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<1>
Accession Number
20160075885
Authors
Brenner C. Adrion C. Grabmaier U. Theisen D. Von Ziegler F. Leber A.
Becker A. Sohn H.-Y. Hoffmann E. Mansmann U. Steinbeck G. Franz W.-M.
Theiss H.D.
Institution
(Brenner, Franz) Department of Internal Medicine III, Cardiology and
Angiology, Medical University of Innsbruck, Anichstr. 35, Innsbruck 6020,
Austria
(Brenner, Grabmaier, Von Ziegler, Becker, Steinbeck, Franz, Theiss)
Department of Internal Medicine i, Klinikum Grosshadern,
Ludwig-Maximilians-University, Munich, Germany
(Adrion, Mansmann) Institute for Medical Informatics, Biometry und
Epidemiology (IBE), Ludwig-Maximilians-University, Munich, Germany
(Leber, Hoffmann) Department of Cardiology, Klinikum Bogenhausen, Munich,
Germany
(Theisen) Institute of Clinical Radiology, Ludwig-Maximilians-University,
Munich, Germany
(Sohn) Department of Cardiology, Klinikum Innenstadt,
Ludwig-Maximilians-University, Munich, Germany
Title
Sitagliptin plus granulocyte colony-stimulating factor in patients
suffering from acute myocardial infarction: A double-blind, randomized
placebo-controlled trial of efficacy and safety (SITAGRAMI trial).
Source
International Journal of Cardiology. 205 (pp 23-30), 2016. Date of
Publication: 15 Feb 2016.
Publisher
Elsevier Ireland Ltd
Abstract
Objective In animal models, G-CSF based progenitor cell mobilization
combined with a DPP4 inhibitor leads to increased homing of bone marrow
derived progenitor cells to the injured myocardium via the SDF1/CXCR4 axis
resulting in improved ejection fraction and survival after acute
myocardial infarction (AMI). Research design and methods After successful
revascularization in AMI, 174 patients were randomized 1:1 in a
multi-centre, prospective, placebo-controlled, parallel group, double
blind, phase III efficacy and safety trial to treatment with G-CSF and
Sitagliptin (GS) or placebo. Diabetic and non-diabetic patients were
included in our trial. The primary efficacy endpoint hierarchically
combined global left and right ventricular ejection fraction changes from
baseline to 6 months of follow-up (DELTA<inf>LVEF</inf>,
DELTA<inf>RVEF</inf>), as determined by cardiac MRI. Results At follow-up
DELTA<inf>LVEF</inf> as well as DELTA<inf>RVEF</inf> did not differ
between the GS and placebo group. Patients in the placebo group had a
similar risk for a major adverse cardiac event within 12 months of
follow-up as compared to patients under GS. Conclusion Progenitor cell
therapy comprising the use of G-CSF and Sitagliptin after successfully
revascularized acute myocardial infarction fails to show a beneficial
effect on cardiac function and clinical events after 12 months. (EudraCT:
2007-003,941-34; ClinicalTrials.gov: NCT00650143, funding: Heinz-Nixdorf
foundation).

<2>
Accession Number
20160045256
Authors
Xuejuan Z. Jietao Z. Di H. Yu Z. Xiaozi G. Yunfa L. Lihua D.
Institution
(Xuejuan, Jietao, Di, Yu, Xiaozi, Yunfa) General Medicine, Affiliated
Hospital of Qingdao University, Qingdao 266031, China
(Lihua) Department of Neurology, Rizhao People's Hospital, Rizhao 276826,
China
Title
Protective Effects of Danhong Injection against Cerebral Damage during
On-Pump Coronary Artery Bypass Graft Surgery.
Source
Evidence-based Complementary and Alternative Medicine. 2015 (no
pagination), 2015. Article Number: 527219. Date of Publication: 2015.
Publisher
Hindawi Publishing Corporation (410 Park Avenue, 15th Floor, 287 pmb, New
York NY 10022, United States)
Abstract
To explore the protective effects of Danhong injection against cerebral
damage during on-pump coronary artery bypass graft surgery and its
mechanism. Methods. Fifty patients scheduled for on-pump CABG surgery were
randomly divided into Danhong injection group (group D) and control group
(group C). Group D was given Danhong injection while group C was given the
same volume of normal saline when the artery was cut open. Jugular bulb
blood right before the operation began (T1), when body temperature
rewarming to 36degreeC (T2), 30 min after the termination of
cardiopulmonary bypass (T3), and 6 hrs after the termination of CPB (T4)
was collected. The superoxide dismutase activity by using xanthine oxidase
method and concentration determination of malondialdehyde were examined.
Results. In group C, SOD activity was less at T2-T4 than at T1. It was
also less active comparatively in group D at T2-T4. The MDA concentration
increased in both groups but was more obvious in group C. Levels of TNF-,
IL-6, IL-8, and IL-10 increased in both groups C and D at T3 and T4,
compared to T1. Conclusions. Danhong injection shows significant
protective effects against cerebral damage during on-pump coronary artery
bypass graft surgery.

<3>
Accession Number
20160045764
Authors
Cantor W.J. Mehta S.R. Yuan F. Dzavik V. Worthley M. Niemela K. Valentin
V. Fung A. Cheema A.N. Widimsky P. Natarajan M. Jedrzejowski B. Jolly S.S.
Institution
(Cantor) Southlake Regional Health Centre, 581 Davis Drive, Newmarket, ON
L3Y 2P6, Canada
(Mehta, Yuan, Natarajan, Jedrzejowski, Jolly) McMaster University,
Population Health Research Institute, Hamilton Health Sciences, Hamilton,
ON, Canada
(Dzavik) Peter Munk Cardiac Centre, University Health Network, Toronto,
ON, Canada
(Worthley) University of Adelaide, Royal Adelaide Hospital, Adelaide,
Australia
(Niemela) Tampere University Hospital and Heart Center, Tampere, Finland
(Valentin) Hospital Universitari Dr Peset, Valencia, Spain
(Fung) University of British Columbia, Vancouver, BC, Canada
(Cheema) St. Michael's Hospital, Toronto, ON, Canada
(Widimsky) Charles University, Hospital Kralovske Vinohrady, Prague, Czech
Republic
Title
Radial versus femoral access for elderly patients with acute coronary
syndrome undergoing coronary angiography and intervention: Insights from
the RIVAL trial.
Source
American Heart Journal. 170 (5) (pp 880-886), 2015. Date of Publication:
2015.
Publisher
Mosby Inc.
Abstract
Background Radial access for percutaneous coronary intervention is
associated with lower rates of access site complications and bleeding.
However, elderly patients have more complex vascular anatomy and radial
access may be more challenging in this population. There remains
uncertainty regarding the role of radial access in elderly patients
undergoing cardiac catheterization. Methods and Results The RIVAL trial
randomized patients with acute coronary syndromes undergoing cardiac
catheterization to radial versus femoral access. In this analysis, the
rates of access site complications and access site cross-over were
compared across different age groups. Among the 7,021 patients, 1035 (15%)
were >75 years of age. Across all age categories, radial access was
consistently associated with higher rates of access site cross over and
lower rates of major access site complications, with no significant
interaction between age and access site. Radial access was associated with
lower rates of major vascular access site complications in patients >75
years of age (3.6% vs 6.6%; P =.03) and in patients <75 years of age (1.0%
vs 3.2%; P <.001; P value for interaction =.2). The rates of access site
crossover were higher with radial access among patients >75 (12.5% vs
2.6%; P <.001) and <75 (6.7% vs 1.9%; P <.001; P value for interaction
=.9). There were no significant differences in the primary composite
outcome (death, myocardial infarction, stroke or non coronary artery
bypass graft major bleeding) or its individual components in either age
group. In patients >75 years of age undergoing primary percutaneous
coronary intervention, there was no significant difference in procedure
time (120 vs 115 minutes; P =.3). Conclusions Consistent with the overall
RIVAL trial population, elderly patients undergoing cardiac
catheterization have lower rates of major bleeding or access site
complications and higher rates of access site crossover with radial access
compared to femoral access.

