EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
618502275
Author
Soga Y.; Shintani Y.; Hamasaki T.; Tomoi Y.; Takaoka J.; Suematsu N.;
Yokoi H.; Ando K.; Toyoda F.; Imoto Y.; Nakama T.; Taniguchi M.; Ishikwa
T.; Doi H.; Uehara Y.; Iwamoto K.
Institution
(Soga, Ando) Department of Cardiology, Kokura Memorial Hospital, 3-2-1
Asano, Kokurakita-ku, Kitakyushu 802-0001, Japan
(Shintani, Tomoi) Department of Cardiology, Shin-Koga Hospital, Kurume,
Japan
(Hamasaki) Department of Data Science, National Cerebral and
Cardiovascular Center, Suita, Japan
(Takaoka) Division of Cardiology, Tenyoukai Central Hospital, Kagoshima,
Japan
(Suematsu) Department of Cardiology, Saiseikai Fukuoka Hospital, Fukuoka,
Japan
(Yokoi) Cardiovascular Center, Fukuoka Sanno Hospital, Fukuoka, Japan
Title
Effectiveness of sarpogrelate after endovascular treatment for
femoropopliteal artery disease: ESPALIER study.
Source
Cardiovascular Intervention and Therapeutics. 32 (4) (pp 325-332), 2017.
Date of Publication: 01 Oct 2017.
Publisher
Springer Tokyo (E-mail: orders@springer.jp)
Abstract
Optimal medical therapy following endovascular therapy (EVT) for
femoropopliteal (FP) lesions remains unclear. Therefore, we investigated
whether sarpogrelate improves primary patency after EVT for FP lesions.
This study was performed as a multicenter, randomized, open-label clinical
trial. 186 patients (mean age 75 +/- 9 years, 78 % men) with Rutherford
class 2-5 due to an FP lesion were randomly assigned to receive or not
receive sarpogrelate in addition to aspirin. Primary endpoint was 1-year
primary patency and the secondary endpoints were target lesion
revascularization (TLR) and secondary patency. Primary patency was defined
as a treated vessel without restenosis or repeat revascularization.
Restenosis was defined as >2.5 of peak systolic velocity ratio. Patient,
lesion, and procedural characteristics did not differ significantly
between two groups (mean lesion length 156 +/- 94 mm, total occlusion 35
%). Stenting was performed in 133 patients (76 %). Eighty-four (94 %)
could ingest sarpogrelate during follow-up period. Primary patency was 66
% in sarpogrelate group and 56 % in non-sarpogrelate group, showing no
significant difference between the groups (p = 0.33). The incidence of TLR
did not differ in both groups (sarpogrelate 24 % vs non-sarpogrelate 32 %,
p = 0.12). Secondary patency also did not differ (sarpogrelate 90 % vs
non-sarpogrelate 92 %, p = 0.43). When the interaction of sarpogrelate
with the primary patency was analyzed in previously established subgroups,
no interactions were noted for any subset. Sarpogrelate did not improve
primary patency after EVT for FP disease in this study.<br/>Copyright
&#xa9; 2016, Japanese Association of Cardiovascular Intervention and
Therapeutics.

<2>
Accession Number
616322435
Author
Droghetti A.; Marulli G.; Vannucci J.; Giovanardi M.; Bottoli M.C.; Ragusa
M.; Muriana G.
Institution
(Droghetti, Giovanardi, Bottoli, Muriana) Thoracic Surgery Division, Carlo
Poma Hospital, Mantova, Italy
(Marulli) Thoracic Surgery Division, University of Padova, Padova, Italy
(Vannucci, Ragusa) Thoracic Surgery Division, University of Perugia,
Perugia, Italy
Title
Cost analysis of pulmonary lobectomy procedure: Comparison of stapler
versus precision dissection and sealant.
Source
ClinicoEconomics and Outcomes Research. 9 (pp 201-206), 2017. Date of
Publication: 03 Apr 2017.
Publisher
Dove Medical Press Ltd (PO Box 300-008, Albany, 44 Corinthian Drive,
Albany,Auckland 0752, New Zealand. E-mail: angela@dovepress.com)
Abstract
Objective: We aimed to evaluate the direct costs of pulmonary lobectomy
hospitalization, comparing surgical techniques for the division of
interlobar fissures: stapler (ST) versus electrocautery and hemostatic
sealant patch (ES). Methods: The cost comparison analysis was based on the
clinical pathway and drawn up by collecting the information available from
the Thoracic Surgery Division medical team at Mantova Hospital. Direct
resource consumption was derived from a previous randomized controlled
trial including 40 patients. Use and maintenance of technology, equipment
and operating room; administrative plus general costs; and 30-day use of
postsurgery hospital resources were considered. The analysis was conducted
from the hospital perspective. Results: On the average, a patient
submitted to pulmonary lobectomy costs 9,744.29. This sum could vary from
9,027 (using ES) to 10,460 (using ST). The overall lower incidence (50% vs
95%, P=0.0001) and duration of air leakage (1.7 days vs 4.5 days,
P=0.0001) in the ES group significantly affects the mean time of hospital
stay (11.0 days vs 14.3 days) and costs. Cost saving in the ES group was
also driven by the lower incidence of complications. The main key cost
driver was staff employment (42%), then consumables (34%) and operating
room costs (12%). Conclusion: There is an overall saving of around
1,432.90 when using ES patch for each pulmonary lobectomy. Among patients
undergoing this surgical procedure, ES can significantly reduce air
leakage incidence and duration, as well as decrease hospitalization rates.
However, further multicenter research should be developed considering
different clinical and managerial settings.<br/>Copyright &#xa9; 2017
Droghetti et al.

<3>
Accession Number
616937017
Author
Lopez M.G.; Pretorius M.; Shotwell M.S.; Deegan R.; Eagle S.S.; Bennett
J.M.; Sileshi B.; Liang Y.; Gelfand B.J.; Kingeter A.J.; Siegrist K.K.;
Lombard F.W.; Richburg T.M.; Fornero D.A.; Shaw A.D.; Hernandez A.;
Billings F.T.
Institution
(Lopez, Kingeter, Hernandez, Billings) Vanderbilt University Medical
Center, Division of Anesthesiology Critical Care Medicine, Department of
Anesthesiology, 1211 21st Avenue South, Suite 526, Nashville, TN 37212,
United States
(Pretorius, Deegan, Eagle, Bennett, Sileshi, Liang, Gelfand, Kingeter,
Siegrist, Lombard, Richburg, Shaw, Hernandez, Billings) Vanderbilt
University Medical Center, Division of Cardiothoracic Anesthesiology,
Department of Anesthesiology, 1211 21st Avenue South, Suite 526,
Nashville, TN 37212, United States
(Shotwell) Vanderbilt University Medical Center, Department of
Biostatistics, Nashville, TN, United States
(Fornero) Vanderbilt University Medical Center, Cardiovascular Perfusion
Technology Program, Nashville, TN, United States
Title
The Risk of Oxygen during Cardiac Surgery (ROCS) trial: Study protocol for
a randomized clinical trial.
Source
Trials. 18 (1) (no pagination), 2017. Article Number: 295. Date of
Publication: 26 Jun 2017.
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Anesthesiologists administer excess supplemental oxygen
(hyper-oxygenation) to patients during surgery to avoid hypoxia.
Hyper-oxygenation, however, may increase the generation of reactive oxygen
species and cause oxidative damage. In cardiac surgery, increased
oxidative damage has been associated with postoperative kidney and brain
injury. We hypothesize that maintenance of normoxia during cardiac surgery
(physiologic oxygenation) decreases kidney injury and oxidative damage
compared to hyper-oxygenation. Methods/design: The Risk of Oxygen during
Cardiac Surgery (ROCS) trial will randomly assign 200 cardiac surgery
patients to receive physiologic oxygenation, defined as the lowest
fraction of inspired oxygen (FIO<inf>2</inf>) necessary to maintain an
arterial hemoglobin saturation of 95 to 97%, or hyper-oxygenation
(FIO<inf>2</inf> = 1.0) during surgery. The primary clinical endpoint is
serum creatinine change from baseline to postoperative day 2, and the
primary mechanism endpoint is change in plasma concentrations of
F<inf>2</inf>-isoprostanes and isofurans. Secondary endpoints include
superoxide production, clinical delirium, myocardial injury, and length of
stay. An endothelial function substudy will examine the effects of oxygen
treatment and oxidative stress on endothelial function, measured using
flow mediated dilation, peripheral arterial tonometry, and wire tension
myography of epicardial fat arterioles. Discussion: The ROCS trial will
test the hypothesis that intraoperative physiologic oxygenation decreases
oxidative damage and organ injury compared to hyper-oxygenation in
patients undergoing cardiac surgery. Trial registration:
ClinicalTrials.gov, ID: NCT02361944. Registered on the 30th of January
2015.<br/>Copyright &#xa9; 2017 The Author(s).

<4>
Accession Number
617088123
Author
Leclercq F.; Robert P.; Labour J.; Lattuca B.; Akodad M.; Macia J.-C.;
Gervasoni R.; Roubille F.; Gandet T.; Schmutz L.; Nogue E.; Nagot N.;
Albat B.; Cayla G.
Institution
(Leclercq, Robert, Labour, Akodad, Macia, Gervasoni, Roubille) University
Hospital of Montpellier, Department of Cardiology, Montpellier, France
(Gandet, Albat) University Hospital of Montpellier, Department of
Cardiovascular Surgery, Montpellier, France
(Lattuca, Schmutz, Cayla) University Hospital of Nimes, Department of
Cardiology, Nimes, France
(Nogue, Nagot) University Hospital of Montpellier, Department of Medical
Information, Montpellier, France
(Leclercq) University of Montpellier, Department of Cardiology, Arnaud de
Villeneuve Hospital, Avenue du doyen Giraud, Montpellier cedex 5 34295,
France
Title
Prior balloon valvuloplasty versus DIRECT transcatheter Aortic Valve
Implantation (DIRECTAVI): Study protocol for a randomized controlled
trial.
Source
Trials. 18 (1) (no pagination), 2017. Article Number: 303. Date of
Publication: 04 Jul 2017.
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Balloon predilatation of the aortic valve has been regarded as
an essential step during the transcatheter aortic valve implantation
(TAVI) procedure. However, recent evidence has suggested that aortic
valvuloplasty may cause complications and that high success rates may be
obtained without prior dilatation of the valve. We hypothesize that TAVI
performed without predilatation of the aortic valve and using
new-generation balloon-expandable transcatheter heart valves is associated
with a better net clinical benefit than TAVI performed with predilatation.
Methods/design: The transcatheter aortic valve implantation without prior
balloon dilatation (DIRECTAVI) trial is a randomized controlled open label
trial that includes 240 patients randomized to TAVI performed with prior
balloon valvuloplasty (control arm) or direct implantation of the valve
(test arm). All patients with an indication for TAVI will be included
excepting those requiring transapical access. The trial tests the
hypothesis that the strategy of direct implantation of the new-generation
balloon-expandable SAPIEN 3 valve is noninferior to current medical
practice using predilatation of the valve. The primary endpoint assessing
efficacy and safety of the procedure consists of immediate procedural
success and secondary endpoints include complications at 30-day follow-up
(VARC-2 criteria). A subgroup analysis evaluates neurological ischemic
events with cerebral MRI imaging (25 patients in each strategy group)
performed before and between 1 and 3 days after the procedure. Discussion:
This prospective randomized study is designed to assess the efficacy and
safety of TAVI performed without prior dilatation of the aortic valve
using new-generation balloon-expandable transcatheter heart valves. We aim
to provide robust evidence of the advantages of this strategy to allow the
interventional cardiologist to use it in everyday practice. Trial
registration: ClinicalTrials.gov identifier: NCT02729519. Registered on 15
July 2016.<br/>Copyright &#xa9; 2017 The Author(s).

<5>
Accession Number
614767715
Author
Saad M.; Nairooz R.; Rashed A.; Abdelaziz H.K.; Mentias A.; Abbott J.D.
Institution
(Saad, Nairooz) Department of Medicine, Division of Cardiovascular
Medicine, University of Arkansas for Medical Sciences, Little Rock, AR,
United States
(Rashed) Department of Medicine, Division of Cardiovascular Medicine,
Wayne State University/Detroit Medical Center, Detroit, MI, United States
(Abdelaziz) Department of Cardiovascular Medicine, Blackpool Teaching
Hospital NHS Foundation Trust, Lancashire Cardiac Centre, Blackpool,
United Kingdom
(Mentias) Department of Medicine, Division of Cardiovascular Medicine,
University of Iowa Carver College of Medicine, Iowa City, IA, United
States
(Abbott) Division of Cardiovascular Medicine, Rhode Island Hospital, Brown
Medical School, Providence, RI, United States
Title
Bivalirudin versus heparin in women undergoing percutaneous coronary
intervention: A systematic review and meta-analysis of randomized clinical
trials.
Source
Cardiovascular Revascularization Medicine. 18 (6) (pp 418-424), 2017. Date
of Publication: September 2017.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background The anticoagulant of choice during percutaneous coronary
intervention (PCI) in women is not well established. Methods An electronic
search was conducted for trials that randomized patients undergoing PCI to
bivalirudin versus heparin, and reported outcomes of interest in women.
Random effects DerSimonian-Laird risk ratios (RR) were calculated. Main
outcome was net adverse clinical events (NACE) at 30-days. Other outcomes
included major adverse cardiac events (MACE), all-cause mortality,
myocardial infarction (MI), target vessel revascularization (TVR), and
major bleeding at 30-days. 1-year all-cause mortality and MACE were also
examined. Results Nine trials that randomized women undergoing PCI to
bivalirudin (n = 3960) versus heparin (n = 4050) were included. At
30-days, bivalirudin was associated with reduced risk of NACE (RR = 0.85;
95% CI 0.73-0.98; p = 0.03), mainly driven by reduction in major bleeding
(RR = 0.59; 95% CI 0.49-0.71; p < 0.001) compared with heparin. No
difference in MACE (p = 0.92), all-cause mortality (p = 0.23), MI (p =
0.86); or TVR (p = 0.53) was demonstrated between both groups. At 1-year,
the risk of MACE and all-cause mortality was similar in both groups. On a
subgroup analysis, the benefit associated with bivalirudin appeared to be
less evident when Glycoprotein IIb/IIIa inhibitors (GPI) was used as
bailout therapy with heparin, however without significant interaction.
Furthermore, in STEMI population, no difference in NACE, MACE, or major
bleeding was observed between both groups. Conclusion In women undergoing
PCI, bivalirudin is associated with reduced risk of major bleeding and
NACE compared with heparin especially when GPI is routinely
used.<br/>Copyright &#xa9; 2017 Elsevier Inc.

<6>
Accession Number
620929212
Author
Ma Q.-Q.; Fan X.-D.; Li T.; Hao Y.-Y.; Ma F.
Institution
(Ma, Li, Hao, Ma) Department of Cardiology, Xi'an Central Hospital, Xi'an,
Shaanxi Province, China
(Fan) Department of Infectious Diseases, First Affiliated Hospital of
Xi'an Jiao Tong University, Xi'an, Shaanxi Province, China
Title
Short- and long-term prognostic value of hyponatremia in patients with
acute coronary syndrome: A systematic review and metaanalysis.
Source
PLoS ONE. 13 (3) (no pagination), 2018. Article Number: e0193857. Date of
Publication: March 2018.
Publisher
Public Library of Science (E-mail: plos@plos.org)
Abstract
Hyponatremia is relevant to heart failure, liver cirrhosis and stroke, but
the prognostic value of serum sodium levels in patients with acute
coronary syndrome are still unclear. So we did a systematic review and
meta-analysis to assess the prognostic value of hyponatremia on adverse
events in patients after ACS. We systematically searched PubMed, Embase
and Cochrane Library to find literatures which studied the prognostic
value of hyponatremia in patients with ACS. Our main endpoints were the
all-cause mortality and heart failure in the short- and long-term. Of 369
identified studies, 20 studies were included in our analysis. Compared
with the normal natrium, hyponatremia was significantly associated with
the increased risks of all-cause mortality within 30 days (RR: 2.18;
95%CI: 1.96-2.42) and during the follow-ups (HR: 1.74; 95%CI: 1.56-1.942).
For the second endpoint of short- and long-term heart failure, the pooled
effect sizes in hyponatremia patients were 1.72(95%CI: 1.38-2.14) and
1.69(95%CI: 1.12-2.55) respectively. In conclusion, hyponatremia has a
significant prognostic value for short- and long-term adverse event in
patients after ACS, the dynamic monitoring of serum sodium levels may
could help physicians to identify high risk ACS patients and to stratify
risk for optimal management.<br/>Copyright &#xa9; 2018 Ma et al. This is
an open access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<7>
Accession Number
2000811503
Author
Viszlayova D.; Brozman M.; Langova K.; Herzig R.; Skoloudik D.
Institution
(Viszlayova, Brozman) Department of Neurology, Faculty Hospital Nitra and
Constantine Philosopher University, Nitra, Slovakia
(Viszlayova) Department of Neurology, Faculty of Medicine and Dentistry,
Palacky University, Olomouc, Czech Republic
(Viszlayova) Department of Neurology, Charles University Faculty of
Medicine, Hradec Kralove, Czech Republic
(Langova, Skoloudik) Centre for Research and Science, Faculty of Health
Sciences, Palacky University, Olomouc, Czech Republic
(Langova) Department of Biophysics, Faculty of Medicine and Dentistry,
Palacky University, Olomouc, Czech Republic
(Herzig) Department of Neurology, Comprehensive Stroke Center, Charles
University Faculty of Medicine and University Hospital Hradec Kralove,
Hradec Kralove, Czech Republic
Title
Sonolysis in risk reduction of symptomatic and silent brain infarctions
during coronary stenting (SONOREDUCE): Randomized, controlled trial.
Source
International Journal of Cardiology. 267 (pp 62-67), 2018. Date of
Publication: 15 September 2018.
Publisher
Elsevier Ireland Ltd
Abstract
Background: Silent brain infarcts can be detected on magnetic resonance
imaging (MRI) in ~22% of patients after coronary angioplasty and stenting
(CS). The effect of periprocedural sonolysis on the risk of new brain
infarcts during CS was examined. Methods: Patients undergoing elective CS
were allocated randomly to a bilateral sonolysis group (70 patients, 58
men; mean age, 59.9 years) or a control group (74 patients, 45 men; mean
age, 65.5 years). Neurologic examination, cognitive function tests, and
brain MRI were performed prior to intervention and at 24 h after CS.
Neurologic examination and cognitive function tests were repeated at 30
days after CS. Results: No significant differences were observed in the
number of patients with new infarcts (25.7 vs. 18.9%, P = 0.423), the
number of lesions (1.3 +/- 1.0 vs. 2.9 +/- 5.3, P = 0.493), lesion volume
(0.16 +/- 0.34 vs. 0.28 +/- 0.60 mL, P = 0.143), and the number of
patients with new ischemic lesions in the insonated MCA territories
(18.6vs. 17.6%, P = 0.958) between the sonolysis group and the control
group. There were no cases of stroke, transient ischemic attack,
myocardial infarction, or death in the two groups. Intracranial bleeding
was reported only in 1 patient in the control group (0 vs. 1.4%, P =
0.888). Clock-drawing test scores at 30 days were significantly higher in
the sonolysis group than in the control group (median 3.0 vs. 2.5, P =
0.031). Conclusions: Sonolysis does not reduce the risk of new brain
infarcts after CS. The effect of sonolysis on number and volume of
ischemic lesions and cognitive function should be assessed in further
studies.<br/>Copyright &#xa9; 2018 Elsevier B.V.

<8>
Accession Number
2000887106
Author
Serruys P.W.; Cavalcante R.; Collet C.; Kappetein A.P.; Sabik J.F.;
Banning A.P.; Taggart D.P.; Sabate M.; Pomar J.; Boonstra P.W.; Lembo
N.J.; Onuma Y.; Simonton C.A.; Morice M.-C.; McAndrew T.; Dressler O.;
Stone G.W.
Institution
(Serruys) Imperial College London, London, United Kingdom
(Cavalcante, Kappetein) Erasmus Medical Center, Rotterdam, Netherlands
(Collet) Academic Medical Center, University of Amsterdam, Amsterdam,
Netherlands
(Collet) Department of Cardiology, Universitair Ziekenhuis Brussel,
Brussels, Belgium
(Sabik) The Cleveland Clinic Foundation, Cleveland, Ohio, United States
(Banning, Taggart) Oxford University Hospitals, Oxford, United Kingdom
(Sabate, Pomar) Hospital Clinico y Provincial de Barcelona, Barcelona,
Spain
(Boonstra) Medisch Centrum Leeuwarden, Leeuwarden, Netherlands
(Lembo) Piedmont Hospital Atlanta, Atlanta, Georgia
(Onuma) Cardialysis BV, Rotterdam, Netherlands
(Simonton) Abbott Vascular, Santa Clara, California, United States
(Morice) Ramsay Generale de Sante, Hopital Prive Jacques Cartier, Massy,
France
(McAndrew, Dressler, Stone) New York Presbyterian Hospital, Columbia
University Medical Center, the Cardiovascular Research Foundation, New
York, New York, United States
Title
Outcomes After Coronary Stenting or Bypass Surgery for Men and Women With
Unprotected Left Main Disease: The EXCEL Trial.
Source
JACC: Cardiovascular Interventions. 11 (13) (pp 1234-1243), 2018. Date of
Publication: 9 July 2018.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: The aim of the present study was to assess outcomes after
coronary artery bypass grafting surgery (CABG) and percutaneous coronary
intervention (PCI) according to sex in a large randomized trial of
patients with unprotected left main disease. Background: In the SYNTAX
(Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac
Surgery) trial, sex had a significant interaction effect with
revascularization strategy, and women had an overall higher mortality when
treated with PCI than CABG. Methods: The EXCEL (Evaluation of XIENCE
Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main
Revascularization) trial was a multinational randomized trial that
compared PCI with everolimus-eluting stents and CABG in patients with
unprotected left main disease. The primary endpoint was the composite of
all-cause death, myocardial infarction, or stroke at 3 years. Results: Of
1,905 patients randomized, 1,464 (76.9%) were men and 441 (23.1%) were
women. Compared with men, women were older; had higher prevalence rates of
hypertension, hyperlipidemia, and diabetes; and were less commonly smokers
but had lower coronary anatomic burden and complexity (mean SYNTAX score
24.2 vs. 27.2, p < 0.001). By multivariate analysis, sex was not
independently associated with either the primary endpoint (hazard ratio
[HR]: 1.10; 95% confidence interval [CI]: 0.82 to 1.48; p = 0.53) or
all-cause death (HR: 1.39; 95% CI: 0.92 to 2.10; p = 0.12) at 3 years. At
30 days, all-cause death, myocardial infarction, or stroke had occurred in
8.9% of woman treated with PCI, 6.2% of women treated with CABG, 3.6% of
men treated with PCI, and 8.4% of men treated with CABG (p for interaction
= 0.003). The 3-year rate of the composite primary endpoint was 19.7% in
women treated with PCI, 14.6% in women treated with CABG, 13.8% in men
treated with PCI, and 14.7% in men treated with CABG (p for interaction =
0.06). These differences were driven by higher periprocedural rates of
myocardial infarction in women after PCI and in men after CABG.
Conclusions: In patients with unprotected left main disease in the EXCEL
trial, sex was not an independent predictor of adverse outcomes after
revascularization. However, women undergoing PCI had a trend toward worse
outcomes, a finding related to associated comorbidities and increased
periprocedural complications. Further studies are required to determine
the optimal revascularization modality in women with complex coronary
artery disease.<br/>Copyright &#xa9; 2018 American College of Cardiology
Foundation

<9>
Accession Number
2000813985
Author
Maes F.; Stabile E.; Ussia G.P.; Tamburino C.; Pucciarelli A.; Masson
J.-B.; Marsal J.R.; Barbanti M.; Cote M.; Rodes-Cabau J.
Institution
(Maes, Cote, Rodes-Cabau) Department of Cardiology, Quebec Heart & Lung
Institute, Laval University, Quebec City, Quebec, Canada
(Stabile) Department of Advanced Biomedical Sciences, University "Federico
II", Napoli, Italy
(Ussia) Department of Cardiology, Tor Vergata University of Rome, Rome,
Italy
(Tamburino, Barbanti) Department of Cardiology, Ferrarotto Hospital,
University of Catania, Catania, Italy
(Pucciarelli) Department of Cardiology, Clinica Montevergine, Mercogliano,
Italy
(Masson) Department of Cardiology, Centre Hospitalier Universitaire de
Montreal, Montreal, Quebec, Canada
(Marsal) Epidemiology Unit of the Cardiology Department and CIBER de
Epidemiologia y Salud Publica (CIBERESP), Vall d'Hebron University
Hospital, Barcelona, Spain
Title
Meta-Analysis Comparing Single Versus Dual Antiplatelet Therapy Following
Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. 122 (2) (pp 310-315), 2018. Date of
Publication: 15 July 2018.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
To compare dual antiplatelet therapy (DAPT) versus single antiplatelet
therapy (SAPT) as antithrombotic treatment after transcatheter aortic
valve implantation (TAVI) for the prevention of ischemic events, vascular
and bleeding events, and death. Data from the 3 randomized trials
comparing DAPT versus SAPT post-TAVI were pooled and analyzed in a
patient-level meta-analysis. The primary end point was the occurrence of
death, major or life-threatening bleedings, and major vascular
complications at 30-day follow-up. Events were adjudicated according to
the Valve Academic Research Consortium 2 definitions. A total of 421
patients randomized to DAPT (210 patients) or SAPT (211 patients)
post-TAVI were analyzed. There were no differences between groups in
baseline clinical and procedural characteristics. The occurrence of the
30-day combined primary end point was higher in the DAPT group (17.6% vs
10.9%, odds ratio 1.73, 95% confidence interval 1.00 to 2.98, p = 0.050),
with an increased rate of major or life-threatening bleeding events in the
DAPT group (11.4% vs 5.2%, odds ratio 2.24, 95% confidence interval 1.12
to 4.46, p = 0.022). There were no differences between DAPT and SAPT
groups in the incidence of death (5.2% vs 3.8%, p = 0.477), global
ischemic events (3.8% vs 3.8%, p = 0.999), or stroke (2.4% vs 2.4%, p =
0.996). DAPT (vs SAPT) was associated with a higher rate of major adverse
events after TAVI, mainly driven by an increased risk of major or
life-threatening bleeding complications along with a lack of beneficial
effect on ischemic events. These results do not support the current
recommendation of DAPT as antithrombotic therapy after TAVI.<br/>Copyright
&#xa9; 2018 Elsevier Inc.

