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<1>
Accession Number
2004776440
Title
Long-term clinical outcomes with use of an angiotensin-converting enzyme
inhibitor early after heart transplantation: ACE-I after Heart
Transplantation.
Source
American Heart Journal. 222 (pp 30-37), 2020. Date of Publication: April
2020.
Author
Arashi H.; Sato T.; Kobashigawa J.; Luikart H.; Kobayashi Y.; Okada K.;
Sinha S.; Honda Y.; Yeung A.C.; Khush K.; Fearon W.F.
Institution
(Arashi, Luikart, Kobayashi, Okada, Sinha, Honda, Yeung, Khush, Fearon)
Stanford Cardiovascular Institute and Division of Cardiovascular Medicine,
Stanford, CA, Indonesia
(Sato, Kobashigawa) Advanced Heart Disease Section, Cedars-Sinai Heart
Institute, CA, Los Angeles, Indonesia
(Fearon) Cardiology Section, Palo Alto Veterans Affairs Health Care
System, Palo Alto, CA, Indonesia
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: The safety and efficacy of angiotensin converting enzyme
inhibition (ACEI) after heart transplantation (HT) is unknown. This study
examined long-term clinical outcomes after ACEI in HT recipients.
<br/>Method(s): The ACEI after HT study was a prospective, randomized
trial that tested the efficacy of ACEI with ramipril after HT. In this
study, long-term clinical outcomes were assessed in 91 patients randomized
to either ramipril or placebo (median, 5.8 years). The primary endpoint
was a composite of death, retransplantation, hospitalization for rejection
or heart failure, and coronary revascularization. <br/>Result(s): The
primary endpoint occurred in 10 of 45 patients (22.2%) in the ramipril
group and in 14 of 46 patients (30.4%) in the placebo group (Hazard ratio
(HR), 0.68; 95% CI, 0.29-1.51; P = .34). When the analysis was restricted
to comparing patients who remained on a renin-angiotensin system inhibitor
beyond 1 year with those who did not, there was a trend to improved
outcomes (HR, 0.54; 95% CI, 0.22-1.28, P = .16). There was no significant
difference in creatinine, blood urea nitrogen, and potassium at 3 years
after randomization. The cumulative incidence of the primary endpoint was
significantly higher in patients in whom the index of microcirculatory
resistance increased from baseline to 1 year compared with those in whom
it did not (39.1 vs 17.4%, HR: 3.36; 95% CI, 1.07-12.7; P = .037).
<br/>Conclusion(s): The use of ramipril after HT safely lowers blood
pressure and is associated with favorable long-term clinical outcomes.
Clinical Trial Registration-URL: https://www.clinicaltrials.gov. Unique
identifier: NCT01078363.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<2>
Accession Number
2004657989
Title
Effect of remote ischaemic conditioning on coagulation function as
measured by whole blood impedance aggregometry and rotational
thromboelastometry in off-pump coronary artery bypass surgery: A
randomised controlled trial.
Source
Thrombosis Research. 187 (pp 72-78), 2020. Date of Publication: March
2020.
Author
Kim T.K.; Nam K.; Cho Y.J.; Choi S.; Row H.S.; Jeon Y.
Institution
(Kim, Nam, Cho, Choi, Row, Jeon) Department of Anaesthesiology and Pain
Medicine, Seoul National University Hospital, Seoul National University
College of Medicine, Seoul, South Korea
(Kim, Choi, Row) Department of Anaesthesiology and Pain Medicine, SMG-SNU
Boramae Medical Centre, Seoul National University College of Medicine,
Seoul, South Korea
Publisher
Elsevier Ltd
Abstract
Introduction: Remote ischaemic conditioning (RIC) has been shown to
prevent platelet activation during ablation for atrial fibrillation. RIC
has also been associated with more postoperative transfusion in the
off-pump coronary artery bypass graft surgery (OPCAB) patients. We
evaluated the effects of RIC on coagulation function in OPCAB patients.
<br/>Method(s): A total of 58 patients undergoing OPCAB were randomised to
the RIC or control group. In the RIC group, four cycles of 5 min of
ischaemia and 5 min of reperfusion were applied twice to the upper arm
after the induction of anaesthesia (preconditioning), and after the
completion of coronary anastomoses (postconditioning). Whole blood
impedance aggregometry (Multiplate) and rotational thromboelastometry
(ROTEM) were performed before the induction of anaesthesia, at the end of
surgery, and at postoperative day 1. <br/>Result(s): The trend towards a
decrease in adenosine diphosphate-induced whole blood aggregation at the
end of surgery was greater in the RIC group than in the control group, but
this effect was not statistically significant (-10.4 [18.1] vs. -5.7
[24.8] U, P = 0.424). In ROTEM analysis, the EXTEM area under the velocity
curve was lower in the RIC group than in the control group at the end of
surgery (3567 [1399-5794] vs. 5693 [4718-6179] mm*100, respectively; P =
0.030). A tendency of larger perioperative blood loss was identified in
the RIC group. <br/>Conclusion(s): Although some parameters indicated a
tendency for hypocoagulation in the RIC group at the end of surgery, most
effects were not statistically significant. RIC does not significantly
affect perioperative platelet aggregability and coagulation in patients
undergoing OPCAB.<br/>Copyright &#xa9; 2020

<3>
Accession Number
628307242
Title
Quality of life after catheter and minimally invasive surgical ablation of
paroxysmal and early persistent atrial fibrillation: results from the
SCALAF trial.
Source
Clinical Research in Cardiology. 109 (2) (pp 215-224), 2020. Date of
Publication: 01 Feb 2020.
Author
Buist T.J.; Adiyaman A.; Beukema R.J.; Smit J.J.J.; Delnoy P.P.H.M.;
Hemels M.E.W.; Sie H.T.; Ramdat Misier A.R.; Elvan A.
Institution
(Buist, Adiyaman, Beukema, Smit, Delnoy, Hemels, Ramdat Misier, Elvan)
Department of Cardiology, Isala Heart Center, Dr. Van Heesweg 2, Zwolle
8025 AB, Netherlands
(Sie) Department of Cardiothoracic Surgery, Isala Heart Center, Zwolle,
Netherlands
Publisher
Springer
Abstract
Aims: In the SCALAF trial, catheter-based pulmonary vein isolation (PVI)
was as effective in long-term prevention of atrial fibrillation (AF) as
minimally invasive thoracoscopic PVI and left atrial appendage ligation
(MIPI). Catheter ablation (CA) resulted in significantly less major
complications as compare to MIPI. We report quality of life (QOL) outcome
in these patients. <br/>Method(s): In this study, 52 patients with
symptomatic paroxysmal or early persistent AF were randomized to either
MIPI or CA. QOL was assessed at baseline, 3, 6, and 12 months follow-up
using the SF-36 Health Survey Questionnaire. AF-related symptoms were
quantified at each follow-up visit using the European Heart Rhythm
Association (EHRA) score. <br/>Result(s): Median age was 57 years and 78%
was male. Paroxysmal AF was present in 74%. At 3 months follow-up,
physical role limitations (88.2 +/- 29.5; versus 40.9 +/- 44.0; P = 0.001,
respectively) and bodily pain scores (95.5 +/- 8.7; versus 76.0 +/- 27.8;
P = 0.021, respectively) were significantly higher after CA compared to
MIPI, indicating less limitation in daily activity caused by physical
problems and less pain after CA than after MIPI. AF symptoms assessed by
the EHRA scores improved significantly at 3, 6, 12, and 24 months compared
to baseline in both treatment groups (P < 0.001), with no significant
differences between treatment groups. <br/>Conclusion(s): CA and MIPI
ablation of AF both resulted in an improvement in several QOL
measurements, although CA resulted in significantly less physical problems
and bodily pain 3 months after treatment compared to MIPI. Clinical trial
number: ClinicalTrials.gov identifier: NCT00703157. Graphic abstract:
[Figure not available: see fulltext.].<br/>Copyright &#xa9; 2019,
Springer-Verlag GmbH Germany, part of Springer Nature.

<4>
Accession Number
2004352172
Title
The prognostic implication of perioperative cardiac enzyme elevation in
patients with fractured neck of femur: A systematic review and
meta-analysis.
Source
Injury. 51 (2) (pp 164-173), 2020. Date of Publication: February 2020.
Author
Lowe M.J.; Lightfoot N.J.
Institution
(Lowe) Department of Anaesthesia, Auckland City Hospital, Auckland, New
Zealand
(Lightfoot) Department of Anaesthesia and Pain Medicine, Middlemore
Hospital, Auckland, New Zealand
Publisher
Elsevier Ltd
Abstract
Background: Neck of Femur (NOF) fractures are a common injury in comorbid
elderly patients which are associated with increased rates of morbidity
and mortality following fracture. Because of their injury, patients can
experience reductions in quality of life and independent living leading to
transfer to nursing home or dependent levels of care. Numerous factors are
associated with either complications or reductions in survival following
fractured NOF. From the VISION cohort there is evidence that troponin
elevation in the post-operative period following a diverse range of
non-cardiac surgical procedures may lead to an increased risk of mortality
in the absence of classical ischaemic or cardiac symptoms. The aim of this
systematic review and meta-analysis is to validate the utility of
perioperative troponin elevation as a prognostic indicator for mortality
and cardiac morbidity in those with fractured NOF. <br/>Method(s): The
PRISMA guidelines for the conduct of meta-analyses were followed. An
electronic search was conducted of the EMBASE, MEDLINE (Ovid) and Biosis
databases. Studies were included for analysis if they stratified outcomes
by perioperative troponin elevation in surgically managed fractured NOF
and reported sufficient data on troponin elevation and mortality following
surgery. Primary and secondary outcomes assessed were all-cause
post-operative mortality and a composite measure of cardiac complications
(myocardial infarction, cardiac failure and arrhythmia) respectively.
<br/>Result(s): Eleven studies met inclusion criteria giving a total of
1363 patients. Overall, 497 patients (36.5%) experienced an elevation in
troponin levels following surgery. Perioperative troponin elevation was
significantly associated with all-cause mortality (OR 2.6; 95% CI 1.5 -
4.6; p <0.001) and cardiac complications (OR 7.4; 95% CI 3.5 - 15.8; p
<0.001). Patient factors significantly associated with troponin elevation
included pre-existing coronary artery disease, cardiac failure,
hypertension, previous stroke and previous myocardial infarction.
<br/>Conclusion(s): Perioperative troponin elevation is significantly
associated with increased mortality and post-operative cardiac
complications following fractured NOF and may be a useful prognostic
indicator in these patients. Future research should further stratify
patients by the magnitude of troponin elevation and further refine the
risk factors.<br/>Copyright &#xa9; 2019

<5>
Accession Number
2004744322
Title
Complete 2-Year Results Confirm Bayesian Analysis of the SURTAVI Trial.
Source
JACC: Cardiovascular Interventions. 13 (3) (pp 323-331), 2020. Date of
Publication: 10 February 2020.
Author
Van Mieghem N.M.; Popma J.J.; Deeb G.M.; Yakubov S.J.; Serruys P.W.;
Windecker S.; Sondergaard L.; Gada H.; Chetcuti S.; Kleiman N.S.; Kodali
S.; George I.; Teefy P.; Kiaii B.; Oh J.K.; Chang Y.; Mugglin A.S.;
Reardon M.J.; Sorajja P.; Sun B.; Agarwal H.; Langdon T.; den Heijer P.;
Bentala M.; O'Hair D.; Bajwa T.; Byrne T.; Caskey M.; Paulus B.; Garrett
E.; Stoler R.; Hebeler R.; Khabbaz K.; Lim D.S.; Bladergroen M.; Fail P.;
Feinberg E.; Rinaldi M.; Skipper E.; Chawla A.; Hockmuth D.; Makkar R.;
Cheng W.; Aji J.; Bowen F.; Schreiber T.; Henry S.; Hengstenberg C.;
Bleiziffer S.; Harrison J.K.; Hughes C.; Joye J.; Gaudiani V.; Babaliaros
V.; Thourani V.; van Mieghem N.; Kappetein A.P.; Dauerman H.; Schmoker J.;
Skelding K.; Casale A.; Kovac J.; Spyt T.; Seshiah P.; Smith J.M.; McKay
R.; Hagberg R.; Matthews R.; Starnes V.; O'Neill W.; Paone G.; Hernandez
Garcia J.M.; Such M.; Moris de la Tassa C.; Llosa Cortina J.C.; Carrel T.;
Whisenant B.; Doty J.; Resar J.; Conte J.; Aharonian V.; Pfeffer T.; Ruck
A.; Corbascio M.; Blackman D.; Kaul P.; Kliger C.; Brinster D.; Leya F.;
Bakhos M.; Sandhu G.; Pochettino A.; Piazza N.; de Varennes B.; van Boven
A.; Boonstra P.; Waksman R.; Bafi A.; Asgar A.; Cartier R.; Kipperman R.;
Brown J.; Lin L.; Rovin J.; Sharma S.; Adams D.; Katz S.; Hartman A.;
Al-Jilaihawi H.; Williams M.; Crestanello J.; Lilly S.; Ghani M.;
Bodenhamer R.M.; Rajagopal V.; Kauten J.; Mumtaz M.; Bachinsky W.;
Nickenig G.; Welz A.; Olsen P.S.; Yakubov S.; Watson D.; Chhatriwalla A.;
Allen K.; Teirstein P.; Tyner J.; Mahoney P.; Newton J.; Merhi W.; Keiser
J.; Yeung A.; Miller C.; ten Berg J.; Heijmen R.; Petrossian G.; Robinson
N.; Brecker S.; Jahangiri M.; Davis T.; Batra S.; Hermiller J.; Heimansohn
D.; Radhakrishnan S.; Fremes S.; Maini B.; Bethea B.; Brown D.; Ryan W.;
Reardon M.; Kleiman N.; Spies C.; Lau J.; Herrmann H.; Bavaria J.; Horlick
E.; Feindel C.; Neumann F.-J.; Beyersdorf F.; Binder R.; Maisano F.; Costa
M.; Markowitz A.; Tadros P.; Zorn G.; de Marchena E.; Salerno T.; Labinz
M.; Ruel M.; Sup Lee J.; Gleason T.; Ling F.; Knight P.; Robbins M.; Ball
S.; Giacomini J.; Burdon T.; Applegate R.; Kon N.; Schwartz R.; Schubach
S.; Forrest J.; Mangi A.
Institution
(Van Mieghem) Department of Interventional Cardiology, Erasmus University
Medical Centre, Rotterdam, Netherlands
(Popma) Department of Interventional Cardiology, Beth Israel Deaconess
Medical Center, Boston, MA, United States
(Deeb) Cardiac Surgery, University of Michigan, Ann Arbor, MI, United
States
(Yakubov) Interventional Cardiology, OhioHealth Riverside Methodist
Hospital, Columbus, OH, United States
(Serruys) Cardiovascular Science Division of the National Heart and Lung
Institute, Imperial College London, London, United Kingdom
(Windecker) Department of Interventional Cardiology, University Hospital
Bern, Bern, Switzerland
(Sondergaard) The Heart Center, Rigshospitalet, University of Copenhagen,
Copenhagen, Denmark
(Mumtaz) Cardiac Surgery, University of Pittsburgh Medical Center Pinnacle
Health, Harrisburg, PA, United States
(Gada) Interventional Cardiology, University of Pittsburgh Medical Center
Pinnacle Health, Harrisburg, PA, United States
(Chetcuti) Interventional Cardiology, University of Michigan, Ann Arbor,
MI, United States
(Kleiman) Cardiology, Methodist DeBakey Heart and Vascular Center,
Houston, TX, United States
(Kodali, George) Structural Heart and Valve Center, Columbia University
Medical Center, New York, NY, United States
(Teefy) Department of Medicine, Cardiology Division, London Health
Sciences Centre, University Hospital, London, Ontario, Canada
(Kiaii) Department of Cardiovascular and Thoracic Surgery, London Health
Sciences Centre, University Hospital, London, Ontario, Canada
(Oh) Echocardiography Core Laboratory, Mayo Clinic, Rochester, MN, United
States
(Kappetein) Baaken Research Center, Medical Affairs, Medtronic,
Maastricht, Netherlands
(Chang) Clinical, Medtronic, Mounds View, MN, United States
(Mugglin) Paradigm Biostatistics, Anoka, MN, United States
(Reardon) Department of Cardiothoracic Surgery, Methodist DeBakey Heart
and Vascular Center, Houston, TX, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: The aim of this study was to report the 2-year results of the
SURTAVI (Surgical Replacement and Transcatheter Aortic Valve Implantation)
trial and confirm the interim Bayesian analysis. <br/>Background(s):
Transcatheter aortic valve replacement (TAVR) with a self-expanding valve
was noninferior to surgery in patients with severe aortic stenosis and
intermediate operative risk using Bayesian statistical methods. Novel
Bayesian designs have been used to shorten the time to primary endpoint
analysis in randomized clinical trials, although the predictive value of
Bayesian analysis compared with frequentist approaches remains debated.
<br/>Method(s): The SURTAVI trial randomized 1,660 patients. An interim
analysis was performed 1 year after the 1,400th patient was treated to
estimate the primary 2-year endpoint of all-cause mortality or disabling
strokes for all patients. <br/>Result(s): The Kaplan-Meier rate for the
complete 2-year primary endpoint was 12.7% in the TAVR group and 12.6% in
the surgery group (0.0% difference; 95% confidence interval: -3.4% to
3.5%), compared with 12.6% with TAVR and 14.0% with surgery (-1.4%
difference; Bayesian credible interval: -5.2% to 2.3%) in the interim
Bayesian analysis. A comparison of individual clinical, hemodynamic, and
quality-of-life endpoints using Bayesian and frequentist methods found no
significant differences. <br/>Conclusion(s): The complete analysis of all
patients with aortic stenosis at intermediate risk for surgery in the
SURTAVI trial confirmed the noninferiority, with respect to the frequency
of all-cause mortality or disabling stroke, of TAVR to surgery, as
determined in the interim Bayesian analysis. Follow-up will extend out to
10 years.<br/>Copyright &#xa9; 2020 American College of Cardiology
Foundation

<6>
Accession Number
2004554822
Title
Cochrane Corner: Perioperative beta-blockers for preventing
surgery-related mortality and morbidity.
Source
Revista Portuguesa de Cardiologia. 38 (10) (pp 691-694), 2019. Date of
Publication: October 2019.
Author
Alegria S.; Costa J.; Vaz-Carneiro A.; Caldeira D.
Institution
(Alegria) Servico de Cardiologia, Hospital Garcia de Orta, Almada,
Portugal
(Costa, Vaz-Carneiro) Centro de Estudos de Medicina Baseada na Evidencia,
Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
(Costa, Vaz-Carneiro) Centro Colaborador Portugues da Rede Cochrane
Iberoamericana, Faculdade de Medicina, Universidade de Lisboa, Lisboa,
Portugal
(Costa, Caldeira) Laboratorio de Farmacologia Clinica e Terapeutica,
Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas
Moniz, Lisboa 1649-028, Portugal
(Costa, Caldeira) Instituto de Medicina Molecular, Faculdade de Medicina,
Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa 1649-028,
Portugal
(Caldeira) Servico de Cardiologia, Hospital Universitario de Santa Maria
(CHLN), CAML, Centro Cardiovascular da Universidade de Lisboa - CCUL,
Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas
Moniz, Lisboa 1649-028, Portugal
Publisher
Sociedade Portuguesa de Cardiologia (E-mail: secretariado@mail.spc.pt)
Abstract
Randomized controlled trials have yielded conflicting results regarding
the impact of beta-blockers on perioperative cardiovascular morbidity and
mortality. This Cochrane systematic review assessed the impact of this
intervention on mortality and cardiovascular events. Eighty-eight
randomized controlled trials with 19 161 participants were included (53
trials on cardiac surgery and 35 trials on non-cardiac surgery). In
cardiac surgery perioperative beta-blockers had a protective effect
against supraventricular and ventricular arrhythmias but had no
significant effect on mortality or on the occurrence of acute myocardial
infarction (AMI), stroke, heart failure, hypotension or bradycardia. In
non-cardiac surgery, beta-blockers had a protective effect against AMI and
arrhythmias, but this was counterbalanced by an increased risk of death
and stroke. In conclusion, perioperative use of beta-blockers appears
overall to be beneficial in cardiac surgery. However, in non-cardiac
surgery the substantial reduction in rhythm disturbances and AMI appears
to be offset by an increase in mortality and stroke, and so the systematic
use of beta-blockers in this setting is not recommended.<br/>Copyright
&#xa9; 2019 Sociedade Portuguesa de Cardiologia

<7>
Accession Number
630663311
Title
Perioperative Outcomes of Adjunctive Hypnotherapy Compared with Conscious
Sedation Alone for Patients Undergoing Transfemoral Transcatheter Aortic
Valve Implantation.
Source
International heart journal. 61 (1) (pp 60-66), 2020. Date of Publication:
31 Jan 2020.
Author
Takahashi M.; Mouillet G.; Khaled A.; Boukantar M.; Gallet R.; Rubimbura
V.; Lim P.; Dubois-Rande J.-L.; Teiger E.
Institution
(Takahashi, Mouillet, Boukantar, Gallet, Rubimbura, Lim, Dubois-Rande,
Teiger) Department of Cardiology, Henri Mondor University Hospital
(Takahashi) Department of Cardiovascular Medicine, Jichi Medical
University School of Medicine
(Khaled) Department of Anesthesiology, Henri Mondor University Hospital
Publisher
NLM (Medline)
Abstract
Transcatheter aortic valve implantation (TAVI) using a transfemoral
approach under local anesthesia with conscious sedation (LACS) is becoming
an increasingly common TAVI strategy. However, patients who are awake
during the TAVI procedure can experience stress, anxiety, and pain, even
when LACS is used. Clinical hypnotherapy is an anxiolytic intervention
that can be beneficial for patients undergoing invasive surgery. This
study aimed to assess the perioperative outcomes of adjunctive
hypnotherapy undergoing transfemoral TAVI with LACS.Consecutive patients
(n = 143) with symptomatic severe aortic stenosis who underwent
transfemoral TAVI with LACS only (n = 107) or with LACS and hypnotherapy
(n = 36) between January 2015 and April 2016 were retrospectively included
in the study. The clinical outcomes were compared between the two groups.
The LACS with hypnotherapy group had a significantly shorter length of
stay in the intensive care unit (ICU; LACS only versus LACS with
hypnotherapy: 4.0 (4.0-5.5) days versus 3.0 (3.0-5.0) days, P < 0.01).
Moreover, the use of anesthetics (propofol and remifentanil) and
norepinephrine was significantly lower in the LACS with hypnotherapy group
(e.g., for propofol, LACS only versus LACS with hypnotherapy: 96.4 +/-
104.7 mg versus 15.0 +/- 31.8 mg, P < 0.001). The multiple regression
analysis showed that being male, hypnotherapy, and the composite
complication score were independently associated with the length of stay
in the ICU.The adjunctive hypnotherapy on LACS among transfemoral TAVI
patients may facilitate perioperative management. However, a prospective
randomized study is necessary to confirm the efficacy of hypnotherapy
among TAVI patients.

<8>
Accession Number
630663083
Title
Meta-Analysis of the Impact of Pre-Procedural Serum Albumin on Mortality
in Patients Undergoing Transcatheter Aortic Valve Replacement.
Source
International heart journal. 61 (1) (pp 67-76), 2020. Date of Publication:
31 Jan 2020.
Author
Liu G.; Hu X.; Long M.; Du Z.-M.; Li Y.; Hu C.-H.
Institution
(Liu, Hu, Long, Du, Li, Hu) Department of Cardiology, First Affiliated
Hospital, Sun Yat-Sen University, Key Laboratory on Assisted Circulation,
Ministry of Health
Publisher
NLM (Medline)
Abstract
Pre-procedural serum albumin's impact on prognosis after transcatheter
aortic valve replacement (TAVR) has been studied. Literature on the
prognostic role of serum albumin in the survival of patients undergoing
TAVR shows conflicting results. This meta-analysis was conducted to
evaluate the impact of pre-procedural serum albumin on outcomes after
TAVR. A comprehensive literature search of EMBASE, MEDLINE, and the
Cochrane Library was undertaken through July 2019. The primary end points
were 30-day and one-year all-cause mortality after TAVR. Risk ratios (HRs)
and 95% confidence intervals (CIs) were calculated using the random-effect
model. Ten eligible studies with 8,236 patients were analyzed. Of the
8,236 patients undergoing TAVR, with a mean age of 83 years, 48.8% were
men and were categorized into two groups according to low and normal serum
albumin (cut-off value: 3.5 or 4 g/dL). Overall, low albumin was
significantly associated with an approximately two-fold increase in 30-day
all-cause mortality (HR, 2.09; 95% CI, 1.53-2.86) and a 61% increase risk
for one-year mortality (HR, 1.61; 95% CI, 1.31-1.98) in patients after
TAVR. Sensitivity analyses showed the results to be robust. The
association of low albumin level with an increase in one-year mortality
risk was not modified by study design, albumin cut-off value, Society of
Thoracic Surgeons Predicted Risk of Mortality (STS-PROM), and study
quality. In conclusion, low albumin levels were associated with poor
prognosis in patients after TAVR. Pre-procedural albumin can be used as a
simple tool related to prognosis after TAVR.

