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<1>
Accession Number
629385587
Title
Complex interaction of obesity, intentional weight loss and heart failure:
A systematic review and meta-analysis.
Source
Heart. 106 (1) (pp 58-68), 2020. Date of Publication: 01 Jan 2020.
Author
Mahajan R.; Stokes M.; Elliott A.; Munawar D.A.; Khokhar K.B.;
Thiyagarajah A.; Hendriks J.; Linz D.; Gallagher C.; Kaye D.; Lau D.;
Sanders P.
Institution
(Mahajan, Stokes, Elliott, Munawar, Khokhar, Thiyagarajah, Hendriks, Linz,
Gallagher, Lau, Sanders) Centre for Heart Rhythm Disorders, University of
Adelaide, Adelaide, SA, Australia
(Mahajan) Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale,
SA, Australia
(Stokes, Elliott, Munawar, Khokhar, Thiyagarajah, Hendriks, Linz,
Gallagher, Lau, Sanders) Department of Cardiology, Royal Adelaide
Hospital, Adelaide, SA, Australia
(Kaye) Department of Cardiology, Alfred Hospital, Melbourne, VIC,
Australia
(Kaye) Heart Research, Baker IDI Heart and Diabetes Institute, Melbourne,
VIC, Australia
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Objective The aim of the meta-analysis was to determine the association of
obesity and heart failure (HF) and the cardiac impact of intentional
weight loss following bariatric surgery on cardiac structure and
myocardial function in obese subjects. Methods MEDLINE, Embase and Web of
Science were searched up to 3 April 2018. Studies reporting association
and prognostic impact of obesity in HF and the impact of intentional
weight loss following bariatric surgery on cardiac structure and
myocardial function in obesity were included in the meta-analysis. Results
4959 citations were reviewed. After exclusions, 29 studies were analysed.
A 'J curve' relationship was observed between body mass index (BMI) and
risk of HF with maximum risk in the morbidly obese (1.73 (95% CI 1.30 to
2.31), p<0.001, n=11). Although 'obesity paradox' was observed for
all-cause mortality, the overweight group was associated with lower
cardiovascular (CV) mortality (OR=0.86 (95% CI 0.79 to 0.94), n=11) with
no significant differences across other BMI groups. Intentional weight
loss induced by bariatric surgery in obese patients (n=9) without
established HF, atrial fibrillation or known coronary artery disease, was
associated with a reduction in left ventricular mass index (p<0.0001),
improvement in left ventricular diastolic function (p<=0.0001) and a
reduction in left atrial size (p=0.02). Conclusions Despite the increased
risk of HF with obesity, an 'obesity paradox' is observed for all-cause
mortality. However, the nadir for CV mortality is observed in the
overweight group. Importantly, intentional weight loss was associated with
improvement in indices of cardiac structure and myocardial function in
obese patients. Trial registration number APP 74412.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2020. No commercial re-use. See rights
and permissions. Published by BMJ.

<2>
Accession Number
631083048
Title
Effect and safety of 4% albumin in the treatment of cardiac surgery
patients: Study protocol for the randomized, double-blind, clinical ALBICS
(ALBumin in Cardiac Surgery) trial.
Source
Trials. 21 (1) (no pagination), 2020. Article Number: 235. Date of
Publication: 28 Feb 2020.
Author
Vlasov H.; Juvonen T.; Hiippala S.; Suojaranta R.; Peltonen M.; Schramko
A.; Arvonen K.; Salminen U.-S.; Kleine Budde I.; Eranen T.; Mazanikov M.;
Meinberg M.; Vahasilta T.; Wilkman E.; Pettila V.; Pesonen E.
Institution
(Vlasov, Hiippala, Schramko, Arvonen, Mazanikov, Meinberg, Wilkman,
Pettila, Pesonen) Department of Anesthesiology and Intensive Care and Pain
Medicine, University of Helsinki, Helsinki University Hospital, Helsinki,
Finland
(Juvonen, Suojaranta, Salminen, Vahasilta) Department of Cardiac Surgery,
Heart and Lung Center, University of Helsinki, Helsinki University
Hospital, Helsinki, Finland
(Peltonen) National Institute for Health and Welfare, Helsinki, Finland
(Kleine Budde) Department of Clinical Operations, Sanquin Plasma Products
B.V., Amsterdam, Netherlands
(Eranen) HUS Pharmacy, University of Helsinki, Helsinki University
Hospital, Helsinki, Finland
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: In cardiac surgery with cardiopulmonary bypass (CPB), large
amounts of fluids are administered. CPB priming with crystalloid solution
causes marked hemodilution and fluid extravasation. Colloid solutions may
reduce fluid overload because they have a better volume expansion effect
than crystalloids. The European Medicines Agency does not recommend the
use of hydroxyethyl starch solutions (HES) due to harmful renal effects.
Albumin solution does not impair blood coagulation but the findings on
kidney function are conflicting. On the other hand, albumin may reduce
endothelial glycocalyx destruction and decrease platelet count during CPB.
No large randomized, double-blind, clinical trials have compared albumin
solution to crystalloid solution in cardiac surgery. Methods/design: In
this single-center, double-blind, randomized controlled trial comprising
1386 adult cardiac surgery patients, 4% albumin solution will be compared
to Ringer's acetate solution in CPB priming and volume replacement up to
3200 mL during surgery and the first 24 h of intensive care unit stay. The
primary efficacy outcome is the number of patients with at least one major
adverse event (MAE) during 90 postoperative days (all-cause death, acute
myocardial injury, acute heart failure or low output syndrome,
resternotomy, stroke, major arrhythmia, major bleeding, infection
compromising post-procedural rehabilitation, acute kidney injury).
Secondary outcomes are total number of MAEs, incidence of major adverse
cardiac events (MACE; cardiac death, acute myocardial injury, acute heart
failure, arrhythmia), amount of each type of blood product transfused (red
blood cells, fresh frozen plasma, platelets), total fluid balance at the
end of the intervention period, total measured blood loss, development of
acute kidney injury, days alive without mechanical ventilation in 90 days,
days alive outside intensive care unit at 90 days, days alive at home at
90 days, and 90-day mortality. <br/>Discussion(s): The findings of this
study will provide new evidence regarding efficacy and safety of albumin
solution in adult patients undergoing cardiac surgery with CPB. Trial
registration: EudraCT (clinicaltrialsregister.eu) 2015-002556-27
Registered 11 Nov 2016 and ClinicalTrials.gov NCT02560519. Registered 25
Sept 2015.<br/>Copyright &#xa9; 2020 The Author(s).

<3>
Accession Number
2003886872
Title
Home-based exercise with telemonitoring guidance in patients with coronary
artery disease: Does it improve long-term physical fitness?.
Source
European Journal of Preventive Cardiology. 27 (4) (pp 367-377), 2020. Date
of Publication: 01 Mar 2020.
Author
Avila A.; Claes J.; Buys R.; Azzawi M.; Vanhees L.; Cornelissen V.
Institution
(Avila, Vanhees, Cornelissen) Department of Rehabilitation Science, KU
Leuven, Belgium
(Claes, Buys) Department of Cardiovascular Sciences, KU Leuven, Belgium
(Azzawi) Cardiovascular Research Group, Manchester Metropolitan
University, United Kingdom
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Background: Home-based interventions might facilitate the lifelong uptake
of a physically active lifestyle following completion of a supervised
phase II exercise-based cardiac rehabilitation. Yet, data on the long-term
effectiveness of home-based exercise training on physical activity and
exercise capacity are scarce. <br/>Objective(s): The purpose of the
TeleRehabilitation in Coronary Heart disease (TRiCH) study was to compare
the long-term effects of a short home-based phase III exercise programme
with telemonitoring guidance to a prolonged centre-based phase III
programme in coronary artery disease patients. The primary outcome was
exercise capacity. Secondary outcomes included physical activity
behaviour, cardiovascular risk profile and health-related quality of life.
<br/>Method(s): Ninety coronary artery disease patients (80 men) were
randomly assigned to 3 months of home-based (30), centre-based (30) or a
control group (30) on a 1:1:1 basis after completion of their phase II
ambulatory cardiac rehabilitation programme. Outcome measures were
assessed at discharge of the phase II programme and after one year.
<br/>Result(s): Eighty patients (72 (91%) men; mean age 62.6 years)
completed the one-year follow-up measurements. Exercise capacity and
secondary outcomes were preserved in all three groups (P<inf>time</inf> >
0.05 for all), irrespective of the intervention (P<inf>interaction</inf> >
0.05 for all). Eighty-five per cent of patients met the international
guidelines for physical activity (P<inf>time</inf> < 0.05). No interaction
effect was found for physical activity. <br/>Conclusion(s): Overall,
exercise capacity remained stable during one year following phase II
cardiac rehabilitation. Our home-based exercise intervention was as
effective as centre-based and did not result in higher levels of exercise
capacity and physical activity compared to the other two interventions.
Trial registration: ClinicalTrials.gov NCT02047942.
https://clinicaltrials.gov/ct2/show/NCT02047942<br/>Copyright &#xa9; The
European Society of Cardiology 2019.

<4>
Accession Number
2004390386
Title
State of the Science in Women's Cardiovascular Disease: A Canadian
Perspective on the Influence of Sex and Gender.
Source
Journal of the American Heart Association. 9 (4) (no pagination), 2020.
Article Number: e015634. Date of Publication: 18 Feb 2020.
Author
Norris C.M.; Yip C.Y.Y.; Nerenberg K.A.; Clavel M.-A.; Pacheco C.; Foulds
H.J.A.; Hardy M.; Gonsalves C.A.; Jaffer S.; Parry M.; Colella T.J.F.;
Dhukai A.; Grewal J.; Price J.A.D.; Levinsson A.L.E.; Hart D.; Harvey
P.J.; Van Spall H.G.C.; Sarfi H.; Sedlak T.L.; Ahmed S.B.; Baer C.;
Coutinho T.; Edwards J.D.; Green C.R.; Kirkham A.A.; Srivaratharajah K.;
Dumanski S.; Keeping-Burke L.; Lappa N.; Reid R.D.; Robert H.; Smith G.;
Martin-Rhee M.; Mulvagh S.L.
Institution
(Norris) Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
(Yip, Martin-Rhee) Heart and Stroke Foundation of Canada, Toronto, ON,
Canada
(Nerenberg) Department of Medicine/Division of General Internal Medicine,
University of Calgary, AB, Canada
(Clavel) Institut Universitaire de Cardiologie et Pneumologie de Quebec,
Quebec, Canada
(Pacheco) Hopital Pierre-Boucher, University of Montreeal, Montreal, QC,
Canada
(Foulds) College of Kinesiology, University of Saskatchewan, Saskatoon,
SK, Canada
(Hardy, Hart, Harvey, Sarfi, Lappa, Robert) Canadian Women's Heart Health
Alliance, Ottawa, ON, Canada
(Gonsalves) Interdisciplinary Human Studies, Laurentian University,
Sudbury, ON, Canada
(Jaffer) Department of Medicine/Community Internal Medicine, University of
British Columbia, Vancouver, BC, Canada
(Parry, Dhukai, Price) Lawrence S. Bloomberg Faculty of Nursing,
University of Toronto, ON, Canada
(Colella) University Health Network/Toronto Rehab Cardiovascular
Prevention and Rehabilitation Program, Toronto, ON, Canada
(Grewal) Division of Cardiology, University of British Columbia,
Vancouver, BC, Canada
(Price) Women's College Research Institute, Women's College Hospital,
Toronto, ON, Canada
(Levinsson) Montreal Heart Institute, Montreal, QC, Canada
(Levinsson) Beaulieu-Saucier Universite de Montreal Pharmacogenomics
Centre, Montreal, QC, Canada
(Levinsson) Faculty of Medicine, Universite de Montreal, Montreal, QC,
Canada
(Harvey) Women's College Research Institute and Division of Cardiology,
Department of Medicine Women's College Hospital, University of Toronto,
ON, Canada
(Van Spall) Division of Cardiology, Department of Medicine, McMaster
University, Hamilton, ON, Canada
(Sedlak) Leslie Diamond Women's Heart Centre, Vancouver General Hospital,
University of British Columbia, Vancouver, BC, Canada
(Ahmed) Department of Medicine and Libin Cardiovascular Institute,
University of Calgary, AB, Canada
(Baer) Division of General Internal Medicine, Department of Medicine,
Moncton Hospital, Dalhousie University, Halifax, NS, Canada
(Coutinho, Reid) Division of Cardiac Prevention and Rehabilitation,
Division of Cardiology and Canadian Women's Heart Health Centre,
University of Ottawa Heart Institute, Ottawa, ON, Canada
(Edwards) School of Epidemiology and Public Health, University of Ottawa
and University of Ottawa Heart Institute, Ottawa, ON, Canada
(Green) Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON,
Canada
(Kirkham) Department of Biomedical Engineering, University of Alberta,
Edmonton, AB, Canada
(Srivaratharajah) Division of General Internal Medicine, Department of
Medicine, McMaster University, Hamilton, ON, Canada
(Dumanski) Department of Medicine, University of Calgary, AB, Canada
(Keeping-Burke) University of New Brunswick, Saint John, NB, Canada
(Smith) Department of Obstetrics and Gynecology, Kingston Health Sciences
Centre, Queen's University, Kingston, ON, Canada
(Mulvagh) Division of Cardiology, Dalhousie University, Halifax, NS,
Canada
(Mulvagh) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
Publisher
American Heart Association Inc.

<5>
Accession Number
2002370320
Title
Inter- and intrasite variability of mortality and stroke for sites
performing both surgical and transcatheter aortic valve replacement for
aortic valve stenosis in intermediate-risk patients.
Source
Journal of Thoracic and Cardiovascular Surgery. 159 (4) (pp 1233-1244.e4),
2020. Date of Publication: April 2020.
Author
Greason K.L.; Blackstone E.H.; Rajeswaran J.; Lowry A.M.; Svensson L.G.;
Webb J.G.; Tuzcu E.M.; Smith C.R.; Makkar R.R.; Mack M.J.; Thourani V.H.;
Kodali S.K.; Leon M.B.; Miller D.C.
Institution
(Greason) Department of Cardiovascular Surgery, Mayo Clinic, Rochester,
Minn, United States
(Blackstone, Rajeswaran, Lowry, Svensson) Department of Thoracic and
Cardiovascular Surgery, Heart and Vascular Institute, Cleveland, OH,
United States
(Blackstone, Rajeswaran, Lowry) Department of Quantitative Health Sciences
Cleveland Clinic, Research Institute, Cleveland, United States
(Svensson) Aorta Center, Heart and Vascular Institute, Cleveland, United
States
(Webb) Department of Cardiology, St. Paul's Hospital, Vancouver, British
Columbia, Canada
(Tuzcu) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic Foundation, Cleveland, United States
(Smith) Department of Surgery, Columbia University Medical Center of New
York Presbyterian Hospital, New York, NY, United States
(Makkar) Department of Cardiovascular Diseases, Cedars-Sinai Medical
Center, Los Angeles, Calif, United States
(Mack) Cardiovascular Service Line, Baylor Scott & White Health, Plano,
Tex, United States
(Thourani) Department of Cardiac Surgery, MedStar Heart & Vascular
Institute, Georgetown University School of Medicine, Washington, DC,
United States
(Kodali, Leon) Structural Heart & Valve Center, Division of Cardiology,
NewYork-Presbyterian Hospital/Columbia University Medical Center, New
York, NY, United States
(Kodali, Leon) Center for Interventional Vascular Therapy, Division of
Cardiology, NewYork-Presbyterian Hospital/Columbia University Medical
Center, New York, NY, United States
(Miller) Department of Cardiovascular Surgery, Stanford University School
of Medicine, Stanford, Calif, United States
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Objectives: Multisite procedure-based randomized trials may be confounded
by performance variability and variability among sites. Therefore, we
studied variability in mortality and stroke after patients were randomized
to surgical (SAVR) or transcatheter aortic valve replacement (TAVR) in the
Placement of Aortic Transcatheter Valves-2A (PARTNER-2A) randomized trial.
<br/>Method(s): Patients at intermediate risk for SAVR were randomized to
SAVR (n = 1017) or TAVR (n = 1011) with a SAPIEN XT device (Edwards
Lifesciences, Irvine, Calif) at 54 sites. Patients were followed to 2
years. A mixed-effect model quantified variability at intersite and
intrasite levels. <br/>Result(s): There were 336 deaths (SAVR 170, TAVR
166) and 176 strokes (SAVR 85, TAVR 91). Intersite variability for
mortality was similar across sites for SAVR (hazard ratios ranging from
0.52-1.93 among sites) and TAVR (hazard ratios ranging from 0.49-2.03),
but intersite variability for stroke was greater for SAVR (hazard ratios
ranging from 0.44-2.26) than for TAVR (no detectable variability). Case
mix and lower site trial volume accounted for 37% of mortality intersite
variability for SAVR and 73% for TAVR, but only 14% for stroke for SAVR.
Intrasite mortality hazard ratios demonstrated all but 1 site's 95%
confidence interval overlapped 1.0, indicating generally similar SAVR and
TAVR mortalities within sites. <br/>Conclusion(s): Intersite variability
was similar for mortality in SAVR and TAVR, but variability for stroke was
greater for SAVR than for TAVR. Intrasite events were similar for both
SAVR and TAVR. These findings suggest that in performance-based trials,
site variability and its sources should be taken into account in analyzing
and interpreting trial results.<br/>Copyright &#xa9; 2019

<6>
Accession Number
2004593538
Title
Are Serum Potassium and Magnesium Levels Associated with Atrial
Fibrillation After Cardiac Surgery?.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
Howitt S.H.; Grant S.W.; Campbell N.G.; Malagon I.; McCollum C.
Institution
(Howitt, Grant, Campbell, Malagon, McCollum) Division of Cardiovascular
Sciences, University of Manchester, ERC, Manchester University Hospitals
Foundation Trust, Manchester, United Kingdom
(Malagon) Department of Cardiothoracic Anesthesia and Critical Care,
Wythenshawe Hospital, Manchester University Hospitals Foundation Trust,
Manchester, United Kingdom
Publisher
W.B. Saunders
Abstract
Objectives: Potassium and magnesium are frequently administered after
cardiac surgery to reduce the risk of atrial fibrillation (AF). The
evidence for this practice is unclear. This study was designed to evaluate
the relationship between serum potassium and magnesium levels and AF after
cardiac surgery. <br/>Design(s): Observational cohort study.
<br/>Setting(s): A cardiac intensive care unit in the United Kingdom.
<br/>Participant(s): Patients undergoing cardiac surgery between January
2013 and November 2017. <br/>Intervention(s): None. <br/>Measurements and
Main Results: Cardiac rhythm was assessed using continuous
electrocardiogram (ECG) monitoring in 3,068 patients on the cardiac
intensive care unit. Associations between serum potassium and magnesium
concentrations extracted from hospital databases and postoperative AF were
assessed using univariable and multivariable analyses. The association
between electrolyte supplementation therapy and AF was also analyzed. AF
developed within 72 hours of cardiac surgery in 545 (17.8%) of the 3,068
patients. After adjusting for logistic EuroSCORE, surgery type,
cardiopulmonary bypass time and age, mean serum potassium concentration
<4.5 mmol/L was associated with an increased risk of AF (odds ratio [OR]
1.43 (95% confidence interval (CI): 1.17-1.75), p < 0.001). Mean magnesium
concentration <1.0 mmol/L was not associated with an increased risk of AF
(OR 0.89, 0.71-1.13, p = 0.342), but the administration of magnesium was
associated with increased risk of developing AF (OR 1.61, 1.33-1.96, p <
0.001). <br/>Conclusion(s): Maintaining a serum potassium concentration
>=4.5 mmol/L after cardiac surgery may reduce the incidence of
postoperative AF. Magnesium supplementation was associated with an
increased risk of postoperative AF. Prospective randomized trials are
required to clarify these associations.<br/>Copyright &#xa9; 2019

<7>
Accession Number
628545849
Title
Does prehabilitation improve outcomes in cardiac surgical patients?.
Source
Interactive cardiovascular and thoracic surgery. 29 (4) (pp 608-611),
2019. Date of Publication: 01 Oct 2019.
Author
Sandhu M.S.; Akowuah E.F.
Institution
(Sandhu, Akowuah) Department of Cardiothoracic Surgery, James Cook
University Hospital, Middlesbrough, United Kingdom
Publisher
NLM (Medline)
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was: does prehabilitation
improve outcomes in cardiac surgical patients? Altogether more than 483
papers were found using the reported search, of which 10 represented the
best evidence to answer the clinical question. The authors, journal, date
and country of publication, patient group studied, study type, relevant
outcomes and results of these papers are tabulated. Four meta-analyses
concluded that prehabilitation reduced postoperative pulmonary
complications (PPCs). The 6 randomized controlled trials (RCT) included,
differed significantly in the type of prehabilitation delivered. There was
replication of some RCTs across the meta-analyses. The consensus across
the meta-analyses was a reduction in PPCs and 3 of 4 meta-analyses finding
a reduction in length of stay (LOS). There were no adverse events or
difference in mortality found. Two small RCTs showed feasibility and
modest improvements in physiological parameters. Three RCTs demonstrated a
reduction in LOS and a reduction in PPCs. One RCT found no difference in
quality of life scores, LOS or postoperative atrial fibrillation. None of
the RCTs found negative evidence of prehabilitation interventions. We
conclude that the prehabilitation is a positive preoperative intervention,
most favourably in older patients and in those who are at risk of PPCs.
Specifically inspiratory muscle training is the intervention with most
favourable evidence.<br/>Copyright &#xa9; The Author(s) 2019. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<8>
Accession Number
628462408
Title
Annual case volume on mortality after coronary artery bypass grafting: a
dose-response meta-analysis.
Source
Interactive cardiovascular and thoracic surgery. 29 (4) (pp 568-575),
2019. Date of Publication: 01 Oct 2019.
Author
Tie H.-T.; Shi R.; Zhou Q.; Wang K.; Zheng X.-Q.; Wu Q.-C.
Institution
(Tie, Wu) Department of Cardiothoracic Surgery, First Affiliated Hospital
of Chongqing Medical University, Chongqing, China
(Shi) Department of Cardiology, First Affiliated Hospital of Chongqing
Medical University, Chongqing, China
(Zhou) Department of Science and Education, First People's Hospital of
Changde City, Hunan, China
(Wang) Department of Endocrine and Breast Surgery, First Affiliated
Hospital of Chongqing Medical University, Chongqing, China
(Zheng) Department of Chemical Biology, School of Pharmaceutical Science,
Peking University Health Science Center, Beijing, China
Publisher
NLM (Medline)
Abstract
OBJECTIVES: This study evaluated the effect of both hospital and surgeon
annual case volumes on patient mortality following coronary artery bypass
grafting (CABG). <br/>METHOD(S): PubMed and Embase databases were searched
for clinical studies on CABG. The outcome was mortality, including
operative mortality, in-hospital mortality and 30-day mortality.
<br/>RESULT(S): Twenty-five studies involving 3492101 participants and
143951 deaths were included for hospital volume, and 4 studies involving
108356 participants and 2811 deaths were included for surgeon volume. The
pooled estimate revealed that both hospital and surgeon annual case
volumes were inversely associated with mortality in patients after CABG
[odds ratio (OR) for hospital: 0.62, 95% confidence interval (CI)
0.56-0.69; P<0.001; OR for surgeon: 0.51, 95% CI 0.31- 0.83; P<0.001] with
high heterogeneity (hospital: I2=90.6%, Pheterogeneity<0.001; surgeon:
I2=86.8%, Pheterogeneity<0.001). The relationship remained consistent and
robust in most subgroup and sensitivity analyses. Our meta-regression
analysis of time suggested that the strength of the negative associations
between volume and mortality for both hospitals and surgeons remained
unattenuated over time even though the CABG mortality gradually decreased
over time. The dose-response analysis suggested a non-linear relationship
between both hospital and surgeon annual case volumes and mortality (both
Pnon-linearity=0.001). <br/>CONCLUSION(S): Both higher hospital and
surgeon annual case volumes are associated with lower mortality in
patients undergoing CABG, and the negative associations remain
unattenuated over time. CLINICAL REGISTRATION NUMBER: The study was
registered at PROSPERO as CRD42017067912.<br/>Copyright &#xa9; The
Author(s) 2019. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<9>
Accession Number
628214302
Title
In thoracic aortic surgery, is innominate artery cannulation a safe and
effective alternative to axillary artery cannulation?.
Source
Interactive cardiovascular and thoracic surgery. 29 (4) (pp 604-607),
2019. Date of Publication: 01 Oct 2019.
Author
Harky A.; Grafton-Clarke C.; Hadlett M.; Shuttleworth E.
Institution
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Grafton-Clarke) College of Life Sciences, University of Leicester,
Leicester, United Kingdom
(Hadlett, Shuttleworth) Department of Surgery, Countess of Chester
Hospital, Chester, United Kingdom
Publisher
NLM (Medline)
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was: in a patient undergoing
thoracic aortic surgery, is innominate artery cannulation superior to
axillary artery cannulation in terms of postoperative outcomes? Five
hundred and thirty-one papers were found using the reported search
strategy, of which 5 represented the best evidence to answer the clinical
question. A total of 1338 participants were included across the 5 studies.
Seven hundred and twenty-two patients were cannulated via the axillary
artery and 616 were cannulated via the innominate artery. The included 5
studies were 2 prospective observational cohorts, 2 retrospective
case-series analysis and a single-blinded randomized trial. Thirty-day or
in-hospital mortality rates were reported in all 5 studies. There were no
significant differences in mortality with innominate artery cannulation
compared to axillary artery cannulation (P>0.05), with slightly lower
mortality rates in 2 studies, slightly higher mortality rates in 2 and
equal in 1 study. Though statistical significance was not demonstrated
(P>0.05), a stroke occurred slightly less frequently in patients receiving
innominate artery cannulation compared to axillary artery cannulation in 3
of the 4 studies. Innominate artery cannulation is non-inferior to
axillary artery cannulation for thoracic aortic surgery, with a similar
level of neuroprotection and is not associated with increased levels of
mortality.<br/>Copyright &#xa9; The Author(s) 2019. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<10>
Accession Number
631222390
Title
Upper Gastrointestinal Mucosal Injury Associated with Ticagrelor Plus
Aspirin, Ticagrelor Alone, or Aspirin Alone at 1-Year Post-CABG.
Source
Journal of gastroenterology and hepatology. (no pagination), 2020. Date of
Publication: 10 Mar 2020.
Author
Tang C.; Zhu Y.; Yang X.; Xu B.; Ye C.; Yang Y.; Zhong J.; Zhao Q.; Yu L.
Institution
(Tang, Xu, Zhong, Yu) Department of Gastroenterology, Ruijin Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Tang) Department of Gastroenterology, First Affiliated Hospital to
Soochow University, China
(Zhu, Ye, Yang, Zhao) Department of Cardiovascular Surgery, Ruijin
Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai,
China
(Yang) Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
(Ye) Department of General Thoracic Surgery, Shanghai Pulmonary Hospital,
Tongji University School of Medicine, Shanghai, China
Publisher
NLM (Medline)
Abstract
BACKGROUND AND AIM: The presence and severity of upper gastrointestinal
mucosal lesions have not been evaluated using esophagogastroduodenoscopy
(EGD) in patients receiving ticagrelor plus aspirin or alone after
myocardial revascularization. We assessed upper gastrointestinal mucosal
injury and use of proton pump inhibitors (PPIs) in patients receiving 1
year of antiplatelet therapy after coronary artery bypass grafting (CABG).
<br/>METHOD(S): In this single-centre prospective substudy of a randomised
trial, 231 patients completing 1-year antiplatelet therapy (ticagrelor 90
mg twice daily plus aspirin 100 mg once daily, ticagrelor 90 mg twice
daily, or aspirin 100 mg once daily, in 81, 80 and 70 patients,
respectively) after CABG underwent 13 C urea breath testing (UBT) and EGD.
Gastroduodenal lesions were assessed by modified Lanza score and reflux
esophagitis (RE) was evaluated according to Los Angeles classification.
Additionally, at least one ulcer >=5 mm was separately analysed.
<br/>RESULT(S): Among 231 patients, EGD showed 28 (12.1%) with ulcers >=5
mm, which were detected in 13.6% (11/81) of ticagrelor plus aspirin
recipients, 8.8% (7/80) of ticagrelor recipients and 14.3% (10/70) of
aspirin recipients, and 24 (10.4%) had RE. Eighty-eight (38.1%) patients
had a positive 13 C UBT after 1 year of treatment and one patient received
eradication therapy during follow-up. Nineteen (8.2%) patients received a
PPI for >=6 months. <br/>CONCLUSION(S): Severe upper gastrointestinal
mucosal lesions were more frequently observed in patients treated with
ticagrelor plus aspirin and aspirin monotherapy than in patients treated
with ticagrelor monotherapy for 1 year post-CABG. Prophylactic use of PPIs
might be inadequate. Clinicaltrials.gov: NCT02201771.<br/>Copyright This
article is protected by copyright. All rights reserved.