<10>
Accession Number
622728023
Author
Milojevic M.; Head S.J.; Mack M.J.; Mohr F.W.; Morice M.-C.; Dawkins K.D.;
Holmes D.R.; Serruys P.W.; Kappetein A.P.
Institution
(Milojevic, Head, Kappetein) Department of Cardiothoracic Surgery, Erasmus
University Medical Center, 's-Gravendijkwal 230, Rotterdam 3015 CA,
Netherlands
(Mack) Department of Cardiovascular Surgery, Heart Hospital Baylor Plano,
Baylor Healthcare System, Plano, TX, United States
(Mohr) Department of Cardiovascular Surgery, Herzzentrum Universitat
Leipzig, Leipzig, Germany
(Morice) Department of Cardiology, Institut Hospitalier Jacques Cartier,
Massy, France
(Dawkins) Boston Scientific Corporation, Marlborough, MA, United States
(Holmes) Division of Cardiovascular Diseases, Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Serruys) International Centre for Circulatory Health, NHLI, Imperial
College London, London, United Kingdom
Title
The impact of chronic kidney disease on outcomes following percutaneous
coronary intervention versus coronary artery bypass grafting in patients
with complex coronary artery disease: Five-year follow-up of the SYNTAX
trial.
Source
EuroIntervention. 14 (1) (pp 102-111), 2018. Date of Publication: May
2018.
Publisher
EuroPCR
Abstract
Aims: The aim of this study was to investigate short-term and five-year
follow-up results from patients randomised to coronary artery bypass
grafting (CABG) or percutaneous coronary intervention (PCI) with
paclitaxel-eluting stents in the SYNTAX trial, focusing on patients with
chronic kidney disease (CKD). Methods and results: Baseline glomerular
filtration rate estimates (eGFR) were available in 1,638 patients (PCI=852
and CABG=786). The Kidney Disease: Improving Global Outcomes (KDIGO)
threshold was used to define staging of CKD. At five years, death was
significantly higher in patients with CKD compared to patients with normal
kidney function after PCI (26.7% vs. 10.8%, p<0.001) and CABG (21.2% vs.
10.6%, p=0.005). Comparing PCI with CABG, there was a significant
interaction according to kidney function for death (pint=0.017) but not
the composite endpoint of death/stroke/MI (pint=0.070) or MACCE
(pint=0.15). In patients with CKD, the rate of MACCE was significantly
higher after PCI compared with CABG (42.1% vs. 31.5%, p=0.019), driven by
repeat revascularisation (21.9% vs. 8.9%, p=0.004) and allcause death
(26.7% vs. 21.2%, p=0.14). In patients with CKD who also had diabetes, PCI
versus CABG was significantly worse in terms of death/stroke/MI (47.9% vs.
24.4%, p=0.005) and all-cause death (40.9% vs. 17.7%, p=0.004).
Conclusions: During a five-year follow-up, adverse event rates were
comparable between PCI and CABG patients with moderate CKD but
significantly higher compared to the patients with impaired or normal
kidney function. The negative impact of CKD on long-term outcome following
PCI appears to be stronger when compared to CABG, especially in the CKD
patients with diabetes and extensive coronary disease. ClinicalTrials.gov
Identifier: NCT00114972<br/>Copyright &#xa9; Europa Digital & Publishing
2018.

<11>
Accession Number
622727992
Author
Bellemain-Appaix A.; Begue C.; Bhatt D.L.; Ducci K.; Harrington R.A.; Roe
M.; Wiviott S.D.; Cucherat M.; Silvain J.; Collet J.-P.; Bernasconi F.;
Montalescot G.
Institution
(Bellemain-Appaix, Bernasconi) Service de Cardiologie, Antibes Hospital,
Antibes, France
(Bellemain-Appaix, Begue, Silvain, Collet, Montalescot) ACTION Study
Group, Paris, France
(Begue, Silvain, Collet, Montalescot) Sorbonne Universite Paris 6,
Institut de Cardiologie, Pitie-Salpetriere Hospital (AP-HP), Paris, France
(Bhatt) Brigham and Women's Hospital Heart, Vascular Center, Harvard
Medical School, Boston, MA, United States
(Ducci) Cardiovascular and Neurologic Department, San Donato Hospital,
Arezzo, Italy
(Harrington) Stanford University, Medical School, Stanford, CA, United
States
(Roe) Division of Cardiology, Duke University Medical Center, Duke
Clinical Research Institute, Durham, NC, United States
(Wiviott) Cardiovascular Division, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Cucherat) UMR CNRS 5558, Universite Lyon 1 Laennec, Lyon, France
Title
The efficacy of early versus delayed P2Y12 inhibition in percutaneous
coronary intervention for ST-elevation myocardial infarction: A systematic
review and meta-analysis.
Source
EuroIntervention. 14 (1) (pp 78-85), 2018. Date of Publication: May 2018.
Publisher
EuroPCR
Abstract
Aims: The aim of this meta-analysis was to compare the benefit of "early"
vs. "delayed" P2Y12 inhibition in patients undergoing percutaneous
coronary intervention (PCI) for ST-elevation myocardial infarction
(STEMI). Methods and results: We conducted a meta-analysis including seven
randomised controlled trials (RCTs) which compared early vs. delayed P2Y12
inhibition in STEMI patients scheduled for PCI, providing data on major
adverse cardiac events (MACE), all-cause death, and major bleeding. The
primary endpoint was MACE. Secondary endpoints included stent thrombosis
and the use of GP IIb/IIIa inhibitors (GPI). All endpoints were analysed
at the shortest follow-up available. A total of 9,648 patients were
included ("early"=4,792, "delayed"=4,856). "Early" P2Y12 inhibition was
associated with a significant reduction in MACE rate (OR 0.73, 95% CI:
0.61-0.88, p=0.0008), myocardial infarction (OR 0.71, 95% CI: 0.57- 0.90,
p=0.004), bail-out GPI use (OR 0.87, 95% CI: 0.75-1.00, p=0.04) and
improved coronary reperfusion before PCI (OR for Thrombolysis In
Myocardial Infarction [TIMI] flow grade 2-3=1.12, 95% CI: 1.00- 1.26,
p=0.04). Major bleeding was not increased (OR 0.87, 95% CI: 0.62-1.21,
p=0.41). Conclusions: A strategy of early effective P2Y12 inhibition in
PCI of STEMI appears to improve coronary reperfusion before PCI, and
reduce MACE, MI and bail-out GPI use without increase of major
bleeding.<br/>Copyright &#xa9; Europa Digital & Publishing 2018.

<12>
Accession Number
622727978
Author
Mohananey D.; Sengodan P.; Banerjee K.; Kumar A.; Jobanputra Y.;
Sankaramangalam K.; Krishnaswamy A.; Mick S.; White J.M.; Svensson L.G.;
Kapadia S.R.
Institution
(Mohananey, Sengodan, Banerjee, Kumar, Jobanputra, Sankaramangalam,
Krishnaswamy, White, Kapadia) Department of Cardiovascular Medicine, Heart
and Vascular Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH
44195, United States
(Mick, Svensson) Department of Cardiothoracic Surgery, Heart and Vascular
Institute, Cleveland Clinic, Cleveland, OH, United States
Title
Comparative analysis of cerebrovascular events in transcatheter and
surgical aortic valve replacement: A systematic review and meta-analysis
of randomised trials.
Source
EuroIntervention. 14 (1) (pp 69-77), 2018. Date of Publication: May 2018.
Publisher
EuroPCR
Abstract
Aims: Transcatheter aortic valve replacement (TAVR) has become the
procedure of choice for inoperable patients and a safe alternative to
surgical aortic valve replacement (SAVR) among moderate-risk patients. We
used meta-analysis to compare the incidence of cerebrovascular events
amongst patients undergoing TAVR and SAVR in randomised controlled trials
(RCT). Methods and results: Our search revealed five RCT published between
2011 and 2017 with a total of 5,414 patients. Data were summarised as
Mantel-Haenszel relative risk (RR) and 95% confidence intervals (CI). The
risk of major stroke (RR 0.89, 95% CI: 0.53-1.51), all strokes (RR 0.85,
95% CI: 0.59-1.22) and all cerebrovascular events (RR 0.94, 95% CI:
0.75-1.17) was comparable between patients undergoing TAVR and SAVR at 30
days of follow-up. The risk of all strokes (RR 0.92, 95% CI: 0.69-1.22),
major stroke (RR 0.92, 95% CI: 0.62-1.37) and all cerebrovascular events
(RR 1.03, 95% CI: 0.79-1.33) was comparable between TAVR and SAVR at one
year of follow-up. The incidence of major stroke (RR 1.02, 95% CI:
0.64-1.61), all strokes (RR 1.12, 95% CI: 0.78-1.62) and all
cerebrovascular events (RR 1.23, 95% CI: 0.91-1.66) was comparable between
TAVR and SAVR between 30 days and one year of follow-up. Conclusions: In
our meta-analysis of RCT comparing TAVR and SAVR, we showed comparable
risk of major stroke, all stroke and all cerebrovascular
events.<br/>Copyright &#xa9; Europa Digital & Publishing 2018.

<13>
Accession Number
620085906
Author
Chaikof E.L.; Dalman R.L.; Eskandari M.K.; Jackson B.M.; Lee W.A.; Mansour
M.A.; Mastracci T.M.; Mell M.; Murad M.H.; Nguyen L.L.; Oderich G.S.;
Patel M.S.; Schermerhorn M.L.; Starnes B.W.
Institution
(Chaikof, Patel, Schermerhorn) Department of Surgery, Beth Israel
Deaconess Medical Center, Boston, Mass, United States
(Dalman, Mell) Department of Surgery, Stanford University, Palo Alto,
Calif, United States
(Eskandari) Department of Surgery, Northwestern University, Chicago, Ill,
United States
(Jackson) Department of Surgery, University of Pennsylvania, Philadelphia,
Pa, United States
(Lee) Christine E. Lynn Heart & Vascular Institute, Boca Raton Regional
Hospital, Boca Raton, Fla, United States
(Mansour) Department of Surgery, Spectrum Health Medical Group, Grand
Rapids, Mich, United States
(Mastracci) The Royal Free Hospital, London, United Kingdom
(Murad) Evidence-based Practice Center, Mayo Clinic, Rochester, Minn,
United States
(Nguyen) Department of Surgery, Brigham and Women's Hospital, Boston,
Mass, United States
(Oderich) Department of Surgery, Mayo Clinic, Rochester, Minn, United
States
(Patel) Department of Surgery, Massachusetts General Hospital, Boston,
Mass, United States
(Starnes) Department of Surgery, University of Washington, Seattle, Wash,
United States
Title
The Society for Vascular Surgery practice guidelines on the care of
patients with an abdominal aortic aneurysm.
Source
Journal of Vascular Surgery. 67 (1) (pp 2-77.e2), 2018. Date of
Publication: January 2018.
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background Decision-making related to the care of patients with an
abdominal aortic aneurysm (AAA) is complex. Aneurysms present with varying
risks of rupture, and patient-specific factors influence anticipated life
expectancy, operative risk, and need to intervene. Careful attention to
the choice of operative strategy along with optimal treatment of medical
comorbidities is critical to achieving excellent outcomes. Moreover,
appropriate postoperative surveillance is necessary to minimize subsequent
aneurysm-related death or morbidity. Methods The committee made specific
practice recommendations using the Grading of Recommendations Assessment,
Development, and Evaluation system. Three systematic reviews were
conducted to support this guideline. Two focused on evaluating the best
modalities and optimal frequency for surveillance after endovascular
aneurysm repair (EVAR). A third focused on identifying the best available
evidence on the diagnosis and management of AAA. Specific areas of focus
included (1) general approach to the patient, (2) treatment of the patient
with an AAA, (3) anesthetic considerations and perioperative management,
(4) postoperative and long-term management, and (5) cost and economic
considerations. Results Along with providing guidance regarding the
management of patients throughout the continuum of care, we have revised a
number of prior recommendations and addressed a number of new areas of
significance. New guidelines are provided for the surveillance of patients
with an AAA, including recommended surveillance imaging at 12-month
intervals for patients with an AAA of 4.0 to 4.9 cm in diameter. We
recommend endovascular repair as the preferred method of treatment for
ruptured aneurysms. Incorporating knowledge gained through the Vascular
Quality Initiative and other regional quality collaboratives, we suggest
that the Vascular Quality Initiative mortality risk score be used for
mutual decision-making with patients considering aneurysm repair. We also
suggest that elective EVAR be limited to hospitals with a documented
mortality and conversion rate to open surgical repair of 2% or less and
that perform at least 10 EVAR cases each year. We also suggest that
elective open aneurysm repair be limited to hospitals with a documented
mortality of 5% or less and that perform at least 10 open aortic
operations of any type each year. To encourage the development of
effective systems of care that would lead to improved outcomes for those
patients undergoing emergent repair, we suggest a door-to-intervention
time of <90 minutes, based on a framework of 30-30-30 minutes, for the
management of the patient with a ruptured aneurysm. We recommend treatment
of type I and III endoleaks as well as of type II endoleaks with aneurysm
expansion but recommend continued surveillance of type II endoleaks not
associated with aneurysm expansion. Whereas antibiotic prophylaxis is
recommended for patients with an aortic prosthesis before any dental
procedure involving the manipulation of the gingival or periapical region
of teeth or perforation of the oral mucosa, antibiotic prophylaxis is not
recommended before respiratory tract procedures, gastrointestinal or
genitourinary procedures, and dermatologic or musculoskeletal procedures
unless the potential for infection exists or the patient is
immunocompromised. Increased utilization of color duplex ultrasound is
suggested for postoperative surveillance after EVAR in the absence of
endoleak or aneurysm expansion. Conclusions Important new recommendations
are provided for the care of patients with an AAA, including suggestions
to improve mutual decision-making between the treating physician and the
patients and their families as well as a number of new strategies to
enhance perioperative outcomes for patients undergoing elective and
emergent repair. Areas of uncertainty are highlighted that would benefit
from further investigation in addition to existing limitations in
diagnostic tests, pharmacologic agents, intraoperative tools, and
devices.<br/>Copyright &#xa9; 2017 Society for Vascular Surgery

<14>
Accession Number
620908706
Author
Ling X.; Zhou H.; Ni Y.; Wu C.; Zhang C.; Zhu Z.
Institution
(Ling) Outpatient Nursing Department, Second Affiliated Hospital of
Jiaxing University, Jiaxing City, Zhejiang Province, China
(Zhou, Ni, Wu, Zhang, Zhu) Department of Anesthesiology, Second Affiliated
Hospital of Jiaxing University, Jiaxing City, Zhejiang Province, China
Title
Does dexmedetomidine have an antiarrhythmic effect on cardiac patients? A
meta-analysis of randomized controlled trials.
Source
PLoS ONE. 13 (3) (no pagination), 2018. Article Number: e0193303. Date of
Publication: March 2018.
Publisher
Public Library of Science (E-mail: plos@plos.org)
Abstract
Background Cardiac surgery patients often experience several types of
tachyarrhythmias after admission to the intensive care unit (ICU), which
increases mortality and morbidity. Dexmedetomidine (DEX) is a popular
medicine used for sedation in the ICU, and its other pharmacological
characteristics are gradually being uncovered. Purpose To determine
whether DEX has an antiarrhythmic effect after cardiac surgery. Methods
The three primary databases MEDLINE, Embase (OVID SP) and the Cochrane
Central Register of Controlled Trials (CENTRAL) were searched, and all
English-language and randomized control-designed clinical publications
comparing DEX to control medicines for sedation after elective cardiac
surgery were included. Two colleagues independently extracted the data and
performed other quality assessments. A subgroup analysis was performed
according to the different medicines used and whether cardiopulmonary
bypass (CPB) was applied. All tachyarrhythmias that occurred in the atria
and ventricles were analyzed. Results A total of 1295 patients in 9
studies met the selection criteria among 2587 studies that were screened.
After quantitative synthesis, our results revealed that the DEX group was
associated with a lower incidence of ventricular arrhythmia (VA, OR 0.24,
95% CI 0.09-0.64, I² = 0%, P = 0.005) than the control group.
Subgroup analysis did not reveal a significant difference between the DEX
and propofol subgroups (OR 0.13, 95% CI 0.03-0.56, I² = 0%, P =
0.007). Additionally, no difference in the incidence of atrial
fibrillation (AF) was observed regardless of the different control
medicines (OR 0.82, 95% CI 0.60-1.10, I² = 25%, P = 0.19) or
whether CPB was applied. Conclusions This meta-analysis revealed that DEX
has an antiarrhythmic effect that decreases the incidence of VA compared
to other drugs used for sedation following cardiac surgery. DEX May not
have an effect on AF, but cautious interpretation should be exercised due
to high heterogeneity.<br/>Copyright &#xa9; 2018 Ling et al. This is an
open access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<15>
Accession Number
618870648
Author
Zeymer U.; Werdan K.; Schuler G.; Zahn R.; Neumann F.-J.; Furnau G.; de
Waha S.; Schneider S.; Thiele H.
Institution
(Zeymer, Zahn) Klinikum Ludwigshafen, Medizinische Klinik B, Germany
(Zeymer, Schneider) Institut fur Herzinfarktforschung Ludwigshafen,
Germany
(Werdan) Universitatsklinikum Halle, Klinik fur Kardiologie, Germany
(Schuler, Furnau, Thiele) Universitat Leipzig, Herzzentrum, Kardiologie,
Germany
(Neumann) Herzzentrum Bad Krozingen, Germany
(de Waha) Herzzentrum Bad Segeberg, Germany
(Thiele) Medical Clinic II, Universitares Herzzentrum Lubeck University
Hospital Schleswig-Holstein, Germany
Title
Editor's Choice- Impact of immediate multivessel percutaneous coronary
intervention versus culprit lesion intervention on 1-year outcome in
patients with acute myocardial infarction complicated by cardiogenic
shock: Results of the randomised IABP-SHOCK II trial.
Source
European Heart Journal: Acute Cardiovascular Care. 6 (7) (pp 601-609),
2017. Date of Publication: 01 Oct 2017.
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Background: Current guidelines recommend immediate multivessel
percutaneous coronary intervention (PCI) in patients with cardiogenic
shock, despite the lack of randomised trials. We sought to investigate the
use and impact on outcome of multivessel PCI in comparison to culprit
lesion only PCI in a retrospective analysis in patients with cardiogenic
shock complicating acute myocardial infarction. Methods and results: In
the randomised IABP-SHOCK II trial, investigating the effect of
intra-aortic balloon pump on outcome, 451 (75%) of the total of 600
patients had multivessel coronary artery disease and underwent PCI.
Immediate multivessel PCI was performed in 167 (37%) patients. TIMI 3
patency after PCI in all treated vessels was observed in 83.2% versus
79.0% of patients after multivessel versus culprit lesion PCI,
respectively. The 30-day (44.9% vs. 42.3%) and 12-month (54.8% vs. 52.7%)
mortality rates did not significantly differ between the two groups. In
the multivariate analysis multivessel PCI was not associated with an
improved mortality after 12 months (odds ratio 0.92, 95% confidence
intervals 0.69-1.21). Conclusion: In this retrospective analysis of the
largest randomised study in cardiogenic shock immediate multivessel PCI
was used in approximately one third of patients with cardiogenic shock.
There was no benefit with immediate multivessel PCI in comparison to
culprit lesion only PCI. Therefore a randomised trial is needed to
determine the definitive role of multivessel PCI in cardiogenic shock.
Clinical Trial Registration: ClinicalTrials.gov,
NCT00491036.<br/>Copyright &#xa9; 2016, &#xa9; The European Society of
Cardiology 2016.

<16>
Accession Number
616501045
Author
Crowle C.; Walker K.; Galea C.; Novak I.; Badawi N.
Institution
(Crowle, Walker, Badawi) Grace Centre for Newborn Care, The Children's
Hospital Westmead, Sydney, Australia
(Crowle, Walker, Novak, Badawi) University of Sydney, Sydney, Australia
(Walker, Galea, Novak, Badawi) Cerebral Palsy Alliance Research Institute,
Sydney, Australia
Title
General movement trajectories and neurodevelopment at 3 months of age
following neonatal surgery.
Source
Early Human Development. 111 (pp 42-48), 2017. Date of Publication: August
2017.
Publisher
Elsevier Ireland Ltd
Abstract
Background Neonates who undergo major surgery are at risk of
neurodevelopmental disability. The General Movements Assessment (GMA) is a
valid and reliable method to predict neurodevelopment, however, there are
minimal data on the applicability among infants post-surgery. Aim To
describe GMs trajectories following neonatal surgery. Study design
Prospective cohort study. Subjects 217 infants following major cardiac and
non-cardiac neonatal surgery. Outcome measures Infants were assessed
following surgery at term age (mean 40 weeks, SD 2.3), and at 3 months of
age (mean 12 weeks, SD 1.6) using the GMA and the Bayley Scales of Infant
and Toddler Development III. GMA videos were independently scored by three
advanced trained assessors, two blinded to infant details. Results The
most common result in the writhing period was 'poor repertoire' (n = 117,
54%), however, 99 (84%) of these infants had normal fidgety movements. For
infants with normal writhing (n = 75, 34%), only four had absent fidgety
movements. Cramped synchronised movements were seen in 10 infants, and
three of these were rated as absent fidgety. There was no significant
difference between the surgical groups. In total, 24 infants (11%) had
absent fidgety movements and lower scores on average in all subtests of
the BSID-III than those with normal fidgety movements. Conclusions This is
the first report describing GMs trajectories in infants who have undergone
neonatal surgery. Similar to other high risk infant populations, this
group showed a high proportion of poor repertoire writhing movements,
however, most infants demonstrated normal fidgety movements and
development at 3 months of age.<br/>Copyright &#xa9; 2017 Elsevier B.V.

<17>
[Use Link to view the full text]
Accession Number
616669989
Author
Noiseux N.; Stevens L.-M.; Chartrand-Lefebvre C.; Soulez G.; Prieto I.;
Basile F.; Mansour S.; Dyub A.M.; Kieser T.M.; Lamy A.
Institution
(Noiseux, Stevens, Chartrand-Lefebvre, Soulez, Mansour) Research Center,
Centre Hospitalier, Universite de Montreal (CRCHUM), Montreal, QC, Canada
(Noiseux, Stevens, Prieto, Basile) Division of Cardiac Surgery, Centre
Hospitalier, Universite de Montreal, 3840 Saint-Urbain Street, Montreal,
QC H2W1T8, Canada
(Chartrand-Lefebvre, Soulez) Department of Radiology, Centre Hospitalier,
Universite de Montreal, Montreal, QC, Canada
(Mansour) Division of Cardiology, Centre Hospitalier, Universite de
Montreal, Montreal, QC, Canada
(Dyub, Lamy) Division of Cardiac Surgery, McMaster University, Hamilton,
ON, United States
(Lamy) Population Health Research Institute (PHRI), Hamilton Health
Sciences, Hamilton, ON, United States
(Kieser) University of Calgary, Calgary, AB, Canada
Title
Off-pump Versus On-pump Coronary Artery Bypass Surgery: Graft Patency
Assessment with Coronary Computed Tomographic Angiography.
Source
Journal of Thoracic Imaging. 32 (6) (pp 370-377), 2017. Date of
Publication: 2017.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Purpose: A large multicenter randomized trial (RCT) is needed to assess
off-pump coronary artery bypass graft (CABG) patency when performed by
skilled surgeons. This prospective multicenter randomized pilot study
compares graft patency after on-pump and off-pump techniques and addresses
the feasibility of such an RCT. Materials and Methods: Consecutive
patients were prospectively recruited for >=64-slice computed tomography
angiography graft patency assessment 1 year after randomization to
off-pump or on-pump CABG. Blinded assessment of graft patency was
performed, and the results were categorized as normal, >=50% stenosis, or
occlusion. A multilevel model with random effects on the patient was used
to account for correlation of results in patients with multiple grafts.
Results: A total of 157 patients (3 centers, 84 off-pump and 73 on-pump
patients, 512 grafts, assessability rate 98.4%) were included. Patency
index (% nonoccluded grafts) was 89% for the off-pump technique and 95%
for the on-pump technique (P=0.09). Patency was similar for arterial and
vein grafts (both 92%; P=0.88), as well as between target territories (89%
to 94%; P=0.53). Conclusions: In this pilot study, 1-year graft patency
results after off-pump and on-pump surgery were similar. This feasibility
trial demonstrates that a large multicenter RCT to compare CABG patency
after on-pump with that after off-pump techniques is feasible and can be
reliably undertaken using computed tomography angiography.<br/>Copyright
&#xa9; 2017 Wolters Kluwer Health, Inc. All rights reserved.

