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<1>
Accession Number
20151004888
Authors
Maleki M.H. Derakhshan P. Sharifabad A.R. Amouzeshi A.
Institution
(Maleki, Sharifabad, Amouzeshi) Atherosclerosis and Coronary Artery
Research Center, Birjand University of Medical Sciences, Birjand, Iran,
Islamic Republic of
(Derakhshan) Department of Anesthesiology, Rasoul Akram Hospital, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Title
Comparing the effects of 5% albumin and 6% hydroxyethyl starch 130/0.4
(Voluven) on renal function as priming solutions for cardiopulmonary
bypass: A randomized double blind clinical trial.
Source
Anesthesiology and Pain Medicine. 6 (1) (pp 1-6), 2016. Article Number:
e30326. Date of Publication: February 2016.
Publisher
Kowsar Medical Publishing Company
Abstract
Background: The ideal strategy to prime the cardiopulmonary bypass (CPB)
circuit in adult cardiac surgery is still a matter of debate. Objectives:
In this retrospective study, we examined Albumin solution and hydroxyethyl
starch (HES) for priming the CPB circuit and evaluated the differences in
kidney function and bleeding and coagulation status in the two groups of
patients. Patients and Methods: Sixty consecutive patients undergoing
elective coronary artery bypass grafting were studied. Patients were
excluded due to emergency surgery, history of cardiac surgery, history of
receiving medication with antiplatelet agents except ASA 80 (mg/day)
within the previous five days, preoperative coagulation disorder, left
ventricular ejection fraction less than 50%, preoperative renal
dysfunction (serum creatinine > 1.4 mg/dL), preoperative hepatic
dysfunction (serum aspartate/alanine amino transferase > 60 U/l),
preoperative electrolyte imbalance, known hypersensitivity to HES and
chronic diuretic therapy. The patients were divided randomly into two
groups of HES (n = 30) and Albumin (n = 30). Hemodynamic parameters, serum
creatinine concentrations and glomerular filtration rate, PT, PTT and INR
were measured. Early bleeding was measured according to the first 24-hour
drainage from the tube. Hemodynamics and all laboratory measurements were
performed after induction of anesthesia and at the morning of the first,
second and third postoperative days in the ICU. Results: GFR differences
were statistically lower in Albumin group in comparison with Group B at
24, 48 and 72 hours postoperation. Platelet count difference and
postoperative bleeding were significantly lower in Albumin group.
Conclusions: Administration of Albumin compared to HES in patients with a
normal renal function results in a lower drop of GFR and platelet count,
less bleeding and lower rise of serum creatinine.
<2>
Accession Number
20151004928
Authors
Nezafati M.H. Vojdanparast M. Nezafati P.
Institution
(Nezafati) Department of Cardiac Surgery, Imam Reza Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Vojdanparast) Atherosclerosis Prevention Research Center, School of
Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences,
Mashhad, Iran, Islamic Republic of
(Nezafati) Department of Cardiac Surgery, Imam Reza Hospital, Student
Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran,
Islamic Republic of
Title
Antidepressants and cardiovascular adverse events: A narrative review.
Source
ARYA Atherosclerosis. 11 (5) (pp 295-304), 2015. Date of Publication:
2015.
