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
2015660288
Authors
Xiong Y. Sun Y. Ji B. Liu J. Wang G. Zheng Z.
Institution
(Xiong, Sun, Ji, Liu) Department of Cardiopulmonary Bypass, Cardiovascular
Institute, Fuwai Heart Hospital, Beijing, China
(Xiong) Department of Cardiopulmonary Bypass, Second XiangYa Hospital,
Central South University, ChangSha, China
(Wang) Department of Anesthesiology, Cardiovascular Institute, Fuwai Heart
Hospital, Beijing, China
(Zheng) Department of Cardiovascular Surgery, Cardiovascular Institute,
Fuwai Heart Hospital, Beijing, China
Title
Systematic Review and Meta-Analysis of benefits and risks between
normothermia and hypothermia during cardiopulmonary bypass in pediatric
cardiac surgery.
Source
Paediatric Anaesthesia. 25 (2) (pp 135-142), 2015. Date of Publication: 01
Feb 2015.
Publisher
Blackwell Publishing Ltd
Abstract
Background The controversy over the benefits between normothermic and
hypothermic cardiopulmonary bypass (CPB) for children is still uncertain.
The purpose of this systematic review and meta-analysis is to investigate
the benefits and risks of normothermia comparing with hypothermia in
pediatric cardiac surgery by randomized controlled trials. Methods Pubmed,
Embase, and the Cochrane Central Register of Controlled Trials were
searched for studies reported in English up to September 28, 2013.
Eligible studies were those in which investigators enrolled pediatric
patients, who had cardiac surgery, randomized them to normothermic or
hypothermic CPB. We prespecified the use of random-effects models to
calculate risk ratios and 95% CIs for binary variables, weighted mean
difference (WMD) or standard mean difference and 95% CIs for continuous
variables. We assessed heterogeneity using I². When
heterogeneity was absent (I² = 0%), we used fixed-effects
models. The endpoints were serum lactate, serum creatinine, duration of
clamp, and duration of CPB in pediatrics who had cardiac surgery in
normothermic CPB compared with those in hypothermic CPB. Results The
initial search strategy identified 3910 citations, of which 10 trials
compared pediatrics and seven trails were eligible. These seven trials
included 419 participants from seven countries. The serum lactate and the
serum creatinine had three time points. The outcomes had no different
between normothermic group and hypothermic group. Duration of clamp (WMD =
-10.793, 95% CI -28.89, 7.304; P = 0.242; I² = 86.6%; 204
patients, three trials) and duration of CPB (WMD = -41.780, 95% CI
-89.523, 5.963; P = 0.086; I² = 95.6%; 199 patients, three
trials) also had no significant differences between two groups. Conclusion
Normothermic CPB is as safe as hypothermic CPB in children requiring
correction of simple congenital cardiac defects.

<3>
Accession Number
2015830629
Authors
Linni K. Aspalter M. Butturini E. Dabernig W. Guggenbichler S. Hitzl W.
Holzenbein T.
Institution
(Linni, Aspalter, Butturini, Dabernig, Guggenbichler, Holzenbein)
Department of Vascular and Endovascular Surgery, PMU Salzburg, Mullner
Hauptstrasse 48, Salzburg A-5020, Austria
(Hitzl) Department of Biostatistics, PMU, Salzburg, Austria
Title
Arm veins versus contralateral greater saphenous veins for lower extremity
bypass reconstruction: Preliminary data of a randomized study.
Source
Annals of Vascular Surgery. 29 (3) (pp 551-559), 2015. Date of
Publication: 01 Apr 2015.
Publisher
Elsevier Inc.
Abstract
Background The aim of this randomized study was to determine whether arm
vein (AV) or contralateral greater saphenous vein (CGSV) is the better
alternative vein source for lower extremity bypass reconstruction. Methods
Consecutive patients with absent ipsilateral greater saphenous vein
undergoing lower extremity revascularization were allocated to group A (AV
bypass) or B (CGSV bypass). Results From 6, 2010, to 11, 2013, 64 patients
(32 each group) were randomized. In all, 29 of 93 patients had to be
excluded for various reasons. Median age was 76 years vs. 71 years (P =
0.01) for group A and B patients. There were no statistically significant
differences regarding gender, cardiovascular risk factors, redo bypass
procedures (P = 0.77), below-knee bypass procedures (P = 0.61), median
bypass length (P = 0.6), and median length of incision on ipsilateral leg
to perform anastomoses (P = 0.2) between group A and B patients,
respectively. Incisions for vein harvest were longer in group A (P =
0.003). Overall surgical site infections (SSIs, P = 1.0) and SSI from vein
harvest (P = 1.0) were equally distributed. No patient was lost to
follow-up (17 vs. 18 months, P = 0.74). There was no statistically
significant difference regarding primary (P = 0.77) and secondary (P =
0.25) patency rates at 1 year (group A: 52% vs. group B: 54% and group A:
72% vs. group B: 61%) and at 2 years (52% vs. 48% and 64% vs. 61%),
respectively. There were 4 vs. 6 major amputations (P = 0.23) and 5 vs. 2
deaths (P = 0.1) in groups A and B during follow-up. Conclusions
Preliminary results suggest that both AV and CGSV may serve as a secondary
vein bypass graft equally well.