<18>
Accession Number
622820855
Author
Dimitriu I.; Voiculescu D.; Lacraru A.; Sinescu C.
Institution
(Dimitriu, Voiculescu, Lacraru, Sinescu) University of Medicine and
Pharmacy Carol Davila, Bucharest, Romania
Title
Importance of NT pro BNP in management of chronic ischemic patient to
prevent heart failure.
Source
European Journal of Clinical Investigation. Conference: 52nd Annual
Scientific Meeting of the European Society for Clinical Investigation.
Spain. 48 (Supplement 1) (pp 123), 2018. Date of Publication: May 2018.
Publisher
Blackwell Publishing Ltd
Abstract
Background: To prove the importance of NTproBNP for preventing heart
failure at ischemic patients. Materials and methods: We included 196
patients who were presented at hospital during 2 years, with myocardial
infarction, angioplasty or aortocoronary bypass in their medical history.
We excluded patients who are already diagnosed with heart failure or who
had current symptoms of heart failure. We randomized patients into 2 equal
groups: a control group and an intervention group. NTproBNP value was
determined for all patients. In the intervention group patients were
treated according to the NTproBNP. Patients with NTproBNP < 125 pg/dL (54
patients) received standard treatment for their symptoms. Patients with
NTproBNP > 125 pg/dL (44 patients) were the ones on which we intervened to
prevent heart failure. They were investigated by cardiac ultrasound and
other tests and they received specific treatment. Patients in the control
group received standard treatment regardless of the NTproBNP value.
Results: After 2 years, the end points were: diagnosis of heart failure
left ventricular dysfunction, death from any cause, the rate of
hospitalizations for cardiovascular pathology. After 2 years in the
control group were twentyone (21 8%) patients who developed heart failure
compared to fourteen (14 2%) patients in the intervention group. Fifty
four (59 1%) patients were diagnosed with left ventricular systolic
dysfunction, compared to thirty-nine (39 7%) in the intervention group.
Also, and rate of admissions for cardiovascular pathology was higher in
the control group thirtytwo (22 4%) vs nine (9, 18%) in the intervention
group. Conclusions: Patients in the intervention group, in which the value
of NTproBNP was used in choosing therapeutic management, had lower rate of
incidence of heart failure or cardiovascular events than patients in the
control group. The NTproBNP value in ischemic patients without heart
failure can detect patients at risk of developing heart failure. And more,
medical intervention guided by NTproBNP can prevent or delay heart
failure.

<19>
Accession Number
622819860
Author
Romanov A.B.; Pokushalov E.; Ponomarev D.; Bayramova S.; Shabanov V.;
Strelnikov A.; Sergeevichev D.; Losik D.; Kozlov B.; Po S.S.; Steinberg
J.S.
Institution
(Romanov, Pokushalov, Ponomarev, Bayramova, Shabanov, Strelnikov,
Sergeevichev, Losik, Kozlov, Po, Steinberg) E. Meshalkin National Medical
Research Center of the Ministry of Health of the R, Novosibirsk, Russian
Federation, Institute of Cardiology, Siberian Division of Russian Academy
of Medical Sciences, Tomsk, Russian Federation, University of Oklahoma,
Heart Rhythm Institute, Oklahoma City, OK, Summit Medical Group, Short
Hills, NJ
Title
Three-year outcomes after botulinum toxin injections into epicardial fat
pads for atrial fibrillation prevention in patients undergoing coronary
artery bypass grafting.
Source
Heart Rhythm. Conference: 39th Annual Scientific Sessions of the Heart
Rhythm Society, Heart Rhythm 2018. United States. 15 (6) (pp 942), 2018.
Date of Publication: June 2018.
Publisher
Elsevier B.V.
Abstract
Introduction: Botulinum toxin injections into epicardial fat pads in
patients undergoing coronary artery bypass grafting (CABG) has resulted in
substantial atrial fibrillation (AF) suppression during early
postoperative period and 1-year follow up without serious adverse events
in a pilot program. To assess the 3-year clinical outcomes and AF
prevention by botulinum toxin injections into epicardial fat pads in
patients undergoing CABG. Methods: Sixty patients with history of
paroxysmal AF and indications for CABG were randomized to either botulinum
toxin (50U/1ml at each fat pad; botox group; n=30) or placebo (0.9% normal
saline, 1ml at each fat pad; placebo group n=30) injections into 4
posterior epicardial fat pads. All patients received an ICM with regular
follow-up. The primary endpoint of the extended follow up was incidence of
any atrial tachyarrhythmia including AF and atrial tachycardia after 30
days of procedure until 36 months on no antiarrhythmic drugs. The
secondary endpoints included clinical events and AF burden. Applications:
At the end of 36 months, the incidence of any atrial tachyarrhythmia was
23.3% in the botox group as compared to 50% in the placebo group (hazard
ratio 0.36, 95% confidence interval 0.14-0.88, p= 0.026) (Figure). The
three-year AF burden was significantly lower in the botox group compared
to the placebo group: 1.4% vs 6.9% (p < 0.001). In botox group, 2 (7%)
patients were hospitalized during follow-up compared to 10 (33%) in
placebo group (p=0.02); and there were no major clinical adverse events in
botox group versus 4 patients (13%) in placebo group who developed stroke
or died (p=0.1). Next Steps/Future: Injections of botulinum toxin into
epicardial fat pads in patients undergoing coronary artery bypass grafting
resulted in a sustained substantial reduction of atrial tachyarrhythmia
incidence and AF burden during 3-year follow-up, accompanied by reduction
in hospitalizations and major clinical adverse events. A large-scale
mul-ticenter randomized trial is needed to focus on hard clinical outcomes
to more comprehensively test the value of botulinum toxin injections
during cardiac surgery. [Figure Presented].

<20>
Accession Number
622745297
Author
Salaminia S.; Sayehmiri F.; Angha P.; Sayehmiri K.; Motedayen M.
Institution
(Salaminia) Yasuj University of Medical Science, Department of Cardiac
Surgery, Yasuj, Iran, Islamic Republic of
(Sayehmiri) Shahid Beheshti University of Medical Sciences, Proteomics
Research Center, Tehran, Iran, Islamic Republic of
(Angha) Yasuj University of Medical Sciences, Social Determinants of
Health Research Center, Yasuj, Iran, Islamic Republic of
(Sayehmiri) Ilam University of Medical Sciences, Department of Social
Medicine, School of Medicine, Ilam, Iran, Islamic Republic of
(Motedayen) Zanjan University of Medical Sciences, Department of
Cardiology, Faculty of Medicine, Zanjan, Iran, Islamic Republic of
Title
Evaluating the effect of magnesium supplementation and cardiac arrhythmias
after acute coronary syndrome: A systematic review and meta-analysis.
Source
BMC Cardiovascular Disorders. 18 (1) (no pagination), 2018. Article
Number: 129. Date of Publication: 28 Jun 2018.
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Atrial and ventricular cardiac arrhythmias are one of the most
common early complications after cardiac surgery and these serve as a
major cause of mortality and morbidity after cardiac revascularization. We
want to evaluate the effect of magnesium sulfate administration on the
incidence of cardiac arrhythmias after cardiac revascularization by doing
this systematic review and meta-analysis. Methods: The search performed in
several databases (SID, Magiran, IranDoc, IranMedex, MedLib, PubMed,
EmBase, Web of Science, Scopus, the Cochrane Library and Google Scholar)
for published Randomized controlled trials before December 2017 that have
reported the association between Magnesium consumption and the incidence
of cardiac arrhythmias. This relationship measured using odds ratios (ORs)
with a confidence interval of 95% (CIs). Funnel plots and Egger test used
to examine publication bias. STATA (version 11.1) used for all analyses.
Results: Twenty-two studies selected as eligible for this research and
included in the final analysis. The total rate of ventricular arrhythmia
was lower in the group receiving magnesium sulfate than placebo (11.88%
versus 24.24%). The same trend obtained for the total incidence of
supraventricular arrhythmia (10.36% in the magnesium versus 23.91% in the
placebo group). In general the present meta-analysis showed that magnesium
could decrease ventricular and supraventricular arrhythmias compared with
placebo (OR = 0.32, 95% CI 0.16-0.49; p < 0.001 and OR = 0.42, 95% CI
0.22-0.65; p < 0.001, respectively). Subgroup analysis showed that the
effect of magnesium on the incidence of cardiac arrhythmias was not
affected by clinical settings and dosage of magnesium. Meta-regression
analysis also showed that there was no significant association between the
reduction of ventricular arrhythmias and sample size. Conclusion: The
results of this meta-analysis study suggest that magnesium sulfate can be
used safely and effectively and is a cost-effective way in the prevention
of many of ventricular and supraventricular arrhythmias.<br/>Copyright
&#xa9; 2018 The Author(s).

<21>
Accession Number
622826738
Author
Verma A.; Ha A.C.T.; Rutka J.T.; Verma S.
Institution
(Ha) Department of Medicine, University of Toronto, Toronto, ON, Canada
(Verma, Rutka, Verma) Department of Surgery, University of Toronto, 30
Bond St, Toronto, ON M5B 1W8, Canada
Title
What surgeons should know about non-Vitamin K oral anticoagulants a
review.
Source
JAMA Surgery. 153 (6) (pp 577-585), 2018. Date of Publication: June 2018.
Publisher
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)
Abstract
IMPORTANCE Non-vitamin K oral anticoagulants (NOACs) are increasingly
prescribed for patients to treat or prevent arterial or venous
thromboembolism. The following 4 NOAC agents are approved by the US Food
and Drug Administration for clinical use: dabigatran etexilate, apixaban,
edoxaban tosylate, and rivaroxaban. A good understanding of these agents'
pharmacologic properties is important for surgeons given their marked
differences compared with warfarin sodium. This review highlights key
practical issues surrounding the use of NOACs in the perioperative
setting. OBSERVATIONS The PubMed and Cochrane Library databases were
searched for English-language studies from May 1, 2009, until May 1, 2017,
for randomized clinical trials, meta-analyses, systematic reviews,
observational studies, and clinical guidelines. From a systematic review
of the published literature that included 70 articles and 166 404
patients, this study identified 5 key practical issues surrounding the use
of NOACs in the perioperative setting. These include patient populations
for which NOAC use is indicated and contraindicated, the timing of NOAC
treatment cessation before invasive interventions, management of
NOAC-treated patients requiring urgent interventions, the need for
"bridging," and the timing of NOAC treatment's reinitiation after invasive
interventions. Important findings are as follows: NOAC agents are not
recommended for patients with mechanical heart valves or advanced kidney
disease (creatinine clearance, <15 mL/min); minimal to no anticoagulant
effect remains when therapy with a NOAC is withheld for 48 to 72 hours
before surgery in the context of normal kidney function; a reversal agent
is clinically available for dabigatran, while reversal agents for
apixaban, edoxaban, and rivaroxaban are under regulatory review; and
laboratory testing of the anticoagulant effects of NOACs are not routinely
available. There is a paucity of high-quality data on the optimal timing
of NOAC cessation and resumption in the perioperative period, particularly
for patients who undergo procedures with high bleeding risk. CONCLUSIONS
AND RELEVANCE The anticoagulant effect of NOAC agents is predictable but
not readily measurable in routine clinical practice. A number of
uncertainties remain surrounding the use of these agents in the
perioperative setting. Ongoing prospective studies and randomized clinical
trials will provide greater clarity on these management issues in the near
future.<br/>Copyright &#xa9; 2018 American Medical Association. All rights
reserved.

<22>
Accession Number
622811123
Author
Ladak L.A.; Hasan B.S.; Gullick J.; Gallagher R.
Institution
(Ladak, Gallagher) Charles Perkins Centre, Sydney Nursing School,
University of Sydney, Sydney, NSW 2006, Australia
(Hasan) Department of Pediatrics and Child Health, Aga Khan University,
Karachi, Pakistan
(Gullick) Sydney Nursing School, University of Sydney, Sydney, Australia
Title
Health-related quality of life in congenital heart disease surgery in
children and young adults: A systematic review and meta-analysis.
Source
Archives of Disease in Childhood. (no pagination), 2018. Date of
Publication: 23 Mar 2018.
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Background: As survival improves in the congenital heart disease (CHD)
population, health-related quality of life (HRQOL) outcomes become
increasingly important. While surgery improves survival, poor HRQOL occurs
postoperatively and cardiac-related HRQOL outcomes are rarely reported.
Objective: To conduct a systematic review and meta-analyses of general and
cardiac-related HRQOL in CHD surgical children and young adults. Method:
Medline, CINAHL and EMBASE were searched. Quantitative designs with a
minimum of 80% CHD surgical patients and mean age <=18 years compared with
healthy controls were included in the review. Data were analysed in RevMan
V.5.3 using a random effects model. Outcome measures: General and
cardiac-related HRQOL. Results: Studies (n=20) were conducted in
high-income countries and included 3808 patients plus 2951 parental
reports of patients. HRQOL was worse in postoperative patients with CHD
versus healthy controls in all domains with the largest difference seen
for physical function (standard mean difference (SMD) of '0.56, 95% CI
'0.82 to '0.30). Cardiac-related HRQOL was worse in complex compared with
simple CHD with the largest SMD ( '0.60, 95% CI '0.80 to '0.40) for
symptoms. Heterogeneity ranged from 0% to 90%. Conclusions: CHD surgical
patients have substantially worse HRQOL compared with age-matched healthy
controls. Strategies should focus on improving HRQOL in this subgroup.
Results may not be applicable to low/middle-income countries given the
dearth of relevant research.<br/>Copyright &#xa9; Article author(s) (or
their employer(s) unless otherwise stated in the text of the article)
2018. All rights reserved. No commercial use is permitted unless otherwise
expressly granted.

<23>
Accession Number
2000625675
Author
Morrone D.; Marzilli M.; Panico R.A.; Kolm P.; Weintraub W.S.
Institution
(Morrone, Kolm, Weintraub) Christiana Care Health System, Newark, DE,
United States
(Morrone, Marzilli, Panico) Surgery Pathology, Medical, Molecular and
Critic Area Department-Cardiovascular Disease Section, Pisa University,
Italy
Title
A narrative overview: Have clinical trials of PCI vs medical therapy
addressed the right question?.
Source
International Journal of Cardiology. 267 (pp 35-40), 2018. Date of
Publication: 15 September 2018.
Publisher
Elsevier Ireland Ltd
Abstract
Background: In RCTs about revascularization, the terms "coronary artery
disease" and "ischemic heart disease" are sometimes used interchangeably.
This can create confusion concerning inclusion and exclusion criteria,
which may lead to uncertain results. Objective: Our purpose is to
investigate whether the study populations in randomized controlled trials
(RCTs) which compared percutaneous coronary revascularization to medical
therapy for stable ischemic heart disease specifically enrolled patients
with demonstrable ischemia, and how many patients were included in trials
with evidence of coronary atherosclerosis but without evidence of
ischemia. Methods: Trial published data were obtained from ACME I, ACME
II, RITA I, RITA II, MASS I, MASS II, AVERT, ACIP, COURAGE and FAME2.
Published data were used to calculate the number of patients included in
the trials with a negative stress test but significant coronary artery
stenosis and the number of patients excluded from the trials with a
positive stress test or angina, but without significant coronary artery
stenosis at the time of angiography. Results: A total of 196,433 patients
were screened between 1998 and 2011. Overall about 30% of patients were
excluded if they did not meet the angiographic criteria, even though the
presence of inducible ischemia or angina, and, about 20% of patients were
included without inducible ischemia. Conclusion: RCTs have contributed to
the confusion between coronary artery disease and ischemic heart disease.
This may limit the ability to interpret the results and apply them in
practice.<br/>Copyright &#xa9; 2018 Elsevier B.V.

<24>
Accession Number
622706299
Author
Husebye T.; Eritsland J.; Bjornerheim R.; Andersen G.O.
Institution
(Husebye, Eritsland, Bjornerheim, Andersen) Department of Cardiology, Oslo
University Hospital Ulleval, Norway
(Husebye, Eritsland, Bjornerheim, Andersen) Centre for Heart Failure
Research, University of Oslo, Norway
(Husebye) Faculty of Medicine, University of Oslo, Norway
(Andersen) Centre for Clinical Heart Research, Oslo University Hospital
Ulleval, Norway
Title
Systolic mitral annulus velocity is a sensitive index for changes in left
ventricular systolic function during inotropic therapy in patients with
acute heart failure.
Source
European Heart Journal: Acute Cardiovascular Care. 7 (4) (pp 321-329),
2018. Date of Publication: 01 Jun 2018.
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Background: Echocardiography is recommended for assessment of left
ventricular systolic function in patients with acute heart failure but few
randomised trials have validated techniques like tissue Doppler (TDI) and
speckle tracking (STE) in patients with acute heart failure following
ST-elevation myocardial infarction. Methods: This was a substudy from the
LEAF (LEvosimendan in Acute heart Failure following myocardial infarction)
trial (NCT00324766), which randomised 61 patients developing acute heart
failure, including cardiogenic shock, within 48 hours after ST-elevation
myocardial infarction, double-blind to a 25-hour infusion of levosimendan
or placebo. TDI-derived systolic mitral annulus velocity (S'), STE-derived
global longitudinal strain (S<inf>l</inf>) and strain rate
(SR<inf>l</inf>) were measured at baseline, day 1, day 5 and after 42
days. Results: Datasets rejected for analyses were 2% (TDI) and 17% (STE).
S' increased by 23% in the levosimendan group versus 8% in the placebo
group from baseline to day 1 (p= 0.011) and by 30% vs. 3% from baseline to
day 5 (p <0.0005). Significant, but less pronounced, improvements in
global S<inf>l</inf> (p = 0.025 and p = 0.032) and in global
SR<inf>l</inf> (p = 0.046 and p = 0.001) in favour of levosimendan were
also present. Conclusion: S' by TDI and STE-derived S<inf>l</inf> and
SR<inf>l</inf> were sensitive indices for changes in left ventricular
systolic function related to treatment with levosimendan. However, S' by
TDI was more feasible and sensitive and might be preferred for assessment
of changes in left ventricular systolic function in critically ill
patients with acute heart failure receiving inotropic
therapy.<br/>Copyright &#xa9; 2017, The European Society of Cardiology
2017.

<25>
Accession Number
620683046
Author
Gygax E.; Kaeser H.-U.; Stalder M.; Gahl B.; Rieben R.; Carrel T.; Erdoes
G.
Institution
(Gygax, Kaeser, Stalder, Carrel) Department of Cardiovascular Surgery,
Inselspital, University Hospital Bern, University of Bern, Bern,
Switzerland
(Gahl) Clinical Trials Unit, Inselspital, University Hospital Bern,
University of Bern, Bern, Switzerland
(Rieben) Department for Biomedical Research, Inselspital, University
Hospital Bern, University of Bern, Bern, Switzerland
(Erdoes) Department of Anesthesiology and Pain Therapy, Inselspital,
University Hospital Bern, University of Bern, Bern, Switzerland
Title
Type II Minimal-Invasive Extracorporeal Circuit for Aortic Valve
Replacement: A Randomized Controlled Trial.
Source
Artificial Organs. 42 (6) (pp 620-629), 2018. Date of Publication: June
2018.
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Extracorporeal circulation triggers systemic inflammatory response and
coagulation disorders which may lead to unfavorable clinical outcome. A
type II minimally-invasive extracorporeal circuit (MiECC) is a closed
system with markedly reduced artificial surface as compared to
conventional extracorporeal circuits (CECC). The aim of this study was to
investigate and compare inflammatory responses, complement activation and
selected clinical end-points in isolated surgical aortic valve replacement
(SAVR) performed with a type II MiECC circuit or a CECC. Fifty patients
were prospectively randomized to MiECC or CECC perfusion regimen.
Complement activation (sC5b-9), inflammation (IL-6, TNF-alpha,
sCD40-ligand) and activation of the coagulation system (D-dimer,
TAT-complex) were determined before operation, at 2 hours and 24 hours
after surgery. Clinical end-points included perfusion time, transfusion of
allogeneic blood products, postoperative bleeding, sepsis, new onset of
atrial fibrillation, stroke and in-hospital mortality. Patient
characteristics and baseline plasma markers were similar in both groups.
Levels for sC5b-9, TNF-alpha, sCD40 ligand, TAT-complex and D-dimers were
not significantly different between MiECC and CECC at 2 hours and 24 hours
after surgery. The IL-6 plasma concentration was lower in the CECC group
at 24 hours (P = 0.026, vs. MiECC). Comparisons of the baseline level to
values at 2 hours and 24 hours, adjusted for the type of oxygenator and
hemoglobin, showed a significantly lower sC5b-9 in MiECC at 2 hours (P =
0.013), but no difference at 24 hours (P=0.990). Compared with CECC, MiECC
patients had a shorter perfusion time (P = 0.037) and less transfusion
requirements (P = 0.04). In this selected cohort of SAVR patients, the
type II MiECC was not inferior to CECC in terms of inflammatory response
and complement activation. Thus, MiECC might be an alternative perfusion
strategy to conventional.<br/>Copyright &#xa9; 2018 International Center
for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

<26>
Accession Number
622793560
Author
Yang Z.; Xie Z.; Pei X.; Quan X.; Feng D.
Institution
(Yang, Xie, Pei, Quan, Feng) Department of Cardiovascular Surgery, Henan
Provincial People's Hospital, Zhengzhou, Henan 450003, China
Title
Effect of thrombelastography on timing of coronary artery bypass grafting.
Source
Experimental and Therapeutic Medicine. 16 (2) (pp 579-584), 2018. Date of
Publication: August 2018.
Publisher
Spandidos Publications (10 Vriaxidos Street, Athens 116 10, Greece.
E-mail: subscriptions@spandidos-publications.com)
Abstract
The guiding value of thrombelastography (TEG) on the selection of surgical
timing for patients scheduled for coronary artery bypass grafting (CABG)
was investigated. A total of 90 subjects with acute coronary syndrome
(ACS) treated between February 2014 and December 2016 in Henan Provincial
People's Hospital were recruited. The patients received dual antiplatelet
therapy (DAPT) and were scheduled for CABG. Subjects were randomly
allocated into two groups, TEG group (n=45) and non-TEG group (n=45).
Patients in the TEG group withheld medications at 24 h prior to surgery
and received TEG examination. Based on maximum amplitude of adenosine
diphosphate (MA<inf>ADP</inf> ), subjects were further grouped into three
sub-groups with MA<inf>ADP</inf> <35 mm, 35-50 mm, and >50 mm, and
accordingly received CABG within 1 day, 3-5 days and 5 days later,
respectively. Subjects in the control group (non-TEG group) received CABG
5-7 days after medication withdrawal. Chest drainage volume within 24 h
after surgery and red blood cell transfusion during perioperative period
were compared. Other recorded parameters were incubation period, intensive
care unit length of stay, hospital stay, incidence of 30-day adverse
events and readmission rate. The average waiting time before CABG for
patients of TEG group was shorter compared with the commonly recommended
time. The red blood cell transfusions during perioperative period of
subjects in TEG group and non-TEG group were significantly different
(P=0.23). The median hospital stay of subjects in TEG group was shorter
than that of non-TEG group (P=0.037). The bleeding amount of patients in
TEG group was 220.16+/-80.56 ml, which was significantly lower than that
of non-TEG group (435.29+/-90.16). The difference was statistically
significant (P=0.032). The results suggested that TEG assay-based
evaluation of platelet function for patients scheduled for CABG reasonably
guides surgeons with appropriate surgical timing and reduces the amount of
time patients wait to be treated.<br/>Copyright &#xa9; 2018, Spandidos
Publications. All rights reserved.

<27>
Accession Number
622684275
Author
Stephan F.; Berard L.; Rezaiguia-Delclaux S.; Amaru P.
Institution
(Stephan, Rezaiguia-Delclaux, Amaru) Service de Reanimation adulte,
Hopital Marie Lannelongue, Le Plessis Robinson, France
(Berard) APHP, GH HUEP, Hopital St An-toine, Plateforme de recherche
Clinique de l'Est Parisien (URC-Est-CRC-Est), Paris, France
Title
High-flow nasal cannula therapy versus intermittent noninvasive
ventilation in obese subjects after cardiothoracic surgery.
Source
Respiratory Care. 62 (9) (pp 1193-1202), 2017. Date of Publication: 2017.
Publisher
American Association for Respiratory Care
Abstract
BACKGROUND: Obese patients are considered at risk of respiratory failure
after cardiothoracic surgery. High-flow nasal cannula has demonstrated its
non-inferiority after cardiothoracic surgery compared to noninvasive
ventilation (NIV), which is the recommended treatment in obese patients.
We hypothesized that NIV was superior to high-flow nasal cannula for
preventing or resolving acute respiratory failure after cardiothoracic
surgery in this population. METHODS: We performed a post hoc analysis of a
randomized, controlled trial. Obese subjects were randomly assigned to
receive NIV for at least 4 h/d (inspiratory pressure, 8 cm H<inf>2</inf>O;
expiratory pressure, 4 cm H<inf>2</inf>O; F<inf>IO2</inf>, 0.5) or
high-flow nasal cannula delivered continuously (flow, 50. L/min,
F<inf>IO2</inf> 0.5). RESULTS: Treatment failure (defined as
re-intubation, switch to the other treatment, or premature
discontinuation) occurred in 21 of 136 (15.4%, 95% CI 9.8-22.6%) subjects
with NIV compared to 18 of 135 (13.3%, 95% CI 8.1-20.3%) subjects with
high-flow nasal cannula (P =.62). No significant differences were found
for dyspnea and comfort scores. Skin breakdown was significantly more
common with NIV after 24 h (9.2%, 95% CI 5.0-16.0 vs 1.6%, 95% CI 1.0-6.0;
P =.01). No significant differences were found for ICU mortality (5.9% for
subjects with NIV vs 2.2% for subjects with high-flow nasal cannula, P
=.22) or for any of the other secondary outcomes. CONCLUSIONS: Among obese
cardiothoracic surgery subjects with or without respiratory failure, the
use of continuous high-flow nasal cannula compared to intermittent NIV
(8/4 cm H<inf>2</inf>O) did not result in a worse rate of treatment
failure. Because high-flow nasal cannula presents some advantages, it may
be used instead of NIV in obese patients after cardiothoracic
surgery.<br/>Copyright &#xa9; 2017 Daedalus Enterprises.