Publisher
Isfahan University of Medical Sciences(IUMS) (Hezar Jerib Avenue, P.O. Box
81745-319, Isfahan, Iran, Islamic Republic of)
Abstract
BACKGROUND: Major depression or deterioration of previous mood disorders
is a common adverse consequence of coronary heart disease, heart failure,
and cardiac revascularization procedures. Therefore, treatment of
depression is expected to result in improvement of mood condition in these
patients. Despite demonstrated effects of anti-depressive treatment in
heart disease patients, the use of some antidepressants have shown to be
associated with some adverse cardiac and non-cardiac events. In this
narrative review, the authors aimed to first assess the findings of
published studies on beneficial and also harmful effects of different
types of antidepressants used in patients with heart diseases. Finally, a
new categorization for selecting antidepressants according to their
cardiovascular effects was described. METHODS: Using PubMed, Web of
Science, SCOPUS, Index Copernicus, CINAHL, and Cochrane Database, we
identified studies designed to evaluate the effects of depression and also
using antidepressants on cardiovascular outcome. A 40 studies were finally
assessed systematically. Among those eligible studies, 14 were cohort or
historical cohort studies, 15 were randomized clinical trial, 4 were
retrospective were case-control studies, 3 were meta-analyses and 2 animal
studies, and 2 case studies. RESULTS: According to the current review, we
recommend to divide antidepressants into three categories based on the
severity of cardiovascular adverse consequences including (1) the safest
drugs including those drugs with cardio-protective effects on ventricular
function, as well as cardiac conductive system including selective
serotonin reuptake inhibitors, (2) neutralized drugs with no evidenced
effects on cardiovascular system including serotonin-norepinephrine
reuptake inhibitors, and (3) harmful drugs with adverse effects on cardiac
function, hemodynamic stability, and heart rate variability including
tricyclic antidepressants, serotonin antagonist and reuptake inhibitors,
and noradrenergic and specific serotonergic antidepressants. CONCLUSION:
The presented categorization of antidepressants can be clinically helpful
to have the best selection for antidepressants to minimizing their
cardiovascular harmful effects.
<3>
Accession Number
20151004271
Authors
Combes A. Brechot N. Amour J. Cozic N. Lebreton G. Guidon C. Zogheib E.
Thiranos J.-C. Rigal J.-C. Bastien O. Benhaoua H. Abry B. Ouattara A.
Trouillet J.-L. Mallet A. Chastre J. Leprince P. Luyt C.-E.
Institution
(Combes, Brechot, Trouillet, Chastre, Luyt) Medical-Surgical Intensive
Care Unit, Institute of Cardiometabolism and Nutrition, Universite Pierre,
Marie Curie-Paris 6, Paris, France
(Amour) Anesthesiology and Critical Care Medicine Department, Institute of
Cardiometabolism and Nutrition, Universite Pierre, Marie Curie-Paris 6,
Paris, France
(Cozic, Mallet) Unite de Recherche Clinique, Institute of Cardiometabolism
and Nutrition, Universite Pierre, Marie Curie-Paris 6, Paris, France
(Lebreton, Leprince) Cardiac Surgery Department, Institute of
Cardiometabolism and Nutrition, Universite Pierre, Marie Curie-Paris 6,
Paris, France
(Guidon) Anesthesiology and Critical Care Medicine Department, CHU la
Timone, Marseille, France
(Zogheib) Anesthesiology and Critical Care Medicine Department, Amiens
University Hospital, Universite de Picardie Jules-Verne, Amiens, France
(Thiranos) Anesthesiology and Critical Care Medicine Department, CHU de
Strasbourg, Strasbourg, France
(Rigal) Department D'Anesthesiologie et Reanimation, CHU de Nantes,
Nantes, France
(Bastien) Anesthesiology and Critical Care Medicine Department, CHU de
Lyon, Lyon, France
(Benhaoua) Anesthesiology and Critical Care Medicine Department, CHU de
Toulouse, Toulouse, France
(Abry) Anesthesiology and Critical Care Medicine Department, Clinique
Jacques Cartier, Massy, France
(Ouattara) Department of Anesthesia and Critical Care II, CHU de Bordeaux
and Universite de Bordeaux, Adaptation Cardiovasculaire A L'Ischemie,
Pessac U1034, France
Title
Early high-volume hemofiltration versus standard care for post-cardiac
surgery shock the HEROICS study.
Source
American Journal of Respiratory and Critical Care Medicine. 192 (10) (pp
1179-1190), 2015. Date of Publication: 15 Nov 2015.