<9>
Accession Number
630484464
Title
Can high-intensity interval training improve physical and mental health
outcomes? A meta-review of 33 systematic reviews across the lifespan.
Source
Journal of sports sciences. 38 (4) (pp 430-469), 2020. Date of
Publication: 01 Feb 2020.
Author
Martland R.; Mondelli V.; Gaughran F.; Stubbs B.
Institution
(Martland, Gaughran) Department of Psychosis Studies, Institute of
Psychiatry, Psychology and Neuroscience (IoPPN), King's College London,
London, United Kingdom
(Mondelli, Stubbs) Department of Psychological Medicine, Institute of
Psychiatry, Psychology and Neuroscience (IoPPN), King's College London,
London, United Kingdom
(Gaughran, Stubbs) South London and Maudsley NHS Foundation Trust, London,
United Kingdom
Publisher
NLM (Medline)
Abstract
High-intensity-interval-training (HIIT) has been suggested to have
beneficial effects in multiple populations across individual systematic
reviews, although there is a lack of clarity in the totality of the
evidence whether HIIT is effective and safe across different populations
and outcomes. The aim of this meta-review was to establish the benefits,
safety and adherence of HIIT interventions across all populations from
systematic reviews and meta-analyses. Major databases were searched for
systematic reviews (with/without meta-analyses) of randomised &
non-randomised trials that compared HIIT to a control. Thirty-three
systematic reviews (including 25 meta-analyses) were retrieved
encompassing healthy subjects and people with physical health
complications. Evidence suggested HIIT improved cardiorespiratory fitness,
anthropometric measures, blood glucose and glycaemic control, arterial
compliance and vascular function, cardiac function, heart rate, some
inflammatory markers, exercise capacity and muscle mass, versus non-active
controls. Compared to active controls, HIIT improved cardiorespiratory
fitness, some inflammatory markers and muscle structure. Improvements in
anxiety and depression were seen compared to pre-training. Additionally,
no acute injuries were reported, and mean adherence rates surpassed 80% in
most systematic reviews. Thus, HIIT is associated with multiple benefits.
Further large-scale high-quality studies are needed to reaffirm and expand
these findings.Abbreviations: ACSM: American College of Sports Medicine;
BMI: Body Mass Index; BNP: Brain Natriuretic Peptide; BP: Blood Pressure;
CAD: Coronary Artery Disease; CHD: Coronary Heart Disease; COPD: Chronic
Obstructive Pulmonary Disease; CRP: c- reactive Protein; CVD:
Cardiovascular Disease; DBP: Diastolic Blood Pressure; ES: Effect Size;
FAS: Reduced Fatty Acid Synthase; FATP-1: Reduced Fatty Acid Transport
Protein 1; FMD: Flow Mediated Dilation; Hs-CRP: High-sensitivity c-
reactive Protein; HDL: High Density Lipoprotein; HIIT: High-Intensity
Interval Training; HOMA: Homoeostatic Model Assessment; HR: Heart Rate;
HTx: Heart Transplant Recipients; IL-6: Interleukin-6; LDL: Low Density
Lipoprotein; LV: Left Ventricular; LVEF: Left Ventricular Ejection
Fraction; MD: Mean Difference; MetS: Metabolic Syndrome; MPO:
Myeloperoxidase; MICT: Moderate-Intensity Continuous Training; NO: Nitric
Oxide; NRCT: Non-Randomised Controlled Trial; PA: Physical Activity;
PAI-1: Plasminogen-activator-inhibitor-1; QoL: Quality of Life; RCT:
Randomised Controlled Trial; RoB: Risk of Bias; RPP: Rate Pressure
Product; RT: Resistance Training; SBP: Systolic Blood Pressure; SD:
Standardised Difference; SMD: Standardised Mean Difference; TAU:
Treatment-As-Usual; T2DM: Type 2 Diabetes Mellitus; TC: Total Cholesterol;
TG: Triglycerides; TNF-alfa: Tumour Necrosis Factor alpha; UMD:
Unstandardised Mean Difference; WC: Waist Circumference; WHR: Waist-to-Hip
Ratio; WMD: Weighted Mean DifferenceKey points: HIIT may improve
cardiorespiratory fitness, cardiovascular function, anthropometric
variables, exercise capacity, muscular structure and function, and anxiety
and depression severity in healthy individuals and those with physical
health disorders.Additionally, HIIT appears to be safe and does not seem
to be associated with acute injuries or serious cardiovascular events.

<10>
Accession Number
2004776548
Title
Association of body mass index and all-cause mortality in patients after
cardiac surgery: A dose-response meta-analysis.
Source
Nutrition. 72 (no pagination), 2020. Article Number: 110696. Date of
Publication: April 2020.
Author
Liu X.; Xie L.; Zhu W.; Zhou Y.
Institution
(Liu) Department of Critial Care Medicine, The First Affiliated Hosptial
of Gannan Medical University, Ganzhou of Jiangxi, China
(Xie) Department of Respiratory Diseases, The Second Affiliated Hospital
of Nanchang University, Nanchang, China
(Zhu) Department of Cardiology, The First Affiliated Hospital of Sun
Yat-Sen University, Guangzhou, Guangdong, China
(Zhou) Department of Pediatric Ophthalmology, The Second Affiliated
Hospital of Nanchang University, Jiangxi, China
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Ample studies have reported the effect of body mass index (BMI) on the
prognosis of patients undergoing cardiac surgery, but the results remain
inconsistent. Therefore, we aimed to conduct a dose-response meta-analysis
to clarify the relationship between BMI and all-cause mortality in this
population. A systematic search was performed in the PubMed and Embase
databases through April 2019 for studies that reported the impact of BMI
on all-cause mortality in patients after cardiac surgery. Pooled risk
ratios (RRs) were calculated using a random-effects model. Non-linear
associations were explored with restricted cubic spline models. Forty-one
studies with a total of 54,300 cases/1,774,387 patients were included. The
pooled RR for all-cause mortality was 0.93 (95% CI 0.89-0.97) for every
5-unit increment in BMI, indicating that higher BMI did not increase the
risk of all-cause mortality in patients after cardiac surgery. A U-shaped
association with the nadir of risk at a BMI of 25-27.5 kg/m²
was observed, as well as a higher mortality risk for the underweight and
the extremely obese patients. The subgroup analysis revealed that this
phenomenon remained regardless of mean age, surgery type, geographic
location and number of cases. Overall, for patients after cardiac surgery,
a slightly higher BMI may be instrumental in survival, whereas underweight
and extreme obesity is associated with a worse prognosis.<br/>Copyright
&#xa9; 2019 Elsevier Inc.

<11>
Accession Number
2004747861
Title
Intraoperative xenon for prevention of delirium after on-pump cardiac
surgery: a randomised, observer-blind, controlled clinical trial.
Source
British Journal of Anaesthesia. (no pagination), 2020. Date of
Publication: 2020.
Author
Al tmimi L.; Verbrugghe P.; Van de Velde M.; Meuris B.; Meyfroidt G.;
Milisen K.; Fieuws S.; Rex S.
Institution
(Al tmimi, Van de Velde, Rex) Department of Anaesthesiology, University
Hospitals Leuven, Leuven, Belgium
(Al tmimi, Verbrugghe, Van de Velde, Meuris, Rex) Department of
Cardiovascular Sciences, KU Leuven, Leuven, Belgium
(Verbrugghe, Meuris) Department of Cardiac Surgery, University Hospitals
Leuven, Leuven, Belgium
(Meyfroidt) Department of Intensive Care Medicine, University Hospitals
Leuven, Leuven, Belgium
(Meyfroidt) Department of Cellular and Molecular Medicine, KU Leuven,
Leuven, Belgium
(Milisen) Department of Public Health and Primary Care, KU Leuven, Leuven,
Belgium
(Fieuws) Leuven Biostatistics and Statistical Bioinformatics Centre
(L-BioStat), KU Leuven, Leuven, Belgium
Publisher
Elsevier Ltd
Abstract
Background: Older patients undergoing cardiac surgery have a 40-60% risk
of developing postoperative delirium (POD), which is associated with
increased morbidity and mortality. In animals, xenon has been found to be
neuroprotective. Little is known about its neuroprotective effects in
humans. We evaluated whether xenon anaesthesia prevents POD in patients
undergoing cardiac surgery. <br/>Method(s): We conducted a randomised,
observer-blind, controlled trial in which 190 patients 65 yr or older
undergoing on-pump cardiac surgery were randomly allocated to xenon or
sevoflurane anaesthesia. During cardiopulmonary bypass, propofol infusion
was used for anaesthetic maintenance. Subjects were screened for POD daily
during the first 5 postoperative days using the 3-Minute Diagnostic
Interview for Confusion Assessment Method (CAM) or with a CAM version for
patients in ICU (CAM-ICU). Other methods to detect delirium, such as chart
review, were also used. Secondary outcomes included the duration and
severity of POD, and postoperative cognitive function. <br/>Result(s): The
overall incidence of POD was 41% (78/190). There was no statistically
significant difference in the POD incidence between the xenon and
sevoflurane groups (42.7% [41/96] vs 39.4% [37/94], P=0.583). The odds
ratio for POD when comparing xenon with sevoflurane was 1.18 (95%
confidence interval, 0.65-2.16). <br/>Conclusion(s): In older patients
undergoing cardiac surgery, xenon anaesthesia did not result in a
significant reduction in POD. Based on these results alone, use of xenon
cannot be recommended for this purpose. Clinical trial registration:
EudraCT: 2014-005370-11 (May 13, 2015;
https://www.clinicaltrialsregister.eu/ctr-search/search?query=2014-005370-
11).<br/>Copyright &#xa9; 2020 British Journal of Anaesthesia

<12>
Accession Number
2004744527
Title
Percutaneous aortic valve intervention in patients scheduled for
noncardiac surgery: A Japanese multicenter study.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2020. Date of
Publication: 2020.
Author
Yamamoto M.; Kagase A.; Shimura T.; Koyama Y.; Tsujimoto S.; Kano S.;
Hosoba S.; Tada N.; Yamanaka F.; Naganuma T.; Araki M.; Shirai S.;
Mizutani K.; Tabata M.; Ueno H.; Takagi K.; Higashimori A.; Watanabe Y.;
Hayashida K.
Institution
(Yamamoto, Kagase, Koyama, Tsujimoto) Department of Cardiology, Nagoya
Heart Canter, Nagoya, Japan
(Yamamoto, Shimura, Kano, Hosoba) Department of Cardiology, Toyohashi
Heart Canter, Toyohashi, Japan
(Tada) Department of Cardiology, Sendai Kosei Hospital, Sendai, Japan
(Yamanaka) Department of Cardiology, Syonan Kamakura General Hospital,
Kanagawa, Japan
(Naganuma) Department of Cardiology, New Tokyo Hospital, Chiba, Japan
(Araki) Department of cardiology, Saiseikai Yokohama City Eastern
Hospital, Yokohama, Japan
(Shirai) Department of cardiology, Kokura Memorial Hospital, Kokura, Japan
(Mizutani) Department of Cardiology, Osaka City General Hospital, Osaka,
Japan
(Tabata) Department of Cardiovascular Surgery, Tokyo Bay Urayasu-Ichikawa
Medical Center, Chiba, Japan
(Ueno) Toyama University Hospital, Toyama, Japan
(Takagi) Ogaki Municipal Hospital, Gifu, Japan
(Higashimori) Kishiwada Tokushukai Hospital, Osaka, Japan
(Watanabe) Department of cardiology, Teikyo University School of Medicine,
Tokyo, Japan
(Hayashida) Department of cardiology, Keio University School of Medicine,
Tokyo, Japan
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: The optimal management of preexisting severe aortic stenosis
(AS) in patients undergoing noncardiac surgery (non-CS) remains uncertain.
This study aimed to investigate the safety and effectiveness of
percutaneous aortic valve intervention (PAVI) in patients with AS before
non-CS. <br/>Method(s): We analyzed pooled data within a multicenter
Japanese registry from 118 patients with severe AS who underwent PAVI
before non-CS. Sixty patients underwent percutaneous balloon aortic
valvuloplasty (BAV) and 58 patients underwent transcatheter aortic valve
replacement (TAVR). The groups' baseline characteristics, perioperative
complications, and 30-day mortality and midterm mortality after non-CS
were compared. <br/>Result(s): The postprocedural mean pressure gradient
was higher in the BAV group than in the TAVR group (35.0 +/- 11.5 mmHg vs.
11.5 +/- 4.8 mmHg, p < 0.001). The non-CS operation risk did not differ
between the groups (p = 0.69). One patient in each group experienced a
noncardiac death (p = 0.74), and the 30-day mortality rate after non-CS
was 1.7%. Heart failure occurred in 2 patients in each group (p = 0.68).
One patient in the TAVR group experienced a non-disabling stroke, and no
myocardial infarctions occurred. Consequently, the combined adverse events
were 5.0% and 6.9% in the 2 groups (p = 0.48). The bleeding rates during
the non-CS were similar in both groups (33.3% vs. 25.9%, p = 0.25). There
were no differences between the groups regarding midterm mortality (p =
0.60), whereas 53.3% of the patients in the BAV group required invasive
treatment of their AS during follow-up. <br/>Conclusion(s): Among patients
with severe AS, PAVI before non-CS reduces the AS severity and may
contribute to procedural safety during non-CS.<br/>Copyright &#xa9; 2019

<13>
Accession Number
2004835375
Title
CRT-600.19 Short- and Long-Term Outcomes of Patients With and Without
End-Stage Renal Disease on Dialysis Undergoing Transcatheter Aortic Valve
Implantation: A Meta-Analysis.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2020 Cardiovascular
Research Technologies. Gaylord National Hotel & Convention Center, United
States. 13 (4 Supplement) (pp S52-S53), 2020. Date of Publication: 24
February 2020.
Author
Kuno T.; Takagi H.; Ando T.; Ueyama H.; Masaki K.; Numasawa Y.; Briasoulis
A.; Hayashida K.
Institution
(Kuno, Ueyama) Mount Sinai Beth Israel, New York, NY, United States
(Takagi) Shizuoka Medical Center, Shizuoka, Japan
(Ando) NewYork-Presbyterian Hospital/Columbia University Medical Center,
New York, NY, United States
(Masaki, Numasawa) Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan
(Briasoulis) Iowa University, Iowa City, IA, United States
(Hayashida) Keio University School of Medicine, Tokyo, Japan
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve implantation (TAVI) has become the
main treatment for symptomatic, severe aortic stenosis, but patients on
dialysis have been excluded from major randomized controlled trials. Our
aim was to compare outcomes after TAVI of patients with end-stage renal
disease (ESRD) on dialysis vs. those without dialysis. <br/>Method(s):
EMBASE and PUBMED were searched through June 2019 to investigate the
comparative outcomes between ESRD patients on dialysis and those without
who underwent TAVI. Primary outcome was short-term (30-day/in-hospital)
mortality and clinical outcomes, and secondary outcome was long-term (> 6
months) all-cause mortality. <br/>Result(s): Our search identified 9
observational studies enrolling a total of 126,849 (5,313 on dialysis)
patients. Patients with dialysis had a significantly higher rate of
short-term and long-term mortality compared to those without (odds ratio
[95% confidential interval]: 2.14 [1.59-2.89], P < 0.0001,
I²=65%; 1.70 [1.35-2.16], P= 0.003, I²=71%,
respectively). In addition, patients on dialysis had significantly higher
rates of short-term life threatening and/or major bleeding, and permanent
pacemaker implantation (odds ratio [95% confidential interval]: 2.08
[1.38-3.13], P= 0.0005, I²=68%; 1.34 [1.16-1.55], P< 0.0001,
I²=0%, respectively), but did not have significantly high rates
of vascular complications and stroke. <br/>Conclusion(s): Dialysis
patients had significantly higher rates of short- and long-term mortality,
life-threatening and/or major bleeding, and permanent pacemaker
implantation. Careful patient selection to determine who would benefit
from TAVI among those with ESRD on dialysis is necessary to prevent
high-rates of post-procedural adverse outcomes.<br/>Copyright &#xa9; 2020

<14>
Accession Number
2004835369
Title
CRT-600.15 Procedural Complications of Transcatheter Aortic-Valve
Replacement Versus Surgical Aortic-Valve Replacement in Low- to
Intermediate-Risk Patients With Severe Aortic Stenosis: A Meta-Analysis of
Randomized Trials.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2020 Cardiovascular
Research Technologies. Gaylord National Hotel & Convention Center, United
States. 13 (4 Supplement) (pp S51), 2020. Date of Publication: 24 February
2020.
Author
Khalid M.F.; Murtaza G.; Kohli V.; Truong T.; Paul T.K.
Institution
(Khalid, Murtaza, Kohli, Paul) East Tennessee State University, Johnson
City, TN, United States
(Truong) Loma Linda University, VA Medical Center, Loma Linda, CA, United
States
Publisher
Elsevier Inc.
Abstract
Background: This study compares procedural complications between
transcatheter aortic-valve replacement (TAVR) and surgical aortic-valve
replacement (SAVR) in low- to intermediate-risk patients with severe
aortic stenosis (AS). <br/>Method(s): PubMed,, Google Scholar and the
Cochrane Central Register of Randomized Controlled Trials (RCTs) were
searched for studies published until September 2019. We analyzed data on
bleeding, atrial fibrillation (AF), major vascular complications and
pacemaker implantation post-procedure during short (<=30 days) and
long-term (>30 days) follow-up. <br/>Result(s): A total of 7 RCTs with
6,805 patients were included. Compared with SAVR, TAVR was associated with
decreased rates of procedural complications, including short-term bleeding
(OR: 0.34, CI: 0.15-0.79, p= 0.01), long-term bleeding (OR: 0.25, CI:
0.20-0.32, p< 0.00001), early AF (OR: 0.15, CI: 0.10-0.21, p< 0.00001),
and late AF (OR: 0.22, CI: 0.14-0.34, p< 0.00001). There were higher rates
of short-term pacemaker implantation (OR: 2.78, CI: 1.56-4.95, p= 0.0005),
long-term pacemaker implantation (OR: 2.99, CI: 1.25-7.15, p= 0.01), and
major vascular complications (OR: 3.02, CI: 1.25-7.30, p< 0.01) in TAVR as
compared to SAVR. <br/>Conclusion(s): This study showed lower rates of
short- and long-term bleeding and early and late AF with TAVR, but higher
rates of short- and long-term pacemaker implantation and major vascular
complications, as compared to SAVR in low- to intermediate-risk patients
with severe AS. [Formula presented]<br/>Copyright &#xa9; 2020

<15>
Accession Number
2004835363
Title
CRT-500.02 Ultrathin Bioresorbable-Polymer Sirolimus-Eluting Stents Versus
Thin Durable-Polymer Everolimus-Eluting Stents in Patients Undergoing
Coronary Revascularization: Three-Year Outcomes From the Randomized
BIOFLOW V Trial.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2020 Cardiovascular
Research Technologies. Gaylord National Hotel & Convention Center, United
States. 13 (4 Supplement) (pp S42), 2020. Date of Publication: 24 February
2020.
Author
Kandzari D.E.; Koolen J.J.; Doros G.; Garcia-Garcia H.M.; Bennett J.;
Roguin A.; Gharib E.G.; Cutlip D.E.; Waksman R.
Institution
(Kandzari) Piedmont Heart Institute, Atlanta, GA, United States
(Koolen) Catharina Hospital, Eindhoven, Netherlands
(Doros) Department of Biostatistics and Epidemiology, Boston University
School of Public Health, Baim Institute for Clinical Research, Boston, MA,
United States
(Garcia-Garcia, Waksman) Division of Interventional Cardiology, MedStar
Cardiovascular Research Network, MedStar Washington Hospital Center,
Washington, DC, United States
(Bennett) Department of Cardiovascular Medicine, University Hospitals
Leuven, Leuven, Belgium
(Roguin) Department of Cardiology, Hillel Yaffe Medical Center, Hadera,
Israel
(Gharib) Charleston Area Medical Center, Charleston, WV, United States
(Cutlip) Beth Israel Deaconess Medical Center, Baim Institute for Clinical
Research, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Coronary drug-eluting stent (DES) development has included new
metal alloys, changes in stent architecture and bioresorbable polymers.
Emerging evidence from comparative study demonstrates improved safety and
efficacy with ultrathin-strut DES. <br/>Method(s): BIOFLOW V
(ClinicalTrials.gov ) was an international, 2:1 randomized trial conducted
in 13 countries comparing an ultrathin-strut (60 mum)
bioresorbable-polymer sirolimus-eluting stent (BP SES) with a thin-strut
(81 mum) durable-polymer everolimus-eluting stent (DP EES) regarding the
primary endpoint of 12-month target lesion failure (TLF). Prespecified
outcomes through 3 years were assessed. <br/>Result(s): Among 1,334
patients randomized to treatment with BP SES (884 patients) or DP EES (450
patients), the 3-year rate of TLF was 8.6% (70/814) for BP SES and 14.4%
(59/411) for DP EES, p=0.003), primarily driven by differences in both
target vessel myocardial infarction (MI; 5.5% [44/804] versus 10.1%
[41/406], p=0.004) and clinically driven target lesion revascularization
(TLR; 3.4% [27/804] versus 6.9% [28/404], p=0.01). In landmark analysis,
significant differences in target vessel MI, TLR and definite late/very
late stent thrombosis were observed favoring treatment with BP SES.
Cardiac death or MI rates were 8.1% (66/813) versus 12.4% (51/410)
(p=0.02) for BP SES and DP EES, respectively. <br/>Conclusion(s): In a
large randomized trial, both TLF and the individual outcomes of target
vessel MI and clinically driven TLR at 3-years follow-up were
significantly lower among patients treated with BP SES versus DP EES.
Late/very late definite stent thrombosis was also significantly lower
among patients treated with BP SES. The outperformance of this ultrathin
BP SES in a complex patient population undergoing percutaneous coronary
intervention suggests a new direction in improving next-generation DES
technology.<br/>Copyright &#xa9; 2020

<16>
Accession Number
2004835304
Title
CRT-600.08 A Comparison of Clinical Outcomes According to the Timing of
PCI and TAVR: A Pooled Analysis From a Multicenter Registry.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2020 Cardiovascular
Research Technologies. Gaylord National Hotel & Convention Center, United
States. 13 (4 Supplement) (pp S48-S49), 2020. Date of Publication: 24
February 2020.
Author
Kumar A.; Sammour Y.; Reginauld S.; Sato K.; Agrawal N.; Meenakshisundaram
C.; Kamioka N.; Sawant A.C.; Devireddy C.; Krishnaswamy A.; Greenbaum
A.B.; Mavromatis K.; Grubb K.; Byku I.; Svensson L.; Tuzcu M.; Block P.C.;
Iyer V.; Kapadia S.; Babaliaros V.
Institution
(Kumar, Reginauld, Kamioka, Devireddy, Greenbaum, Mavromatis, Grubb, Byku,
Block, Babaliaros) Andreas Gruentzig Cardiovascular Center, Emory
University School of Medicine, Atlanta, GA, United States
(Sammour, Sato, Meenakshisundaram, Krishnaswamy, Svensson, Tuzcu, Kapadia)
Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH,
United States
(Agrawal, Sawant, Iyer) Department of Medicine, Division of Cardiology,
State University of New York at Buffalo, Buffalo, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: There is a paucity of data regarding the optimum timing of
percutaneous coronary intervention (PCI) in relation to transcatheter
aortic valve replacement (TAVR). <br/>Method(s): We compared the major
adverse cardiovascular and cerebrovascular events (MACCE) rates among
patients who underwent PCI before TAVR with those who received PCI
with/after TAVR. <br/>Result(s): Among 3,982 consecutive patients who
underwent TAVR, 327 (8%) patients underwent PCI within one year before
TAVR, 38 (1%) had same-day PCI and TAVR, and 15 (0.5%) had PCI within 2
months after TAVR. Overall, among patients who received PCI and TAVR
(n=380), those with a history of previous CABG (HR: 0.501; p=0.001),
higher BMI at TAVR (HR: 0.970; p=0.038) and statin therapy after TAVR
(HR:0.660, p=0.037) were independently associated with lower MACCE, while
Coumadin therapy after TAVR was associated with a higher risk of MACCE
(HR:1.779, p=0.017). Patients who received PCI within 1 year before TAVR
had similar baseline demographics, STS scores and clinical risk factors
compared to patients receiving PCI with/after TAVR. Both groups were
similar in PCI (SYNTAX Score, ACC/AHA lesion class) and TAVR (Valve types,
Access) related variables. Both groups demonstrated similar MACCE (Log
Rank p=0.550), all-cause mortality (Log Rank p=0.433), strokes (Log Rank
p=0.153) and repeat PCI rates (Log Rank p=0.054). The adverse event rates
were similar even after the analysis was repeated after risk-matching the
two groups. A sub-analysis revealed that patients who received PCI within
two months before TAVR (n=205, 54%) had similar MACCE, death, and strokes,
but lower rates of repeat PCI (Log Rank p <0.001) when compared to
patients who received PCI within 2 months after TAVR (n=15).
<br/>Conclusion(s): Among patients who underwent both PCI and TAVR, the
timing of PCI did not have an impact on major adverse events rates.
[Formula presented]<br/>Copyright &#xa9; 2020

<17>
Accession Number
2004835290
Title
CRT-600.26 Vascular Outcomes in Transcatheter Versus Surgical Aortic Valve
Replacement in Previously Placed Permanent Pacemaker Patients.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2020 Cardiovascular
Research Technologies. Gaylord National Hotel & Convention Center, United
States. 13 (4 Supplement) (pp S55), 2020. Date of Publication: 24 February
2020.
Author
Vindhyal M.R.; Ndunda P.; Okut H.; Fanari Z.
Institution
(Vindhyal, Ndunda, Okut, Fanari) KUSM-Wichita, Andover, KS, United States
Publisher
Elsevier Inc.
Abstract
Introduction: There is an increased incidence of pacemaker placement after
TAVR when compared to SAVR. Most of the complications after pacemaker
placement are acute, but late complications have also been reported. No
studies to date have reported vascular outcomes after TAVR or SAVR in
previously placed permanent pacemaker patients. <br/>Method(s): Permanent
pacemaker patients undergoing TAVR (n = 400) or SAVR (n = 400) in 2015
were identified in the National Inpatient Sample (NIS) after undergoing
propensity matching. Baseline characteristics and vascular outcomes were
compared. <br/>Result(s): Patients with previous permanent pacemakers
undergoing TAVR and SAVR had similar mean ages (69.5 vs 69.8) and similar
comorbidities. Propensity-score matching yielded 400 pairs of patients
matched on 36 baseline covariates. TAVR was associated with statistically
significant lower rates of pericardial effusion (2% vs 27%; p = 0.0001),
and cardiac tamponade (1% vs 10%; p < 0.0001), but similar rates of aortic
dissection (0.25% vs 0.25%), and stroke (6.25% vs 8.5%; p = 0.33), when
compared with SAVR. <br/>Conclusion(s): The data show statistically
significant lower rates of pericardial effusion and cardiac tamponade, but
similar rates of stroke and aortic dissection, when compared to SAVR. More
randomized controlled clinical trials are needed to strengthen the study
outcomes in TAVR patients with previously placed pacemaker
patients.<br/>Copyright &#xa9; 2020