<28>
Accession Number
622796865
Author
Elias J.; Van Dongen I.M.; Ramunddal T.; Laanmets P.; Eriksen E.;
Meuwissen M.; Michels H.R.; Bax M.; Ioanes D.; Suttorp M.J.; Strauss B.H.;
Barbato E.; Marques K.M.; Claessen B.E.P.M.; Hirsch A.; Van Der Schaaf
R.J.; Tijssen J.G.P.; Henriques J.P.S.; Hoebers L.P.
Institution
(Elias, Van Dongen, Claessen, Tijssen, Henriques, Hoebers) Department of
Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam
1105 AZ, Netherlands
(Ramunddal, Ioanes) Sahlgrenska University Hospital, Gothenburg, Sweden
(Laanmets) North-Estonia Medical Centre, Talinn, Estonia
(Eriksen) Haukeland University Hospital, Bergen, Norway
(Meuwissen) Department of Cardiology, Amphia Hospital, Breda, Netherlands
(Michels) Catharina Hospital, Eindhoven, Netherlands
(Bax) Department of Cardiology, Haga Teaching Hospital, The Hague,
Netherlands
(Suttorp) Department of Cardiology, Sint Antonius Ziekenhuis, Nieuwegein,
Netherlands
(Strauss) Sunnybrook Health Sciences Centre, Toronto, Canada
(Barbato) Cardiovascular Center, Onze Lieve Vrouwe Ziekenhuis, Aalst,
Belgium
(Marques) VU University Medical Center, Amsterdam, Netherlands
(Hirsch) Erasmus Medical Center, Rotterdam, Netherlands
(Van Der Schaaf) Department of Cardiology, Onze Lieve Vrouwe Gasthuis,
Amsterdam, Netherlands
Title
Long-term impact of chronic total occlusion recanalisation in patients
with ST-elevation myocardial infarction.
Source
Heart. (no pagination), 2018. Date of Publication: 20 Feb 2018.
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Background: During primary percutaneous coronary intervention (PCI), a
concurrent chronic total occlusion (CTO) is found in 10% of patients with
ST-elevation myocardial infarction (STEMI). Long-term benefits of CTO-PCI
have been suggested; however, randomised data are lacking. Our aim was to
determine mid-term and long-term clinical outcome of CTO-PCI versus CTO-No
PCI in patients with STEMI with a concurrent CTO. Methods: The Evaluating
Xience and left ventricular function in PCI on occlusiOns afteR STEMI
(EXPLORE) was a multicentre randomised trial that included 302 patients
with STEMI after successful primary PCI with a concurrent CTO. Patients
were randomised to either CTO-PCI or CTO-No PCI. The primary end point of
the current study was occurrence of major adverse cardiac events (MACE):
cardiac death, coronary artery bypass grafting and MI. Other end points
were 1-year left ventricular function (LVF); LV-ejection fraction and LV
end-diastolic volume and angina status. Results: The median long-term
follow-up was 3.9 (2.1-5.0) years. MACE was not significantly different
between both arms (13.5% vs 12.3%, HR 1.03, 95% CI 0.54 to 1.98; P=0.93).
Cardiac death was more frequent in the CTO-PCI arm (6.0% vs 1.0%, P=0.02)
with no difference in all-cause mortality (12.9% vs 6.2%, HR 2.07, 95% CI
0.84 to 5.14; P=0.11). One-year LVF did not differ between both arms.
However, there were more patients with freedom of angina in the CTO-PCI
arm at 1 year (94% vs 87%, P=0.03). Conclusions: In this randomised trial
involving patients with STEMI with a concurrent CTO, CTO-PCI was not
associated with a reduction in long-term MACE compared to CTO-No PCI.
One-year LVF was comparable between both treatment arms. The finding that
there were more patients with freedom of angina after CTO-PCI at 1-year
follow-up needs further investigation. Clinical trial registration:
EXPLORE trial number NTR1108 www.trialregister.nl.<br/>Copyright &#xa9;
Article author(s) (or their employer(s) unless otherwise stated in the
text of the article) 2018. All rights reserved. No commercial use is
permitted unless otherwise expressly granted.

<29>
Accession Number
622796742
Author
Harmel E.K.; Reichenspurner H.; Girdauskas E.
Institution
(Harmel, Reichenspurner, Girdauskas) Department of Cardiovascular Surgery,
University Heart Center Hamburg, Hamburg 20251, Germany
Title
Subannular reconstruction in secondary mitral regurgitation: A
meta-analysis.
Source
Heart. (no pagination), 2018. Date of Publication: 13 Mar 2018.
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Objective: Mitral valve repair using an undersized complete annuloplasty
ring in secondary mitral regurgitation with restricted leaflet motion
during systole (Carpentier's surgical classification of mitral valve
pathology: type IIIb) only inadequately addresses the underlying left
ventricular disease. This may lead to an ongoing ventricular remodelling
and progressive papillary muscle displacement with increasing leaflet
tethering. Several subannular techniques have been proposed to counteract
the reoccurrence of mitral regurgitation after mitral valve repair. We
aimed to evaluate the potential additive effect of such subannular
techniques on the late reoccurrence rate of secondary mitral
regurgitation. Methods: Systematic literature review and meta-analysis
were performed on PubMed, Embase and Google Scholar for studies published
up to March 2016 and reporting late reoccurrence of mitral regurgitation
after mitral valve repair using standard annuloplasty (control group)
versus annuloplasty with subannular correction (study group) cohorts.
Primary endpoint was late reoccurrence of mitral regurgitation >=2 after
surgical mitral valve repair, as defined by follow-up echocardiography.
Results: The cumulative number of 1093 patients in 12 included studies
served as our study population. A total of 743 patients underwent combined
mitral valve repair including annuloplasty and subannular manoeuvre (ie,
study group), while the remaining 350 patients underwent an isolated ring
annuloplasty (ie, control group). Secondary mitral regurgitation was
caused by ischaemic heart disease in 733/743 patients in the study group
and 334/350 patients in the control group. Mean echocardiographic
follow-up was 42.7+/-13.9 months. Pooled outcome analysis demonstrated
that the combination of subannular repair with ring annuloplasty was
associated with a significantly lower reoccurrence rate of mitral
regurgitation >=2 as compared with annuloplasty alone (OR 0.27, 95% CI
0.19 to 0.38, P=0.0001). Conclusion: The combination of subannular
reconstruction and mitral valve annuloplasty is associated with a lower
late reoccurrence of mitral regurgitation after surgical mitral valve
repair, as compared with annuloplasty alone.<br/>Copyright &#xa9; Article
author(s) (or their employer(s) unless otherwise stated in the text of the
article) 2018. All rights reserved. No commercial use is permitted unless
otherwise expressly granted.

<30>
Accession Number
618879798
Author
Velagapudi P.; Turagam M.; Kolte D.; Khera S.; Parikh P.; Hyder O.; Aronow
H.; Abbott J.D.
Institution
(Velagapudi, Kolte, Parikh, Hyder, Aronow, Abbott) Division of
Cardiovascular Medicine, Brown University Warren Alpert Medical School,
Providence, RI, United States
(Turagam) Division of Cardiovascular Medicine, University of Missouri
Health Care, Columbia, MO, United States
(Khera) Division of Cardiovascular Medicine, New York Medical College,
Valhalla, NY, United States
Title
Less than two versus greater than two hour invasive strategy in non-ST
elevation myocardial infarction: a meta-analysis of randomized controlled
trials.
Source
Expert Review of Cardiovascular Therapy. 16 (1) (pp 67-72), 2018. Date of
Publication: 02 Jan 2018.
Publisher
Taylor and Francis Ltd (E-mail: info@expert-reviews.com)
Abstract
Background: Optimal timing for an invasive strategy in non-ST elevation
myocardial infarction (NSTEMI) is unclear. Whether clinical outcomes are
improved with a less than two (LT2) compared with greater than two hour
(GT2) invasive strategy remains to be determined. We performed a
meta-analysis of randomized controlled trials (RCTs) comparing LT2 vs GT2
for NSTEMI. Methods: A comprehensive literature search for RCTs comparing
LT2 vs. GT2 in NSTEMI patients was performed. Three eligible studies
consisting of 1,075 patients (LT2: 537, GT2: 538) with NSTEMI were
identified. Follow-up ranged from 1 to 12 months. Results: Time from
randomization to sheath insertion ranged from 0.5-2.2 and 14.0-85.0 hours
in the LT2 and GT2 groups. More percutaneous coronary interventions and
fewer coronary artery bypass grafting were performed in the LT2 vs. GT2
group. There was no significant difference in all-cause mortality,
myocardial infarction (MI), and major bleeding between the two groups. LT2
was numerically, but not statistically superior to GT2 at preventing
recurrent ischemia/urgent revascularization/refractory ischemia.
Conclusion: Our meta-analysis found no significant difference in outcomes
between less than two versus greater than two hours invasive strategy for
NSTEMI. The differences observed in the mode of revascularization
according to timing of catheterization deserve further
study.<br/>Copyright &#xa9; 2017 Informa UK Limited, trading as Taylor &
Francis Group.

<31>
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Accession Number
617216444
Author
Kang S.H.; Lee C.W.; Lee J.-B.; Lee P.H.; Ahn J.-M.; Park D.-W.; Kang
S.-J.; Lee S.-W.; Kim Y.-H.; Park S.-W.; Park S.-J.
Institution
(Kang) Department of Cardiology, CHA Bundang Medical Center, CHA
University, Seongnam, South Korea
(Lee, Lee, Ahn, Park, Kang, Lee, Kim, Park, Park) Division of Cardiology,
Heart Institute, Asan Medical Center, University of Ulsan, 88, Olympic-ro
43-gil, Songpa-gu, Seoul 138-736, South Korea
(Lee) Department of Clinical Epidemiology and Biostatistics, Asan Medical
Center, University of Ulsan College of Medicine, Seoul, South Korea
Title
Mortality of patients with previous stroke undergoing drug-eluting stent
implantation.
Source
Coronary Artery Disease. 28 (7) (pp 543-549), 2017. Date of Publication:
2017.
Publisher
Lippincott Williams and Wilkins (E-mail: agents@lww.com)
Abstract
Objective Patients with previous stroke are increasing among patients
receiving percutaneous coronary intervention (PCI) with drug-eluting
stents (DES); however, data about the influence of previous stroke on
patient outcomes are limited. We evaluated whether previous stroke is
associated with increased risk for mortality in coronary artery disease.
Patients and methods A total of 18 650 patients with coronary artery
disease undergoing PCI with DES were enrolled. Databases from three
real-world PCI registries were merged for a patient-level meta-analysis.
The primary outcome was death from any cause. The secondary outcomes were
death from a cardiac cause, myocardial infarction, stent thrombosis,
stroke, or repeat revascularization. Results Patients with previous stroke
(n=1361), compared with those without previous stroke (n=17 289), were
older and had a higher prevalence of risk factors or comorbidities. At a
median follow-up of 47.0 months, patients with previous stroke had a
higher risk for death from any cause [adjusted hazard ratio (HR)=1.623;
95% confidence interval (CI): 1.342-1.962; P<0.001], death from a cardiac
cause (adjusted HR=1.686; 95% CI: 1.339-2.124; P<0.001), and stroke
(adjusted HR=2.456; 95% CI: 1.853-3.255; P<0.001). There were no
significant differences in the risks for myocardial infarction, stent
thrombosis, or repeat revascularization. Conclusion Patients with previous
stroke showed higher risks for all-cause death and stroke after PCI with
DES than those without stroke. Previous stroke should be considered a risk
factor for all-cause death and stroke in this patient
population.<br/>Copyright &#xa9; 2017 Wolters Kluwer Health, Inc. All
rights reserved.

<32>
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Accession Number
618778259
Author
Thomas M.P.; Bates E.R.
Institution
(Thomas, Bates) CVC Cardiovascular Medicine, 1500 E. Medical Center Drive,
Ann Arbor, MI 48109-5869, United States
Title
Percutaneous coronary intervention strategies in patients with ST-segment
elevation myocardial infarction and multivessel coronary artery disease.
Source
Current Opinion in Cardiology. 32 (6) (pp 755-760), 2017. Date of
Publication: 01 Nov 2017.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Purpose of review This review aims to summarize recent reports on
percutaneous coronary intervention (PCI) strategies for patients with
ST-elevation myocardial infarction (STEMI) and multivessel coronary artery
disease (CAD). Recent findings Recent randomized clinical trials and
meta-analyses have suggested that patients with STEMI and multivessel CAD
may benefit more from multivessel PCI (either multivessel primary PCI or
staged PCI before hospital discharge) than culprit vessel-only primary
PCI. These reports have changed clinical practice guideline
recommendations that now conclude that multivessel PCI may be considered
in selected hemodynamically stable patients with significant noninfarct
artery stenoses based on anatomic criteria alone. Fractional flow reserve
measurement can document functional significance in nonculprit stenoses,
but fractional flow reserve-guided PCI has not been shown to impact
mortality or myocardial infarction rates. Additionally, nonculprit artery
chronic total occlusion PCI was not effective in improving left
ventricular function in one randomized trial. Summary Multivessel primary
PCI or staged PCI is effective and safe in selected patients with STEMI
and multivessel coronary disease. Future randomized controlled trials are
needed to define the optimal timing of multivessel PCI, as well as the
appropriate use of PCI in nonculprit stenoses.<br/>Copyright &#xa9; 2017
Wolters Kluwer Health, Inc. All rights reserved.

<33>
Accession Number
619009666
Author
Ghods K.; Davari H.; Ebrahimian A.
Institution
(Ghods, Ebrahimian) Cardiac Intensive Care Unit, Kowsar Educational and
Research Center, Semnan University of Medical Sciences, School of Nursing
and Midwifery, Km 5 Damghan Road, Semnan, Iran, Islamic Republic of
(Davari) Nursing Care Research Center, Semnan University of Medical
Sciences, Semnan, Iran, Islamic Republic of
Title
Evaluation of the effect of metformin and insulin in hyperglycemia
treatment after coronary artery bypass surgery in nondiabetic patients.
Source
Annals of Cardiac Anaesthesia. 20 (4) (pp 427-431), 2017. Date of
Publication: October-December 2017.
Publisher
Medknow Publications (B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai 400 075, India)
Abstract
Introduction: Insulin therapy is the most commonly used treatment for
controlling hyperglycemia after coronary artery bypass surgery in both
diabetic and nondiabetic patients. Metformin has been indicated for
critically ill patients as an alternate for the treatment of
hyperglycemia. This study evaluated the effect of metformin and insulin in
hyperglycemia treatment after coronary artery bypass surgery in
nondiabetic patients. Settings and Design: This study was a clinical trial
comprising nondiabetic patients who had undergone coronary artery bypass
surgery. Patients were randomly divided into the insulin group and the
metformin group. Methods: Patients in the insulin group received
continuous infusion of insulin while those in the metformin group received
500 mg metformin tablets twice daily. All the patients were followed up
for 3 days after stabilization of blood glucose levels. Statistical
Analysis: Data were analyzed using Chi-square test and Mann-Whitney
U-test. Results: This study included a total of 56 patients. During the
study period, the mean blood glucose levels decreased from 225.24 to
112.36 mg/dl (112.88 mg/dl) in the insulin group and from 221.80 to 121.92
mg/dl in the metformin group (99.88 mg/dl). There was no significant
difference in the blood glucose levels of the patients between the two
groups at any measurement times (P > 0.05). Conclusion: Using 500 mg
metformin twice daily is similar to using insulin in nondiabetic patients
undergoing coronary artery bypass graft. Therefore, the use of metformin
can be considered as a treatment strategy for controlling hyperglycemia in
this group of patients.<br/>Copyright &#xa9; 2017 Annals of Cardiac
Anaesthesia <br/> Published by Wolters Kluwer - Medknow.

<34>
Accession Number
619009639
Author
Joshi V.S.; Kollu S.S.; Sharma R.M.
Institution
(Joshi) Department of Cardiac Anaesthesia, Military Hospital CTC, Pune,
Maharashtra, India
(Kollu) Department of Anaesthesiology and Critical Care, AFMC, Pune,
Maharashtra, India
(Sharma) Department of Anaesthesiology and Critical Care, Command Hospital
Air Force, Bengaluru, Karnataka, India
Title
Comparison of dexmedetomidine and ketamine versus propofol and ketamine
for procedural sedation in children undergoing minor cardiac procedures in
cardiac catheterization laboratory.
Source
Annals of Cardiac Anaesthesia. 20 (4) (pp 422-426), 2017. Date of
Publication: October-December 2017.
Publisher
Medknow Publications (B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai 400 075, India)
Abstract
Background: The ideal anaesthetic technique for management of paediatric
patients scheduled to undergo cardiac catheterisation is still not
standardised. Aim: To compare the effects of ketamine-propofol and
ketamine-dexmedetomidine combinations on hemodynamic parameters and
recovery time in paediatric patients undergoing minor procedures and
cardiac catheterisation under sedation for various congenital heart
diseases. Material and Methods: 60 children of either sex undergoing
cardiac catheterisation were randomly assigned into two groups
Dexmedetomidine-ketamine group (DK) and Propofol-ketamine (PK) of 30
patients each. All patients were premedicated with glycopyrrolate and
midazolam (0.05mg/kg) intravenously 5-10 min before anaesthetic induction.
Group 'DK'received dexmedetomidineiv infusion 1 mug/kg over 10 min +
ketamine1mg/kg bolus, followed by iv infusion of dexmedetomidine
0.5mug/kg/hr and of ketamine1 mg/kg/hr. Group 'PK' received propofol
1mg/kg and ketamine 1mg/kg/hr for induction followed by iv infusion of
propofol 100 mug/kg/hr and ketamine 1 mg/kg/hr for maintenance.
Haemodynamic parameters and recovery time was recorded postoperatively.
Statistical Analysis: Independent sample t test was used to compare the
statistical significance of continuous variables of both the groups.Chi
square test was used for numerical data like gender.Fischer exact test was
applied for non parametric data like ketamine consumption. Results: We
observed that heart rate in dexmedetomidine (DK) group was significantly
lower during the initial 25 mins after induction compared to the propofol
(PK) group. Recovery was prolonged in the DK group compared to the PK
group (40.88 vs. 22.28 min). Even ketamine boluses consumption was higher
in DK group. Conclusion: Use of dexmedetomidine-ketamine combination is a
safe alternative, without any hemodynamic orrespiratory effects during the
cardiac catheterization procedure but with some delayed
recovery.<br/>Copyright &#xa9; 2017 Annals of Cardiac Anaesthesia <br/>
Published by Wolters Kluwer - Medknow.

<35>
Accession Number
619009615
Author
Elgebaly A.S.
Institution
(Elgebaly) Department of Anesthesia and PSICUD, Faculty of Medicine, Tanta
University, 19 Elfaloga St, Elgharbia, Tanta, Egypt
Title
Does bilevel positive airway pressure improve outcome of acute respiratory
failure after open-heart surgery?.
Source
Annals of Cardiac Anaesthesia. 20 (4) (pp 416-421), 2017. Date of
Publication: October-December 2017.
Publisher
Medknow Publications (B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai 400 075, India)
Abstract
Background: Respiratory failure is of concern in the postoperative period
after cardiac surgeries. Invasive ventilation (intermittent positive
pressure ventilation [IPPV]) carries the risks and complications of
intubation and mechanical ventilation (MV). Aims: Noninvasive positive
pressure ventilation (NIPPV) is an alternative method and as effective as
IPPV in treating insufficiency of respiration with less complications and
minimal effects on respiratory and hemodynamic parameters next to
open-heart surgery. Design: This is a prospective, randomized and
controlled study. Materials and Methods: Forty-four patients scheduled for
cardiac surgery were divided into two equal groups: Group I (IPPV) and
Group II (NIPPV). Heart rate (HR), mean arterial pressure (MAP),
respiratory rate (RR), oxygen saturation (SpO<inf>2</inf>), arterial blood
gas, weaning time, reintubation, tracheotomy rate, MV time, postoperative
hospital stay, and ventilator-associated pneumonia during the period of
hospital stay were recorded. Results: There was statistically significant
difference in HR between groups with higher in Group I at 30 and 60 min
and at 12 and 24 h. According to MAP, it started to increase significantly
at hypoxemia, 15 min, 30 min, 4 h, 12 h, and at 24 h which was higher in
Group I also. RR, PaO<inf>2</inf>, and PaCO<inf>2</inf>showed significant
higher in Group II at 15, 30, and 60 min and 4 h. According to pH, there
was a significant difference between groups at 15, 30, and 60 min and at
4, 12, and 24 h postoperatively. SpO<inf>2</inf>showed higher significant
values in Group I at 15 and 30 min and at 12 h postoperatively. Duration
of postoperative supportive ventilation was higher in Group I than that of
Group II with statistically significant difference. Complications were
statistically insignificant between Group I and Group II. Conclusion: Our
study showed superiority of invasive over noninvasive mode of ventilator
support. However, NIPPV (bilevel positive airway pressure) was proved to
be a safe method.<br/>Copyright &#xa9; 2017 Annals of Cardiac Anaesthesia
<br/> Published by Wolters Kluwer - Medknow.

<36>
Accession Number
619009547
Author
Soliman R.; Hussien M.
Institution
(Soliman) Departments of Cardiac Anesthesia, Madinah Cardiac Center,
Almadinah Almonwarah, Saudi Arabia
(Soliman) Department of Anesthesia, Cairo University, Giza, Egypt
(Hussien) Cardiac Surgery, Madinah Cardiac Center, Almadinah Almonwarah,
Saudi Arabia
Title
Comparison of the renoprotective effect of dexmedetomidine and dopamine in
high-risk renal patients undergoing cardiac surgery: A double-blind
randomized study.
Source
Annals of Cardiac Anaesthesia. 20 (4) (pp 408-415), 2017. Date of
Publication: October-December 2017.
Publisher
Medknow Publications (B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai 400 075, India)
Abstract
Objective: The purpose of the current study was to compare the
renoprotective effects of continuous infusion of dexmedetomidine and
dopamine in high-risk renal patients undergoing cardiac surgery. Design: A
double-blind randomized study. Setting: Cardiac Centers. Patients: One
hundred and fifty patients with baseline serum creatinine level >=1.4
mg/dl were scheduled for cardiac surgery with cardiopulmonary bypass.
Intervention: The patients were classified into two groups (each = 75):
Group Dex - the patients received a continuous infusion of dexmedetomidine
0.4 mug/kg/h without loading dose during the procedure and the first 24
postoperative hours and Group Dopa - the patients received a continuous
infusion of dopamine 3 mug/kg/min during the procedure and the first 24
postoperative hours. Measurements: The monitors included serum creatinine,
creatinine clearance, blood urea nitrogen, and urine output. Main Results:
The creatinine levels and blood urea nitrogen decreased at days 1, 2, 3,
4, and 5 in Dex group and increased in patients of Dopa group (P < 0.05).
The creatinine clearance increased at days 1, 2, 3, 4, and 5 in Dex group
and decreased in patients of Dopa group (P < 0.05). The amount of urine
output was too much higher in the Dex group than the Dopa group (P <
0.05). Conclusions: The continuous infusion of dexmedetomidine during
cardiac surgery has a renoprotective effect and decreased the
deterioration in the renal function in high-risk renal patients compared
to the continuous infusion of dopamine.<br/>Copyright &#xa9; 2017 Annals
of Cardiac Anaesthesia <br/> Published by Wolters Kluwer - Medknow.

<37>
Accession Number
618659173
Author
Anetsberger A.; Blobner M.; Haller B.; Schmid S.; Umgelter K.; Hager T.;
Langgartner C.; Kochs E.F.; Laugwitz K.-L.; Jungwirth B.; Bernlochner I.
Institution
(Anetsberger, Blobner, Schmid, Umgelter, Hager, Langgartner, Kochs,
Jungwirth) Klinik fur Anasthesiologie, Klinikum rechts der Isar,
Technische Universitat Munchen, Munich, Germany
(Haller) Institut fur Medizinische Statistik und Epidemiologie, Klinikum
rechts der Isar, Technische Universitat Munchen, Munich, Germany
(Laugwitz, Bernlochner) I. Medizinische Klinik und Poliklinik, Klinikum
rechts der Isar, Technische Universitat Munchen, Munich, Germany
Title
Immature platelets as a novel biomarker for adverse cardiovascular events
in patients after non-cardiac surgery.
Source
Thrombosis and Haemostasis. 117 (10) (pp 1887-1895), 2017. Date of
Publication: 2017.
Publisher
Schattauer GmbH (E-mail: iaorl@iaorl.org)
Abstract
This study evaluates whether immature platelets (IPF) determined in the
post anesthesia care unit (PACU) can predict major adverse cardiovascular
events (MACE) or other thromboembolic events after intermediate and
high-risk surgery. IPF are increased in patients with acute coronary
syndrome and recently gained interest as novel biomarker for risk
stratification. In this prospective observational trial 732 patients
undergoing intermediate or high-risk non-cardiac surgery were enrolled
(NCT02097602). IPF was measured preoperatively and postoperatively in the
PACU. Primary outcome was a composite endpoint defined as MACE, deep vein
thrombosis or pulmonary embolism during hospital stay (modMACE). A cut off
for IPF identifying a threshold between a low and high risk for modMACE
was calculated by logrank optimization. A multivariate Cox regression was
calculated in a forward stepwise manner to assess the relation between
this IPF cut off and modMACE as well as other established risk factors
(inclusion if p<0.05). Preoperatively, there were no differences in IPF
between patients with and without modMACE (3.1 % [2.2 % - 4.7 %](median
[interquartile range]) vs. 2.8 % [1.9 % - 4.3 %]. Patients with modMACE
(28 of 730 patients; 3.8 %) had higher IPF values in the PACU compared to
patients without modMACE (3.6 % [2.6-6 %] vs. 2.9 % [2-4.4 %]; p=0.011).
The optimal cut off of IPF > 5.4 % was associated with an increased risk
for modMACE after adjustment for covariates (hazard ratio: 2.528; 95 %
confidence interval: 1.156 to 5.528, p=0.02). In conclusion, IPF is an
independent predictor of modMACE after surgery and might improve risk
stratification of surgical patients.<br/>Copyright &#xa9; Schattauer 2017.