Publisher
American Thoracic Society
Abstract
Rationale: Post-cardiac surgery shock is associated with high morbidity
and mortality. By removing toxins and proinflammatory mediators and
correcting metabolic acidosis, high-volume hemofiltration (HVHF) might
halt the vicious circle leading to death by improving myocardial
performance and reducing vasopressor dependence. Objectives: To determine
whether early HVHF decreases all-cause mortality 30 days after
randomization. Methods: This prospective, multicenter randomized
controlled trial included patients with severe shock requiring high-dose
catecholamines 3-24 hours post-cardiac surgery who were randomized to
early HVHF (80 ml/kg/h for 48 h), followed by standard-volume continuous
venovenous hemodiafiltration (CVVHDF) until resolution of shock and
recovery of renal function, or conservative standard care, with delayed
CVVHDF only for persistent, severe acute kidney injury. Measurements and
Main Results: On Day 30, 40 of 112 (36%) HVHF and 40 of 112 (36%) control
subjects (odds ratio, 1.00; 95% confidence interval, 0.64-1.56; P = 1.00)
had died; only 57% of the control subjects had received renal-replacement
therapy. Between-group survivors' Day-60, Day-90, intensive care unit, and
in-hospital mortality rates, Day-30 ventilator-free days, and renal
function recovery were comparable. HVHF patients experienced faster
correction of metabolic acidosis and tended to be more rapidly weaned off
catecholamines but had more frequent hypophosphatemia, metabolic
alkalosis, and thrombocytopenia. Conclusions: For patients with
post-cardiac surgery shock requiring high-dose catecholamines, the early
HVHF onset for 48 hours, followed by standard volume until resolution of
shock and recovery of renal function, did not lower Day-30 mortality and
did not impact other important patient-centered outcomes compared with a
conservative strategy with delayed CVVHDF initiation only for patients
with persistent, severe acute kidney injury. Clinical trial registered
with www.clinicaltrials.gov (NCT 01077349).
<4>
Accession Number
20151004056
Authors
Steyers C.M. Khera R. Bhave P.
Institution
(Steyers, Khera) Department of Internal Medicine, University of Iowa
Carver College of Medicine, Iowa City, IA, United States
(Bhave) Division of Cardiovascular Medicine, Department of Internal
Medicine, University of Iowa Carver College of Medicine, Iowa City, IA,
United States
Title
Pacemaker dependency after cardiac surgery: A systematic review of current
evidence.
Source
PLoS ONE. 10 (10) , 2015. Article Number: e0140340. Date of Publication:
15 Oct 2015.
Publisher
Public Library of Science
Abstract
Background Severe postoperative conduction disturbances requiring
permanent pacemaker implantation frequently occur following cardiac
surgery. Little is known about the long-term pacing requirements and risk
factors for pacemaker dependency in this population. Methods We performed
a systematic review of the literature addressing rates and predictors of
pacemaker dependency in patients requiring permanent pacemaker
implantation after cardiac surgery. Using a comprehensive search of the
Medline, Web of Science and EMBASE databases, studies were selected for
review based on predetermined inclusion and exclusion criteria. Results A
total of 8 studies addressing the endpoint of pacemaker-dependency were
identified, while 3 studies were found that addressed the recovery of
atrioventricular (AV) conduction endpoint. There were 10 unique studies
with a total of 780 patients. Mean follow-up ranged from 6-72 months.
Pacemaker dependency rates ranged from 32%-91% and recovery of AV
conduction ranged from 16%-42%. There was significant heterogeneity with
respect to the definition of pacemaker dependency. Several patient and
procedure-specific variables were found to be independently associated
with pacemaker dependency, but these were not consistent between studies.
Conclusions Pacemaker dependency following cardiac surgery occurs with
variable frequency. While individual studies have identified various
perioperative risk factors for pacemaker dependency and non-resolution of
AV conduction disease, results have been inconsistent. Well-conducted
studies using a uniform definition of pacemaker dependency might identify
patients who will benefit most from early permanent pacemaker implantation
after cardiac surgery.