<4>
Accession Number
2015324930
Authors
Pinaud F. Corbeau J.-J. Baufreton C. Binuani J.-P. De Brux J.-L. Fouquet
O. Angoulvant D. Furber A. Prunier F.
Institution
(Pinaud, Corbeau, Baufreton, Binuani, De Brux, Fouquet, Furber, Prunier)
L'UNAM Universite, France
(Pinaud, Corbeau, Baufreton, Binuani, De Brux, Fouquet) CHU Angers,
Service de Chirurgie Cardiaque, Angers, France
(Pinaud, Fouquet) Universite d'Angers, INSERM 1083, CNRS UMR 6214, Angers,
France
(Baufreton, Binuani, De Brux, Furber, Prunier) Universite d'Angers, EA
3860 Cardioprotection, Remodelage et Thrombose, Angers, France
(Angoulvant) Universite Francois Rabelais de Tours, EA 4245 Cellules
Dendritiques Immunomodulation et Greffes, CHRU de Tours, Service de
Cardiologie, Tours, France
(Furber, Prunier) CHU Angers, Service de Cardiologie, Angers, France
Title
Remote ischemic preconditioning in aortic valve surgery: Results of a
randomized controlled study.
Source
Journal of Cardiology. 67 (1) (pp 36-41), 2016. Date of Publication: 01
Jan 2016.
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: Although remote ischemic preconditioning (RIPC) has emerged as
an attractive strategy to reduce cardiac injury in patients undergoing
diverse cardiac surgical procedures, it is unclear whether RIPC has
protective effects in patients undergoing aortic valve replacement surgery
without coronary artery bypass grafting (CABG). Methods: Hence, 100 adult
patients undergoing elective aortic valve replacement for aortic valve
stenosis, without combined surgery with CABG, were prospectively randomly
assigned in a 1:1 ratio to either the RIPC group or the control group. The
RIPC group underwent three cycles of 5-min inflation to 200. mmHg and
5-min deflation of an automated upper-arm cuff inflator after induction of
anesthesia. The control group had a deflated cuff placed on upper arm for
30. min. The primary endpoint was 72-h area under curve (AUC) for troponin
I (cTnI). Secondary endpoints were 72-h AUC for creatine kinase-MB
isoenzyme (CK-MB) release, incidence of acute kidney injury, extubation
time, length of stay in intensive care unit, and simplified acute
physiology score (SAPS II). Results: There were no significant differences
in cTnI AUC [195. +/-. 190 arbitrary units (a.u.) in RIPC group vs. 169.
+/-. 117 a.u. in the control group; p = 0.41] and CK-MB AUC between
groups. None of the other secondary endpoints differed between groups.
Acute kidney injury occurred in 12 patients (24.5%) in the control group
and in 13 (26.0%) in the RIPC group (p = 0.86). Conclusions: RIPC did not
exhibit significant cardiac or kidney protective effects in patients
undergoing aortic valve replacement surgery without CABG.

<5>
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Accession Number
20160065459
Authors
Aoun R.J.N. Sattur M.G. Panchanathan R.S. Bendok B.R.
Institution
(Aoun, Sattur, Bendok) Mayo Clinic, United States
(Panchanathan) University of Arizona College of Medicine, Phoenix, AZ,
United States
Title
The ABSORB III trial: Potential new concepts for intracranial
atherosclerosis in the post-SAMMPRIS era.
Source
Neurosurgery. 78 (2) (pp N19-N20), 2016. Date of Publication: 01 Feb 2016.
Publisher
Lippincott Williams and Wilkins

<6>
Accession Number
20160029239
Authors
Lu C. Filion K.B. Eisenberg M.J.
Institution
(Lu, Filion, Eisenberg) Faculty of Medicine, McGill University, Montreal,
QC, Canada
(Filion, Eisenberg) Division of Clinical Epidemiology, Lady Davis
Institute, Jewish General Hospital, McGill University, Montreal, QC,
Canada
(Filion, Eisenberg) Department of Epidemiology, Biostatistics, and
Occupational Health, McGill University, Montreal, QC, Canada
(Eisenberg) Division of Cardiology, Jewish General Hospital, McGill
University, Montreal, QC, Canada
Title
The Safety and Efficacy of Absorb Bioresorbable Vascular Scaffold: A
Systematic Review.
Source
Clinical Cardiology. 39 (1) (pp 48-55), 2016. Date of Publication: 01 Jan
2016.
Publisher
John Wiley and Sons Inc.
Abstract
Bioresorbable stents are novel devices designed to overcome the long-term
limitations of permanent stent implantation. The Absorb bioresorbable
vascular scaffold (BVS; Abbott Vascular, Santa Clara, CA) was the first
bioresorbable stent with Conformite Europeenne mark approval in coronary
vessels and has been the subject of multiple clinical studies. Despite its
potential advantages, the safety and efficacy of BVS remain unclear. To
address this, we conducted a systematic review to examine the safety and
efficacy of BVS. The MEDLINE, Embase, Current Index to Nursing & Allied
Health Literature (CINAHL), Cochrane, and Science Citation Index Expanded
(SCIE) databases were searched for studies examining BVS safety and
efficacy. Our search was restricted to studies published in English or
French. Outcomes of interest include cardiac death, myocardial infarction,
target-lesion revascularization, restenosis, and composite endpoints.
Eleven studies met our inclusion criteria (n = 2990), which included 1
randomized controlled trial and 10 cohort studies (2 controlled). These
studies varied in size (11-1189) and follow-up duration (1-60 months). The
incidence of major adverse cardiac events ranged from 2.6% to 15.5%, with
no statistically significant difference between BVS and control in studies
that included a comparison group. Although available data are limited,
current evidence is promising and suggests that the use of BVS is not
associated with a significant increase in major cardiac events in the
short term. Numerous randomized controlled trials are currently in
progress that will further improve our understanding of the safety and
efficacy of this device.