<38>
Accession Number
615293874
Author
Wang Y.; Zhu S.; Gao P.; Zhang Q.
Institution
(Wang, Zhang) Department of Cardiology, West China Hospital, Sichuan
University, 37 Guoxue Street, Chengdu, Sichuan 610041, China
(Zhu) Department of Epidemiology and Biostatistics, School of Public
Health, Sichuan University, Chengdu, Sichuan, China
(Gao) Department of Nephrology, West China Hospital, Sichuan University,
Chengdu, Sichuan, China
Title
Comparison of coronary artery bypass grafting and drug-eluting stents in
patients with chronic kidney disease and multivessel disease: A
meta-analysis.
Source
European Journal of Internal Medicine. 43 (pp 28-35), 2017. Date of
Publication: September 2017.
Publisher
Elsevier B.V.
Abstract
Background The optimal revascularization strategy of coronary artery
bypass grafting (CABG) versus percutaneous coronary intervention with
drug-eluting stent (PCI-DES) in patients with chronic kidney disease (CKD)
and multivessel disease (MVD) remains unclear. Methods Pubmed, EMBASE and
Cochrane Library electronic databases were searched from inception until
June 2016. Studies that evaluate the comparative benefits of DES versus
CABG in CKD patients with multi-vessel disease were considered for
inclusion. We pooled the odds ratios from individual studies and conducted
heterogeneity, quality assessment and publication bias analyses. Results A
total of 11 studies with 29,246 patients were included (17,928 DES
patients; 11,318 CABG). Compared with CABG, pooled analysis of studies
showed DES had higher long-term all-cause mortality (OR, 1.22; p <
0.00001), cardiac mortality (OR, 1.29; p < 0.00001), myocardial infarction
(OR, 1.89; p = 0.02), repeat revascularization (OR, 3.47; p < 0.00001) and
major adverse cardiac and cerebrovascular events (MACCE) (OR, 2.00; p =
0.002), but lower short-term all-cause mortality (OR, 0.33; p < 0.00001)
and cerebrovascular accident (OR, 0.64; p = 0.0001). Subgroup analysis
restricted to patients with end-stage renal disease (ESRD) yielded similar
results, but no significant differences were found regarding CVA and
MACCE. Conclusions CABG for patients with CKD and MVD had advantages over
PCI-DES in long-term all-cause mortality, MI, repeat revascularization and
MACCE, but the substantial disadvantage in short-term mortality and CVA.
Future large randomized controlled trials are certainly needed to confirm
these findings.<br/>Copyright &#xa9; 2017 European Federation of Internal
Medicine

<39>
Accession Number
618116819
Author
Peigh G.; Kumar J.; Unai S.; Diehl J.T.; Hirose H.
Institution
(Peigh, Kumar, Unai, Diehl, Hirose) Division of Cardiothoracic Surgery,
Thomas Jefferson University Hospital, Philadelphia, PA, United States
(Hirose) Division of Cardiothoracic Surgery, Thomas Jefferson University,
1025 Walnut Street, Room 605, Philadelphia, PA 19107, United States
Title
Randomized trial of sternal closure for low risk patients: Rigid fixation
versus wire closure.
Source
Heart Surgery Forum. 20 (4) (pp E164-E169), 2017. Date of Publication:
August 2017.
Publisher
Carden Jennings Publishing Co. Ltd (375 Greenbrier Drive, Suite #100,
Charlottesville VA 22901-1618, United States)
Abstract
Background: A previous retrospective analysis of our cardiac surgery
patients showed shortened ventilation time and hospital stay among
patients receiving rigid sternal fixation compared to sternal wire
fixation. We performed a prospective randomized study to further
investigate these outcomes and determine if rigid closure can provide
reduced pain after cardiac surgery. Methods: Patients undergoing cardiac
surgery between July 2011 and May 2014 were prospectively randomized into
wire closure (Group C) or rigid fixation using sternal plates (Group R)
groups. Age above 80, emergency surgery, redo sternotomy, and
immunosuppression were among major exclusion criteria precluding
randomization. Intubation time was recorded for all patients. Pain scores
were determined daily from postoperative day 1 until day 5 at 6 a.m. using
a numeric rating scale. Narcotic pain medication requirements from day 1
to 5 were collected and converted into intravenous morphine equivalents.
Results: Of 80 patients, 39 patients were in Group R (average age 65 +/-
8; 31 male and 8 female) and 41 patients were in Group C (average age 66
+/- 9; 34 male and 7 female). Group R patients had a higher body mass
index than patients in Group C (Group R: 31 +/- 5; Group C: 29 +/- 5; P =
.04). No significant differences in the end points of intubation time and
postoperative pain were observed. Conclusion: This randomized study of
cardiac surgery patients showed no significant benefits of rigid fixation
over conventional sternal wire closure with regard to intubation time,
postoperative pain, or length of hospital stay.<br/>Copyright &#xa9; 2017
Forum Multimedia Publishing, LLC

<40>
[Use Link to view the full text]
Accession Number
620315103
Author
Frisoli T.M.; Nowak R.; Evans K.L.; Harrison M.; Alani M.; Varghese S.;
Rahman M.; Noll S.; Flannery K.R.; Michaels A.; Tabaku M.; Jacobsen G.;
McCord J.
Institution
(Frisoli, Tabaku, McCord) Heart and Vascular Institute, K14 Henry Ford
Hospital, Detroit, MI 48202, United States
(Nowak, Harrison, Noll, Flannery) Department of Emergency Medicine, United
States
(Evans, Alani, Varghese, Rahman, Michaels) Department of Internal
Medicine, United States
(Jacobsen) Biostatistics Division, Department of Public Health Sciences,
Henry Ford Hospital, Detroit, MI, United States
Title
Henry Ford HEART Score Randomized Trial: Rapid Discharge of Patients
Evaluated for Possible Myocardial Infarction.
Source
Circulation: Cardiovascular Quality and Outcomes. 10 (10) (no pagination),
2017. Date of Publication: 01 Oct 2017.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background-Hospital evaluation of patients with chest pain is common and
costly. The HEART score risk stratification tool that merges troponin
testing into a clinical risk model for evaluation emergency department
patients with possible acute myocardial infarction (AMI) has been shown to
effectively identify a substantial low-risk subset of patients possibly
safe for early discharge without stress testing, a strategy that could
have tremendous healthcare savings implications. Method and Results-A
total of 105 patients evaluated for AMI in the emergency departments of 2
teaching hospitals in the Henry Ford Health System (Detroit and West
Bloomfield, MI), between February 2014 and May 2015, with a modified HEART
score <=3 (which includes cardiac troponin I <0.04 ng/mL at 0 and 3 hours)
were randomized to immediate discharge (n=53) versus management in an
observation unit with stress testing (n=52). The primary end points were
30-day total charges and length of stay. Secondary end points were
all-cause death, nonfatal AMI, rehospitalization for evaluation of
possible AMI, and coronary revascularization at 30 days. Patients
randomized to early discharge, compared with those who were admitted for
observation and cardiac testing, spent less time in the hospital (median
6.3 hours versus 25.9 hours; P<0.001) with an associated reduction in
median total charges of care ($2953 versus $9616; P<0.001). There were no
deaths, AMIs, or coronary revascularizations in either group. One patient
in each group was lost to follow-up. Conclusions-Among patients evaluated
for possible AMI in the emergency department with a modified HEART score
<=3, early discharge without stress testing as compared with transfer to
an observation unit for stress testing was associated with significant
reductions in length of stay and total charges, a finding that has
tremendous potential national healthcare expenditure implications.
Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique
identifier: NCT03058120.

<41>
Accession Number
617974658
Author
Lamore K.; Montalescot L.; Untas A.
Institution
(Lamore, Montalescot, Untas) Laboratory of Psychopathology and Health
Processes (EA 4057), University of Paris Descartes, Sorbonne Paris Cite,
71, Avenue Edouard-Vaillant, Boulogne-Billancourt 92100, France
Title
Treatment decision-making in chronic diseases: What are the family
members' roles, needs and attitudes? A systematic review.
Source
Patient Education and Counseling. 100 (12) (pp 2172-2181), 2017. Date of
Publication: December 2017.
Publisher
Elsevier Ireland Ltd
Abstract
Objective This systematic review aims to examine the roles of family
members (FMs) in treatment decision-making for adult patients without
cognitive or psychiatric disorders affecting their ability to participate
in decision-making. Methodology A comprehensive, systematic search of the
Cochrane Library, PsycINFO, PubMed and ScienceDirect databases, with
relevant keywords, was conducted. Two authors evaluated the eligibility of
the studies independently, then cross-checked for accuracy. The quality of
included studies were assessed using standardized criteria. Results Out of
the 12.137 studies identified, 40 were included. Results highlighted the
different roles and influences FMs have in the decision-making process.
Moreover, several factors ranging from personal to cultural and
family-related factors influence their level of involvement. Regardless of
the illness, some similarities in family influence exist (e.g., social
support). However, the type of family involvement varies according to the
illness, the treatment choice and the patients' culture. Conclusion FMs
have an important role in the decision-making process. In fact, the final
decision is often made by the patients after consulting their families.
FMs can support both patients and medical teams, and thus facilitate the
process. Practice implications Physicians should include FMs in treatment
decision-making when the patients and their FMs wish to be
included.<br/>Copyright &#xa9; 2017 Elsevier B.V.

<42>
Accession Number
619083017
Author
Castano A.; Narotsky D.L.; Hamid N.; Khalique O.K.; Morgenstern R.; DeLuca
A.; Rubin J.; Chiuzan C.; Nazif T.; Vahl T.; George I.; Kodali S.; Leon
M.B.; Hahn R.; Bokhari S.; Maurer M.S.
Institution
(Castano, Narotsky, Rubin, Maurer) Division of Cardiology, Center for
Advanced Cardiac Care, Columbia University Medical Center, 622 W 168 St,
New York, NY 10032, United States
(Castano, Morgenstern, DeLuca, Bokhari) Division of Cardiology, Department
of Internal Medicine, Columbia University Medical Center, 622 W 168th St,
New York, NY 10032, United States
(Hamid, Khalique, Nazif, Vahl, George, Kodali, Leon, Hahn) Division of
Cardiology, Department of Internal Medicine, Columbia University Medical
Center, 173 Fort Washington Ave, New York, NY 10032, United States
(Chiuzan) Department of Biostatistics, Columbia University, Mailman School
of Public Health, 722 West 168th Street, New York, NY 10032, United States
Title
Unveiling transthyretin cardiac amyloidosis and its predictors among
elderly patients with severe aortic stenosis undergoing transcatheter
aortic valve replacement.
Source
European Heart Journal. 38 (38) (pp 2879-2887), 2017. Date of Publication:
07 Oct 2017.
Publisher
Oxford University Press
Abstract
Aims Transthyretin cardiac amyloidosis (ATTR-CA) has been reported in
patients with aortic stenosis (AS) but its prevalence and phenotype are
not known. We examine elderly patients with severe symptomatic AS
undergoing transcatheter aortic valve replacement (TAVR) and determine the
prevalence and phenotype of ATTR-CA non-invasively. Methods and results We
performed technetium-99m pyrophosphate (^99mTc-PYP) cardiac
scintigraphy prospectively on patients who underwent TAVR, to screen for
ATTR-CA. Transthoracic echocardiography and speckle-strain imaging were
performed. We assessed the association of several parameters with ATTR-CA
using multivariable logistic regression and constructed receiver operating
curves to evaluate the best predictors of ATTR-CA. Among 151 patients
(mean age 84 +/- 6 years, 68% men), 16% (n = 24) screened positive for
ATTR-CA with ^99mTc-PYP scintigraphy. Compared with patients
without ATTR-CA, ATTR-CA patients had a thicker interventricular septum
(1.3 vs. 1.1 cm, P = 0.007), higher left ventricular (LV) mass index (130
vs. 98 g/m², P = 0.002), and lower stroke volume index (30 vs.
36 mL/m², P = 0.009). ATTR-CA patients had advanced diastolic
dysfunction with higher E/A ratio (2.3 vs. 0.9, P = 0.001) and lower
deceleration time (176 vs. 257 ms, P < 0.0001); impairment in systolic
function with lower ejection fraction (48% vs. 56%, P = 0.011), myocardial
contraction fraction (26 vs. 41, P < 0.0001), and average of lateral and
septal mitral annular tissue Doppler S' (4.0 vs. 6.6 cm/s, P < 0.0001).
While ATTR-CA patients had more impaired global longitudinal strain (-12
vs. -16%, P = 0.007), relative apical longitudinal strain was the same
regardless of ATTR-CA diagnosis (0.98 vs. 0.98, P = 0.991). Average S'
best predicted ATTR-CA in multivariable logistic regression (odds ratio
16.67 per 1 cm/s decrease with AUC 0.96, 95% confidence interval
0.90-0.99, P = 0.002) with a value <=6 conferring 100% sensitivity for
predicting a positive ^99mTc-PYP amyloid scan. Conclusions
Transthyretin cardiac amyloidosis is prevalent in 16% of patients with
severe calcific AS undergoing TAVR and is associated with a severe AS
phenotype of low-flow low-gradient with mildly reduced ejection fraction.
Average tissue Doppler mitral annular S' of < 6 cm/s may be a sensitive
measure that should prompt a confirmatory ^99mTc-PYP scan and
subsequent testing for ATTR-CA. Prospective assessment of outcomes after
TAVR is needed in patients with and without ATTR-CA.<br/>Copyright &#xa9;
The Author 2016.

<43>
Accession Number
619678731
Author
Deng Q.-W.; Tan W.-C.; Zhao B.-C.; Deng W.-T.; Xu M.; Liu W.-F.; Liu K.-X.
Institution
(Deng, Zhao, Deng, Liu, Liu) Department of Anesthesiology, Nanfang
Hospital, Southern Medical University, No. 1838, Guangzhou Avenue North,
Guangzhou 510515, China
(Deng, Xu) Department of Anesthesiology, The First Affiliated Hospital,
Sun Yet-sen University, No.58, Zhongshan 2nd Road, Guangzhou 510080, China
(Tan) Department of Endoscopy, Sun Yet-sen University Cancer Center, No.
651, Dongfeng East Road, Guangzhou 510060, China
Title
Risk factors for postoperative acute mesenteric ischemia among adult
patients undergoing cardiac surgery: A systematic review and
meta-analysis.
Source
Journal of Critical Care. 42 (pp 294-303), 2017. Date of Publication:
December 2017.
Publisher
W.B. Saunders
Abstract
Purpose We aimed to seek risk factors for AMI among adult patients
undergoing cardiac surgery. Materials and methods We searched electronic
bibliographic databases for studies reporting risk factors for AMI among
adult patients undergoing cardiac surgery. Pooled odds ratios (OR) and
standard mean differences (SMD or MD) for risk factors between AMI and
control group were estimated. Results 11 studies with 67,195 patients met
the inclusion criteria. 14 risk factors were found to be statistically
significant: preoperative factors including age (MD 4.62 years, 95% CI
(1.97,7.27)), cardiac shock (OR 5.17, (1.17,22.81)), peripheral vascular
disease (OR 3.53, (2.05,6.09)), need for intra-aortic balloon pump (IABP)
(OR 5.89, (3.26,10.65)), emergency surgery (OR 3.75, (1.69,8.33)), and
postoperative factors including atrial fibrillation (OR 2.41,
(1.79,3.24)), CK-MB level (SMD 1.06, (0.62 to 1.50)), serum creatinine >
200 mumol/L (OR 23.39, (11.61,47.12)), blood loss (MD 358.32 mL,
(53.56,663.07)), prolonged ventilation (OR 9.04, (5.24,15.62)), need for
IABP (OR 6.32, (3.19,12.54)), inotropic treatment (OR 8.40, (3.19,22.14)),
blood transfusion (OR 9.15, (4.79,17.48)), reoperation (OR 3.30,
(1.55,7.04)). Conclusions 14 risk factors were associated with an
increased risk of AMI, which indicated that AMI might occur via stenosis
or occlusion of mesenteric vessels, reduced blood volume or
maldistribution of blood flow.<br/>Copyright &#xa9; 2017

<44>
Accession Number
618688563
Author
Vidal-Petiot E.; Stebbins A.; Chiswell K.; Ardissino D.; Aylward P.E.;
Cannon C.P.; Ramos Corrales M.A.; Held C.; Lopez-Sendon J.L.; Stewart
R.A.H.; Wallentin L.; White H.D.; Steg P.G.
Institution
(Vidal-Petiot, Steg) Cardiology and Physiology Departments, Departement
Hospitalo-Universitaire FIRE, AP-HP, Hopital Bichat, 46 rue Henri Huchard,
Paris 75018, France
(Vidal-Petiot, Steg) Paris Diderot University, Sorbonne Paris Cite, Paris,
France
(Vidal-Petiot) INSERM U1149, Paris, France
(Stebbins, Chiswell) Duke Clinical Research Institute, Duke University
Medical Center, 2400 Pratt Street, Durham, NC 27705, United States
(Ardissino) Azienda Ospedaliero, Universitaria di Parma, Via Gramsci 14,
Parma 43126, Italy
(Aylward) South Australian Health and Medical Research Institute, Flinders
University and Medical Centre, Adelaide, Australia
(Cannon) Cardiovascular Division, Brigham and Women's Hospital, 70 Francis
street, Boston, MA 02115, United States
(Ramos Corrales) San Jose Satelite Hospital, Naucalpan, Circunvalacion
Poniente 53, Naucalpan de Juarez 53100, Mexico
(Held, Wallentin) Department of Medical Sciences, Cardiology and Uppsala
Clinical Research Center, Uppsala University, Dag Hammarskjolds vag 14B,
Uppsala SE-752 37, Sweden
(Lopez-Sendon) Hospital Universitario la Paz, IdiPaz, Paseo de la
Castellana 261, Madrid 28046, Spain
(Stewart, White) Green Lane Cardiovascular Service, Auckland City
Hospital, University of Auckland, Private Bag 92024, Auckland 1030, New
Zealand
(Steg) NHLI Imperial College, ICMS, Royal Brompton Hospital, London,
United Kingdom
Title
Visit-to-visit variability of blood pressure and cardiovascular outcomes
in patients with stable coronary heart disease. Insights from the
STABILITY trial.
Source
European Heart Journal. 38 (37) (pp 2813-2822), 2017. Date of Publication:
01 Oct 2017.
Publisher
Oxford University Press
Abstract
Aims To study the relation between visit-to-visit variability of blood
pressure (BP) and cardiovascular risk in patients with stable coronary
heart disease. Methods and results In 15 828 patients from the STABILITY
trial (darapladib vs. placebo in patients with established coronary heart
disease), BP variability was assessed by the standard deviation (SD) of
systolic BP, the SD of diastolic BP, maximum BP, and minimum BP, from 5
measurements (baseline and months 1, 3, 6, and 12) during the first year
after randomisation. Mean (SD) average BP during the first year of study
was 131.0 (13.7) mmHg over 78.3 (8.3) mmHg. Mean (SD) of the
visit-to-visit SD was 9.8 (4.8) mmHg for systolic and 6.3 (3.0)mmHg for
diastolic BP. During the subsequent median follow-up of 2.6 years, 1010
patients met the primary endpoint, a composite of time to cardiovascular
death, myocardial infarction, or stroke. In Cox regression models adjusted
for average BP during first year of study, baseline vascular disease,
treatment, renal function and cardiovascular risk factors, the primary
endpoint was associated with SD of systolic BP (hazard ratio for highest
vs. lowest tertile, 1.30, 95% CI 1.10-1.53, P = 0.007), and with SD of
diastolic BP (hazard ratio for highest vs. lowest tertile, 1.38, 95% CI
1.18-1.62, P < 0.001). Peaks and troughs in BP were also independently
associated with adverse events. Conclusion In patients with stable
coronary heart disease, higher visit-to-visit variabilities of both
systolic and diastolic BP are strong predictors of increased risk of
cardiovascular events, independently of mean BP.

<45>
Accession Number
617931165
Author
Villablanca P.A.; Al-Bawardy R.; Mohananey D.; Maraboto C.; Weinreich M.;
Gupta T.; Briceno D.F.; Ramakrishna H.
Institution
(Villablanca) New York University Langone Medical Center, New York, NY,
United States
(Al-Bawardy) Division of Cardiology, Massachusetts General
Hospital/Harvard Medical School, Boston, MA, United States
(Mohananey) Department of Internal Medicine, Cleveland Clinic, Cleveland,
OH, United States
(Maraboto) Department of Medicine, Jacobi Medical Center/Albert Einstein
College of Medicine, New York, NY, United States
(Weinreich, Gupta, Briceno) Division of Cardiovascular Diseases,
Montefiore Medical Center/Albert Einstein College of Medicine, New York,
NY, United States
(Ramakrishna) Division of Cardiovascular and Thoracic Anesthesiology, Mayo
Clinic College of Medicine, Scottsdale, AZ, United States
Title
Bivalirudin versus heparin in patients undergoing percutaneous
transcatheter aortic valve interventions: A systematic review and
meta-analysis.
Source
Journal of Interventional Cardiology. 30 (6) (pp 586-594), 2017. Date of
Publication: December 2017.
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Bivalirudin may be an effective anticoagulation alternative to
heparin as anticoagulant agent in percutaneous transcatheter aortic valve
interventions (PAVI). We aimed to compare safety and efficacy of
bivalirudin versus heparin as the procedural anticoagulant agent in
patients undergoing PAVI. Methods: We conducted an electronic database
search of all published data. The primary efficacy endpoints were
all-cause mortality, cardiovascular mortality, myocardial infarction, and
stroke. Safety endpoints include major and life-threatening bleed
according to VARC and BARC bleeding, blood transfusion, vascular
complications, and acute kidney injury. Odds ratios (OR) and 95%
confidence intervals (CI) computed using the Mantel-Haenszel method.
Results: Three studies (n = 1690 patients) were included, one randomized
trial and two observational studies. There was a significant difference
favoring bivalirudin over heparin for myocardial infarction (OR 0.41,
95%CI 0.20-0.87). There was no significant difference in all-cause
mortality at 30 days (OR 0.97, 95%CI 0.62-1.52), cardiovascular mortality
(OR 1.03, 95%CI 0.52-2.05), stroke (OR 1.23, 95%CI 0.62-2.46), vascular
complications (OR 0.96, 95%CI 0.70-1.32), acute kidney injury (OR 1.03,
95%CI 0.53-2.00), blood transfusion (OR 0.67, 95% CI 0.45-1.01), major and
life-threatening bleed (OR 0.74, 95%CI 0.37-1.49), and BARC bleeding (OR
0.52, 95%CI 0.23-1.18). Conclusions: In patient undergoing aortic valve
interventions, no difference was seen between the use of bivalirudin and
heparin as the procedural anticoagulant agent, except for a significant
lower myocardial infarction events when bivalirudin was used. Further
large randomized trials are needed to confirm current
results.<br/>Copyright &#xa9; 2017, Wiley Periodicals, Inc.

<46>
Accession Number
614646627
Author
Chen H.-L.; Shen W.-Q.; Liu P.; Liu K.
Institution
(Chen, Shen, Liu) School of Nursing, Nantong University, Nantong, China
(Liu) Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong
University, Nantong, China
Title
Length of surgery and pressure ulcers risk in cardiovascular surgical
patients: a dose-response meta-analysis.
Source
International Wound Journal. 14 (5) (pp 864-869), 2017. Date of
Publication: October 2017.
Publisher
Blackwell Publishing Ltd
Abstract
The aim of this study was to assess the relationship between length of
surgery (LOS) and pressure ulcer (PU) risk in cardiovascular surgery
patients. PubMed and Web of Science were systematically searched. We
compared LOS difference between PU (+) group and PU (-) group. We also
examined the dose-response effect of this relationship. The mean LOS in
the PU(+) groups ranged from 252.5 to 335.7 minutes, compared with 233.0
to 298.3 minutes in PU(-) groups. The LOS was higher in PU(+) groups
compared with PU(-) groups [weighted mean difference (WMD) = 36.081
minutes; 95% CI: 21.640-50.522 minutes; Z = 4.90, P = 0.000]. The funnel
plot showed no publication bias. A significant dose-response association
was also found between the LOS and the risk of surgery-related pressure
ulcers (SRPU, model chi² = 9.29, P = 0.000). In the linear
model, the PU OR was 1.296 (95% CI 1.097-1.531) for a 60-minute increase
in the LOS intervals and 13.344 (95% CI 2.521-70.636) for a 600-minute
increase. In a spline model, the OR of PU increased almost linearly along
with the LOS. Our meta-analysis indicated that LOS was an important risk
factor for pressure ulcers in cardiovascular surgical
patients.<br/>Copyright &#xa9; 2017 Medicalhelplines.com Inc and John
Wiley & Sons Ltd

<47>
Accession Number
2000731187
Author
Nogueira S.S.; Felizardo A.A.; Caldas I.S.; Goncalves R.V.; Novaes R.D.
Institution
(Nogueira, Felizardo, Caldas, Novaes) Institute of Biomedical Sciences,
Federal University of Alfenas, Alfenas, Minas Gerais 37130-001, Brazil
(Caldas) Department of Pathology and Parasitology, Federal University of
Alfenas, Alfenas, Minas Gerais 37130-001, Brazil
(Nogueira, Felizardo, Novaes) Department of Structural Biology, Federal
University of Alfenas, Alfenas, Minas Gerais 37130-001, Brazil
(Goncalves) Department of Animal Biology, Federal University of Vicosa,
Vicosa, Minas Gerais 36570-000, Brazil
Title
Challenges of immunosuppressive and antitrypanosomal drug therapy after
heart transplantation in patients with chronic Chagas disease: A
systematic review of clinical recommendations.
Source
Transplantation Reviews. 32 (3) (pp 157-167), 2018. Date of Publication:
July 2018.
Publisher
W.B. Saunders
Abstract
Background: Although contraindicated for decades, heart transplantation
(HT) has finally become a feasible therapeutic option for the treatment of
Chagasic patients with end-stage heart failure. Part of the success in
achieving acceptable survival rates after HT is due to the enhancement of
the pharmacological management of allograft rejection and reactivation of
Trypanosoma cruzi infection. Methods: By using the framework of a
systematic review, we investigated if Chagasic patients who have undergone
a HT are treated with similar immunosuppressive and antitrypanosomal
regimens in endemic and non-endemic countries and exhibits similar T.
cruzi reactivation, allograft rejection and survival rates. From a
structured search in PubMed/Medline, Scopus, and Web of Sciences
databases, 30 clinical studies were reviewed. Results and conclusion:
Although immunosuppressive regimens are variable in endemic and
non-endemic countries, the current evidence supports the administration of
lower doses of corticosteroids, adjusted cyclosporine levels (100-150
ng/mL) 3 months after HT, and azathioprine rather than mycophenolate
mofetil to reduce the risk of T. cruzi reactivation and rejection
episodes. Antitrypanosomal therapy exclusively based on benznidazole,
nifurtimox, and allopurinol was consistent in endemic and non-endemic
countries, achieving effective results in the control of infection
reactivation. The evidence that supports prophylactic antitrypanosomal
therapy or administration of allopurinol alone is limited. By highlighting
the main sources of research bias, we hope that our critical analysis can
help to expedite clinical research and to reduce methodological bias,
thereby improving the quality of evidence in new research
initiatives.<br/>Copyright &#xa9; 2018 Elsevier Inc.