<5>
Accession Number
20151004419
Authors
Jungen C. Zeus T. Balzer J. Eickholt C. Petersen M. Kehmeier E. Veulemans
V. Kelm M. Willems S. Meyer C.
Institution
(Jungen, Eickholt, Willems, Meyer) Department of Cardiology -
Electrophysiology, CNEP, Cardiac Neuro- and Electrophysiology Research
Group, University Heart Center, University Hospital Hamburg-Eppendorf,
Hamburg, Germany
(Jungen, Eickholt, Willems, Meyer) DZHK (German Center for Cardiovascular
Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
(Jungen, Zeus, Balzer, Eickholt, Petersen, Kehmeier, Veulemans, Kelm,
Meyer) Department of Cardiology, Pulmonology and Vascular Medicine,
Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
Title
Left atrial appendage closure guided by integrated echocardiography and
fluoroscopy imaging reduces radiation exposure.
Source
PLoS ONE. 10 (10) , 2015. Article Number: e0140386. Date of Publication:
14 Oct 2015.
Publisher
Public Library of Science
Abstract
Aims: To investigate whether percutaneous left atrial appendage (LAA)
closure guided by automated real-time integration of
2D-/3D-transesophageal echocardiography (TEE) and fluoroscopy imaging
results in decreased radiation exposure. Methods and Results: In this
open-label single-center study LAA closure (Amplatzer<sup>TM</sup> Cardiac
Plug) was performed in 34 consecutive patients (8 women; 73.1+/-8.5 years)
with (n = 17, EN+) or without (n = 17, EN-) integrated
echocardiography/fluoroscopy imaging guidance (EchoNavigator [EN]; Philips
Healthcare). There were no significant differences in baseline
characteristics between both groups. Successful LAA closure was documented
in all patients. Radiation dose was reduced in the EN+ group about 52%
(EN+: 48.5+/-30.7 vs. EN-: 93.9+/-64.4 Gy/ cm<sup>2; p = 0.01).
Corresponding to the radiation dose fluoroscopy time was reduced (EN+:
16.7+/-7 vs. EN-</sup>: 24.0+/-11.4 min; p = 0.035). These advantages were
not at the cost of increased procedure time (89.6+/-28.8 vs. 90.1+/-30.2
min; p = 0.96) or periprocedural complications. Contrast media amount was
comparable between both groups (172.3+/-92.7 vs. 197.5+/-127.8 ml; p =
0.53). During short-term follow-up of at least 3 months (mean: 8.1+/-5.9
months) no device-related events occurred. Conclusions: Automated
real-time integration of echocardiography and fluoroscopy can be
incorporated into procedural work-flow of percutaneous left atrial
appendage closure without prolonging procedure time. This approach results
in a relevant reduction of radiation exposure.
<6>
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Accession Number
20151004111
Authors
Brinkman W.T. Squiers J.J. Filardo G. Arsalan M. Smith R.L. Moore D. Mack
M.J. Dimaio J.M.
Institution
(Brinkman, Arsalan, Smith, Moore, Mack, Dimaio) Heart Hospital Baylor
Plano, Plano, TX, United States
(Squiers, Filardo, Dimaio) Department of Epidemiology, Baylor Scott and
White Health, Dallas, TX, United States
Title
Perioperative outcomes, transfusion requirements, and inflammatory
response after coronary artery bypass grafting with off-pump,
mini-extracorporeal, and on-pump circulation techniques.
Source
Journal of Investigative Medicine. 63 (8) (pp 916-920), 2015. Date of
Publication: 01 Dec 2015.
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives Mini-extracorporeal circulation (MECC) units were developed to
reduce postoperative morbidity, transfusion requirements, and inflammation
associated with conventional on-pump coronary artery bypass (ONCAB)
surgery without the technical demands of the off-pump (OPCAB) technique.