<18>
Accession Number
2004835288
Title
CRT-600.21 Clinical Outcomes of Transcatheter Aortic-Valve Replacement
Versus Surgical Aortic-Valve Replacement in Low- to Intermediate-Risk
Patients With Severe Aortic Stenosis.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2020 Cardiovascular
Research Technologies. Gaylord National Hotel & Convention Center, United
States. 13 (4 Supplement) (pp S53-S54), 2020. Date of Publication: 24
February 2020.
Author
Khalid M.F.; Murtaza G.; Ayub M.T.; Kohli V.; Bagai J.; Shanmugasundaram
M.; Paul T.K.
Institution
(Khalid, Murtaza, Kohli, Paul) East Tennessee State University, Johnson
City, TN, United States
(Ayub) Rush University Medical center, Chicago, IL, United States
(Bagai) Vanderbilt University Medical Center, Nashville, TN, United States
(Shanmugasundaram) University of Arizona/ Southern Arizona VA Health Care
System, Tucson, AZ, United States
Publisher
Elsevier Inc.
Abstract
Background: Studies have shown similar outcomes of transcatheter
aortic-valve replacement (TAVR) and surgical aortic-valve replacement
(SAVR) in high-risk patients with severe aortic stenosis (AS). This
meta-analysis of randomized controlled trials (RCTs) aims to compare
outcomes in low- to intermediate-risk patients in light of recently
published data. <br/>Method(s): PubMed,, Google Scholar and the Cochrane
Central Register of Randomized Controlled Trials were searched for studies
published until September 2019. Data on all-cause mortality, stroke, major
adverse cardiac events (MACE) and myocardial infarction (MI) during short-
(<=30 days) and long-term (>30 days) follow-up. <br/>Result(s): A total of
7 RCTs with 6,805 patients were included. There was no significant
difference in short-term all-cause mortality (OR: 0.75, CI: 0.44-1.27, p=
0.28), long-term all-cause mortality (OR: 0.94, CI: 0.77-1.13, p= 0.49),
long-term stroke (OR: 0.73, CI: 0.53-1.01, p= 0.05), MACE (OR: 0.81, CI:
0.47-1.41, p= 0.46), short-term MI (OR: 0.76, CI: 0.48-1.21, p= 0.24), and
long-term MI (OR: 0.96, CI: 0.67-1.38, p= 0.83) between SAVR versus TAVR.
TAVR was associated with decreased rates of short-term stroke (OR: 0.56,
CI: 0.38-0.82, p= 0.003) as compared to SAVR. <br/>Conclusion(s): This
study showed lower rates of short-term stroke in TAVR as compared to SAVR.
TAVR is comparable to SAVR in terms of all-cause mortality, long-term
stroke, MACE and MI in low- to intermediate-risk patients with severe AS.
[Formula presented]<br/>Copyright &#xa9; 2020

<19>
Accession Number
2004835285
Title
CRT-600.01 Comparison of Valve Performance of the Intra-Annular
Self-Expanding PorticoTM Transcatheter Aortic Valve With Contemporary
Supra-Annular Self-Expanding and Intra-Annular Balloon-Expandable Valves:
Insights From the PORTICO IDE Trial.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2020 Cardiovascular
Research Technologies. Gaylord National Hotel & Convention Center, United
States. 13 (4 Supplement) (pp S46), 2020. Date of Publication: 24 February
2020.
Author
Makkar R.R.; Waksman R.; Groh M.; Russo M.J.; Hermiller J.; Worthley S.;
Chehab B.; Asch F.M.; Sharma R.P.; Jilaihawi H.; Pichard A.D.; Reardon
M.J.; Fontana G.P.
Institution
(Makkar) Cedars-Sinai Heart Institute, Los Angeles, CA, United States
(Waksman) Washington Hospital Center, Washington, DC, United States
(Groh) Mission Health and Hospitals, Asheville, NC, United States
(Russo) Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ,
Canada
(Hermiller) St Vincent Heart Center, Indianapolis, IN, United States
(Worthley) GenesisCare, Sydney, Australia
(Chehab) Cardiovascular Research Institute of Kansas, Wichita, KS, United
States
(Asch) MedStar Health Research Institute, Washington, DC, United States
(Sharma) Stanford University Medical Center, Stanford, CA, United States
(Jilaihawi) NYU Langone Health, New York, NY, United States
(Pichard) Abbott, Abbott Park, IL, United States
(Reardon) Houston Methodist Hospital, Houston, TX, United States
(Fontana) Los Robles Regional Medical Center, Thousand Oaks, CA, United
States
Publisher
Elsevier Inc.
Abstract
Background: Supra-annular self-expanding transcatheter heart valves (THVs)
are associated with superior hemodynamics and low prosthetic-patient
mismatch (PPM). The PORTICO IDE trial is the first large, head-to-head
device study to compare the performance of three THV designs; the
intra-annular self-expanding PorticoTM valve (Abbott, IL), supra-annular
self-expanding valves, and intra-annular balloon-expandable valves. We
compared hemodynamics, aortic regurgitation and PPM in severe aortic
stenosis patients implanted with a Portico valve and contemporary THVs
(EvolutTM R/PRO (Medtronic, MN) vs SAPIENTM 3 (Edwards Lifesciences, CA)
valves). <br/>Method(s): The post hoc analysis included a subset of
randomized (1:1) subjects implanted per the assigned treatment (Portico
valve vs any commercial valve). Post-procedural transvalvular gradients,
aortic valve area (AVA), indexed effective orifice area and paravalvular
leak (PVL) were obtained using TTE and analyzed by an independent echo
core lab. Prosthesis valve sizing was guided by pre-procedural CT.
Clinically significant PVL and PPM were based on VARC-2 criteria.
<br/>Result(s): 682 subjects implanted with a Portico valve (n=366),
Evolut R/PRO (n=110) or SAPIEN 3 (N=206) were analyzed. At 1 year, Portico
valve was associated with mean gradients (8.57 vs 7.82 mmHg; p=0.10) and
AVA (1.81 vs 1.83cm^2; p=0.80) comparable to Evolut R/PRO; and
superior to SAPIEN 3 (mean gradient 12.42 mmHg and AVA 1.62cm²;
both p<=0.0001). Moderate or greater PVL was higher with Portico valve
compared to SAPIEN 3 at 30 days (6.1% vs 1.6%; p=0.02) and 1 year (7.6% vs
1.3%; p=0.006); but comparable to Evolut R/PRO (4.0% at 30 days; p=0.42
and 2.4% at 1 year; p=0.09). Significant PPM at discharge was 24.8%
(severe: 5.6%) with Portico valve versus 27.6% (severe: 5.1%) with Evolut
R/PRO (p=0.77) and 45.8% (severe: 10.0%) with SAPIEN 3 (p<0.0001). The
long-term clinical impact of significant PPM on hemodynamics and mortality
will be available at the time of the presentation. <br/>Conclusion(s):
Valve performance of the intra-annular self-expanding Portico valve was
comparable to contemporary supra-annular self-expanding valves and
superior, except for PVL, to intra-annular balloon-expandable
valves.<br/>Copyright &#xa9; 2020

<20>
Accession Number
2004835261
Title
CRT-600.20 Transcatheter Aortic Valve Replacement Outcomes in Patients
With Low-Gradient Severe Aortic Stenosis: A Systematic Review and
Meta-Analysis.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2020 Cardiovascular
Research Technologies. Gaylord National Hotel & Convention Center, United
States. 13 (4 Supplement) (pp S53), 2020. Date of Publication: 24 February
2020.
Author
Malik Q.; Saqib N.; Pir M.; Mian R.; Abdul H.; Durkin R.; Puleo P.;
Shirani J.
Institution
(Malik, Durkin, Puleo, Shirani) St. Luke's University Health Network,
Bethlehem, PA, United States
(Saqib, Pir, Mian, Abdul) Wright Center For Graduate Medical Education,
Scranton, PA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) has gained
popularity due to its safety and feasibility in severe aortic stenosis
(AS). There are limited outcomes data for TAVR performed in low-flow,
low-gradient (LFLG) severe AS. <br/>Method(s): Systemic review of
literature identified 9 studies (n=24327; mean age 83 years, 50% men) with
outcomes data in LFLG AS (mean gradient <40 mmHg) patients undergoing
TAVR. Meta-analysis was performed to compare 30-day and 1-year mortality
in patient with LFLG versus normal-flow high-gradient (NFHG; mean gradient
>=40 mm Hg). Sub-group analysis was also performed to compare LFLG AS
patients with preserved (LFLG-PEF) or reduced (LFLG-REF). <br/>Result(s):
TAVR in LFLG severe AS was associated with worse 30-day (OR= 1.56; 95%
CI=1.20-2.03, P<0.01) and 1-year (OR=1.44; 95% CI=1.27-1.63, P<0.01)
outcomes [Figures 1a and 1b]. On sub-group analysis, LFLG-REF as compared
to NFHG was associated with worse 30-day (OR=1.64; 95% CI=1.27-2.12,
P<0.01) mortality [Figure 1c]. There was no significant difference in
30-day mortality between LFLG-PEF and NFHG (p = 0.39) [Figure 1d].
<br/>Conclusion(s): TAVR in patients with LFLG severe AS is associated
with worse 30-day and 1-year mortality compared to NFHG AS. Preserved left
ventricular ejection fraction is associated with lower 30-day post-TAVR
mortality in patients with LFLG severe AS. [Formula
presented]<br/>Copyright &#xa9; 2020

<21>
Accession Number
2004835243
Title
CRT-100.80 Percutaneous Coronary Intervention Versus Coronary Artery
Bypass Grafting for Unprotected Left Main Coronary Artery Stenosis -
Meta-Analysis of Randomized Controlled Trials.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2020 Cardiovascular
Research Technologies. Gaylord National Hotel & Convention Center, United
States. 13 (4 Supplement) (pp S20-S21), 2020. Date of Publication: 24
February 2020.
Author
Khalid M.F.; Murtaza G.; Ayub M.T.; Kohli V.; Paul T.K.
Institution
(Khalid, Murtaza, Kohli, Paul) East Tennessee State University, Johnson
City, TN, United States
(Ayub) Rush University Medical center, Chicago, IL, United States
Publisher
Elsevier Inc.
Abstract
Background: Studies comparing outcomes of percutaneous coronary
intervention (PCI) and coronary artery bypass grafting (CABG) for
unprotected left main coronary artery (ULMCA) stenosis have shown
conflicting results. <br/>Method(s): Electronic databases including
MEDLINE, and the Cochrane Library were searched for all randomized
controlled trials (RCTs) published until October 1, 2019, comparing
outcomes of PCI versus CABG for ULMCA. End points were major adverse
cardiac events (MACE), myocardial infarction (MI), all-cause mortality,
early and late revascularization, and stroke. The odds ratio (OR)/risk
ratio (RR) with 95% confidence interval (CI) were computed and p <0.05 was
considered as a level of significance. <br/>Result(s): A total of 6 RCTs
(n=4,686) were included in the final analysis. There were decreased rates
of MACE (RR: 1.23; CI: 1.05-1.43; p=0.01), and late revascularization (OR:
1.78; CI: 1.45-2.19; p<0.00001) with CABG as compared to PCI of ULMCA.
There was no significant difference in MI (OR: 1.31; CI: 0.85-2.03;
p=0.22), all-cause mortality; (OR: 0.99; CI: 0.75-1.31; p=0.94), early
revascularization (OR: 0.66; CI: 0.27-1.64; p=0.38), and stroke (OR: 0.85;
CI: 0.38-1.92; p=0.70) between the 2 groups. <br/>Conclusion(s): In
patients with ULMCA, there were decreased rates of MACE and late
revascularization with CABG, while no significant difference in MI,
all-cause mortality and stroke between CABG versus PCI [Formula
presented]<br/>Copyright &#xa9; 2020

<22>
Accession Number
2004835225
Title
CRT-600.42 Short-Term Reinterventions and Mortality in Transcatheter
Mitral Valve Repair Patients With Chronic Kidney Disease: A Systematic
Review and Meta-Analysis.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2020 Cardiovascular
Research Technologies. Gaylord National Hotel & Convention Center, United
States. 13 (4 Supplement) (pp S59), 2020. Date of Publication: 24 February
2020.
Author
Dave P.; Abunassar J.; Sayed N.; Babiolakis C.; Bisleri G.; Abuzeid W.
Institution
(Dave, Abunassar, Sayed, Babiolakis, Bisleri, Abuzeid) Queen's University,
Kingston, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Select symptomatic patients with severe Mitral Regurgitation
(MR) can have clinically significant benefit from Transcatheter Mitral
Valve Repair (TMVR). Reintervention on the Mitral Valve post-repair is
costly and subjects patients to further procedural risk. Chronic kidney
disease (CKD) is correlated with mitral annular calcification, which is
associated with peri-surgical complications and is thought to make
interventions more technically challenging. There are limited data on the
effect of TMVR on mortality in patients with chronic kidney disease and
the relationship of CKD with reintervention. <br/>Method(s): A systematic
review and meta-analysis was conducted on outcomes, including mortality
and reintervention rates, in patients with CKD undergoing TMVR. Three
databases were searched (Ovid MEDLINE, EMBASE, EBM reviews) from inception
to October 13, 2019. <br/>Result(s): We identified 1037 articles, of which
12 articles were included based on pre-specified inclusion criteria. A
total of 6828 patients were treated with TMVR from August 2008 to June
2016 with follow-up ranging from 30 days to 2 years. 4465 patients (65%)
had CKD defined as a GFR below 60 mL/min/1.73m². Overall, TMVR
is associated with increased 30-day mortality in patients with CKD (OR:
1.67, p<0.05). Patients with CKD are not associated with an increased rate
of reintervention at 30-days (OR: 0.836, p=0.47). <br/>Conclusion(s): CKD
is a predictor of 30-day mortality in patients undergoing TMVR. Despite
this, it was not a predictor for reintervention, implying the increased
mortality rate in these patients is not directly connected to requirement
for repeat Mitral Valve intervention. Furthermore, it establishes a
direction for future studies to investigate the underlying etiology
driving worse short-term outcomes in CKD patients. [Formula
presented]<br/>Copyright &#xa9; 2020

<23>
Accession Number
630802576
Title
Retrograde autologous priming to reduce allogeneic blood transfusion
requirements: a systematic review.
Source
Perfusion. (pp 267659119895474), 2020. Date of Publication: 03 Feb 2020.
Author
Vranken N.P.; Babar Z.U.; Montoya J.A.; Weerwind P.W.
Institution
(Vranken, Babar, Weerwind) Department of Cardiothoracic Surgery,
Maastricht University Medical Center, Maastricht, Netherlands
(Vranken, Weerwind) Cardiovascular Research Institute Maastricht,
Maastricht University Medical Center, Maastricht, Netherlands
(Montoya) Perfusion Sciences Program, Department of Pharmacology,
University of Arizona, AZ, Tucson, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Efforts have been made to minimize transfusion of packed red
blood cells in patients undergoing cardiac surgery with cardiopulmonary
bypass. One method concerns retrograde autologous priming. Although the
technique has been used for decades, results remain contradictory in terms
of transfusion requirements. <br/>OBJECTIVE(S): This systematic literature
review aimed to summarize the evidence for the efficacy of retrograde
autologous priming in terms of decreasing perioperative packed red blood
cell requirements in adults. <br/>METHOD(S): Two researchers independently
searched PubMed for articles published in the past 10years. The modified
Cochrane collaboration Risk of Bias Tool and the Research Triangle
Institute Item Bank were used to assess bias. <br/>RESULT(S): Eight
studies were included, of which two randomized and six observational
studies. Five studies, including one randomized study, report a
significant decrease in packed red blood cell use in the retrograde
autologous priming group compared to no retrograde autologous priming
used. All studies are flawed by at least a high risk bias of bias score on
one item of the bias assessment. <br/>CONCLUSION(S): Although most studies
reported significantly fewer packed red blood cell transfusions in the
retrograde autologous priming group, it is important to note that
relatively few articles are available which are flawed by several types of
bias. Prospective, randomized multi-center trials are warranted to
conclude decisively on the benefits of retrograde autologous priming.

<24>
Accession Number
630804089
Title
Impact of minimally invasive extracorporeal circulation on coagulation-a
randomized trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2020.
Date of Publication: 03 Feb 2020.
Author
Modrau I.S.; Halle D.R.; Nielsen P.H.; Kimose H.H.; Greisen J.R.; Kremke
M.; Hvas A.-M.
Institution
(Modrau, Halle, Nielsen, Kimose) Department of Cardiothoracic and Vascular
Surgery, Aarhus University Hospital, Aarhus, Denmark
(Modrau, Kimose, Greisen, Hvas) Department of Clinical Medicine, Aarhus
University, Aarhus, Denmark
(Greisen, Kremke) Department of Anaesthesiology and Intensive Care, Aarhus
University Hospital, Aarhus, Denmark
(Hvas) Department of Clinical Biochemistry, Aarhus University Hospital,
Aarhus, Denmark
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Minimally invasive extracorporeal circulation (MiECC) is
suggested to have favourable impact on blood loss compared to conventional
extracorporeal circulation. We aimed to compare the impact of both systems
on coagulation. <br/>METHOD(S): Randomized trial comparing endogenous
thrombin-generating potential early after elective coronary surgery
employing either MiECC group (n=30) or conventional extracorporeal
circulation group (n=30). Secondary outcomes were in vivo thrombin
generation, bleeding end points and haemodilution, as well as morbidity
and mortality up to 30-day follow-up. <br/>RESULT(S): Compared to the
conventional extracorporeal circulation group, the MiECC group showed (i)
a trend towards a higher early postoperative endogenous
thrombin-generating potential (P=0.06), (ii) lower intraoperative levels
of thrombin-antithrombin complex and prothrombin fragment 1+2 (P<0.001),
(iii) less haemodilution early postoperatively as measured by haematocrit
and weight gain, but without correlation to coagulation factors or
bleeding end points. Moreover, half as many patients required
postoperative blood transfusion in the MiECC group (17% vs 37%, P=0.14),
although postoperative blood loss did not differ between groups (P=0.84).
Thrombin-antithrombin complex levels (rs=0.36, P=0.005) and prothrombin
fragment 1+2 (rs=0.45, P<0.001), but not early postoperative endogenous
thrombin-generating potential (rs=0.05, P=0.72), showed significant
correlation to increased transfusion requirements. The MiECC group
demonstrated significantly lower levels of creatine kinase-MB, lactate
dehydrogenase and free haemoglobin indicating superior myocardial
protection, less tissue damage and less haemolysis, respectively.
Perioperative morbidity and 30-day mortality did not differ between
groups. <br/>CONCLUSION(S): Conventional but not MiECC is associated with
significant intraoperative thrombin generation despite full
heparinization. No correlation between coagulation factors or bleeding end
points with the degree of haemodilution could be ascertained.
CLINICALTRIALS.GOV IDENTIFIER: NCT03216720.<br/>Copyright &#xa9; The
Author(s) 2020. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<25>
Accession Number
630803804
Title
A meta-analysis of bridging anticoagulation between low molecular weight
heparin and heparin.
Source
Medicine. 99 (3) (pp e18729), 2020. Date of Publication: 01 Jan 2020.
Author
Tao E.; Luo Y.L.; Tao Z.; Wan L.
Institution
(Tao, Wan) Department of Cardiovascular Surgery of The First Affiliated
Hospital of Nanchang University
(Luo) Department of Neurosurgery of Guandong 39 Brain Hospital, Guan dong
(Tao) Department of Anesthesiology of The First Affiliated Hospital of
Nanchang University, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients with mechanical heart valves (MHV) have an increased
risk of thromboembolic complications. Low molecular weight heparin (LMWH)
and unfractionated heparin (UFH) are often recommended for bridging
anticoagulation; however, it is not clear which strategy is more
beneficial. <br/>METHOD(S): The PubMed, EMBASE, and Cochrane databases
were searched from January 1960 to March 2019. Randomized controlled
trials and observational studies were analyzed. The Newcastle-Ottawa Scale
(NOS) was used to evaluate the quality of the studies. Stata 11.0 was used
for the meta-analysis. <br/>RESULT(S): A total of 6 publications were
included; 1366 events were selected, involving 852 events with LMWH and
514 events with UFH. The thromboembolism risk of the LMWH group was lower
than that of the UFH group (risk ratio [RR] = 0.34, 95% confidence
interval [CI] 0.12-0.95, P = .039). The incidence of major bleeding was
lower in the LMWH group than in the UFH group, albeit without statistical
significance (RR = 0.94, 95% CI 0.68-1.30, P = .728), as was mortality (RR
= 0.52, 95% CI 0.16-1.66, P = .271). Subgroup analysis showed that LMWH
cardiac surgery patients had a higher risk of major bleeding compared with
UFH cardiac surgery patients (RR = 1.17, 95% CI 0.72-1.90, P = .526); but
among non-cardiac surgery patients, the LMWH group had a lower risk of
major bleeding than the UFH group (RR = 0.79, 95% CI 0.51-1.22, P = .284),
although the difference was not statistically significant.
<br/>CONCLUSION(S): Our meta-analysis suggests that LMWH not only reduces
the risk of thromboembolism in patients with MHV but also does not
increase the risk of major bleeding. LMWH may provide safer and more
effective bridging anticoagulation than UFH in patients with MHV. It is
still necessary to conduct future randomized studies to verify this
conclusion.

<26>
Accession Number
630797914
Title
Effect of Eye Masks on Pain and Sleep Quality in Patients Undergoing
Cardiac Surgery: A Randomized Controlled Trial.
Source
Critical care nurse. 40 (1) (pp 27-35), 2020. Date of Publication: 01 Feb
2020.
Author
Mahran G.S.; Leach M.J.; Abbas M.S.; Abbas A.M.; Ghoneim A.M.
Institution
(Mahran) Critical Care Nursing Department, Faculty of Nursing, Assiut
University, Ghada Shalaby Mahran is a lecturer of critical care, Egypt
(Leach) Department of Rural Health, Division of Health Sciences,
University of South Australia, Matthew J. Leach is a senior research
fellow, Adelaide, SA, Australia
(Abbas) Department of Anesthesia and Intensive Care, Faculty of Medicine,
Assiut University, Mostafa Samy Abbas is an assistant professor
(Abbas) Department of Obstetrics and Gynecology, Faculty of Medicine,
Assiut University, Ahmed M. Abbas is an assistant professor
(Ghoneim) Department of Cardio-thoracic Surgery, Faculty of Medicine,
Assiut University, Ahmed Mohamed Ghoneim is a professor
Publisher
NLM (Medline)
Abstract
BACKGROUND: Impaired sleep is a common complaint among patients undergoing
major surgery and may be a contributing factor in postoperative pain. The
provision of eye masks to patients after cardiac surgery may reduce
postoperative pain through improvements in sleep quality.
<br/>OBJECTIVE(S): To examine the effect of nocturnal eye masks on
postoperative pain and sleep quality in cardiac surgical patients.
<br/>METHOD(S): In this randomized controlled trial, 70 adult patients who
had undergone cardiac surgery requiring immediate postoperative care in
the intensive care unit were randomly assigned to sleep with or without
nocturnal eye masks for the first 3 nights in the unit. A visual analog
scale was used to assess pain intensity, and the Arabic version of the
Richards-Campbell Sleep Questionnaire was used to assess subjective sleep
quality. <br/>RESULT(S): A total of 66 patients completed the trial. A
statistically significant difference was found between groups in mean
total Richards-Campbell Sleep Questionnaire score over the 3-day study
period (P = .001), with the intervention group reporting better sleep
quality. A statistically significant difference was also found between
groups in mean pain score on days 1, 2, and 3 (P < .001), with the
intervention group having less pain. <br/>CONCLUSION(S): Nocturnal eye
masks are a simple, low-risk, low-cost intervention that may contribute to
reductions in perceived pain in cardiac surgery patients.<br/>Copyright
&#xa9;2020 American Association of Critical-Care Nurses.