<7>
Accession Number
20160066111
Authors
Asteriou C. Lazopoulos A. Rallis T. Gogakos A.S. Paliouras D. Tsakiridis
K. Zissimopoulos A. Tsavlis D. Porpodis K. Hohenforst-Schmidt W. Kioumis
I. Organtzis J. Zarogoulidis K. Zarogoulidis P. Barbetakis N.
Institution
(Asteriou, Lazopoulos, Rallis, Gogakos, Paliouras, Barbetakis) Department
of Thoracic Surgery, Theagenio Cancer Hospital, Thessaloniki, Greece
(Tsakiridis) Cardiothoracic Surgery Department, Saint Luke Private
Hospital, Panorama, Thessaloniki, Greece
(Zissimopoulos) Nuclear Medicine Department, University General Hospital
of Alexandroupolis, Democritus University of Thrace, Alexandroupolis,
Greece
(Tsavlis, Porpodis, Kioumis, Organtzis, Zarogoulidis, Zarogoulidis)
Pulmonary Department-Oncology Unit, G Papanikolaou" General Hospital,
Aristotle University of Thessaloniki, Thessaloniki, Greece
(Hohenforst-Schmidt) Medical ClinicI ''Fuerth'' Hospital, University of
Erlangen, Fuerth, Germany
Title
Video-assisted thoracic surgery reduces early postoperative stress. A
single-institutional prospective randomized study.
Source
Therapeutics and Clinical Risk Management. 12 (pp 59-65), 2016. Date of
Publication: 12 Jan 2016.
Publisher
Dove Medical Press Ltd. (PO Box 300-008, Albany, Auckland, New Zealand)
Abstract
Background: Video-assisted thoracic surgery (VATS) has been shown to
effectively reduce postoperative pain, enhance mobilization of the
patients, shorten in-hospital length of stay, and minimize postoperative
morbidity rates. The aim of this prospective study is to evaluate
neuroendocrine and respiratory parameters as stress markers in cancer
patients who underwent lung wedge resections, using both mini
muscle-sparing thoracotomy and VATS approach. Methods: The patients were
randomly allocated into two groups: Group A (n=30) involved patients who
were operated on using the VATS approach, while in group B (n=30), the
mini muscle-sparing thoracotomy approach was used. Neuroendocrine and
biological variables assessed included blood glucose levels, Creactive
protein (CRP) levels, cortisol, epinephrine, and adrenocorticotropic
hormone (ACTH) levels. Arterial oxygen (Pao<inf>2</inf>) and carbon
dioxide (Paco<inf>2</inf>) partial pressure were also evaluated. All
parameters were measured at the following time points: 24 hours
preoperatively (T<inf>1</inf>), 4 hours (T<inf>2</inf>), 24 hours
(T<inf>3</inf>), 48 hours (T<inf>4</inf>), and 72 hours (T<inf>5</inf>),
after the procedure. Results: Pao2 levels were significantly higher 4 and
24 hours postoperatively in group A vs group B, respectively
(T<inf>2</inf>: 94.3 vs 77.9 mmHg, P=0.015, T<inf>3</inf>: 96.4 vs 88.7
mmHg, P=0.034). Blood glucose (T<inf>2</inf>: 148 vs 163 mg/dL, P=0.045,
T3: 133 vs 159 mg/dL, P=0.009) and CRP values (T<inf>2</inf>: 1.6 vs 2.5
mg/dL, P=0.024, T<inf>3</inf>: 1.5 vs 2.1 mg/dL, P=0.044) were found
increased in both groups 4 and 24 hours after the procedure. However,
their levels were significantly lower in the VATS group of patients. ACTH
and cortisol values were elevated immediately after the operation and
became normal after 48 hours in both groups, without significant
difference. Postoperative epinephrine levels measured in group A vs group
B, respectively, (T<inf>2</inf>: 78.9 vs 115.6 ng/L, P=0.007,
T<inf>3</inf>: 83.4 vs 122.5 ng/L, P=0.012, T<inf>4</inf>: 67.4 vs 102.6
ng/L, P=0.021). The levels were significantly higher in group B.
Conclusion: This study confirmed that minimally invasive thoracic surgery,
by means of VATS, significantly reduces the acute-phase response and
surgical stress, while enables better postoperative oxygenation.