We compared perioperative outcomes and inflammatory mediation among OPCAB,
MECC, and ONCAB techniques. Methods We prospectively enrolled 102 patients
undergoing elective isolated coronary bypass grafting. Perfusion methods
were OPCAB (n = 34), MECC (n = 34), and ONCAB (n = 34). Serial blood
samples were collected to measure serum inflammatory markers. Results
There were no operative deaths or strokes. Total red blood cell (RBC)
products used in OPCAB, MECC, and ONCAB patients were 0.676, 1.000, and
1.235 units, respectively. Adjusted (by splined Society of Thoracic
Surgeons operative risk score) analysis showed no statistically
significant differences in mean RBC product use among the different
operative systems (OPCAB vs MECC, P = 0.580; OPCAB vs ONCAB, P = 0.311;
MECC vs ONCAB, P = 0.633). Adjusted (by Society of Thoracic Surgeons risk
score and baseline level) mean plasma level differences (24 hours
postoperative - baseline) of C-reactive protein for OPCAB (117.89; 95%
confidence interval [95% CI], 106.23-129.54) and for MECC (124.88; 95% CI,
113.45-136.32) were significantly higher than for ONCAB (98.82; 95% CI,
86.40-111.24). No significant adjusted differences (P = 0.304) in
interleukin-6 level changes were observed. Conclusions Off-pump coronary
artery bypass and MECC did not significantly reduce mean total RBC
transfusion requirements. Off-pump coronary artery bypass and MECC were
associated with greater C-reactive protein elevation than ONCAB,
suggestive of an increased inflammatory response to each of these
techniques.
<7>
Accession Number
20151001057
Authors
Ke J.-D. Hou H.-J. Wang M. Zhang Y.-J.
Institution
(Ke, Hou, Wang, Zhang) Department of Anesthesiology, Friendship Hospital,
Capital Medical University, Beijing 100050, China
Title
The comparison of anesthesia effect of lung surgery through video-assisted
thoracic surgery: A meta-analysis.
Source
Journal of Cancer Research and Therapeutics. 11 (2015) (pp C265-C270),
2015. Date of Publication: 01 Dec 2015.
Publisher
Medknow Publications (B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai 400 075, India)
Abstract
Objective: The epidural anesthesia and general anesthesia are the most
commonly used in lung surgery through video-assisted thoracic surgery
(VATS). Each of these methods has their advantages and disadvantages, so
the aim of this meta-analysis is to identify which anesthesia is more
conducive to lung surgery under VATS and rehabilitation of patients.
Materials and Methods: The Cochrane Library Database (Issue 12, 2013),
PubMed (1966-2015), and China National Knowledge Infrastructure
(1950-2015) were searched without language restrictions. Meta-analyses
were conducted using Review Manager 5.2 software (The Cochrane
Collaboration, Software Update, Oxford). We calculated odds ratio (OR) and
its confidence interval (95% CI) to estimate the difference between
epidural anesthesia and general anesthesia through finishing of the
collected data. Results: Due to our search results, 7 studies were
included in our study. Studies among them show that different contents of
these articles are not all the same about research direction. Our findings
suggested that epidural anesthesia had more advantages than general
anesthesia for operative time (mean difference = - 23.85, 95% CI: - 29.67
- 18.03, P = 0.0001). More than that, epidural anesthesia showed a good
surgical outcome on postoperative hospital stay (mean difference = - 0.43,
95% CI: - 0.85 - 0.01, P = 0.04) than general anesthesia. But we found
that there were no different on numbers of people with complications (OR =
0.45, 95% CI: 0.23-0.89, P = 0.97) and headache occurrence (OR = 2.69, 95%
CI: 0.62-11.70, P = 0.91) between epidural anesthesia and general
anesthesia. Conclusion: These results indicated that epidural anesthesia
can save operating time and postoperative hospital stay time. But epidural
anesthesia and general anesthesia have the same effect on complications.