<4>
Accession Number
2015833633
Authors
Miao X. Liu J. Zhao M. Cui Y. Feng Z. Zhao J. Long C. Li S. Yan F. Wang X.
Hu S.
Institution
(Miao, Liu, Zhao, Cui, Feng, Zhao, Long) Department of Cardiopulmonary
Bypass, Cardiovascular Institute, Fuwai Hospital, No 167, Bei Li Shi Road
Xi Cheng, Beijing 100037, China
(Li, Wang, Hu) Department of Cardiac Surgery, Fuwai Hospital, Chinese
Academy of Medical Science, Beijing, China
(Yan) Department of Anesthesiology, Fuwai Hospital, Chinese Academy of
Medical Science, Beijing, China
Title
Evidence-based use of FFP: The influence of a priming strategy without FFP
during CPB on postoperative coagulation and recovery in pediatric
patients.
Source
Perfusion (United Kingdom). 30 (2) (pp 140-147), 2015. Date of
Publication: 16 Mar 2015.
Publisher
SAGE Publications Ltd
Abstract
Objective: Although fresh frozen plasma (FFP) is one of the most commonly
used hemostatic agents in clinical specialties today, there is little
evidence available supporting its administration. Our present study
observed the effects of a priming strategy without FFP during
cardiopulmonary bypass (CPB) on postoperative coagulation and clinical
recovery in pediatric patients, aiming to supply new evidence for
evidence-based use of FFP. Method: Eighty pediatric patients with
congenital heart disease undergoing cardiac surgery with CPB were
randomized to receive either 10-20 ml/kg 4% succinylated gelatin
(Gelofusine, GEL group, n = 40) or 1-2 units FFP (FFP group, n = 40) in
the pump prime. Rapid-thromboelastography (r-TEG) and functional
fibrinogen level were measured before skin incision and 15 minutes after
heparin reversal. We recorded the volume of chest tube drainage,
transfusion requirements and the dosage of pharmacological agents. The
ventilation time, ICU length of stay and hospitalization time after
surgery were also collected. Results: After heparin neutralization, there
were significantly elevated levels of fibrinogen in the FFP group, which
were manifested by r-TEG parameters MAf and FLEV. No significant
differences were observed between the two groups in postoperative
bleeding, transfusion requirements and the usage of pharmacological
agents. Recovery time was also comparable between the two groups.
Conclusion: In conclusion, prophylactic use of FFP in the priming solution
does not provide clinical benefits as presumed. Artificial colloids, such
as Gelofusine, can be used safely and effectively as a substitute for FFP
in the pump prime. TEG is an effective assessment tool to evaluate
postoperative coagulation function in pediatric patients.

<5>
Accession Number
2015834339
Authors
Hu X.-Q. Cheng J. Tang B. Zhang Z.-H. Huang K. Yang Y.-P. Mao Y.-Y. Zhong
M. Fu S.-W.
Institution
(Hu, Cheng, Tang, Huang, Yang, Mao, Zhong, Fu) Department of
Cardiovascular Medicine, Jinhua Municipal Central Hospital, Jinhua 321000,
China
(Zhang) Department of Critical Care Medicine, Jinhua Municipal Central
Hospital, Jinhua 321000, China
Title
Clinical effect of postconditioning in ST-elevation myocardial infarction
patients treated with primary percutaneous coronary intervention: a
meta-analysis of randomized controlled trials.
Source
Journal of Zhejiang University: Science B. 16 (3) (pp 198-207), 2015. Date
of Publication: 2015.
Publisher
Zhejiang University Press (Hangzhou Post Bureau, Hangzhou 310000, China)
Abstract
Objective: To evaluate the clinical effect of postconditioning on patients
with ST-elevation myocardial infarction (STEMI) treated with primary
percutaneous coronary intervention (PCI).
Methods: Randomized controlled trials were identified by searching
relevant databases published up to April 2nd, 2014. A meta-analysis of
eligible studies was performed by Stata 12.0 and Review Manager 5.2 with a
fixed-effect model.
Results: Ten studies providing adverse cardiac events in a total of 1346
STEMI patients treated with primary PCI were identified. The occurrence of
heart failure was significantly reduced in patients treated with
postconditioning compared with usual care (risk ratio (RR) 0.533; 95%
confidence intervals (CI) 0.368-0.770), whereas non-fatal reinfarction
slightly increased in the postconditioning group (RR 2.746; 95% CI
1.007-7.488). No significant difference in total major adverse cardiac
events (MACEs) was observed between the two groups (RR 0.876; 95% CI
0.671-1.144).
Conclusions: Postconditioning in STEMI patients undergoing primary PCI
significantly reduces the risk of heart failure, but fails to decrease the
incidence of total MACEs and the risk of non-fatal reinfarction.