<11>
Accession Number
631217022
Title
Heart Transplantation From Brain Dead Donors: A Systematic Review of
Animal Models.
Source
Transplantation. (no pagination), 2020. Date of Publication: 05 Mar 2020.
Author
See Hoe L.E.; Wells M.A.; Bartnikowski N.; Obonyo N.G.; Millar J.E.; Khoo
A.; Ki K.K.; Shuker T.; Ferraioli A.; Colombo S.M.; Chan W.; McGiffin
D.C.; Suen J.Y.; Fraser J.F.
Institution
(See Hoe, Wells, Bartnikowski, Obonyo, Millar, Khoo, Ki, Shuker,
Ferraioli, Colombo, Chan, McGiffin, Suen, Fraser) Critical Care Research
Group, Prince Charles Hospital, Brisbane, Australia
(See Hoe, Millar, Khoo, Ki, Shuker, Ferraioli, Colombo, Chan, Suen,
Fraser) Faculty of Medicine, University of Queensland, Brisbane, Australia
(Wells) School of Medical Science, Griffith University, Gold Coast,
Australia
(Bartnikowski) Faculty of Science and Engineering, Queensland University
of Technology, Brisbane, Australia
(Obonyo) Wellcome Trust Centre for Global Health Research, Imperial
College London, United Kingdom
(Millar) Wellcome-Wolfson Institute for Experimental Medicine, Queen's
University Belfast, United Kingdom
(Colombo) Universita degli Studi di Milano, Department of Pathophysiology
and Transplantation, Milan, Italy
(McGiffin) Cardiothoracic Surgery and Transplantation, Alfred Hospital,
Melbourne, Australia
Publisher
NLM (Medline)
Abstract
Despite advances in mechanical circulatory devices and pharmacological
therapies, heart transplantation is the definitive and most effective
therapy for an important proportion of qualifying patients with end-stage
heart failure. However, the demand for donor hearts significantly
outweighs the supply. Hearts are sourced from donors following brain
death, which exposes donor hearts to substantial pathophysiological
perturbations that can influence heart transplant success and recipient
survival. While significant advances in recipient selection, donor and HTx
recipient management, immunosuppression and pretransplant mechanical
circulatory support have been achieved, primary graft dysfunction after
cardiac transplantation continues to be an important cause of morbidity
and mortality.Animal models, when appropriate, can guide/inform medical
practice, and fill gaps in knowledge that are unattainable in clinical
settings. Consequently, we performed a systematic review of existing
animal models that incorporate donor brain death and subsequent heart
transplantation, and assessed studies for scientific rigor and clinical
relevance. Following literature screening via MEDLINE and Embase, 29
studies were assessed. Analysis of included studies identified marked
heterogeneity in animal models of donor brain death coupled to heart
transplantation, with few research groups worldwide identified as
utilizing these models. General reporting of important determinants of
heart transplant success was mixed, and assessment of posttransplant
cardiac function was limited to an invasive technique (pressure-volume
analysis), which is limitedly applied in clinical settings.This review
highlights translational challenges between available animal models and
clinical heart transplant settings that is potentially hindering
advancement of this field of investigation.

<12>
Accession Number
631223698
Title
Bypassing the blues: Insomnia in the depressed post-CABG population.
Source
Annals of Clinical Psychiatry. 32 (1) (pp 17-26), 2020. Date of
Publication: February 2020.
Author
Waterman L.A.; Belnap B.H.; Gebara M.A.; Huang Y.; Abebe K.Z.; Rollman
B.L.; Karp J.F.
Institution
(Waterman) Department of Medicine, University of Pittsburgh, School of
Medicine, Pittsburgh, PA, United States
(Belnap) Center for Behavioral Health and Smart Technology, University of
Pittsburgh, School of Medicine, Pittsburgh, PA, United States
(Belnap) Department of Psychosomatic Medicine and Psychotherapy,
University of Gottingen Medical Center, Gottingen, Germany
(Gebara, Karp) Department of Psychiatry, University of Pittsburgh, School
of Medicine, Pittsburgh, PA, United States
(Huang) Center for Research on Health Care, University of Pittsburgh,
School of Medicine, Pittsburgh, PA, United States
(Abebe) Center for Clinical Trials and Data Coordination, University of
Pittsburgh, School of Medicine, Pittsburgh, PA, United States
(Rollman) Department of Medicine, Center for Behavioral Health and Smart
Technology, Center for Research on Health Care, University of Pittsburgh
School of Medicine, Pittsburgh, PA, United States
Publisher
Quadrant Healthcom Inc.
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. methods: 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
time-by-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/>Copyright &#xa9; 2020 Quadrant Healthcom Inc.. All
rights reserved.

<13>
Accession Number
631189517
Title
Epidemiology and management of primary spontaneous pneumothorax: A
systematic review.
Source
Interactive Cardiovascular and Thoracic Surgery. 30 (3) (pp 337-345),
2020. Date of Publication: March 2020.
Author
Mendogni P.; Vannucci J.; Ghisalberti M.; Anile M.; Aramini B.; Congedo
M.T.; Nosotti M.; Bertolaccini L.; D'Ambrosio A.E.; de Vico A.; Guerrera
F.; Imbriglio G.; Pardolesi A.; Schiavon M.; Russo E.
Institution
(Mendogni, Nosotti) Thoracic Surgery and Lung Transplant Unit, Foundation
IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
(Vannucci, Anile) Department of Thoracic Surgery, Umberto I Hospital,
University of Rome Sapienza, Rome, Italy
(Ghisalberti) Thoracic Surgery Unit, University Hospital of Siena, Siena,
Italy
(Aramini) Division of Thoracic Surgery, Department of Medical and Surgical
Sciences for Children and Adults, University Hospital of Modena and Reggio
Emilia, Modena, Italy
(Congedo) Division of Thoracic Surgery, Fondazione Policlinico Gemelli
IRCCS, Catholic University of Sacred Heart, Rome, Italy
(Bertolaccini) Division of Thoracic Surgery, IEO, European Institute of
Oncology IRCCS, Via Ripamonti 435, Milan 20141, Italy
(D'Ambrosio) Thoracic Surgery Unit, A.O.R.N.A.S. Garibaldi Nesima,
Catania, Italy
(de Vico) Thoracic Surgery Unit, ASST Spedali Civili Brescia, Brescia,
Italy
(Guerrera) Department of Thoracic Surgery, University of Torino, Torino,
Italy
(Imbriglio) Thoracic Surgery Unit, Vito Fazzi Hospital, Lecce, Italy
(Pardolesi) Unit of Thoracic Surgery, Foundation IRCCS National Cancer
Institute of Milan, Milan, Italy
(Schiavon) Thoracic Surgery Unit, Department of Cardiac, Thoracic,
Vascular Sciences and Public Health, University of Padova, Padova, Italy
(Russo) Division of Thoracic Surgery and Lung Transplantation, Department
for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic
Transplantation, IRCCS ISMETT, UPMC, Palermo, Italy
Publisher
Oxford University Press
Abstract
Primary spontaneous pneumothorax (PSP) is one of the most common thoracic
diseases affecting adolescents and young adults. Despite the high
incidence of PSP and the availability of several international guidelines
for its diagnosis and treatment, a significant behavioural heterogeneity
can be found among those management recommendations. A working group of
the Italian Society of Thoracic Surgery summarized the best evidence
available on PSP management with the methodological tool of a systematic
review assessing the quality of previously published guidelines with the
Appraisal of Guidelines for Research and Evaluation (AGREE) II. Concerning
PSP physiopathology, the literature seems to be equally divided between
those who support the hypothesis of a direct correlation between changes
in atmospheric pressure and temperature and the incidence of PSP, so it is
not currently possible to confirm or reject this theory with reasonable
certainty. Regarding the choice between conservative treatment and chest
drainage in the first episode, there is no evidence on whether one option
is superior to the other. Video-assisted thoracic surgery represents the
most common and preferred surgical approach. A primary surgical approach
to patients with their first PSP seems to guarantee a lower recurrence
rate than that of a primary approach consisting of a chest drainage
positioning; conversely, the percentage of futile surgical interventions
that would entail this aggressive attitude must be carefully evaluated.
Surgical pleurodesis is recommended and frequently performed to limit
recurrences; talc poudrage offers efficient pleurodesis, but a
considerable number of surgeons are concerned about administering this
inert material to young patients.<br/>Copyright VC The Author(s) 2019.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<14>
Accession Number
2005098681
Title
Heparin Dose and Point-of-Care Measurements of Hemostasis in Cardiac
Surgery-Results of a Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
Lax M.; Pesonen E.; Hiippala S.; Schramko A.; Lassila R.; Raivio P.
Institution
(Lax, Pesonen, Hiippala, Schramko) Division of Anesthesiology, Department
of Anesthesiology, Intensive Care and Pain Medicine, University of
Helsinki and Helsinki University Hospital, Helsinki, Finland
(Lassila) Coagulation Disorders Unit, Laboratory Services, Department of
Hematology and Comprehensive Cancer Center, Helsinki University Hospital,
Helsinki, Finland
(Raivio) Department of Cardiac Surgery, Heart, and Lung Center, University
of Helsinki and Helsinki University Hospital, Helsinki, Finland
Publisher
W.B. Saunders
Abstract
Objective: High heparin doses during cardiopulmonary bypass (CPB) have
been suggested to reduce thrombin activation and consumption coagulopathy
and consequently bleeding complications. The authors investigated the
effect of a high heparin dose during CPB on point-of-care measurements of
coagulation. The authors hypothesized that during CPB a high heparin dose
compared with a lower heparin dose would reduce thrombin generation and
platelet activation and tested whether this would be reflected in the
results of rotational thromboelastometry (TEM) and platelet aggregation,
measured with multiple electrode aggregometry (MEA). <br/>Design(s):
Prospective, randomized, controlled, open single-center study.
<br/>Setting(s): University teaching hospital. <br/>Participant(s):
Sixty-three consecutive patients undergoing elective coronary artery
bypass grafting with CPB were enrolled. <br/>Intervention(s): Patients
were randomly assigned to receive either a high (600 IU/kg, n = 32) or a
low (300 IU/kg, n = 31) initial dose of heparin. Target levels of
activated clotting time during CPB were >600 seconds in the high heparin
dose group and >400 seconds in the low heparin dose group.
<br/>Measurements and Main Results: Blood samples were collected (1)
preoperatively after induction of anesthesia, (2) 10 minutes after aortic
declamping, (3) 30 minutes after protamine administration, and (4) 3 hours
after protamine administration. TEM and MEA were then measured. There was
no difference in blood loss up to 18 hours postoperatively (median 735 mL
for high dose v 610 mL for low dose; p < 0.056) or transfusions between
the groups. Total median heparin dose (54,300 IU v 27,000 IU; p = 0.001)
and median antifactor Xa levels during CPB (9.38 U/mL v 5.04 U/mL; p =
0.001) were greater in the high than in the low heparin dose group.
However, neither TEM nor MEA results differed significantly between the
groups. <br/>Conclusion(s): Compared with a lower dose of heparin during
CPB, a high dose of heparin had little effect on the point-of-care
measurements of hemostasis, TEM, and MEA. Based on the similarity of
platelet and coagulation activity assessments, the higher heparin dose
does not appear to offer benefit during CPB.<br/>Copyright &#xa9; 2020
Elsevier Inc.

<15>
Accession Number
2004858918
Title
Analysis of Myocardial Ischemia Parameters after Coronary Artery Bypass
Grafting with Minimal Extracorporeal Circulation and a Novel Microplegia
versus Off-Pump Coronary Artery Bypass Grafting.
Source
Mediators of Inflammation. 2020 (no pagination), 2020. Article Number:
5141503. Date of Publication: 2020.
Author
Koechlin L.; Zenklusen U.; Doebele T.; Rrahmani B.; Gahl B.; Schaeffer T.;
Berdajs D.; Eckstein F.S.; Reuthebuch O.
Institution
(Koechlin, Zenklusen, Doebele, Rrahmani, Gahl, Schaeffer, Berdajs,
Eckstein, Reuthebuch) Department of Cardiac Surgery, University Hospital
Basel, Basel, Switzerland
Publisher
Hindawi Limited (410 Park Avenue, 15th Floor, 287 pmb, New York NY 10022,
United States)
Abstract
Background. To compare the performance of our institutionally refined
microplegia protocol in conjunction with minimal extracorporeal
circulation system (MiECC) with off-pump coronary artery bypass grafting
(OPCAB). Methods. We conducted a single center study including patients
undergoing isolated CABG surgery performed either off-pump or on-pump
using our refined microplegia protocol in conjunction with MiECC. We used
propensity modelling to calculate the inverse probability of treatment
weights (IPTW). Primary endpoints were peak values of high-sensitivity
cardiac troponin T (hs-cTnT) during hospitalization, and respective first
values on the first postoperative day. Endpoint analysis was adjusted for
intraoperative variables. Results. After IPTW, we could include 278
patients into our analyses, 153 of which had received OPCAB and 125 of
which had received microplegia. Standardized differences indicated that
treatment groups were comparable after IPTW. The multivariable quantile
regression yielded a nonsignificant median increase of first hs-cTnT by 39
ng/L (95% CI -8 to 87 ng/L, p=0.11), and of peak hs-cTnT by 35 ng/L (CI
-13 to 84, p=0.16), when microplegia was used, as compared to OPCAB. Major
adverse cardiac and cerebrovascular events (MACCE) occurred with equal
frequency in both groups (7.8% vs. 5.0%; p=0.51), and length of stay in
the intensive care unit (ICU) was significantly shorter after the use of
microplegia (geometric mean 1.6 days versus 1.3 days; p=0.01). Conclusion.
The use of our institutionally refined microplegia in conjunction with
MiECC was associated with similar results with regard to ischemic injury,
expressed in hs-cTnT compared to OPCAB. MACCE was seen equally frequent.
ICU discharge was earlier if microplegia was used.<br/>Copyright &#xa9;
2020 Luca Koechlin et al.

<16>
Accession Number
2005054010
Title
Prior Balloon Valvuloplasty Versus Direct Transcatheter Aortic Valve
Replacement: Results From the DIRECTAVI Trial.
Source
JACC: Cardiovascular Interventions. 13 (5) (pp 594-602), 2020. Date of
Publication: 9 March 2020.
Author
Leclercq F.; Robert P.; Akodad M.; Macia J.-C.; Gandet T.; Delseny D.;
Chettouh M.; Schmutz L.; Robert G.; Levy G.; Targosz F.; Maupas E.;
Roubille F.; Marin G.; Nagot N.; Albat B.; Lattuca B.; Cayla G.
Institution
(Leclercq, Robert, Akodad, Macia, Delseny, Chettouh, Roubille) Department
of Cardiology, CHU Montpellier, Montpellier University, Montpellier,
France
(Akodad, Roubille) PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier,
France
(Gandet, Albat) Department of Cardiovascular Surgery, University Hospital
of Montpellier, France
(Schmutz, Lattuca, Cayla) Department of Cardiology, CHU Nimes, Montpellier
University, Nimes, France
(Robert) St. Pierre Clinic, Perpignan, France
(Levy) Millenaire Clinic, Montpellier, France
(Targosz) Perpignan Hospital, Perpignan, France
(Maupas) Franciscaines Clinic, Nimes, France
(Marin, Nagot) Department of Medical Information, University Hospital of
Montpellier, Montpellier, France
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: The aim of this study was to evaluate device success of
transcatheter aortic valve replacement (TAVR) using new-generation
balloon-expandable prostheses with or without balloon aortic valvuloplasty
(BAV). <br/>Background(s): Randomized studies are lacking comparing TAVR
without BAV against the conventional technique of TAVR with BAV.
<br/>Method(s): DIRECTAVI (Direct Transcatheter Aortic Valve Implantation)
was an open-label noninferiority study that randomized patients undergoing
TAVR using the Edwards SAPIEN 3 valve with or without prior balloon
valvuloplasty. The primary endpoint was the device success rate according
to Valve Academic Research Consortium-2 criteria, which was evaluated
using a 7% noninferiority margin. The secondary endpoint included
procedural and 30-day adverse events. <br/>Result(s): Device success was
recorded for 184 of 236 included patients (78.0%). The rate of device
success in the direct implantation group (n = 97 [80.2%]) was noninferior
to that in the BAV group (n = 87 [75.7%]) (mean difference 4.5%; 95%
confidence interval: -4.4% to 13.4%; p = 0.02 for noninferiority). No
severe prosthesis-patient mismatch or severe aortic regurgitation occurred
in any group. In the direct implantation group, 7 patients (5.8%) required
BAV to cross the valve. Adverse events were related mainly to pacemaker
implantation (20.9% in the BAV group vs. 19.0% in the direct implantation
group; p = 0.70). No significant difference was found between the 2
strategies in duration of procedure, contrast volume, radiation exposure,
or rate of post-dilatation. <br/>Conclusion(s): Direct TAVR without prior
BAV was noninferior to the conventional strategy using BAV with
new-generation balloon-expandable valves, but without procedural
simplification. BAV was needed to cross the valve in a few patients,
suggesting a need for upstream selection on the basis of patient anatomy.
(TAVI Without Balloon Predilatation [of the Aortic Valve] SAPIEN 3
[DIRECTAVI]; NCT02729519)<br/>Copyright &#xa9; 2020 American College of
Cardiology Foundation

<17>
Accession Number
2005053319
Title
Survival After Coronary Revascularization With Paclitaxel-Coated Balloons.
Source
Journal of the American College of Cardiology. 75 (9) (pp 1017-1028),
2020. Date of Publication: 10 March 2020.
Author
Scheller B.; Vukadinovic D.; Jeger R.; Rissanen T.T.; Scholz S.S.; Byrne
R.; Kleber F.X.; Latib A.; Clever Y.P.; Ewen S.; Bohm M.; Yang Y.; Lansky
A.; Mahfoud F.
Institution
(Scheller, Vukadinovic, Scholz, Clever, Ewen, Bohm, Mahfoud) Internal
Medicine III-Cardiology, Angiology and Intensive Care Medicine, Saarland
University Hospital, Saarland University, Homburg/Saar, Germany
(Scheller) Clinical and Experimental Interventional Cardiology, University
of Saarland, Homburg/Saar, Germany
(Jeger) University Hospital Basel, University of Basel, Basel, Switzerland
(Rissanen) Heart Center, North Karelia Central Hospital, Siun Sote,
Joensuu, Finland
(Byrne) Department of Cardiology, Deutsches Herzzentrum Munchen,
Technische Universitat Munchen, Munich, Germany
(Kleber) Evangelisches Krankenhaus Paul Gerhardt Stift,
Paul-Gerhardt-Strase 42-45, Lutherstadt Wittenberg, Germany
(Latib) Montefiore Medical Center, New York, NY, United States
(Yang, Lansky) Section of Cardiology, Yale University School of Medicine,
New Haven, CT, United States
Publisher
Elsevier USA
Abstract
Background: Drug-coated balloons (DCBs) are accepted treatment strategies
for coronary in-stent restenosis and are under clinical investigation for
lesions without prior stent implantation. A recently published
meta-analysis suggested an increased risk of death associated with the use
of paclitaxel-coated devices in the superficial femoral artery. The
reasons are incompletely understood as potential underlying
pathomechanisms remain elusive, and no relationship to the administered
dose has been documented. <br/>Objective(s): The purpose of this analysis
was to investigate the available data on survival after coronary
intervention with paclitaxel-coated balloons from randomized controlled
trials (RCTs). <br/>Method(s): PubMed, Web of science, and the Cochrane
library database were searched, and a meta-analysis from RCT was performed
comparing DCB with non-DCB devices (such as conventional balloon
angioplasty, bare-metal stents, or drug-eluting stents) for the treatment
of coronary in-stent restenosis or de novo lesions. The primary outcome
was all-cause death. The number of patients lost to follow-up was observed
at different time points. Risk estimates are reported as risk ratios (RRs)
with 95% confidence intervals (CIs). <br/>Result(s): A total of 4,590
patients enrolled in 26 RCTs published between 2006 and 2019 were
analyzed. At follow-up of 6 to 12 months, no significant difference in
all-cause mortality was found, however, with numerically lower rates after
DCB treatment (RR: 0.74; 95% CI: 0.51 to 1.08; p = 0.116). Risk of death
at 2 years (n = 1,477, 8 RCTs) was similar between the 2 groups (RR: 0.84;
95% CI: 0.51 to 1.37; p = 0.478). After 3 years of follow-up (n = 1,775, 9
RCTs), all-cause mortality was significantly lower in the DCB group when
compared with control treatment (RR: 0.73; 95% CI: 0.53 to 1.00; p =
0.047) with a number needed to treat of 36 to prevent 1 death. A similar
reduction was seen in cardiac mortality (RR: 0.53; 95% CI: 0.33 to 0.85; p
= 0.009). <br/>Conclusion(s): In this meta-analysis, the use of paclitaxel
DCBs for treatment of coronary artery disease was not associated with
increased mortality, as has been suggested for peripheral arteries. On the
contrary, use of coronary paclitaxel-coated balloons was associated with a
trend toward lower mortality when compared with control
treatments.<br/>Copyright &#xa9; 2020 American College of Cardiology
Foundation

<18>
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. 124 (4) (pp 454-462), 2020. Date of
Publication: April 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

<19>
Accession Number
2004098669
Title
Papillary muscle intervention vs mitral ring annuloplasty in ischemic
mitral regurgitation.
Source
Journal of Cardiac Surgery. 35 (3) (pp 645-653), 2020. Date of
Publication: 01 Mar 2020.
Author
Micali L.R.; Qadrouh M.N.; Parise O.; Parise G.; Matteucci F.; de Jong M.;
Tetta C.; Moula A.I.; Johnson D.M.; Gelsomino S.
Institution
(Micali, Qadrouh, Parise, Parise, Matteucci, de Jong, Tetta, Moula,
Johnson, Gelsomino) Department of Cardiothoracic Surgery, Maastricht
University Hospital, Maastricht, Netherlands
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background and Aims: The main pathophysiological factor of chronic
ischemic mitral regurgitation (MR) is the outward displacement of the
papillary muscles (PMs) leading to leaflet tethering. For this reason,
papillary muscle intervention (PMI) in combination with mitral ring
annuloplasty (MRA) has recently been introduced into clinical practice to
correct this displacement, and to reduce the recurrence of regurgitation.
<br/>Method(s): A meta-analysis was conducted comparing the outcomes of
PMI and MRA performed in combination vs MRA performed alone, in terms of
MR recurrence and left ventricular reverse remodeling (LVRR). A
meta-regression was carried out to investigate the impact of the type of
PMI procedure on the outcomes. <br/>Result(s): MR recurrence in patients
undergoing both PMI and MRA was lower than in those who only had MRA (log
incidence rate ratio, -0.66; lower-upper limits, -1.13 to 0.20;
I² = 0.0%; p =.44; Egger's test: intercept 0.35 [-0.78 to
1.51]; p =.42). The group with both PMI and MRA and that with only MRA
showed a slightly higher reduction in left ventricular diameters (-5.94%;
-8.75% to 3.13%,). However, in both groups, LVRR was <10%. No difference
was detected between PM relocation/repositioning and papillary muscle
approximation in terms of LVRR (p =.33). <br/>Conclusion(s): Using PMI and
MRA together has a lower MR recurrence than using MRA alone. No
significant LVRR was observed between the two groups nor between the PMI
techniques employed.<br/>Copyright &#xa9; 2020 The Authors. Journal of
Cardiac Surgery published by Wiley Periodicals, Inc.