<8>
Accession Number
2015703122
Authors
Drummond L.W. Torborg A.M. Rodseth R.N. Biccard B.M.
Institution
(Drummond, Torborg, Rodseth, Biccard) Department of Anaesthesia, Nelson R
Mandela Medical School, University of KwaZulu-Natal, Durban, South Africa
Title
Postoperative atrial fibrillation in patients on statins undergoing
isolated cardiac valve surgery: A meta-analysis.
Source
Southern African Journal of Anaesthesia and Analgesia. 20 (6) (pp
238-244), 2014. Date of Publication: 2014.
Publisher
Medpharm Publications (PO Box 14804, Lyttelton, Gauteng 0157, South
Africa)
Abstract
Introduction: The efficacy of perioperative statin therapy in decreasing
postoperative morbidity in patients undergoing valve replacements and
repairs is unknown. The aim of our study was to determine whether or not
the literature supports the hypothesis that statins decrease postoperative
atrial fibrillation (AF), and hence improve short-term postoperative
outcomes in patients undergoing isolated cardiac valve surgery. Method: We
conducted a meta-analysis of studies on postoperative outcomes associated
with statin therapy following isolated valve replacement or repair. The
data was taken from published studies on valvular heart surgery patients.
Participants were patients who underwent either isolated cardiac valve
replacement or repair. Patients in the intervention group received statins
prior to their surgery. Three databases were searched: Ovid Healthstar,
1966 to April 2012; Ovid Medline, 1946 to 31 May 2012; and Embase, 1974 to
30 May 2012. The meta-analysis was conducted using Review
Manager<sup></sup> version 5.1. Results: Statins did not decrease the
incidence of postoperative AF in patients undergoing isolated cardiac
valve surgery [odds ratio (OR) 1.19, 95% confidence interval (CI): 0.80-
1.77)], although there was significant heterogeneity for the outcome of
postoperative AF (I<sup>2</sup> 55%, 95% CI: 27-72). Statins were
associated with a decrease in 30-day mortality (OR 0.43, 95% CI: 0.24-0
75). Conclusion: Although this meta-analysis suggests that chronic statin
therapy did not prevent postoperative AF in unselected valvular heart
surgical patients, the heterogeneity indicates that this outcome should be
viewed with caution and further research is recommended.
<9>
Accession Number
20151000793
Authors
Rudzinski P.N. Kruk M. Demkow M. Dzielinska Z. Pregowski J. Witkowski A.
Ruzyllo W. Kepka C.
Institution
(Rudzinski, Kruk, Demkow, Dzielinska, Ruzyllo, Kepka) Department of
Coronary and Structural Heart Disease, Institute of Cardiology, 42
Alpejska St., Warsaw 04-628, Poland
(Pregowski, Witkowski, Ruzyllo) Department of Interventional Cardiology
and Angiology, Institute of Cardiology, Warsaw, Poland
Title
Coronary artery computed tomography as the first-choice imaging
diagnostics in patients with high pre-test probability of coronary artery
disease (CAT-CAD).
Source
Postepy w Kardiologii Interwencyjnej. 11 (4) (pp 281-284), 2015. Date of
Publication: 2015.
Publisher
Termedia Publishing House Ltd. (Kleeberqa St.2, Poznan 61-615, Poland)
Abstract
Introduction: The primary diagnostic examination performed in patients
with a high pre-test probability of coronary artery disease (CAD) is
invasive coronary angiography. Currently, approximately 50% of all
invasive coronary angiographies do not end with percutaneous coronary
intervention (PCI) because of the absence of significant coronary artery
lesions. It is desirable to eliminate such situations. There is an
alternative, non-invasive method useful for exclusion of significant CAD,
which is coronary computed tomography angiography (CCTA). Aim: We
hypothesize that use of CCTA as the first choice method in the diagnosis
of patients with high pre-test probability of CAD may reduce the number of
invasive coronary angiographies not followed by interventional treatment.