<6>
Accession Number
2015824932
Authors
Kim S.H. Sung J.-H. Shin J. Lee H.J. Lee H.S. Cho D.K. Lim S.W.
Institution
(Kim, Sung, Lim) Department of Cardiology, CHA University, CHA Bundang
Medical Center, 351 Yatap-dong, Bundang-gu, Seongnam-si, Gyeonggi-do
463-712, South Korea
(Shin) Department of Cardiology, Hanyang University Medical Center, Seoul,
South Korea
(Lee) Department of Cardiology, Sejong General Hospital, Bucheon, South
Korea
(Lee) Department of Cardiology, CHA Gumi Medical Center, CHA University,
Gumi, South Korea
(Cho) Department of Cardiology, Myongji Hospital, Goyang, South Korea
Title
Assessment of the efficacy and tolerability of clopidogrel napadisilate in
Korean patients with coronary stenting: A multicenter, prospective,
open-label, randomized trial.
Source
Current Medical Research and Opinion. 31 (3) (pp 449-457), 2015. Date of
Publication: 01 Mar 2015.
Publisher
Informa Healthcare
Abstract
Objective: Clopidogrel is indicated for the treatment and prevention of
peripheral vascular, cerebrovascular, and coronary artery diseases. This
clinical trial was designed to demonstrate that clopidogrel napadisilate
(CN) is not inferior to clopidogrel bisulfate (CB) with respect to its
effectiveness in inhibiting platelet aggregation. Methods: This 4 week
multi-center, prospective, open-label, randomized trial was conducted at
five clinical centers in South Korea. Patients were randomized into the
75mg CN group or the 75mg CB group. Platelet aggregation was assessed by
the VerifyNow assay. The primary outcome was the difference of the
percentage P2Y12 inhibition and the secondary outcome was the baseline and
change in P2Y12 reaction units (PRU). Results: There was no significant
difference in the percentage P2Y12 inhibition (CN vs. CB, 34.92+/-21.33%
vs. 30.43+/-17.90%, p=0.203). The mean difference of the percentage P2Y12
inhibition between groups was 4.49%, their two-sided 95% confidence
interval was-2.45% to 11.44%, and the lower bound (-2.45%) was greater
than the acceptable non-inferiority margin of-9.0%. The baseline PRU was
96.67+/-76.76 in the CN group and 216.95+/-68.86 in the CB group
(p=0.121), and the change in the PRU was-3.32+/-51.71 in the CN group and
10.52+/-43.31 in the CB group (p=0.106). Four subjects experienced AEs
(6.3%, 5 events) in the CN group and 7 subjects (11.11%, 13 events) in the
CB group without statistical significance (p=0.364). With respect to
serious adverse events, 2 events were reported in 2 subjects, 1 in each
group. Conclusion: Clopidogrel napadisilate was not inferior to
clopidogrel bisulfate in terms of antiplatelet efficacy and tolerability,
and there were no clinically significant adverse events.

<7>
Accession Number
2015830842
Authors
Tamborini Permunian E. Riva N. Guasti L. Squizzato A.
Institution
(Tamborini Permunian, Riva, Guasti, Squizzato) University of Insubria,
Research Center on Thromboembolic Disorders and Antithrombotic Therapies,
Department of Clinical and Experimental Medicine, Viale Borri 57, Varese
21100, Italy
Title
Cangrelor for the treatment of arterial thrombosis:
Pharmacokinetics/pharmacodynamics and clinical data.
Source
Expert Opinion on Drug Metabolism and Toxicology. 11 (4) (pp 625-637),
2015. Date of Publication: 01 Apr 2015.
Publisher
Informa Healthcare
Abstract
Introduction: Dual antiplatelet therapy is the standard of care for
patients with acute coronary syndromes or with recent coronary stents
implantation. P2Y12 receptor antagonists have shown to reduce the risk of
recurrent ischemic events among these patients, at the expense of an
increased risk of bleeding. Cangrelor is a novel, intravenous,
short-acting, reversible platelet P2Y12 inhibitor, which has been
evaluated for the treatment of arterial thrombosis.Areas covered: Studies
on the pharmacological characteristics of cangrelor and clinical trials
were retrieved by a PubMed literature search.Expert opinion: Cangrelor has
been tested in patients with coronary artery diseases undergoing
percutaneous coronary intervention and as bridging therapy for patients
undergoing coronary artery bypass graft. The rapid peak of action allows a
fast and complete inhibition of platelet aggregation; the rapid offset is
advantageous in case of bleeding complications; and finally, the
intravenous administration also makes this drug suitable for patients
unable to consume oral medications. Unfortunately, the large clinical
trials evaluating cangrelor in percutaneous coronary intervention did not
show superiority to the standard antiplatelet therapy, and its future use
in this setting still needs to be better assessed. Conversely, when used
as bridging therapy to coronary artery bypass graft, cangrelor showed
promising results.

<8>
Accession Number
2015820577
Authors
Sibilitz K.L. Berg S.K. Hansen T.B. Risom S.S. Rasmussen T.B. Hassager C.
Kober L. Gluud C. Thygesen L.C. Lindschou J. Schmid J.P. Taylor R.S.
Zwisler A.-D.
Institution
(Sibilitz, Berg, Risom, Rasmussen, Hassager, Kober, Zwisler) The Heart
Centre, Department of Cardiology, Rigshospitalet, Copenhagen, University
Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
(Berg, Rasmussen) Department of Cardiology, Gentofte Hospital, Gentofte,
Denmark
(Sibilitz, Berg, Thygesen, Taylor, Zwisler) National Institute of Public
Health, University of Southern Denmark, Copenhagen, Denmark
(Hansen) Department of Cardiology, Roskilde Hospital, Roskilde, Denmark
(Gluud, Lindschou) Copenhagen Trial Unit, Centre for Clinical Intervention
Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen,
Denmark
(Schmid) Cardiology Clinic, Tiefenau Hospital and University of Bern,
Bern, Switzerland
(Taylor) University of Exeter Medical School, Health Services Research,
University of Exeter, Exeter, Devon, United Kingdom
(Zwisler) Department of Cardiology, Holbaek Sygehus, Holbaek, Denmark
Title
Update to the study protocol, including statistical analysis plan for a
randomized clinical trial comparing comprehensive cardiac rehabilitation
after heart valve surgery with control: The CopenHeartVR trial.
Source
Trials. 16 (1) , 2015. Article Number: 38. Date of Publication: February
05, 2015.
Publisher
BioMed Central Ltd.
Abstract
Background: Heart valve diseases are common with an estimated prevalence
of 2.5% in the Western world. The number is rising because of an ageing
population. Once symptomatic, heart valve diseases are potentially lethal,
and heavily influence daily living and quality of life. Surgical
treatment, either valve replacement or repair, remains the treatment of
choice. However, post-surgery, the transition to daily living may become a
physical, mental and social challenge. We hypothesize that a comprehensive
cardiac rehabilitation program can improve physical capacity and
self-assessed mental health and reduce hospitalization and healthcare
costs after heart valve surgery. Methods: This randomized clinical trial,
CopenHeart_VR, aims to investigate whether cardiac
rehabilitation in addition to usual care is superior to treatment as usual
after heart valve surgery. The trial will randomly allocate 210 patients
1:1 to an intervention or a control group, using central randomization,
and blinded outcome assessment and statistical analyses. The intervention
consists of 12 weeks of physical exercise and a psycho-educational
intervention comprising five consultations. The primary outcome is peak
oxygen uptake (VO₂ peak) measured by cardiopulmonary exercise
testing with ventilatory gas analysis. The secondary outcome is
self-assessed mental health measured by the standardized questionnaire
Short Form-36. Long-term healthcare utilization and mortality as well as
biochemistry, echocardiography and cost-benefit will be assessed. A
mixed-method design will be used to evaluate qualitative and quantitative
findings, encompassing a survey-based study before the trial and a
qualitative pre-and post-intervention study. Conclusion: This randomized
clinical trial will contribute with evidence of whether cardiac
rehabilitation should be provided after heart valve surgery. The study is
approved by the local regional Research Ethics Committee (H-1-2011-157),
and the Danish Data Protection Agency (j.nr. 2007-58-0015).