<27>
Accession Number
2004179725
Title
Ultrasound-guided continuous deep serratus anterior plane block versus
continuous thoracic paravertebral block for perioperative analgesia in
videoscopic-assisted thoracic surgery.
Source
European Journal of Pain (United Kingdom). (no pagination), 2020. Date of
Publication: 2020.
Author
Hanley C.; Wall T.; Bukowska I.; Redmond K.; Eaton D.; Ni Mhuircheartaigh
R.; Hearty C.
Institution
(Hanley, Wall, Bukowska, Ni Mhuircheartaigh, Hearty) Department of
Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland
(Redmond, Eaton) Department of Cardiothoracic Surgery, Mater Misericordiae
University Hospital, Dublin, Ireland
Publisher
Blackwell Publishing Ltd
Abstract
Background: The deep serratus anterior plane block (SAPB) is a promising
novel regional anaesthesia technique for blockade of the anterolateral
chest wall. Evidence for the efficacy of SAPB versus other analgesic
techniques in thoracic surgery remains inadequate. <br/>Aim(s): This study
compared ultrasound-guided continuous SAPB with a surgically placed
continuous thoracic paravertebral block (SPVB) technique in patients
undergoing videoscopic-assisted thoracic surgery (VATS). <br/>Method(s):
In a single-centre, double-blinded, randomized, non-inferiority study, we
allocated 40 patients undergoing VATS to either SAPB or SPVB, with both
groups receiving otherwise standardized treatment, including multimodal
analgesia. The primary outcome was 48-hr opioid consumption. Secondary
outcomes included numerical rating scale (NRS) for postoperative pain,
patient-reported worst pain score (WPS) as well as functional measures
(including mobilization distance and cough strength). <br/>Result(s): A
48-hr opioid consumption for the SAPB group was non-inferior compared with
SPVB. SAPB was associated with improved NRS pain scores at rest, with
cough and with movement at 24 hr postoperatively (p =.007, p =.001 and p
=.012, respectively). SAPB was also associated with a lower WPS (p =.008).
Day 1 walking distance was improved in the SAPB group (p =.012), whereas
the difference in cough strength did not reach statistical significance (p
=.071). There was no difference in haemodynamics, opioid side effects,
length of hospital stay or patient satisfaction between the two groups.
<br/>Conclusion(s): The SAPB, as part of a multimodal analgesia regimen,
is non-inferior in terms of 48-hr opioid consumption compared to SPVB and
is associated with improved functional measures in thoracic surgical
patients. ClinicalTrials.gov Identifier: NCT03768193. <br/>Significance:
The SAPB interfascial plane block is an efficacious alternative method of
opioid-sparing analgesia in high-risk thoracic surgical patients as part
of an enhanced recovery programme.<br/>Copyright &#xa9; 2020 European Pain
Federation - EFIC

<28>
Accession Number
2004744305
Title
Rationale and design of the Flow Evaluation to Guide Revascularization in
Multivessel ST-Elevation Myocardial Infarction (FLOWER-MI) trial.
Source
American Heart Journal. 222 (pp 1-7), 2020. Date of Publication: April
2020.
Author
Puymirat E.; Simon T.; de Bruyne B.; Montalescot G.; Steg G.; Cayla G.;
Durand-Zaleski I.; Blanchard D.; Danchin N.; Chatellier G.
Institution
(Puymirat, Blanchard, Danchin) Assistance Publique-Hopitaux de Paris
(AP-HP), hopital Europeen Georges Pompidou, Department of Cardiology,
Paris, France
(Puymirat, Blanchard, Danchin) Universite Paris-Descartes, Paris 75006,
France
(Puymirat, Simon, Steg, Danchin) French Alliance for Cardiovascular Trials
(FACT), France
(Simon) AP-HP, hopital Saint Antoine, Department of Clinical Pharmacology
and Unite de Recherche Clinique (URCEST), Paris, France
(Simon) Universite Pierre et Marie Curie (UPMC-Paris 06), INSERM U-698,
Paris, France
(de Bruyne) Cardiovascular Center Aalst, Aalst, Belgium
(de Bruyne) Department of Cardiology, Lausanne University Center Hospital,
Lausanne, Switzerland
(Montalescot) Sorbonne universite, Paris, France
(Steg) Universite Paris-Diderot, Sorbonne Paris Cite, INSERM Unite-1148,
and Hopital Bichat, Assistance Publique-Hopitaux de Paris, Paris, France
(Steg) Royal Brompton Hospital, Imperial College, London, United Kingdom
(Cayla) Centre Hospitalier Universitaire de Nimes, Nimes, France
(Durand-Zaleski) Clinical Research Unit Eco Ile de France, hopital Hotel
Dieu, AP-HP, Paris, France
(Chatellier) Clinical Research Unit and CIC 1418 INSERM, George-Pompidou
European Hospital, AP-HP, Paris, France
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: In ST-elevation myocardial infarction (STEMI) patients
presenting with multivessel disease (MVD), recent studies have
demonstrated the superiority of fractional flow reserve (FFR)-guided
percutaneous coronary intervention (PCI) for non-culprit lesions compared
to culprit lesion treatment-only therapy. FFR- and angio-guided PCI have
however never been compared in STEMI patients. Trial design: FLOWER-MI is
an open-label multicenter national randomized clinical trial. The aim is
to investigate FFR-guided complete revascularization in comparison to
angio-guided complete revascularization in STEMI patients with successful
PCI of the culprit lesion and >=50% stenosis in at least one additional
non-culprit lesion requiring PCI. Eligible patients will be randomized
after successful primary PCI in a 1:1 fashion to either FFR-guided or
angio-guided complete revascularization during the index procedure or a
staged procedure before discharge (<=5 days). Patients assigned to FFR
guidance first have FFR measured in each non-culprit vessel and only
undergo PCI if FFR is <=0.80. The primary end point of the study is a
composite of major adverse cardiac events, including all-cause death,
non-fatal MI, and unplanned hospitalization leading to urgent
revascularization at 1 year. Secondary end points will include the
individual adverse events, cost-effectiveness, quality of life, and
30-day, 6-month, and 3-year outcomes. Based on estimated event rates, a
sample size of 1170 patients is needed to show superiority of the
FFR-guided revascularization with 80% power. <br/>Conclusion(s): The aim
of FLOWER-MI trial is to assess whether FFR-guided complete
revascularization in the acute setting is superior angio-guided complete
revascularization.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<29>
Accession Number
2003929550
Title
Postinfarction intramyocardial dissection, an interesting case report and
systematic review.
Source
Echocardiography. 37 (1) (pp 124-131), 2020. Date of Publication: 01 Jan
2020.
Author
Hajsadeghi S.; Amirfarhangi A.; Pakbaz M.; Pazoki M.; Tanha K.
Institution
(Hajsadeghi) Research Center for Prevention of Cardiovascular Disease,
Institute of Endocrinology & Metabolism, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Amirfarhangi, Pakbaz, Pazoki) Department of Cardiovascular Disease,
Hazrat-e Rasool General Hospital, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Tanha) Department of Biostatistics, School of Public Health, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Intramyocardial dissection (IMD) with ventricular septal rupture (VSR)
following myocardial infarction (MI) is a rare subacute form of cardiac
rupture. The evidence available in this regard is scarce. We aimed to
share our experience and conduct a systematic review of previous cases. We
searched the literature and performed a systematic review of previous
cases. A total of 37 cases of IMD with VSR were included (1 our original
and 36 literature cases). Mean age was 68 +/- 8 years and 20 (54.1%)
patients were male. Anterior and inferior MI were observed in 14 (37.8%)
and 23 (62.2%) cases, respectively. The dissected area was the septum, RV,
both septum and RV, or LV apex in 21 (56.8%), 9 (24.3%), 5 (13.5%), and 2
(5.4%), respectively. Apicoseptal and inferoseptal VSR were observed in 15
(40.5%) and 22 (59.5%) cases, respectively. At least one occluded artery
was observed in 29 (90.6%) of cases. Reperfusion therapy was done for 15
(40.5%) cases before the VSR occurred. Surgery, percutaneous, and medical
therapy were done for 26 (70.3%), 3 (8.1%), and 7 (18.9%) cases,
respectively. The mortality rate was significantly higher in the medical
versus surgical-treated group (85.7% versus 42.3%, P =.027). There was a
trend to higher mortality in the group with dissection of both septum and
RV (P =.15). We concluded that echocardiography has a critical role in
diagnosing this complication. Surgery is mandatory in IMD with
VSR.<br/>Copyright &#xa9; 2019 Wiley Periodicals, Inc.

<30>
Accession Number
2004744336
Title
Mortality After Repeat Revascularization Following PCI or CABG for Left
Main Disease: The EXCEL Trial.
Source
JACC: Cardiovascular Interventions. 13 (3) (pp 375-387), 2020. Date of
Publication: 10 February 2020.
Author
Giustino G.; Serruys P.W.; Sabik J.F.; Mehran R.; Maehara A.; Puskas J.D.;
Simonton C.A.; Lembo N.J.; Kandzari D.E.; Morice M.-C.; Taggart D.P.;
Gershlick A.H.; Ragosta M.; Kron I.L.; Liu Y.; Zhang Z.; McAndrew T.;
Dressler O.; Genereux P.; Ben-Yehuda O.; Pocock S.J.; Kappetein A.P.;
Stone G.W.
Institution
(Giustino, Mehran, Stone) The Zena and Michael A. Wiener Cardiovascular
Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Serruys) Imperial College of Science, Technology and Medicine, London,
United Kingdom
(Sabik) Department of Surgery, UH Cleveland Medical Center, Cleveland, OH,
United States
(Mehran, Maehara, Lembo, Liu, Zhang, McAndrew, Dressler, Genereux,
Ben-Yehuda, Stone) Clinical Trials Center, Cardiovascular Research
Foundation, New York, NY, United States
(Maehara, Lembo, Ben-Yehuda) NewYork-Presbyterian Hospital/Columbia
University Medical Center, New York, NY, United States
(Puskas) Mount Sinai Heart at Mount Sinai St Luke's, New York, NY, United
States
(Simonton) Abbott Vascular, Santa Clara, CA, United States
(Kandzari) Piedmont Heart Institute, Atlanta, Georgia
(Morice) Ramsay Generale de Sante, Hopital Prive Jacques Cartier, Massy,
France
(Taggart) Department Cardiac Surgery, John Radcliffe Hospital, Oxford,
United Kingdom
(Gershlick) University Hospitals of Leicester, Leicester, United Kingdom
(Ragosta, Kron) Division of Cardiovascular Medicine, University of
Virginia Health System, Charlottesville, VA, United States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Genereux) Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
(Pocock) Department of Medical Statistics, London School of Hygiene and
Tropical Medicine, London, United Kingdom
(Kappetein) Erasmus University Medical Center, Rotterdam, Netherlands
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: The aim of this study was to investigate the incidence and
impact on mortality of repeat revascularization after index percutaneous
coronary intervention (PCI) or coronary artery bypass grafting (CABG) for
left main coronary artery disease (LMCAD). <br/>Background(s): The impact
on mortality of the need of repeat revascularization following PCI or CABG
in patients with unprotected LMCAD is unknown. <br/>Method(s): All
patients with LMCAD and site-assessed low or intermediate SYNTAX (Synergy
Between PCI With Taxus and Cardiac Surgery) scores randomized to PCI (n =
948) or CABG (n = 957) in the EXCEL (Evaluation of XIENCE Versus Coronary
Artery Bypass Surgery for Effectiveness of Left Main Revascularization)
trial were included. Repeat revascularization events were adjudicated by
an independent clinical events committee. The effect of repeat
revascularization on mortality through 3-year follow-up was examined in
time-varying Cox regression models. <br/>Result(s): During 3-year
follow-up, there were 346 repeat revascularization procedures among 185
patients. PCI was associated with higher rates of any repeat
revascularization (12.9% vs. 7.6%; hazard ratio: 1.73; 95% confidence
interval: 1.28 to 2.33; p = 0.0003). Need for repeat revascularization was
independently associated with increased risk for 3-year all-cause
mortality (adjusted hazard ratio: 2.05; 95% confidence interval: 1.13 to
3.70; p = 0.02) and cardiovascular mortality (adjusted hazard ratio: 4.22;
95% confidence interval: 2.10 to 8.48; p < 0.0001) consistently after both
PCI and CABG (p<inf>int</inf> = 0.85 for both endpoints). Although target
vessel revascularization and target lesion revascularization were both
associated with an increased risk for mortality, target vessel non-target
lesion revascularization and non-target vessel revascularization were not.
<br/>Conclusion(s): In the EXCEL trial, repeat revascularization during
follow-up was performed less frequently after CABG than PCI and was
associated with increased mortality after both procedures. Reducing the
need for repeat revascularization may further improve long-term survival
after percutaneous or surgical treatment of LMCAD. (EXCEL Clinical Trial;
NCT01205776)<br/>Copyright &#xa9; 2020 American College of Cardiology
Foundation

<31>
Accession Number
630640148
Title
The impact of Centre's heart transplant status and volume on in-hospital
outcomes following extracorporeal membrane oxygenation for refractory
post-cardiotomy cardiogenic shock: A meta-analysis.
Source
BMC Cardiovascular Disorders. 20 (1) (no pagination), 2020. Article
Number: 10. Date of Publication: 09 Jan 2020.
Author
Kowalewski M.; Raffa G.M.; Zielinski K.; Alanazi M.; Gilbers M.; Heuts S.;
Natour E.; Bidar E.; Schreurs R.; Delnoij T.; Driessen R.; Sels J.-W.; Van
De Poll M.; Roekaerts P.; Meani P.; Maessen J.; Suwalski P.; Lorusso R.
Institution
(Kowalewski, Suwalski) Department of Cardiac Surgery, Central Clinical
Hospital, Ministry of Interior, Centre of Postgraduate Medical Education,
Warsaw, Poland
(Kowalewski, Alanazi, Gilbers, Heuts, Natour, Bidar, Schreurs, Maessen,
Lorusso) Cardio-Thoracic Surgery Department, Maastricht University Medical
Centre, Cardiovascular Research Institute Maastricht (CARIM), Maastricht,
Netherlands
(Kowalewski) Cardiothoracic Research Centre, Innovative Medical Forum,
Bydgoszcz, Poland
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, ISMETT-IRCCS, Palermo, Italy
(Zielinski) Medical University of Warsaw, Warsaw, Poland
(Delnoij, Driessen, Sels, Meani) Cardiology Department, Maastricht
University Medical Centre, Maastricht, Netherlands
(Delnoij, Driessen, Sels, Van De Poll, Roekaerts, Meani) Department of
Intensive Care, Maastricht University Medical Centre, Maastricht,
Netherlands
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Postcardiotomy cardiogenic shock (PCS) that is refractory to
inotropic support remains a major concern in cardiac surgery and is almost
universally fatal unless treated with mechanical support. While reported
mortality rates on ECMO vary from center to center, aim of the current
report is assess if the outcomes differ between centres according to
volume and heart transplantation status. <br/>Method(s): A systematic
search was performed according to PRISMA statement using PubMed/Medline
databases between 2010 and 2018. Relevant articles were scrutinized and
included in the meta-analysis only if reporting in-hospital/30-day
mortality and heart transplantation status of the centre. Paediatric and
congenital heart surgery-related studies along with those conducted in the
setting of veno-venous ECMO for respiratory distress syndrome were
excluded. Differences were assessed by means of subgroup meta-analysis and
meta-regression. <br/>Result(s): Fifty-four studies enrolling N = 4421
ECMO patients were included. Of those, 6 series were performed in non-HTx
centres (204 pts.;4.6%). Overall 30-day survival (95% Confidence
Intervals) was 35.3% (32.5-38.2%) and did not statistically differ between
non-HTx: 33.3% (26.8-40.4%) and HTx centres: 35.7% (32.7-38.8%);
P<inf>interaction</inf> = 0.531. There was no impact of centre volume on
survival as well: s<inf>coef</inf> = 0.0006; P = 0.833. No statistical
differences were seen between HTx and non-HTx with respect to ECMO
duration, limb complications, reoperations for bleeding, kidney injury and
sepsis. There were however significantly less neurological complications
in the HTx as compared to non-HTx centres: 11.9% vs 19.5% respectively; P
= 0.009; an inverse relationship was seen for neurologic complications in
centres performing more ECMOs annually s<inf>coef</inf> = - 0.0066; P =
0.031. Weaning rates and bridging to HTx and/or VADs were higher in HTx
facilities. <br/>Conclusion(s): There was no apparent difference in
survival after ECMO implantation for refractory PCS according to centre's
ECMO volume and transplantation status. Potentially different risk
profiles of patients in these centres must be taken account for before
definite conclusions are drawn.<br/>Copyright &#xa9; 2020 The Author(s).

<32>
Accession Number
628519221
Title
Risk of stroke and other adverse outcomes in patients with perioperative
atrial fibrillation 1 year after non-cardiac surgery.
Source
European heart journal. 41 (5) (pp 645-651), 2020. Date of Publication: 01
Feb 2020.
Author
Conen D.; Alonso-Coello P.; Douketis J.; Chan M.T.V.; Kurz A.; Sigamani
A.; Parlow J.L.; Wang C.Y.; Villar J.C.; Srinathan S.K.; Tiboni M.; Malaga
G.; Guyatt G.; Sivakumaran S.; Rodriguez Funes M.-V.; Cruz P.; Yang H.;
Dresser G.K.; Alvarez-Garcia J.; Schricker T.; Jones P.M.; Drummond L.W.;
Balasubramanian K.; Yusuf S.; Devereaux P.J.
Institution
(Conen, Balasubramanian, Yusuf, Devereaux) Population Health Research
Institute, McMaster University, Hamilton, Canada
(Conen, Douketis, Tiboni, Guyatt, Yusuf, Devereaux) Department of
Medicine, McMaster University, 1280 Main St W, Hamilton L8S 4K1, Canada
(Conen, Alonso-Coello, Guyatt, Yusuf, Devereaux) Department of Health
Research Methods, Evidence, McMaster University, 1280 Main St W, and
Impact, Hamilton L8S 4K1, Canada
(Alonso-Coello) Iberoamerican Cochrane Center, Biomedical Research
Institute Sant Pau (IIB Sant Pau-CIBERESP), Sant Antoni Maria Claret 167,
Barcelona 08025, Spain
(Chan) Department of Anaesthesia and Intensive Care, Chinese University of
Hong Kong, Hong Kong Special administrative Region, China
(Kurz) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44120, USA
(Sigamani) Department of Clinical Research, Narayana Hrudayalaya Limited,
Bommasandra Industrial Area, Hosur Road, India
(Parlow) Department of Anesthesiology and Perioperative Medicine, Kingston
Health Sciences Centre and Queen's University, 76 Stuart St, Kingston,
Canada
(Wang) Department of Anesthesiology, University of Malaya, Kuala Lumpur
50603, Malaysia
(Villar) Departamento de Investigaciones, Fundacion Cardioinfantil
-Instituto de Cardiologia and Facultad de Ciencias de la Salud,
Universidad Autonoma de Bucaramanga, Bucaramanga, Santander, Colombia
(Srinathan) Department of Surgery, University of Manitoba, Rm. GE61, 820
Sherbrook Street, Winnipeg, Canada
(Malaga) School of Medicine, Universidad Peruana Cayetano Heredia, Av.
Honorio Delgado 430, San Martin de Porres 15102, Lima, Peru
(Sivakumaran) Department of Medicine, University of Alberta, 116 St & 85
Ave, Edmonton AB T6G 2R3, Canada
(Rodriguez Funes) Unidad de Investigacion Cientifica, Facultad de
Medicina, Universidad de El Salvador, Final 25 Ave norte, San Salvador, El
Salvador
(Cruz) Department of Anesthesia, Hospital General Universitario Gregorio
Maranon, Calle del Dr. Esquerdo 46, Madrid 28007, Spain
(Yang, Jones) Department of Anesthesia & Perioperative Medicine,
University of Western Ontario, 1151 Richmond St, London, Canada
(Dresser) Department of Medicine, London Health Sciences Centre, Victoria
Hospital, 800 Commissioners Rd E, London, Canada
(Alvarez-Garcia) Department of Cardiology, Hospital de la Santa Creu i
Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau),
Universitat Autonoma de Barcelona, Carrer de Sant Quinti, 89, Barcelona
08041, Spain
(Schricker) Department of Anesthesia, McGill University Health Centre,
McGill University, 1001 Decarie Blvd, Montreal, Canada
(Jones) Department of Epidemiology & Biostatistics, University of Western
Ontario, 1151 Richmond St, London, Canada
(Drummond) Department of Anaesthesia, Nelson R Mandela School of Medicine,
University of KwaZulu-Natal, 719 Umbilo Road 4001, South Africa
Publisher
NLM (Medline)
Abstract
AIMS: To determine the 1-year risk of stroke and other adverse outcomes in
patients with a new diagnosis of perioperative atrial fibrillation (POAF)
after non-cardiac surgery. METHODS AND RESULTS: The PeriOperative ISchemic
Evaluation (POISE)-1 trial evaluated the effects of metoprolol vs. placebo
in 8351 patients, and POISE-2 compared the effect of aspirin vs. placebo,
and clonidine vs. placebo in 10 010 patients. These trials included
patients with, or at risk of, cardiovascular disease who were undergoing
non-cardiac surgery. For the purpose of this study, we combined the POISE
datasets, excluding 244 patients who were in atrial fibrillation (AF) at
the time of randomization. Perioperative atrial fibrillation was defined
as new AF that occurred within 30days after surgery. Our primary outcome
was the incidence of stroke at 1year of follow-up; secondary outcomes were
mortality and myocardial infarction (MI). We compared outcomes among
patients with and without POAF using multivariable adjusted Cox
proportional hazards models. Among 18 117 patients (mean age 69years,
57.4% male), 404 had POAF (2.2%). The stroke incidence 1year after surgery
was 5.58 vs. 1.54 per 100 patient-years in patients with and without POAF,
adjusted hazard ratio (aHR) 3.43, 95% confidence interval (CI) 2.00-5.90;
P<0.001. Patients with POAF also had an increased risk of death (incidence
31.37 vs. 9.34; aHR 2.51, 95% CI 2.01-3.14; P<0.001) and MI (incidence
26.20 vs. 8.23; aHR 5.10, 95% CI 3.91-6.64; P<0.001). <br/>CONCLUSION(S):
Patients with POAF have a significantly increased risk of stroke, MI, and
death at 1 year. Intervention studies are needed to evaluate risk
reduction strategies in this high-risk population.<br/>Copyright Published
on behalf of the European Society of Cardiology. All rights reserved.
&#xa9; The Author(s) 2019. For permissions, please email:
journals.permissions@oup.com.

<33>
Accession Number
629168285
Title
The combined effect of Vitamin C and omega-3 polyunsaturated fatty acids
on fatigue following coronary artery bypass graft surgery: A triple-blind
clinical trial.
Source
Journal of Complementary and Integrative Medicine. 16 (4) (no pagination),
2019. Article Number: jcim-2018-0113. Date of Publication: 01 Dec 2019.
Author
Gholami M.; Najafizadeh H.; Teimouri H.; Ardalan A.; Pooria A.; Tarrahi
M.J.
Institution
(Gholami) School of Nursing and Midwifery, Lorestan University of Medical
Sciences, Khorramabad, Iran, Islamic Republic of
(Najafizadeh) Social Determinants of Health Research Center, Lorestan
University of Medical Sciences, Khorramabad, Iran, Islamic Republic of
(Teimouri, Pooria) Department of Cardiac Surgery, School of Medicine,
Lorestan University of Medical Sciences, Khorramabad, Iran, Islamic
Republic of
(Ardalan) 563 hampshire Rd,Apt 273, Westlake Village, CA 91361, United
States
(Tarrahi) Department of Epidemiology and Biostatistics, School of Health,
Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of
Publisher
De Gruyter (E-mail: peter.golla@degruyter.com)
Abstract
Fatigue is a common compliant among patients who undergo coronary artery
bypass graft (CABG) surgery. This may affect patients' function in all
aspects. A few studies have already assessed the influence of
complementary therapies on minimizing fatigue. This study aimed to
investigate the combined effect of Vitamin C and omega-3 polyunsaturated
fatty acids (n-3 PUFA) on fatigue following CABG surgery. In this
randomized, triple-blind placebo-controlled trial, 160 patients who
already underwent CABG surgery were randomly assigned into an experimental
or a control groups. Each group consisted of 80 patients. The experimental
group was given both n-3 PUFA and Vitamin C the day before surgery. They
also received the same supplements in the first 5 days of operation. The
control group received only placebo. Subjects in both groups responded to
Multidimensional Fatigue Inventory (MFI-20) scale in the beginning, and at
the end of the intervention as well as on the fifth day of the operation.
Chi-square test and independent t-test were used for data analysis. The
mean fatigue score in experimental and control groups came up to 62.01 +/-
4.06 and 67.92 +/- 4.95 (p<0.0001), respectively, which was greater than
that of the values we had before intervention. The mean difference of
fatigue score was 3.97 +/- 3.49 and 9.56 +/- 6.41 (p<0.0001) prior and
following the intervention, correspondingly. Combination of Vitamin C and
n-3 PUFA effectively reduces post-operative fatigue among patients who
undergo CABG surgery.<br/>Copyright &#xa9; 2019 2019 Walter de Gruyter
GmbH, Berlin/Boston.