<20>
Accession Number
631146426
Title
Comparing cardiac troponin levels using sevoflurane and isoflurane in
patients undergoing cardiac surgery: A systematic review and
meta-analysis.
Source
Journal of Cardiovascular and Thoracic Research. 12 (1) (pp 1-9), 2020.
Date of Publication: 2020.
Author
Hosseinifard H.; Ghadimi N.; Kaveh S.; Shabaninejad H.; Lijassi A.;
Azarfarin R.
Institution
(Hosseinifard) Biostatistics, School of Health Management and Information
Sciences, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Kaveh) Health Technology Assessment, School of Health Management and
Information Sciences, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Shabaninejad) Department of Health Services Management, School of Health
Management and Information Sciences, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Shabaninejad) Population Health Sciences Institute, Newcastle University,
Newcastle, United Kingdom
(Lijassi) Faculty of Medicine and Pharmacy of Rabat, Mohammed V University
of Rabat, Rabat, Morocco
(Azarfarin) Echocardiography Research Center, Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
Publisher
Tabriz University of Medical Sciences (E-mail: tmj@taibahu.edu.sa)
Abstract
Introduction: Cardiac troponin is one of the heart biomarkers and its high
levels correlates with a high risk of cardiomyocytes damage. This study
aimed to compare sevoflurane and isoflurane effect on troponin levels in
patients undergoing cardiac surgery. <br/>Method(s): We systematically
searched for RCTs which had been published in Cochrane library, PubMed,
Web of science, CRD, Scopus, and Google Scholar by the end of February
30th, 2019. The quality of articles was evaluated with the Cochrane
checklist. GRADE was used for quality of evidence for this meta-analysis.
Meta-analysis was done based on random or fixed effect model.
<br/>Result(s): Five studies with total of 190 (sevoflurane) and 191
(isoflurane) patients were included. The results showed that pooled mean
difference of troponin levels between the two groups was significant at
ICU admission time and 24 hours after entering. The comparison of troponin
level changes between the two groups (baseline = at time ICU) in 24 and 48
hours after ICU admission was significant. <br/>Conclusion(s): This
meta-analysis showed that blood troponin levels were significantly lower
at the time of arrival in ICU with isoflurane and after 24 hours with
sevoflurane. Generally, given the small mean difference between isoflurane
and sevoflurane, it seems that none of the medications has a negative
effect on the cardiac troponin level.<br/>Copyright &#xa9; 2020 The
Author(s). This is an open access article distributed under the terms of
the Creative Commons Attribution License
(http://creativecommons.org/licenses/by/4.0), which permits unrestricted
use, distribution, and reproduction in any medium, provided the original
work is properly cited.

<21>
Accession Number
631136513
Title
Impact of renin-angiotensin systeminhibitors on clinical outcomes in
patients with severe aortic stenosis undergoing transcatheter aortic valve
replacement: An analysis of from the PARTNER 2 trial and registries.
Source
European Heart Journal. 41 (8) (pp 943-954), 2020. Date of Publication: 21
Feb 2020.
Author
Chen S.; Redfors B.; Nazif T.; Kirtane A.; Crowley A.; Ben-Yehuda O.;
Kapadia S.; Finn M.T.; Goel S.; Lindman B.R.; Alu M.C.; Chau A.H.;
Thourani V.H.; Vahl T.P.; Douglas P.S.; Kodali S.K.; Leon M.B.
Institution
(Chen, Redfors, Crowley, Ben-Yehuda, Alu, Leon) Cardiovascular Research
Foundation, 1700 Broadway, New York, NY 10019, United States
(Chen, Redfors, Nazif, Kirtane, Finn, Alu, Chau, Vahl, Kodali, Leon)
Center for Interventional Vascular Therapy, Columbia University Irving
Medical Center/NewYork-Presbyterian Hospital, 161 Ft. Washington Ave.
HIP-6, New York, NY 10032, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital, Bruna
Straket 16, Gothenburg 413 45, Sweden
(Kapadia, Goel) Department of Cardiovascular Medicine, Cleveland Clinic,
9500 Euclid Ave, Cleveland, OH 44195, United States
(Lindman) Structural Heart and Valve Center, Cardiovascular Medicine
Division, Vanderbilt University Medical Center, 1161 21st Ave S.,
Nashville, TN 37232, United States
(Thourani) Department of Cardiac Surgery, Piedmont Heart Institute, 95
Collier Road NW, Atlanta, GA 30309, United States
(Douglas) Duke Clinical Research Institute, Duke University School of
Medicine, 300 W Morgan St, Durham, NC 27701, United States
Publisher
Oxford University Press
Abstract
Aims Left ventricular pressure overload is associated with activation of
the cardiac renin-angiotensin system, which may contribute to myocardial
fibrosis and worse clinical outcomes. We sought to assess the association
between treatment with angiotensin-converting enzyme inhibitors (ACEIs) or
angiotensin II receptor blockers (ARBs) at baseline and clinical outcomes
in patients with symptomatic, severe aortic stenosis (AS) undergoing
transcatheter aortic valve replacement (TAVR) in the PARTNER 2 trial and
registries Methods and results A total of 3979 intermediate, high, or
prohibitive risk patients who underwent TAVR in the PARTNER 2 trial and
registries (excluding the valve in valve registry) were included in the
study. Clinical outcomes at 2 years were compared according to baseline
ACEI/ARB treatment status using Kaplan-Meier event rates and
study-stratified multivariable Cox proportional hazards regression models.
Sensitivity analysis was conducted using propensity score matching. Of
3979 patients who were included in the current analysis, 1736 (43.6%) were
treated and 2243 (56.4%) were not treated with ACEI/ARB at baseline.
Treatment with ACEI/ARB was associated with lower 2-year all-cause
mortality (18.6% vs. 27.5%, P < 0.0001), cardiovascular mortality (12.3%
vs. 17.9%, P < 0.0001), and noncardiovascular mortality (7.2% vs. 11.7%, P
< 0.0001). Angiotensin-converting enzyme inhibitor/ARB treatment at
baseline remained independently associated with a lower hazard of 2-year
all-cause and cardiovascular mortality after multivariable adjustment, and
propensity score matching. Conclusion In a large cohort of patients with
severe symptomatic AS from the PARTNER 2 trial and registries, ACEI/ARB
treatment at baseline was independently associated with a lower risk of
2-year all-cause and cardiovascular mortality.<br/>Copyright &#xa9; The
Author(s) 2019.

<22>
Accession Number
2004592255
Title
Usefulness of Postprocedural Electrophysiological Confirmation Upon
Totally Thoracoscopic Ablation in Persistent Atrial Fibrillation.
Source
American Journal of Cardiology. 125 (7) (pp 1054-1062), 2020. Date of
Publication: 1 April 2020.
Author
Choi M.S.; On Y.K.; Jeong D.S.; Park K.-M.; Park S.-J.; Kim J.S.; Carriere
K.C.
Institution
(Choi) Department of Thoracic and Cardiovascular Surgery, Dongguk
University Ilsan Hospital, Dongguk University School of Medicine, Goyang,
Gyeonggi, South Korea
(On, Park, Park, Kim) Division of Cardiology, Department of Medicine,
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
South Korea
(Jeong) Department of Thoracic and Cardiovascular Surgery, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Carriere) Biostatistics and Clinical Epidemiology, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Little information is available concerning the usefulness of
electrophysiological confirmation followed by totally thoracoscopic
ablation. This study aimed to examine whether postprocedural
electrophysiological confirmation is always necessary after totally
thoracoscopic ablation (TTA) in patients with isolated persistent atrial
fibrillation. Forty-five patients with isolated persistent atrial
fibrillation were randomized into 2 groups those who received routine
electrophysiological confirmation and additional catheter ablation after
totally thoracoscopic ablation (the hybrid group [n = 22]) and those who
did not (the TTA group [n = 23]). Electrophysiological study was performed
4 or 5 days after surgery. No early or late mortality occurred. In the
hybrid group, 5 patients (23%, 5/22) required additional ablation due to
residual potential in the left atrium. At a year postoperatively, normal
sinus rhythm was observed in 89% of patients (40/45) and similar in both
groups (Odds ratio 0.80, 95% confidence interval 0.32 to 1.99). During
follow-up, sinus rhythm was maintained in 16 patients (70%) in the TTA
group without additional catheter ablation, which was similar (p = 0.920)
to the results in the hybrid group (n = 15, 68.2%). Event-free survival
rate at 12 months did not differ between groups (TTA group vs hybrid
group, 78% vs 77%; p = 0.633). In simple Cox regression analysis,
preoperative left atrium volume index was associated with atrial
arrhythmia (p = 0.030, hazards ratio 1.087, 95% confidence interval
1.01-1.18). In conclusion, thoracoscopic ablation provided good 1-year
durability in patients with isolated persistent AF irrespective of
postprocedural electrophysiological confirmation. Seventy-percent of the
TTA group did not need additional catheter ablation.<br/>Copyright &#xa9;
2020 Elsevier Inc.

<23>
Accession Number
631157945
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.; Funes M.-V.R.; 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, and Impact, McMaster University, 1280 Main St
W, 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, United States
(Sigamani) Department of Clinical Research, Narayana Hrudayalaya Limited,
258/A,Hosur Road, Bommasandra Industrial Area, Anekal Taluk, Bangalore
560099, India
(Parlow) Department of Anesthesiology and Perioperative Medicine, Kingston
Health Sciences Centre and Queen's University, 76 Stuart St, Kingston, ON
K7L 2V7, 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, Av. 42 ##48 - 11, Bucaramanga,
Santander, Colombia
(Srinathan) Department of Surgery, University of Manitoba, Rm. GE61, 820
Sherbrook Street, Winnipeg, MB R3A 1R9, Canada
(Malaga) School of Medicine, Universidad Peruana Cayetano Heredia, Av.
Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru
(Sivakumaran) Department of Medicine, University of Alberta, 116 St and 85
Ave, Edmonton, AB T6G 2R3, Canada
(Funes) Unidad de Investigacion Cientifica, Facultad de Medicina,
Universidad de El Salvador, Final 25 Ave norte, El Salvador
(Cruz) Department of Anesthesia, Hospital General Universitario Gregorio
Maranon, Calle del Dr. Esquerdo 46, Madrid 28007, Spain
(Yang, Jones) Department of Anesthesia and Perioperative Medicine,
University of Western Ontario, 1151 Richmond St, London, ON N6A 3K7,
Canada
(Dresser) Department of Medicine, London Health Sciences Centre, Victoria
Hospital, 800 Commissioners Rd E, London, ON N6A 5W9, Canada
(Alvarez-Garcia) Department of Cardiology, Hospital de la Santa Creu i
Sant Pau, CIBERCV, 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, QC H4A 3J1, Canada
(Jones) Department of Epidemiology and Biostatistics, University of
Western Ontario, 1151 Richmond St, London, ON N6A 3K7, Canada
(Drummond) Department of Anaesthesia, Nelson R Mandela School of Medicine,
University of KwaZulu-Natal, 719 Umbilo Road, Umbilo 4001, South Africa
Publisher
Oxford University Press
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 30 days after surgery. Our primary outcome
was the incidence of stroke at 1 year 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 69 years,
57.4% male), 404 had POAF (2.2%). The stroke incidence 1 year after
surgery was 5.58 vs. 1.54 per 100 patientyears 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). Conclusion 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 &#xa9; The Author(s) 2019.

<24>
Accession Number
2005189601
Title
Efficacy of Bilateral Transversus Thoracis Muscle Plane Block in Pediatric
Patients Undergoing Open Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
Zhang Y.; Chen S.; Gong H.; Zhan B.
Institution
(Zhang, Chen, Gong) Department of Anesthesiology, First Affiliated
Hospital of Nanchang University, Nanchang, China
(Zhan) Department of Cardiology, The Second Affiliated Hospital of
Nanchang University, Jiangxi, China
Publisher
W.B. Saunders
Abstract
Objectives: Adequate pain management is crucial for pediatric patients
undergoing open cardiac surgery. The aim of the present study was to
investigate the effect of a bilateral transversus thoracis muscle plane
(TTP) block on open cardiac surgery outcomes. <br/>Setting(s): First
Affiliated Hospital of Nanchang University. <br/>Participant(s): Patients
ages 6 to 60 months undergoing cardiac surgical procedures were included.
<br/>Intervention(s): A group of 100 children were randomly allocated to
receive either bilateral TTP block (TTP group) or no nerve block.
<br/>Measurements and Main Results: The primary endpoint was postoperative
pain, which was measured with the Modified Objective Pain Score. The
secondary outcome measures included intraoperative and postoperative
fentanyl consumption; time to extubation; time to first feces; length of
stay in the intensive care unit; length of hospital stay; and possible
complications such as ropivacaine allergy, pneumothorax, hematomas,
infections, and injuries to the internal mammary artery and vein. The TTP
group had a significantly lower Modified Objective Pain Score until 24
hours after extubation than the no nerve block group. The TTP group
reported significantly less fentanyl consumption. Time to extubation and
lengths of stay in the intensive care unit and hospital were significantly
decreased in the TTP group. <br/>Conclusion(s): Bilateral TTP blocks
provide effective analgesia and accelerate recovery in pediatric
patients.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<25>
Accession Number
2005127868
Title
Does Intraoperative Cell Salvage Reduce Postoperative Infection Rates in
Cardiac Surgery?.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
van Klarenbosch J.; van den Heuvel E.R.; van Oeveren W.; de Vries A.J.
Institution
(van Klarenbosch) Department of Anesthesiology, University Medical Center
Utrecht, Utrecht, Netherlands
(van den Heuvel) Department of Mathematics & Computer Science, Eindhoven
University of Technology, Eindhoven, Netherlands
(van Oeveren) HaemoScan BV, Groningen, Netherlands
(de Vries) Department of Anesthesiology, University Medical Center
Groningen, Groningen, Netherlands
Publisher
W.B. Saunders
Abstract
Objective: Primary outcome was the risk for infections after cell salvage
in cardiac surgery. <br/>Design(s): Data of a randomized controlled trial
on cell salvage and filter use (ISRCTN58333401). <br/>Setting(s): Six
cardiac surgery centers in the Netherlands. <br/>Participant(s): All 716
patients undergoing elective coronary artery bypass grafting, valve
surgery, or combined procedures over a 4-year period who completed the
trial. <br/>Intervention(s): Postoperative infection data were assessed
according to Centre of Disease Control and Prevention/National Healthcare
Safety Network surveillance definitions. <br/>Measurements and Main
Results: Fifty-eight (15.9%) patients with cell salvage had infections,
compared with 46 (13.1%) control patients. Mediation analysis was
performed to estimate the direct effect of cell salvage on infections (OR
2.291 [1.177;4.460], p = 0.015) and the indirect effects of allogeneic
transfusion and processed cell salvage blood on infections. Correction for
confounders, including age, seks and body mass index was performed.
Allogeneic transfusion had a direct effect on infections (OR = 2.082
[1.133;3.828], p = 0.018), but processed cell salvage blood did not (OR =
0.999 [0.999; 1.001], p = 0.089). There was a positive direct effect of
cell salvage on allogeneic transfusion (OR = 0.275 [0.176;0.432], p <
0.001), but a negative direct effect of processed cell salvage blood
(1.001 [1.001;1.002], p < 0.001) on allogeneic transfusion. Finally, there
was a positive direct effect of cell salvage on the amount of processed
blood. <br/>Conclusion(s): Cell salvage was directly associated with
higher infection rates, but this direct effect was almost completely
eliminated by its indirect protective effect through reduced allogeneic
blood transfusion.<br/>Copyright &#xa9; 2020 The Authors

<26>
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. 47 (3) (pp 975-982), 2020. Date of Publication: 01 Mar
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.

<27>
Accession Number
2003508562
Title
The challenge of non-adherence to early rehabilitation after coronary
artery bypass surgery: Secondary results from the SheppHeartCABG trial.
Source
European Journal of Cardiovascular Nursing. 19 (3) (pp 238-247), 2020.
Date of Publication: 01 Mar 2020.
Author
Hojskov I.E.; Thygesen L.C.; Moons P.; Egerod I.; Olsen P.S.; Berg S.K.
Institution
(Hojskov, Olsen, Berg) The Heart Centre, University of Copenhagen, Denmark
(Hojskov) Department of Nursing and Nutrition Education, The Faculty of
Health Sciences, University College, Copenhagen, Denmark
(Thygesen) National Institute of Public Health, University of Southern
Denmark, Denmark
(Moons) Department of Public Health and Primary Care, University of
Leuven, Belgium
(Moons) Department of Pediatrics and Child Health, University of Cape
Town, South Africa
(Egerod) Department of Intensive Care Unit, Rigshospitalet, University of
Copenhagen, Denmark
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Background: Attending and maintaining a cardiac rehabilitation programme
is a challenge. <br/>Aim(s): The purpose of this study was to explore
associations between non-adherence to early coronary artery bypass graft
rehabilitation and sociodemographic and clinical baseline data.
<br/>Method(s): Coronary artery bypass graft patients were randomised 1:1
to either four weeks of comprehensive early rehabilitation or usual care.
Outcomes were assessed at three time-points points: baseline, discharge
and four weeks post-coronary artery bypass graft. Differences in
sociodemographic and clinical baseline data in adherent versus
non-adherent patients were tested using the Pearson chi² test
for categorical variables. To test associations between non-adherence to
exercise training and sociodemographic and clinical baseline data,
multivariate logistic regression was used to estimate the odds ratio for
in-hospital training and post-discharge training adjusted for age, sex and
left ventricular ejection fraction. <br/>Result(s): Non-adherence to
in-hospital versus post-discharge exercise training was 31% (n=48) versus
53% (n=81). Female non-adherence was 20% versus 70%. Non-adherence to
in-hospital versus post-discharge mindfulness was 87% versus 70%. Male
non-adherence to mindfulness was 85% versus 70%. Non-adherence to
psycho-educational consultations was 3%, most of whom were men. Patients
with university level education were more adherent to in-hospital exercise
training than patients with lower educational level (odds ratio=3.14 (95%
confidence interval; 1.16-8.51), p=0.02). Diabetic patients were more
non-adherent to exercise training after discharge (3.74 (1.54-9.08),
p=0.004) as were overweight patients (0.37 (0.17-0.80), p=0.01).
<br/>Conclusion(s): This study demonstrated wide acceptance of
psycho-educational consultations in post-coronary artery bypass graft
patients. Adherence to physical rehabilitation was low especially after
discharge from hospital and the opportunity to attend a mindfulness
programme was not used.<br/>Copyright &#xa9; The European Society of
Cardiology 2019.

<28>
Accession Number
631124205
Title
Effect of an ICU diary on psychiatric disorders, quality of life, and
sleep quality among adult cardiac surgical ICU survivors: A randomized
controlled trial.
Source
Critical Care. 24 (1) (no pagination), 2020. Article Number: 81. Date of
Publication: 06 Mar 2020.
Author
Wang S.; Xin H.-N.; Chung Lim Vico C.; Liao J.-H.; Li S.-L.; Xie N.-M.; Hu
R.-F.
Institution
(Wang, Liao, Xie, Hu) School of Nursing, Fujian Medical University,
University Town, 1 Xue Yuan Road, Fuzhou 350122, China
(Xin) Fujian Provincial Hospital, Fuzhou, China
(Chung Lim Vico) School of Nursing, Hong Kong Polytechnic University,
Kowloon, Hong Kong
(Li) Fujian Medical University Union Hospital, Fuzhou, China
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Although studies on the effectiveness of the use of ICU
diaries on psychiatric disorders and quality of life have been published,
the results still seem to be controversial. The study aimed to determine
the effects of using an ICU diary on psychiatric disorders, sleep quality,
and quality of life (QoL) in adult ICU survivors in China. <br/>Method(s):
One hundred and twenty-six patients who underwent a scheduled cardiac
surgery and were expected to stay >= 24 h in ICU were randomized to two
groups (63 in each group). The patients in the intervention group received
the use of ICU diaries during the period of post-ICU follow-up, while the
patients in the control group received usual care without ICU diaries. The
primary outcome was significant PTSD symptoms (Chinese version of Impact
of Event Scale-Revised, IES-R; total score >= 35 was defined as
significant PTSD symptoms) and its severity in patients 3 months post-ICU.
The secondary outcomes included memories of the ICU at 1 month, QoL
(Medical Outcomes Study 36-item Short-Form, SF-36), sleep quality
(Pittsburgh Sleep Quality Index Questionnaire, PSQI), anxiety, and
depression symptoms (Hospital Anxiety and Depression Scale, HADS) at 3
months. <br/>Result(s): Eighty-five and 83 patients completed the
follow-up interviews at 1 month and 3 months post-ICU, respectively.
Significant PTSD symptoms were reported by 6 of 41 (14.63%) in the
intervention group vs 9 of 42 (21.43%) in the control group (risk
difference, - 9% [95% CI, - 2% to 21%], P = 0.10). There was no
significant differences between groups in IES-R score, symptoms of
intrusion, symptoms of avoidance, numbers of memories of feeling and
delusional memories, SF-36 score and anxiety score (P > 0.05), while
significant differences were found in symptom of hyperarousal score,
numbers of factual memories and PSQI score (P < 0.05). No adverse effect
was reported. <br/>Conclusion(s): Using an ICU diary is not useful for
preventing PTSD symptoms and anxiety symptoms and preserving the quality
of life of the patients at 3 months post-ICU, while it significantly
improves the survivor's factual memory of ICU and sleep quality, and
prevents the hyperarousal symptom. Trial registration: Chinese Clinical
Trial Registry, ChiCTR-IOR-16009109, registered on 28 August
2016<br/>Copyright &#xa9; 2020 The Author(s).