<9>
Accession Number
2015740491
Authors
Wang J.-G. Han J. Jiang T. Li Y.-J.
Institution
(Wang, Li) Department of Pathology, Affiliated Hospital of Qingdao
University, 16 Jiangsu Road, Qingdao 266003, China
(Han) Department of Pathology, Zhongshan Hospital, Fudan University,
Shanghai, China
(Jiang) Department of Oncology, Affiliated Hospital of Qingdao University,
Qingdao, China
Title
Cardiac paragangliomas.
Source
Journal of Cardiac Surgery. 30 (1) (pp 55-60), 2015. Date of Publication:
01 Jan 2015.
Publisher
Blackwell Publishing Inc.
Abstract
Cardiac paraganglioma is a rare entity. We review the clinical data from
158 patients reported in 132 isolated papers, and discuss clinical
presentations, imaging findings, pathology, location, therapy, and
outcomes. doi: 10.1111/jocs.12455 (J Card Surg 2015;30:55-60)

<10>
Accession Number
2015826567
Authors
Murphy G.J. Pike K. Rogers C.A. Wordsworth S. Stokes E.A. Angelini G.D.
Reeves B.C.
Institution
(Murphy) Department of Cardiovascular Sciences, University of Leicester,
Glenfield General Hospital, Leicester, United Kingdom
(Pike, Rogers, Angelini, Reeves) Bristol Heart Institute, School of
Clinical Sciences, University of Bristol, Bristol Royal Infirmary, Bristol
BS2 8HW, United Kingdom
(Wordsworth, Stokes) Health Economics Research Centre, Nuffield Department
of Population Health, University of Oxford, Oxford, United Kingdom
Title
Liberal or restrictive transfusion after cardiac surgery.
Source
New England Journal of Medicine. 372 (11) (pp 997-1008), 2015. Date of
Publication: 12 Mar 2015.
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND: Whether a restrictive threshold for hemoglobin level in
red-cell transfusions, as compared with a liberal threshold, reduces
postoperative morbidity and health care costs after cardiac surgery is
uncertain. METHODS: We conducted a multicenter, parallel-group trial in
which patients older than 16 years of age who were undergoing nonemergency
cardiac surgery were recruited from 17 centers in the United Kingdom.
Patients with a postoperative hemoglobin level of less than 9 g per
deciliter were randomly assigned to a restrictive transfusion threshold
(hemoglobin level <7.5 g per deciliter) or a liberal transfusion threshold
(hemoglobin level <9 g per deciliter). The primary outcome was a serious
infection (sepsis or wound infection) or an ischemic event (permanent
stroke [confirmation on brain imaging and deficit in motor, sensory, or
coordination functions], myocardial infarction, infarction of the gut, or
acute kidney injury) within 3 months after randomization. Health care
costs, excluding the index surgery, were estimated from the day of surgery
to 3 months after surgery. RESULTS: A total of 2007 patients underwent
randomization; 4 participants withdrew, leaving 1000 in the
restrictive-threshold group and 1003 in the liberal-threshold group.
Transfusion rates after randomization were 53.4% and 92.2% in the two
groups, respectively. The primary outcome occurred in 35.1% of the
patients in the restrictivethreshold group and 33.0% of the patients in
the liberal-threshold group (odds ratio, 1.11; 95% confidence interval
[CI], 0.91 to 1.34; P = 0.30); there was no indication of heterogeneity
according to subgroup. There were more deaths in the restrictivethreshold
group than in the liberal-threshold group (4.2% vs. 2.6%; hazard ratio,
1.64; 95% CI, 1.00 to 2.67; P = 0.045). Serious postoperative
complications, excluding primary-outcome events, occurred in 35.7% of
participants in the restrictivethreshold group and 34.2% of participants
in the liberal-threshold group. Total costs did not differ significantly
between the groups. CONCLUSIONS: A restrictive transfusion threshold after
cardiac surgery was not superior to a liberal threshold with respect to
morbidity or health care costs. (Funded by the National Institute for
Health Research Health Technology Assessment program; Current Controlled
Trials number, ISRCTN70923932.)