<34>
Accession Number
2004831741
Title
Reporting of Cardiovascular Events in Clinical Trials Supporting FDA
Approval of Contemporary Cancer Therapies.
Source
Journal of the American College of Cardiology. 75 (6) (pp 620-628), 2020.
Date of Publication: 18 February 2020.
Author
Bonsu J.M.; Guha A.; Charles L.; Yildiz V.O.; Wei L.; Baker B.; Brammer
J.E.; Awan F.; Lustberg M.; Reinbolt R.; Miller E.D.; Jneid H.; Ruz P.;
Carter R.R.; Milks M.W.; Paskett E.D.; Addison D.
Institution
(Bonsu, Guha, Charles, Yildiz, Wei, Baker, Lustberg, Ruz, Carter, Milks,
Addison) Cardio-Oncology Program, Division of Cardiology, The Ohio State
University Medical Center, Columbus, OH, United States
(Guha) Harrington Heart and Vascular Institute, Case Western Reserve
University, Cleveland, OH, United States
(Yildiz, Wei) Center for Biostatistics, Department of Biomedical
Informatics, The Ohio State University, Columbus, OH, United States
(Baker, Paskett, Addison) Division of Cancer Prevention and Control,
Department of Internal Medicine, College of Medicine, The Ohio State
University, Columbus, OH, United States
(Brammer, Awan) Division of Hematology, James Cancer Hospital and Solove
Research Institute at The Ohio State University, Columbus, OH, United
States
(Awan) Division of Hematology, University of Texas-Southwestern Cancer
Center, Dallas, TX, United States
(Lustberg, Reinbolt) Division of Medical Oncology, James Cancer Hospital
and Solove Research Institute at The Ohio State University, Columbus, OH,
United States
(Miller) Department of Radiation Oncology, James Cancer Hospital and
Solove Research Institute at The Ohio State University, Columbus, OH,
United States
(Jneid) Division of Cardiology, Baylor College of Medicine, Michael E.
DeBakey VA Medical Center, Houston, TX, United States
(Carter) Center for the Advancement of Team Science, Analytics, and
Systems Thinking (CATALYST), Ohio State University College of Medicine,
Columbus, OH, United States
Publisher
Elsevier USA
Abstract
Background: Cardiovascular disease (CVD) has become an increasingly common
limitation to effective anticancer therapy. Yet, whether CVD events were
consistently reported in pivotal trials supporting contemporary anticancer
drugs is unknown. <br/>Objective(s): The authors sought to evaluate the
incidence, consistency, and nature of CVD event reporting in cancer drug
trials. <br/>Method(s): From the Drugs@FDA, clinicaltrials.gov, MEDLINE,
and publicly available U.S. Food and Drug Administration (FDA) drug
reviews, all reported CVD events across latter-phase (II and III) trials
supporting FDA approval of anticancer drugs from 1998 to 2018 were
evaluated. The primary outcome was the report of major adverse
cardiovascular events (MACE), defined as incident myocardial infarction,
stroke, heart failure, coronary revascularization, atrial fibrillation, or
CVD death, irrespective of treatment arm. The secondary outcome was report
of any CVD event. Pooled reported annualized incidence rates of MACE in
those without baseline CVD were compared with reported large contemporary
population rates using relative risks. Population risk differences for
MACE were estimated. Differences in drug efficacy using pooled binary
endpoint hazard ratios on the basis of the presence or absence of reported
CVD were also assessed. <br/>Result(s): Overall, there were 189 trials,
evaluating 123 drugs, enrolling 97,365 participants (58.5 +/- 5 years,
46.0% female, 72.5% on biologic, targeted, or immune-based therapies) with
148,138 person-years of follow-up. Over a median follow-up of 30 months,
1,148 incidents of MACE (375 heart failure, 253 myocardial infarction, 180
strokes, 65 atrial fibrillation, 29 revascularizations, and 246 CVD
deaths; 792 in the intervention vs. 356 in the control arm; p < 0.01) were
reported from the 62.4% of trials noting any CVD. The overall
weighted-average incidence was 542 events per 100,000 person-years (716
per 100,000 in the intervention arm), compared with 1,408 among
similar-aged non-cancer trial subjects (relative risk: 0.38; p < 0.01),
translating into a risk difference of 866. There was no association
between reporting CVD events and drug efficacy (hazard ratio: 0.68 vs.
0.67; p = 0.22). <br/>Conclusion(s): Among pivotal clinical trials linked
to contemporary FDA-approved cancer drugs, reported CVD event rates trail
expected population rates.<br/>Copyright &#xa9; 2020

<35>
Accession Number
2004171377
Title
Rivaroxaban in patients undergoing surgical mitral valve repair.
Source
Journal of Thrombosis and Thrombolysis. (no pagination), 2020. Date of
Publication: 2020.
Author
Noohi F.; Sadeghipour P.; Kordrostami S.; Shafe O.; Maleki M.; Kyavar M.;
Bakhshandeh H.; Rezaei Y.; Rokni M.; Moosavi J.; Amin A.; Tashakori
Beheshti A.; Hosseini S.
Institution
(Noohi, Kordrostami, Rezaei, Hosseini) Heart Valve Diseases Research
Center, Rajaie Cardiovascular, Medical, and Research Center, Iran
University of Medical Sciences, Vali-Asr Ave, Tehran 1995614331, Iran,
Islamic Republic of
(Noohi, Sadeghipour, Shafe, Maleki, Kyavar, Moosavi) Cardiovascular
Intervention Research Center, Rajaie Cardiovascular, Medical, and Research
Center, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Sadeghipour, Bakhshandeh) Clinical Trial Center, Rajaie Cardiovascular,
Medical, and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Bakhshandeh, Rokni, Amin, Tashakori Beheshti) Rajaie Cardiovascular,
Medical, and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
Publisher
Springer
Abstract
In patients undergoing mitral valve repair (MVre), a 3-month course of
anticoagulation is currently recommended. The role of the non-vitamin K
antagonist oral anticoagulants has here been scarcely studied. In the
present mixed cohort study, the safety and efficacy of rivaroxaban
(prospective analysis) were compared with those of warfarin (retrospective
analysis) in patients undergoing MVre. Anticoagulation therapy was
continued for at least 3 months, and the patients were followed for 1 year
following surgery. The present study recruited 736 patients undergoing
MVre with or without concomitant coronary artery bypass or surgical repair
on the other valves. Concomitant valvular replacement and severe chronic
kidney diseases were the most important exclusion criteria. The final
analysis was conducted on 153 patients treated with rivaroxaban and 144
patients treated with warfarin. Dissimilarities in baseline
characteristics necessitated propensity score matching, in which 104
patients in each group were compared. No major bleeding or cerebrovascular
accident occurred during the 1-year follow-up. Clinically relevant
non-major bleeding was reported in 2 patients in the rivaroxaban group and
4 patients in the warfarin group, a difference non-statistically
significant before and after propensity score matching (P = 0.371 and P =
0.407, respectively). The type of anticoagulation did not predict the
1-year outcome (HR 2.165, 95% CI 0.376 to 12.460; P = 0.387). In this
mixed cohort study, rivaroxaban was both safe and efficient in patients
with MVre. Such preliminary results should prompt larger randomized
controlled trials.<br/>Copyright &#xa9; 2020, Springer Science+Business
Media, LLC, part of Springer Nature.

<36>
Accession Number
2004693095
Title
Preoperative Pulse Pressure and Adverse Postoperative Outcomes: A
Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 34 (3) (pp 624-631),
2020. Date of Publication: March 2020.
Author
Zeng J.; Zheng G.; Li Y.; Yang Y.
Institution
(Zeng, Zheng, Li) Department of Anesthesiology, The First Affiliated
Hospital of Jinan University, Guangzhou, China
(Zeng) Department of Anesthesiology, Liuzhou People's Hospital, Liuzhou,
China
(Yang) Out-patient Department, Liuzhou People's Hospital, Liuzhou, China
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the association between preoperative pulse pressure
(PP) and the incidences of renal, neurologic, cardiac, and mortality
outcomes after surgery. <br/>Design(s): Systematic review and
meta-analysis of cohort studies. <br/>Setting(s): Hospitals.
<br/>Participant(s): Patients who underwent cardiac or noncardiac
surgeries. <br/>Intervention(s): The preoperative PP was measured.
Measurement and Main Results: Relevant cohort studies were obtained by
systematic search of PubMed and Embase databases. A randomized effect
model was used to pool the results. The multivariate adjusted risk ratio
(RR) and its 95% confidence intervals (CI) were calculated to reflect the
association between preoperative PP and adverse postoperative outcomes.
Twelve cohort studies that included 40,143 patients who had undergone
cardiac, vascular, or noncardiac surgery were included in the
meta-analysis. The results showed that above a threshold of 40 mmHg, an
increase in preoperative PP of 10 mmHg was independently associated with
increased risk for renal events (adjusted RR: 1.13, 95% CI 1.08-1.19, p <
0.001; I² = 0%), neurologic events (adjusted RR: 1.75, 95% CI
1.01-3.02, p = 0.04; I² = 70%), cardiac events (adjusted RR:
1.19, 95% CI 1.03-1.37, p = 0.01; I² = 0%), major
cardiovascular adverse events (adjusted RR: 1.62, 95% CI 1.10-2.41, p =
0.02; I² = 0%), and overall mortality (adjusted RR: 1.13, 95%
CI 1.07-1.20, p < 0.001; I² = 0%) after surgery.
<br/>Conclusion(s): Patients with higher-than-normal preoperative PP are
at increased risk for adverse postoperative outcomes.<br/>Copyright &#xa9;
2019

<37>
Accession Number
2003437325
Title
Invasive evaluation of the microvasculature in acute myocardial
infarction: Coronary flow reserve versus the index of microcirculatory
resistance.
Source
Journal of Clinical Medicine. 9 (1) (no pagination), 2020. Article Number:
86. Date of Publication: January 2020.
Author
Clarke J.-R.D.; Kennedy R.; Lau F.D.; Lancaster G.I.; Zarich S.W.
Institution
(Clarke, Lau) Department of Internal Medicine, Yale-New Haven
Health/Bridgeport Hospital, Bridgeport, CT 06610, United States
(Kennedy) Department of Internal Medicine, St. Vincent Charity Medical
Center, Cleveland, OH 44115, United States
(Lancaster, Zarich) The Heart and Vascular Institute, Yale-New Haven
Health/Bridgeport Hospital, Bridgeport, CT 06610, United States
Publisher
MDPI AG (Postfach, Basel CH-4005, Switzerland. E-mail: indexing@mdpi.com)
Abstract
Acute myocardial infarction (AMI) is one of the most common causes of
death in both the developed and developing world. It has high associated
morbidity despite prompt institution of recommended therapy. The focus
over the last few decades in ST-segment elevation AMI has been on timely
reperfusion of the epicardial vessel. However, microvascular consequences
after reperfusion, such as microvascular obstruction (MVO), are equally
reliable predictors of outcome. The attention on the microcirculation has
meant that traditional angiographic/anatomic methods are insufficient. We
searched PubMed and the Cochrane database for English-language studies
published between January 2000 and November 2019 that investigated the use
of invasive physiologic tools in AMI. Based on these results, we provide a
comprehensive review regarding the role for the invasive evaluation of the
microcirculation in AMI, with specific emphasis on coronary flow reserve
(CFR) and the index of microcirculatory resistance (IMR).<br/>Copyright
&#xa9; 2019 by the authors. Licensee MDPI, Basel, Switzerland.

<38>
Accession Number
2003619143
Title
Prophylactic use of magnesium sulphate to prevent arrythmias in patients
with rheumatic heart disease undergoing closed mitral valvotomy.
Source
JK Science. 21 (4) (pp 152-155), 2019. Date of Publication:
October-December 2019.
Author
Vimesh P.; Angral R.; Kour R.; Anshu
Institution
(Vimesh, Angral, Kour, Anshu) Department of Cardiothoracic Anaesthesia,
SSH, Government Medical College, Jammu, Jammu and Kashmir, India
Publisher
JK Science
Abstract
Maintenance of sinus rhythm is superior to incidence of atrial
fibrillation (AF) in patients with rheumatic heart disease undergoing
Closed Mitral Valvotomy (CMV). The present study was done to evaluate the
effect of prophylactic use of Magnesium Sulphate (MgSo4), intravenously
(i.v) soon after opening the stenosed Mitral Valve using Tubbs dilators by
Surgeon, in patients undergoing CMV. One hundred and twenty patients with
Mitral Stenosis (MS) (mitral valve area < 1cm2), normal mitral valvular
apparatus, no mitral regurgitation, mitral score not more than 7/16
planned for CMV. These patients were divided in two groups of 60 each.
Group (I) (n=60) received. MgSo4, 30 mg/kg diluted to 20 ml with normal
saline soon after mitral valvotomy and Group-II (n=60) received 20 ml of
normal saline. The standardized protocol for CMV was maintained for all
the patients. Before surgery AF was observed in 56.67% of patients in
group I and 48.33% of patients in group II (p=0.46). Postoperatively in
ICU, 30% of patients in group I and 70% of patients in group II had
AF(p<0.0001). A single prophylactic intra operative dose of i.v MgSO4
decreased post valvotomy arrhythmia in comparision to placebo group .
Thus, a single dose of intraoperative MgSO4 can be used to decrease
postoperative arrhythmias in patients of M.S undergoing CMV.<br/>Copyright
&#xa9; 2019, JK Science. All rights reserved.

<39>
Accession Number
2004322340
Title
Remote Ischaemic Preconditioning Attenuates Cardiac Biomarkers During
Vascular Surgery: A Randomised Clinical Trial.
Source
European Journal of Vascular and Endovascular Surgery. 59 (2) (pp
301-308), 2020. Date of Publication: February 2020.
Author
Kepler T.; Kuusik K.; Lepner U.; Starkopf J.; Zilmer M.; Eha J.; Vahi M.;
Kals J.
Institution
(Kepler, Lepner, Kals) Department of Surgery, Institute of Clinical
Medicine, University of Tartu, Tartu, Estonia
(Kepler, Kuusik, Zilmer, Kals) Department of Biochemistry, Institute of
Biomedicine and Translational Medicine, Centre of Excellence for Genomics
and Translational Medicine, University of Tartu, Tartu, Estonia
(Kuusik, Eha) Department of Cardiology, Institute of Clinical Medicine,
University of Tartu, Tartu, Estonia
(Lepner, Starkopf, Eha, Kals) Tartu University Hospital, Tartu, Estonia
(Starkopf) Department of Anaesthesiology and Intensive Care, Institute of
Clinical Medicine, University of Tartu, Tartu, Estonia
(Vahi) Institute of Mathematics and Statistics, University of Tartu,
Tartu, Estonia
Publisher
W.B. Saunders Ltd
Abstract
Objective: The main aim of this study was to evaluate the effect of remote
ischaemic preconditioning (RIPC) on preventing the leakage of cardiac
damage biomarkers in patients undergoing vascular surgery. <br/>Method(s):
This is a randomised, sham-controlled, double-blinded, single-centre
study. Patients undergoing open abdominal aortic aneurysm repair, surgical
lower limb revascularisation surgery or carotid endarterectomy were
recruited non-consecutively. The RIPC protocol consisting of 4 cycles of 5
minutes of ischaemia, followed by 5 minutes of reperfusion, was applied. A
RIPC or a sham procedure was performed noninvasively along with
preparation for anaesthesia. High sensitivity troponin T level was
measured preoperatively and 2, 8 and 24 hours after surgery and pro b-type
natriuretic peptide was measured preoperatively and 24 hours after
surgery. <br/>Result(s): There was significantly higher leakage of high
sensitivity troponin T (peak change median 2 ng/L, IQR 0.9-6.2 ng/L vs 0.6
ng/L, IQR 0.7-2.1 ng/L, p = .0002) and pro b-type natriuretic peptide
(change median 144 pg/mL, IQR 17-318 pg/mL vs 51 pg/mL, IQR 12-196 pg/mL,
p = .02) in the sham group compared to the RIPC group. <br/>Conclusion(s):
RIPC reduces the leakage of high sensitivity troponin T and pro b-type
natriuretic peptide. Therefore, it may offer cardioprotection in patients
undergoing non-cardiac vascular surgery. The clinical significance of RIPC
has to be evaluated in larger studies excluding the factors known to
influence its effect.<br/>Copyright &#xa9; 2019 European Society for
Vascular Surgery

<40>
Accession Number
630776798
Title
Insulin glargine in critically ill patients: Once-daily versus twice-daily
dosing.
Source
Pharmacotherapy. (no pagination), 2020. Date of Publication: 29 Jan 2020.
Author
Fox M.A.; Perry M.C.; Liu-DeRyke X.
Institution
(Fox, Perry, Liu-DeRyke) Pharmacy Services, Orlando Regional Medical
Center, 52 Underwood St, FL, Orlando 32806, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Twice-daily (BID) dosing of insulin glargine has been used to
treat hyperglycemia in clinical practice, however, data supporting its use
in the critically ill population is lacking. This study was designed to
evaluate the safety and efficacy of BID insulin glargine in critically ill
patients. <br/>METHOD(S): A retrospective study was conducted in adult
patients admitted to the intensive care units between February 2013 and
June 2017 and received insulin glargine BID or >=40 units daily for >=48
hours. Post cardiovascular surgery patients were excluded. Data was
collected for up to 14 patient days. The efficacy outcomes included the
incidence of hyperglycemia (blood glucose [BG] >180 mg/dL), pre-dose
hyperglycemia rate (BG >180 mg/dL within 4 hours before the dose), and BG
variability (standard deviation). The safety outcome was assessed by the
development of hypoglycemia (BG <70 mg/dL). <br/>RESULT(S): A total of 58
patients (BID=23; daily=35) were included in the analysis. Demographics
were similar between groups, including history of diabetes mellitus,
baseline glycated hemoglobin (HgbA1c ), and home insulin use. There was no
difference between the BID and daily groups in the mean BG (153 vs. 154
mg/dL, p=0.95 respectively), and BG variability (46 vs. 44 mg/dL, p=0.29
respectively). While the overall incidence of hyperglycemia was similar
between BID and daily groups (96% vs. 97%, p=1.00 respectively), the BID
group had a significantly lower pre-dose hyperglycemia rate (BID 0.27 vs.
daily 0.43; p=0.02). Additionally, the BID group did not experience an
increased incidence of hypoglycemia (BID 23% vs. daily 34%, p=0.57) or
hypoglycemia without having anything by mouth (NPO; BID 0% vs. daily 9%,
p=0.27). <br/>CONCLUSION(S): This is the first study demonstrating BID
insulin glargine reduced the rate of pre-dose hyperglycemia without
increasing the risk of hypoglycemia in critically ill patients. A large,
randomized study is needed to confirm the safety and efficacy of BID
glargine in the critically ill.<br/>Copyright &#xa9; 2020 Pharmacotherapy
Publications, Inc.

<41>
Accession Number
2004766641
Title
Expression of PKM2 in NSCLC and its correlation with clinicopathological
features and prognosis.
Source
Acta Medica Mediterranea. 36 (1) (pp 29-33), 2020. Date of Publication:
2020.
Author
Yang W.; Chen L.; Cha J.; Peng X.; Li Z.; Li A.; Yang L.
Institution
(Yang, Li, Li, Yang) Department of Cardiothoracic Surgery, First
Affiliated Hospital of Dali University, Dali, China
(Chen, Peng) Department of Respiratory and Critical Care Medicine, Sichuan
Provincial People's Hospital, University of Electronic Science and
Technology of China, Chengdu, China
(Cha) Department of Gastroenterology, First Affiliated Hospital of Dali
University, Dali, China
Publisher
A. CARBONE Editore
Abstract
Objective: To investigate the expression of PKM2 in non-small cell lung
cancer (NSCLC) and its correlation with clinicopathological features and
prognosis. <br/>Method(s): From March 2017 to June 2018, 171 cases of
NSCLC tissue and 28 normal para-cancer tissue were randomly selected by
the thoracic surgery department of our hospital. Immunohistochemical
staining was performed after extracting total RNA from the NSCLC tissue
and adjacent tissue. The expression of M2 pyruvate kinase (PKM2) in NSCLC
tissue and adjacent tissue was detected by immunohistochemistry. The
relationship between PKM2 and clinicopathological features in NSCLC tissue
was analysed. The patients were followed up by telephone and outpatient
review to analyse the relationship between PKM2 and NSCLC patients. Cox
proportional hazard regression models were used to analyse independent
risk factors affecting NSCLC patients. <br/>Result(s): The expression
level of PKM2 in NSCLC tissue was significantly higher than that in normal
adjacent tissue (P < .05). The expression of PKM2 in NSCLC tissue was
associated with TNM staging and lymph node metastasis (P < .05). The
expression of PKM2 in NSCLC tissue was not related to age, gender, alcohol
consumption, smoking, or differentiation (P > .05). The 5-year survival
rate of patients with high PKM2 expression was 36/117 (31.03%). This was
significantly lower than that of patients with low PKM2 expression 29/54
(55.18%) (P < .05). High expression of PKM2 is an independent risk factor
affecting the survival of patients with NSCLC; while the TNM stage and
lymph node metastasis are risk factors for the overall survival of
patients with NSCLC. <br/>Conclusion(s): The expression of PKM2 protein in
NSCLC tissue is significantly higher than that in adjacent tissue, and its
expression level is related to TNM stage and lymph node metastasis. This
suggests that the high expression of PKM2 protein may promote the
development of tumour cells. If so, the high expression of PKM2 protein
may be an important reference index for evaluating the prognosis of
patients with NSCLC. PKM2 is expected to become a new target to treat
NSCLC.<br/>Copyright &#xa9; 2020 A. CARBONE Editore. All rights reserved.

<42>
Accession Number
2004168856
Title
Impact of leaflet thrombosis on hemodynamics and clinical outcomes after
bioprosthetic aortic valve replacement: A meta-analysis.
Source
Clinical Cardiology. (no pagination), 2020. Date of Publication: 2020.
Author
Tian Z.; Li T.; Ma S.
Institution
(Tian, Li, Ma) Department of Cardiology, Shengjing Hospital of China
Medical University, Shengyang, Liaoning Province, China
Publisher
John Wiley and Sons Inc. (E-mail: cs-journals@wiley.com)
Abstract
Background: Leaflet thrombosis (LT, also called cusp thrombosis) detected
by multidetector computed tomography (MDCT) is common in bioprosthetic
aortic valve replacement (bAVR). However, it remains contradictory whether
MDCT-defined LT following bAVR is associated with hemodynamic
deterioration and stroke. Thus, we performed the first meta-analysis to
assess hemodynamic outcomes and updated the latest researches on the
clinical outcomes of MDCT-defined LT after bAVR. Hypothesis: MDCT-defined
LT might be associated with worse hemodynamic and clinical outcomes after
bAVR. <br/>Method(s): MEDLINE, EMBASE, Cochrane Library, and
ClinicalTrial.gov were searched from inception to 15th April 2019. The
fix-effect model was utilized to calculate odds ratio (OR) and 95%
confidence interval (CI). The primary outcomes were hemodynamic stability
indexes, including mean pressure gradient (MPG), left ventricular ejection
fraction (LVEF), paravalvular leak (PVL), and clinical heart failure. The
secondary endpoints were major adverse cardiovascular and cerebrovascular
events (MACCEs), which consisted of myocardial infarction, all-cause
death, stroke, and transient ischemic attack (TIA). <br/>Result(s): Twelve
studies with 4820 patients were included. The total prevalence of
MDCT-defined LT was 9.7%. MDCT-defined LT was associated with a
significantly increased risk of MPG (inverse variance 0.43, 95% CI: [0.30,
0.57]), MACCEs (OR 2.43, 95% CI: [1.45, 4.06]), stroke (OR 1.79, 95% CI:
[1.03, 3.11]), and TIA (OR 4.09, 95% CI: [1.59, 10.54]). There were no
differences for other outcomes. <br/>Conclusion(s): MDCT-defined LT after
bAVR is associated with increased MPG and increased risk of adverse
cerebrovascular events, including TIA and stroke. While LVEF, PVL, and
clinical heart failure were similar between patient with and without
LT.<br/>Copyright &#xa9; 2020 The Authors. Clinical Cardiology published
by Wiley Periodicals, Inc.

<43>
Accession Number
2004161471
Title
Review of air kerma-area product, effective dose and dose conversion
coefficients for non-cardiac interventional fluoroscopy procedures.
Source
Medical Physics. (no pagination), 2020. Date of Publication: 2020.
Author
Miller D.L.
Institution
(Miller) Center for Devices and Radiological Health, U.S. Food and Drug
Administration, Silver Spring, MD 20993, United States
Publisher
John Wiley and Sons Ltd. (E-mail: contentdelivery@wiley.com)
Abstract
Purpose: To provide current data on average air kerma-area product
(P<inf>KA</inf>) and effective dose (E) for noncardiac interventional
fluoroscopy procedures and suggested values of dose coefficients
(DC<inf>E</inf>) for conversion of P<inf>KA</inf> to estimates of
effective dose. <br/>Method(s): A PubMed literature search covering the
time period from 2006 to August 2019 was performed to obtain recent data
on P<inf>KA</inf>, E and DC<inf>E</inf> for interventional fluoroscopy
procedures. <br/>Result(s): There is very wide variation in the reported
values of P<inf>KA</inf>, E, and DC<inf>E</inf> in the literature. A
number of factors are involved in this variability and the resultant
uncertainty in average values of these dose quantities.
<br/>Conclusion(s): The values of P<inf>KA</inf>, average E and suggested
DC<inf>E</inf> presented here can be of use for comparison of the
radiation detriment from different procedures and may be useful for
categorizing detriment within an order of magnitude or so. They do not
represent actual or expected radiation dose or detriment from any specific
procedure or for a specific patient and should be not be used as
such.<br/>Copyright Published 2020. This article is a U.S. Government work
and is in the public domain in the USA.

<44>
Accession Number
2004166619
Title
Global longitudinal strain assessment of the left ventricle by speckle
tracking echocardiography detects acute cellular rejection in orthotopic
heart transplant recipients: A systematic review and meta-analysis.
Source
Echocardiography. (no pagination), 2020. Date of Publication: 2020.
Author
Elkaryoni A.; Altibi A.M.; Khan M.S.; Okasha O.; Ellakany K.; Hassan A.;
Singh A.; Qarajeh R.; Mehta S.; Nanda N.C.
Institution
(Elkaryoni, Okasha, Singh, Qarajeh, Mehta) Division of Internal Medicine,
University of Missouri Kansas City, Kansas City, MO, United States
(Altibi) Division of Internal Medicine, Henry Ford Allegiance Health,
Detroit, MI, United States
(Altibi) Harvard T.H. Chan School of Public Health, Harvard University,
Boston, MA, United States
(Khan) Division of Internal Medicine, John H Stroger Jr Hospital of Cook
County, Chicago, IL, United States
(Ellakany) Division of Cardiovascular Disease, University of Alexandria
School of medicine, Alexandria, Egypt
(Hassan) Divison of Internal Medicine, University of Iowa Hospitals and
Clinics, Iowa City, IA, United States
(Nanda) Division of Cardiovascular Disease, University of Alabama at
Birmingham, Birmingham, AL, United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: In orthotopic heart transplant recipients, surveillance with
endomyocardial biopsy is crucial to detect acute cellular rejection (ACR)
early. ACR is a common and serious complication of transplantation with
substantial morbidity and mortality. Speckle tracking echocardiography
with global longitudinal strain (GLS) assessment of the left ventricle has
emerged as a possible noninvasive screening modality. We have conducted a
systematic literature review and meta-analysis to evaluate the role of GLS
in diagnosing ACR. <br/>Method(s): The following databases were queried:
PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus,
and Embase. We compiled all articles evaluating changes in GLS in
comparison to endomyocardial biopsy in ACR dated prior to September 2019.
Weighted mean differences (WMD) and 95% confidence intervals (CIs) were
pooled by using a random effects model. In order to determine the risk of
bias, we used the revised version of the Quality Assessment of Diagnostic
Accuracy Studies (QUADAS-2) tool. <br/>Result(s): Twelve studies met
inclusion criteria of which ten were chosen. These studies encompassed 511
patients and 1267 endomyocardial biopsies. There was a significant
difference in GLS between patients who did and did not have ACR proven by
biopsy (WMD = 2.18; 95% CI: 1.57-2.78, P = <.001; I² = 76%).
The overall sensitivity for GLS in detecting ACR was 78% (CI: 63%-90%, P
=.123; I² = 52.2%) while the overall specificity was 68% (CI:
50%-83%, P = <.001; I² = 88.3%). <br/>Conclusion(s): Global
longitudinal strain assessment of the left ventricle by speckle tracking
echocardiography is useful in detecting ACR and could potentially reduce
the burden of frequent endomyocardial biopsies in heart transplant
recipients.<br/>Copyright &#xa9; 2020 Wiley Periodicals, Inc.