<8>
Accession Number
20160044661
Authors
Unverdorben M. Vallbracht C. Cremers B. Heuer H. Hengstenberg C. Maikowski
C. Werner G.S. Antoni D. Kleber F.X. Bocksch W. Leschke M. Ackermann H.
Boxberger M. Speck U. Degenhardt R. Scheller B.
Institution
(Unverdorben, Degenhardt) Institut fur Klinische Forschung, Herz-und
Kreislaufzentrum, Rotenburg an der Fulda, Germany
(Vallbracht) Kardiologische Klinik, Herz-und Kreislaufzentrum, Rotenburg
an der Fulda, Germany
(Cremers, Scheller) Klinik fur Innere Medizin III, Universitatsklinikum
des Saarlandes, Homburg, Saar, Germany
(Heuer) Medizinische Klinik, Kardiologie, St. Johannes Hospital, Dortmund,
Germany
(Hengstenberg) Klinik und Poliklinik fur Innere Medizin II,
Universitatsklinikum Regensburg, Regensburg, Germany
(Maikowski) Kerckhoff Klinik, Bad Nauheim, Germany
(Werner) Medizinische Klinik i, Klinikum Darmstadt, Darmstadt, Germany
(Antoni) I. Medizinische Abteilung, Krankenhaus Bogenhausen, Munich,
Germany
(Kleber) Klinik fur Innere Medizin, Unfallkrankenhaus Berlin, Berlin,
Germany
(Bocksch) Medizinische Klinik Mit Schwerpunkt Kardiologie, Campus
Virchow-Klinikum, Universitatsklinikum Charite, Berlin, Germany
(Leschke) Klinik fur Kardiologie, Pneumologie und Angiologie, Klinikum
Esslingen, Esslingen, Germany
(Ackermann) Zentrum fur Medizinische Informatik, Abteilung fur
Biomathematik, Universitat Frankfurt/Main, Frankfurt, Main, Germany
(Boxberger) B. Braun Melsungen AG, Vascular Systems, Berlin, Germany
(Speck) Institut fur Radiologie, Campus Charite Mitte,
Charite-Universitatsmedizin Berlin, Berlin, Germany
Title
Paclitaxel-coated balloon catheter versus paclitaxel-coated stent for the
treatment of coronary in-stent restenosis: The three-year results of the
PEPCAD II ISR study.
Source
EuroIntervention. 11 (8) (pp 926-934), 2015. Date of Publication: December
2015.
Publisher
EuroPCR
Abstract
Aims: Treatment of bare metal in-stent restenosis with the
paclitaxel-coated balloon catheter based on the PACCOCATH technology has
yielded superior six-month angiographic and one-year clinical results
compared to a paclitaxel-eluting stent. The three-year clinical follow-up
is presented. Methods and results: One hundred and thirty-one patients
with coronary bare metal in-stent restenosis (>70%, length: <22 mm, vessel
diameter: 2.5-3.5 mm) were randomly treated with the paclitaxel-coated
balloon (DCB) (3 mug/mm²) or a paclitaxel-eluting stent (DES).
Clinical follow-up information was requested from the patients and from
their physicians. Quantitative angiographic and demographic baseline data
were statistically not different between the groups. Per
intention-to-treat analysis at 12 months, the lesion-related rates of
major adverse cardiac events were 7.6% and 16.9% (p=0.11) while at 36
months the respective numbers were 9.1% and 18.5% (p=0.14). These
differences were primarily due to reduced target lesion revascularisation
(TLR) in DCB 4/66 (6.2%) compared to DES patients 10/65 (15.4%) (p=0.10).
From 12 to 36 months, 1/65 (1.5%) DCB patients experienced a myocardial
infarction while neither TLR nor death occurred in any study patient in
either group during that period. Conclusions: The six-month superiority of
the paclitaxel-coated balloon compared to the paclitaxel-eluting stent in
the treatment of bare metal coronary in-stent restenosis persisted
throughout the three-year clinical follow-up period indicating stability
of the lesions treated.

<9>
Accession Number
20160057892
Authors
Ozturk I. Ozturk S.
Institution
(Ozturk) Medeniyet University Goztepe Education and Research Hospital,
Department of Anesthesiology and Reanimation, Istanbul, Turkey
(Ozturk) Dr. Siyami Ersek Cardiovascular Surgery Education and Research
Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey
Title
Association between postoperative atrial fibrillation and the levels of
hemoglobin or hematocrit: A systematic review and metaanalysis.
Source
Anaesthesia, Pain and Intensive Care. 19 (3) (pp 247-253), 2015. Date of
Publication: September 2015.
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Objective: Postoperative atrial fibrillation is the most commonly observed
arrythmia following cardiac surgery. Both atrial fibrillation and
preoperative anemia hve been related to high rate of mortality and
postoperative morbidity. In this systematic review and meta-analysis, we
aimed to analyze whether levels of preoperative hemoglobin or hematocrit
were useful biomarkers for development of postoperative atrial
fibrillation after cardiac surgery or not. Methodology: The literature
screening was performed from PubMed database without any date limitation.
All patients who underwent open cardiac surgery procedures were
considered. Outcome measures included the association between preoperative
levels of hemoglobin/hematocrit and atrial fibrillation after cardiac
surgery. The results of trials were evaluated with random or fixed effect
model according to the heterogeniety. The statistical evaluation was
performed by using Open Meta Analyst programme. Results: A total of 9948
articles were found after database searching. 17 articles were included in
metaanalysis consisting of 5934 patients who fulfilled inclusion criteria.
The rate of postoperative atrial fibrillation was 35.6% (2114 cases out of
5934). Effect size was observed as heterogenous for studies including
hematocrit (Q(df): 30.76, p <0.001, I²: 73.99%). However, it
was not observed as heterogeneous for studies including hemoglobin (Q(df):
11.10, p: 0.26, I²:18.96%). Analysis results of studies
including hematocrit according to random effect model were SMD: 0.013, 95%
CI -0.21-0.18 and p: 0.89 (p > 0.05). And analysis results of studies
including hemoglobin according to fixed effect model were SMD: 0.172, 95%
CI -0.23-0.11 and p < 0.001. Conclusion: The results of quantitative
analysis showed that preoperative hemoglobin is associated with
development of atrial fibrillation, but hematocrit is not. However, more
studies may be required including both hemoglobin and hematocrit in the
same trials to clearly establish this association.

<10>
Accession Number
20160057889
Authors
Chowdhury M.M.R. Islam M.S. Bhowmick D.K. Kamal M.M. Akhtaruzzaman A.K.M.
Institution
(Chowdhury, Islam, Bhowmick, Kamal, Akhtaruzzaman) Department of
Anesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh
Mujib Medical University, Dhaka, Bangladesh
Title
Effects of clonidine on hemodynamic response and dural tightness in
patients with supra-tentorial space occupying lesion undergoing craniotomy
- A placebo controlled comparative study.
Source
Anaesthesia, Pain and Intensive Care. 19 (3) (pp 233-239), 2015. Date of
Publication: September 2015.
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background and Aims: hypotensive anesthesia is preferred in craniotomy.
Current study was conducted to evaluate the effects of oral clonidine
premedication upon hemodynamic status, dural tightness and quality of
anesthesia using 3 point scoring system in patients scheduled for
craniotomy under general anesthesia. Methodology: Amongst twenty two
selected cases they were grouped equally in this randomized single - blind
comparative study. Group A and B patients received sugar tablet and oral
clonidine 3 mug/kg as a premedication respectively. Monitoring of
hemodynamic variables like heart rate, systolic arterial pressure,
diastolic arterial pressure, mean arterial pressure, SpO<inf>2</inf>,
E<inf>T</inf>CO<inf>2</inf> and dural tightness were performed. Results:
Diastolic arterial pressure was significantly low in Group B during
positioning, performing burr hole and during dura incision. Mean arterial
pressure was highly significant for Group B during positioning. Heart rate
change was significantly high for Group B during burr hole. Regarding
dural tightness, 10 patients in Group B and 6 in Group A had no dural
swelling. 1 patient in Group B and 5 patients in Group A had minimal
swelling and surgery continued. Once all results b being assessed using
'Three point scoring system', it became highly significant in Group B with
respect to Group A. Conclusion: Oral clonidine premedication provides
optimal hemodynamic stability and good neuro-surgical comprising heart
rate, mean arterial pressure and dural tightness. 'Three point scoring
system' seems to be an effective tool for intra-operative monitoring of
patients undergoing supra-tentorial craniotomy.