<11>
Accession Number
2015821453
Authors
Vercueil A.
Institution
(Vercueil) King's College Hospital, NHS Foundation Trust King's Health
Partners, London, United Kingdom
Title
Ischaemic conditioning: Intervening to protect; Before, after, and at a
distance.
Source
Anaesthesia. 70 (4) (pp 379-383), 2015. Date of Publication: 01 Apr 2015.
Publisher
Blackwell Publishing Ltd

<12>
Accession Number
2015747552
Authors
Kajimoto K. Yamamoto T. Amano A.
Institution
(Kajimoto, Yamamoto, Amano) Department of Cardiovascular Surgery, Juntendo
University School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421,
Japan
Title
Coronary artery bypass revascularization using bilateral internal thoracic
arteries in diabetic patients: A systematic review and meta-analysis.
Source
Annals of Thoracic Surgery. 99 (3) (pp 1097-1104), 2015. Date of
Publication: 01 Mar 2015.
Publisher
Elsevier USA
Abstract
This study examined the effect of coronary artery bypass graft surgery
with bilateral internal thoracic artery grafting in diabetic patients.
Coronary artery bypass graft surgery using skeletonized bilateral internal
thoracic artery grafts was not associated with an increased risk of deep
sternal wound infection or early death. Moreover, patients who underwent
coronary artery bypass graft surgery using bilateral internal thoracic
artery grafting had lower remote mortality and cardiac mortality. We
conclude that coronary artery bypass surgery using bilateral internal
thoracic artery grafts is an excellent strategy, even for diabetic
patients.

<13>
Accession Number
2015723737
Authors
Lam C.S.P. McEntegart M. Claggett B. Liu J. Skali H. Lewis E. Kober L.
Rouleau J. Velazquez E. Califf R. McMurray J.J. Pfeffer M. Solomon S.
Institution
(Lam) National University Health System, Tower Block, 1E Kent Ridge Road
119228, Singapore
(McEntegart, McMurray) Department of Cardiology, Western Infirmary
Scotland, Glasgow, United Kingdom
(Claggett, Liu, Skali, Lewis, Pfeffer, Solomon) Brigham and Women's
Hospital, Boston, MA, United States
(Kober) Rigshospitalet, Copenhagen, Denmark
(Rouleau) Montreal Heart Institute, QC, Canada
(Velazquez, Califf) Duke University Medical Center, Durham, NC, United
States
Title
Sex differences in clinical characteristics and outcomes after myocardial
infarction: Insights from the Valsartan in Acute Myocardial Infarction
Trial (VALIANT).
Source
European Journal of Heart Failure. 17 (3) (pp 301-312), 2015. Date of
Publication: 01 Mar 2015.
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom)
Abstract
Background We examined the association of sex with clinical
characteristics and outcomes in patients following myocardial infarction
(MI) in the Valsartan in Acute Myocardial Infarction Trial (VALIANT).
Methods and Results A total of 4570 women and 10 133 men with heart
failure (HF), left ventricular systolic dysfunction or both were enrolled
0.5-10 days after myocardial infarction (MI) and followed for a median of
24.7 months. Compared with men, women were older, had more comorbidities,
and were more likely to present in Killip Class III/IV and experience
post-infarction angina or HF. After adjusting for baseline differences,
both short-term and longer-term mortality were similar in men and women.
However, women were more likely than men to experience the composite
outcome of cardiovascular death, MI, HF, stroke, and resuscitation from
cardiac arrest [adjusted hazard ratio (HR) 1.15; 95% confidence interval
(CI); 1.06-1.24, P = 0.001], mainly owing to an increased risk of
hospitalization for HF (adjusted HR 1.36; 95% CI 1.22-1.52; P < 0.001). In
a subset of patients who underwent echocardiographic study (n = 603),
women had smaller left ventricular volumes indexed by body size than men
but similar ejection fractions and similar changes in ventricular volumes
from baseline to 1 month and 20 months. Conclusions In VALIANT, the risk
of HF following MI was higher in women than men after adjusting for age
and comorbidities, although the risk of other fatal and non-fatal outcomes
were similar. The higher long-term risk of HF in women appears to be
independent of the extent of left ventricular systolic dysfunction or
remodelling compared with men.