<29>
Accession Number
631123962
Title
'Organisation of delivery of care in operating suite recovery rooms within
48 hours postoperatively and patient outcomes after adult non-cardiac
surgery: A systematic review'.
Source
BMJ Open. 10 (3) (no pagination), 2020. Article Number: e027262. Date of
Publication: 04 Mar 2020.
Author
Lloyd C.; Ludbrook G.; Story D.; Maddern G.
Institution
(Lloyd, Ludbrook) Faculty of Health and Medical Sciences, University of
Adelaide, Adelaide, SA, Australia
(Story) Perioperative and Pain Medicine Unit, Melbourne Medical School,
University of Melbourne, Parkville, VIC, Australia
(Maddern) Discipline of Surgery, Faculty of Health and Medical Sciences,
University of Adelaide, Adelaide, SA, Australia
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Context Postoperative recovery rooms have existed since 1847, however,
there is sparse literature investigating interventions undertaken in
recovery, and their impact on patients after recovery room discharge.
Objective This review aimed to investigate the organisation of care
delivery in postoperative recovery rooms; and its effect on patient
outcomes; including mortality, morbidity, unplanned intensive care unit
(ICU) admission and length of hospital stay. Data sources NCBI PubMed,
EMBASE and Cumulative Index to Nursing and Allied Health Literature. Study
selection Studies published since 1990, investigating health system
initiatives undertaken in postoperative recovery rooms. One author
screened titles and abstracts, with two authors completing full-text
reviews to determine inclusion based on predetermined criteria. A total of
3288 unique studies were identified, with 14 selected for full-text
reviews, and 8 included in the review. Data extraction EndNote V.8
(Clarivate Analytics) was used to manage references. One author extracted
data from each study using a data extraction form adapted from the
Cochrane Data Extraction Template, with all data checked by a second
author. Data synthesis Narrative synthesis of data was the primary outcome
measure, with all data of individual studies also presented in the summary
results table. Results Four studies investigated the use of the
postanaesthesia care unit (PACU) as a non-ICU pathway for postoperative
patients. Two investigated the implementation of physiotherapy in PACU,
one evaluated the use of a new nursing scoring tool for detecting patient
deterioration, and one evaluated the implementation of a two-track
clinical pathway in PACU. Conclusions Managing selected postoperative
patients in a PACU, instead of ICU, does not appear to be associated with
worse patient outcomes, however, due to the high risk of bias within
studies, the strength of evidence is only moderate. Four of eight studies
also examined hospital length of stay; two found the intervention was
associated with decreased length of stay and two found no association.
PROSPERO registration number This protocol is registered on the
International Prospective Register of Systematic Reviews (PROSPERO)
database, registration number CRD42018106093.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<30>
Accession Number
631198464
Title
2020 Southern Regional Meeting.
Source
Journal of Investigative Medicine. Conference: 2020 Southern Regional
Meeting. United States. 68 (2) (no pagination), 2020. Date of Publication:
February 2020.
Author
Anonymous
Publisher
BMJ Publishing Group
Abstract
The proceedings contain 673 papers. The topics discussed include: obesity
and cardiovascular outcomes: another look at a meta-analysis of Mendelian
randomization studies; reliability of ultrashort electrocardiographic
indices in hypertension: the quest for a clinically applicable prognostic
marker; U-shaped relationship between left ventricular mass index and
estimated glomerular filtration rate in patients with primary
aldosteronism; traditional signs and symptoms commonly attributed to
hypogonadism do not correlate with testosterone levels: the cooper center
longitudinal study experience; metformin decreases hyaluronan synthesis by
vascular smooth muscle cells; low hematocrit levels: a risk factor for
long-term outcomes in patients requiring prolonged mechanical ventilation
after cardiovascular surgery. a retrospective study; and association of
intestinal permeability with admission vitamin D deficiency in patients
who are critically ill.

<31>
Accession Number
2004432104
Title
Association Between Obesity and Cardiovascular Outcomes: Updated Evidence
from Meta-analysis Studies.
Source
Current Cardiology Reports. 22 (4) (no pagination), 2020. Article Number:
25. Date of Publication: 01 Apr 2020.
Author
Dwivedi A.K.; Dubey P.; Cistola D.P.; Reddy S.Y.
Institution
(Dwivedi) Division of Biostatistics & Epidemiology, Department of
Molecular and Translational Medicine, Paul L. Foster School of Medicine,
Texas Tech University Health Sciences Center El Paso, 5001 El Paso Drive,
El Paso, TX 79905, United States
(Dubey, Reddy) Department of Obstetrics & Gynecology, Paul L. Foster
School of Medicine, Texas Tech University Health Sciences Center El Paso,
4800 Alberta Avenue, El Paso, TX 79905, United States
(Cistola) Center of Emphasis in Diabetes & Metabolism, Department of
Molecular and Translational Medicine, Paul L. Foster School of Medicine,
Texas Tech University Health Sciences Center El Paso, 5001 El Paso Drive,
El Paso, TX 79905, United States
Publisher
Springer
Abstract
Purpose of Review: The prevalence of obesity and cardiovascular disease
(CVD) has been increasing worldwide. Studies examining the association
between adiposity and CVD outcomes have produced conflicting findings. The
interplay between obesity and CVD outcomes in the general population and
in specific subpopulations is complex and requires further elucidation.
Recent Findings: We report updated evidence on the association between
obesity and CVD events through a review of meta-analysis studies. This
review identified that obesity or high body mass index (BMI) was
associated with an increased risk of CVD events, including mortality, in
the general population and that cardiac respiratory fitness (CRF) and
metabolic health status appear to stratify the risk of CVD outcomes. In
patients with diabetes, hypertension, or coronary artery disease,
mortality displayed a U-shaped association with BMI. This U-shaped
association may result from the effect of unintentional weight loss or
medication use. By contrast, patients with other severe heart diseases or
undergoing cardiac surgery displayed a reverse J-shaped association
suggesting the highest mortality associated with low BMI. In these
conditions, a prolonged intensive medication use might have attenuated the
risk of mortality associated with high BMI. <br/>Summary: For the general
population, a large body of evidence points to the importance of obesity
prevention and maintenance of a healthy weight. However, for those with
diagnosed cardiovascular diseases or diabetes, the relationship between
BMI and cardiovascular outcomes is more complex and varies with the type
of disease. More studies are needed to define how heterogeneity in the
longitudinal changes in BMI affects mortality, especially in patients with
severe heart diseases or going under cardiac surgery, in order to target
subgroups for tailored interventions. Interventions for managing body
weight, in conjunction with improving CRF and metabolic health status and
avoiding unintentional weight loss, should be used to improve CVD
outcomes.<br/>Copyright &#xa9; 2020, Springer Science+Business Media, LLC,
part of Springer Nature.

<32>
Accession Number
2005199500
Title
Comparison between erector spinal plane block and epidural block
techniques for postoperative analgesia in open cholecystectomies: a
randomized clinical trial.
Source
Brazilian Journal of Anesthesiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Sakae T.M.; Yamauchi L.H.I.; Takaschima A.K.K.; Brandao J.C.; Benedetti
R.H.
Institution
(Sakae, Yamauchi, Takaschima, Benedetti) Servico de Anestesiologia
SIANEST, Florianopolis, SC, Brazil
(Sakae, Benedetti) Universidade do Sul de Santa Catarina (UNISUL),
Florianopolis, SC, Brazil
(Yamauchi, Takaschima, Benedetti) Hospital Florianopolis, Florianopolis,
SC, Brazil
(Yamauchi, Takaschima, Brandao, Benedetti) TSA Sociedade Brasileira de
Anestesiologia (SBA), Rio de Janeiro, RJ, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Introduction and objectives: Blockade of the Erector Spinal Muscle (ESP
block) is a relatively new block, initially described for chronic thoracic
pain analgesia, but it has already been described for anesthesia and
analgesia in thoracic surgical procedures and, more recently, for high
abdominal surgeries. The aim of the study was to compare two techniques,
ESP Block and Epidural block with morphine and local anesthetic for
postoperative analgesia of open cholecystectomy surgeries. <br/>Method(s):
Controlled single-blind randomized clinical trial with 31 patients (ESP
block, n = 15; Epidural, n = 16), of both genders, ages between 27 and 77
years. The ESP block was performed at the T8 level with injection of 20 mL
of 0.5% ropivacaine bilaterally. The epidural block was performed at the
T8-T9 space with 20 mL of 0.5% ropivacaine and 1 mg of morphine.
<br/>Result(s): The ESP block group presented higher mean Numeric Pain
Scale (NPS) values for pain in the up to 2 hour (p = 0.001) and in the 24
hour (p = 0.001) assessments. The ESP block group had a three-fold
increased risk (43.7% vs. 13.3%) of rescue opioid use in the 24
postoperative hours when compared to the epidural group (RR = 3.72, 95%
CI: 0.91 to 15.31, p = 0.046). <br/>Conclusion(s): ESP block did not prove
to be an effective technique for postoperative analgesia of open
cholecystectomy, at the doses performed in this study, having required
more use of rescue opioid, and without differences in NPS. More
comprehensive studies are required to assess the efficacy of ESP block for
the visceral and abdominal somatic component, considering the specific
blockade level.<br/>Copyright &#xa9; 2020

<33>
Accession Number
631217822
Title
Sex-Specific Management in Patients With Acute Myocardial Infarction and
Cardiogenic Shock: A Substudy of the CULPRIT-SHOCK Trial.
Source
Circulation. Cardiovascular interventions. 13 (3) (pp e008537), 2020. Date
of Publication: 01 Mar 2020.
Author
Rubini Gimenez M.; Zeymer U.; Desch S.; de Waha-Thiele S.; Ouarrak T.;
Poess J.; Meyer-Saraei R.; Schneider S.; Fuernau G.; Stepinska J.; Huber
K.; Windecker S.; Montalescot G.; Savonitto S.; Jeger R.V.; Thiele H.
Institution
(Rubini Gimenez, Desch, Thiele) From the Department of Internal
Medicine/Cardiology, Heart Center Leipzig, Germany (M.R.G., S.D.
(Rubini Gimenez, Jeger) Cardiology Department, University Hospital Basel
(Zeymer) Klinikum Ludwigshafen, Germany (U.Z.)
(Desch, Meyer-Saraei, Fuernau) German Center for Cardiovascular Research,
Germany (S.D., R.M.-S., Berlin, Germany
(de Waha-Thiele, Poess, Meyer-Saraei, Fuernau) Department of Internal
Medicine/Cardiology/ Angiology/Intensive Care Medicine, University Heart
Center Lubeck, Germany (S.d.W.-T., R.M.-S.
(Ouarrak, Schneider) Institut fur Herzinfarktforschung, Ludwigshafen,
Germany (T.O.
(Stepinska) Institute of Cardiology, Poland (J.S.), Warsaw, United States
(Huber) 3rd Department of Internal Medicine, Cardiology and Intensive Care
Medicine, Wilhelminenhospital and Sigmund Freud University, Medical
School, Vienna, Austria
(Windecker) Department of Cardiology, Inselspital, Bern University
Hospital, University of Bern
(Montalescot) Department of Cardiology, Sorbonne Universite, Institut de
Cardiologie (AP-HP), hopital Pitie Salpetriere, Paris, United States
(Savonitto) Department of Cardiology, Manzoni Hospital, Lecco, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: Women are more likely to suffer and die from cardiogenic shock
(CS) as the most severe complication of acute myocardial infarction. Data
concerning optimal management for women with CS are scarce. Aim of this
study was to better define characteristics of women experiencing CS and to
the influence of sex on different treatment strategies. <br/>METHOD(S): In
the CULPRIT-SHOCK trial (The Culprit Lesion Only PCI Versus Multivessel
PCI in Cardiogenic Shock), patients with CS complicating acute myocardial
infarction and multivessel coronary artery disease were randomly assigned
to one of the following revascularization strategies: either percutaneous
coronary intervention of the culprit-lesion-only or immediate multivessel
percutaneous coronary intervention. Primary end point was composite of
death from any cause or severe renal failure leading to renal replacement
therapy within 30 days. We investigated sex-specific differences in
general and according to the revascularization strategies. <br/>RESULT(S):
Among all 686 randomized patients included in the analysis, 24% were
women. Women were older and had more often diabetes mellitus and renal
insufficiency, whereas they had less often history of previous acute
myocardial infarction and smoking. After 30 days, the primary clinical end
point was not significantly different between groups (56% women versus 49%
men; odds ratio, 1.29 [95% CI, 0.91-1.84]; P=0.15). There was no
interaction between sex and coronary revascularization strategy regarding
mortality and renal failure (Pinteraction=0.11). The primary end point
occurred in 56% of women treated by the culprit-lesion-only strategy
versus 42% men, whereas 55% of women and 55% of men in the multivessel
percutaneous coronary intervention group. <br/>CONCLUSION(S): Although
women presented with a different risk profile, mortality and renal
replacement were similar to men. Sex did not influence mortality and renal
failure according to the different coronary revascularization strategies.
Based on these data, women and men presenting with CS complicating acute
myocardial infarction and multivessel coronary artery disease should not
be treated differently. However, further randomized trials powered to
address potential sex-specific differences in CS are still necessary.
Registration: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT01927549.

<34>
Accession Number
631210667
Title
Controlling effects of treprostinil on pulmonary arterial hypertension
during surgery for congenital heart disease complicated with severe
pulmonary arterial hypertension by echocardiography.
Source
Minerva cardioangiologica. (no pagination), 2020. Date of Publication: 04
Mar 2020.
Author
Jiang H.; Yu X.; Zhang L.; Wang M.
Institution
(Jiang) Department of Ultrasonography, Weihai Central Hospital, Weihai,
China
(Yu) Blood Purification Center, Weihai Central Hospital, Weihai, China
(Zhang) Penglai People's Hospital, Yantai, China
(Wang) Department of Ultrasonography, Weihai Central Hospital, Weihai,
China
Publisher
NLM (Medline)
Abstract
BACKGROUND: To evaluate the effects of treprostinil injection on the
control of pulmonary blood pressure in children with congenital heart
disease (CHD) complicated by severe pulmonary arterial hypertension (PAH).
<br/>METHOD(S): Eighty children with CHD complicated by severe pulmonary
arterial hypertension admitted to our hospital from January 2015 to June
2018 were selected and randomly divided into a control group (n=40) and a
treatment group (n=40). Based on standard treatment, the treatment group
was intravenously infused with 812 ng/kg.min treprostinil, while the
control group received the same dose of normal saline. Hemodynamic
parameters such as BP, AP, P and SpO2% were monitored before anesthesia
induction (T0), before cardiopulmonary bypass (T1), 1 h after
cardiopulmonary bypass (T2) and at the end of cardiopulmonary bypass (T3).
Pulmonary arterial pressure parameters (PASP, PADP and PAMP) were measured
at T1, T2 and T3 by transesophageal echocardiography. <br/>RESULT(S): For
the treatment group, the HR values at T2 and T3 were lower than that at T0
(P<0.05). For the control group, HR at T3 was lower than that at T0
(P<0.05). HR at T3 of the treatment group was lower than that of the
control group (P<0.05). SpO2 of the treatment group was higher than that
of the control group at T3 (P<0.05). At T2 and T3, PASP, PADP and PAMP of
both groups were lower than those before surgery (P<0.05), and the values
of the treatment group were lower than those of the control group
(P<0.05). <br/>CONCLUSION(S): Treprostinil can improve cardiac function
and reduce pulmonary circulation resistance in PAH children.

<35>
Accession Number
631172562
Title
Development and usability testing of HEARTPAN: Protocol for a mixed
methods strategy to develop an integrated smartphone and web-based
intervention for women with cardiac pain.
Source
BMJ Open. 10 (3) (no pagination), 2020. Article Number: e033092. Date of
Publication: 09 Mar 2020.
Author
Parry M.; Dhukai A.; Clarke H.; Bjornnes A.K.; Cafazzo J.A.; Cooper L.;
Harvey P.; Katz J.; Lalloo C.; Leegaard M.; Legare F.; Lovas M.;
McFetridge-Durdle J.; McGillion M.; Norris C.; Parente L.; Patterson R.;
Pilote L.; Pink L.; Price J.; Stinson J.; Uddin A.; Victor J.C.;
Watt-Watson J.; Auld C.; Faubert C.; Park D.; Park M.; Rickard B.; DeBonis
V.S.
Institution
(Parry, Dhukai) University of Toronto Lawrence S Bloomberg Faculty of
Nursing, Toronto, ON, Canada
(Clarke) Pain Research Unit, University Health Network, Toronto, ON,
Canada
(Clarke, Cafazzo, Harvey, Victor) University of Toronto, Toronto, ON,
Canada
(Bjornnes) Department of Nursing and Health Promotion, Oslo Metropolitan
University, Oslo, Norway
(Cafazzo, Lovas, Parente, Uddin) Healthcare Human Factors, University
Health Network, Toronto, ON, Canada
(Cooper, Auld, Faubert, Park, Park, DeBonis) Patient Advisor, Toronto, ON,
Canada
(Harvey, Price) Women's College Hospital, Toronto, ON, Canada
(Katz) Faculty of Health - Department of Psychology, York University,
Toronto, ON, Canada
(Lalloo, Stinson) Peter Gilgan Centre for Research and Learning, Toronto,
ON, Canada
(Leegaard) Institute of Nursing, Oslo Metropolitan University, Oslo,
Akershus, Norway
(Legare) Medecine Familiale, Universite Laval, Quebec, QC, Canada
(McFetridge-Durdle) College of Nursing, Florida State University,
Tallahassee, FL, United States
(McGillion) Faculty of Health Sciences, McMaster University, Hamilton, ON,
Canada
(Norris) Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
(Patterson) Anishnawbe Health, Toronto, ON, Canada
(Pilote) Medicine, McGill University, Montreal, QC, Canada
(Pink) Wasser Pain Management Centre, Sinai Health System, Toronto, ON,
Canada
(Stinson, Watt-Watson) Lawrence S Bloomberg Faculty of Nursing, University
of Toronto, Toronto, ON, Canada
(Rickard) Moose Factory, ON, Canada
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Introduction: More women experience cardiac pain related to coronary
artery disease and cardiac procedures compared with men. The overall goal
of this programme of research is to develop an integrated smartphone and
web-based intervention (HEARTPAN) to help women recognise and self-manage
cardiac pain. Methods and analysis: This protocol outlines the mixed
methods strategy used for the development of the HEARTPAN content/core
feature set (phase 2A), usability testing (phase 2B) and evaluation with a
pilot randomised controlled trial (RCT) (phase 3). We are using the
individual and family self-management theory, mobile device functionality
and pervasive information architecture of mHealth interventions, and
following a sequential phased approach recommended by the Medical Research
Council to develop HEARTPAN. The phase 3 pilot RCT will enable us to
refine the prototype, inform the methodology and calculate the sample size
for a larger multisite RCT (phase 4, future work). Patient partners have
been actively involved in setting the HEARTPAN research agenda, including
defining patient-reported outcome measures for the pilot RCT: pain and
health-related quality of life (HRQoL). As such, the guidelines for
Inclusion of Patient-Reported Outcomes in Clinical Trial Protocols
(SPIRIT-PRO) are used to report the protocol for the pilot RCT (phase 3).
Quantitative data (eg, demographic and clinical information) will be
summarised using descriptive statistics (phases 2AB and 3) and a content
analysis will be used to identify themes (phase 2AB). A process evaluation
will be used to assess the feasibility of the implementation of the
intervention and a preliminary efficacy evaluation will be undertaken
focusing on the outcomes of pain and HRQoL (phase 3). Ethics and
dissemination: Ethics approval was obtained from the University of Toronto
(36415; 26 November 2018). We will disseminate knowledge of HEARTPAN
through publication, conference presentation and national public forums
(Cafe Scientifique), and through fact sheets, tweets and
webinars.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2020.

<36>
Accession Number
2004421235
Title
The effect of restrictive versus liberal transfusion strategies on
longer-term outcomes after cardiac surgery: a systematic review and
meta-analysis with trial sequential analysis.
Source
Canadian Journal of Anesthesia. (no pagination), 2020. Date of
Publication: 2020.
Author
Kashani H.H.; Lodewyks C.; Kavosh M.S.; Jeyaraman M.M.; Neilson C.; Okoli
G.; Rabbani R.; Abou-Setta A.M.; Zarychanski R.; Grocott H.P.
Institution
(Kashani, Kavosh, Grocott) Department of Anesthesiology, Perioperative and
Pain Medicine, St. Boniface Hospital, University of Manitoba, CR3008-369
Tache Ave, Winnipeg, MB R2H 2A6, Canada
(Lodewyks) Section of Cardiac Surgery, Department of Surgery, University
of Manitoba, Winnipeg, MB, Canada
(Jeyaraman, Okoli, Rabbani, Abou-Setta) The George & Fay Yee Center for
Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada
(Jeyaraman, Okoli, Rabbani, Abou-Setta, Zarychanski) Department of
Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
(Neilson) Neil John Maclean Health Sciences Library, University of
Manitoba, Winnipeg, MB, Canada
(Zarychanski) Department of Internal Medicine, University of Manitoba,
Winnipeg, MB, Canada
(Zarychanski) Department of Medical Oncology and Hematology, Cancer Care
Manitoba, Winnipeg, MB, Canada
Publisher
Springer
Abstract
Purpose: Blood transfusions are frequently administered in cardiac
surgery. Despite a large number of published studies comparing a
"restrictive" strategy with a "liberal" strategy, no clear consensus has
emerged to guide blood transfusion practice in cardiac surgery patients.
The purpose of this study was to identify, critically appraise, and
summarize the evidence on the overall effect of restrictive transfusion
strategies compared with liberal transfusion strategies on mortality,
other clinical outcomes, and transfusion-related outcomes in adult
patients undergoing cardiac surgery. Source: We searched MEDLINE (OvidSP),
EMBASE (OvidSP) and Cochrane CENTRAL (Wiley) from inception to 1 December
2017 and queried clinical trial registries and conference proceedings for
randomized-controlled trials of liberal vs restrictive transfusion
strategies in cardiac surgery. Principal findings: From 7,908 citations,
we included ten trials (9,101 patients) and eight companion publications.
Overall, we found no significant difference in mortality between
restrictive and liberal transfusion strategies (risk ratio [RR], 1.08; 95%
confidence interval [CI], 0.76 to 1.54; I² = 33%; seven trials;
8,661 patients). The use of a restrictive transfusion strategy did not
appear to adversely impact any of the secondary clinical outcomes. As
expected, the proportion of patients who received red blood cells (RBCs)
in the restrictive group was significantly lower than in the liberal group
(RR, 0.68; 95% CI, 0.64 to 0.73; I² = 56%; 5 trials; 8,534
patients). Among transfused patients, a restrictive transfusion strategy
was associated with fewer transfused RBC units per patient than a liberal
transfusion strategy. <br/>Conclusion(s): In adult patients undergoing
cardiac surgery, a restrictive transfusion strategy reduces RBC
transfusion without impacting mortality rate or the incidence of other
perioperative complications. Nevertheless, further large trials in
subgroups of patients, potentially of differing age, are needed to
establish firm evidence to guide transfusion in cardiac surgery. Trial
registration: PROSPERO (CRD42017071440); registered 20 April,
2018.<br/>Copyright &#xa9; 2020, Canadian Anesthesiologists' Society.

<37>
Accession Number
631213845
Title
Left Main Coronary Artery Disease Revascularization According to the
SYNTAX Score: Analysis from the EXCEL Trial.
Source
Circulation: Cardiovascular Quality and Outcomes. (no pagination), 2020.
Date of Publication: 2020.
Author
Shlofmitz E.; Genereux P.; Chen S.; Dressler O.; Ben-Yehuda O.; Morice
M.-C.; Puskas J.D.; Taggart D.P.; Kandzari D.E.; Crowley A.; Redfors B.;
Mehdipoor G.; Kappetein A.P.; Sabik J.F.; Serruys P.W.; Stone G.W.
Institution
(Shlofmitz, Genereux, Chen, Dressler, Ben-Yehuda, Crowley, Redfors,
Mehdipoor, Stone) Columbia University Medical Center, Cardiovascular
Research Foundation, 1700 Broadway, New York, NY 10019, United States
(Shlofmitz, Ben-Yehuda, Stone) New York-Presbyterian Hospital, Columbia
University Medical Center, United States
(Genereux) Morristown Medical Center, NJ, United States
(Genereux) Hopital du Sacre-Coeur de Montreal, QC, Canada
(Morice) Institut Cardiovasculaire Paris Sud, Ramsay Generale de Sante,
Massy, France
(Puskas) Mount Sinai Saint Luke's, NY, United States
(Taggart) John Radcliffe Hospital, Oxford, United Kingdom
(Kandzari) Piedmont Heart Institute, Atlanta, GA, United States
(Kandzari) Sahlgrenska University Hospital, Gothenburg, Sweden
(Kappetein) Thoraxcenter, Erasmus Medical Center, Rotterdam, Netherlands
(Sabik) UH Cleveland Medical Center, Cleveland, OH, United States
(Serruys) Imperial College London, United Kingdom
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: The SYNTAX (Synergy Between Percutaneous Coronary Intervention
With Taxus and Cardiac Surgery) score (SS), a measure of anatomic coronary
artery disease (CAD) extent and complexity, has proven useful in past
studies to determine the absolute and relative prognosis after
revascularization with percutaneous coronary intervention (PCI) versus
coronary artery bypass grafting (CABG). We sought to assess contemporary
outcomes after PCI and CABG in patients with left main CAD according to SS
and revascularization type from a large randomized trial. <br/>Method(s):
The EXCEL trial (Evaluation of XIENCE Versus Coronary Artery Bypass
Surgery for Effectiveness of Left Main Revascularization) randomized
patients with left main CAD and site-assessed SS<=32 to PCI with
everolimus-eluting stents or CABG. Four-year outcomes were examined
according to angiographic core laboratory-assessed SS using multivariable
Cox proportional hazards regression. <br/>Result(s): A total of 1840
patients with left main CAD randomized to PCI (n=914) versus CABG (n=926)
had angiographic core laboratory SS assessment. The mean SS was 26.5+/-9.3
(range 5-74); 24.1% of patients had angiographic core laboratory-assessed
SS >=33. The 4-year rate of the primary major adverse cardiac event end
point of death, stroke, or myocardial infarction was similar between PCI
and CABG (18.6% versus 16.7%, respectively; P=0.40) and did not vary
according to SS (P<inf>interaction</inf>=0.33). Rates of ischemia-driven
revascularization rose with increasing SS after PCI, but not after CABG.
As a result, the major secondary composite end point of major adverse
cardiac or cerebrovascular events (major adverse cardiac event or
ischemia-driven revascularization) occurred more frequently with PCI than
CABG (28.0% versus 22.0%, P=0.01), a difference which rose progressively
with increasing SS (P<inf>interaction</inf>=0.03). <br/>Conclusion(s): In
the EXCEL trial, the 4-year primary composite major adverse cardiac event
end point of death, myocardial infarction, or stroke was similar after PCI
with everolimus-eluting stents and CABG and was independent of the
baseline anatomic complexity and extent of CAD. In contrast, the relative
and absolute hazard of major adverse cardiac or cerebrovascular events
with PCI compared with CABG rose progressively with the SS. These data
should be considered by the heart team when deciding between PCI versus
CABG for revascularization in patients with left main CAD. Clinical Trial
Registration: URL: https://www.clinicaltrials.gov. Unique identifier
NCT01205776.<br/>Copyright &#xa9; 2020 Cambridge University Press. All
rights reserved.

