardiology, Hospital Universitario
Clinico San Carlos, Madrid, Spain
(Smolka) Division of Cardiology, Medical University of Silesia, Katowice,
Poland
(Noble) Department of Medical Specialties, Cardiology Division, Universite
de Geneve, Geneva, Switzerland
(Cruz-Gonzalez) Division of Interventional Cardiology, Hospital
Universitario de Salamanca, Salamanca, Spain
(Arzamendi, Serra) Division of Interventional Cardiology, Hospital de la
Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
(Sia) Centre Hospitalier Universitaire de Montreal, Universite de
Montreal, Montreal, QC, Canada
Title
Transcatheter Reduction of Paravalvular Leaks: ASystematic Review and
Meta-analysis.
Source
Canadian Journal of Cardiology. 31 (3) (pp 260-269), 2015. Date of
Publication: 01 Mar 2015.
Publisher
Pulsus Group Inc.
Abstract
Background: Significant paravalvular leak (PVL) after surgical valve
replacement can result in intractable congestive heart failure and
hemolytic anemia. Because repeat surgery is performed in only few
patients, transcatheter reduction of PVL is emerging as an alternative
option, but its safety and efficacy remain uncertain. In this study we
sought to assess whether a successful transcatheter PVL reduction is
associated with an improvement in clinical outcomes. Methods: We
identified 12 clinical studies that compared successful and failed
transcatheter PVL reductions in a total of 362 patients. A Bayesian
hierarchical meta-analysis was performed using cardiac mortality as a
primary end point. The combined occurrence of improvement in New York
Heart Association functional class or hemolytic anemia and the need for
repeat surgery, were used as secondary end points. Results: A successful
transcatheter PVL reduction was associated with a lower cardiac mortality
rate (odds ratio [OR], 0.08; 95% credible interval [CrI], 0.01-0.90) and
with a superior improvement in functional class or hemolytic anemia,
compared with a failed intervention (OR, 9.95; 95% CrI, 2.10-66.73). Fewer
repeat surgeries were also observed after successful procedures (OR, 0.08;
95% CrI, 0.01-0.40). Conclusions: A successful transcatheter PVL reduction
is associated with reduced all-cause mortality and improved functional
class in patients deemed unsuitable for surgical correction.

<12>
Accession Number
71810035
Authors
Khan I.Y. Johnson S.R. Singer L.G. De Perrot M. Granton J.T. Keshavjee S.
Chau C. Kron A.T.
Institution
(Johnson) Division of Rheumatology, Toronto Western Hospital, University
Health Network Pulmonary Hypertension Programme, Toronto, Canada
(Khan) Pulmonary Hypertension Programme, University Health Network,
University of Toronto, Toronto, Canada
(Singer) Division of Respirology, University of Toronto, Canada
(Singer) Toronto Lung Transplant Program, University Health Network,
Toronto, Canada
(De Perrot, Keshavjee) Division of Thoracic Surgery, University Health
Network, University of Toronto, Toronto, Canada
(Granton) Toronto Pulmonary Hypertension Programme, Toronto General
Hospital, University of Toronto, Toronto, Canada
(Chau, Kron) Toronto Scleroderma Research Program, Toronto Western
Hospital, University of Toronto, Toronto, Canada
Title
Survival after lung transplantation in systemic sclerosis. A systematic
review.
Source
Clinical and Experimental Rheumatology. Conference: 3rd Systemic Sclerosis
World Congress Rome Italy. Conference Start: 20140206 Conference End:
20140208. Conference Publication: (var.pagings). 32 (2 SUPPL. 81) (pp
S18), 2014. Date of Publication: 2014.
Publisher
Clinical and Experimental Rheumatology S.A.S.
Abstract
Background/Purpose. Lung transplantation is a life-saving option for
systemic sclerosis (SSc)-associated pulmonary arterial hypertension (PAH)
and interstitial lung disease (SSc-ILD) patients. Yet, there is risk of
post-transplantation mortality. The objective of this study was to
evaluate survival of SSc patients post-lung transplantation. We
secondarily evaluated SSc lung transplant recipient characteristics, and
compared post-lung transplantation survival of SSc patients to non- SSc
patients (idiopathic PAH, and ILD). Methods. A systematic review of
MEDLINE, EMBASE, Cochrane Central Registry of Controlled Trials and CINAHL
(all inception to 2012) was performed to identify studies evaluating
post-lung transplant survival in SSc compared to non-SSc patients. Two
reviewers independently abstracted study and survival data using a
standardized form. Results. 226 citations were screened to identify 7
observational studies reporting SSc patients who underwent single lung,
double lung, or heart-lung transplantation. Mean age at transplantations
ranged 46-53 years. SSc post-transplantation survival ranged 69%-91% at
30-days, 69%-85% at 6-months, 59%-93% at 1-year, 49%-80% at 2-years, and
46%-79% at 3-years. ILD post-transplant survival was 80% at 30-days,
80%-90% at 6-months, 59%-83% at 2-years, and 69% at 3-years. IPAH post
transplant survival was 79% at 30-days, 79%-90% at 6-months, and 74%-90%
at 1-year. The reporting of overlapping cohorts potentially including the
same patients precluded meta-analysis. Causes of death in SSc patients,
when reported, included graft failure (n=6), infection (n=8), cardiac
events (n=3), hemorrhagic stroke (n=1), respiratory failure (n=3),
malignancy (n=2), pulmonary hypertension (n=1), complications of
bronchiolitis obliterans syndrome (BOS) (n=1), anesthetic complication
(n=1), and scleroderma renal crisis (n=1). There were no reports of
recurrence of SSc in the lung allograft. Conclusion. SSc survival
post-lung transplantation is very good, and improving with time. The
short-term and intermediate-term survival post-lung transplantation are
similar to IPAH and ILD patients requiring lung transplantation. Future
researchers should delineate the access process for lung transplantation
and report the occurrence of acute rejection, infection, bronchiolitis
obliterans syndrome, renal dysfunction and dialysis, gastroparesis, and
need for tube feeding.