<14>
Accession Number
2015812729
Authors
Opfermann P. Derhaschnig U. Felli A. Wenisch J. Santer D. Zuckermann A.
Dworschak M. Jilma B. Steinlechner B.
Institution
(Opfermann, Felli, Dworschak, Steinlechner) Division of Cardiothoracic and
Vascular Anesthesia and Intensive Care, Medical University of Vienna,
Vienna, Austria
(Derhaschnig, Jilma) Department of Clinical Pharmacology, Medical
University of Vienna, Vienna, Austria
(Wenisch) Department of Internal Medicine I, Department of Clinical
Pharmacology, Medical University of Vienna, Vienna, Austria
(Zuckermann) Division of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Santer) Division of Cardiovascular Surgery, Hietzing Hospital, Vienna,
Austria
Title
A pilot study on reparixin, a CXCR1/2 antagonist, to assess safety and
efficacy in attenuating ischaemia-reperfusion injury and inflammation
after on-pump coronary artery bypass graft surgery.
Source
Clinical and Experimental Immunology. 180 (1) (pp 131-142), 2015. Date of
Publication: 01 Apr 2015.
Publisher
Blackwell Publishing Ltd
Abstract
Summary: Reparixin, a CXCR 1/2 antagonist, has been shown to mitigate
ischaemia-reperfusion injury (IRI) in various organ systems in animals,
but data in humans are scarce. The aim of this double-blinded,
placebo-controlled pilot study was to evaluate the safety and efficacy of
reparixin to suppress IRI and inflammation in patients undergoing on-pump
coronary artery bypass grafting (CABG). Patients received either reparixin
or placebo (n=16 in each group) after induction of anaesthesia until 8h
after cardiopulmonary bypass (CPB). We compared markers of systemic and
pulmonary inflammation, surrogates of myocardial IRI and clinical outcomes
using Mann-Whitney U- and Fisher's exact tests. Thirty- and 90-day
mortality was 0% in both groups. No side effects were observed in the
treatment group. Surgical revision, pleural and pericardial effusion,
infection and atrial fibrillation rates were not different between groups.
Reparixin significantly reduced the proportion of neutrophil granulocytes
in blood at the beginning [49%, interquartile range (IQR)=45-57 versus
58%, IQR=53-66, P=0035], end (71%, IQR=67-76 versus 79%, IQR=71-83,
P=0023) and 1h after CPB (73%, IQR=71-75 versus 77%, IQR=72-80, P=0035).
Reparixin patients required a lesser positive fluid balance during surgery
(2575ml, IQR=2027-3080 versus 3200ml, IQR=2928-3778, P=0029) and during
ICU stay (2603ml, IQR=1023-4288 versus 4200ml, IQR=2313-8160, P=0021).
Numerically, more control patients required noradrenaline > 011mug/kg/min
(50 versus 19%, P=0063) and dobutamine (50 versus 25%, P=014). Therefore,
administration of reparixin in CABG patients appears to be feasible and
safe. It concurrently attenuated postoperative granulocytosis in
peripheral blood.

<15>
Accession Number
2015824155
Authors
Shakouri S.K. Salekzamani Y. Taghizadieh A. Sabbagh-Jadid H. Soleymani J.
Sahebi L. Sahebi R.
Institution
(Shakouri, Salekzamani, Sabbagh-Jadid, Soleymani) Physical Medicine and
Rehabilitation Research Center, Tabriz University of Medical Sciences,
Tabriz, Iran, Islamic Republic of
(Taghizadieh) Tuberculosis and Lung Disease Research Center, Tabriz
University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Sahebi, Sahebi) Tabriz Health Service Management Research Center,
National public health management center (NPMC), Tabriz University of
Medical Sciences, Tabriz, Iran, Islamic Republic of
Title
Effect of respiratory rehabilitation before open cardiac surgery on
respiratory function: A randomized clinical trial.
Source
Journal of Cardiovascular and Thoracic Research. 7 (1) (pp 13-17), 2015.
Date of Publication: 2015.
Publisher
Tabriz University of Medical Sciences
Abstract
Introduction: Prevention of pulmonary complications after coronary artery
bypass graft is attended as a very important issue. The aim of this study
was to evaluate the role of pulmonary rehabilitation before surgery for
reducing the risk of pulmonary complications after surgery. Methods: In a
randomized clinical trial, 60 patients undergoing heart surgery were
randomly divided into two groups A and B. Chest physiotherapy was
performed before and after surgery on group A patients however it was done
on group B's, only after surgery. Effects of preoperative pulmonary
rehabilitation were compared between two groups, using spirometry and
arterial blood gas (ABG). Results: Thirty nine males (65%) and 21 females
(35%) with mean age of 8.10 +/- 9.56 were analyzed. The mean differences
were statistically significant for predicted forced vital capacity (FVC)
(CI 95%:1.3 to 8.7) and Predicted Peak Flow indices (PEF) (CI 95%: 1.9 to
9.4) of spirometry indicator, PCO2 index (of ABG parameter) (CI 95%: 1.4
to 8.9) and mean oxygen saturation (mean Spo2) (CI 95%: 0.6 to 1.7) of ABG
index in two groups. Conclusion: The performance of pulmonary
rehabilitation program before surgery is recommended, as it may result in
the reduction of complications of heart surgery.

<16>
Accession Number
2015811458
Authors
Lai K.S.P. Herrmann N. Saleem M. Lanctot K.L.
Institution
(Lai, Herrmann, Saleem, Lanctot) Neuropsychopharmacology Research Group,
Sunnybrook Health Sciences Centre, Toronto, ON M4N3M5, Canada
(Lai) Faculty of Medicine, University of Toronto, Toronto, ON M5S1A8,
Canada
(Herrmann, Lanctot) Department of Psychiatry, University of Toronto,
Toronto, ON M5T1R8, Canada
(Saleem, Lanctot) Department of Pharmacology and Toxicology, University of
Toronto, Toronto, ON M5S1A8, Canada
Title
Cognitive outcomes following transcatheter aortic valve implantation: A
systematic review.
Source
Cardiovascular Psychiatry and Neurology. 2015 , 2015. Article Number:
209569. Date of Publication: 2015.
Publisher
Hindawi Publishing Corporation (410 Park Avenue, 15th Floor, 287 pmb, New
York NY 10022, United States)
Abstract
Severe aortic stenosis is the most common valvular heart disease in the
elderly in the Western world and contributes to a large proportion of all
deaths over the age of 70. Severe aortic stenosis is conventionally
treated with surgical aortic valve replacement; however, the less invasive
transcatheter aortic valve implantation (TAVI) is suggested for those at
high surgical risk. While TAVI has been associated with improved survival
and favourable outcomes, there is a higher incidence of cerebral
microembolisms in TAVI patients. This finding is of concern given
mechanistic links with cognitive decline, a symptom highly prevalent in
those with cardiovascular disease. This paper reviews the literature
assessing the possible link between TAVI and cognitive changes. Studies to
date have shown that global cognition improves or remains unchanged over 3
months following TAVI while individual cognitive domains remain preserved
over time. However, the association between TAVI and cognition remains
unclear due to methodological limitations. Furthermore, while these
studies have largely focused on memory, cognitive impairment in this
population may be predominantly of vascular origin. Therefore, cognitive
assessment focusing on domains important in vascular cognitive impairment,
such as executive dysfunction, may be more helpful in elucidating the
association between TAVI and cognition in the long term.