<11>
Accession Number
20160055889
Authors
Sahu M.K. Das A. Malik V. Subramanian A. Singh S.P. Hote M.
Institution
(Sahu, Das, Singh, Hote) Department of Cardiothoracic and Vascular
Surgery, CN Centre, All India Institute of Medical Sciences, New Delhi 110
029, India
(Malik, Subramanian) Departments of Cardiac Anaesthesia, All India
Institute of Medical Sciences, New Delhi, India
Title
Comparison of levosimendan and nitroglycerine in patients undergoing
coronary artery bypass graft surgery.
Source
Annals of Cardiac Anaesthesia. 19 (1) (pp 52-58), 2016. Date of
Publication: January-March 2016.
Publisher
Medknow Publications (B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai 400 075, India)
Abstract
Background: Levosimendan a calcium ion sensitizer improves both systolic
and diastolic functions. This novel lusitropic drug has predictable
antiischemic properties which are mediated via the opening of
mitochondrial adenosine triphosphate-sensitive potassium channels. This
action of levosimendan is beneficial in cardiac surgical patients as it
improves myocardial contractility, decreases systemic vascular resistance
(SVR), and increases cardiac index (CI) and is thought to be
cardioprotective. We decided to study whether levosimendan has any impact
on the outcomes such as the duration of ventilation, the length of
Intensive Care Unit (ICU) stay, and the hospital stay when compared with
the nitroglycerine (NTG), which is the current standard of care at our
center. Materials and Methods: Forty-seven patients undergoing elective
coronary artery bypass surgery were randomly assigned to two groups
receiving either levosimendan or NTG. The medications were started before
starting surgery and continued until 24 h in the postoperative period.
Baseline hemodynamic parameters were evaluated before beginning of the
operation and then postoperatively at 3 different time intervals.
N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) levels
were also measured in both groups. Results: In comparison to the NTG
group, the duration of ventilation and length of ICU stay were
significantly less in levosimendan group (P < 0.05, P = 0.02). NT-proBNP
level analysis showed a slow rising pattern in both groups and a
statistically significant rise in the levels was observed in NTG group (P
= 0.03, P = 0.02) in postoperative period when compared to levosimendan
group of patients. Conclusion: Levosimendan treatment in patients
undergoing surgical revascularization resulted in improved CI, decreased
SVR and lower heart rate. And, thereby the duration of ventilation and
length of ICU stay were significantly less in this group of patients when
compared with NTG group.

<12>
Accession Number
20160055887
Authors
Tempe D.K. Chaudhary K. Diwakar A. Datt V. Virmani S. Tomar A.S. Mohandas
A. Mohire V.B.
Institution
(Tempe) Department of Anaesthesiology and Intensive Care, Maulana Azad
Medical College and Assoc. Lok Nayak Hospital, GB Pant and GNEC Hospitals,
MAMC Complex, New Delhi, India
(Chaudhary) Department of Anaesthesiology and Intensive Care, Lady
Hardinge Medical College and Assoc. Hospitals, New Delhi, India
(Diwakar, Datt, Virmani, Tomar, Mohandas, Mohire) Department of
Anaesthesiology and Intensive Care, GB Pant Hospital, Maulana Azad Medical
College, New Delhi, India
Title
Comparison of hemodynamic responses to laryngoscopy and intubation with
Truview PCDTM , McGrath and Macintosh laryngoscope in patients undergoing
coronary artery bypass grafting: A randomized prospective study.
Source
Annals of Cardiac Anaesthesia. 19 (1) (pp 68-75), 2016. Date of
Publication: January-March 2016.
Publisher
Medknow Publications (B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai 400 075, India)
Abstract
Context: We hypothesized that reduced oropharyngolaryngeal stimulation
with video laryngoscopes would attenuate hemodynamic response to
laryngoscopy and intubation. Aim: Comparison of hemodynamic response to
laryngoscopy and intubation with video laryngoscopes and Macintosh (MC)
laryngoscope. Setting and Design: Superspecialty tertiary care public
hospital; prospective, randomized control study. Methods: Sixty adult
patients undergoing elective coronary artery bypass grafting (CABG) were
randomly allocated to three groups of 20 each: MC, McGrath (MG), and
Truview (TV). Hemodynamic parameters were serially recorded before and
after intubation. Laryngoscopic grade, laryngoscopy, and tracheal
intubation time, ST segment changes, and intra-/post-operative
complications were also recorded and compared between groups. Statistical
Analysis: SPSS version 17 was used, and appropriate tests applied. P <
0.05 was considered significant. Results: Heart rate and diastolic
arterial pressure increased at 0 and 1 min of intubation in all the three
groups (P < 0.05) while mean arterial pressure increased at 0 min in the
MG and TV groups and at 1 min in all three groups (P < 0.05). A
significant increase in systolic arterial pressure was only observed in TV
group at 1 min (P < 0.05). These hemodynamic parameters returned to
baseline by 3 min of intubation in all the groups. The intergroup
comparisons of all hemodynamic parameters were not significant at any time
of observation. Highest intubation difficulty score was observed with MC
(2.16 +/- 1.86) as compared with MG (0.55 +/- 0.88) and TV (0.42 +/- 0.83)
groups (P = 0.003 and P = 0.001, respectively). However, duration of
laryngoscopy and intubation was significantly less in MC (36.68 +/- 16.15
s) as compared with MG (75.25 +/- 30.94 s) and TV (60.47 +/- 27.45 s)
groups (P = 0.000 and 0.003, respectively). Conclusions: Video
laryngoscopes did not demonstrate any advantage in terms of hemodynamic
response in patients with normal airway undergoing CABG.

<13>
Accession Number
20160055859
Authors
Das S. Nanda S.K. Bisoi A.K. Wadhawan A.N.
Institution
(Das, Nanda) Department of Cardiac Anaesthesia, Cardio Thoracic Sciences
Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi
110 029, India
(Bisoi) Departments of Cardio Thoracic Vascular Surgery, All India
Institute of Medical Sciences, New Delhi, India
(Wadhawan) Department of Clinical Psychology, Neurosciences Center, All
India Institute of Medical Sciences, New Delhi, India
Title
Effect of preoperative statin therapy on early postoperative memory
impairment after off-pump coronary artery bypass surgery.
Source
Annals of Cardiac Anaesthesia. 19 (1) (pp 38-44), 2016. Date of
Publication: January-March 2016.
Publisher
Medknow Publications (B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai 400 075, India)
Abstract
Context: Frequent incidence of early postoperative memory impairment
(POMI) after cardiac surgery remains a concern because of associated
morbidity, impaired quality of life, and increased health care cost. Aim:
To assess the effect of preoperative statin therapy on POMI in patients
undergoing off-pump coronary artery bypass (OPCAB) surgery. Setting and
Design: Prospective observational study in a tertiary level hospital.
Methods: Sixty patients aged 45-65 years undergoing OPCAB surgery were
allocated into two groups of 30 each. Group A patients were receiving
statin and Group B patients were not receiving statins. All patients
underwent memory function assessment preoperatively after admission to
hospital and on the 6 ^th postoperative day using postgraduate
institute memory scale. Statistical Analysis: Appropriate tests were
applied with SPSS 20 to compare both groups. The value P < 0.05 was
considered statistically significant. Multiple regression analysis was
performed with confounding factors to determine the effect on memory
impairment. Results: Patients in Group A showed significant postoperative
deterioration in 6 of the 10 functions and in Group B showed deterioration
in 9 of 10 functions tested compared to preoperative scores. Intergroup
comparison detected less POMI in Group A compared to Group B and was
statistically significant in 8 memory functions. Multiple regression
analysis detected statin as an independent factor in preventing memory
impairment. Conclusions: Preoperative statin therapy attenuates the early
POMI in patients undergoing OPCAB. Future long-term studies will define
the efficacy of statin on POMI.