<48>
Accession Number
622658895
Author
Chua A.-P.; Koo C.-Y.; Kristanto W.; Parot M.V.J.M.; Tan E.S.-J.; Koh
E.H.-T.; Abd Gani M.B.; Kojodjojo P.; Han T.-O.; Chan S.-P.; Chong
J.P.-C.; Frampton C.; Richards A.M.; Lee C.-H.
Institution
(Chua, Parot) Division of Respiratory Medicine, Department of Medicine, Ng
Teng Fong General Hospital, Singapore
(Koo, Tan, Kojodjojo, Richards, Lee) Department of Cardiology, National
University Heart Centre Singapore, Singapore
(Kristanto, Kojodjojo) Division of Cardiology, Department of Medicine, Ng
Teng Fong General Hospital, Singapore
(Koh, Abd Gani, Han) Clinical Research Unit, Ng Teng Fong General
Hospital, Singapore
(Chan, Chong, Richards, Lee) Yong Loo Lin School of Medicine, National
University of Singapore, Singapore
(Chan, Chong, Richards, Lee) Cardiovascular Research Institute, National
University of Singapore, Singapore
(Frampton, Richards) Department of Medicine, University of Otago,
Christchurch, New Zealand
Title
Sleep study-guided multidisciplinary therapy (SGMT) for patients with
acute coronary syndrome: Trial rationale and design.
Source
Clinical Cardiology. 41 (6) (pp 721-728), 2018. Date of Publication: June
2018.
Publisher
John Wiley and Sons Inc. (E-mail: cs-journals@wiley.com)
Abstract
Obstructive sleep apnea (OSA) is an emerging risk marker for acute
coronary syndrome (ACS). This randomized trial aims to determine the
effects of sleep study-guided multidisciplinary therapy (SGMT) comprising
overnight sleep study, continuous positive airway pressure, and behavioral
therapy for OSA during the subacute phase of ACS. We hypothesize that SGMT
will reduce (1) the plasma levels of N-terminal pro brain natriuretic
peptide and suppression of tumorigenicity 2; (2) the estimated 10-year
risk of cardiovascular mortality as measured by the European Systematic
Coronary Risk Evaluation (SCORE) algorithm; and (3) the cardiovascular
event rate during a 3-year follow-up, compared with standard therapy. In
the SGMT trial, 180 patients presenting with ACS will be randomly assigned
to SGMT (n = 90) and standard therapy (n = 90) groups. Both groups will
receive guideline-mandated treatment for ACS. Those assigned to SGMT will
additionally undergo a sleep study and, if OSA is diagnosed, attend a
multidisciplinary OSA clinic where they will receive personalized
treatment including continuous positive airway pressure and
behavioral/lifestyle counseling. The primary endpoint is the plasma
N-terminal pro brain natriuretic peptide concentration at 7-month
follow-up. This report presents the baseline characteristics of 117
patients (SGMT group: n =54; standard therapy group: n =63) who had been
enrolled into the study as of August 31, 2017. The results of this trial
will help us to understand whether active OSA diagnosis and treatment will
improve the physiologic and clinical cardiovascular outcomes of this group
of patients.<br/>Copyright &#xa9; 2018 Wiley Periodicals, Inc.

<49>
Accession Number
622602737
Author
Balasubramanian S.; Harrild D.M.; Kerur B.; Marcus E.; Del Nido P.; Geva
T.; Powell A.J.
Institution
(Balasubramanian, Harrild, Kerur, Marcus, Geva, Powell) Department of
Cardiology, Boston Children's Hospital, Boston, United States
(Balasubramanian, Harrild, Marcus, Geva, Powell) Department of Pediatrics,
Harvard Medical School, Boston, United States
(Del Nido) Department of Cardiac Surgery, Boston Children's Hospital,
Boston, United States
(Del Nido) Department of Surgery, Boston Children's Hospital, Boston,
United States
Title
Impact of surgical pulmonary valve replacement on ventricular strain and
synchrony in patients with repaired tetralogy of Fallot: A cardiovascular
magnetic resonance feature tracking study.
Source
Journal of Cardiovascular Magnetic Resonance. 20 (1) (no pagination),
2018. Article Number: 37. Date of Publication: 18 Jun 2018.
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: In patients with repaired tetralogy of Fallot (TOF), a better
understanding of the impact of surgical pulmonary valve replacement (PVR)
on ventricular mechanics may lead to improved indications and outcomes.
Therefore, we used cardiovascular magnetic resonance (CMR) feature
tracking analysis to quantify ventricular strain and synchrony in repaired
TOF patients before and after PVR. Methods: Thirty-six repaired TOF
patients (median age 22.4 years) prospectively underwent CMR a mean of 4.5
+/- 3.8 months before PVR surgery and 7.3 +/- 2.1 months after PVR
surgery. Feature tracking analysis on cine steady-state free precession
images was used to measure right ventricular (RV) and left ventricular
(LV) circumferential strain from short-axis views at basal,
mid-ventricular, and apical levels; and longitudinal strain from 4-chamber
views. Intraventricular synchrony was quantified using the maximum
difference in time-to-peak strain, the standard deviation of the
time-to-peak, and cross correlation delay (CCD) metrics; interventricular
synchrony was assessed using the CCD metric. Results: Following PVR, RV
end-diastolic volume, end-systolic volume, and ejection fraction declined,
and LV end-diastolic volume and end-systolic volume both increased with no
significant change in the LV ejection fraction. LV global basal and apical
circumferential strains, and basal synchrony improved. RV global
circumferential and longitudinal strains were unchanged, and there was a
varied impact on synchrony across the locations. Interventricular
synchrony worsened at the midventricular level but was unchanged at the
base and apex, and on 4-chamber views. Conclusions: Surgical PVR in
repaired TOF patients led to improved LV global strain and no change in RV
global strain. LV and RV synchrony parameters improved or were unchanged,
and interventricular synchrony worsened at the midventricular
level.<br/>Copyright &#xa9; 2018 The Author(s).

<50>
Accession Number
618451939
Author
Guimaraes P.O.; Granger C.B.; Stebbins A.; Chiswell K.; Held C.; Hochman
J.S.; Krug-Gourley S.; Lonn E.; Lopes R.D.; Stewart R.A.H.; Vinereanu D.;
Wallentin L.; White H.D.; Hagstrom E.; Danchin N.
Institution
(Guimaraes, Granger, Stebbins, Chiswell, Lopes) Duke Clinical Research
Institute, Durham, NC, United States
(Granger, Lopes) Duke University Medical Center, Durham, NC, United States
(Held, Wallentin, Hagstrom) Department of Medical Sciences, Cardiology and
Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
(Hochman) Department of Medicine, NYU Langone Medical Center, New York,
NY, United States
(Krug-Gourley) Metabolic Pathways and Cardiovascular Therapeutic Area,
GlaxoSmithKline, Collegeville, PA, United States
(Lonn) Department of Medicine and Population Health Research Institute,
McMaster University, Hamilton, ON, Canada
(Stewart, White) Green Lane Cardiovascular Service, Auckland City Hospital
and University of Auckland, Auckland, New Zealand
(Vinereanu) University of Medicine and Pharmacy Carol Davila, Bucharest,
Romania
(Danchin) Hopital Europeen Georges Pompidou, Assistance Publique Hopitaux
de Paris, INSERM U-970 and Universite Paris Descartes, Paris, France
Title
Sex differences in clinical characteristics, psychosocial factors, and
outcomes among patients with stable coronary heart disease: Insights from
the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of
Darapladib Therapy) trial.
Source
Journal of the American Heart Association. 6 (9) (no pagination), 2017.
Article Number: e006695. Date of Publication: 01 Sep 2017.
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Background-Greater understanding of differences between men and women with
coronary heart disease is needed. Methods and Results-In this post hoc
analysis of the STABILITY (Stabilization of Atherosclerotic Plaque by
Initiation of Darapladib Therapy) trial, we described psychosocial
factors, treatments, and outcomes of men versus women with stable coronary
heart disease and explored the association of sex with psychosocial
characteristics and cardiovascular risk. Cox proportional hazards models
were used to assess the relationship between sex and outcomes.
Interactions among sex, psychosocial factors, and the composite of
cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke
were tested. Of 15 828 patients, 2967 (19%) were women. Among women, 21.2%
felt often or always stressed at home (versus 9.8% of men), and 19.2% felt
often or always sad or depressed (versus 10.1% of men; all P < 0.0001).
The median duration of follow-up was 3.7 years (25th-75th percentiles:
3.5-3.8 years). Use of evidence-based medications for coronary heart
disease at baseline and 24 months was similar between sexes, as were event
rates for all outcomes analyzed. In the multivariable model including
psychosocial measures, female sex was associated with lower cardiovascular
risk. There was a statistically significant interaction (P=0.03) such that
the lower risk in women varied by depressive symptom frequency, whereby
women who were more depressed had a risk similar to men.
Conclusions-Female sex was independently associated with better long-term
clinical outcomes, although this was modified by frequency of depressive
symptoms. This suggests that emotional state may be an important target
for improving outcomes in patients with coronary heart disease,
specifically in women.<br/>Copyright &#xa9; 2017 The Authors.

<51>
Accession Number
617455309
Author
Relbo Authen A.; Grov I.; Karason K.; Gustafsson F.; Eiskjaer H.; Radegran
G.; Gude E.; Jansson K.; Dellgren G.; Solbu D.; Arora S.; Andreassen A.K.;
Gullestad L.
Institution
(Relbo Authen, Grov, Gude, Arora, Andreassen, Gullestad) Department of
Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
(Karason) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Gustafsson) Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
(Eiskjaer) Department of Cardiology, Aarhus University Hospital, Aarhus,
Denmark
(Radegran) The Section for Heart Failure and Valvular Disease, VO. Heart
and Lung medicine, Skane University Hospital and Department of Clinical
Sciences Lund, Cardiology, Lund University, Lund, Sweden
(Jansson) Department of Cardiology and Clinical Physiology, Institute of
Medicine and Health Sciences, Linkoping University, Linkoping, Sweden
(Dellgren) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Solbu) Novartis Norge AS, Oslo, Norway
(Arora, Andreassen, Gullestad) Center for Heart Failure Research, Faculty
of Medicine, University of Oslo, Oslo, Norway
Title
Effect of everolimus vs calcineurin inhibitors on quality of life in heart
transplant recipients during a 3-year follow-up: Results of a randomized
controlled trial (SCHEDULE).
Source
Clinical Transplantation. 31 (9) (no pagination), 2017. Article Number:
e13038. Date of Publication: September 2017.
Publisher
Blackwell Publishing Ltd (E-mail:
customerservices@oxonblackwellpublishing.com)
Abstract
The Scandinavian heart transplant everolimus de novo study with early
calcineurin inhibitors avoidance (SCHEDULE) trial was a 12 month,
randomized, open-label, parallel-group trial that compared everolimus
(EVR; n=56) to conventional CsA (n=59) immunosuppression. Previously, we
reported that EVR outperformed CsA in improving renal function and
coronary artery vasculopathy, despite a higher rejection rate with EVR.
This study aimed to compare the effects of these treatments on quality of
life (QoL). Within five post-operative days, patients (mean age 50+/-13
years, 27% women) were randomized to EVR or a standard CsA dosage (CsA
group). This study assessed quality of life (QoL), based on the Short
Form-36, EuroQol-5D, and Beck Depression Inventory (BDI). Assessments were
performed pre-HTx and 12 and 36 months post-HTx. At 12 and 36 months, the
groups showed similar improvements in Short Form-36 measures (at pre-HTx,
12 and 36 months the values were as follows: Physical component summary:
EVR: 31.5+/-110.9, 49.1+/-9.7, and 47.9+/-10.6; P<.01; CsA: 32.5+/-8.2,
48.4+/-8.5, and 46.5+/-11.5; P<.01; mental component summary: EVR:
46.0+/-12.0, 51.7+/-11.9, and 52.1+/-13.0; P<.01; CsA: 38.2+/-12.5,
53.4+/-7.1, and 54.3+/-13.0; P<.01); similar decrease in mean BDI (EVR:
10.9+/-10.2, 5.4+/-4.7, and 8.1+/-9.0; P<.01; CsA: 11.8+/-7.1, 6.3+/-5.4,
and 6.2+/-6.5; P<.01); and similar Euro Qol-improvements. Thus, in this
small-sized study, EVR-based and conventional CsA immunosuppressive
strategies produced similar QoL improvements.<br/>Copyright &#xa9; 2017
John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

<52>
Accession Number
622684681
Author
Silvetti S.; Aloisio T.; Cazzaniga A.; Ranucci M.
Institution
(Silvetti, Aloisio, Cazzaniga, Ranucci) IRCCS Policlinico San Donato,
Department of Cardiovascular Anesthesia and Intensive Care, Via Morandi
30, San Donato Milanese, Milan 20097, Italy
Title
Jugular vs femoral vein for central venous catheterization in pediatric
cardiac surgery (PRECiSE): Study protocol for a randomized controlled
trial.
Source
Trials. 19 (1) (no pagination), 2018. Article Number: 329. Date of
Publication: 25 Jun 2018.
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Placement of central venous catheters (CVCs) is essential and
routine practice in the management of children with congenital heart
disease. The purpose of the present protocol is to evaluate the risk for
infectious complications in terms of catheter colonization, catheter
line-associated bloodstream infections, and catheter-related bloodstream
infections (CRBSIs), and the mechanical complications from different
central venous access sites in infants and newborns undergoing cardiac
surgery. Methods: One hundred sixty patients under 1 year of age and
scheduled for cardiac surgery will be included in this randomized
controlled trial (RCT); patients will be randomly allocated to the jugular
or femoral vein arms. CVC insertion will be performed by one of three
selected expert operators. Discussion: The choice of the insertion site
for central venous catheterization can influence the incidence and type of
infectious complications in adults but this is not unanimously evidenced
in the pediatric setting. The experimental hypothesis of this RCT is that
the jugular insertion site is less likely to induce catheter colonization
and CRBSI than the femoral site.<br/>Copyright &#xa9; 2018 The Author(s).

<53>
[Use Link to view the full text]
Accession Number
622386754
Author
Akbulut S.
Institution
(Akbulut) Department of Surgery and Liver Transplant Institute, Inonu
University Faculty of Medicine, Turgut Ozal Medical Center, Elazig Yolu
15. Km, 44280, Malatya 44280, Turkey
Title
Parietal complication of the hydatid disease comprehensive literature
review.
Source
Medicine (United States). 97 (21) (no pagination), 2018. Article Number:
e10671. Date of Publication: 2018.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: The aim of the study was to provide an overview of the medical
literature on parietal complications of hydatid disease (HD). Methods: A
literature search was conducted on PubMed, Medline, Google Scholar, and
Google databases in accordance with the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses guidelines, using keywords to
identify articles related to parietal complications of HD in the thoracic
and abdominal cavities. The following keywords were used: HD, hydatid
cyst, cystic echinococcosis, alveolar echinococcosis, abdominal HD,
thoracic HD, parietal complication, cutaneous fistulization,
cystocutaneous fistulization, cutaneous involvement, external rupture,
external fistulization, subcutaneous involvement, and subcutaneous
abscess. The language of publication, journal, or country was not included
as limitation criteria, and publications dated before August 1, 2016, were
considered. Articles or abstracts containing adequate information, such as
age, sex, cyst size, cyst location, clinical presentation, fistula opening
location, and management were included in the study, whereas articles with
insufficient clinical and demographic data were excluded. Results: The
literature review included 52 articles involving 55 patients with parietal
complications of HD. Thirty-two articles were written in English, 15 in
French, 2 in Spanish, 1 in Italian, 1 in German and 1 in Russian. All 55
patients (women, 30; men, 23; unknown, 2) involved in the study were aged
7 to 93 (mean +/- standard deviation, 54.5 +/- 20.2) years. A total of 24
patients had cysto-cutaneous fistula (Echinococcus granulosus), 12 had
subcutaneous rupture, 10 had cutaneous fistula (E multilocularis), 3 had
cystosubcutaneous abscess, 3 had cysto-cutaneo-bronchial fistula, 2 had
cysto-cutaneo-bronchio-biliary fistula, and 1 had cutaneo-bronchial
fistula. E granulosus were detected in 43 and E multilocularis in 12
patients through clinical, radiological, or histopathological
examinations. Conclusion: Parietal complications such as cysto-cutaneous
fistulization are a rare complication of HD. Complicated HD should be
considered in the differential diagnosis of patients presenting with
cutaneous involvement, especially in HD endemic regions. Abbreviations: CT
= computed tomography, HD = hydatid disease, MRI = magnetic resonance
imaging, SD = standard deviation, US = ultrasonography.<br/>Copyright
&#xa9; &#xa9; 2018 the Author(s). Published by Wolters Kluwer Health, Inc.

<54>
Accession Number
620383465
Author
Kverneland L.S.; Kramer P.; Ovroutski S.
Institution
(Kverneland) Department of Internal Medicine, Herlev Hospital, Copenhagen,
Denmark
(Kverneland, Kramer, Ovroutski) Department of Congenital Heart
Disease/Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany
Title
Five decades of the Fontan operation: A systematic review of international
reports on outcomes after univentricular palliation.
Source
Congenital Heart Disease. 13 (2) (pp 181-193), 2018. Date of Publication:
March/April 2018.
Publisher
Blackwell Publishing Ltd
Abstract
Almost fifty years after its first clinical application, the modified
Fontan operation is among the most frequently performed procedures in
congenital heart disease surgery in children today. The objective of this
review is to systematically summarize the international evolution of
outcomes in regard to morbidity and mortality of patients with Fontan
palliation. All studies published over the past five decades with more
than 100 Fontan patients included were screened. In eligible studies,
information concerning preoperative patients' characteristics, Fontan
modifications employed, early mortality, long-term survival and frequency
of relevant complications was extracted. Ultimately, thirty-one studies
published by the largest surgical centers with an overall number of 9390
patients were included in this review. The extracardiac total
cavopulmonary anastomosis is the most frequently used Fontan modification.
Hemodynamic data demonstrate a rigorous overall adherence to suggested
Fontan selection criteria. The analysis showed a clear trend toward
improved early and long-term survival over the time period covered.
Although inconsistently reported, severe complications such as
arrhythmias, thromboembolic events and protein-losing enteropathy as well
as reoperations and reinterventions were frequent. In conclusion, patients
palliated for complex univentricular heart malformations nowadays benefit
from the experience and technical developments of the past decades and
have a significantly improved long-term prognosis. However, important
issues concerning postoperative long-term morbidity and mortality are
still unsolved and clear intrinsic limitations of the Fontan circulation
are becoming evident as the population of Fontan patients
ages.<br/>Copyright &#xa9; 2018 Wiley Periodicals, Inc.

<55>
Accession Number
618467553
Author
Giannitsis E.; Wallentin L.; James S.K.; Bertilsson M.; Siegbahn A.;
Storey R.F.; Husted S.; Cannon C.P.; Armstrong P.W.; Steg P.G.; Katus H.A.
Institution
(Giannitsis, Katus) Medizinische Klinik, Universitatsklinikum Heidelberg,
Germany
(Wallentin, James, Siegbahn) Department of Medical Sciences, Uppsala
University, Sweden
(Wallentin, James, Bertilsson, Siegbahn) Uppsala Clinical Research Center,
Uppsala University, Sweden
(Storey) Department of Cardiovascular Science, University of Sheffield,
United Kingdom
(Husted) Medical Department, Hospital Unit West, Herning/Holstebro,
Denmark
(Cannon) Cardiovascular Division, Brigham and Women's Hospital, United
States
(Cannon) Harvard Clinical Research Institute, United States
(Armstrong) Canadian VIGOUR Centre, University of Alberta, Canada
(Steg) INSERM-Unite 1148, France
(Steg) Hopital Bichat, France
(Steg) Universite Paris-Diderot, Sorbonne-Paris Cite, France
(Steg) National Heart and Lung Institute, Imperial College London, United
Kingdom
(Steg) Institute of Cardiovascular Medicine and Science, Royal Brompton
Hospital, United Kingdom
Title
Outcomes after planned invasive or conservative treatment strategy in
patients with non-ST-elevation acute coronary syndrome and a normal value
of high sensitivity troponin at randomisation: A Platelet Inhibition and
Patient Outcomes (PLATO) trial biomarker substudy.
Source
European Heart Journal: Acute Cardiovascular Care. 6 (6) (pp 500-510),
2017. Date of Publication: 01 Sep 2017.
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Aims: Current guidelines for patients with non-ST-elevation acute coronary
syndrome (NSTE-ACS) recommend early invasive treatment in
intermediate-to-high risk patients based on medical history,
electrocardiogram (ECG) and elevated troponin. Patients with normal levels
of cardiac troponin measured with a high-sensitivity method (cTnT-hs)
might not benefit from early invasive procedures. Methods and results: In
this Prospective Randomized Platelet Inhibition and Patient Outcomes
(PLATO) blood-core substudy, 1232 patients presented with NSTE-ACS had a
high sensitivity cardiac troponin T (cTnT-hs) level <99^th
percentile (<14 ng/l) at randomisation. The outcomes in relation to a
planned invasive (n=473) vs planned conservative treatment (n=759), were
evaluated by adjusted Cox proportional hazard analyses. In patients with a
normal cTnT-hs at randomisation, regardless of randomised treatment, a
planned invasive vs conservative treatment was associated with a 2.3-fold
higher risk (7.3% vs 3.4%, p=0.0028) for cardiovascular (CV) death or
myocardial infarction (MI), driven by higher rates of procedure-related MI
(3.4% vs 0.1%), while there were no differences in rates of CV death (1.3%
vs 1.3%, p=0.72) or spontaneous MI (3.0% vs 2.1%, p=0.28). There were
significantly more major bleeds (hazard ratio (HR) 2.98, p<0.0001), mainly
due to coronary artery bypass graft (CABG)-related (HR 4.05, p<0.0001) and
non-CABG procedural-related major bleeding events (HR 5.31, p=0.0175),
however there were no differences in non-procedure-related major bleeding
(1.5% vs 1.9%, p=0.45). Findings were consistent for patients with a
normal cTnI-hs at randomisation. Conclusions: In patients with NSTE-ACS
and normal cTnT-hs, a planned early invasive treatment strategy was
associated with increased rates of procedure-related MI and bleeding but
no differences in long-term spontaneous MI, non-procedure-related bleeding
or mortality.<br/>Copyright &#xa9; 2016, &#xa9; The European Society of
Cardiology 2016.