Coronary computed tomography angiography also seems not to be connected
with additional risks and costs of the diagnosis. Confirmation of these
assumptions may impact cardiology guidelines. Material and methods: One
hundred and twenty patients with indications for invasive coronary
angiography determined by current ESC guidelines regarding stable CAD are
randomized 1:1 to classic invasive coronary angiography group and the CCTA
group. Results: All patients included in the study are monitored for the
occurrence of possible end points during the diagnostic and therapeutic
cycle (from the first imaging examination to either complete
revascularization or disqualification from the invasive treatment), or
during the follow-up period. Conclusions: Based on the literature, it
appears that the use of modern CT systems in patients with high pre-test
probability of CAD, as well as appropriate clinical interpretation of the
imaging study by invasive cardiologists, enables precise planning of
invasive therapeutic procedures. Our randomized study will provide data to
verify these assumptions.
<10>
Accession Number
20151000520
Authors
Guerra A. Rangan B.V. Coleman A. Xu H. Kotsia A. Christopoulos G. Sosa A.
Chao H. Han H. Abdurrahim G. Roesle M. De Lemos J.A. McGuire D.K. Packer
M. Banerjee S. Brilakis E.S.
Institution
(Guerra, Rangan, Coleman, Xu, Kotsia, Christopoulos, Sosa, Chao, Han,
Abdurrahim, Roesle, De Lemos, McGuire, Packer, Banerjee, Brilakis) Dallas
VA Medical Center (111A), 4500 South Lancaster Road, Dallas, TX 75216,
United States
Title
Effect of Extended-Release Niacin on Carotid Intima Media Thickness,
Reactive Hyperemia, and Endothelial Progenitor Cell Mobilization: Insights
from the Atherosclerosis Lesion Progression Intervention Using Niacin
Extended Release in Saphenous Vein Grafts (ALPINE-SVG) Pilot Trial.
Source
Journal of Invasive Cardiology. 27 (12) (pp 555-560), 2015. Date of
Publication: December 2015.
Publisher
HMP Communications
Abstract
BACKGROUND: Thirty-eight patients with intermediate (30%-60% diameter
stenosis) saphenous vein graft lesions were randomized to extended-release
niacin (ER-niacin) or placebo for 12 months. We sought to evaluate the
impact of ER-niacin on carotid intima media thickness (CIMT), endothelial
function, and endothelial progenitor cell (EPC) mobilization. METHODS:
Carotid B-mode ultrasound was used to image the common and internal
carotid arteries, at baseline and at 12 months after enrollment. Reactive
hyperemia peripheral arterial tonometry, as assessed with EndoPAT 2000
(Itamar Medical, Inc) and EPC mobilization assessed with flow cytometry,
were measured at enrollment, and at 1 and 12 months. RESULTS: The baseline
clinical characteristics were similar in the two study groups.
High-density lipoprotein cholesterol levels tended to increase more in the
ER-niacin group (5.9 +/- 8.7 mg/dL vs 1.4 +/- 7.1 mg/dL; P<.14). Between
baseline and 12 months, right common carotid artery (0.96 +/- 0.44 mm vs
0.70 +/- 0.24 mm; P<.04), and left common carotid artery (0.80 +/- 0.30 mm
vs 0.70 +/- 0.20 mm; P<.08) CIMT tended to decrease in the ER-niacin
group, compared with no change in the placebo group. The change in
logarithmic reactive hyperemia index between 1 month and 12 months was
similar in patients receiving ER-niacin vs placebo (0.003 +/- 0.12 vs
-0.058 +/- 0.12; P<.39), whereas EPC mobilization increased in the
ER-niacin group and decreased in the placebo group (8.65 +/- 28.41 vs
-5.87 +/- 30.23 EPC colony forming units/mL of peripheral blood; P<.02).
CONCLUSIONS: ER-niacin did not have a significant impact on CIMT or
endothelial function, but increased EPC mobilization.