<14>
Accession Number
2015479521
Authors
Hamarneh A. Sivaraman V. Bulluck H. Shanahan H. Kyle B. Ramlall M. Chung
R. Jarvis C. Xenou M. Ariti C. Cordery R. Yellon D.M. Hausenloy D.J.
Institution
(Hamarneh, Sivaraman, Bulluck, Ramlall, Chung, Cordery, Yellon, Hausenloy)
Hatter Cardiovascular Institute, University College London, 67 Chenies
Mews, London, United Kingdom
(Shanahan, Kyle, Jarvis, Xenou) Heart Hospital, London, United Kingdom
(Ariti) Nuffield Trust, London, United Kingdom
(Yellon, Hausenloy) National Institute of Health Research, University
College London, Hospitals Biomedical Research Centre, London, United
Kingdom
(Hausenloy) National Heart Research Institute Singapore, National Heart
Centre Singapore, Singapore, Singapore
(Hausenloy) Cardiovascular and Metabolic Disorders Program, Duke-National
University of Singapore, Singapore, Singapore
Title
The effect of remote ischemic conditioning and glyceryl trinitrate on
perioperative myocardial injury in cardiac bypass surgery patients:
Rationale and design of the ERIC-GTN study.
Source
Clinical Cardiology. 38 (11) (pp 641-646), 2015. Date of Publication: 01
Nov 2015.
Publisher
John Wiley and Sons Inc.
Abstract
Remote ischemic conditioning (RIC) using transient limb
ischemia/reperfusion has been reported to reduce perioperative myocardial
injury in patients undergoing coronary artery bypass grafting and/or valve
surgery. The role of intravenous glyceryl trinitrate (GTN) therapy
administered during cardiac surgery as a cardioprotective agent and
whether it interferes with RIC cardioprotection is not clear and is
investigated in the ERIC-GTN trial (http://www.clinicaltrials.gov:
NCT01864252). The ERIC-GTN trial is a single-site, double-blind,
randomized, placebo-controlled study. Consenting adult patients (age > 18
years) undergoing elective coronary artery bypass grafting +/- valve
surgery with blood cardioplegia will be eligible for inclusion. Two
hundred sixty patients will be randomized to 1 of 4 treatment groups
following anesthetic induction: (1) RIC alone, a RIC protocol comprising
three 5-minute cycles of simultaneous upper-arm and thigh cuff
inflation/deflation followed by an intravenous (IV) placebo infusion; (2)
GTN alone, a simulated sham RIC protocol followed by an IV GTN infusion;
(3) RIC + GTN, a RIC protocol followed by an IV GTN infusion; and (4)
neither RIC nor GTN, a sham RIC protocol followed by IV placebo infusion.
The primary endpoint will be perioperative myocardial injury as quantified
by the 72-hour area-under-the-curve serum high-sensitivity troponin T. The
ERIC-GTN trial will determine whether intraoperative GTN therapy is
cardioprotective during cardiac surgery and whether it affects RIC
cardioprotection.

<15>
Accession Number
72170031
Authors
Chung J. Filatov A. Ladoris L. Farinas A. Cruz Pico C.X. Postoev A.
Ibikunle C. Sanni A.
Institution
(Chung, Postoev, Filatov, Ladoris, Farinas, Cruz Pico, Postoev, Ibikunle,
Sanni) Georgia Regents University/University of Georgia Medical
Partnership, Athens, GA; Georgia Surgicare, Loganville, GA
Title
Postoperative outcomes of surgical sutureless aortic valve replacement vs
transcatheter aortic valve implantation for severe symptomatic aortic
stenosis.
Source
Journal of the American College of Surgeons. Conference: 101st Annual
Clinical Congress of the American College of Surgeons Chicago, IL United
States. Conference Start: 20151004 Conference End: 20151008. Conference
Publication: (var.pagings). 221 (4 SUPPL. 1) (pp S26), 2015. Date of
Publication: October 2015.
Publisher
Elsevier Inc.
Abstract
INTRODUCTION: High surgical risk patients with severe symptomatic aortic
stenosis (SSAS) are currently being managed with transcatheter aortic
valve implantation (TAVI). Limitations of this procedure include increased
cost, resultant paravalvular leakage, coronary occlusion, and possible
aortic rupture. A new surgical option for this group has emerged with the
advent of surgical sutureless aortic valve replacement (SU-AVR). This
study reviews the postoperative outcomes of SU-AVR in comparison with
TAVI. METHODS: A systematic review was conducted, identifying all relevant
studies with comparative data on SU-AVR vs TAVI. The primary endpoint was
the incidence of postoperative mortality and paravalvular leaks. Other
postoperative outcomes measured were the incidence of postoperative atrial
fibrillation (AF), stroke, acute myocardial infarction (AMI), and acute
renal failure (ARF). Statistical analysis was done using SPSS to calculate
odds ratios and 95% confidence intervals. RESULTS: Five studies were
quantitatively assessed and included for meta-analysis of 2 prospective
and 3 retrospective studies. There 303 SU-AVR patients and 417 TAVI
patients. The SU-AVR was associated with reduced rates of postoperative
mortality (odds ratio [OR] 0.19; 95% CI, 0.07-0.57) and paravalvular leaks
(OR 0.12; 95% CI, 0.07-0.21) when compared with TAVI. There were no
significant differences between SU-AVR and TAVI for the occurrence of
postoperative AF (OR 1.05; 95% CI, 0.59-1.89), stroke (OR 0.34; 95% CI,
0.09-1.3), AMI (OR 0.37; 95% CI, 0.04-3.3), and ARF (OR 0.74; 95% CI,
0.29-1.9). CONCLUSIONS: Surgical sutureless aortic valve replacement is a
valid alternative to TAVI in high risk surgical patients because it is
associated with lower incidence of postoperative mortality and
paravalvular leaks.