<56>
Accession Number
614345630
Author
Qiao P.-G.; Han C.; Qian T.; Li G.-J.; Yin H.
Institution
(Qiao, Yin) Department of Radiology, Xijing Hospital, The Fourth Military
Medical University, Xi'an, China
(Qiao, Li) Department of Radiology, Affiliated Hospital of Academy of
Military Medical Sciences, Beijing, China
(Han) Department of Neurosurgery, Affiliated Hospital of Academy of
Military Medical Sciences, Beijing, China
(Qian) Germany Siemens Healthcare, MR Collaborations NE Asia, Beijing,
China
Title
BOLD-fMRI with median nerve electrical stimulation predict hemodynamic
improvement after revascularization in patients with moyamoya disease.
Source
Journal of Magnetic Resonance Imaging. 46 (4) (pp 1159-1166), 2017. Date
of Publication: October 2017.
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Purpose: To assess the severity of cerebral hemodynamic impairment and
hemodynamic improvements, after revascularization in moyamoya disease
(MMD) by means of blood-oxygen-level dependent functional magnetic
resonance imaging (BOLD-fMRI). Materials and Methods: BOLD-fMRI with
median nerve electrical stimulation based on echo planar imaging was
performed in 73 volunteers with MMD and 15 healthy volunteers using a 3.0
Tesla MRI scanner. Twenty-four MMD patients were reexamined after
encephaloduroarteriosynangiosis. Time-signal intensity curves of the
activated area of the contralateral primary somatosensory cortex were
computed. Negative response time (Tnr) and peak (Pnr), positive response
time (Tpr) and peak (Ppr), and time to negative peak (TTPn) and positive
peak (TTPp) were measured. Results: Compared with nonparesthesia group and
the asymptomatic side of paresthesia group, the patients with paresthesia
showed extended Tnr (22.04 +/- 3.34 s versus 9.57 +/- 2.27 s and 12.67 +/-
2.69 s, P = 0.0096), decreased Pnr (-0.47 +/- 0.06 versus -0.30 +/- 0.09
and -0.33 +/- 0.09, P = 0.010), delayed TTPn (9.04 +/- 1.39 s versus 3.66
+/- 0.79 s and 4.88 +/- 1.10 s, P = 0.0064), shortened Tpr (22.75 +/- 2.30
s versus 36.85 +/- 2.68 s and 33 +/- 2.49 s, P = 0.0010), and decreased
Ppr (0.62 +/- 0.08 versus 0.99 +/- 0.15 and 0.97 +/- 0.11, P = 0.0149)
when subjected to median nerve electrical stimulation in the symptomatic
side. After surgery, the patients with paresthesia showed shorter Tnr
(1.53 +/- 1.66 s versus 17.88 +/- 22.61 s, P = 0.0002), increased Pnr
(-0.14 +/- 0.17 versus -0.44 +/- 0.53, P = 0.0178), advanced TTPn (1.29
+/- 1.21 s versus 7.29 +/- 8.21 s, P = 0.0005), extended Tpr (36.94 +/-
6.41 s versus 25.18 +/- 15.51 s, P = 0.0091), increased Ppr (1.21 +/- 0.87
versus 0.77 +/- 0.60, P = 0.0201), and advanced TTPp (11.18 +/- 4.70 s
versus 27.29 +/- 20.00 s, P = 0.0046). Conclusion: Bold-fMRI is useful to
assess disease severity and surgical efficacy in MMD. Level of Evidence:
1. Technical Efficacy: Stage 4. J. Magn. Reson. Imaging
2017;46:1159-1166.<br/>Copyright &#xa9; 2017 International Society for
Magnetic Resonance in Medicine

<57>
Accession Number
616965919
Author
Veen E.V.; Bovendeert J.F.M.; Backx F.J.G.; Huisstede B.M.A.
Institution
(Veen, Bovendeert, Backx, Huisstede) University Medical Center Utrecht,
Rudolf Magnus Institute of Neurosciences, Department of Rehabilitation,
Nursing Science & Sports, Utrecht, Netherlands
Title
E-coaching: New future for cardiac rehabilitation? A systematic review.
Source
Patient Education and Counseling. 100 (12) (pp 2218-2230), 2017. Date of
Publication: December 2017.
Publisher
Elsevier Ireland Ltd
Abstract
Objective To provide an evidence-based overview of the effectiveness of
e-coaching as a cardiac rehabilitation program (CRP). Methods Pubmed,
Embase, PEDro and CINAHL were searched to identify relevant RCTs. The
e-coaching programs were divided into basic or complex depending on their
content. Two reviewers independently assessed the methodological quality
and extracted the data. A best-evidence synthesis was used to summarize
the results. Results 19 RCTs were included. Detailed descriptions of the
e-coaching programs were lacking. Complex e-coaching was more effective
than usual-care for physical capacity (moderate evidence for short-, and
mid-term; strong evidence for long-term), for clinical status (limited
evidence for short- and mid-term; moderate evidence for the long-term),
and for psychosocial health (moderate evidence for short-term; strong
evidence for mid-, and long-term). For basic e-coaching only limited or no
evidence for effectiveness was found. Conclusion Promising results were
found for the effectiveness of complex e-coaching as a CRP to improve a
patients' physical capacity, clinical status and psychosocial health.
Practice implications The content of the e-coaching programs were not
clearly described. This makes it difficult to identify which components of
e-coaching are most effective and should be further developed to deliver
the most optimal care for cardiac rehabilitation patients.<br/>Copyright
&#xa9; 2017 Elsevier B.V.

<58>
Accession Number
616823653
Author
Bikmoradi A.; Masmouei B.; Ghomeisi M.; Roshanaei G.; Masiello I.
Institution
(Bikmoradi) Department of health economics and management, School of
public health, Hamadan University of Medical Sciences, Hamadan, Iran,
Islamic Republic of
(Masmouei) Department of Medical Surgical Nursing, School of Nursing and
Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran, Islamic
Republic of
(Ghomeisi) Department of Surgery, School of Medicine, Kermanshah
University of Medical Sciences, Kermanshah, Iran, Islamic Republic of
(Roshanaei) Department of Epidemiology &amp; Biostatistics, School of
Public Health, Hamadan University of Medical Sciences, Hamadan, Iran,
Islamic Republic of
(Masiello) Department of Clinical Science and Education, Karolinska
Institutet, Sodersjukhuset, Stockholm, Sweden
Title
Impact of telephone counseling on the quality of life of patients
discharged after coronary artery bypass grafts.
Source
Patient Education and Counseling. 100 (12) (pp 2290-2296), 2017. Date of
Publication: December 2017.
Publisher
Elsevier Ireland Ltd
Abstract
Background This study aimed to assess the impact of telephone counseling
on quality of life in patients with coronary artery bypass graft. Methods
A quasi-experimental study was conducted with 71 discharged patients after
coronary artery bypass graft surgery at Ekbatan Edcuational hospital in
Hamadan, Iran, in 2014. The patients were randomly allocated into
intervention (n = 36) and control group (n = 35). The intervention group
received education and counseling about therapeutic plan via telephone
after discharge. Patients in the control group received only routines. All
patients completed the quality of life questionnaire before and after the
intervention period of five weeks. Results There was no significant
difference between intervention and control group about quality of life
before intervention (p = 0.696). However, there was significant and
positive deference between the two groups in favor of the telephone
counseling after the intervention (P = 0.01) and control group (P = 0.04).
Quality of life in the intervention group was significantly better
compared to control group (P = 0.01). Conclusions Telephone counseling
could be a cost-effective patient counseling plan for therapeutic
adherence after coronary artery bypass surgery in order to improve the
patients' quality of life. Practice implications Telephone counseling is
feasible to implement and well accepted for patient counseling for many
diseases.<br/>Copyright &#xa9; 2017 Elsevier B.V.

<59>
Accession Number
618156033
Author
Gargiulo G.; Valgimigli M.; Capodanno D.; Bittl J.A.
Institution
(Gargiulo, Valgimigli) Department of Cardiology, Bern University Hospital,
University of Bern, Bern, Switzerland
(Gargiulo) Department of Advanced Biomedical Sciences, Federico II
University of Naples, Naples, Italy
(Capodanno) Cardiac-Thoracic-Vascular Department, Ferrarotto Hospital,
University of Catania, Catania, Italy
(Bittl) Munroe Regional Medical Center, 1500 SE 1st Avenue, Ocala, FL
34471, United States
Title
State of the art: Duration of dual antiplatelet therapy after percutaneous
coronary intervention and coronary stent implantation - Past, present and
future perspectives.
Source
EuroIntervention. 13 (6) (pp 717-733), 2017. Date of Publication: August
2017.
Publisher
EuroPCR
Abstract
Evidence from studies published more than 10 years ago suggested that
patients receiving first-generation drug-eluting stents (DES) needed dual
antiplatelet therapy (DAPT) for at least 12 months. Current evidence from
randomised controlled trials (RCT) reported within the past five years
suggests that patients with stable ischaemic heart disease who receive
newer-generation DES need DAPT for a minimum of three to six months.
Patients who undergo stenting for an acute coronary syndrome benefit from
DAPT for at least 12 months, but a Bayesian network meta-analysis confirms
that extending DAPT beyond 12 months confers a trade-off between reduced
ischaemic events and increased bleeding. However, the network
meta-analysis finds no credible increase in all-cause mortality if DAPT is
lengthened from three to six months to 12 months (posterior median odds
ratio [OR] 0.98; 95% Bayesian credible interval [BCI]: 0.73-1.43), from 12
months to 18-48 months (OR 0.87; 95% BCI: 0.64-1.17), or from three to six
months to 18-48 months (OR 0.86; 95% BCI: 0.63-1.21). Future investigation
should focus on identifying scoring systems that have excellent
discrimination and calibration. Although predictive models should be
incorporated into systems of care, most decisions about DAPT duration will
be based on clinical judgement and patient preference.<br/>Copyright
&#xa9; Europa Digital & Publishing 2017. All rights reserved.

<60>
Accession Number
616414885
Author
Unal S.; Acar B.; Yayla C.; Balci M.M.; Ertem A.G.; Kara M.; Maden O.;
Temizhan A.; Tola M.; Balbay Y.
Institution
(Unal, Acar, Yayla, Balci, Ertem, Kara, Maden, Temizhan, Balbay) Turkiye
Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara,
Turkey
(Tola) Turkiye Yuksek Ihtisas Training and Research Hospital, Radiology
Clinic, Ankara, Turkey
Title
Manual heating of the radial artery (Balbay maneuver) to facilitate radial
puncture prior to transradial coronary catheterization.
Source
Revista Portuguesa de Cardiologia. 36 (6) (pp 409-414), 2017. Date of
Publication: June 2017.
Publisher
Sociedade Portuguesa de Cardiologia (E-mail: secretariado@mail.spc.pt)
Abstract
Objective Transradial access is widely used for both diagnostic and
interventional cardiac procedures. The use of transradial access offers
several advantages, including decreased bleeding, fewer vascular
complications, and reduced length of hospital stay and cost. However, the
small size of the radial artery limits the size of the equipment that can
be used via this approach. In this study we sought to investigate whether
preprocedural manual heating of the radial artery facilitates radial
artery puncture. Methods Patients undergoing transradial cardiac
catheterization were randomized to subcutaneous nitroglycerin plus
diltiazem or manual heating. The study endpoint was puncture score (score
1: easiest - puncture at first attempt; score 2: second attempt; score 3:
third attempt; score 4: fourth attempt or more; score 5: puncture failed).
Results Ninety consecutive patients were enrolled in the study, 45
allocated to the drug treatment group and 45 to the heating group.
Patients underwent radial artery ultrasound before catheterization.
Complications were rare: one hematoma (drug treatment group) and one
radial artery occlusion (heating group). Baseline demographic and clinical
characteristics were similar. Baseline radial artery diameter was similar
in both groups (2.41+/-0.46 mm and 2.29+/-0.48 mm in the heating and drug
treatment groups, respectively). However, the median puncture score was
lower in the heating group (1; interquartile range 1-2) compared to the
drug treatment group (2; interquartile range 1-3; p=0.001). Conclusions
Preprocedural manual heating of the radial artery facilitates radial
artery puncture in patients undergoing transradial cardiac
catheterization.<br/>Copyright &#xa9; 2017 Sociedade Portuguesa de
Cardiologia

<61>
Accession Number
617299562
Author
Cavalcante R.; Sotomi Y.; Mancone M.; Whan Lee C.; Ahn J.-M.; Onuma Y.;
Lemos P.A.; Van Geuns R.-J.; Park S.-J.; Serruys P.W.
Institution
(Cavalcante, Mancone, Onuma, Van Geuns) Thoraxcenter, Erasmus University
Medical Center, 's-Gravendijkwal 230, Rotterdam 3015 CE, Netherlands
(Cavalcante, Lemos) Department of Interventional Cardiology, Heart
Institute (InCor), University of Sao Paulo Medical School, Av. Dr. Eneas
de Carvalho Aguiar, 44 - Pinheiros, Sao Paulo - SP, Brazil
(Sotomi) Academic Medical Center, University of Amsterdam, Meibergdreef 9,
Amsterdam-Zuidoost 1105 AZ, Netherlands
(Mancone) Department of Cardiovascular, Respiratory, Nephrologic,
Anesthesiological and Geriatric Sciences, Sapienza University of Rome,
Policlinico Umberto i, Viale del Policlinico 155, Rome 00161, Italy
(Whan Lee, Ahn, Park) Department of Cardiology, Heart Institute,
University of Ulsan College of Medicine, Asan Medical Center,
Poongnap-dong, Songpa-gu, Seoul 138-736, South Korea
(Serruys) Imperial College London, London, United Kingdom
Title
Impact of the SYNTAX scores i and II in patients with diabetes and
multivessel coronary disease: A pooled analysis of patient level data from
the SYNTAX, PRECOMBAT, and BEST trials.
Source
European Heart Journal. 38 (25) (pp 1969-1977), 2017. Date of Publication:
01 Jul 2017.
Publisher
Oxford University Press
Abstract
Aims To assess the impact of the SYNTAX scores I and II in outcomes after
percutaneous coronary intervention (PCI) and coronary artery bypass graft
(CABG) for patients with diabetes and multivessel disease (MVD). Methods
and results We performed a patient-level pooled analysis of three large
randomized trials of patients with MVD. The impact of coronary anatomic
complexity as measured by the SYNTAX score in the differences in outcomes
following PCI and CABG was assessed at a median follow-up of 5 years. We
also assessed the performance of the SYNTAX II score model in patients
with and without diabetes. From the 3280 patients enrolled in the three
trials, a total of 1068 (32.6%) had diabetes. The rate of the composite of
death, myocardial infarction (MI), or stroke was similar in the PCI and
CABG arms in patients with low-intermediate (<=32) SYNTAX scores (15.1%
vs. 14.9%, respectively; P = 0.93) while it was significantly higher in
the PCI arm in patients with high (>=33) SYNTAX scores (24.5% vs. 13.2%,
respectively; P = 0.018). The SYNTAX score II showed good calibration and
moderate discrimination ability in patients with diabetes (c-index = 0.68)
as well as in those without (c-index = 0.67). Conclusions Differences in 5
years outcomes following PCI and CABG for patients with MVD and diabetes
were influenced by anatomic complexity as measured by the SYNTAX score.
The SYNTAX score II mortality prediction model showed similar performance
regardless of the diabetes status.<br/>Copyright &#xa9; The Author 2017.
All rights reserved.

<62>
Accession Number
617305902
Author
Takagi H.; Ando T.; Umemoto T.
Institution
(Takagi, Umemoto) Department of Cardiovascular Surgery, Shizuoka Medical
Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka 411-8611, Japan
(Ando) Department of Cardiology, Detroit Medical Center, Detroit, MI,
United States
Title
Perioperative depression or anxiety and postoperative mortality in cardiac
surgery: a systematic review and meta-analysis.
Source
Heart and Vessels. 32 (12) (pp 1458-1468), 2017. Date of Publication: 01
Dec 2017.
Publisher
Springer Tokyo (E-mail: orders@springer.jp)
Abstract
We performed a systematic review and meta-analysis to determine whether
perioperative depression and anxiety are associated with increased
postoperative mortality in patients undergoing cardiac surgery. MEDLINE
and EMBASE were searched through January 2017 using PubMed and OVID, to
identify observational studies enrolling patients undergoing cardiac
surgery and reporting relative risk estimates (RREs) (including odds,
hazard, or mortality ratios) of short term (30 days or in-hospital) and/or
late all-cause mortality for patients with versus without perioperative
depression or anxiety. Study-specific estimates were combined using
inverse variance-weighted averages of logarithmic RREs in the
random-effects models. Our search identified 16 eligible studies. In
total, the present meta-analysis included data on 236,595 patients
undergoing cardiac surgery. Pooled analysis demonstrated that
perioperative depression was significantly associated with increased both
postoperative early (RRE, 1.44; 95% confidence interval [CI] 1.01-2.05; p
= 0.05) and late mortality (RRE, 1.44; 95% CI 1.24-1.67; p < 0.0001), and
that perioperative anxiety significantly correlated with increased
postoperative late mortality (RRE, 1.81; 95% CI 1.20-2.72; p = 0.004). The
relation between anxiety and early mortality was reported in only one
study and not statistically significant. In the association of depression
with late mortality, there was no evidence of significant publication bias
and meta-regression indicated that the effects of depression are not
modulated by the duration of follow-up. In conclusion, perioperative
depression and anxiety may be associated with increased postoperative
mortality in patients undergoing cardiac surgery.<br/>Copyright &#xa9;
2017, Springer Japan KK.

<63>
Accession Number
614533311
Author
Rafiq S.; Johansson P.I.; Kofoed K.F.; Lund J.T.; Olsen P.S.; Bentsen S.;
Steinbruchel D.A.
Institution
(Rafiq, Lund, Olsen, Bentsen, Steinbruchel) Department of Cardiothoracic
Surgery, The Heart Centre, Rigshospitalet, Copenhagen University Hospital,
Copenhagen, Denmark
(Johansson) Capital Region Blood Bank, Section for Transfusion Medicine,
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
(Kofoed) Department of Cardiology, The Heart Centre, Rigshospitalet,
Copenhagen University Hospital, Copenhagen, Denmark
Title
Thrombelastographic hypercoagulability and antiplatelet therapy after
coronary artery bypass surgery (TEG-CABG trial): a randomized controlled
trial.
Source
Platelets. 28 (8) (pp 786-793), 2017. Date of Publication: 17 Nov 2017.
Publisher
Taylor and Francis Ltd (E-mail: healthcare.enquiries@informa.com)
Abstract
A hypercoagulable state has, in observational studies, been associated
with increased risk of thromboembolic events. The aim of this trial was to
study whether dual antiplatelet therapy (DAPT) with clopidogrel in
addition to aspirin could reduce the rate of graft occlusions,
thromboembolic events, and death compared to aspirin monotherapy in
hypercoagulable patients undergoing coronary artery bypass surgery. A
total of 1683 patients were screened for eligibility, among which 165
patients were randomized and 133 patients underwent multislice computed
tomography scan to evaluate their grafts. Thrombelastography (TEG) and
multiplate aggregometry were performed before and after surgery, and again
at three months follow up. TEG hypercoagulability was defined as the
maximum amplitude above 69 mm. At three months follow up, 17 out of 66
(25.7%) DAPT patients and 15 of 67 (22.4%) aspirin patients had
significant graft stenosis or occlusions (p = 0.839). Saphenous vein
grafts (SVGs) were stenosed or occluded in 15 (22.7%) patients in the DAPT
group and 7 (10.4%) in the aspirin group (p = 0.167). Thromboembolic
events and death after the second postoperative day (when clopidogrel was
started) were numerically, but not statistically, lower in the DAPT group,
3 (3.8%) vs. 8 (9.9%), p = 0.211. In univariate logistic regression
analysis, only postoperative day 4 platelet response to aspirin measured
with multiplate was correlated with graft occlusion, OR 1.020
[1.002-1.039], p = 0.033. This is the first trial to test the hypothesis
of intensified antiplatelet therapy in hypercoagulable patients. Due to
the low enrollment and high loss to follow up, our results can only be
viewed as hypothesis generating. We found a high rate of graft occlusions
in this patient population. Our results were not suggestive of that DAPT
improved saphenous vein graft patency. A trend was observed in patients on
DAPT toward fewer MI and deaths. Postoperative response to aspirin therapy
was found to be associated with early SVG occlusion.<br/>Copyright &#xa9;
2017 Taylor & Francis.

<64>
Accession Number
616719956
Author
Zaman S.; Zaman S.S.; Scholtes T.; Shun-Shin M.J.; Plymen C.M.; Francis
D.P.; Cole G.D.
Institution
(Zaman, Zaman, Scholtes, Shun-Shin, Plymen, Francis, Cole) International
Centre for Circulatory Health, National Heart and Lung Institute, Imperial
College London, London, United Kingdom
Title
The mortality risk of deferring optimal medical therapy in heart failure:
a systematic comparison against norms for surgical consent and patient
information leaflets.
Source
European Journal of Heart Failure. 19 (11) (pp 1401-1409), 2017. Date of
Publication: November 2017.
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
Aims: The prescription of optimal medical therapy for heart failure is
often delayed despite compelling evidence of a reduction in mortality. We
calculated the absolute risk resulting from delayed prescription of
therapy. For comparison, we established the threshold applied by
clinicians when discussing the risk for death associated with an
intervention, and the threshold used in official patient information
leaflets. Methods and results: We undertook a meta-analysis of randomized
controlled trials to calculate the excess mortality caused by deferral of
medical therapy for 1 year. Risk ratios for angiotensin-converting enzyme
inhibitors, beta-blockers and aldosterone antagonists were 0.80, 0.73 and
0.77, respectively. In patients who might achieve a 1-year survival rate
of 90% if treated, a 1-year deferral of treatment reduced survival to 78%
(i.e. an annual absolute increase in mortality of 12 in 100 patients).
This corresponds to an additional absolute mortality risk per month of 1%.
A survey of clinicians carried out to establish the risk threshold at
which they would obtain written consent showed the majority (85%) sought
written consent for interventions associated with a 12-fold lower
mortality risk: one in 100 patients. A systematic review of UK patient
information leaflets to establish the magnitude of risk considered
sufficient to be stated explicitly showed that leaflets begin to mention
death at a ~18 000-fold lower mortality risk of just 0.0007 in 100
patients. Conclusions: Deferring heart failure treatment for 1 year
carries far greater risk than the level at which most doctors seek written
consent, and 18 000 times more risk than the level at which patient
information leaflets begin to mention death.<br/>Copyright &#xa9; 2017 The
Authors. European Journal of Heart Failure published by John Wiley & Sons
Ltd on behalf of European Society of Cardiology.

<65>
Accession Number
2000802013
Author
Gaynor J.W.; Nicolson S.C.; Spray D.M.; Burnham N.B.; Chittams J.L.;
Sammarco T.; Walsh K.W.; Spray T.L.; Licht D.J.
Institution
(Gaynor, Spray, Burnham, Walsh, Spray) Division of Cardiothoracic Surgery,
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United
States
(Nicolson) Department of Anesthesia and Critical Care Medicine, Children's
Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
(Licht) Department of Pediatrics, Division of Neurology, Children's
Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
(Chittams, Sammarco) Biostatistics Consulting Unit, Office of Nursing
Research, University of Pennsylvania School of Nursing, Philadelphia,
Pennsylvania, United States
Title
Remote Ischemic Preconditioning Does Not Prevent White Matter Injury in
Neonates.
Source
Annals of Thoracic Surgery. 106 (1) (pp 151-155), 2018. Date of
Publication: July 2018.
Publisher
Elsevier USA
Abstract
Background: Remote ischemic preconditioning (RIPC) is a mechanism to
protect tissues from injury during ischemia and reperfusion. We
investigated the neuroprotective effects of RIPC in neonates undergoing
cardiac surgery. Methods: The outcome was white matter injury (WMI),
assessed by the change in volume of WMI from preoperative to postoperative
brain magnetic resonance imaging (MRI). Patients were randomized to RIPC
or SHAM. RIPC was induced prior to cardiopulmonary bypass by four 5-minute
cycles of blood pressure cuff inflation to produce ischemia of the lower
extremity. For patients randomized to SHAM, the cuff was positioned, but
not inflated. Results: The study included 67 patients, with 33 randomized
to RIPC and 34 randomized to SHAM. Preoperative and postoperative MRIs
were available in 50 patients, including 26 of the 33 RIPC patients and 24
of the 34 SHAM patients. There were no differences in baseline and
operative characteristics for either the overall study group or the group
with evaluable MRIs. WMI was identified in 28% of the patients
preoperatively and in 62% postoperatively. There was no difference in the
prevalence of WMI by treatment group (p > 0.5). RIPC patients had an
average change in WMI of 600 mL³, and SHAM subjects had an
average WMI change of 107 mL³. There was no significant
difference in the mean value of WMI change between patients who received
RIPC and those who received SHAM treatments (p = 0.178). Conclusions: In
this randomized, blinded clinical trial, there was no evidence that use of
RIPC provides neuroprotection in neonates undergoing repair of congenital
heart defects with cardiopulmonary bypass.<br/>Copyright &#xa9; 2018 The
Society of Thoracic Surgeons

<66>
Accession Number
614949867
Author
Cavaca R.; Teixeira R.; Vieira M.J.; Goncalves L.
Institution
(Cavaca, Teixeira, Goncalves) Faculdade de Medicina, Universidade de
Coimbra, Coimbra, Portugal
(Teixeira, Goncalves) Servico de Cardiologia, Centro Hospitalar e
Universitario de Coimbra - Hospital Geral, Coimbra, Portugal
(Vieira) Servico de Cardiologia, Hospital de Santarem, Santarem, Portugal
Title
Paradoxical aortic stenosis: A systematic review.
Source
Revista Portuguesa de Cardiologia. 36 (4) (pp 287-305), 2017. Date of
Publication: 01 Apr 2017.
Publisher
Sociedade Portuguesa de Cardiologia (E-mail: secretariado@mail.spc.pt)
Abstract
Aortic stenosis (AS) is a complex systemic valvular and vascular disease
with a high prevalence in developed countries. The new entity "paradoxical
low-flow, low-gradient aortic stenosis" refers to cases in which patients
have severe AS based on assessment of aortic valve area (AVA) (<=1
cm²) or indexed AVA (<=0.6 cm²/m²), but
paradoxically have a low mean transvalvular gradient (<40 mmHg) and a low
stroke volume index (<=35 ml/m²), despite preserved left
ventricular ejection fraction (>=50%). A search was carried out in the
PubMed database on paradoxical AS for the period 2007-2014. A total of 57
articles were included for this review. The prevalence of paradoxical AS
ranged from 3% to 35% of the population with severe degenerative AS. It
was more frequent in females and in older patients. Paradoxical AS was
associated with characteristic left ventricular remodeling as well as an
increase in systemic arterial stiffness. It was noted that there may be
errors and inaccuracies in the calculation of AVA by the continuity
equation, which could erroneously suggest the paradoxical phenotype. There
are new diagnostic methods to facilitate the study of AS, such as aortic
valve calcium score, valvuloarterial impedance and the longitudinal
mechanics of the left ventricle. With regard to its natural history, it is
not clear whether paradoxical AS corresponds to an advance stage of the
disease or if paradoxical AS patients have a distinct phenotype with
specific characteristics. Valve replacement, either surgical or
percutaneous, may be indicated in patients with severe and symptomatic
paradoxical AS.<br/>Copyright &#xa9; 2016 Sociedade Portuguesa de
Cardiologia

<67>
Accession Number
622653312
Author
Shankar P.; Mueller A.; Packiasabapathy S.; Gasangwa D.; Patxot M.; O'Gara
B.; Shaefi S.; Marcantonio E.R.; Subramaniam B.
Institution
(Shankar, Mueller, Packiasabapathy, Gasangwa, Patxot, O'Gara, Shaefi,
Subramaniam) Beth Israel Deaconess Medical Center, Center for Anesthesia
Research Excellence (CARE), Department of Anesthesia, Critical Care and
Pain Medicine, One Deaconess Road, CC-650, Boston, MA 02215, United States
(Mueller, O'Gara, Shaefi, Marcantonio, Subramaniam) Harvard Medical
School, 25 Shattuck Street, Boston, MA 02215, United States
(Marcantonio) Beth Israel Deaconess Medical Center, Harvard Medical
School, Division of General Medicine and Primary Care, 330 Brookline
Avenue, Boston, MA 02215, United States
Title
Dexmedetomidine and intravenous acetaminophen for the prevention of
postoperative delirium following cardiac surgery (DEXACET trial): Protocol
for a prospective randomized controlled trial.
Source
Trials. 19 (1) (no pagination), 2018. Article Number: 326. Date of
Publication: 22 Jun 2018.
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Postoperative delirium is common in elderly cardiac surgery
patients. It is multifactorial and is influenced by the patient's baseline
status and the nature of the medical and surgical interventions that the
patient receives. Some of these factors are potentially modifiable,
including postoperative sedation and analgesia protocols. This study has
been designed to evaluate the effectiveness of postoperative intravenous
acetaminophen in conjunction with either dexmedetomidine or propofol in
decreasing the incidence of delirium. Methods: This is a prospective,
randomized, placebo-controlled, double-blinded, factorial trial that
includes patients who are at least 60 years old and who are undergoing
cardiac surgeries involving cardiopulmonary bypass, including coronary
artery bypass graft (CABG) and combined CABG/valve surgeries. Patients are
randomly assigned to receive one of four postoperative analgesic-sedation
regimens: (1) acetaminophen and dexmedetomidine, (2) acetaminophen and
propofol, (3) dexmedetomidine and placebo, or (4) propofol and placebo.
The primary outcome, incidence of delirium, will be assessed with the
Confusion Assessment Method (CAM or CAM-ICU). The secondary outcome,
postoperative cognitive decline, will be assessed with the Montreal
Cognitive Assessment. Additional secondary outcomes, including duration of
delirium, postoperative analgesic requirement, length of stay, and
incidence of adverse events, will also be reported. Data will be analyzed
in 120 randomly assigned patients who received at least one dose of the
study medication(s) on a modified intention-to-treat basis. Discussion:
This study has been approved by the institutional review board at Beth
Israel Deaconess Medical Center, and the trial is currently recruiting.
This study will systematically examine the implications of modification in
postoperative sedative/analgesic protocols after cardiac surgery,
specifically for short- and long-term cognitive outcomes. Any positive
outcomes from this study could direct simple yet effective practice
changes aimed to reduce morbidity. Trial registration: ClinicalTrials.gov
Identifier: NCT02546765 , registered January 13, 2015.<br/>Copyright
&#xa9; 2018 The Author(s).