<17>
Accession Number
2015821403
Authors
Maurice-Szamburski A. Auquier P. Viarre-Oreal V. Cuvillon P. Carles M.
Ripart J. Honore S. Triglia T. Loundou A. Leone M. Bruder N.
Institution
(Maurice-Szamburski, Viarre-Oreal, Triglia, Bruder) Service d'Anesthesie
Reanimation, Hopital de la Timone Adulte, 264 Rue Saint Pierre, Marseille
CEDEX 05 13385, France
(Auquier) Laboratoire Universitaire EA 3279, Sante Publique et Maladies
Chroniques, Universite Aix-Marseille, Marseille, France
(Cuvillon) Service d'Anesthesie, Institut du Cancer, Universite
Montpellier 1, Montpellier, France
(Carles) Service d'Anesthesie Reanimation, Hopital Archet, Universite Nice
Sophia-Antipolis, Nice, France
(Ripart) Service d'Anesthesie, Pole ARDU, Hopital Universitaire Caremeau,
Nimes, Montpellier, France
(Honore) Expertise Pharmaceutique, Hopital de la Timone Adulte, Universite
Aix, Marseille, France
(Loundou) Unite d'Aide Methodologique, Direction de la Recherche Clinique,
AP-HM, Marseille, France
(Leone) Service d'Anesthesie Reanimation, Hopital Nord, Universite
Aix-Marseille, Marseille, France
Title
Effect of sedative premedication on patient experience after general
anesthesia: A randomized clinical trial.
Source
JAMA - Journal of the American Medical Association. 313 (9) (pp 916-925),
2015. Date of Publication: 03 Mar 2015.
Publisher
American Medical Association
Abstract
IMPORTANCE Sedative premedication is widely administered before surgery,
but little clinical evidence supports its use. OBJECTIVE To assess the
efficacy of sedative premedication on perioperative patient experience.
DESIGN, SETTING, AND PARTICIPANTS A randomized clinical trial, the PremedX
study, enrolled 1062 adult patients who were younger than 70 years and had
been scheduled for various elective surgeries under general anesthesia at
5 French teaching hospitals (in Marseille, Montpellier, Nimes, and Nice)
between January 2013 and June 2014. Neurosurgery, obstetrical, cardiac,
and outpatient surgery were excluded. INTERVENTIONS Patients were
randomized to 3 groups of 354 participants each to receive 2.5mg of
lorazepam, no premedication, or placebo. MAIN OUTCOMES AND MEASURES The
primary outcomewas perioperative patient experience assessed 24 hours
after surgery with a validated questionnaire (Evaluation du Vecu de
l'Anesthesie Generale; EVAN-G) describing 6 domains of satisfaction and a
global index (score range, 0-100; high scores represent high
satisfaction); secondary outcomes included time to extubation and early
cognitive recovery. A subgroup analysis was planned a priori in patients
with a high level of preoperative anxiety. RESULTS Premedication with
lorazepam did not improve the EVAN-G mean global index for overall level
of patient satisfaction (72 [95%CI, 70-73]; n = 330) compared with no
premedication (73 [95%CI, 71-74]; n = 319) or placebo (71 [95%CI, 70-73];
n = 322) (P = .38). Among patients with heightened preoperative anxiety,
there were no significant differences found in the EVAN-G mean global
index between the lorazepam group (68 [95%CI, 65-72]; n = 87) and the no
premedication group (73 [95%CI, 69-77]; n = 57) or the placebo group (70
[95%CI, 67-72]; n = 87) (P = .18). Time to extubation was 17 minutes
(95%CI, 14-20 minutes) in the lorazepam group, 12 minutes (95%CI, 11-13
minutes) for the no premedication group, and 13 minutes (95%CI, 12-14
minutes) for the placebo group (P < .001) and the rate of early cognitive
recovery was 51% (95%CI, 45%-56%), 71%(95%CI, 66%-76%), and 64% (95%CI,
59%-69%), respectively (P < .001). CONCLUSIONS AND RELEVANCE Among
patients undergoing elective surgery under general anesthesia, sedative
premedication with lorazepam compared with placebo or no premedication did
not improve the self-reported patient experience the day after surgery,
but was associated with modestly prolonged time to extubation and a lower
rate of early cognitive recovery. The findings suggest a lack of benefit
with routine use of lorazepam as sedative premedication in patients
undergoing general anesthesia.