<16>
Accession Number
24598306
Authors
Garg A.X. Vincent J. Cuerden M. Parikh C. Devereaux P.J. Teoh K. Yusuf S.
Hildebrand A. Lamy A. Zuo Y. Sessler D.I. Shah P. Abbasi S.H. Quantz M.
Yared J.-P. Noiseux N. Tagarakis G. Rochon A. Pogue J. Walsh M. Chan M.T.
Lamontagne F. Salehiomran A. Whitlock R.
Institution
(Garg, Vincent, Cuerden, Parikh, Devereaux, Teoh, Yusuf, Hildebrand, Lamy,
Zuo, Sessler, Shah, Abbasi, Quantz, Yared, Noiseux, Tagarakis, Rochon,
Pogue, Walsh, Chan, Lamontagne, Salehiomran, Whitlock) Western University,
London, Canada
Title
Steroids In caRdiac Surgery (SIRS) trial: acute kidney injury substudy
protocol of an international randomised controlled trial.
Source
BMJ open. 4 (3) (pp e004842), 2014. Date of Publication: 2014.
Abstract
INTRODUCTION: Steroids In caRdiac Surgery trial (SIRS) is a large
international randomised controlled trial of methylprednisolone or placebo
in patients undergoing cardiac surgery with the use of a cardiopulmonary
bypass pump. At the time of surgery, compared with placebo,
methylprednisolone divided into two intravenous doses of 250 mg each may
reduce the risk of postoperative acute kidney injury (AKI).
METHODS AND ANALYSIS: With respect to the study schedule, over 7000
substudy eligible patients from 81 centres in 18 countries were randomised
in December 2013. The authors will use a logistic regression to estimate
the adjusted OR of methylprednisolone versus placebo on the primary
outcome of AKI in the 14 days following surgery (a postoperative increase
in serum creatinine of >50%, or >26.5 mumol/L, from the preoperative
value). The stage of AKI will also be considered, as will the outcome of
AKI in those with and without preoperative chronic kidney disease. After
receipt of grant funding, the authors began to record additional
perioperative serum creatinine measurements in consecutive patients
enrolled at substudy participating centres, and patients were invited to
enroll in a 6-month serum creatinine collection. In these trial
subpopulations, the authors will consider the outcome of AKI defined in
alternate ways, and the outcome of a 6-month change in kidney function
from the preoperative value.
ETHICS AND DISSEMINATION: The authors were competitively awarded a grant
from the Canadian Institutes of Health Research for this SIRS AKI
substudy. Ethics approval was obtained for additional serum creatinine
recordings in consecutive patients enrolled at participating centres. The
additional kidney data collection first began for patients enrolled after
1 March 2012. In patients who provided consent, the last 6-month kidney
outcome data will be collected in 2014. The results will be reported no
later than 2015.
CLINICAL TRIAL REGISTRATION: Number NCT00427388.

<17>
Accession Number
25701373
Authors
Guethoff S. Stroeh K. Grinninger C. Koenig M.A. Kleinert E.C. Rieger A.
Mayr T. von Ziegler F. Reichart B. Hagl C. Schramm R. Kaczmarek I. Meiser
B.M.
Institution
(Guethoff) Department of Cardiac Surgery; Walter Brendel Centre of
Experimental Medicine. Electronic address:
(Stroeh) Department of Cardiac Surgery; Transplantation Center
(Grinninger) Department of Cardiac Surgery; Transplantation Center
(Koenig) Department of Cardiac Surgery
(Kleinert) Walter Brendel Centre of Experimental Medicine
(Rieger) Institute for Medical Information Sciences, Biometry and
Epidemiology
(Mayr) Department of Cardiac Surgery; Walter Brendel Centre of
Experimental Medicine
(von Ziegler) Department of Cardiology, Ludwig-Maximilians University,
Munich, Germany
(Reichart) Walter Brendel Centre of Experimental Medicine
(Hagl) Department of Cardiac Surgery
(Schramm) Department of Cardiac Surgery; Transplantation Center
(Kaczmarek) Department of Cardiac Surgery; Transplantation Center
(Meiser) Transplantation Center
Title
De novo sirolimus with low-dose tacrolimus versus full-dose tacrolimus
with mycophenolate mofetil after heart transplantation--8-year results.
Source
The Journal of heart and lung transplantation : the official publication
of the International Society for Heart Transplantation. 34 (5) (pp
634-642), 2015. Date of Publication: 01 May 2015.
Abstract
BACKGROUND: Although acute cellular rejection after heart transplantation
(HTX) can be controlled by full-dose calcineurin inhibitor (CNI)-based
immunosuppressive regimens, cardiac allograft vasculopathy (CAV),
nephrotoxicity, and malignancy remain ongoing problems. To evaluate the
potential beneficial effects of sirolimus and CNI reduction, we compared
de novo low-dose tacrolimus and sirolimus with standard tacrolimus and
mycophenolate mofetil (MMF)-based immunosuppression after HTX.
METHODS: We analyzed a long-term follow-up cohort of 126 patients who
underwent HTX during the period 1998-2005 and received either de novo
low-dose tacrolimus/sirolimus (lowTAC/SIR; n = 61) or full-dose
tacrolimus/MMF (TAC/MMF; n = 64).
RESULTS: Freedom from treatment switch was less in the low TAC/SIR group
than in the TAC/MMF group (51.7% vs 73.0%, p = 0.038) 8 years after HTX.
Freedom from acute rejection was 90.6% in the low TAC/SIR group vs 80.3%
in the TAC/MMF group (p = 0.100). There was no difference in freedom from
International Society for Heart and Lung Transplantation CAV grade > 1
(55.4% vs 60.0%, p = 0.922), time until CAV diagnosis (4.2 +/- 2.0 years
vs 3.2 +/- 2.4 years, p = 0.087), and CAV severity (p = 0.618). The
benefit of reduced early maximum creatinine for low TAC/SIR treatment (1.8
+/- 0.9 mg/dl vs 2.4 +/- 1.1 mg/dl in TAC/MMF group, p < 0.001) did not
continue 5 years and 8 years after HTX (1.4 +/- 0.4 mg/dl vs 1.7 +/- 1.2
mg/dl, p = 0.333, and 1.6 +/- 1.1 mg/dl vs 1.6 +/- 0.8 mg/dl, p = 0.957).
The trend for superior survival at 5 years with low TAC/SIR treatment
(93.1% vs 81.3% in TAC/MMF group, p = 0.051) could not be confirmed after
8 years (84.7% vs 75.0%, p = 0.138). Multivariate analysis at 8 years did
not reveal any benefit of low TAC/SIR treatment.
CONCLUSIONS: Reduction of de novo CNI did not result in superior long-term
renal function. Low-dose mechanistic target of rapamycin inhibition did
not achieve any benefit in CAV prevention compared with full-dose TAC/MMF
after HTX.