<13>
Accession Number
71808902
Authors
Chandraprakasam S. Pandya J. Reddy A.K. Alla V.M.B.
Institution
(Chandraprakasam, Pandya, Reddy, Alla) Creighton University, Omaha, NE,
United States
Title
A meta-analysis of clinical outcomes between edwards valve versus
corevalve after transcatheter aortic valve replacement.
Source
JACC: Cardiovascular Interventions. Conference: Cardiovascular Research
Technologies, CRT 2015 Washington, DC United States. Conference Start:
20150221 Conference End: 20150224. Conference Publication: (var.pagings).
8 (2 SUPPL. 1) (pp S52-S53), 2015. Date of Publication: 01 Feb 2015.
Publisher
Elsevier Inc.
Abstract
BACKGROUND Transcatheter aortic valve replacement (TAVR) has been approved
by US FDA for high surgical risk and inoperable patients with severe
aortic stenosis. However, there is no single large study comparing the
performance of valves with respect to mortality or stroke. OBJECTIVE To
compare the 30-day mortality and stroke outcomes in TAVR patients treated
with balloon expandable valve (BEV, Edwards Lifesciences Corporation,
Irvine, Ca) and self-expanding valve (SEV, Medtronic CV, Luxembourg
S.a.r.l.). METHODS We performed an electronic search for studies published
between 2009 and 2014 reporting clinical outcomes for BEV and SEV. Pooled
odd's ratio with 95% confidence intervals was calculated using Mantel
Haenszel random effects model. RESULTS A total of 165 studies were
initially selected of which 10 studies were included in the final
analysis, yielding a total of 5204 patients (2779 with Edwards Valve and
2425 with CoreValve). Pooled estimate of 30-day mortality was 9.4% (493/
5204) and of stroke was 1.3% (71/5204). There was no difference in the
30-day mortality between the valves (OR 1.03, 95% CI 0.76 to 1.39). There
was no statistically significant difference in stroke risk (OR 1.75, 95%
CI 0.96 to 3.21). Figure 1 CONCLUSION Post-operative mortality and stroke
risk appear to be similar with both valves. Large randomized controlled
trials assessing clinical outcomes are warranted as these analyses may be
confounded by heterogeneity in study population, baseline risk
characteristics and TAVR approaches. (Table Presented).