<38>
Accession Number
610196600
Title
Cardiovascular and other outcomes postintervention with insulin glargine
and omega-3 fatty acids (ORIGINALE).
Source
Diabetes Care. 39 (5) (pp 709-716), 2016. Date of Publication: 01 May
2016.
Author
Gerstein H.C.; Bosch J.; Dagenais G.R.; Jung H.; Maggioni A.P.; Pogue J.;
Probstfield J.; Ramachandran A.; Riddle M.C.; Ryden L.E.; Yusuf S.;
Richardson L.; Diaz R.; Johnston P.; Vige R.; Birkeland K.; Budaj A.;
Cardona E.; Chazova I.; Commerford P.; Danilova L.; Davies M.; Fernando
R.; Fodor G.; Gilbert R.; Gomis R.; Hanefeld M.; Hildebrandt P.;
Kacerovsky-Bielesz G.; Keltai M.; Kim J.H.; Krum H.; Lanas F.; Lewis B.S.;
Lonn E.; Lopez-Jaramillo P.; Marin-Neto J.; Marre M.; McKelvie R.; McQueen
M.; Mendoza I.; Morillo C.; Pan C.; Profozic V.; Ratner R.; Rosenstock J.;
Spinas G.A.; Sreenan S.; Stoel I.; Syvanne M.; Yale J.F.; Avezum A.; Bahit
M.C.; Bogaty P.; Bordeleau L.; Chacomicronn C.; Corson M.; Harper W.L.;
Halon D.; Magloire P.; Mann J.; Pavlova V.; Punthakee Z.; Silva J.; Tsang
B.; Yakubovich N.; Abdallah A.; Ahmad S.; Chandra J.; Chandra R.;
Cukierman-Yaffee T.; Dyal L.; Joldersma L.; MacRae L.; MacRae S.; Malik
S.; Mead A.; Pasha F.; Pazmino-Canizares J.; Pohl K.; Sakalas A.; Tyrwhitt
J.; Ahuad Guerrero R.; Alebuena A.; Alvarez N.; Alzogaray M.; Amuchastegui
M.; Andres M.; Angos M.; Baglivo H.; Barbieri M.; Bassi F.; Bello F.; Bono
J.; Bustamante Labarta M.; Bustos B.; Caccavo A.; Calveira M.; Camino A.;
Cantero M.; Capozzi M.; Cardone M.; Cartasegna L.; Cassetari A.;
Castellanos R.; Chavez Caballero R.; Cipullo M.; Contreras A.; Coria J.;
Corinaldesi F.; Costa G.; Crespo C.; Cruz M.; Cuello J.; Cuneo C.; Del
Corro I.; Diez R.; Dituro C.; Dominguez A.; Facta A.; Faingold C.; Farah
M.; Fares Taie A.; Fernandez A.; Ferrari A.; Ferrari N.; Garcia Monteverde
C.; Garrido M.; Giachello C.; Gonzalez M.; Gutierrez N.; Guzman L.; Guzman
P.; Hasbani E.; Henquin R.; Hershon A.; Hirschon Alvarez Prado A.; Hominal
M.; Hrabar A.; Imposti H.; La Grutta M.; Lanchiotti P.; Lobo Marquez L.;
Lopez Santi R.; Lowenstein J.; Lugo M.; Luqueci M.; Mainini S.; Majul C.;
Manzano R.; Manzur S.; Marcucci G.; Marino M.; Massari F.; Mendez N.;
Molina M.; Montana O.; Mulazzi M.; Nardone L.; Odetto I.; Orlandini A.;
Oviedo A.; Paez O.; Parnas A.; Patron F.R.; Pedernera C.; Pelagagge M.;
Plastino M.; Polari P.; Pomposiello J.; Porta A.; Prado A.; Quiroz M.;
Ramirez A.; Rodriguez M.; Ronderos R.; Sago L.; Sanchez A.; Sanchez R.;
Sandrin A.; Schygiel P.; Sernia V.; Sinay I.; Smith Casabella T.; Sosa
Liprandi A.; Sosa Liprandi M.; Soso L.; Sposetti G.; Stisman D.;
Streitenberger P.; Suarez G.; Tonin H.; Ulla M.; Valdez J.; Vico M.;
Villamil A.; Villarino A.; Viscaya Castro A.; Visco V.; Vogel D.; Waisman
F.; Zaidman C.; Amerena J.; Applebe A.; Aylward P.; Binnekamp M.; Bruce
I.; Burdeniuk C.; Burnet R.; Colman P.; Colquhoun D.; Davis S.; De Looze
F.; De Pasquale C.; D'Emden M.; Eaton H.; Farshid A.; Foulanos S.; Galanos
J.; Gordon G.; Guhu M.; Ho J.; Jeffery I.; Jerums G.; Kwan M.; Lefkovits
J.; Luu S.; MacIsaac R.; Marjason J.; Mohabbati V.; Nankervis A.; O'Neal
D.; Perera N.; Poynten A.; Rahman A.; Razak S.; Roberts T.; Sebastian M.;
Simpson R.; Soldatos G.; Sullivan D.; Teede H.; Tiong F.; Topliss D.;
Torpy D.; Waddell-Smith K.; Waites J.; Wenman J.; Whelan A.; Williams L.;
Yeap B.; Yeow W.; Yong G.; Aczel S.; Azimy N.; Bertha P.; Blocher J.;
Bohnel C.; Brath H.; Breuss J.; De Campo A.; Drexel H.; Ettmuller Y.;
Feder A.; Feinboeck C.; Gulz E.; Hofmann M.; Hoppichler F.; Jahnel H.;
Jankovic V.; Kann T.; Kathrein T.; Kotter T.; Kratz E.; Kreuzwieser E.;
Loreck C.; Ludvik B.; Marte T.; Mellitzer K.; Nistler S.; Placher-Sorko
G.; Prager R.; Rein P.; Riedl M.; Saly C.; Schernthaner G.; Schichka E.;
Seidlhofer C.; Sonnenfeld M.; Stefan H.; Steiner K.; Thomas B.; Toplak H.;
Urstoger K.; Vetter B.; Vonbank A.; Waldschutz W.; Wallner F.; Winkler F.;
Goncharik D.; Lazareva I.; Lichorad N.; Mrochek A.; Murashko N.; Radyuk
D.; Ramanovski A.; Sudzhaeva S.; Sujayeva V.; Yarashevich N.; Campbell G.;
Marshall S.; West A.; Abreu F.; Alves M.; Ayoub-Aidar J.; Barros M.;
Barros-Silveira J.; Blacher M.; Costa E.; Costa F.; Daltro C.; Delana J.;
Eliaschewitz F.; Facanha C.; Feitosa G.; Figueiredo J.; Forti A.; Franco
D.; Franken M.; Freire F.; Garcia V.; Gouvea-Neto A.; Grofallo S.;
Kanedlai N.; Kerr-Saraiva J.; Ladeira R.; Leaes P.; Lemos M.; Lima F.;
Lima Filho M.; Macedo L.; Manenti E.; Monte O.; Mossman A.; Mothe F.;
Mouco O.; Moyses Golbert M.; Nasser Hissa L.; Nasser-Hissa M.; Nicolau J.;
Nigro Maia L.; Ninno T.; Nunes C.; Oliveira C.; Oliveira O.; Passos da
silva R.; Pericles-Esteves J.; Rabelo L.; Rabelo-Alves Junior A.; Rassi
S.; Rech R.; Roldan F.; Salles J.; Sampaio C.; Seabra A.; Sealissi N.;
Seixas A.; Sena R.; Shehadeh I.; Teixeira M.; Turin H.; Vicente Serrano
C.; Vidigal M.; Vilela M.; Wajchenberg B.; Abbott C.; Abu-Bakare A.;
Ardilouze J.; Auersperg E.; Bailey A.; Bailey G.; Baillargeon J.;
Beaurivage C.; Belair J.; Belanger A.; Bellabarba D.; Berlingieri J.;
Bernier F.; Bhargava R.; Bhesania T.; Booth W.; Bose S.; Boulianne M.;
Bourgeois S.; Breton D.; Brossoit R.; Buithieu J.; Campeau J.; Carlson B.;
Carpentier A.; Cavalcanti R.; Cha J.; Chagnon P.; Chan Y.; Chessex C.;
Chiasson J.; Chouinard S.; Clayton D.; Conway J.; Crepeau J.; Cudmore D.;
D'Ignazio G.; Doig G.; Dominguez M.; Dube F.; Dumas R.; Dupuis R.; Dyrda
I.; Eddy D.; Eiley D.; Fox H.; Fratesi S.; Gallant S.; Garceau C.;
Garfield N.; Germain C.; Glazer S.; Gosselin G.; Gould D.; Grills G.;
Halle J.; Hardin P.; Harper W.; Heath J.; Heath V.; Hivert M.; Ho K.;
Houde G.; Hramiak I.; Hutchinson A.; Huynh T.; Ilie-Haynes R.; Imran S.;
Islam A.; Iwanochko M.; Jones C.; Joyce C.; Kirouac I.; Kumar R.; Lamothe
M.; Langlois M.; Lauzon C.; Lavoie M.; Leader R.; Lecours S.; Lepage S.;
Lochnan H.; Ma P.; McLean A.; Mecci S.; Mehta P.; Mercier M.; Miller D.;
Morisset A.; Nawaz S.; Nisker W.; Nyomba G.; O'Keefe D.; Palardy J.;
Parekh P.; Paul T.; Perron P.; Pesant M.; Phillips R.; Pruneau G.; Quintin
I.; Raby K.; Richard C.; Rosenfeld G.; Saulnier D.; Shaban J.; Shah A.;
Shu D.; Sigal R.; Silverman M.; Singh J.; Sivucha W.; Skamene A.;
Sliwowicz D.; Smith R.; St Hilaire R.; Steinson D.; Sussex B.; Tan K.;
Tannous R.; Telner A.; Theroux P.; Tsoukas C.; Tsoukas G.; van Buuren J.;
VanRossum N.; Vexler R.; Vizel S.; Warnica W.; Weingert M.; Wilson R.;
Wong W.; Woo V.; Yale J.; Acevedo M.; Alwyn C.; Baier E.; Baier S.;
Galloso R.; Lahsen R.; Lorenas G.; Montecinos A.; Montecinos M.; Pineda
P.; Pollak F.; Sapunar J.; Serrano V.; Stockins B.; Varleta P.; Yovanovich
J.; Zambra F.; Ba J.; Bao Y.; Bi Y.; Bu S.; Chen B.; Chen H.; Chen J.;
Chen L.; Chen M.; Chen Y.; Cui J.; Dong M.; Feng P.; Feng Z.; Gao C.; Gao
F.; Gao X.; Gao Z.; Gong Y.; Guang L.; Guo X.; Han F.; Han X.; Hou X.; Hu
R.; Ji L.; Jia J.; Jia W.; Jiao X.; Jin X.; Kuang J.; Li M.; Li Q.; Li X.;
Li Y.; Ling Y.; Liu F.; Liu Z.; Lu B.; Lu J.; Lu Z.; Lv X.; Ning G.; Peng
Y.; Ren Y.; Shao Y.; Shi Y.; Shu X.; Sun H.; Sun L.; Sun X.; Tang K.; Tian
H.; Wang C.; Wang F.; Wang L.; Wang Q.; Wang W.; Wang X.; Wang Y.; Wen J.;
Wu C.; Wu H.; Wu J.; Wu M.; Xing X.; Xue Y.; Yan L.; Yan S.; Yang H.; Yang
N.; Yang W.; Yang Z.; Yao J.; Yao L.; Yu D.; Yu H.; Yu M.; Yu X.; Yuan L.;
Yuan M.; Yuan S.; Yuan W.; Yuan Y.; Yuan Z.; Zeng T.; Zhang J.; Zhang R.;
Zhang X.; Zhao L.; Zheng B.; Zheng J.; Zhou W.; Zhu N.; Zhu Y.; Zou D.;
Zou J.; Accini J.L.; Bohorquez R.; Botero R.; Cure C.; Figueredo M.;
Hernandez E.; Kattah W.; Llamas A.; Orozco L.; Pava L.; Perez M.; Pineda
M.; Quintero A.; Quiros R.; Urina M.; Velez S.; Altabas V.; Baotic I.;
Berkovic M.; Goldoni V.; Kerum T.; Mirosevic G.; Tarle D.; Vidovic I.;
Zjacic-Rotkvic V.; Abbas R.; Andersen H.; Auscher S.; Baumbach L.;
Brockstedt H.; Christensen P.; Christiansen M.; Clemmensen K.; Egstrup K.;
Gislason G.; Haar D.; Hansen K.; Heden Andersen P.; Helleberg K.;
Hermansen K.; Holmer J.; Jeppesen J.; Klausen I.; Koustrup-Sonder T.;
Krarup T.; Lerche S.; Lervang H.; Linde B.; Lund P.; Lund S.; Madsbed S.;
Molvig J.; Orskov C.; Ostergaaard O.; Perrild H.; Pietraszek A.; Ralfkjaer
N.; Roenne H.; Rokkedal Nielsen J.; Seibaek M.; Soendergaard H.; Sorensen
L.; Sundahl Mortensen L.; Torp-Pedersen C.; Tuxen C.; Urhammer S.;
Vadstrup E.; Pirags V.; Ambos A.; Janson A.; Rudenko P.; Viitas L.; Aranko
S.; Badeau M.; Eriksson J.; Haapamaki H.; Kajander O.; Kuusisto A.;
Luukkonen S.; Makela J.; Nieminen S.; Niskanen L.; Ripatti J.;
Ruotsalainen S.; Saltevo J.; Savela K.; Strand J.; Valle T.; Virkamaki A.;
Aboud E.; Alavoine L.; Bekherraz A.; Bohme P.; Bourezane H.; Catargi B.;
Charpentier G.; Clergeot A.; Courreges J.; Delmas T.; Duengler F.; Feknous
C.; Gendre D.; Guerci B.; Hadjadj S.; Kerlan V.; Laguerre N.; Le Potier
J.; Lombardo F.; Malville E.; Marechaud R.; Mattei C.; Moreira J.;
Penfornis A.; Petit C.; Pinel J.; Piquel X.; Raccah D.; Reznik Y.; Rod A.;
Roudaut N.; Rousseau E.; Schillo F.; Schmitt B.; Sonnet E.; Torremocha F.;
Travert F.; Vanhoute C.; Vimeux M.; Abdollahnia R.; Adamidou A.; Arslan
S.; Bach-Kliegel B.; Bartusch B.; Bauer N.; Bieler T.; Blankenfeld H.;
Boeckmann U.; Busch K.; Butzer R.; Chenchanna-Merzhaeuser M.; Denger R.;
Deutsch C.; Diessel S.; Donati-Hirsch I.; Dornisch M.; Enghofer K.; Fleig
T.; Forst T.; Frommherz M.; Goeller K.; Habbig J.; Hadziselimovic S.;
Hamann A.; Hampel T.; Heger S.; Helmes C.; Hoffman C.; Hohberg C.; Humpert
P.; Kamke A.; Kamke W.; Kindermann P.; Klein C.; Klein D.; Koehler A.;
Kuehn A.; Langer K.; Limmer S.; Loew A.; Maimer A.; Marck C.; Meier G.;
Methner-Friederich M.; Metzler W.; Meyer K.; Miftari N.; Milde J.; Minnich
J.; Molkewehrum M.; Morcos M.; Mueller-Hoff C.; Nguyen M.; Nishwitz M.;
Oldenburg J.; Ott P.; Pauli K.; Pauly B.; Pfeiffer A.; Pfuetzner A.;
Pischa U.; Radke R.; Reismann P.; Riemer M.; Rochlitz H.; Rudofsky G.;
Ruhla S.; Sammler A.; Schaper F.; Schiemenz K.; Scholz G.; Schumm-Draeger
P.; Segiet T.; Segner A.; Seissler J.; Spahn S.; Stier U.; Tonon G.; von
Amelunxen S.; von Schacky C.; Wilhelm B.; Wilhelm K.; Witt K.;
Wuechner-Hofmann S.; Baranyai M.; Birkus Z.; Foldesi I.; Gaal Z.; Harcsa
E.; Hati K.; Hohmann Z.; Istenes I.; Jozsef I.; Juhasz E.; Kempler P.;
Keresztes B.; Keresztes K.; Kis-Gombos P.; Kovacs I.; Kozma T.; Laszlo Z.;
Noori E.; Nyirati G.; Papp Z.; Patkay J.; Poor F.; Pusztai P.; Putz Z.;
Rigo E.; Sereg M.; Simon K.; Somogyi A.; Sumegi J.; Szabo A.; Szabo J.;
Szigeti S.; Szilveszter D.; Tarko M.; Varga C.; Varga Szabo L.; Voros P.;
Arathi; Aravind S.; Badgandi M.; Balaji M.; Balaji V.; Chamukuttan S.;
Devi Manduva P.; Fatima S.; Ganapathy B.; George O.; George P.; Jaffar M.;
Jain P.; Kamath P.; Karthik V.; Koshy G.; Krishnan L.; Kumar H.; Lal P.;
Mithal A.; Modi S.; Mohan V.; Moses V.; Oomen R.; Pais P.; Pati P.;
Pendsey S.; Rai P.; Rajagopal R.; Ramu M.; Ranjit U.; Rao P.; Senthil V.;
Seshaiah V.; Sethi B.; Shah P.; Sharma R.; Shetty S.; Shobha A.; Siddharth
R.; Sridhar G.; Sudeep K.; Sunil C.; Sunitha S.; Suresh S.; Thomas N.;
Vageesh A.; Anwer Z.; Barton J.; Behan L.; Bell M.; Cullen M.; Dineen S.;
Draman Yusof M.; Dunne F.; Gibney J.; Hussain T.; Khan M.; Kinsley B.;
Kyithar P.; Lavin F.; McGowan A.; McGurk C.; Mirza A.; Mohammadi B.;
O'Brien T.; O'Connell J.; O'Halloran D.; O'Shea D.; Roberts G.; Tomkin G.;
Wan Mahmood W.; Abramod-Ness R.; Adawi F.; Aharon B.; Backer M.;
Beniashvili A.; Berliner A.; Bloch L.; Bugelman D.; Butnaru A.; Cohen O.;
Cohen Y.; Frenkel M.; Glant M.; Gustava B.; Guttman H.; Halabi S.;
Harman-Boehm I.; Ilany J.; Karkabi B.; Khader N.; Khaskia A.; Khudyak Y.;
Klainman E.; Kogan N.; Lender D.; Levin I.; Mardi T.; Marmor A.; Mosseri
M.; Nabriski D.; Omary M.; Orlovsky S.; Peres D.; Quasim M.; Raz I.;
Remesnik M.; Rogowski O.; Rozenfeld I.; Scharr D.; Shnifer I.; Shuster T.;
Solomon R.; Steiner H.; Tzivoni D.; Wolfson N.; Yossef Z.; Zahger D.;
Zeltser D.; Zimlichman R.; Aina F.; Ariatti C.; Bonetti R.; Cacciatore F.;
Calcinaro F.; Corona G.; De Maria P.; Del Prato S.; Derosa G.; Di Pasquale
G.; Falorni A.; Fanelli R.; Fedele D.; Filorizzo G.; Fogari R.; Furgi G.;
Ghio A.; Giorda C.; Gregori G.; Iannuzzi G.; Lapolla A.; Luciano B.;
Lucotti P.; Maggi A.; Marafetti L.; Marchese T.; Martino G.; Marzotti S.;
Miccoli R.; Monti L.D.; Moretti L.; Palvarini M.; Petacchi R.; Piarulli
F.; Piatti P.M.; Rudi S.; Santeusanio F.; Sesti G.; Setola E.; Sforza A.;
Shehaj E.; Veniani M.; Viviani G.; Zigoura E.; Chae S.; Cho D.; Cho E.;
Cho Y.; Choi Y.; Chung M.; Hong E.; Hong Y.; Jeong M.; Kim B.; Kim D.; Kim
H.; Kim I.; Kim J.; Kim P.; Kim S.; Koo B.; Kwok S.; Kwon H.; Lee J.; Lim
J.; Oh S.; Ohn J.; Park C.; Park H.; Park K.; Seung K.; Son H.; Woo J.;
Yoon K.; Ansmite B.; Balcere I.; Bumbure A.; Ducena K.; Lejnieks A.; Rasa
I.; Ritenberga R.; Romanova M.; Salmina I.; Steina S.; Badariene J.;
Gailiuniene S.; Grigonis S.; Juskiene R.; Petrulioniene Z.; Sakalyte G.;
Stasiunas T.; Sulskiene M.; Urbonaite B.; Zarankiene R.; Ziukaite R.;
Arechavaleta R.; Beltran-Jaramillo T.; Calvo-Vargas C.; Campillo-Cardenas
C.; Cardona D.; Carmona-Huerta J.; Cedano-Limon M.; Comellas-De M.;
Dominguez C.; Gomez-Cruz J.; Gonzalez-Perez R.; Illescas J.; Jimenez-Ramos
S.; Lopez-Alvarado A.; Marquez-Rodriguez E.; Martinez G.; Pascoe S.;
Plascencia Vazquez O.; Rodriguez H.; Ruiz-Cornejo M.; Velasco-Sanchez G.;
Vidrio-Velazquez M.; Villeda-Espinosa E.; Badings E.; Bartels G.;
Bruggink-Andre de la Porte P.; Bruijns E.; Cornel J.; De Milliano P.; De
Mulder M.; De Swart J.; Derks A.; Dirkali A.; Droste J.; Galjee M.;
Hautvast R.; Hermans W.; Holwerda N.; Ilmer B.; Kofflard M.;
Kooistra-Huizer J.; Kurvers M.; Langerveld J.; Leenders C.; Liem A.; Lok
D.; Neumann D.; Nierop P.; Plomp K.; Posma J.; Reichert C.; Roeters Van
Lennep H.; Ronner E.; Said S.; Takens L.; Umans V.; Van der Sluis A.A.;
Van der Zwaan C.; Van Dobbenburgh J.; Van Es A.; Van Hessen M.; Van
Mechelen R.; Van Miltenburg-Van Zijl A.; Van Zeijl L.; Veerhoek M.;
Viergever E.; Weijers E.E.; Willems F.; Blix I.; Cooper J.; Debowska A.;
Erichsen K.; Fossum J.; Gjertsen E.; Grill V.; Gudnason S.; Hoye K.; Istad
H.; Winther J.; Joakimsen R.; Jorde R.; Larsen I.; Mella B.; Otterstad J.;
Risberg K.; Skare K.; Skeie S.; Sommervoll L.; Tandberg A.; Whitfield R.;
Wium C.; Cunanan E.; Fernando-Catindig E.; Gomez M.; Jaring C.;
Lantion-Ang F.; Licaros M.; Lim-Abrahan M.; Madronio E.; Panelo A.; Raboca
J.; Ramos G.; Tugna S.; Aksamit-Bialoszewska E.; Bandurska-Stankiewicz E.;
Baranska M.; Bronisz A.; Bronisz M.; Chrustowski W.; Cieslak B.;
Czupryniak L.; Drazkowicz-Gozdzik B.; Galuszka-Bilinska A.; Gmytrasiewicz
M.; Janik K.; Jedynasty K.; Kania G.; Kawka-Urbanek T.; Kinalska I.;
Kincel K.; Kleszczewska U.; Kruszewski J.; Loba J.; Malicka J.;
Mielecka-Kincel M.; Milczarczyk A.; Milosz D.; Mrowczynska A.; Mytnik M.;
Nowakowski A.; Nowakowski P.; Oleskowska L.; Omelanczuk-Wiech E.;
Pawlowski M.; Poplawska A.; Rucinska M.; Rucinski M.; Rutkowska J.;
Saryusz-Wolska M.; Siewko K.; Sikora-Frac M.; Stecka-Wierzbicka J.;
Swiatkowski M.; Swierczynski R.; Szpajer M.; Szymkowiak K.; Tarach J.;
Tarasiewicz U.; Wiatr D.; Wojewoda P.; Woszczak-Marcinkowska H.; Zadrozny
J.; Hancu N.; Albota A.; Bala C.; Barbonta D.; Botnariu G.; Bradescu O.;
Busegeanu M.; Bzduch M.; Catrinoiu D.; Caziuc R.; Cerghizan A.; Cheta D.;
Cif A.; Ciomos D.; Cosma D.; Creteanu G.; Crisan I.; Danciulescu R.;
Dobjanschi C.; Dodan R.; Duma L.; Ferariu I.; Ghenes T.; Ghise G.; Graur
M.; Ilinca M.; Marton R.; Mindrescu N.; Morosanu A.; Morosanu M.; Mota M.;
Nafornita V.; Negrisan G.; Nicodim S.; Nicolau A.; Nita C.; Onaca A.;
Panus C.; Pletea N.; Pop C.; Pop L.; Popa B.; Roman G.; Rosu M.; Sandu N.;
Serban V.; Sima A.; Stamoran L.; Strugariu M.; Suciu G.; Szilagyi I.;
Vacaru G.; Veresiu I.; Vlad A.; Adasheva T.; Ageev F.; Akhmedganov N.;
Akinina A.; Alexandrov A.; Ambatiello L.; Ametov A.; Ausheva A.; Babaeva
L.; Babenko A.; Balyasnikova E.; Bart B.; Belova J.; Berstein L.;
Bondarenko I.; Bondarev E.; Bulkina O.; Chernikova N.; Chumak B.; Deeva
T.; Demicheva O.; Demidova T.; Doskina E.; Duganova A.; Dzhaiani N.;
Egorova I.; Ettinger O.; Feofanova S.; Fofanova T.; Galaktionov P.;
Gavrilova N.; Gilyarevsky S.; Gnidkina N.; Golubev A.; Gornyakova N.;
Grigorova S.; Grineva E.; Gurevich V.; Irtuganov N.; Ivanova L.; Jaiani
N.; Kalashnikova M.; Karpov Y.; Khalimov Y.; Khorocheva G.; Kirillova E.;
Kistner J.; Kobalava Z.; Kochergina I.; Kravchenko T.; Krylov K.; Kulkova
P.; Kuparev I.; Kurbanova E.; Lysenko T.; Markovich A.; Martyanova I.;
Martynyuk T.; Masiinvets M.; Mavlyavieva E.; Maychuk E.; Melnichenko G.;
Mikhailusova M.; Mkrtumyan A.; Mychka V.; Nebieridze D.; Nesterova E.;
Orlov V.; Orlova V.; Orlova Y.; Papov F.; Patroucherva I.; Petunina N.;
Pirozhinskaya S.; Podachina S.; Postnikova S.; Pshikova O.; Rogova L.;
Romashevskiy B.; Runikhina N.; Sadulayeva I.; Safaryan A.; Sakovich E.;