<45>
Accession Number
2003731409
Title
Prospective, multicenter, randomized, controlled trial evaluating the
performance of a novel combination powder vs hemostatic matrix in
cardiothoracic operations.
Source
Journal of Cardiac Surgery. 35 (2) (pp 313-319), 2020. Date of
Publication: 01 Feb 2020.
Author
Dang N.C.; Ardehali A.; Bruckner B.A.; Parrino P.E.; Gillen D.L.; Hoffman
R.W.; Spotnitz R.; Cavoores S.; Shorn I.J.; Manson R.J.; Spotnitz W.D.
Institution
(Dang) Department of Surgery, Kaiser Moanalua Medical Center, Honolulu,
HI, United States
(Ardehali) Department of Surgery, University of California at Los Angeles,
Los Angeles, CA, United States
(Bruckner) Methodist DeBakey Heart and Vascular Center, Houston Methodist
Hospital, Houston, TX, United States
(Parrino) Thoracic and Cardiovascular Surgery Section, Ochsner Medical
Center, New Orleans, LA, United States
(Gillen) Department of Statistics, University of California, Irvine, CA,
United States
(Hoffman, Spotnitz, Cavoores, Shorn, Manson, Spotnitz) Biom'up SA, Lyon,
France
(Manson) Department of Surgery, Duke University, Durham, NC, United States
(Manson) Department of Mechanical Engineering and Materials Science, Duke
University, Durham, NC, United States
(Spotnitz) Department of Surgery, University of Virginia, Charlottesville,
VA, United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Aim: This trial compared the hemostatic performance of a novel combination
powder (CP) to a control hemostatic matrix (HM) in cardiothoracic
operations. <br/>Method(s): Patients meeting eligibility criteria were
enrolled after providing informed consent. Subjects were randomized
intraoperatively to receive CP (HEMOBLAST Bellows; Biom'up, France) or HM
(FLOSEAL Hemostatic Matrix; Baxter Healthcare Corporation, Hayward, CA).
Bleeding was assessed using a clinically validated, quantitative bleeding
severity scale. The primary endpoint was total time to hemostasis (TTTH),
from the start of device preparation, as an indicator of when a surgeon
asks for a surgical hemostat until hemostasis was achieved. TTTH at 3
minutes was utilized for the primary analysis, while TTTH at 5 minutes was
considered as a secondary endpoint. <br/>Result(s): A total of 105
subjects were enrolled across four institutions. The primary efficacy
endpoint for the superiority of CP relative to HM for success at achieving
hemostasis within 3 minutes was met, with 64.2% of the CP group achieving
hemostasis compared with 9.6% of the HM group, a difference of 54.54%
(37.4%-71.6%; P <.001 for superiority). The secondary efficacy endpoint
was also met, with 92.5% of the CP group achieving hemostasis at 5 minutes
versus 44.2% in the HM group, a difference of 48.2% (31.1%-65.4%; P <.001
for noninferiority). There were no device-related adverse events.
<br/>Conclusion(s): In this multicenter, randomized, controlled trial,
comparison of CP to HM revealed CP superiority and noninferiority for TTTH
at 3 and 5 minutes, respectively.<br/>Copyright &#xa9; 2019 The Authors.
Journal of Cardiac Surgery published by Wiley Periodicals, Inc.

<46>
Accession Number
630624044
Title
A prospective, randomized, single-blind, multicentre, phase III study on
organ preservation with Custodiol-N solution compared with Custodiol
solution in organ transplantation (kidney, liver and pancreas).
Source
Trials. 21 (1) (no pagination), 2020. Article Number: 62. Date of
Publication: 10 Jan 2020.
Author
Kniepeiss D.; Houben P.; Stiegler P.; Berghold A.; Riedl R.; Kahn J.;
Schemmer P.
Institution
(Kniepeiss, Stiegler, Kahn, Schemmer) General, Visceral and Transplant
Surgery, Department of Surgery, Medical University of Graz,
Auenbruggerplatz 29, Graz 8036, Austria
(Kniepeiss, Stiegler, Kahn, Schemmer) Transplant Center Graz (TCG),
Medical University of Graz, Auenbruggerplatz 29, Graz 8036, Austria
(Houben) Department of General, Visceral and Transplant Surgery,
University Hospital of Heidelberg, Heidelberg, Germany
(Berghold, Riedl) Institute for Medical Informatics, Statistics and
Documentation, Medical University Graz, Graz, Austria
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Organ preservation before transplantation is still a
challenge. Both the University of Wisconsin and Bretschneider's
histidine-tryptophan-ketoglutarate (HTK; Custodiol) solution are standard
for liver, kidney and pancreas preservation. Organ preservation with both
solutions is comparable; recently, however, Custodiol solution has been
modified to Custodiol-N according to the needs of today. Thus, our study
was defined to study its effect in clinical transplantation.
<br/>Method(s): Patients undergoing kidney transplantation (n = 412)
(including approximately 30 combined kidney-pancreas) or liver
transplantation (n = 202) receive grafts that have been cold stored in
either Custodiol or Custodiol-N to demonstrate noninferiority of
Custodiol-N regarding both graft function and graft injury after
transplantation. <br/>Discussion(s): Preclinical data have clearly shown
that Custodiol-N is superior to Custodiol in cold static organ
preservation via mechanisms including inhibition of hypoxic cell injury,
cold-induced cell injury and avoidance of adverse effects during warm
exposure to the solution. Further clinical safety data on Custodiol-N for
cardioplegia are available. Thus, this study was designed to compare
Custodiol with Custodiol-N for the first time in a prospective,
randomized, single-blinded, multicentre, phase III clinical
transplantation trial. Trial registration: Eudra-CT, 2017-002198-20.
Registered on 28 November 2018.<br/>Copyright &#xa9; 2020 The Author(s).

<47>
Accession Number
2004729809
Title
First clinical evidence characterizing safety and efficacy of the new CoCr
Biolimus-A9 eluting stent: The Biomatrix AlphaTM registry.
Source
IJC Heart and Vasculature. 26 (no pagination), 2020. Article Number:
100472. Date of Publication: February 2020.
Author
Menown I.B.A.; Mamas M.A.; Cotton J.M.; Hildick-Smith D.; Eberli F.R.;
Leibundgut G.; Tresukosol D.; Macaya C.; Copt S.; Sadozai Slama S.; Stoll
H.-P.
Institution
(Menown) Craigavon Cardiac Centre & Queens University Belfast, United
Kingdom
(Mamas) University Hospital of North Midlands NHS Trust, Keele
Cardiovascular Research Group, Keele University, United Kingdom
(Cotton) Royal Wolverhampton NHS Trust, United Kingdom
(Hildick-Smith) Brighton and Sussex University Hospitals, United Kingdom
(Eberli) Triemli Hospital, Switzerland
(Leibundgut) Kantonsspital Baselland, Switzerland
(Tresukosol) Her Majesty Cardiac Center, Thailand
(Macaya) Hospital Clinico San Carlos, Spain
(Copt, Sadozai Slama, Stoll) Biosensors Clinical Research, Morges,
Switzerland
Publisher
Elsevier Ireland Ltd (P.O. Box 211, Amsterdam 1000 AE, Netherlands)
Abstract
Background: The biolimus-eluting stent (BES) was the first to elute
anti-proliferative drug from a biodegradable polymer. In the randomized
LEADERS trial, a stainless steel BES showed non-inferior efficacy compared
to a sirolimus-eluting stent and a long-term safety advantage. We report
the first clinical efficacy and safety outcomes of a new thin-strut cobalt
chromium biolimus-eluting stent (CoCr-BES) from an international
multi-centre registry. <br/>Method(s): We studied 400 all-comer patients
with coronary disease receiving CoCr-BES at 12 centres, with follow-up at
9 months and 2 years. The primary endpoint was incidence of major adverse
cardiac events (MACE) at 9 months comprising cardiac death, myocardial
infarction (MI), and clinically indicated target vessel revascularization
(ci-TVR). Key protocol elements were the same as the randomized LEADERS
trial to enable a historical control for propensity-matched comparison.
<br/>Result(s): Mean patient age was 65 +/- 11 years, 19% had diabetes,
and 55% presented with unstable angina or MI. On discharge, 96% of
patients were on dual antiplatelet therapy (DAPT) and 69% were on DAPT at
9 months. MACE at 9 months occurred in 3.9% of patients, cardiac death in
0.8%, MI in 1.1% and ci-TVR in 2.7%. One patient (0.25%) experienced
definite or probable stent thrombosis (ST). A propensity-adjusted
comparison showed similar clinical outcomes to the BES arm in the LEADERS
trial for the primary endpoint MACE. <br/>Conclusion(s): The new CoCr-BES
showed low rates of MACE, MI, ci-TVR and ST at 9 months, similar to the
BES arm in LEADERS.<br/>Copyright &#xa9; 2020 The Authors

<48>
Accession Number
2004680999
Title
Efficacy and Safety of Tranexamic Acid in Major Non-Cardiac Surgeries at
High Risk for Transfusion: A Systematic Review and Meta-Analysis.
Source
Transfusion Medicine Reviews. 34 (1) (pp 51-62), 2020. Date of
Publication: January 2020.
Author
Houston B.L.; Uminski K.; Mutter T.; Rimmer E.; Houston D.S.; Menard C.E.;
Garland A.; Ariano R.; Tinmouth A.; Abou-Setta A.M.; Rabbani R.; Neilson
C.; Rochwerg B.; Turgeon A.F.; Falk J.; Breau R.H.; Fergusson D.A.;
Zarychanski R.
Institution
(Houston, Uminski, Rimmer, Houston, Menard, Garland, Zarychanski) Rady
Faculty of Health Sciences, Max Rady College of Medicine, Department of
Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
(Houston, Rimmer, Houston, Menard, Zarychanski) Department of Medical
Oncology and Haematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada
(Houston, Ariano, Falk, Zarychanski) Rady Faculty of Health Sciences,
College of Pharmacy, University of Manitoba, Winnipeg, Manitoba, Canada
(Mutter) Rady Faculty of Health Sciences, Max Rady College of Medicine,
Department of Anesthesiology, Perioperative and Pain Medicine, University
of Manitoba, Winnipeg, Manitoba, Canada
(Tinmouth, Breau, Fergusson) Clinical Epidemiology Program, Ottawa
Hospital Research Institute (OHRI), Department of Medicine, University of
Ottawa, Ottawa, Ontario, Canada
(Abou-Setta, Rabbani) George & Fay Yee Center for Healthcare Innovation,
University of Manitoba/Winnipeg Regional Health Authority, Winnipeg,
Manitoba, Canada
(Rabbani) Department Community Health Sciences, Max Rady College of
Medicine, Rady Faculty of Health Sciences, University of Manitoba,
Winnipeg, Manitoba, Canada
(Neilson) University of Manitoba, MHIKNET program, Winnipeg, Manitoba,
Canada
(Rochwerg) Division of Critical Care, Department of Medicine, McMaster
University, Ontario, Hamilton, Canada
(Turgeon) Universite Laval / CHU de Quebec - Universite Laval Research
Centre, Quebec, Quebec, Canada
Publisher
W.B. Saunders
Abstract
Tranexamic acid (TXA) reduces transfusion requirements in cardiac surgery
and total hip and knee arthroplasty, where it has become standard of care.
Our objective is to determine the efficacy and safety of TXA in other
surgeries associated with a high risk for red blood cell (RBC)
transfusion. We identified randomized controlled trials in Medline,
Embase, CENTRAL, and CAB abstracts from inception to June 2019. We
included trials evaluating intraoperative IV TXA in adult patients
undergoing a non-cardiac and non-hip and knee arthroplasty surgeries at
high-risk for RBC transfusion, defined as a baseline transfusion rate >=5%
in comparator arm. We assessed risk of bias using the Cochrane Risk of
Bias tool. We used GRADE methodology to assess certainty of evidence. From
8565 citations identified, we included 69 unique trials, enrolling 6157
patients. TXA reduces both the proportion of patients transfused RBCs
(relative risk (RR) 0.59; 95% confidence interval (CI) 0.48 to 0.72; low
certainty evidence) and the volume of RBC transfused (MD -0.51 RBC units;
95%CI -0.13 to -0.9 units; low certainty evidence) when compared to
placebo or usual care. TXA was not associated with differences in deep
vein thrombosis, pulmonary embolism, all-cause mortality, hospital length
of stay, need for re-operation due to hemorrhage, myocardial infarction,
stroke or seizure. In patients undergoing a broad range of non-cardiac and
non-hip and knee arthroplasty surgeries at high risk for RBC transfusion,
perioperative TXA reduced exposure to RBC transfusion. No differences in
thrombotic outcomes were identified; however, summary effect estimates
were limited by lack of systemic screening and short duration of
follow-up.<br/>Copyright &#xa9; 2019 Elsevier Inc.

<49>
Accession Number
2004192412
Title
Effect of atrial pacing on post-operative atrial fibrillation following
coronary artery bypass grafting: Pairwise and network meta-analyses.
Source
International Journal of Cardiology. 302 (pp 103-107), 2020. Date of
Publication: 1 March 2020.
Author
Ruan Y.; Robinson N.B.; Naik A.; Silva M.; Hameed I.; Rahouma M.; Oakley
C.; Di Franco A.; Zamvar V.; Girardi L.N.; Gaudino M.
Institution
(Ruan, Robinson, Naik, Silva, Hameed, Rahouma, Oakley, Di Franco, Girardi,
Gaudino) Department of Cardiothoracic Surgery, Cornell Medicine, New York,
NY, United States
(Zamvar) Department of Cardiothoracic Surgery, Royal Infirmary of
Edinburgh, Edinburgh, United Kingdom
(Ruan) Department of Cardiovascular Surgery, Renmin Hospital of Wuhan
University, Wuhan, China
Publisher
Elsevier Ireland Ltd
Abstract
Background: To determine the effect of atrial pacing on the rate of
post-operative atrial fibrillation (POAF) following coronary artery bypass
grafting. <br/>Method(s): After a systematic literature search, randomized
clinical trials (RCTs) comparing any combination of no pacing (NP),
bi-atrial (BiA) pacing, left-atrial (LA) pacing and right-atrial (RA)
pacing were included. Pairwise and network meta-analyses were performed
using the generic inverse variance method. The primary outcome was POAF
incidence. Secondary outcomes were postoperative bleeding, infection, and
operative mortality. Leave-one-out and meta-regression were done.
<br/>Result(s): Fourteen RCTs were included with a total of 1727 patients.
Compared with NP, any form of atrial pacing was significantly associated
with lower incidence of POAF (odds ratio [OR]: 0.49; 95% confidence
interval [CI]: 0.35-0.69). BiA pacing was associated with the larger risk
reduction (OR: 0.36; 95% CI: 0.20-0.64 vs. 0.59; 95% CI: 0.34-1.02 for LA
and 0.64; 95% CI: 0.38-1.07 for RA). Secondary outcomes were similar
between the no pacing and pacing groups. On meta-regression, age and the
use of continuous monitoring were associated with lower reduction of the
incidence of POAF. In the network meta-analysis, BiA pacing ranked the
best strategy for the prevention of POAF (OR: 0.34; 95% CI: 0.21-0.55).
<br/>Conclusion(s): Compared to other pacing modalities, BiA pacing is
associated with lower rates of POAF following CABG.<br/>Copyright &#xa9;
2019 Elsevier B.V.

<50>
Accession Number
628420147
Title
Ultrasound-guided radial artery cannulation using dynamic needle tip
positioning versus conventional long-axis in-plane techniques in cardiac
surgery patients: a randomized, controlled trial.
Source
Minerva anestesiologica. 86 (1) (pp 30-37), 2020. Date of Publication: 01
Jan 2020.
Author
Nam K.; Jeon Y.; Yoon S.; Kwon S.M.; Kang P.; Cho Y.J.; Kim T.K.
Institution
(Nam, Jeon, Yoon, Kwon, Kang, Cho) Department of Anesthesiology and Pain
Medicine, SMG-SNU Boramae Medical Center, Seoul National University
College of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae
Medical Center, Seoul National University College of Medicine, Seoul,
South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: A novel ultrasound imaging technique, dynamic needle tip
positioning (DNTP), enables continuous visualization of the needle tip
during ultrasound-guided cannulation. The purpose of this study was to
compare the rate of successful first-attempt radial artery cannulations
between DNTP and the conventional long-axis in-plane (LAX-IP) technique.
<br/>METHOD(S): Adult patients undergoing cardiac surgery requiring radial
artery cannulation were included and randomly allocated into either a DNTP
or LAX-IP group. Radial artery cannulation was performed by a single
experienced practitioner. The primary outcome was the first-attempt
success rate of radial artery cannulation. Secondary outcomes included the
length of time needed for cannulation and overall incidence of
complications. <br/>RESULT(S): A total of 136 patients were studied. The
first-attempt success rate of cannulation was 94% in the DNTP group
(N.=70) and 68% in the LAX-IP group (N.=66; OR 7.70, 95% CI 2.48-24.94,
P<0.001). The total procedure time was also shorter in the DNTP group
(median [IQR]; 87 [72-108] seconds) versus the LAX-IP group (118 [93-182]
seconds; P<0.001). During cannulation, vasospasm occurred less often in
the DNTP (4%) group compared to the LAX-IP group (17%; P=0.018).
<br/>CONCLUSION(S): The DNTP technique had a greater first-attempt success
rate of radial artery cannulation compared to the conventional LAX-IP
technique. Also, DNTP required significantly less time for cannulation and
had fewer complications.

<51>
Accession Number
629744540
Title
Bypassing the blues: Insomnia in the depressed post-CABG population.
Source
Annals of clinical psychiatry : official journal of the American Academy
of Clinical Psychiatrists. 32 (1) (pp 17-26), 2020. Date of Publication:
01 Feb 2020.
Author
Waterman L.A.; Belnap B.H.; Gebara M.A.; Huang Y.; Abebe K.Z.; Rollman
B.L.; Karp J.F.
Institution
(Karp) Western Psychiatric Institute and Clinic, Pittsburgh, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Recovery from coronary artery bypass graft (CABG) surgery
often is complicated by depression and insomnia, resulting in poorer
health-related quality of life and clinical outcomes. We explored the
relationships among depression, insomnia, quality of life, and the impact
of a collaborative care strategy on reducing insomnia in patients after
CABG surgery. <br/>METHOD(S): Patients with a Patient Health Questionnaire
score >=10 were randomized to nurse-delivered collaborative care for
depression (n = 150) or their physician's usual care (n = 152). A
convenience sample of patients without depression (n = 151) served as the
control group. Using the Hamilton Depression Rating Scale sleep questions,
we created an "insomnia index." RESULTS: At baseline, 63% of participants
who were depressed vs 12% of those who were not depressed reported
insomnia. Compared with usual care, fewer collaborative care participants
reported insomnia at 8 months, and they tended to have a lower insomnia
score (insomnia index change score -0.95 and -1.47, respectively; P = .05)
with no timeby- randomization interaction, Cohen's d = 0.22 (95%
confidence interval, -0.001 to 0.43). Participants with baseline insomnia
reported greater improvements in mental health-related quality of life
(Medical Outcomes Survey 36-item Short Form Mental Component Summary
score; -3.32, P = .02), but insomnia was not a significant moderator of
the effect of collaborative care. <br/>CONCLUSION(S): This is the first
study to examine the long-term impact on insomnia among post-CABG patients
treated for depression. Future collaborative care studies could consider
including a therapeutic focus for insomnia.

<52>
Accession Number
2004768370
Title
The Low Randomisation Rate in a Trial of Lung Metastasectomy Was More
Often Due to Failure of Clinical Equipoise Rather Than Patients'
Unwillingness to Be Randomised.
Source
European Journal of Surgical Oncology. Conference: ESSO 39. Netherlands.
46 (2) (pp e11), 2020. Date of Publication: February 2020.
Author
Treasure T.; Batchelor T.; Baum M.; Edwards J.; Fallowfield L.; Macbeth
F.; Shackcloth M.
Institution
(Treasure) UCL Department of Mathematics, Clinical Operational Research
Unit, London, United Kingdom
(Batchelor) Bristol Hospitals NHS Trust, Thoracic Surgery, Bristol, United
Kingdom
(Baum) University College London, Surgery, London, United Kingdom
(Edwards) Northern General Hospital, Thoracic Surgery, Sheffield, United
Kingdom
(Fallowfield) SHORE-C, Patient Reported Outcomes Research, Brighton,
United Kingdom
(Macbeth) Cardiff University, Trials Research, Cardiff, United Kingdom
(Shackcloth) Liverpool Heart and Chest Hospital, Thoracic Surgery,
Liverpool, United Kingdom
Publisher
W.B. Saunders Ltd
Abstract
Background: The PulMiCC trial (Pulmonary Metastasectomy in Colorectal
Cancer) recruited 512 patients into Stage 1. Of them only 65 (12.7%) are
reported in the randomised component of the study, a number too small for
a conclusive result. During 2016, aware of this evolving problem, the Data
Monitoring Committee recommended an investigation of the reasons for
failure to randomise. <br/>Material(s) and Method(s): The three largest
recruiting sites were asked to give the reasons why patients who consented
to join the trial in Stage 1 were not randomised into Stage 2.
Specifically (1) How many patients were deemed ineligible and why? (2)
Whose decision was it to not randomise the eligible patients: the
patient's or the clinicians'? (3) How many had metastasectomy and how many
did not? Results: There were 155 Stage 1 consented patients at the three
sites who were not randomised. Answers were: (1) The management of 8
patients was as yet undecided. In 10 the lung nodule proved to be primary
cancer. 18 were deemed ineligible but in half of the instances (9/18) this
was due to a local incorrect interpretation of the protocol. (2) Of the
remaining 119, 41 patients wanted to make their own decision, and for 78
the clinical team decided. (3) When the patient decided 22/41 (54%) opted
for metastasectomy and 19/41 (46%) preferred to avoid operation. Among the
78 patients for whom the clinicians took the decision 77 (99%) were
operated on. As a result 87 patients (the 9+78 detailed above) were lost
to the randomised component of the trial by clinicians' decisions.
<br/>Conclusion(s): There is an embedded belief that patients should be
monitored to detect metastases and to have them removed in selected cases.
Published meta-analytic evidence from multiple randomised trials does not
show survival benefit from such policies. Survival benefit from
metastasectomy has never been studied in a randomised trial and has been
questioned. PulMiCC was designed to answer that question. Although the
local Principle Investigators had signed up to equipoise there were
considerable pressures on them from colleagues to not 'deny' patients
metastasectomy. Adding weight to that view, the European Journal of
Cardio-thoracic surgery published an Editorial opening 'Surgery for
pulmonary metastases is a pillar of modern thoracic surgery'. Contrary to
the commonly stated perception that patients want their metastases removed
and randomisation is unacceptable to them, in this instance the obstacle
to randomisation came not from patients but from professional
conviction.<br/>Copyright &#xa9; 2019

<53>
[Use Link to view the full text]
Accession Number
630753510
Title
Methylene blue versus hydroxocobalamin for postoperative vasoplegia: A
retrospective analysis.
Source
Critical Care Medicine. Conference: 49th Society of Critical Care Medicine
Critical Care Congress, SCCM 202. United States. 48 (Supplement 1) (pp
24), 2020. Date of Publication: January 2020.
Author
Jennings M.; Peters H.
Institution
(Jennings) Indiana University Health, Indianapolis, IN, United States
(Peters) Indiana University Health Methodist Hospital, Indianapolis, IN,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction/Hypothesis: Vasoplegia is common post cardiothoracic surgery
(CTS) and is typically refractory to first line vasopressors. Methylene
blue (MB) and hydroxocobalamin (HC) have been used for treatment of
refractory vasoplegia but have never been compared. This study sought to
compare the effects of methylene blue and hydroxocobalamin on mean
arterial pressure (MAP) in patients with vasoplegia following CTS.
<br/>Method(s): From 2013 to 2018, adult patients ages >= 18 years who
received either MB or HC at IU Methodist Hospital were assessed for
inclusion. Patients were included if they received >= 1mg/kg of MB or 5g
of HC and met the definition of vasoplegia within 72 hours of CTS.
Patients with hemorrhagic shock, surgery other than CTS, and the addition
of new vasopressors or titration of existing agents +/-15 minutes from
receiving either MB or HC. Patients were also excluded if MB and HC were
given <= 2 hours of each other. The primary endpoint was a 20% increase in
MAP within 2 hours of receiving the MB or HC. Secondary outcomes evaluated
morbidity, mortality and hospital length of stay. Baseline characteristics
and outcomes were assessed using descriptive statistics. Nominal data was
compared using the Fischer exact test and continuous data was assessed
using Student's T-test for parametric and the Mann Whitney U test for
non-parametric data. <br/>Result(s): A total of 38 patients met inclusion
criteria (n=13 HC, n=25 MB). Baseline characteristics were similar between
the groups, with the exception of lower baseline MAPs in the HC group (mm
Hg) compared to MB group (49.6+/-8.14 vs.58.4 +/-12.1, p=0.012). The
primary outcome of a 20% increase in MAP within 2 hours of receiving
either agent occurred in (61.5%) and (52%) (p=0.0734) of patients
receiving HC and MB, respectively. The secondary outcomes of length of
hospital stay, survival to discharge, presence of new renal or liver
failure was not statistically different between the groups.
<br/>Conclusion(s): Methylene blue and hydroxocobalamin raised MAP by 20%
in patients with vasoplegia post CTS > 50% of the time. Large randomized
studies are needed to help guide selection of MB verses HC as the
preferred agent for treatment of vasoplegia following CTS.