<18>
Accession Number
25662857
Authors
Pascoalino L.N. Ciolac E.G. Tavares A.C. Castro R.E. Ayub-Ferreira S.M.
Bacal F. Issa V.S. Bocchi E.A. Guimaraes G.V.
Institution
(Pascoalino) Heart Institute, School of Medicine, University of Sao Paulo
- USP, Sao Paulo, Sao Paulo, Brazil
(Ciolac) Exercise and Chronic Disease Research Laboratory, Physical
Education Department, School of Sciences, Sao Paulo State University -
UNESP, Bauru, Sao Paulo, Brazil. Electronic address: ciolac@fc.unesp.br
(Tavares) Heart Institute, School of Medicine, University of Sao Paulo -
USP, Sao Paulo, Sao Paulo, Brazil; Syrian-Lebanese Hospital, Sao Paulo,
Sao Paulo, Brazil
(Castro) Heart Institute, School of Medicine, University of Sao Paulo -
USP, Sao Paulo, Sao Paulo, Brazil
(Ayub-Ferreira) Heart Institute, School of Medicine, University of Sao
Paulo - USP, Sao Paulo, Sao Paulo, Brazil
(Bacal) Heart Institute, School of Medicine, University of Sao Paulo -
USP, Sao Paulo, Sao Paulo, Brazil
(Issa) Heart Institute, School of Medicine, University of Sao Paulo - USP,
Sao Paulo, Sao Paulo, Brazil
(Bocchi) Heart Institute, School of Medicine, University of Sao Paulo -
USP, Sao Paulo, Sao Paulo, Brazil
(Guimaraes) Heart Institute, School of Medicine, University of Sao Paulo -
USP, Sao Paulo, Sao Paulo, Brazil
Title
Exercise training improves ambulatory blood pressure but not arterial
stiffness in heart transplant recipients.
Source
The Journal of heart and lung transplantation : the official publication
of the International Society for Heart Transplantation. 34 (5) (pp
693-700), 2015. Date of Publication: 01 May 2015.
Abstract
BACKGROUND: Hypertension is the most prevalent comorbidity after heart
transplantation (HT). Exercise training (ET) is widely recommended as a
key non-pharmacologic intervention for the prevention and management of
hypertension, but its effects on ambulatory blood pressure (ABP) and some
mechanisms involved in the pathophysiology of hypertension have not been
studied in this population. The primary purpose of this study was to
investigate the effects of ET on ABP and arterial stiffness of HT
recipients.
METHODS: 40 HT patients, randomized to ET (n = 31) or a control group (n =
9) underwent a maximal graded exercise test, 24-hour ABP monitoring, and
carotid-femoral pulse wave velocity (PWV) assessment before the
intervention and at a 12-week follow-up assessment. The ET program was
performed thrice-weekly and consisted primarily of endurance exercise (40
minutes) at ~70% of maximum oxygen uptake (Vo2MAX).
RESULTS: The ET group had reduced 24-hour (4.0 +/- 1.4 mm Hg, p < 0.01)
and daytime (4.8 +/- 1.6 mm Hg, p < 0.01) systolic ABP, and 24-hour (7.0
+/- 1.4 mm Hg, p < 0.001) daytime (7.5 +/- 1.6 mm Hg, p < 0.001) and
nighttime (5.9 +/- 1.5 mm Hg, p < 0.001) diastolic ABP after the
intervention. The ET group also had improved Vo2MAX (9.7% +/- 2.6%, p <
0.001) after the intervention. However, PWV did not change after ET. No
variable was changed in the control group after the intervention.
CONCLUSIONS: The 12-week ET program was effective for reducing ABP but not
PWV in heart transplant recipients. This result suggests that endurance ET
may be a tool to counteract hypertension in this high-risk population.

<19>
Accession Number
25814353
Authors
Elgendy I.Y. Huo T. Mahmoud A. Bavry A.A.
Institution
(Elgendy) Department of Medicine, University of Florida, 1600 SW Archer
Road, P.O. Box 100277, Gainesville, FL, 32610, USA. Electronic address:
islam.elgendy@medicine.ufl.edu
(Huo) Department of Medicine, University of Florida, 1600 SW Archer Road,
P.O. Box 100277, Gainesville, FL, 32610, USA. Electronic address:
thuo@ufl.edu
(Mahmoud) Department of Medicine, University of Florida, 1600 SW Archer
Road, P.O. Box 100277, Gainesville, FL, 32610, USA. Electronic address:
(Bavry) Department of Medicine, University of Florida, 1600 SW Archer
Road, P.O. Box 100277, Gainesville, FL, 32610, USA; North Florida/South
Georgia Veterans Health Systems, 1601 SW Archer Road, Gainesville, FL
32608, USA. Electronic address: anthony.bavry@va.gov
Title
Complete versus culprit-only revascularization in patients with
multi-vessel disease undergoing primary percutaneous coronary
intervention: A meta-analysis of randomized trials.
Source
International journal of cardiology. 186 (pp 98-103), 2015. Date of
Publication: 2015.
Abstract
BACKGROUND: The best approach for revascularization of multi-vessel
coronary disease in patients with ST-elevation myocardial infarction
(STEMI) undergoing primary percutaneous coronary intervention (PCI) is
controversial.
METHODS: We searched the Medline and Web of Science databases, the
Cochrane Register of Controlled Trials, and major conference proceedings
for clinical trials that randomized STEMI patients with multi-vessel
disease to a complete versus culprit-only revascularization strategy.
Random effects summary risk ratios (RR) were constructed using a
DerSimonian-Laird model.
RESULTS: A total of 6 trials met our selection criteria, which yielded
1,190 patients. The mean follow-up duration was 20.5 months. The incidence
of major adverse cardiac events was significantly reduced in the complete
revascularization group versus the culprit-only revascularization group
(RR 0.57, 95% confidence interval (CI) 0.41-0.78, p < 0.001). This was due
to a lower risk of urgent revascularization with complete
revascularization (RR 0.55, 95% CI 0.35-0.86, p = 0.01). A non-significant
reduction was observed with complete versus culprit-only revascularization
for the combined outcome of mortality or myocardial infarction (RR 0.56,
95% CI 0.30-1.04, p = 0.06).
CONCLUSION: Complete revascularization of significant coronary lesions at
the time of primary PCI in patients with STEMI and multi-vessel disease
was associated with better outcomes. This was primarily due to a reduction
in the need for urgent revascularization. Larger trials are needed to
determine if complete revascularization reduces death or myocardial
infarction.