Saprikina T.; Sargsyan V.; Semikozova O.; Shkolnik E.; Shubina A.; Shustov
S.; Sinitsina I.; Solovyeva E.; Storogakov G.; Stovpyuk O.; Sussekov A.;
Telnova M.; Temirov A.; Terekhov V.; Tereschenko S.; Tiourina T.;
Tolkacheva V.; Tsoy U.; Urazgyldeeva S.; Vasyuk Y.; Vinnitskay N.;
Voevodina E.; Volkova A.; Zadionchenko V.; Zalevskaya A.; Zhelninova T.;
Zhukova N.; Zilov A.; Bernatova J.; Duris T.; Markova I.; Martinka E.;
Michalova L.; Minarik P.; Peter L.; Raslova K.; Silvia D.; Subadova M.;
Tisonova J.; Vohnout B.; Adam M.; Badat A.; Bester A.; Bester F.; Blacking
L.; Bouwer D.; Brice B.; Cassimjee S.; Cronje T.; Deftereos J.; Distiller
L.; Ellis G.; Forster O.; Fulat M.; Gani M.; Gibson G.; Hansa S.;
Hendricks N.; Herbst L.; Hitzeroth J.; Joffe B.; Kelbe C.; Kelbe D.; King
J.; Kramer B.; Landau S.; Levitt N.; Meyer-Nell S.; Moore R.; Muller D.;
Nell H.; Omar M.; Randeree H.; Seeber M.; Seedat; Segynu D.; Siebert M.;
Van den Berg E.; Van der Walt P.; Van Dyk C.; Van Niekerk F.; Van Zyl L.;
Wellman H.; Bertomeu V.; Botella M.; Buno M.; Calle A.; Cano Perez J.;
Coves M.; Juanatey J.G.; Garcia-Mayor R.; Gaztambide S.; Gippini A.;
Goikolea I.; Gonzalez J.; Hillman N.; Lopez Garcia Aranda V.; Magueda I.;
Mato J.; Mazon P.; Morillas P.; Novials A.; Pallardo L.; Perez L.;
Rodriguez J.; Romero L.; Sagarra E.; Shamagian L.; Soto A.; Torrealday H.;
Valero R.; Agergaard S.; Agewall S.; Andersson K.; Bergstrom O.;
Bjornstedt Bennermo M.; Blomgren J.; Boman K.; Brohall G.; Cherfan C.;
Dahlen C.; Dotevall A.; Enander P.; Ericsson U.; Hallgren P.; Hansson A.;
Henareh L.; Henriksson P.; Herlitz J.; Holmqvist J.; Jarevi G.; Linderfalk
C.; Jonasson L.; Jovinge S.; Kalen J.; Kilstrup M.; Leosdotir M.; Leppert
J.; Ljungberg J.; Lofdahl B.; Lundman P.; Lysell-Bergstrom C.; Mathiesen
U.; Mellbin L.; Morner S.; Nathanson D.; Nilsson L.; Peterson M.;
Quittenbaum S.; Rosengren A.; Ryttberg B.; Scheel S.; Svensson K.; Tenerz
A.; Vasko P.; Waldenstrom A.; Wieloch M.; Spinas G.; Braendle M.; Felix
B.; Gerber P.; Moccetti T.; Pitteloud N.; Kultursay H.; Aydinalp A.; Balci
M.; Cayli M.; Hatipoglu E.; Ilkova H.; Kayikcioglu M.; Koc M.;
Muderrisoglu H.; Sari R.; Saygili F.; Tekin K.; Tutuncu N.; Yurekli B.;
Adler A.; Ali A.; Balasubramanian; Bandypadhyay P.; Barakat O.; Barnett
A.; Borthwick L.; Brookes; Burton J.; Cecil J.; Chaterjee S.; Clark J.;
Collinson D.; Collinson S.; Crasto W.; Donnelly R.; du Plessis J.; Egan
S.; Ellery A.; Evans R.; Ewing J.; Fox C.; Gibson M.; Hall T.; Higgs E.;
Hollway M.; Hughes E.; Jackson N.; Jalihawi H.; Jones G.; Knights H.;
Korsheed S.; Kumar Singh R.; Laithwaite D.; Lawrence I.; Litchfield J.;
Manning G.; McNally P.; Millar-Craig M.; Mohammed I.; Narayanan R.; Nayani
G.; Norris A.; Purohit J.; Quinn M.; Ramtoola; Randall J.; Rea R.;
Reckless J.; Richardson T.; Robertson D.; Robinson A.; Salem K.; Sampson
M.; Savage M.; Shaker J.; Srinivasan T.; Tracy I.; Tringham J.; Viljoen
A.; Ward A.; Waterhouse H.; Wijenaike N.; Wiles P.; Ahmann A.; Ahmed I.;
Alam A.; Arakaki R.; Asad S.; Banarer S.; Baum H.; Belew K.; Bergenstal
R.; Bethel M.; Boyer C.; Catton S.; Challans P.; Childs B.; Christian R.;
Clement S.; Cuddihy R.; Dailey G.; Damberg G.; De Bold C.; De Lemos J.;
Donovan D.; Dudl J.; Dunbar J.; Ebner S.; Failor R.; Feinglos M.; Flaker
G.; Freiburghaus M.; Furlong K.; Gardner D.; Gillespie E.; Goland R.;
Goldberg R.; Gotham A.; Guthrie R.; Hamaty M.; Hirsch I.; Jabbour S.;
Janci M.; Javorsky B.; Jones S.; Kamana V.; Kashyap M.; Kaufman S.; Kearns
P.; Khera A.; Klopfenstein B.; Kniffen W.; Kringas P.; Licata A.;
Lopez-Jimenez C.; Madden M.; Marx C.; McCall A.; McCallum J.; McFarlane
S.; McGuire D.; Melish J.; Meneghini L.; Miller S.; Miranda-Palma B.;
Mitchell R.; Nasr C.; Nelson J.; Niblack P.; Nylen E.; Osei K.; Pandey A.;
Papademetriou V.; Pilar Solano M.; Sameshima L.; Savarese V.; Schnure J.;
Schuster D.; Shin J.; Taylor A.; Thomson P.; Ting-Ryan M.; Trence D.; Vo
A.; Weiland K.; Wells K.; Wu P.; Zimering M.; Zimmerman R.; Ascanio P.;
Brajkovich I.; Carrillo E.; Coll J.; Gonzalez K.; Gonzalez N.; Jimenez E.;
Lopez R.; Marante D.; Morr I.; Paolillo M.; Perche D.; Portillo M.;
Valbuena H.; Velarde M.; Vergara G.; Augensen N.; Azzalina J.; Fidaly S.;
Bollero G.; Casiello A.I.; Ferraro F.; Guridi M.J.; Ines M.; Martin M.E.;
Pascual A.; Pereyra J.; Toscanelli M.; Appiah M.; Grech S.; Pouras S.;
Watts C.; Denke E.; Feik C.; Litvinenko M.; Platonenko O.; Shadur S.;
Johnson J.; Bonilla E.; Carraway B.; Faith J.; Greer C.; Harding A.;
Heston J.; Lin Y.; Mecca T.; Schuler M.; Rizk C.; Sissoko A.; Strickland
K.; Andrade A.; Lux L.; Machado D.; Mancin E.; Aquino J.; Belanger B.;
Bourque C.; Gagnier K.; Hagerimana A.; McNeil A.; Osachoff J.; Richard B.;
Rogan J.; Styner L.; Maturana X.; Naranjo M.E.; Li E.; Liu Q.; Shuai M.;
Tan Z.; Tang M.; Zhao J.; Ardila M.; Gomez A.M.; Uscategui A.M.;
Marinkovic N.; Miocevic V.V.; Pezo S.; Andersen I.; Bastrup-Larsen B.;
Jeppesen E.; Kofoed-Djursner M.; Joe H.; Hiironen V.; Tarvainen M.; Von
Hedenberg H.; Guillarme C.; Rastelli O.; Roy P.; Igel L.; Lenz T.; Leptich
A.; Peikert S.; Domokos S.; Szotyorine-Polcza G.; Wenczl M.; Chaudhary S.;
Jaiswal G.; Khatri P.; Shah K.; Gibson S.; Bechar Y.; Erdheim D.; Eyal N.;
Frankel M.; Shimoni S.; Tsuri J.; Bianco L.; Cali R.; Sganga P.; Jang M.;
Kim J.M.; Kim Y.; Lim S.; Park J.S.; Song Y.; Kalve E.; Dienyte E.;
Alvarado F.; Rodriguez R.; Bar J.; Lijfering-Lorie K.; Palstra M.; Van der
Kuijl K.; Van de Wetering A.; Eriksen S.; Hejazifar S.; Jendeberg A.;
Johannessen G.; Khammari I.; Meredith E.L.; Dayag A.M.; Figueroa P.;
Hoffmann Korpalska A.; Przemyk M.; Craciunescu A.; Lupu D.; Osanu A.;
Popscu L.; Toader C.; Kirsanova T.; Timoshina E.; Gomez B.; Jankularova
I.; Brett S.; Meyer A.; Pereira V.; Vawda N.; Castano B.; Farre Avella
J.M.; Jimenez I.; Turet N.; Froberg M.; Reppert E.; Wessman S.; Boschung
Y.; Carrozzino F.; Gerstl K.; Cetin Z.; Demirci S.; Ovalioglu S.; Lenehan
A.; McLean H.; Mutsaers K.; Redfern P.; Scoggins A.; Isea Y.; Alvarez M.;
Alvarez D'Amelio A.; Aqueveque S.; Argenta M.; Aviles A.; Barreiro E.;
Battistessa Y.; Bergamo S.; Bertran B.; Bocanera M.; Bowen L.; Brescia H.;
Caceres M.; Cappi A.; Cardelli A.; Carolini E.; Carpintero S.; Carrique
A.; Carrique P.; Casquero M.; Castro M.; Cendali G.; Chatelain M.;
Costanzi A.; Cristofaro C.; Crunger P.; Ehrich S.; Espinosa M.; Esposito
L.; Flenche M.; Fracaro V.; Funosas C.; Garrido I.; Gomez Garrido A.;
Guzman A.; Izzicupo M.; Luca S.; Luciani C.; Majul S.; Moreno Cepeda I.;
Moschin Y.; Niemann G.; Novas V.; Olmi M.; Palma F.; Peralta A.; Puig A.;
Rodera Vigil M.; Ronderos G.; Rosell M.; Samudio M.; Santicchia C.;
Szczygiel V.; Takla M.; Tinnirello C.; Tonin S.; Tristan A.; Troncoso C.;
Vignau S.; Yanez K.; Zarate M.; Appeldorf R.; Batrouney B.; Bonner A.;
Bonner M.; Cahill P.; Carr J.; Caruana M.; Chare J.; Doran A.; Flavel;
Gein J.; Griek S.; Hulley A.; Keays P.; Kent S.; Lai N.; Legg H.; Long A.;
Lynch L.; Maxwell V.; McNamara K.; Nairn J.; Nichols V.; Peeler C.;
Phillips J.; Price-Smith S.; Ryan S.; Stockle P.; Tapp E.; Taverner P.;
Tulloch G.; Viola V.; Wilson L.; Beck A.; Damon S.; Drexel V.; Grabner E.;
Hofurthner A.; Kivioja P.; Kretschmer S.; Lener P.; Maiweg J.; Tscherner
D.; Weichelt H.; Winkler J.; Jones D.; Alves L.; Batista R.; Bernardes A.;
Demore de Souza A.; Ferraz R.; Ferreira A.; Freitas E.; Guanaes D.;
Kuschel K.; Muniz R.; Nasser-Hissa V.; Nhan P.; Osorio R.; Queirantes C.;
Reboucas R.; Souza C.; Tonani M.; Vicente C.; Zilli A.; Andersen K.; Aro
L.; Barber C.; Barnable B.; Berard L.; Bernier A.; Boudreault C.;
Bourbonnais A.; Bourgeois L.; Boutin D.; Boyer D.; Branco N.; Briol L.;
Brousseau M.; Burke M.; Chambers C.; Champoux A.; Chan S.; Colborne C.;
Coles K.; Couture M.; Cryderman C.; DeCurtis D.; Dewar C.; Drown J.; Dunn
P.; Eichmann D.; Eikel L.; Fox B.; Gauthier S.; Gibbons D.; Hicks R.; Ho
V.; Kitagawa H.; Kooistra L.; Landry F.; Lapointe F.; Larrivee L.; Leonard
P.; Louch D.; MacNair D.; Magennis L.; Mallette D.; Marchand C.; McLean
S.; Meilleur M.; Murdock H.; Naud M.; Olson K.; Otis J.; Ouimet F.;
Paquette H.; Peck C.; Pelletier A.; Perkins L.; Petrie F.; Pockett S.;
Poulin F.; Poulin M.; Primbas K.; Renton J.; Rouatt S.; Roy M.; Scarcelli
D.; Schellenberg S.; Schellevis K.; Schmidt N.; Scott L.; Skarpinsky B.;
Smith B.; Smith E.; Stafford C.; Stata C.; Sternberg B.; St-Jean N.;
Stoger S.; Thibodeau C.; Toupin A.; Ullyatt L.; Velonas J.; Vienneau R.;
Wall C.; Zaniol D.; Arau M.; Fuentes J.; Hidalgo J.; Landaeta O.; Padilla
I.; Sanzana S.; Tellos G.; Toro F.; Vergara R.; Che T.; Du Y.; He Y.;
Huang C.; Li H.; Liu S.; Luo X.; Ma Y.; Pan S.; Wan Q.; Wang H.; Wang S.;
Xie Y.; Xu X.; Xu Y.; Zhao F.; Zhou M.; Accini M.; Bello O.; Caceres A.;
Camargo S.; Figueroa J.; Florez M.; Gomez Morales K.; Granados L.;
Martinez M.; Medina Ramos M.; Mejia C.; Montoya L.; Ramos C.; Restrepo P.;
Rodriguez D.; Santamaria A.; Valencia T.; Spanic V.; Borre Hansen A.;
Bulow M.; Ehlers G.; Frederiksen A.; Gottschalck H.; Hejlskov B.; Holm
Fruesnsgaard Pedersen L.; Hornum H.; Jansen S.; Johansen A.; Jorgensen A.;
Kjaeulff Svaneborg T.; Kruse A.; Lund K.; Lundgaard M.; Madsen J.; Meier
A.; Muurholm A.; Nedergaard A.; Nielsen S.; Norgaard D.; Olsen A.; Raae
D.; Reiter P.; Sigsgaard U.; Vestergaar I.; Witt A.; Mitt T.; Timmusk P.;
Heikkila E.; Heiskanen R.; Huotari E.; Keskitalo A.; Kylmala L.; Laitinen
M.; Laukkanen M.; Leskinen S.; Liesivuori J.; Lukkari-Kuronen L.; Merisalo
P.; Muurinen E.; Nikkanen P.; Niskanen T.; Pasanen P.; Pekkonen L.; Retsu
A.; Soppela A.; Andreu N.; Ankotche A.; Bairras C.; Boch C.; Camachon L.;
Cherchouly A.; Coudret S.; Demer C.; Gilg R.; Lemonade L.; Madec O.;
Pinotti D.; Poirier I.; Tenne N.; Vogler C.; Amman M.; Andratschke-Gentsch
B.; Beckmann H.; Bischoff S.; Bleich B.; Bueschges G.; Busch E.;
Deigentasch S.; Dietze S.; Dollinger M.; El-Bahay C.; Flehmig G.; Frenzel
I.; Geissler K.; Guerro J.; Heike B.; Holler D.; Inhoffen C.; Klein K.;
Kraehe I.; Kress P.; Krueger H.; Lenz R.; Linnebach B.; Lueck A.; Markhof
P.; Matthies K.; Meier C.; Metzler E.; Moor E.; Noll I.; Paulsen S.;
Pfeffer B.; Promnitz N.; Saljew B.; Schad S.; Schoner C.; Sellmann R.;
Tanis M.; Vogelbusch J.; Wagner E.; Winkler S.; Zenker K.; Zvork S.;
Balogh E.; Buncsikne Molnar S.; Gulyasne Gaspar E.; Herold M.; Kovacs E.;
Kozmane Paszternak A.; Maarne Nagy S.; Nagyne Zoltan A.; Nemeth Z.; Roth
T.; Rozsa I.; Szalai M.; Anuradha M.; Bawa T.; Bhaskar B.; Chalkhore S.;
Choudhary D.; Dhanalaxmi T.; Dhingra V.; Gayatri R.; Gnanasundram R.;
Gopal U.; Govindaraj S.; Indira P.; James S.; Karkuzhli K.; Koppikar V.;
Malhotra N.; Manmohan B.; Mazher A.; Menon R.; Nalini S.; Panda M.; Patel
K.; Poongothai S.; Ramanathan S.; Ramu I.; Sangeetha K.; Sankar K.;
Savitha; Seeli Abraham C.; Shrinivas K.; Sudha S.; Tripathi S.; Vaseem A.;
Yamuna A.; Banques R.; Chong J.; Courcy M.; Donnelly E.; Fauzi A.; Gately
M.; Hanlon G.; Kelly-Conroy M.; McAteer S.; McGovern G.; Meaney E.; Storey
S.; Todd M.; Aharonof-Segal M.; Aliazarov N.; Arbeli S.; Butbul E.; Chagai
E.; Confino K.; Domb L.; Dvir R.; Erez N.; Foiening O.; Frishberg A.;
Genin I.; Gertman R.; Golan L.; Grosberd A.; Hadad D.; Israeli S.;
Kaplunski Y.; Karpf D.; Katzir A.; Kivity Z.; Li L.; Livshitz L.; Nachmias
A.; Orr I.; Peer E.; Platner N.; Pritulo L.; Rojansky A.; Rosenblat T.;
Saranga H.; Schterchman G.; Shenhar S.; Shkliar T.; Stam T.; Stinmann S.;
Suliman A.; Tsirulnikov E.; Uziel K.; Weinshtock S.; Yedid-Am S.; Yuval
R.; Zuker S.; Brunella L.; Durante A.; Nada E.; Pugolotti M.; Robusto A.;
Testa M.; Toniato R.; Ha I.; Jung S.; Kim C.; Mi Ran K.; Song B.; Wi Y.;
Yang K.; You J.; Gaisute R.; Ozolina L.; Dzagajeva N.; Kasperaviciene V.;
Krikstaponiene Z.; Montviliene R.; Morkunaite K.; Piepoliene L.; Stoniene
E.; Stonkus S.; Ulpaityte I.; Arenas-Vanhorn M.; Espitia-Serrato L.;
Garcia-Munoz E.; Nunez V.; Sainz T.; Bakker H.; Danse I.; De Greef S.; De
Jong C.; De Wit M.; Didden E.; Dommerholt R.; Goddrie M.; Haazer C.;
Havenaar J.; Hendriks-Van Woerden M.; Jongenotter M.; Kort I.; Koster L.;
Kramer H.; Maarssen E.; Posthuma-Visscher M.; Reijnierse-Buitenwerf H.;
Rood P.; Swets E.; Tousain W.A.; Van Buchem-Damming G.; Van
Buijsen-Nutters A.; Van de Loo R.; Van den Hondel M.; Van den Berg A.; Van
der Knaap-van Keulen M.; Van der Zeijst M.; Van Setten-Van der Meer L.;
Von Bannisseht E.E.; Wouda Z.; Aarsland T.; Amlie L.; Andresen B.;
Bakketun A.; Bognaes A.; Botten C.; Coucheron S.; Halsne A.; Hansen H.;
Holthe T.; Husby E.; Iversen E.; Kvalvik A.; Landbakk T.; Lovseth E.; Moen
S.; Orvik E.; Ovrehus G.; Salater S.; Sorgard B.; Sorstrom A.; Tandberg
L.; Veiding B.; Vinje G.; Winge A.; Abquina G.; Patena B.; Reyes R.;
Tamondong A.; Vega A.; Vitug L.; Makuch M.; Torun A.; Adam A.; Basaraba
M.; Chira C.; Darida C.; Haica C.; Nedelcu A.; Patru D.; Patrut L.; Rau
I.; Rotaru N.; Szabo L.; Vrinceanu G.; Sovenko T.; Zatsevskaya O.;
Horynova Z.; Vankova L.; Barkhuizen M.; Barnard L.; Bekker D.; Botha D.;
Commerford A.; de Klerk A.; De Waal A.; Devchand S.; Drummond F.; Du Toit
A.; Du Toit S.; Ellis T.; Engelbrecht M.; Eramus T.; Fonda K.; Goosen A.;
Gopel E.; Govender P.; Hodge E.; Ismael F.; Jonker E.; Jonker L.; Joubert
A.; Kilian M.; Koegenlenberg N.; Lehner L.; Lingham R.; Llyod T.; Mangoeng
P.; Mapele S.; Meiring J.; Methusi P.; Mmethi M.; Mohamed K.; Moore A.;
Ndiweni H.; Parker F.; Schoneman J.; Smit M.; Steyn A.; Van Dongren J.;
Van Schalkwyk S.; Van Staden L.; van Wyngaard G.; Wolf A.; Ashbaugh R.;
Bande C.; Barquero R.; Gaspar R.; Martin E.; Megia B.; Rodriguez C.;
Seoane A.; Viaplana J.; Akesson Jacobsson I.; Andersson C.; Asperen M.;
Backlund M.; Berglund M.; Bjorck L.; Borjesson M.; Brolin G.; Danielsson
Frojd M.; Duckert A.; Eriksson K.; Fehling K.; Glaas A.; Hage C.; Hoglund
K.; Jernhed H.; Johansson K.; Johansson S.; Lidin M.; Lundell L.; Lundgren
C.; Magnusson K.; Matsson E.; Norman J.; Nystrom K.; Ojutkangas M.;
Olofsson M.; Olsson C.; Pettersson U.; Pramberg E.; Raschperger A.; Sjolin
M.; Soderlund M.; Stensgaard Nake E.; Torebo E.; Uggeldahl I.; Walldin C.;
Welin-Berger B.; Dwyer A.; Meyer-Lazzarini V.; Morello R.; Schefer M.;
Oney S.; Seker T.; Tavlayan S.; Appleby M.; Astin J.; Baker M.; Brann H.;
Brennan C.; Bryan L.; Campbell D.; Carey J.; Cox K.; Davis C.; Dyson B.;
Everdell R.; Gammon B.; Godden J.; Gray T.; Griffiths E.; Grimes Y.; Hall
D.; Hall K.; Holme A.; Howe J.; Lambley-Burke R.; Nation M.; Norcott K.;
Mitchell K.; Poxon S.; Quick C.; Shute C.; Thomas J.; Vinnell T.; Bawa S.;
Bogan C.; Fallye O.; Ginsberg J.; Gregory B.; House B.; Isonaga M.;
Keanne-Richmond P.; Kelly C.; Kimpel J.; Leiby A.; Lyons L.; McCoy B.;
Monk A.; Pelayo E.; Perron M.; Posey D.; Rehan M.; Suarez R.; Tilton L.;
Waite K.; White G.; Chacon R.; Meza Y.; Misticchio F.; Torres M.; Urbaneja
H.
Publisher
American Diabetes Association Inc. (E-mail: membership@diabetes.org)
Abstract
OBJECTIVE: The Outcome Reduction With Initial Glargine Intervention
(ORIGIN) trial reported neutral effects of insulin glargine on
cardiovascular outcomes and cancers and reduced incident diabetes in
high-cardiovascular risk adults with dysglycemia after 6.2 years of active
treatment. Omega-3 fatty acids had neutral effects on cardiovascular
outcomes. The ORIGIN and Legacy Effects (ORIGINALE) study measured
posttrial effects of these interventions during an additional 2.7 years.
RESEARCH DESIGN AND METHODS: Surviving ORIGIN participants attended up to
two additional visits. The hazard of clinical outcomes during the entire
follow-up period from randomization was calculated. <br/>RESULT(S): Of
12,537 participants randomized, posttrial data were analyzed for 4,718
originally allocated to insulin glargine (2,351) versus standard care
(2,367), and 4,771 originally allocatedto omega-3 fatty acid supplements
(2,368) versus placebo (2,403). Posttrial, small differences in median
HbA1c persisted (glargine 6.6% [49 mmol/mol], standard care 6.7% [50
mmol/mol], P = 0.025). From randomization to the end of posttrial
follow-up, no differences were found between the glargine and standard
care groups in myocardial infarction, stroke, or cardiovascular death
(1,185 vs. 1,165 events; hazard ratio 1.01 [95%CI 0.94-1.10]; P = 0.72);
myocardial infarction, stroke, cardiovascular death, revascularization, or
hospitalization for heart failure (1,958 vs. 1,910 events; 1.03
[0.97-1.10]; P = 0.38); or any cancer (524 vs. 529 events; 0.99
[0.88-1.12]; P = 0.91) or between omega-3 and placebo groups in
cardiovascular death (688 vs. 700; 0.98 [0.88-1.09]; P = 0.68) or other
outcomes. <br/>CONCLUSION(S): During >6 years of treatment followed by
>2.5 years of observation, insulin glargine had neutral effects on health
outcomes and salutary effects on metabolic control, whereas omega-3 fatty
acid supplementation had no effect.<br/>Copyright &#xa9; 2016 by the
American Diabetes Association.