<54>
[Use Link to view the full text]
Accession Number
630753508
Title
Surgical intensive care unit pain management in the era of intravenous
opioid shortages.
Source
Critical Care Medicine. Conference: 49th Society of Critical Care Medicine
Critical Care Congress, SCCM 202. United States. 48 (Supplement 1) (pp
23), 2020. Date of Publication: January 2020.
Author
Bouwma A.; Mlynarek M.; Peters M.; Procopio V.; Martz C.
Institution
(Bouwma, Mlynarek, Peters, Martz) Henry Ford Hospital, Detroit, MI, United
States
(Procopio) Henry Ford Macomb Hospital, Clinton Township, MI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction/Hypothesis: Fentanyl is widely used for the treatment of pain
in mechanically ventilated (MV) intensive care unit (ICU) patients, but a
shortage of fentanyl forced hospitals to utilize other medications. This
study compared pain control in MV patients before and during continuous
intravenous infusion (CIVI) fentanyl shortages. <br/>Method(s): This was a
multi-center, IRB approved, quasi-experimental study conducted in surgical
ICU (SICU) patients. Patients were included if they were admitted due to
trauma or post-procedure, excluding neurologic and cardiac surgeries, and
on MV for >24 hours. The before and during shortage groups included
patients prior to fentanyl shortages (4/2017-9/2017) who received CIVI
fentanyl and during fentanyl shortages (4/2018-9/2018) without CIVI
fentanyl administration, respectively. Patients were excluded if they were
comfort care, pharmacologically paralyzed, in alcohol withdrawal, or able
to verbalize a pain score. Randomization for patient inclusion occurred
via a random number generator. The primary outcome was the percentage of
Critical-Care Pain Observation Tool (CPOT) scores within goal. Secondary
endpoints included the percentage of Richmond Agitation-Sedation Scale
scores within goal, time to first CPOT goal, morphine milligram
equivalents (MME), ventilator days, ICU length of stay, medications used
for pain, agitation, delirium (PAD), rates of CIVI PAD medications, and
confusion assessment method for the ICU (CAM-ICU). Data was collected
until extubation or up to 7 days on MV. Descriptive statistics,
chi-squared, and Mann Whitney U test were used, as appropriate.
<br/>Result(s): A total of 164 patients were included (82 patients in the
before and during shortage groups respectively). There was no
statistically significant difference in the percentage of CPOT scores at
goal (79.5% vs. 80.6%; p=0.365) however, the during shortage group did
have significantly less oral MME compared to the before group (37.9 MME
vs. 240 MME, respectively; p < 0.001). There were no statistically
significant differences found in other secondary endpoints, with the
exception of higher CIVI propofol rates and increased positive CAM-ICU
scores in the during shortage group. <br/>Conclusion(s): Patients on MV in
the SICU appear to have adequate pain control with less overall MME
without CIVI fentanyl utilization.

<55>
Accession Number
630752821
Title
(20) Temperature strategies during cardiopulmonary bypass surgery and
outcomes in infants with congenital heart defects.
Source
Pediatrics. Conference: National Conference on Education 2017. United
States. 142 (1) (no pagination), 2018. Date of Publication: July 2018.
Author
Bhalala U.S.; Thangavelu M.; Owens R.; Appachi E.; Nento D.; Mumtaz M.A.
Institution
(Bhalala) Baylor College of Medicine, Children's Hospital of San Antonio,
San Antonio, TX, United States
(Thangavelu, Owens, Appachi, Nento, Mumtaz) Children's Hospital of San
Antonio, San Antonio, TX, United States
Publisher
American Academy of Pediatrics
Abstract
Purpose: Many known risk factors for adverse outcomes in children with
congenital heart defects (CHD) are not modifiable; however, the
temperature during cardiopulmonary bypass (CPB) is an important risk
factor, which may be altered in an attempt to improve outcomes.
Moderate-to-deep hypothermia (MDH), traditionally used during CPB, has
been associated with short-term and long-term neurologic sequelae.
Therefore, a handful of centers have adopted mild hypothermia (MH) on CPB
during surgical repair in infants. There is no comparative study of
short-term outcomes following MH versus MDH on CPB in children after
surgical repair. <br/>Method(s): We conducted a retrospective review of
infants who underwent CPB during surgical repair of CHD at Children's
Hospital of San Antonio from January 2014 to February 2017. The patients
were categorized into 2 groups - MH (32-34 degreeC) or MDH (18-28
degreeC). Data was collected on CPB parameters such as lowest temperature,
rate of rewarming, CPB time, cross clamp time, preoperative and
post-operative neurologic function (Pediatric Cerebral and Overall
Performance Category - PCPC/POPC), cardiac function (laboratory and
echocardiographic evidence of cardiac dysfunction, vasoactive inotrope
score, occurrence of arrhythmia), renal function (pediatric Risk, Injury,
Failure and Loss of function - pRIFL criteria), bleeding and volume of
blood product transfusion. Outcome measures were compared including,
ventilator days, ICU days, hospital days, ICU and hospital mortality and
PCPC/POPC at hospital discharge in each group. The comparative data was
analyzed using student t-test and chi-squared test with a significant
p-value < 0.05. <br/>Result(s): There were 39 infants who underwent
cardiac surgery with CBP over a period of 2 years. There were 32 in MH
group and 7 in MDH group. The results of the study are summarized in table
1 and 2. All the baseline characteristics, including RACHS category were
comparable in the two groups. All the infants in the MH group survived to
hospital discharge with favorable neurological outcomes (median
pre-operative and discharge PCPC/POPC= 1). The CPB time (p=0.003) and
intra-op peak lactate (p=0.04) were significantly higher in MDH as
compared to MH group. The postoperative ECMO use (p=0.002), ICU and
hospital mortality (p=0.03) were significantly higher in the MDH group as
compared to MH group. <br/>Conclusion(s): Mild Hypothermia is a recently
adopted temperature strategy for CPB in infants undergoing surgical repair
of CHD. It is associated with favorable short-term outcomes as compared to
moderate-to-deep hypothermia in this small retrospective study. Larger,
multi-center, prospective, randomized studies are needed to evaluate the
long-term outcomes of mild hypothermia before it is widely accepted as a
standard bypass strategy.

<56>
Accession Number
630752802
Title
(18) New frontiers in pediatric critical care: Mild hypothermia and
selective antegrade cerebral perfusion during cardiopulmonary bypass
surgery in children.
Source
Pediatrics. Conference: National Conference on Education 2017. United
States. 142 (1) (no pagination), 2018. Date of Publication: July 2018.
Author
Bhalala U.S.; Thangavelu M.; Owens R.; Zamora M.; Appachi E.; Mumtaz M.A.
Institution
(Bhalala) Baylor College of Medicine, Children's Hospital of San Antonio,
San Antonio, TX, United States
(Thangavelu, Owens, Zamora, Appachi, Mumtaz) Children's Hospital of San
Antonio, San Antonio, TX, United States
Publisher
American Academy of Pediatrics
Abstract
Purpose: Many known risk factors for adverse outcomes in children with
congenital heart defects (CHD) are not modifiable; however, the
temperature and blood flow during cardiopulmonary bypass (CPB), are two
risk factors, which may be altered in an attempt to improve outcomes.
Moderate-to-deep hypotherma (MDH), traditionally used for aortic arch
repair, has been associated with short-term and long-term neurologic
sequelae. Therefore, a handful of centers have adopted mild hypothermia
(MH) with selective antegrade cerebral perfusion (SACP) on CPB during
aortic arch repair in neonates and infants. There is no comparative study
of short-term outcomes following MH + SACP versus MDH + SACP on CPB in
children after aortic arch repair. <br/>Method(s): We conducted a
retrospective chart review of neonates and infants who underwent SACP on
CPB during aortic arch repair at our tertiary care children's hospital. We
categorized all the patients into 2 groups - MH + SACP or MDH + SACP. We
gathered data on CPB parameters such as lowest CPB temperature, rate of
rewarming, SACP time and flow, CPB time and cross clamp time.
preoperative, intra-operative and post-operative data on neurologic
function (PCPC/POPC), cardiac function (laboratory and echocardiographic
evidence of cardiac dysfunction, vasoactive inotrope score, occurrence of
arrhythmia), renal function (pRIFL criteria) and bleeding and volume of
blood product transfusion. We measured the outcomes of ventilator days,
ICU days, hospital days, ICU and hospital mortality and PCPC/POPC at
hospital discharge in each group. We analyzed comparative data using
student t-test and chi-squared test with a significant p-value < 0.05.
<br/>Result(s): There were 13 neonates and infants who underwent SACP on
CPB during cardiac surgery over 2 years at our children's hospital. There
were 6 in MH + SACP group and 7 in MDH + SACP group. The results of the
study are summarized in the Table 1 and 2. All the neonates and infants in
MH + SACP group survived at the hospital discharge with favorable
neurologic outcomes (median pre-operative and discharge PCPC/POPC=1) . The
post-operative arrhythmia was significantly higher in MDH + SACP group as
compared to the MH + SACP group (p=0.04). There was no statistically
significant difference between the two groups for end organ dysfunction,
ventilator days, ICU days, hospital days, ICU and hospital mortality and
PCPC/POPC at hospital discharge. <br/>Conclusion(s): Mild Hypothermia +
SACP, which is a newly adopted temperature strategy on CPB in neonates and
infants undergoing aortic arch repair, is associated with favorable
short-term outcomes and lower post-operative arrhythmia rate as compared
to moderate-to-deep hypothermia + SACP. Larger, multi-center, prospective,
randomized studies are needed to evaluate the long-term outcomes of mild
hypothermia with SACP before it is widely accepted as a standard bypass
strategy.

<57>
Accession Number
630762691
Title
Effects of cycle ergometer use in early mobilization following cardiac
surgery: a randomized controlled trial.
Source
Clinical rehabilitation. (pp 269215520901763), 2020. Date of Publication:
29 Jan 2020.
Author
Gama Lordello G.G.; Goncalves Gama G.G.; Lago Rosier G.; Viana P.A.D.C.;
Correia L.C.; Fonteles Ritt L.E.
Institution
(Gama Lordello, Goncalves Gama, Viana, Correia, Fonteles Ritt) Bahiana
School of Medicine and Public Health, Salvador, Brazil
(Gama Lordello, Lago Rosier, Viana) Hospital Santa Izabel, Santa Casa da
Bahia, Salvador, Brazil
(Goncalves Gama) Edgard Santos Teaching Hospital, Federal University of
Bahia, Salvador, Brazil
(Correia) Hospital Alianca, Salvador, Brazil
(Fonteles Ritt) Hospital Cardio Pulmonar, Salvador, Brazil
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To evaluate the effect of early use of a cycle ergometer,
compared to a standard care protocol, in postoperatory in-hospital
mobility following cardiac surgery. DESIGN: A randomized controlled trial.
SETTING: Tertiary hospital in Salvador, Bahia, Brazil. SUBJECTS: Patients
submitted to elective cardiac surgery (valvular or coronary bypass surgery
by sternotomy). INTERVENTION: Patients were randomly allocated in two
groups: (1) cycle ergometer training group (10-minute session) and (2)
control group submitted standard physiotherapy protocol (10-minute
session). Training was provided twice a day, immediately following
extubation and until patient was discharged from the intensive care. MAIN
MEASURES: The primary outcome was the difference in the total number of
steps recorded on the pedometer over three days. Secondary outcomes were
mobility in different subgroups and the reasons that prevented individuals
from walking during early cardiac rehabilitation. <br/>RESULT(S): A total
of 228 participants completed the study. No significant difference was
found in the total number of steps between the groups after intervention:
2183 (range: 1729-2772) in the intervention group versus 2006 (1517-2657)
in the control group (P=0.167). However, self-reports indicated better
motivation in the intervention group (P=0.044). No adverse events occurred
during the study. <br/>CONCLUSION(S): As a strategy for early mobilization
following cardiac surgery, the use of a cycle ergometer failed to increase
independent physical activity compared to a standard care protocol.
Nevertheless, it was safe and could be an alternative to make
rehabilitation more attractive and motivational for this patient
population.

<58>
Accession Number
630761210
Title
Bioresorbable vascular stents and drug-eluting stents in treatment of
coronary heart disease: a meta-analysis.
Source
Journal of cardiothoracic surgery. 15 (1) (pp 26), 2020. Date of
Publication: 28 Jan 2020.
Author
Ni L.; Chen H.; Luo Z.; Yu Y.
Institution
(Ni, Chen) 900th Hospital of PLA Joint Logistics Support Force, Fujian
Province, 156 West Second Ring Road, China
(Luo) 900th Hospital of PLA Joint Logistics Support Force, Fujian
Province, 156 West Second Ring Road, China
(Yu) 900th Hospital of PLA Joint Logistics Support Force, Fujian Province,
156 West Second Ring Road, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To compare the efficacy and safety of bioresorbable vascular
stents (BVS) and drug-eluting stents (DES) in coronary heart disease.
<br/>METHOD(S): The full text of clinical studies involving BVS and DES
was retrieved in PubMed, Springer, EMBASE, Wiley-Blackwell, and Chinese
Journal Full-text Database. Review Manager 5.3 was used for meta-analysis
to evaluate the risk of target lesion failure, stent thrombosis and
cardiac death in BVS and DES. <br/>RESULT(S): Finally, 10 studies with
6383 patients were included in the meta-analysis. Compared with DES group,
BVS group had significantly increased risk of target lesion failure
(OR=1.46, 95%CI 1.20-1.79, P =0.0002; P Heterogeneity =0.68, I2 =0%),
stent thrombosis (OR=2.70, 95%CI 1.57-4.66, P =0.0003; P Heterogeneity
=1.00, I2 =0%) and cardiac death (OR=2.19, 95%CI 1.17-4.07, P =0.01; P
Heterogeneity =0.93, I2 =0%). <br/>CONCLUSION(S): This study shows that
DES is a safer treatment than BVS for coronary revascularization.

<59>
Accession Number
630759722
Title
High-dose Nitroglycerin Administered during Rewarming Preserves
Erythrocyte Deformability in Cardiac Surgery with Cardiopulmonary Bypass.
Source
Microcirculation (New York, N.Y. : 1994). (no pagination), 2020. Date of
Publication: 28 Jan 2020.
Author
Tai Y.-H.; Chu Y.-H.; Wu H.-L.; Lin S.-M.; Tsou M.-Y.; Huang C.-H.; Chang
H.-H.; Lu C.-C.
Institution
(Tai, Chu, Wu, Lin, Tsou, Lu) Department of Anesthesiology, Taipei
Veterans General Hospital, Taipei, Taiwan (Republic of China)
(Tai, Wu, Lin, Tsou, Huang) School of Medicine, National Yang-Ming
University, Taipei, Taiwan (Republic of China)
(Tai) Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical
University, New Taipei City, Taiwan (Republic of China)
(Tai) Department of Anesthesiology, School of Medicine, College of
Medicine, Taipei Medical University, Taipei, Taiwan (Republic of China)
(Chu, Lu) Graduate Institute of Life Sciences, National Defense Medical
Center, Taipei, Taiwan (Republic of China)
(Huang, Chang) Division of Cardiovascular Surgery, Department of Surgery,
Taipei Veterans General Hospital, Taipei, Taiwan (Republic of China)
(Lu) Institute of Aerospace Medicine, National Defense Medical Center,
Taipei, Taiwan (Republic of China)
Publisher
NLM (Medline)
Abstract
OBJECTIVE: We aimed to determine whether high-dose nitroglycerin, a nitric
oxide donor, preserves erythrocyte deformability during cardiopulmonary
bypass and examine the signaling pathway of nitric oxide in erythrocytes.
<br/>METHOD(S): In a randomized and controlled fashion, forty-two patients
undergoing cardiac surgery with hypothermic cardiopulmonary bypass were
allocated to high-dose (N=21) and low-dose groups (N=21). During rewarming
period, patients were given intravenous nitroglycerin with an infusion
rate 5 and 1 micro&#32;g.kg-1 .min-1 in high-dose and low-dose groups,
respectively. Tyrosine phosphorylation level of non-muscle myosin IIA in
erythrocyte membrane was used as an index of erythrocyte deformability and
analyzed using immunoblotting. <br/>RESULT(S): Tyrosine phosphorylation of
non-muscle myosin IIA was significantly enhanced after bypass in high-dose
group (3.729 +/- 1.700 folds, p = 0.011) but not low-dose group (1.545 +/-
0.595 folds, p = 0.076). Phosphorylation of aquaporin 1,
vasodilator-stimulated phosphoprotein, and focal adhesion kinase in
erythrocyte membrane was also upregulated in high-dose group after bypass.
Besides, plasma nitric oxide level was highly correlated with fold change
of non-muscle myosin IIA phosphorylation (Pearson's correlation
coefficient 0.871). <br/>CONCLUSION(S): High-dose nitroglycerin
administered during cardiopulmonary bypass improves erythrocyte
deformability through activating phosphorylation of aquaporin 1,
vasodilator-stimulated phosphoprotein and focal adhesion kinase in
erythrocytes.<br/>Copyright &#xa9; 2020 John Wiley & Sons Ltd.

<60>
Accession Number
2004154997
Title
Part VII: Behavioral economics-A framework for donor organ decision-making
in pediatric heart transplantation.
Source
Pediatric Transplantation. (no pagination), 2020. Article Number: e13655.
Date of Publication: 2020.
Author
Butler A.; Chapman G.; Johnson J.N.; Amodeo A.; Bohmer J.; Camino M.;
Davies R.R.; Dipchand A.I.; Godown J.; Miera O.; Perez-Blanco A.;
Rosenthal D.N.; Zangwill S.; Kirk R.
Institution
(Butler, Chapman) Carnegie Mellon University, Pittsburgh, PA, United
States
(Johnson) Division of Pediatric Cardiology, Mayo Clinic, Rochester, MN,
United States
(Amodeo) Bambino Gesu Children's Hospital, Rome, Italy
(Bohmer) The Queen Silvia Children's Hospital, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Camino) Madrid Hospital Gregorio Maranon, Madrid, Spain
(Davies) Department of Cardiovascular and Thoracic Surgery, University of
Texas Southwestern Medical Center, Children's Medical Center, Dallas, TX,
United States
(Dipchand) Labatt Family Heart Centre, Hospital for Sick Children,
University of Toronto, Toronto, ON, Canada
(Godown) Vanderbilt University Medical Center, Nashville, TN, United
States
(Miera) Department of Congenital Heart Disease/Pediatric Cardiology,
Deutsches Herzzentrum, Berlin, Germany
(Perez-Blanco) Spanish National Transplant Organization, Madrid, Spain
(Rosenthal) Stanford University, Palo Alto, CA, United States
(Zangwill) Phoenix Children's Hospital, Phoenix, AZ, United States
(Kirk) Division of Pediatric Cardiology, University of Texas Southwestern
Medical Center, Children's Medical Center, Dallas, TX, United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
The high discard rate of pediatric donor hearts presents a major challenge
for children awaiting heart transplantation. Recent literature identifies
several factors that contribute to the disparities in pediatric donor
heart usage, including regulatory oversight, the absence of guidelines on
pediatric donor heart acceptance, and variation among transplant programs.
However, a likely additional contributor to this issue are the behavioral
factors influencing transplant team decisions in donor offer scenarios, a
topic that has not yet been studied in detail. Behavioral economics and
decision psychology provide an excellent foundation for investigating
decision-making in the pediatric transplant setting, offering key insights
into the behavior of transplant professionals. We conducted a systematic
review of published literature in pediatric heart transplant related to
behavioral economics and the psychology of decision-making. In this
review, we draw on paradigms from these two domains in order to examine
how existing aspects of the transplant environment, including regulatory
oversight, programmatic variation, and allocation systems, may precipitate
potential biases surrounding donor offer decisions. Recognizing how human
decision behavior influences donor acceptance is a first step toward
improving utilization of potentially viable pediatric donor
hearts.<br/>Copyright &#xa9; 2020 Wiley Periodicals, Inc.

<61>
Accession Number
2004060171
Title
The effect of inhalation aromatherapy in patients undergoing cardiac
surgery: A systematic review and meta-analysis of randomized controlled
trials.
Source
Complementary Therapies in Medicine. 48 (no pagination), 2020. Article
Number: 102256. Date of Publication: January 2020.
Author
Abdelhakim A.M.; Hussein A.S.; Doheim M.F.; Sayed A.K.
Institution
(Abdelhakim) Kasr Alainy, Faculty of Medicine, Cairo University, 395
portsaid street, Bab el-kalq, Cairo, Egypt
(Hussein) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Doheim) Faculty of Medicine, Alexandria University, Alexandria, Egypt
(Sayed) Faculty of Medicine, Minia University, Minia, Egypt
Publisher
Churchill Livingstone
Abstract
Objective: The goal of this study was to synthesize evidence regarding the
efficacy of inhalation aromatherapy in patients undergoing cardiac
surgery. <br/>Method(s): We conducted an electronic search of four
authentic databases. Randomized controlled trials (RCTs), which compared
inhalation aromatherapy versus control in patients undergoing cardiac
surgery, were included. Data were extracted from eligible studies and
pooled in a meta-analysis model. We sought to evaluate anxiety, pain,
stress, and vital signs including heart rate, systolic and diastolic blood
pressure. <br/>Result(s): Nine RCTs were included in this study with a
total of 656 patients. Our analysis showed inhalation aromatherapy was
significantly effective in reducing anxiety (MD= -3.11, 95 % CI [-5.26,
-0.96], p = 0.005), and pain (MD= -0.83, 95 % CI [-1.59, -0.07], p = 0.03)
in patients undergoing cardiac surgery. Additionally, inhalation
aromatherapy significantly reduced heart rate compared to control group
(MD= -5.49, 95 % CI [-9.07, -1.81], p = 0.003). However, no significant
differences were found between both groups in mental stress, systolic and
diastolic blood pressure. <br/>Conclusion(s): Inhalation aromatherapy
administration especially with lavender can significantly reduce anxiety,
pain, and heart rate in patients performed cardiac surgery. However, it is
not associated with significant differences in systolic and diastolic
blood pressure. Further studies are needed to confirm our
results.<br/>Copyright &#xa9; 2019 Elsevier Ltd

<62>
Accession Number
625375415
Title
Laryngeal mask airway versus endotracheal tube for percutaneous
dilatational tracheostomy in critically ill adults.
Source
Cochrane Database of Systematic Reviews. 2018 (11) (no pagination), 2018.
Article Number: CD009901. Date of Publication: 15 Nov 2018.
Author
Strametz R.; Bergold M.N.; Weberschock T.
Institution
(Strametz) RheinMain University of Applied Science, Wiesbaden Business
School, Bleichstr. 44, Wiesbaden 65183, Germany
(Bergold) Evangelisches Krankenhaus Oldenburg - European Medical School,
Department of Anesthesiology, Intensive Care Medicine and Pain Therapy,
Steinweg 13-17, Oldenburg D-26122, Germany
(Weberschock) Johann Wolfgang Goethe-University Hospital, Department of
Dermatology, Venereology and Allergology, Theodor-Stern-Kai 7, Frankfurt
am Main 60590, Germany
(Weberschock) Goethe University, Evidence-Based Medicine Frankfurt,
Institute for General Practice, Theodor Stern Kai 7, Frankfurt 60590,
Germany
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
Background: Percutaneous dilatational tracheostomy (PDT) is one of the
most common bedside surgical procedures performed in critically ill
adults, on intensive care units (ICUs), who require long-term ventilation.
PDT is associated with relevant life-threatening complications: Cuff
rupture or accidental extubation may lead to hypoxia, aspiration or loss
of airway. Puncture of the oesophagus, or creating a false passage during
dilatation or replacement of the tracheostomy tube, can lead to
pneumothorax or emphysema. Wound infections may occur which can cause
mediastinits, especially after creation of false passage or in early
tracheotomized post-sternotomy patients after cardiac surgery. During the
procedure, the patient's airway can be secured with an endotracheal tube
(ETT) or a laryngeal mask airway (LMA). This is an updated version of the
review first published in 2014. <br/>Objective(s): To assess the safety
and effectiveness of LMA versus ETT in critically ill adults undergoing
PDT on the ICU. <br/>Search Method(s): We searched the following databases
to 9 January 2018: Cochrane Central Register of Controlled Trials
(CENTRAL), MEDLINE and Embase. We searched for reports of ongoing trials
in the metaRegister of Controlled Trials (mRCT). We handsearched for
relevant studies in conference proceedings of five relevant annual
congresses. We contacted study authors and experts concerning unpublished
data and ongoing trials. We searched for further relevant studies in the
reference lists of all included trials and of relevant systematic reviews.
<br/>Selection Criteria: We included randomized controlled trials (RCTs)
that compared use of laryngeal mask airways versus endotracheal tubes in
critically ill adults undergoing elective PDT in the ICU, without injuries
to or diseases of the face or neck. We imposed no restrictions with regard
to language, timing or technique of PDT performed. <br/>Data Collection
and Analysis: Two review authors independently assessed the eligibility
and methodological quality of each study and carried out data extraction.
Our primary outcomes were all-cause mortality, procedure-related mortality
and tally of participants with one or more serious adverse events. Where
possible, we combined homogeneous studies for meta-analysis. We used
Cochrane's 'Risk of bias' tool and used GRADE to assess the quality of
evidence for key outcomes. <br/>Main Result(s): We included nine RCTs in
this review involving 517 participants. Studies had a high or unclear risk
of bias. The main reason for this was low methodological quality or
missing data, even after study authors were contacted. Study size was
generally small, with a minimum of 40, and a maximum of 73 participants.
In one study (40 participants), three deaths in the LMA group and two
deaths in the ETT group were reported, although none of the deaths were
related to the procedure (very low-quality evidence). Five studies (281
participants) reported on procedure-related deaths, stating that no
procedure-related death occurred at all (very low-quality evidence). It is
uncertain whether there is a difference in the number of people
experiencing one or more serious adverse event(s) between LMA and ETT
(risk ratio (RR) 0.86, 95% confidence interval (CI) 0.41 to 1.80; 467
participants, 8 studies, very low-quality evidence). The duration of the
procedure may be shorter in the LMA group (mean difference (MD) -1.46
minutes, 95% CI -1.92 to -1.01 minutes; 6 studies, 324 participants,
low-quality evidence). However failure of procedure, as allocated by
randomization, requiring conversion to any other procedure, may be higher
in the LMA group (RR 2.82, 95% CI 1.22 to 6.52; 8 studies, 439
participants, low-quality evidence). We did not find any clear evidence of
a difference between ETT and LMA groups for all other outcomes. Only one
study provided follow-up data for late complications related to the
intervention, showing no clear evidence of benefit for any treatment
group. Authors' conclusions: Evidence on the safety of LMA for PDT is too
limited to allow conclusions to be drawn on either its efficacy or safety
compared with ETT. Although the LMA procedure may shorten the period
during which the airway is insecure, it may also lead to higher conversion
rates. Also, late complications have not been investigated sufficiently.
These results are primarily based on single-centre trials with small
sample sizes, and therefore the level of evidence remains low. Studies
with low risk of bias focusing on late complications and relevant
patient-related outcomes are necessary for definitive conclusions on
safety issues related to this procedure. The dependency of the successful
placement of a LMA on the type of LMA used should also be further
assessed. There are two studies awaiting classification that may alter the
conclusions once assessed.<br/>Copyright &#xa9; 2018 The Cochrane
Collaboration.