<11>
Accession Number
72108243
Authors
Ramos P. Ricci N. Suster E. Paisani D. Chiavegato L.
Title
Early mobilization in the postoperative patients submitted to cardiac
surgery-A systematic review.
Source
European Respiratory Journal. Conference: European Respiratory Society
Annual Congress 2015 Amsterdam Netherlands. Conference Start: 20150926
Conference End: 20150930. Conference Publication: (var.pagings). 46 ,
2015. Date of Publication: 01 Sep 2015.
Publisher
European Respiratory Society
Abstract
Background: Cardiovascular diseases are currently the main cause of
mortality and hospitalization in the adult population and cardiac surgery
is an option of treatment. Postoperative complications are still frequent
and can determines the length of hospital staying. Early mobilization can
be used in these patients to reduce such complications and the evidences
for such intervention remains unknown. Objective: Systematically review
the effects of early mobilization on length of hospital stay and on
postoperative complications in patients undergoing elective cardiac
surgery. Methods: Randomized controlled trials using early mobilization in
patients after cardiac surgery were searched and selected on the following
databases: Medline, Embase, CINAHL, PEDro, Web of Science and Cochrane
Central Register of Controlled Trials. Early mobilization was defined as
any form of exercise within 72 hours after surgery. Results: 2514 studies
were identified and 18 articles were full read for eligibility analysis.
Nine studies were included and they present low risk of bias by PEDro
score (range 5 to 9). The length of hospital staying ranged from 5.9 to
12.2 days. Only three studies observed that the early mobilization group
reduced the length of hospital stay when compared to the control group.
Five studies evaluated postoperative complications and only one showed
lower incidence of complications with early mobilization. Conclusion: The
results of this systematic review show that there is still low quality
evidence suggesting that early mobilization can reduce the incidence of
postoperative complications and the length of hospital stay in patients
submitted to cardiac surgery.
<12>
Accession Number
72108232
Authors
Ximenes N. Nina V. Borges D. Lima R. Silva M. Silva L. Baldez T. Costa M.
Title
Influence of early resistance exercise after coronary artery bypass
grafting.
Source
European Respiratory Journal. Conference: European Respiratory Society
Annual Congress 2015 Amsterdam Netherlands. Conference Start: 20150926
Conference End: 20150930. Conference Publication: (var.pagings). 46 ,
2015. Date of Publication: 01 Sep 2015.
Publisher
European Respiratory Society
Abstract
Introduction: Early resistance exercise can improve functional capacity,
clinical outcome and survival of patients, leading to a decrease in the
harmful effects caused by prolonged bed rest as well as decreased
healthcare costs and hospital stay. Objective: To evaluate the influence
of early resistance exercise after coronary artery bypass grafting (CABG).
Methods: A randomized controlled trial with 37 patients that underwent
on-pump CABG between August 2013 and May 2014. Patients were distributed
into two groups by simple draw: a control group (n = 20), who received
conventional physical therapy, and an intervention group (n = 17), who
were subjected to resistance exercise. Pulmonary function and functional
capacity were evaluated during the preoperative period and at hospital
discharge by spirometry and the six-minute walk test (6MWT). For
statistical analysis, the Shapiro-Wilk test, Mann-Whitney test, Student's
t test, Fisher's exact test and G-test were used. Variables with p < 0.05
were considered significant. Results: Groups were homogeneous in terms of
demographic, clinical, and surgical variables. Resistance exercise exerted
no effect on pulmonary function when compared to conventional physical
therapy. However, intervention group maintained the functional capacity in
the two periods evaluated, as there was a significant decrease (p < 0.006)
in the functional capacity of control group. In addition, a significant
decrease in hospital stay was observed in intervention group (6.3 +/- 1.2
vs. 7.6 +/- 2.5 days) (p = 0.03). Conclusion: In this study, early
resistance exercise after CABG promoted the maintenance of functional
capacity and reduced hospital stay compared with conventional physical
therapy.
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