<14>
Accession Number
71808602
Authors
Modi R. Patted S.V. Halkati P.C. Porwal S.C.
Institution
(Modi, Patted, Halkati, Porwal) KLES University and MRC, Belgaum, India
Title
Left main stenting registry.
Source
Indian Heart Journal. Conference: 66th Annual Conference of Cardiological
Society of India, CSI 2014 Hyderabad India. Conference Start: 20141204
Conference End: 20141207. Conference Publication: (var.pagings). 66 (pp
S94), 2014. Date of Publication: November 2014.
Publisher
Elsevier
Abstract
Background: Several studies have compared the treatment effects for left
main disease between coronary stenting and coronaryartery bypass grafting
(CABG). Various metaanalysis and present guidelines have revealed the
significance of syntax scores and anatomical location in left main artery
stenosis for determination of Major adverse cardiac events (MACE)
.However, debate still persists over the best treatment regarding
long-term outcomes of these two interventions for patients with left main
coronary artery disease. The aim of the study was to examine the
demographic parameters, presentation, immediate and long term outcomes of
stenting of left main coronary artery stenosis at out centre. Methods: Our
ongoing study has presently evaluated 100 patients in our centre with left
main coronary artery disease who underwent stent implantation between June
2011 and to date. We compared demographic parameters, SYNTAX scores,
anatomic conditions associated with left main artery stenosis and adverse
outcomes (death, Q-wave myocardial infarction, or stroke; and
target-vessel revascularization) in patients with left main artery
stenting. Results: Our results of demographic analysis revealed majority
of the patients with left main artery stenting to be males with age group
between 51-60 years. Among the risk factors, hypertension, diabetes and
dyslipidemia were found to be significant. Out of 100, stenting of
unprotected left main was performed in 90 patients. Syntax scores were low
in 70 intermediate in 19 and high in 11 patients. Anatomical location of
left main stenosis was ostial in 27, mid in 7 and distal in 66 with medina
classification of 1,1,1 in 49 patients . The most common technique used in
was crossover (72%) patients. In the study no patients reported of any
MACEE or adverse outcomes at regular follow up. Conclusions: In the study
of patients with left main artery disease, we found no significant MACEE
after stenting with drug eluting stents with respect to the syntax scores
and anatomical location of the left main artery stenosis.

<15>
Accession Number
71801378
Authors
Yuncu G. Ozturk G.
Institution
(Yuncu) Thoracic Surgery, Turkey
(Ozturk) PAU, Denizli, Turkey
Title
Peroperative enteral nutrition with arginine-omega-3 fatty acids and
ribonucleic acid and glutamin supplemented diet could improve
postoperative recovery in lung cancer patients.
Source
Clinical Nutrition. Conference: 36th European Society for Clinical
Nutrition and Metabolism, ESPEN Congress Geneva Switzerland. Conference
Start: 20140906 Conference End: 20140909. Conference Publication:
(var.pagings). 33 (pp S60), 2014. Date of Publication: September 2014.
Publisher
Churchill Livingstone
Abstract
Rationale: The purpose of this study was to evaluate the effect of
peroperative immunonutrition pharmaceutics diet versus standard enteral
nutrition on postoperative recovery of patients with lung cancer. Methods:
A retrospective, controlled clinical study was conducted from January 2012
to March 2014 in the Department of Thoracic Surgery, Pamukkale University,
School of Medicine. Patients with lung cancer undergoing elective surgery
were divided into an immunonutrition group (n=32) and a control group
(n=30). Patients in the immunonutrition group received oral
supplementation containing arginine, omega-3 fatty acids, RNA and glutamin
for 7 days prior to surgery and for 15 days after surgery. Patients in the
control group received no artificial nutrition and were allowed to consume
regular food before surgery. Postoperative complications, surgical site
infections, and the days of postoperative hospitalization were measured.
Results: No significant differences between the 2 groups were noted for
the body mass index, total protein, albumin, hemoglobin, surgical methods,
operation time, or volume of intraoperative bleeding. The incidence of
postoperative complications was significantly lower and the days of
postoperative hospitalization were significantly decreased in the
immunonutrition group (P<0.05). Conclusion: Peroperative enteral
immunonutrition improves postoperative recovery in lung cancer patients.

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