<18>
Accession Number
2015815007
Authors
Prijic S. Buchhorn R. Kosutic J. Vukomanovic V. Prijic A. Bjelakovic B.
Zdravkovic M.
Institution
(Prijic, Kosutic, Vukomanovic) Mother and Child Health Institute of Serbia
- Cardiology Department, R. Dakica St. 6-8, Belgrade 11070, Serbia
(Prijic, Kosutic, Vukomanovic, Zdravkovic) School of Medicine - University
of Belgrade, D r. Subotica St. 8, Belgrade 11000, Serbia
(Buchhorn) Klinik Kinder- und Jugend-medizin, Caritas-Krankenhaus,
Uhlandstr. 7, Bad Mergentheim 97980, Germany
(Prijic) Medical Center "Dr. D. Misovic - Dedinje", Heroja Milana Tepica
St. 1, Belgrade 11000, Serbia
(Bjelakovic) Clinical Center Nis - Pediatric Cardiology Department, D r.
Z. Djindjica Boulevard 48, Nis 18000, Serbia
(Bjelakovic) School of Medicine, University of Nis, Dr Z. Djindjica
Boulevard 81, Nis 18000, Serbia
(Zdravkovic) University Medical Center Bezanijska Kosa - Cardiology
Department, Bezanijska Kosa bb, Belgrade 11000, Serbia
Title
Beta-blockers (carvedilol) in children with systemic ventricle systolic
dysfunction - systematic review and meta-analysis.
Source
Reviews on Recent Clinical Trials. 9 (2) (pp 68-75), 2014. Date of
Publication: 01 Jan 2014.
Publisher
Bentham Science Publishers B.V. (P.O. Box 294, Bussum 1400 AG,
Netherlands)
Abstract
Background: Numerous prospective randomized clinical trials demonstrated
favorable effect of beta-blockers in adults with chronic heart failure.
However, effectiveness of beta blockers in pediatric patients with
systemic ventricle systolic dysfunction was not recognized sufficiently.
Limited number of pediatric patients might be the course of unrecognized
carvediolol treatment benefit. Currently, no meta-analysis has examined
the impact of carvedilol and conventional therapy on the clinical outcome
in children with chronic heart failure due to impaired systemic ventricle
systolic function. Materials and Methods: We have systematically searched
the Medline/PubMed and Cochrane Library for the controlled clinical trials
that examine carvedilol and standard treatment efficacy in pediatric
patients with systemic ventricle systolic dysfunction. Mean differences
for continuous variables, odds ratios for dichotomous outcomes,
heterogeneity between studies and publication bias were calculated using
Cochrane Review Manager (Rev Man 5.2). Results: Total of 8
prospective/observational studies met established criteria. Odds ratio for
chronic heart failure related mortality/heart transplantation secondary to
carvedilol was 0.52 (95% CI: 0.28-0.97, I² = 0%). Our analysis
showed that carvedilol could prevent 1 death/ heart transplantation by
treating 14 pediatric patients with impaired systemic ventricle systolic
function. Conclusion: Meta-analysis demonstrated clinical outcome benefit
of carvedilol in children with chronic heart failure.

<19>
Accession Number
71752116
Authors
Saffi M. Furtado M.V. Montenegro M.M. Ribeiro I.W.J. Kampits C.
Rabelo-Silva E.R. Polanczyk C.A. Rosing C.K. Haas A.N.
Institution
(Saffi, Rabelo-Silva, Polanczyk) School of Medicine, Federal University of
Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Porto Alegre,
Brazil
(Furtado) School of Medicine, Federal University of Rio Grande do Sul,
Institute for Health Technology Assessment (IATS-CNPq), Porto Alegre,
Brazil
(Montenegro, Ribeiro, Kampits, Rosing, Haas) Faculty of Dentistry
Periodontology, Federal University of Rio Grande do Sul, Porto Alegre,
Brazil
Title
The effect of periodontal therapy on endothelial function and
proinflammatory biomarkers in patients with stable coronary disease:
Protocol for a RCT.
Source
Atherosclerosis. Conference: 82nd European Atherosclerosis Society
Congress, EAS 2014 Madrid Spain. Conference Start: 20140531 Conference
End: 20140603. Conference Publication: (var.pagings). 235 (2) (pp
e227-e228), 2014. Date of Publication: August 2014.
Publisher
Elsevier Ireland Ltd
Abstract
Objectives: Scarce information exists regarding the preventive effect of
periodontal treatment in the recurrence of cardiovascular events.
Prevention may be achieved by targeting risk factors for recurrent
coronary artery disease (CAD) in patients with previous history of
cardiovascular events. The aim of this trial is to compare the effect of
two periodontal treatment approaches on levels of C-reactive protein,
lipids, flow-mediated dilation and serum concentrations of proinflammatory
and endothelial markers in stable CAD patients with periodontitis over a
period of 12 months. Methods: This is a randomized, parallel design,
examiner blinded, controlled clinical trial. Individuals from both
genders, 35 years of age and older, with concomitant diagnosis of CAD and
periodontitis will be included. CAD will be defined as the occurrence of
at least one of the following events: history of myocardial infarction;
myocardial revascularization; angina and positive testing of ischemia.
Periodontitis will be defined using the definition (>2 interproximal sites
with clinical attachment loss >6 mm and >1 interproximal site with probing
depth >5 mm). Individuals will have to present at least ten teeth present
to be included. One hundred individuals will be allocated to test
(intensive periodontal treatment comprised by scaling and root planing) or
control (community periodontal treatment consisting of one session of
supragingival plaque removal) treatment groups. Full-mouth six sites per
tooth periodontal examinations and subgingival biofilm samples will be
conducted at baseline, 3, 6 and 12 months after treatment. Results:
Primary outcome will be C-reactive protein changes over time. Secondary
outcomes include levels of total cholesterol, LDL-C, HDL-C, triglycerides,
IL-1beta, IL-6, TNFalpha, fibrinogen, ICAM-1, VCAM-1 and E-selectin.
Flow-mediated dilation will be assessed at baseline,1, 3 and 6 months
after periodontal therapy. Conclusion: This trial will provide new
evidence regarding the effect of periodontal treatment on risk markers for
recurrence of cardiovascular events in stable coronary artery disease
patients.