<68>
Accession Number
2000888513
Author
Wu M.; Liang Y.; Dai Z.; Wang S.
Institution
(Wu, Liang, Dai, Wang) Department of anesthesiology, The Affiliated
Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266071, China
Title
Perioperative dexmedetomidine reduces delirium after cardiac surgery: A
meta-analysis of randomized controlled trials.
Source
Journal of Clinical Anesthesia. 50 (pp 33-42), 2018. Date of Publication:
November 2018.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Study objective: To evaluate the efficiency of dexmedetomidine on the
incidence of delirium in patients after cardiac surgery. Design:
Meta-analysis of randomized controlled trials. Setting: Operating room and
Intensive Care Unit (ICU). Patients: Ten trials with a total of 1387
patients undergoing cardiac surgery met the inclusion criteria.
Intervention: Randomized controlled trials (RCTs) comparing the effect of
dexmedetomidine versus non-treatment of dexmedetomidine (normal saline
(NS), propofol and other anesthetic drugs) on delirium in patients
undergoing cardiac surgery were retrieved from PubMed/Medline, Embase, the
Cochrane Library and Web of science. The primary outcome was the incidence
of delirium. The secondary outcomes were the rate of bradycardia and
hypotension, the duration of mechanical ventilation and the length of ICU
and hospital stay. Main results: Compared with the control group,
Dexmedetomidine significantly decreased the incidence of postoperative
delirium, (risk ratio 0.46; 95% confidence intervals, 0.34 to 0.62; P <
0.00001), while the incidence of bradycardia was increased in
dexmedetomidine group (risk ratio 1.86; 95% confidence intervals, 1.16 to
2.99; P = 0.01). There was no significant difference between groups with
regarding to the occurrence of hypotension (risk ratio 0.90; 95%
confidence intervals, 0.59 to 1.38; P = 0.63), the duration of mechanical
ventilation (Mean Difference 0.21; 95% confidence intervals, -0.70 to
1.12; P = 0.65), and the length of ICU (Standard Mean Difference - 0.07;
95% confidence intervals, -0.19 to 0.06; P = 0.3) and hospital stay (Mean
Difference - 0.13; 95% confidence intervals, -0.56 to 0.30; P = 0.56).
Conclusion: Perioperative dexmedetomidine administration decreased the
incidence of delirium in patients after cardiac surgery, but might
increase the rate of bradycardia. Furthermore, we did not observe
significant differences in the incidence of hypotension, the duration of
mechanical ventilation and length of ICU and hospital stay between groups.
Future studies are needed to ascertain the effect of dexmedetomidine on
the incidence of delirium after coronary artery bypass grafting (CABG) and
in patient with cognitive disorder at baseline, whether intraoperative
dexmedetomidine infusion could reduce postoperative delirium and the
optimal dose of dexmedetomidine.<br/>Copyright &#xa9; 2018 Elsevier Inc.

<69>
Accession Number
622727847
Author
Slipczuk L.; Rafique A.M.; Davila C.D.; Beigel R.; Pressman G.S.; Siegel
R.J.
Institution
(Slipczuk, Rafique, Beigel, Siegel) Cedars-Sinai Heart Institute, Los
Angeles, CA, United States
(Davila, Pressman) Einstein Medical Center, Philadelphia, PA, United
States
Title
The role of medical therapy in moderate to severe degenerative mitral
regurgitation.
Source
Reviews in Cardiovascular Medicine. 17 (1-2) (pp 28-39), 2016. Date of
Publication: 2016.
Publisher
MedReviews LLC (494 Eighth Ave Ste 1000, New York NY 10001, United States.
E-mail: mcroft@medreviews.com)
Abstract
Mitral regurgitation (MR) is a common valvular disorder that has important
health and economic consequences. Standardized guidelines exist regarding
when and in whom to perform mitral valve surgery, but little information
is available regarding medical treatment of MR. Many patients with
moderate or severe MR do not meet criteria for surgery or are deemed to be
at high risk for surgical therapy. We reviewed the available published
data on medical therapy in the treatment of patients with primary MR.
b-blockers and renin-angiotensin-aldosterone system inhibitors had the
strongest supporting evidence for providing beneficial effects. b-blockers
appear to lessen MR, prevent deterioration of left ventricular function,
and improve survival in asymptomatic patients with moderate to severe
primary MR. Angiotensin-converting enzyme inhibitor and angiotensin
receptor blocker therapy reduces MR, especially in asymptomatic patients.
However, in the setting of hypertrophic cardiomyopathy or mitral valve
prolapse, vasodilators can increase the severity of MR. To define the
precise role of medical therapy, a larger randomized controlled trial is
needed to confirm benefit and assess in which subsets of patients medical
therapy is most useful. Medical therapy in some patients improves
symptoms, lessens MR, and may delay the need for surgical
intervention.<br/>Copyright &#xa9; 2016 MedReviews, LLC.

<70>
Accession Number
2000888541
Author
Siddiqui W.J.; Alvarez C.; Aslam M.; Bakar A.; Khan M.H.; Aslam A.; Hanif
M.O.; Hasni S.F.; Ranganna K.; Eisen H.; Aggarwal S.
Institution
(Siddiqui, Hanif, Hasni, Ranganna, Eisen, Aggarwal) Drexel University
College of Medicine, Philadelphia, Pennsylvania, United States
(Siddiqui, Hanif, Hasni, Ranganna, Eisen, Aggarwal) Hahnemann University
Hospital, Philadelphia, Pennsylvania, United States
(Alvarez) Seton Hall University, St. Francis Medical Center, Trenton, New
Jersey, United States
(Aslam, Bakar) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Khan) Aga Khan University Medical College, Karachi, Pakistan
(Aslam) Department of Medicine, Beth Israel Deaconess Medical Center,
Harvard University, Boston, Massachusetts, United States
Title
Meta-Analysis Comparing Outcomes and Need for Renal Replacement Therapy of
Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve
Replacement.
Source
American Journal of Cardiology. (no pagination), 2018. Date of
Publication: 2018.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Acute kidney injury (AKI) is commonly associated with aortic valve
replacement. Surgical aortic valve replacement (SAVR) is a known risk
factor for AKI but little is known about the short- and long-term effects
of transcatheter aortic valve implantation (TAVI). The purpose of our
analysis is to identify the short- and long-term effect of TAVI on renal
outcomes. We searched Medline and PUBMED from January 1, 2000 to November
6, 2017 for randomized control trials (RCTs) comparing TAVI to SAVR in
patients with severe aortic stenosis. Three hundred sixty-nine trials were
identified, 6 RCTs were included in our analysis. RevMan version 5.3 was
used for statistical analysis. Heterogeneity is calculated using
I² statistics. Primary outcomes were AKI within 30days and 1
year of TAVI, and requirement for renal replacement therapy. We included
5,536 patients (2,796 in TAVI and 2,740 in SAVR arm) from 6 RCTs. Baseline
characteristics were similar. There was reduced incidence of AKI at 30days
of TAVI compared with SAVR, 57 versus 133 (odds ratio [OR] 0.40,
confidence interval [CI] 0.28 to 0.56, p <0.00001, I² = 7%)
with no difference at 1 year (OR 0.65, CI 0.32 to 1.32, p = 0.23,
I² = 76%) and need for renal replacement therapy OR 0.95, CI
0.50 to 1.80, p = 0.87, I² = 0%). Permanent pacemaker was more
frequent in the TAVI arm compared with SAVR arm, 379 versus 110, (OR 3.75,
CI 1.67 to 8.42, p = 0.001, I² = 89%). In conclusion, TAVI is
associated with a reduction in AKIs at 30days despite the exposure to
contrast and higher incidence of new permanent pacemaker
placement.<br/>Copyright &#xa9; 2018 Elsevier Inc.

<71>
Accession Number
622635366
Author
Liu X.-Y.; Jacobsen P.K.; Pehrson S.; Chen X.
Institution
(Liu) Department of Cardiology, Wuxi People's Hospital Affiliated to
Nanjing Medical University, No 299, Qingyang Road, Wuxi 214023, China
(Liu, Jacobsen, Pehrson, Chen) Department of Cardiology, Heart Centre,
Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen
2100, Denmark
Title
Catheter ablation of incisional atrial tachycardia using remote magnetic
navigation in patients after heart surgery: Comparison between acquired
and congenital heart disease.
Source
Europace. 20 (Supplement 2) (pp ii33-ii39), 2018. Date of Publication: 01
May 2018.
Publisher
Oxford University Press
Abstract
Aims The objectives of this study were to assess the acute and long-term
outcomes of catheter ablation in incisional atrial tachycardia (IAT) using
remote magnetic navigation (RMN) in patients after heart surgery. Methods
and results A total of 46 patients with IAT after heart surgery who
underwent catheter ablation using RMN were included. Of these patients, 22
patients had acquired heart disease (AHD) and the remaining 24 patients
had various types of congenital heart disease (CHD). In these 46 patients,
57 re-entry circuits were found in 56 procedures. The re-entry circuits
were mainly distributed in right atrium (RA). Acute success of first
ablation reached in 42 of 46 (91%) patients. Mean procedure duration was
115 +/- 39 min, ablation duration was 678 (920.5) s, X-ray time was 4
(4.8) min, and X-ray dose was 3 (6.0) gy cm 2. After a mean follow-up of
28 +/- 19 months, 39 of 46 (85%) patients were free from IAT. No major
complications were observed. There were no significant differences in
procedure durations (AHD 113 +/- 40 min vs. CHD 119 +/- 38 min), ablation
durations [AHD 643 (1027) s vs. CHD 712 (929) s], X-ray time [AHD 4 (4.5)
min vs. CHD 4 (5.0) min], circuits in RA (AHD 85% vs. CHD 86%), acute
success rates (AHD 91% vs. CHD 92%), and long-term success rates (AHD 86%
vs. CHD 83%) between the two groups (P > 0.05). Conclusion Catheter
ablation of IAT in patients after heart surgery using RMN is safe and
effective. No significant differences related to success rates and
procedure characteristics were found between patients with AHD and
CHD.<br/>Copyright &#xa9; The Author(s) 2018.

<72>
Accession Number
622347418
Author
Shi R.; Li Z.-H.; Chen D.; Wu Q.-C.; Zhou X.-L.; Tie H.-T.
Institution
(Shi, Chen, Wu, Tie) Department of Cardiothoracic Surgery, the First
Affiliated Hospital of Chongqing Medical University, Chongqing, China
(Shi, Zhou) Department of Cardiology, the First Affiliated Hospital of
Chongqing Medical University, Chongqing, China
(Li) Department of Metabolism and Endocrinology, Shanghai East Hospital,
Tongji University School of Medicine, Shanghai, China
Title
Sole and combined vitamin C supplementation can prevent postoperative
atrial fibrillation after cardiac surgery: A systematic review and
meta-analysis of randomized controlled trials.
Source
Clinical Cardiology. 41 (6) (pp 871-878), 2018. Date of Publication: June
2018.
Publisher
John Wiley and Sons Inc. (E-mail: cs-journals@wiley.com)
Abstract
We undertook a systematic review and meta-analysis to evaluate the effect
of vitamin C supplementation (vitamin C solely or as adjunct to other
therapy) on prevention of postoperative atrial fibrillation (POAF) in
patients after cardiac surgery. PubMed, Embase, Web of Science, and
Cochrane Library were systematically searched to identify randomized
controlled trials assessing the effect of vitamin C supplementation in
adult patients undergoing cardiac surgery, and the meta-analysis was
performed with a random-effects model. Thirteen trials involving 1956
patients were included. Pooling estimate showed a significantly reduced
incidence of POAF (relative risk [RR]: 0.68, 95% confidence interval [CI]:
0.54 to 0.87, P = 0.002) both in vitamin C alone (RR: 0.75, 95% CI: 0.63
to 0.90, P = 0.002) and as an adjunct to other therapy (RR: 0.32, 95% CI:
0.20 to 0.53, P < 0.001). The results remain stable and robust in subgroup
and sensitivity analyses, and trial sequential analysis also confirmed
that the evidence was sufficient and conclusive. Additionally, vitamin C
could significantly decrease intensive care unit length of stay (weighted
mean difference: -0.24 days, 95% CI: -0.45 to -0.03, P = 0.023), hospital
length of stay (weighted mean difference: -0.95 days, 95% CI: -1.64 to
-0.26, P = 0.007), and risk of adverse events (RR: 0.45, 95% CI: 0.21 to
0.96, P = 0.039). Use of vitamin C alone and as adjunct to other therapy
can prevent POAF in patients undergoing cardiac surgery and should be
recommended for patients receiving cardiac surgery for prevention of
POAF.<br/>Copyright &#xa9; 2018 Wiley Periodicals, Inc.

<73>
Accession Number
622640991
Author
Liu L.; Huang J.; Zhang X.; Tang X.
Institution
(Liu, Zhang, Tang) Department of Cardiology, First Affiliated Hospital,
Chongqing Medical University, Chongqing, China
(Huang) Department of Cardiology, Chongqing Emergency Medical Center,
Chongqing, China
Title
Efficacy and safety of triple therapy versus dual antiplatelet therapy in
patients with atrial fibrillation undergoing coronary stenting: A
meta-analysis.
Source
PLoS ONE. 13 (6) (no pagination), 2018. Article Number: e0199232. Date of
Publication: June 2018.
Publisher
Public Library of Science (E-mail: plos@plos.org)
Abstract
Background The optimal antithrombotic therapy for atrial fibrillation (AF)
patients undergoing coronary stenting is unknown. The present
meta-analysis sought to investigate the efficacy and safety of triple
therapy (TT; warfarin, clopidogrel and aspirin) vs dual antiplatelet
therapy (DAPT; clopidogrel plus aspirin) in those patients. Methods PubMed
and Cochrane Library were searched for studies enrolling AF patients
undergoing coronary stenting on TT and DAPT up to September 2016, and
fourteen studies were included. Efficacy outcomes included ischemic
stroke, stent thrombosis, major adverse cardiovascular event (MACE),
all-cause mortality and myocardial infarction (MI); safety outcome was
major bleeding. We conducted meta-analysis and used odds ratio (OR) with
95% confidence intervals (CI) to compare TT and DAPT. Meta-regression,
sensitivity and subgroup analysis were taken to investigate the source of
heterogeneity in the outcome of major bleeding. Results 14 eligible
observational studies with 11,697 subjects were identified. Compared with
DAPT, TT had decreased the risk of ischemic stroke [OR = 0.74, 95% CI
(0.59, 0.93), P = 0.009] and stent thrombosis [OR = 0.40, 95% CI (0.18,
0.93), P = 0.033]. While, there was an increased risk of major bleeding
[OR = 1.55, 95% CI (1.16, 2.09), P = 0.004] associated with TT. The risk
of MACE, all-cause mortality and MI had no significant statistical
difference between TT and DAPT. Furthermore, the results of univariate and
multivariate meta-regression analysis implicated that there were no
obvious correlations between certain baseline characteristics (age,
gender, race, hypertension, study design) and risk of major bleeding. Also
of major bleeding, the findings of sensitivity analysis were generally
robust, and a prespecified subgroup analysis of race demonstrated that the
source of heterogeneity might attribute to Asian studies mostly.
Conclusions TT reduced the risk of ischemic stroke and stent thrombosis
with an acceptable major bleeding risk compared with DAPT, and TT was
considered as a valid alternative in AF patients undergoing coronary
stenting. Further prospective randomized trials are needed to ensure the
reliability of these data and find the optimal therapeutic strategy in
this setting of patients.<br/>Copyright &#xa9; 2018 Liu et al. This is an
open access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<74>
[Use Link to view the full text]
Accession Number
614085331
Author
Praz F.; Siontis G.C.M.; Verma S.; Windecker S.; Juni P.
Institution
(Praz, Siontis, Windecker) Department of Cardiology, Bern University
Hospital, Bern, Switzerland
(Verma) Division of Cardiac Surgery, Canada
(Juni) Applied Health Research Centre (AHRC), Li Ka Shing Knowledge
Institute, University of Toronto, Toronto, ON, Canada
Title
Latest evidence on transcatheter aortic valve implantation vs. surgical
aortic valve replacement for the treatment of aortic stenosis in high and
intermediate-risk patients.
Source
Current Opinion in Cardiology. 32 (2) (pp 117-122), 2017. Date of
Publication: 01 Mar 2017.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Purpose of review The goal of this review is to summarize the current
evidence supporting the use of transcatheter aortic valve implantation
(TAVI) in high and intermediate-risk patients. The focus is on the five
randomized controlled trials comparing TAVI with surgical aortic valve
replacement (SAVR) published to date, as well as two recent meta-Analyses.
Recent findings TAVI has profoundly transformed the treatment of elderly
patients presenting with symptomatic severe aortic stenosis. In
experienced hands, the procedure has become well tolerated and the results
more predictable. So far, two trials using two different devices
[Placement of Aortic Transcatheter Valve (PARTNER) 1A and US CoreValve
High Risk] have shown that TAVI is able to compete in terms of mortality
with SAVR in high-risk patients. These findings have been extended to the
intermediate-risk population in two recently published randomized
controlled trials [PARTNER 2 and Nordic Aortic Valve Intervention
(NOTION)]. The two meta-Analyses suggested improved survival in both high
and intermediate-risk patients during the first 2 years following the
intervention. The survival benefit was only found in patients treated via
the transfemoral access, and appeared more pronounced in women. Summary
Individual randomized trials enrolling high and intermediate-risk patients
have established the noninferiority of TAVI in comparison with SAVR,
whereas subsequent meta-Analyses suggest superiority of transfemoral TAVI
in terms of a sustained survival benefit 2 years after valve implantation
irrespective of the surgical risk category. The benefit of TAVI appears
more pronounced in women than in men.<br/>&#xa9; Copyright 2017 Wolters
Kluwer Health, Inc. All rights reserved.

<75>
Accession Number
622516366
Author
Hartley L.; Clar C.; Flowers N.; Stranges S.; Rees K.
Institution
(Hartley, Flowers, Stranges, Rees) Warwick Medical School, University of
Warwick, Division of Health Sciences, Coventry, Warwickshire CV4 7AL,
United Kingdom
(Clar) Cochrane Metabolic and Endocrine Disorders Group, Hasenheide 67,
Berlin 10967, Germany
Title
Vitamin K for the primary prevention of cardiovascular disease.
Source
Cochrane Database of Systematic Reviews. 2014 (6) (no pagination), 2014.
Article Number: CD011148. Date of Publication: 10 Jun 2014.
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
This is the protocol for a review and there is no abstract. The objectives
are as follows: To determine the effectiveness of vitamin K
supplementation as a single ingredient for the primary prevention of
CVD.<br/>Copyright &#xa9; 2014 The Cochrane Collaboration.

<76>
Accession Number
622516420
Author
Hartley L.; Flowers N.; Ernst E.; Rees K.
Institution
(Hartley, Flowers, Rees) Warwick Medical School, University of Warwick,
Division of Health Sciences, Coventry, Warwickshire CV4 7AL, United
Kingdom
(Ernst) Peninsula Medical School, Complementary Medicine, Veysey Building,
Salmon Pool Lane, Exeter, Devon EX2 4SG, United Kingdom
Title
Tai chi for primary prevention of cardiovascular disease.
Source
Cochrane Database of Systematic Reviews. 2013 (2) (no pagination), 2013.
Article Number: CD010366. Date of Publication: 28 Feb 2013.
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
This is the protocol for a review and there is no abstract. The objectives
are as follows: To determine the effectiveness of tai chi for the primary
prevention of CVD.<br/>Copyright &#xa9; 2013 The Cochrane Collaboration.

<77>
Accession Number
619326008
Author
Fallatah R.; Elasfar A.A.; Alzubaidi S.; Alraddadi M.; Abuelatta R.
Institution
(Fallatah, Elasfar, Alzubaidi, Abuelatta) Madina Cardiac Center, Madina,
Saudi Arabia
(Fallatah) King Abdulaziz University, Jeddah, Saudi Arabia
(Elasfar) Cardiology Department, Tanta University, Egypt
(Alraddadi) King Fahad Hospital, AlMadina AlMonaoarah, Saudi Arabia
Title
Endovascular repair of a leaking aortic-arch pseudoaneurysm using graft
stent combined with chimney protection to left common carotid artery: Case
report and review of literature.
Source
Journal of the Saudi Heart Association. 30 (3) (pp 254-259), 2018. Date of
Publication: July 2018.
Publisher
Elsevier B.V.
Abstract
Aortic pseudoaneurysm (PsA) is a rare but serious condition that has high
mortality and morbidity rates if untreated. We report a rare case of
leaking aortic-arch PsA repaired by thoracic endovascular aortic repair
using graft stent with the chimney technique to protect the left common
carotid artery. Unlike other cases in the literature, our case was unique,
having leaking PsA not related to previous cardiac surgery or aortic
dissection. The successful management of this patient using thoracic
endovascular aortic repair combined with the chimney technique suggests
that this approach may be an attractive therapeutic alternative to treat
aortic-arch PsA.<br/>Copyright &#xa9; 2017 The Authors

<78>
Accession Number
2000887055
Author
Harky A.; Bashir M.; Francis N.; Barts Consortium of Surgeons; Roberts N.;
Uppal R.
Institution
(Harky, Bashir, Francis, Barts Consortium of Surgeons, Roberts, Uppal)
Department of Cardiac Surgery, Barts Heart Centre, St Bartholomew's
Hospital, London, United Kingdom
Title
Stented vs Stentless aortic valve replacement in patients with small
aortic root: A systematic review and meta-analysis.
Source
International Journal of Surgery. (no pagination), 2018. Date of
Publication: 2018.
Publisher
Elsevier Ltd

<79>
Accession Number
2000887022
Author
Harky A.; MacCarthy-Ofosu B.; Bashir M.; Garner M.; Roberts N.; Shipolini
A.; Uppal R.
Institution
(Harky, MacCarthy-Ofosu, Bashir, Garner, Roberts, Shipolini, Uppal)
Department of Cardiac Surgery, Barts Heart Centre, St Bartholomew's
Hospital, London, United Kingdom
Title
Is mitral valve repair superior to mitral valve replacement in patients
with native mitral valve endocarditis? A systematic review and
meta-analysis.
Source
International Journal of Surgery. (no pagination), 2018. Date of
Publication: 2018.
Publisher
Elsevier Ltd

<80>
Accession Number
2000886850
Author
Bashir M.; Harky A.; Ahmad M.; Consortium of Surgeons B.; Shipolini A.;
Uppal R.
Institution
(Bashir, Harky, Ahmad, Consortium of Surgeons, Shipolini, Uppal)
Department of Cardiac Surgery, Barts Heart Centre, London, United Kingdom
(Ahmad) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
Title
Innominate vs Axillary artery cannulation in thoracic aortic surgery: A
systematic review and meta-analysis.
Source
International Journal of Surgery. (no pagination), 2018. Date of
Publication: 2018.
Publisher
Elsevier Ltd