<39>
Accession Number
365300092
Title
Basal insulin and cardiovascular and other outcomes in dysglycemia.
Source
New England Journal of Medicine. 367 (4) (pp 319-328), 2012. Date of
Publication: 26 Jul 2012.
Author
Gerstein H.C.; Bosch J.; Dagenais G.R.; Jung H.; Maggioni A.P.; Pogue J.;
Probstfield J.; Ramachandran A.; Riddle M.C.; Ryden L.E.; Yusuf S.;
Richardson L.; Diaz R.; Johnston P.; Vige R.; Birkeland K.; Budaj A.;
Cardona E.; Chazova I.; Commerford P.; Danilova L.; Davies M.; Fernando
R.; Fodor G.; Gilbert R.; Gomis R.; Hanefeld M.; Hildebrandt P.;
Kacerovsky-Bielesz G.; Keltai M.; Kim J.H.; Krum H.; Lanas F.; Lewis B.S.;
Lonn E.; Lopez-Jaramillo P.; Marin-Neto J.; Marre M.; McKelvie R.; McQueen
M.; Mendoza I.; Morillo C.; Pan C.; Profozic V.; Ratner R.; Rosenstock J.;
Spinas G.A.; Sreenan S.; Stoel I.; Syvanne M.; Yale J.F.; Avezum A.; Bahit
M.C.; Bogaty P.; Bordeleau L.; Chacomicronn C.; Corson M.; Harper W.L.;
Halon D.; Magloire P.; Mann J.; Pavlova V.; Punthakee Z.; Silva J.; Tsang
B.; Yakubovich N.; Abdallah A.; Ahmad S.; Chandra J.; Chandra R.;
Cukierman-Yaffee T.; Dyal L.; Joldersma L.; MacRae L.; MacRae S.; Malik
S.; Mead A.; Pasha F.; Pazmino-Canizares J.; Pohl K.; Sakalas A.; Tyrwhitt
J.; Ahuad Guerrero R.; Alebuena A.; Alvarez N.; Alzogaray M.; Amuchastegui
M.; Andres M.; Angos M.; Baglivo H.; Barbieri M.; Bassi F.; Bello F.; Bono
J.; Bustamante Labarta M.; Bustos B.; Caccavo A.; Calveira M.; Camino A.;
Cantero M.; Capozzi M.; Cardone M.; Cartasegna L.; Cassetari A.;
Castellanos R.; Chavez Caballero R.; Cipullo M.; Contreras A.; Coria J.;
Corinaldesi F.; Costa G.; Crespo C.; Cruz M.; Cuello J.; Cuneo C.; Del
Corro I.; Diez R.; Dituro C.; Dominguez A.; Facta A.; Faingold C.; Farah
M.; Fares Taie A.; Fernandez A.; Ferrari A.; Ferrari N.; Garcia Monteverde
C.; Garrido M.; Giachello C.; Gonzalez M.; Gutierrez N.; Guzman L.; Guzman
P.; Hasbani E.; Henquin R.; Hershon A.; Hirschon Alvarez Prado A.; Hominal
M.; Hrabar A.; Imposti H.; La Grutta M.; Lanchiotti P.; Lobo Marquez L.;
Lopez Santi R.; Lowenstein J.; Lugo M.; Luqueci M.; Mainini S.; Majul C.;
Manzano R.; Manzur S.; Marcucci G.; Marino M.; Massari F.; Mendez N.;
Molina M.; Montana O.; Mulazzi M.; Nardone L.; Odetto I.; Orlandini A.;
Oviedo A.; Paez O.; Parnas A.; Patron F.R.; Pedernera C.; Pelagagge M.;
Plastino M.; Polari P.; Pomposiello J.; Porta A.; Prado A.; Quiroz M.;
Ramirez A.; Rodriguez M.; Ronderos R.; Sago L.; Sanchez A.; Sanchez R.;
Sandrin A.; Schygiel P.; Sernia V.; Sinay I.; Smith Casabella T.; Sosa
Liprandi A.; Sosa Liprandi M.; Soso L.; Sposetti G.; Stisman D.;
Streitenberger P.; Suarez G.; Tonin H.; Ulla M.; Valdez J.; Vico M.;
Villamil A.; Villarino A.; Viscaya Castro A.; Visco V.; Vogel D.; Waisman
F.; Zaidman C.; Amerena J.; Applebe A.; Aylward P.; Binnekamp M.; Bruce
I.; Burdeniuk C.; Burnet R.; Colman P.; Colquhoun D.; Davis S.; De Looze
F.; De Pasquale C.; D'Emden M.; Eaton H.; Farshid A.; Foulanos S.; Galanos
J.; Gordon G.; Guhu M.; Ho J.; Jeffery I.; Jerums G.; Kwan M.; Lefkovits
J.; Luu S.; MacIsaac R.; Marjason J.; Mohabbati V.; Nankervis A.; O'Neal
D.; Perera N.; Poynten A.; Rahman A.; Razak S.; Roberts T.; Sebastian M.;
Simpson R.; Soldatos G.; Sullivan D.; Teede H.; Tiong F.; Topliss D.;
Torpy D.; Waddell-Smith K.; Waites J.; Wenman J.; Whelan A.; Williams L.;
Yeap B.; Yeow W.; Yong G.; Aczel S.; Azimy N.; Bertha P.; Blocher J.;
Bohnel C.; Brath H.; Breuss J.; De Campo A.; Drexel H.; Ettmuller Y.;
Feder A.; Feinboeck C.; Gulz E.; Hofmann M.; Hoppichler F.; Jahnel H.;
Jankovic V.; Kann T.; Kathrein T.; Kotter T.; Kratz E.; Kreuzwieser E.;
Loreck C.; Ludvik B.; Marte T.; Mellitzer K.; Nistler S.; Placher-Sorko
G.; Prager R.; Rein P.; Riedl M.; Saly C.; Schernthaner G.; Schichka E.;
Seidlhofer C.; Sonnenfeld M.; Stefan H.; Steiner K.; Thomas B.; Toplak H.;
Urstoger K.; Vetter B.; Vonbank A.; Waldschutz W.; Wallner F.; Winkler F.;
Goncharik D.; Lazareva I.; Lichorad N.; Mrochek A.; Murashko N.; Radyuk
D.; Ramanovski A.; Sudzhaeva S.; Sujayeva V.; Yarashevich N.; Campbell G.;
Marshall S.; West A.; Abreu F.; Alves M.; Ayoub-Aidar J.; Barros M.;
Barros-Silveira J.; Blacher M.; Costa E.; Costa F.; Daltro C.; Delana J.;
Eliaschewitz F.; Facanha C.; Feitosa G.; Figueiredo J.; Forti A.; Franco
D.; Franken M.; Freire F.; Garcia V.; Gouvea-Neto A.; Grofallo S.;
Kanedlai N.; Kerr-Saraiva J.; Ladeira R.; Leaes P.; Lemos M.; Lima F.;
Lima Filho M.; Macedo L.; Manenti E.; Monte O.; Mossman A.; Mothe F.;
Mouco O.; Moyses Golbert M.; Nasser Hissa L.; Nasser-Hissa M.; Nicolau J.;
Nigro Maia L.; Ninno T.; Nunes C.; Oliveira C.; Oliveira O.; Passos da
silva R.; Pericles-Esteves J.; Rabelo L.; Rabelo-Alves Junior A.; Rassi
S.; Rech R.; Roldan F.; Salles J.; Sampaio C.; Seabra A.; Sealissi N.;
Seixas A.; Sena R.; Shehadeh I.; Teixeira M.; Turin H.; Vicente Serrano
C.; Vidigal M.; Vilela M.; Wajchenberg B.; Abbott C.; Abu-Bakare A.;
Ardilouze J.; Auersperg E.; Bailey A.; Bailey G.; Baillargeon J.;
Beaurivage C.; Belair J.; Belanger A.; Bellabarba D.; Berlingieri J.;
Bernier F.; Bhargava R.; Bhesania T.; Booth W.; Bose S.; Boulianne M.;
Bourgeois S.; Breton D.; Brossoit R.; Buithieu J.; Campeau J.; Carlson B.;
Carpentier A.; Cavalcanti R.; Cha J.; Chagnon P.; Chan Y.; Chessex C.;
Chiasson J.; Chouinard S.; Clayton D.; Conway J.; Crepeau J.; Cudmore D.;
D'Ignazio G.; Doig G.; Dominguez M.; Dube F.; Dumas R.; Dupuis R.; Dyrda
I.; Eddy D.; Eiley D.; Fox H.; Fratesi S.; Gallant S.; Garceau C.;
Garfield N.; Germain C.; Glazer S.; Gosselin G.; Gould D.; Grills G.;
Halle J.; Hardin P.; Harper W.; Heath J.; Heath V.; Hivert M.; Ho K.;
Houde G.; Hramiak I.; Hutchinson A.; Huynh T.; Ilie-Haynes R.; Imran S.;
Islam A.; Iwanochko M.; Jones C.; Joyce C.; Kirouac I.; Kumar R.; Lamothe
M.; Langlois M.; Lauzon C.; Lavoie M.; Leader R.; Lecours S.; Lepage S.;
Lochnan H.; Ma P.; McLean A.; Mecci S.; Mehta P.; Mercier M.; Miller D.;
Morisset A.; Nawaz S.; Nisker W.; Nyomba G.; O'Keefe D.; Palardy J.;
Parekh P.; Paul T.; Perron P.; Pesant M.; Phillips R.; Pruneau G.; Quintin
I.; Raby K.; Richard C.; Rosenfeld G.; Saulnier D.; Shaban J.; Shah A.;
Shu D.; Sigal R.; Silverman M.; Singh J.; Sivucha W.; Skamene A.;
Sliwowicz D.; Smith R.; St Hilaire R.; Steinson D.; Sussex B.; Tan K.;
Tannous R.; Telner A.; Theroux P.; Tsoukas C.; Tsoukas G.; van Buuren J.;
VanRossum N.; Vexler R.; Vizel S.; Warnica W.; Weingert M.; Wilson R.;
Wong W.; Woo V.; Yale J.; Acevedo M.; Alwyn C.; Baier E.; Baier S.;
Galloso R.; Lahsen R.; Lorenas G.; Montecinos A.; Montecinos M.; Pineda
P.; Pollak F.; Sapunar J.; Serrano V.; Stockins B.; Varleta P.; Yovanovich
J.; Zambra F.; Ba J.; Bao Y.; Bi Y.; Bu S.; Chen B.; Chen H.; Chen J.;
Chen L.; Chen M.; Chen Y.; Cui J.; Dong M.; Feng P.; Feng Z.; Gao C.; Gao
F.; Gao X.; Gao Z.; Gong Y.; Guang L.; Guo X.; Han F.; Han X.; Hou X.; Hu
R.; Ji L.; Jia J.; Jia W.; Jiao X.; Jin X.; Kuang J.; Li M.; Li Q.; Li X.;
Li Y.; Ling Y.; Liu F.; Liu Z.; Lu B.; Lu J.; Lu Z.; Lv X.; Ning G.; Peng
Y.; Ren Y.; Shao Y.; Shi Y.; Shu X.; Sun H.; Sun L.; Sun X.; Tang K.; Tian
H.; Wang C.; Wang F.; Wang L.; Wang Q.; Wang W.; Wang X.; Wang Y.; Wen J.;
Wu C.; Wu H.; Wu J.; Wu M.; Xing X.; Xue Y.; Yan L.; Yan S.; Yang H.; Yang
N.; Yang W.; Yang Z.; Yao J.; Yao L.; Yu D.; Yu H.; Yu M.; Yu X.; Yuan L.;
Yuan M.; Yuan S.; Yuan W.; Yuan Y.; Yuan Z.; Zeng T.; Zhang J.; Zhang R.;
Zhang X.; Zhao L.; Zheng B.; Zheng J.; Zhou W.; Zhu N.; Zhu Y.; Zou D.;
Zou J.; Accini J.L.; Bohorquez R.; Botero R.; Cure C.; Figueredo M.;
Hernandez E.; Kattah W.; Llamas A.; Orozco L.; Pava L.; Perez M.; Pineda
M.; Quintero A.; Quiros R.; Urina M.; Velez S.; Altabas V.; Baotic I.;
Berkovic M.; Goldoni V.; Kerum T.; Mirosevic G.; Tarle D.; Vidovic I.;
Zjacic-Rotkvic V.; Abbas R.; Andersen H.; Auscher S.; Baumbach L.;
Brockstedt H.; Christensen P.; Christiansen M.; Clemmensen K.; Egstrup K.;
Gislason G.; Haar D.; Hansen K.; Heden Andersen P.; Helleberg K.;
Hermansen K.; Holmer J.; Jeppesen J.; Klausen I.; Koustrup-Sonder T.;
Krarup T.; Lerche S.; Lervang H.; Linde B.; Lund P.; Lund S.; Madsbed S.;
Molvig J.; Orskov C.; Ostergaaard O.; Perrild H.; Pietraszek A.; Ralfkjaer
N.; Roenne H.; Rokkedal Nielsen J.; Seibaek M.; Soendergaard H.; Sorensen
L.; Sundahl Mortensen L.; Torp-Pedersen C.; Tuxen C.; Urhammer S.;
Vadstrup E.; Pirags V.; Ambos A.; Janson A.; Rudenko P.; Viitas L.; Aranko
S.; Badeau M.; Eriksson J.; Haapamaki H.; Kajander O.; Kuusisto A.;
Luukkonen S.; Makela J.; Nieminen S.; Niskanen L.; Ripatti J.;
Ruotsalainen S.; Saltevo J.; Savela K.; Strand J.; Valle T.; Virkamaki A.;
Aboud E.; Alavoine L.; Bekherraz A.; Bohme P.; Bourezane H.; Catargi B.;
Charpentier G.; Clergeot A.; Courreges J.; Delmas T.; Duengler F.; Feknous
C.; Gendre D.; Guerci B.; Hadjadj S.; Kerlan V.; Laguerre N.; Le Potier
J.; Lombardo F.; Malville E.; Marechaud R.; Mattei C.; Moreira J.;
Penfornis A.; Petit C.; Pinel J.; Piquel X.; Raccah D.; Reznik Y.; Rod A.;
Roudaut N.; Rousseau E.; Schillo F.; Schmitt B.; Sonnet E.; Torremocha F.;
Travert F.; Vanhoute C.; Vimeux M.; Abdollahnia R.; Adamidou A.; Arslan
S.; Bach-Kliegel B.; Bartusch B.; Bauer N.; Bieler T.; Blankenfeld H.;
Boeckmann U.; Busch K.; Butzer R.; Chenchanna-Merzhaeuser M.; Denger R.;
Deutsch C.; Diessel S.; Donati-Hirsch I.; Dornisch M.; Enghofer K.; Fleig
T.; Forst T.; Frommherz M.; Goeller K.; Habbig J.; Hadziselimovic S.;
Hamann A.; Hampel T.; Heger S.; Helmes C.; Hoffman C.; Hohberg C.; Humpert
P.; Kamke A.; Kamke W.; Kindermann P.; Klein C.; Klein D.; Koehler A.;
Kuehn A.; Langer K.; Limmer S.; Loew A.; Maimer A.; Marck C.; Meier G.;
Methner-Friederich M.; Metzler W.; Meyer K.; Miftari N.; Milde J.; Minnich
J.; Molkewehrum M.; Morcos M.; Mueller-Hoff C.; Nguyen M.; Nishwitz M.;
Oldenburg J.; Ott P.; Pauli K.; Pauly B.; Pfeiffer A.; Pfuetzner A.;
Pischa U.; Radke R.; Reismann P.; Riemer M.; Rochlitz H.; Rudofsky G.;
Ruhla S.; Sammler A.; Schaper F.; Schiemenz K.; Scholz G.; Schumm-Draeger
P.; Segiet T.; Segner A.; Seissler J.; Spahn S.; Stier U.; Tonon G.; von
Amelunxen S.; von Schacky C.; Wilhelm B.; Wilhelm K.; Witt K.;
Wuechner-Hofmann S.; Baranyai M.; Birkus Z.; Foldesi I.; Gaal Z.; Harcsa
E.; Hati K.; Hohmann Z.; Istenes I.; Jozsef I.; Juhasz E.; Kempler P.;
Keresztes B.; Keresztes K.; Kis-Gombos P.; Kovacs I.; Kozma T.; Laszlo Z.;
Noori E.; Nyirati G.; Papp Z.; Patkay J.; Poor F.; Pusztai P.; Putz Z.;
Rigo E.; Sereg M.; Simon K.; Somogyi A.; Sumegi J.; Szabo A.; Szabo J.;
Szigeti S.; Szilveszter D.; Tarko M.; Varga C.; Varga Szabo L.; Voros P.;
Arathi; Aravind S.; Badgandi M.; Balaji M.; Balaji V.; Chamukuttan S.;
Devi Manduva P.; Fatima S.; Ganapathy B.; George O.; George P.; Jaffar M.;
Jain P.; Kamath P.; Karthik V.; Koshy G.; Krishnan L.; Kumar H.; Lal P.;
Mithal A.; Modi S.; Mohan V.; Moses V.; Oomen R.; Pais P.; Pati P.;
Pendsey S.; Rai P.; Rajagopal R.; Ramu M.; Ranjit U.; Rao P.; Senthil V.;
Seshaiah V.; Sethi B.; Shah P.; Sharma R.; Shetty S.; Shobha A.; Siddharth
R.; Sridhar G.; Sudeep K.; Sunil C.; Sunitha S.; Suresh S.; Thomas N.;
Vageesh A.; Anwer Z.; Barton J.; Behan L.; Bell M.; Cullen M.; Dineen S.;
Draman Yusof M.; Dunne F.; Gibney J.; Hussain T.; Khan M.; Kinsley B.;
Kyithar P.; Lavin F.; McGowan A.; McGurk C.; Mirza A.; Mohammadi B.;
O'Brien T.; O'Connell J.; O'Halloran D.; O'Shea D.; Roberts G.; Tomkin G.;
Wan Mahmood W.; Abramod-Ness R.; Adawi F.; Aharon B.; Backer M.;
Beniashvili A.; Berliner A.; Bloch L.; Bugelman D.; Butnaru A.; Cohen O.;
Cohen Y.; Frenkel M.; Glant M.; Gustava B.; Guttman H.; Halabi S.;
Harman-Boehm I.; Ilany J.; Karkabi B.; Khader N.; Khaskia A.; Khudyak Y.;
Klainman E.; Kogan N.; Lender D.; Levin I.; Mardi T.; Marmor A.; Mosseri
M.; Nabriski D.; Omary M.; Orlovsky S.; Peres D.; Quasim M.; Raz I.;
Remesnik M.; Rogowski O.; Rozenfeld I.; Scharr D.; Shnifer I.; Shuster T.;
Solomon R.; Steiner H.; Tzivoni D.; Wolfson N.; Yossef Z.; Zahger D.;
Zeltser D.; Zimlichman R.; Aina F.; Ariatti C.; Bonetti R.; Cacciatore F.;
Calcinaro F.; Corona G.; De Maria P.; Del Prato S.; Derosa G.; Di Pasquale
G.; Falorni A.; Fanelli R.; Fedele D.; Filorizzo G.; Fogari R.; Furgi G.;
Ghio A.; Giorda C.; Gregori G.; Iannuzzi G.; Lapolla A.; Luciano B.;
Lucotti P.; Maggi A.; Marafetti L.; Marchese T.; Martino G.; Marzotti S.;
Miccoli R.; Monti L.D.; Moretti L.; Palvarini M.; Petacchi R.; Piarulli
F.; Piatti P.M.; Rudi S.; Santeusanio F.; Sesti G.; Setola E.; Sforza A.;
Shehaj E.; Veniani M.; Viviani G.; Zigoura E.; Chae S.; Cho D.; Cho E.;
Cho Y.; Choi Y.; Chung M.; Hong E.; Hong Y.; Jeong M.; Kim B.; Kim D.; Kim
H.; Kim I.; Kim J.; Kim P.; Kim S.; Koo B.; Kwok S.; Kwon H.; Lee J.; Lim
J.; Oh S.; Ohn J.; Park C.; Park H.; Park K.; Seung K.; Son H.; Woo J.;
Yoon K.; Ansmite B.; Balcere I.; Bumbure A.; Ducena K.; Lejnieks A.; Rasa
I.; Ritenberga R.; Romanova M.; Salmina I.; Steina S.; Badariene J.;
Gailiuniene S.; Grigonis S.; Juskiene R.; Petrulioniene Z.; Sakalyte G.;
Stasiunas T.; Sulskiene M.; Urbonaite B.; Zarankiene R.; Ziukaite R.;
Arechavaleta R.; Beltran-Jaramillo T.; Calvo-Vargas C.; Campillo-Cardenas
C.; Cardona D.; Carmona-Huerta J.; Cedano-Limon M.; Comellas-De M.;
Dominguez C.; Gomez-Cruz J.; Gonzalez-Perez R.; Illescas J.; Jimenez-Ramos
S.; Lopez-Alvarado A.; Marquez-Rodriguez E.; Martinez G.; Pascoe S.;
Plascencia Vazquez O.; Rodriguez H.; Ruiz-Cornejo M.; Velasco-Sanchez G.;
Vidrio-Velazquez M.; Villeda-Espinosa E.; Badings E.; Bartels G.;
Bruggink-Andre de la Porte P.; Bruijns E.; Cornel J.; De Milliano P.; De
Mulder M.; De Swart J.; Derks A.; Dirkali A.; Droste J.; Galjee M.;
Hautvast R.; Hermans W.; Holwerda N.; Ilmer B.; Kofflard M.;
Kooistra-Huizer J.; Kurvers M.; Langerveld J.; Leenders C.; Liem A.; Lok
D.; Neumann D.; Nierop P.; Plomp K.; Posma J.; Reichert C.; Roeters Van
Lennep H.; Ronner E.; Said S.; Takens L.; Umans V.; Van der Sluis A.A.;
Van der Zwaan C.; Van Dobbenburgh J.; Van Es A.; Van Hessen M.; Van
Mechelen R.; Van Miltenburg-Van Zijl A.; Van Zeijl L.; Veerhoek M.;
Viergever E.; Weijers E.E.; Willems F.; Blix I.; Cooper J.; Debowska A.;
Erichsen K.; Fossum J.; Gjertsen E.; Grill V.; Gudnason S.; Hoye K.; Istad
H.; Winther J.; Joakimsen R.; Jorde R.; Larsen I.; Mella B.; Otterstad J.;
Risberg K.; Skare K.; Skeie S.; Sommervoll L.; Tandberg A.; Whitfield R.;
Wium C.; Cunanan E.; Fernando-Catindig E.; Gomez M.; Jaring C.;
Lantion-Ang F.; Licaros M.; Lim-Abrahan M.; Madronio E.; Panelo A.; Raboca
J.; Ramos G.; Tugna S.; Aksamit-Bialoszewska E.; Bandurska-Stankiewicz E.;
Baranska M.; Bronisz A.; Bronisz M.; Chrustowski W.; Cieslak B.;
Czupryniak L.; Drazkowicz-Gozdzik B.; Galuszka-Bilinska A.; Gmytrasiewicz
M.; Janik K.; Jedynasty K.; Kania G.; Kawka-Urbanek T.; Kinalska I.;