<63>
Accession Number
2002473442
Title
Global longitudinal strain to predict left ventricular dysfunction in
asymptomatic patients with severe mitral valve regurgitation: literature
review.
Source
Netherlands Heart Journal. 28 (2) (pp 63-72), 2020. Date of Publication:
01 Feb 2020.
Author
Bijvoet G.P.; Teske A.J.; Chamuleau S.A.J.; Hart E.A.; Jansen R.; Schaap
J.
Institution
(Bijvoet) Department of Cardiology, Maastricht University Medical Centre,
Maastricht, Netherlands
(Teske, Chamuleau, Hart, Jansen) Department of Cardiology, University
Medical Centre Utrecht, Utrecht, Netherlands
(Schaap) Department of Cardiology, Amphia Hospital, Breda, Netherlands
Publisher
Bohn Stafleu van Loghum (E-mail: e.smid@ntvg.nl)
Abstract
The optimal treatment strategy for asymptomatic patients with severe
mitral valve regurgitation (MR) and preserved left ventricular (LV)
function is challenging. This manuscript reviews the available literature
on the value of left ventricular global longitudinal strain (LV-GLS) in
predicting LV dysfunction after mitral valve surgery in these patients and
discusses its current place in the treatment strategy. Studies were
identified from Cochrane Library, SCOPUS, PubMed and Web of Science up to
February 2018. The domain used was MR. The determinant was LV-GLS; other
methods of deformation imaging were excluded. The examined outcome was LV
dysfunction after surgery. A total of 144 articles were retrieved, of
which 11 publications met the inclusion criteria, including a total of
2415 patients. Ten studies showed a significant correlation between
preoperative LV-GLS and LV dysfunction postoperatively; one study reported
a negative correlation. These studies suggest that LV-GLS is a predictor
of LV dysfunction after surgery in asymptomatic patients with chronic MR.
Hence, incorporation of LV-GLS for clinical decision-making in these
patients might be of additional value. Further research is needed to
confirm the role of LV-GLS in postoperative patients, and additionally in
asymptomatic MR patients during a 'watchful waiting'
strategy.<br/>Copyright &#xa9; 2019, The Author(s).

<64>
Accession Number
2002266195
Title
Randomized clinical trial of an elastomeric sealant for hemostasis in
thoracic aortic surgery.
Source
General Thoracic and Cardiovascular Surgery. 68 (2) (pp 112-121), 2020.
Date of Publication: 01 Feb 2020.
Author
Morita S.; Matsuda T.; Tashiro T.; Komiya T.; Ogino H.; Mukohara N.;
Tominaga R.
Institution
(Morita) Department of Thoracic and Cardiovascular Surgery, Clinical
Research Institute, National Hospital Organization Kyushu Medical Center,
1-8-1 Jigyohama, Fukuoka 810-8563, Japan
(Matsuda) Division of Biomedical Engineering, Graduate School of Medical
Science, Kyushu University, Fukuoka, Japan
(Tashiro) Department of Cardiovascular Surgery, University of Fukuoka
Medical School, Fukuoka, Japan
(Komiya) Department of Cardiovascular Surgery, Kurashiki Central Hospital,
Kurashiki, Okayama, Japan
(Ogino) Department of Cardiovascular Surgery, National Cardiovascular and
Research Center, Suita, Osaka, Japan
(Mukohara) Department of Cardiovascular Surgery, Hyogo Brain and Heart
Center, Himeji, Japan
(Tominaga) Division of Cardiovascular Surgery, Graduate School of Medical
Science, Kyushu University, Fukuoka, Japan
Publisher
Springer
Abstract
Objectives: This study aimed to demonstrate the efficacy and safety of a
newly developed elastomeric sealant, which does not require any blood
coagulation system to exert its effect, during thoracic aortic surgery.
<br/>Method(s): This is a multicenter, randomized study conducted in six
hospitals in Japan. A total of 81 patients undergoing replacement surgery
of a thoracic aortic aneurysm using cardiopulmonary bypass were randomized
with a ratio of 2-:1 for those patients designated to receive the sealant
(Group S, 54 patients) or those without the usage of the sealant (Group C,
27 patients). The primary endpoints were bleeding from each anastomosis at
two time points: (1) immediately before applying protamine and (2) 15 min
after applying protamine. The patients were followed for 6 months.
<br/>Result(s): The number of anastomoses checked for bleeding was 196 in
Group S and 117 in Group C. Before protamine sulfate administration,
complete hemostasis was obtained in 155 anastomoses (79%) in Group S
compared to 45 anastomoses (38%) in Group C (p < 0.001). Fifteen minutes
after the administration of protamine sulfate infusion, bleeding stopped
completely in 173 anastomoses (88%) in Group S and in 71 anastomoses (61%,
p < 0.001) in Group C. Between the two groups, there were no marked
differences in the patient background or in the incidence of major adverse
events. <br/>Conclusion(s): The sealant is effective in achieving
hemostasis, even under fully heparinized conditions. The novel sealant is
safe and effective in thoracic aortic surgery, one of the most demanding
surgical situations for hemostasis.<br/>Copyright &#xa9; 2019, The
Author(s).

<65>
Accession Number
629884279
Title
Balloon-Expandable Versus Self-Expanding Transcatheter Aortic Valve
Replacement: A Propensity-Matched Comparison From the FRANCE-TAVI
Registry.
Source
Circulation. 141 (4) (pp 243-259), 2020. Date of Publication: 28 Jan 2020.
Author
Van Belle E.; Vincent F.; Labreuche J.; Auffret V.; Debry N.; Lefevre T.;
Eltchaninoff H.; Manigold T.; Gilard M.; Verhoye J.-P.; Himbert D.; Koning
R.; Collet J.-P.; Leprince P.; Teiger E.; Duhamel A.; Cosenza A.; Schurtz
G.; Porouchani S.; Lattuca B.; Robin E.; Coisne A.; Modine T.; Richardson
M.; Joly P.; Rioufol G.; Ghostine S.; Bar O.; Amabile N.; Champagnac D.;
Ohlmann P.; Meneveau N.; Lhermusier T.; Leroux L.; Leclercq F.; Gandet T.;
Pinaud F.; Cuisset T.; Motreff P.; Souteyrand G.; Iung B.; Folliguet T.;
Commeau P.; Cayla G.; Bayet G.; Darremont O.; Spaulding C.; Le Breton H.;
Delhaye C.
Institution
(Van Belle, Vincent, Debry, Cosenza, Schurtz, Porouchani, Robin, Coisne,
Modine, Richardson, Delhaye) Departement de Cardiologie, Inserm U1011,
Institut Pasteur de Lille, F.V., T. Modine, E.R
(Labreuche, Duhamel) Department of Biostatistics, EA 2694-Sante Publique:
epidemiologie et Qualite des Soins (J.L.
(Auffret, Verhoye, Le Breton) CHU de Lille, Universite de Lille, Service
de Cardiologie et Maladies Vasculaires, Laboratoire de Traitement du
Signal et de l'Image, Inserm U1099, Universite de Rennes 1, Rennes CIC-IT
804, France
(Lefevre) Institut Cardiovasculaire Paris-Sud, Massy, France
(Eltchaninoff) Service de Cardiologie, Rouen, France
(Manigold) CHU Guillaume et Rene Laennec, Institut du Thorax, Service de
Cardiologie, Nantes, Brazil
(Gilard) CHU La Cavale Blanche, Departement de Cardiologie, Optimisation
des Regulations Physiologiques, UFR Sciences et Techniques, Brest, Belarus
(Himbert, Iung) AP-HP, Hopital Bichat, Departement de Cardiologie,
Universite Paris-Diderot
(Koning) Clinique Saint-Hilaire, Service de Cardiologie, Rouen, France
(Collet, Leprince) AP-HP, CHU La Pitie-Salpetriere, Service de
Cardiologie, Paris, United States
(Teiger) Hopital Henri-Mondor Assistance Publique Hopitaux de Paris,
Departement de Cardiologie, Creteil
(Lattuca, Cayla) CHU Nimes, Cardiologie, Universite Montpellier, Nimes,
France
(Joly) Hopital Saint-Joseph, Federation de Cardiologie, Marseille, France
(Rioufol) Division de Cardiologie, Centre d'Investigation Clinique de Lyon
(CIC), Bron, France
(Ghostine) Centre Marie Lannelongue, Departement de Cardiologie, Le
Plessis Robinson
(Bar) Clinique Saint Gatien, Service de Cardiologie, Tours, France
(Amabile) Institut Mutualiste Montsouris, Departement de Cardiologie,
Paris, United States
(Champagnac) Clinique du Tonkin, Service de Cardiologie, Villeurbanne,
France
(Ohlmann) Nouvel Hopital Civil, Departement de Cardiologie, Universite de
Strasbourg, CHU de Strasbourg
(Meneveau) CHU Besancon, Cardiologie, Hopital Jean Minjoz, Besancon
(Lhermusier) Departement de Cardiologie, Inserm U1048, CHU de
ToulouseUniversite de Toulouse 3
(Leroux) Hopital Cardiologique du Haut-Leveque, Departement de Cardiologie
Interventionnelle, Universite de Bordeaux, Pessac, France
(Leclercq, Gandet) Service de Cardiologie, CHU Arnaud de Villeneuve,
Montpellier, France
(Pinaud) CHU d'Angers, Service de Chirurgie Cardiaque, CNRS UMR 6214,
INSERM 1083, Universite d'Angers
(Cuisset) CHU La Timone Assistance Publique Hopitaux de Marseille,
Departement de Cardiologie, Inserm UMR1062, INRA UMR 1260, Universite
d'Aix-Marseille
(Motreff, Souteyrand) CHU Gabriel Montpied, Departement de Cardiologie,
ISIT, CNRS (UMR-6284), Clermont-Ferrand, Universite d'Auvergne
(Folliguet) Service de Chirurgie Cardiovasculaire, Vandoeuvre-les-Nancy,
CHU de Nancy
(Commeau) Polyclinique les Fleurs, Cardiologie, Ollioules, France
(Bayet) Hopital Prive Clairval, Service de Cardiologie, Marseille, France
(Darremont) Clinique Saint Augustin, Service de Cardiologie, Bordeaux,
France
(Spaulding) Hopital Europeen Georges Pompidou, Paris, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: No randomized study powered to compare balloon expandable (BE)
with self expanding (SE) transcatheter heart valves (THVs) on individual
end points after transcatheter aortic valve replacement has been conducted
to date. <br/>METHOD(S): From January 2013 to December 2015, the
FRANCE-TAVI nationwide registry (Registry of Aortic Valve Bioprostheses
Established by Catheter) included 12 141 patients undergoing BE-THV
(Edwards, n=8038) or SE-THV (Medtronic, n=4103) for treatment of native
aortic stenosis. Long term mortality status was available in all patients
(median 20 months; interquartile range, 14 to 30). Patients treated with
BE-THV (n=3910) were successfully matched 1:1 with 3910 patients treated
with SE-THV by using propensity score (25 clinical, anatomical, and
procedural variables) and by date of the procedure (within 3 months). The
first coprimary outcome was >= moderate occurrence of paravalvular
regurgitation or in-hospital mortality, or both. The second coprimary
outcome was 2-year all-cause mortality. <br/>RESULT(S): In
propensity-matched analyses, the incidence of the first coprimary outcome
was higher with SE-THV (19.8%) compared with BE-THV (11.9%; relative risk,
1.68 [95% CI, 1.46-1.91]; P<0.0001). Each component of the outcome was
also higher in patients receiving SE-THV: >= moderate paravalvular
regurgitation (15.5% versus 8.3%; relative risk, 1.90 [95% CI, 1.63-2.22];
P<0.0001) and in hospital mortality (5.6% versus 4.2%; relative risk, 1.34
[95% CI, 1.07-1.66]; P=0.01). During follow up, all cause mortality
occurred in 899 patients treated with SE-THV (2-year mortality, 29.8%) and
in 801 patients treated with BE-THV (2-year mortality, 26.6%; hazard
ratio, 1.17 [95% CI, 1.06-1.29]; P=0.003). Similar results were found
using inverse probability of treatment weighting using propensity score
analysis. <br/>CONCLUSION(S): The present study suggests that use of
SE-THV was associated with a higher risk of paravalvular regurgitation and
higher in-hospital and 2-year mortality compared with use of BE-THV. These
data strongly support the need for a randomized trial sufficiently powered
to compare the latest generation of SE-THV and BE-THV. CLINICAL TRIAL
REGISTRATION: https://www.clinicaltrials.gov. Unique identifier:
NCT01777828.

<66>
Accession Number
2004705745
Title
Association of obstructive sleep apnea and postoperative cardiac
complications: A systematic review and meta-analysis with trial sequential
analysis.
Source
Journal of Clinical Anesthesia. 62 (no pagination), 2020. Article Number:
109731. Date of Publication: June 2020.
Author
Ng K.T.; Lee Z.X.; Ang E.; Teoh W.Y.; Wang C.Y.
Institution
(Ng, Wang) Department of Anaesthesiology, Faculty of Medicine, University
of Malaya, Jalan Universiti, Kuala Lumpur 50603, Malaysia
(Lee, Ang) University Hospital of Wales, Health Park, Cardiff CF14 4XN,
United Kingdom
(Teoh) University of Liverpool, School of Medicine, Cedar House, Ashton
Street, Liverpool L69 3GE, United Kingdom
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: The repetitive hypoxic and hypercapnia events of obstructive
sleep apnea (OSA) are believed to adversely affect cardiopulmonary
function, which make them vulnerable to a higher incidence of
postoperative complications. The primary aim of this systematic review and
meta-analysis was to examine the association of OSA and the composite
endpoints of postoperative cardiac or cerebrovascular complications in
adult undergoing non-cardiac surgery. Data sources: MEDLINE, EMBASE and
CENTRAL were systematically searched from its inception until May 2019.
Review methods: All observational studies were included. <br/>Result(s):
Twenty-two studies (n = 3,033,814; 184,968 OSA vs 2,848,846 non-OSA) were
included for quantitative meta-analysis. In non-cardiac surgery, OSA was
significantly associated with a higher incidence of the composite
endpoints of postoperative cardiac or cerebrovascular complications (odd
ratio: 1.44, 95%CI: 1.17 to 1.78, rho = 0.007, trial sequential analysis =
conclusive; certainty of evidence = very low). In comparison to non-OSA,
OSA patients were reported to have nearly 2.5-fold risk of developing
pulmonary complications (odd ratio: 2.52, 95%CI: 1.92 to 3.31, rho <
0.001, certainty of evidence = very low), postoperative delirium (odd
ratio: 2.45, 95%CI: 1.50 to 4.01, rho < 0.001, certainty of evidence =
low) and acute kidney injury (odd ratio: 2.41, 95%CI: 1.93 to 3.02, rho <
0.001, certainty of evidence = very low). <br/>Conclusion(s): This
meta-analysis of 22 comparative studies demonstrated that OSA is a
potential risk factor to postoperative adverse complications in adults
undergoing non-cardiac surgery. However, the conclusions need to be
interpreted with caution due to the nature of included observational
studies with significant heterogeneity and low quality of evidence.
PROSPERO: CRD42019136564.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<67>
Accession Number
629667401
Title
High-Flow Nasal Cannula Therapy With Early Extubation for Subjects
Undergoing Off-Pump Coronary Artery Bypass Graft Surgery.
Source
Respiratory care. 65 (2) (pp 183-190), 2020. Date of Publication: 01 Feb
2020.
Author
Tatsuishi W.; Sato T.; Kataoka G.; Sato A.; Asano R.; Nakano K.
Institution
(Tatsuishi, Sato, Kataoka, Asano, Nakano) Department of Cardiovascular
Surgery
(Sato) Department of Clinical Engineering, Tokyo Women's Medical
University, Medical Center East, Tokyo, Japan
Publisher
NLM (Medline)
Abstract
BACKGROUND: The effects of high-flow nasal cannula (HFNC) therapy on
postoperative atelectasis and duration of oxygen therapy after off-pump
coronary artery bypass graft are unknown. The purpose of this study was to
compare the effects of HFNC therapy for subjects who underwent off-pump
coronary artery bypass graft with the effects of standard oxygen therapy
in terms of oxygen requirement and atelectasis. <br/>METHOD(S): This
prospective single-blinded randomized, controlled trial included 148
subjects who underwent off-pump coronary artery bypass graft between 2010
and 2015 with HFNC (n = 72) or without HFNC (standard O2, n = 76). The
primary end point was the percentage difference in loss of lung volume
between subjects with or without HFNC therapy. Secondary end points
included the total amount of oxygen administered and duration of oxygen
therapy with and without HFNC therapy. <br/>RESULT(S): There were
significant between-group differences in the percentage loss of lung
volume (P < .001), total amount of oxygen administered (P < .001),
duration of oxygen therapy (P < .001), and the need for postoperative
diuretic therapy (P = .037). The amount (rho = 0.569, P < .001) and
duration (rho = 0.678, P < .001) of oxygen administered were correlated
with atelectasis volume. <br/>CONCLUSION(S): Using HFNC therapy after
off-pump coronary artery bypass graft shortened the duration of oxygen
therapy and reduced the percentage loss of lung volume and total amount of
oxygen administered when compared with standard oxygen
therapy.<br/>Copyright &#xa9; 2020 by Daedalus Enterprises.

<68>
Accession Number
630740001
Title
Clinical outcomes of incidental findings in initial body computed
tomography angiography prior to transcatheter aortic valve replacement: A
systematic review and meta-analysis.
Source
Journal of Invasive Cardiology. Conference: 15th Annual Complex
Cardiovascular Catheter Therapeutics, C3 2019. United States. 31 (11) (pp
E329-E330), 2019. Date of Publication: November 2019.
Author
Liang Tan J.; Lee J.Z.; Fong H.K.; Ali U.; Lee K.S.; Raza M.
Publisher
HMP Communications
Abstract
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is increasingly
performed in patients with severe symptomatic aortic valve stenosis and
intermediate/high surgical risk with life expectancy of >12 months.
Multislice computed tomography (MSCT) imaging of the aorta and peripheral
vessels is usually performed prior to TAVR. As MSCT imaging extends from
thorax to iliofemoral vessels, numerous incidental pathologies, also known
as incidental findings (IFs), not directly relevant to the TAVR procedure
may be identified. <br/>OBJECTIVE(S): The aim of this meta-analysis was to
systematically review the available data on the prevalence and clinical
outcomes of IFs with respect to 1-year survival and time to treatment, on
MSCT in the work-up prior to TAVR. <br/>METHOD(S): A systematic literature
search was performed in accordance with PRISMA guidelines using PubMed,
EMBASE, Web of Science, CINAHL, ClinicalTrials.gov, and the Cochrane
Library databases for studies comparing longterm outcomes of patients with
and without IFs on MSCT prior to TAVR. Pooled analysis was conducted and
the Mantel- Haenszel risk ratio (RR) with 95% confidence interval (CI) was
calculated. Random-effects model was used based on I2 statistics. All
P-values were 2-tailed, and the statistical significance was considered at
<.05. <br/>RESULT(S): Data from 6 studies (n=2269 patients) were included
in our analysis. The overall prevalence of clinical significant IF (eg,
aortic aneurysm and pulmonary or kidney mass) and highly suspicious
malignant findings was 23.4% and 3.3%, respectively. Analysis of 1-year
mortality in TAVR patients (n=2269 patients) showed no significant
difference between patients with clinically significant IFs and with
non-significant/no IFs (RR, 0.97; 95% CI, 0.69-1.37; P=.87). There was no
difference in the mean time from CT angiography scanning to therapeutic
decision (TAVR intervention) in patients with IF and patients with
non-significant/no IF (weighted mean difference, 2.35; 95% CI, -0.91-5.62;
P=.16). Among patients with IF evaluated for TAVR, TAVR was associated
with lower 1-year mortality compared with no TAVR (17% vs 49%,
respectively; P<.0001). DISCUSSION: The exact definition of clinically
significant IFs remains a subject of debate. Although this analysis of
2269 patients who underwent TAVR showed that patients with clinically
significant IFs had a lower 1-year mortality rate (16%) compared to
patients with non-significant/no IFs (21%), the difference did not reach
statistical significance. This result may be attributed to early
identification of treatable IFs and a non-standardized definition of
clinically significant IFs (some findings do not necessarily affect
patient survival). The decision whether to proceed with TAVR after picking
up IFs on CT angiography still requires a multidisciplinary heart team
approach for optimal treatment. <br/>CONCLUSION(S): There was no
significant difference in 1-year mortality in patients with vs without
clinically significant IF undergoing TAVR. This suggests that clinically
significant IF detected during TAVR evaluation should not be an absolute
contraindication for TAVR.

<69>
Accession Number
630739853
Title
Severity of mitral regurgitation post transcatheter aortic valve
replacement in patients with coexisting moderate mitral regurgitation
according to BSE guidelines.
Source
Journal of Invasive Cardiology. Conference: 15th Annual Complex
Cardiovascular Catheter Therapeutics, C3 2019. United States. 31 (11) (pp
E326-E327), 2019. Date of Publication: November 2019.
Author
Raja F.
Publisher
HMP Communications
Abstract
BACKGROUND: Aortic stenosis (AS) is one of the most commonly treated
valvular diseases in Europe. Many patients with severe AS present with
concomitant mitral regurgitation (MR). The majority of patients with
severe AS are >70 years old; hence, they may also have coronary artery
disease, explaining the increased likelihood of secondary MR.
Additionally, AS patients may have primary MR. In the presence of AS, the
transmitral pressure gradient is amplified, resulting in an increased
back-flow rate and volume. The coexistence of MR and AS alters clinical
presentation of AS. The left ventricle (LV) can dilate to concerning
levels and a hypertrophic pattern may be present (Unger et al, 2009).
Moreover, the mitral valve closes prematurely to limit regurgitation to
the left atrium. These patients have worse LV function and higher
mortality rates than those with a single valve disease (Nombela-Franco et
al, 2014). <br/>OBJECTIVE(S): The aim of this study was to determine if
moderate to severe MR improves post TAVR. This was done by assessing the
clinical significance of MR and how MR affects mortality. HYPOTHESIS: A
reduction in the level of secondary MR post TAVR should be seen in
patients with significant preprocedure MR. <br/>METHOD(S): This is a
retrospective study of 92 patients who underwent TAVR. Data were collected
from various NHS databases between July 2013 and October 2018. Inclusion
criteria: patients with severe AS who had at least moderate MR before TAVR
in accordance with BSE guidelines, ie, moderate and severe. Exclusion
criteria: patients with mild MR and mild or moderate AS. MR was graded as
trivial, mild, moderate, or severe. A decrease of MR to at least mild post
TAVR was considered an improvement. Statistical analysis was undertaken
using SPSS statistics (IBM). <br/>RESULT(S): There was a significant
difference in MR pre and post TAVR. At 1 day, a reduction in MR was
observed in approximately 72% of patients, with no change in 27% and
worsened MR in 1%. At 7 days, improvement was seen in 71% of patients,
with no improvement in 28% and worsened MR in 1%. DISCUSSION:
Physiologically, secondary MR should improve post TAVR as AS is resolved,
decreasing LV afterload. This relieves stress from the mitral valve,
reducing MR. This process is defined as LV remodeling and improves LV
hemodynamics as well as mitral valve leaflet tethering (Barbanti et al,
2013). Primary MR affects the valve directly; hence, no change in etiology
is expected. The severity of MR is strongly correlated with mortality
(Cortes et al, 2016). The low mortality rate of this cohort can be
attributed to the reduction in MR. A meta-analysis by Sannino et al (2014)
highlighted the link between preoperative severity of MR and mortality.
They stated that the mortality rate significantly increased post TAVR in
patients who had moderate/severe MR beforehand in comparison to those who
had mild MR or less. Another meta-analysis was undertaken by
Nombela-Franco et al (2016), whereby mitral severity was assessed in
relation to mortality. The study included randomized trials and national
TAVR registries. Analysis was performed and overall, significant
heterogeneity was found across the studies, concluding a strong
correlation between MR and mortality rates. <br/>CONCLUSION(S):
Significant MR commonly coexists with severe AS. MR is strongly correlated
with mortality; hence, a reduction in MR will increase patient life
expectancy. TAVR improves LV function, reducing concomitant symptoms. The
TAVR procedure improves the level of MR, thus supporting the hypothesis of
this study.

<70>
Accession Number
630739529
Title
Eczema and major cardiovascular outcomes: A systematic review of
population based studies.
Source
Dermatologie in Beruf und Umwelt. Conference: 2nd European
Dermato-Epidemiology Network Forum, EDEN 2018. Germany. 66 (1) (pp 31-32),
2018. Date of Publication: 2018.
Author
Ascott A.; Yu A.M.; Mulick A.; Schmidt M.; Abuabara K.; Smeeth L.; Langan
S.M.
Institution
(Ascott, Mulick, Smeeth, Langan) Faculty of Epidemiology and Population
Health, London School of Hygiene and Tropical Medicine, United Kingdom
(Yu) Faculty of Medicine, University of Ottawa, Canada
(Schmidt) Department of Clinical Epidemiology, Aarhus University Hospital,
Denmark
(Abuabara) School of Medicine, University of California, United States
Publisher
Dustri-Verlag Dr. Karl Feistle
Abstract
Background: Conflicting mechanistic and epidemiological data exist
regarding the link between eczema and cardiovascular outcomes.
<br/>Aim(s): To systematically review population based studies on the
association between eczema and eczema severity and cardiovascular outcomes
(angina, myocardial infarction, coronary revascularisation, heart failure,
cardiac arrhythmias, stroke, and cardiovascular death). <br/>Method(s): A
comprehensive prospectively-registered review was undertaken using
MEDLINE, EMBASE, and Global Health from inception to December 2017. Two
reviewers independently screened and extracted data. Quality of evidence
across studies was assessed using the Grading of Recommendations,
Assessment, Development and Evaluation criteria. Random effects
metaanalyses are currently underway. <br/>Result(s): We identified 5,435
studies. 19 studies were eligible for inclusion, eight of which were
longitudinal in design. The included studies involved a range of
cardiovascular outcomes and adjusted for different potential confounders
and mediators. In addition, a few of the studies assessed associations
with cardiovascular outcomes by disease severity. All studies were of
sufficient quality for inclusion in the narrative synthesis. The
association between eczema and cardiovascular outcomes was heterogeneous,
with some studies reporting no association while other studies suggested
that eczema was associated with an increased risk of cardiovascular
outcomes. Metaanalysis results will be available by March 2018.
<br/>Discussion(s): For further discussion following the meta-analyses.