Kincel K.; Kleszczewska U.; Kruszewski J.; Loba J.; Malicka J.;
Mielecka-Kincel M.; Milczarczyk A.; Milosz D.; Mrowczynska A.; Mytnik M.;
Nowakowski A.; Nowakowski P.; Oleskowska L.; Omelanczuk-Wiech E.;
Pawlowski M.; Poplawska A.; Rucinska M.; Rucinski M.; Rutkowska J.;
Saryusz-Wolska M.; Siewko K.; Sikora-Frac M.; Stecka-Wierzbicka J.;
Swiatkowski M.; Swierczynski R.; Szpajer M.; Szymkowiak K.; Tarach J.;
Tarasiewicz U.; Wiatr D.; Wojewoda P.; Woszczak-Marcinkowska H.; Zadrozny
J.; Hancu N.; Albota A.; Bala C.; Barbonta D.; Botnariu G.; Bradescu O.;
Busegeanu M.; Bzduch M.; Catrinoiu D.; Caziuc R.; Cerghizan A.; Cheta D.;
Cif A.; Ciomos D.; Cosma D.; Creteanu G.; Crisan I.; Danciulescu R.;
Dobjanschi C.; Dodan R.; Duma L.; Ferariu I.; Ghenes T.; Ghise G.; Graur
M.; Ilinca M.; Marton R.; Mindrescu N.; Morosanu A.; Morosanu M.; Mota M.;
Nafornita V.; Negrisan G.; Nicodim S.; Nicolau A.; Nita C.; Onaca A.;
Panus C.; Pletea N.; Pop C.; Pop L.; Popa B.; Roman G.; Rosu M.; Sandu N.;
Serban V.; Sima A.; Stamoran L.; Strugariu M.; Suciu G.; Szilagyi I.;
Vacaru G.; Veresiu I.; Vlad A.; Adasheva T.; Ageev F.; Akhmedganov N.;
Akinina A.; Alexandrov A.; Ambatiello L.; Ametov A.; Ausheva A.; Babaeva
L.; Babenko A.; Balyasnikova E.; Bart B.; Belova J.; Berstein L.;
Bondarenko I.; Bondarev E.; Bulkina O.; Chernikova N.; Chumak B.; Deeva
T.; Demicheva O.; Demidova T.; Doskina E.; Duganova A.; Dzhaiani N.;
Egorova I.; Ettinger O.; Feofanova S.; Fofanova T.; Galaktionov P.;
Gavrilova N.; Gilyarevsky S.; Gnidkina N.; Golubev A.; Gornyakova N.;
Grigorova S.; Grineva E.; Gurevich V.; Irtuganov N.; Ivanova L.; Jaiani
N.; Kalashnikova M.; Karpov Y.; Khalimov Y.; Khorocheva G.; Kirillova E.;
Kistner J.; Kobalava Z.; Kochergina I.; Kravchenko T.; Krylov K.; Kulkova
P.; Kuparev I.; Kurbanova E.; Lysenko T.; Markovich A.; Martyanova I.;
Martynyuk T.; Masiinvets M.; Mavlyavieva E.; Maychuk E.; Melnichenko G.;
Mikhailusova M.; Mkrtumyan A.; Mychka V.; Nebieridze D.; Nesterova E.;
Orlov V.; Orlova V.; Orlova Y.; Papov F.; Patroucherva I.; Petunina N.;
Pirozhinskaya S.; Podachina S.; Postnikova S.; Pshikova O.; Rogova L.;
Romashevskiy B.; Runikhina N.; Sadulayeva I.; Safaryan A.; Sakovich E.;
Saprikina T.; Sargsyan V.; Semikozova O.; Shkolnik E.; Shubina A.; Shustov
S.; Sinitsina I.; Solovyeva E.; Storogakov G.; Stovpyuk O.; Sussekov A.;
Telnova M.; Temirov A.; Terekhov V.; Tereschenko S.; Tiourina T.;
Tolkacheva V.; Tsoy U.; Urazgyldeeva S.; Vasyuk Y.; Vinnitskay N.;
Voevodina E.; Volkova A.; Zadionchenko V.; Zalevskaya A.; Zhelninova T.;
Zhukova N.; Zilov A.; Bernatova J.; Duris T.; Markova I.; Martinka E.;
Michalova L.; Minarik P.; Peter L.; Raslova K.; Silvia D.; Subadova M.;
Tisonova J.; Vohnout B.; Adam M.; Badat A.; Bester A.; Bester F.; Blacking
L.; Bouwer D.; Brice B.; Cassimjee S.; Cronje T.; Deftereos J.; Distiller
L.; Ellis G.; Forster O.; Fulat M.; Gani M.; Gibson G.; Hansa S.;
Hendricks N.; Herbst L.; Hitzeroth J.; Joffe B.; Kelbe C.; Kelbe D.; King
J.; Kramer B.; Landau S.; Levitt N.; Meyer-Nell S.; Moore R.; Muller D.;
Nell H.; Omar M.; Randeree H.; Seeber M.; Seedat; Segynu D.; Siebert M.;
Van den Berg E.; Van der Walt P.; Van Dyk C.; Van Niekerk F.; Van Zyl L.;
Wellman H.; Bertomeu V.; Botella M.; Buno M.; Calle A.; Cano Perez J.;
Coves M.; Juanatey J.G.; Garcia-Mayor R.; Gaztambide S.; Gippini A.;
Goikolea I.; Gonzalez J.; Hillman N.; Lopez Garcia Aranda V.; Magueda I.;
Mato J.; Mazon P.; Morillas P.; Novials A.; Pallardo L.; Perez L.;
Rodriguez J.; Romero L.; Sagarra E.; Shamagian L.; Soto A.; Torrealday H.;
Valero R.; Agergaard S.; Agewall S.; Andersson K.; Bergstrom O.;
Bjornstedt Bennermo M.; Blomgren J.; Boman K.; Brohall G.; Cherfan C.;
Dahlen C.; Dotevall A.; Enander P.; Ericsson U.; Hallgren P.; Hansson A.;
Henareh L.; Henriksson P.; Herlitz J.; Holmqvist J.; Jarevi G.; Linderfalk
C.; Jonasson L.; Jovinge S.; Kalen J.; Kilstrup M.; Leosdotir M.; Leppert
J.; Ljungberg J.; Lofdahl B.; Lundman P.; Lysell-Bergstrom C.; Mathiesen
U.; Mellbin L.; Morner S.; Nathanson D.; Nilsson L.; Peterson M.;
Quittenbaum S.; Rosengren A.; Ryttberg B.; Scheel S.; Svensson K.; Tenerz
A.; Vasko P.; Waldenstrom A.; Wieloch M.; Spinas G.; Braendle M.; Felix
B.; Gerber P.; Moccetti T.; Pitteloud N.; Kultursay H.; Aydinalp A.; Balci
M.; Cayli M.; Hatipoglu E.; Ilkova H.; Kayikcioglu M.; Koc M.;
Muderrisoglu H.; Sari R.; Saygili F.; Tekin K.; Tutuncu N.; Yurekli B.;
Adler A.; Ali A.; Balasubramanian; Bandypadhyay P.; Barakat O.; Barnett
A.; Borthwick L.; Brookes; Burton J.; Cecil J.; Chaterjee S.; Clark J.;
Collinson D.; Collinson S.; Crasto W.; Donnelly R.; du Plessis J.; Egan
S.; Ellery A.; Evans R.; Ewing J.; Fox C.; Gibson M.; Hall T.; Higgs E.;
Hollway M.; Hughes E.; Jackson N.; Jalihawi H.; Jones G.; Knights H.;
Korsheed S.; Kumar Singh R.; Laithwaite D.; Lawrence I.; Litchfield J.;
Manning G.; McNally P.; Millar-Craig M.; Mohammed I.; Narayanan R.; Nayani
G.; Norris A.; Purohit J.; Quinn M.; Ramtoola; Randall J.; Rea R.;
Reckless J.; Richardson T.; Robertson D.; Robinson A.; Salem K.; Sampson
M.; Savage M.; Shaker J.; Srinivasan T.; Tracy I.; Tringham J.; Viljoen
A.; Ward A.; Waterhouse H.; Wijenaike N.; Wiles P.; Ahmann A.; Ahmed I.;
Alam A.; Arakaki R.; Asad S.; Banarer S.; Baum H.; Belew K.; Bergenstal
R.; Bethel M.; Boyer C.; Catton S.; Challans P.; Childs B.; Christian R.;
Clement S.; Cuddihy R.; Dailey G.; Damberg G.; De Bold C.; De Lemos J.;
Donovan D.; Dudl J.; Dunbar J.; Ebner S.; Failor R.; Feinglos M.; Flaker
G.; Freiburghaus M.; Furlong K.; Gardner D.; Gillespie E.; Goland R.;
Goldberg R.; Gotham A.; Guthrie R.; Hamaty M.; Hirsch I.; Jabbour S.;
Janci M.; Javorsky B.; Jones S.; Kamana V.; Kashyap M.; Kaufman S.; Kearns
P.; Khera A.; Klopfenstein B.; Kniffen W.; Kringas P.; Licata A.;
Lopez-Jimenez C.; Madden M.; Marx C.; McCall A.; McCallum J.; McFarlane
S.; McGuire D.; Melish J.; Meneghini L.; Miller S.; Miranda-Palma B.;
Mitchell R.; Nasr C.; Nelson J.; Niblack P.; Nylen E.; Osei K.; Pandey A.;
Papademetriou V.; Pilar Solano M.; Sameshima L.; Savarese V.; Schnure J.;
Schuster D.; Shin J.; Taylor A.; Thomson P.; Ting-Ryan M.; Trence D.; Vo
A.; Weiland K.; Wells K.; Wu P.; Zimering M.; Zimmerman R.; Ascanio P.;
Brajkovich I.; Carrillo E.; Coll J.; Gonzalez K.; Gonzalez N.; Jimenez E.;
Lopez R.; Marante D.; Morr I.; Paolillo M.; Perche D.; Portillo M.;
Valbuena H.; Velarde M.; Vergara G.; Augensen N.; Azzalina J.; Fidaly S.;
Bollero G.; Casiello A.I.; Ferraro F.; Guridi M.J.; Ines M.; Martin M.E.;
Pascual A.; Pereyra J.; Toscanelli M.; Appiah M.; Grech S.; Pouras S.;
Watts C.; Denke E.; Feik C.; Litvinenko M.; Platonenko O.; Shadur S.;
Johnson J.; Bonilla E.; Carraway B.; Faith J.; Greer C.; Harding A.;
Heston J.; Lin Y.; Mecca T.; Schuler M.; Rizk C.; Sissoko A.; Strickland
K.; Andrade A.; Lux L.; Machado D.; Mancin E.; Aquino J.; Belanger B.;
Bourque C.; Gagnier K.; Hagerimana A.; McNeil A.; Osachoff J.; Richard B.;
Rogan J.; Styner L.; Maturana X.; Naranjo M.E.; Li E.; Liu Q.; Shuai M.;
Tan Z.; Tang M.; Zhao J.; Ardila M.; Gomez A.M.; Uscategui A.M.;
Marinkovic N.; Miocevic V.V.; Pezo S.; Andersen I.; Bastrup-Larsen B.;
Jeppesen E.; Kofoed-Djursner M.; Joe H.; Hiironen V.; Tarvainen M.; Von
Hedenberg H.; Guillarme C.; Rastelli O.; Roy P.; Igel L.; Lenz T.; Leptich
A.; Peikert S.; Domokos S.; Szotyorine-Polcza G.; Wenczl M.; Chaudhary S.;
Jaiswal G.; Khatri P.; Shah K.; Gibson S.; Bechar Y.; Erdheim D.; Eyal N.;
Frankel M.; Shimoni S.; Tsuri J.; Bianco L.; Cali R.; Sganga P.; Jang M.;
Kim J.M.; Kim Y.; Lim S.; Park J.S.; Song Y.; Kalve E.; Dienyte E.;
Alvarado F.; Rodriguez R.; Bar J.; Lijfering-Lorie K.; Palstra M.; Van der
Kuijl K.; Van de Wetering A.; Eriksen S.; Hejazifar S.; Jendeberg A.;
Johannessen G.; Khammari I.; Meredith E.L.; Dayag A.M.; Figueroa P.;
Hoffmann Korpalska A.; Przemyk M.; Craciunescu A.; Lupu D.; Osanu A.;
Popscu L.; Toader C.; Kirsanova T.; Timoshina E.; Gomez B.; Jankularova
I.; Brett S.; Meyer A.; Pereira V.; Vawda N.; Castano B.; Farre Avella
J.M.; Jimenez I.; Turet N.; Froberg M.; Reppert E.; Wessman S.; Boschung
Y.; Carrozzino F.; Gerstl K.; Cetin Z.; Demirci S.; Ovalioglu S.; Lenehan
A.; McLean H.; Mutsaers K.; Redfern P.; Scoggins A.; Isea Y.; Alvarez M.;
Alvarez D'Amelio A.; Aqueveque S.; Argenta M.; Aviles A.; Barreiro E.;
Battistessa Y.; Bergamo S.; Bertran B.; Bocanera M.; Bowen L.; Brescia H.;
Caceres M.; Cappi A.; Cardelli A.; Carolini E.; Carpintero S.; Carrique
A.; Carrique P.; Casquero M.; Castro M.; Cendali G.; Chatelain M.;
Costanzi A.; Cristofaro C.; Crunger P.; Ehrich S.; Espinosa M.; Esposito
L.; Flenche M.; Fracaro V.; Funosas C.; Garrido I.; Gomez Garrido A.;
Guzman A.; Izzicupo M.; Luca S.; Luciani C.; Majul S.; Moreno Cepeda I.;
Moschin Y.; Niemann G.; Novas V.; Olmi M.; Palma F.; Peralta A.; Puig A.;
Rodera Vigil M.; Ronderos G.; Rosell M.; Samudio M.; Santicchia C.;
Szczygiel V.; Takla M.; Tinnirello C.; Tonin S.; Tristan A.; Troncoso C.;
Vignau S.; Yanez K.; Zarate M.; Appeldorf R.; Batrouney B.; Bonner A.;
Bonner M.; Cahill P.; Carr J.; Caruana M.; Chare J.; Doran A.; Flavel;
Gein J.; Griek S.; Hulley A.; Keays P.; Kent S.; Lai N.; Legg H.; Long A.;
Lynch L.; Maxwell V.; McNamara K.; Nairn J.; Nichols V.; Peeler C.;
Phillips J.; Price-Smith S.; Ryan S.; Stockle P.; Tapp E.; Taverner P.;
Tulloch G.; Viola V.; Wilson L.; Beck A.; Damon S.; Drexel V.; Grabner E.;
Hofurthner A.; Kivioja P.; Kretschmer S.; Lener P.; Maiweg J.; Tscherner
D.; Weichelt H.; Winkler J.; Jones D.; Alves L.; Batista R.; Bernardes A.;
Demore de Souza A.; Ferraz R.; Ferreira A.; Freitas E.; Guanaes D.;
Kuschel K.; Muniz R.; Nasser-Hissa V.; Nhan P.; Osorio R.; Queirantes C.;
Reboucas R.; Souza C.; Tonani M.; Vicente C.; Zilli A.; Andersen K.; Aro
L.; Barber C.; Barnable B.; Berard L.; Bernier A.; Boudreault C.;
Bourbonnais A.; Bourgeois L.; Boutin D.; Boyer D.; Branco N.; Briol L.;
Brousseau M.; Burke M.; Chambers C.; Champoux A.; Chan S.; Colborne C.;
Coles K.; Couture M.; Cryderman C.; DeCurtis D.; Dewar C.; Drown J.; Dunn
P.; Eichmann D.; Eikel L.; Fox B.; Gauthier S.; Gibbons D.; Hicks R.; Ho
V.; Kitagawa H.; Kooistra L.; Landry F.; Lapointe F.; Larrivee L.; Leonard
P.; Louch D.; MacNair D.; Magennis L.; Mallette D.; Marchand C.; McLean
S.; Meilleur M.; Murdock H.; Naud M.; Olson K.; Otis J.; Ouimet F.;
Paquette H.; Peck C.; Pelletier A.; Perkins L.; Petrie F.; Pockett S.;
Poulin F.; Poulin M.; Primbas K.; Renton J.; Rouatt S.; Roy M.; Scarcelli
D.; Schellenberg S.; Schellevis K.; Schmidt N.; Scott L.; Skarpinsky B.;
Smith B.; Smith E.; Stafford C.; Stata C.; Sternberg B.; St-Jean N.;
Stoger S.; Thibodeau C.; Toupin A.; Ullyatt L.; Velonas J.; Vienneau R.;
Wall C.; Zaniol D.; Arau M.; Fuentes J.; Hidalgo J.; Landaeta O.; Padilla
I.; Sanzana S.; Tellos G.; Toro F.; Vergara R.; Che T.; Du Y.; He Y.;
Huang C.; Li H.; Liu S.; Luo X.; Ma Y.; Pan S.; Wan Q.; Wang H.; Wang S.;
Xie Y.; Xu X.; Xu Y.; Zhao F.; Zhou M.; Accini M.; Bello O.; Caceres A.;
Camargo S.; Figueroa J.; Florez M.; Gomez Morales K.; Granados L.;
Martinez M.; Medina Ramos M.; Mejia C.; Montoya L.; Ramos C.; Restrepo P.;
Rodriguez D.; Santamaria A.; Valencia T.; Spanic V.; Borre Hansen A.;
Bulow M.; Ehlers G.; Frederiksen A.; Gottschalck H.; Hejlskov B.; Holm
Fruesnsgaard Pedersen L.; Hornum H.; Jansen S.; Johansen A.; Jorgensen A.;
Kjaeulff Svaneborg T.; Kruse A.; Lund K.; Lundgaard M.; Madsen J.; Meier
A.; Muurholm A.; Nedergaard A.; Nielsen S.; Norgaard D.; Olsen A.; Raae
D.; Reiter P.; Sigsgaard U.; Vestergaar I.; Witt A.; Mitt T.; Timmusk P.;
Heikkila E.; Heiskanen R.; Huotari E.; Keskitalo A.; Kylmala L.; Laitinen
M.; Laukkanen M.; Leskinen S.; Liesivuori J.; Lukkari-Kuronen L.; Merisalo
P.; Muurinen E.; Nikkanen P.; Niskanen T.; Pasanen P.; Pekkonen L.; Retsu
A.; Soppela A.; Andreu N.; Ankotche A.; Bairras C.; Boch C.; Camachon L.;
Cherchouly A.; Coudret S.; Demer C.; Gilg R.; Lemonade L.; Madec O.;
Pinotti D.; Poirier I.; Tenne N.; Vogler C.; Amman M.; Andratschke-Gentsch
B.; Beckmann H.; Bischoff S.; Bleich B.; Bueschges G.; Busch E.;
Deigentasch S.; Dietze S.; Dollinger M.; El-Bahay C.; Flehmig G.; Frenzel
I.; Geissler K.; Guerro J.; Heike B.; Holler D.; Inhoffen C.; Klein K.;
Kraehe I.; Kress P.; Krueger H.; Lenz R.; Linnebach B.; Lueck A.; Markhof
P.; Matthies K.; Meier C.; Metzler E.; Moor E.; Noll I.; Paulsen S.;
Pfeffer B.; Promnitz N.; Saljew B.; Schad S.; Schoner C.; Sellmann R.;
Tanis M.; Vogelbusch J.; Wagner E.; Winkler S.; Zenker K.; Zvork S.;
Balogh E.; Buncsikne Molnar S.; Gulyasne Gaspar E.; Herold M.; Kovacs E.;
Kozmane Paszternak A.; Maarne Nagy S.; Nagyne Zoltan A.; Nemeth Z.; Roth
T.; Rozsa I.; Szalai M.; Anuradha M.; Bawa T.; Bhaskar B.; Chalkhore S.;
Choudhary D.; Dhanalaxmi T.; Dhingra V.; Gayatri R.; Gnanasundram R.;
Gopal U.; Govindaraj S.; Indira P.; James S.; Karkuzhli K.; Koppikar V.;
Malhotra N.; Manmohan B.; Mazher A.; Menon R.; Nalini S.; Panda M.; Patel
K.; Poongothai S.; Ramanathan S.; Ramu I.; Sangeetha K.; Sankar K.;
Savitha; Seeli Abraham C.; Shrinivas K.; Sudha S.; Tripathi S.; Vaseem A.;
Yamuna A.; Banques R.; Chong J.; Courcy M.; Donnelly E.; Fauzi A.; Gately
M.; Hanlon G.; Kelly-Conroy M.; McAteer S.; McGovern G.; Meaney E.; Storey
S.; Todd M.; Aharonof-Segal M.; Aliazarov N.; Arbeli S.; Butbul E.; Chagai
E.; Confino K.; Domb L.; Dvir R.; Erez N.; Foiening O.; Frishberg A.;
Genin I.; Gertman R.; Golan L.; Grosberd A.; Hadad D.; Israeli S.;
Kaplunski Y.; Karpf D.; Katzir A.; Kivity Z.; Li L.; Livshitz L.; Nachmias
A.; Orr I.; Peer E.; Platner N.; Pritulo L.; Rojansky A.; Rosenblat T.;
Saranga H.; Schterchman G.; Shenhar S.; Shkliar T.; Stam T.; Stinmann S.;
Suliman A.; Tsirulnikov E.; Uziel K.; Weinshtock S.; Yedid-Am S.; Yuval
R.; Zuker S.; Brunella L.; Durante A.; Nada E.; Pugolotti M.; Robusto A.;
Testa M.; Toniato R.; Ha I.; Jung S.; Kim C.; Mi Ran K.; Song B.; Wi Y.;
Yang K.; You J.; Gaisute R.; Ozolina L.; Dzagajeva N.; Kasperaviciene V.;
Krikstaponiene Z.; Montviliene R.; Morkunaite K.; Piepoliene L.; Stoniene
E.; Stonkus S.; Ulpaityte I.; Arenas-Vanhorn M.; Espitia-Serrato L.;
Garcia-Munoz E.; Nunez V.; Sainz T.; Bakker H.; Danse I.; De Greef S.; De
Jong C.; De Wit M.; Didden E.; Dommerholt R.; Goddrie M.; Haazer C.;
Havenaar J.; Hendriks-Van Woerden M.; Jongenotter M.; Kort I.; Koster L.;
Kramer H.; Maarssen E.; Posthuma-Visscher M.; Reijnierse-Buitenwerf H.;
Rood P.; Swets E.; Tousain W.A.; Van Buchem-Damming G.; Van
Buijsen-Nutters A.; Van de Loo R.; Van den Hondel M.; Van den Berg A.; Van
der Knaap-van Keulen M.; Van der Zeijst M.; Van Setten-Van der Meer L.;
Von Bannisseht E.E.; Wouda Z.; Aarsland T.; Amlie L.; Andresen B.;
Bakketun A.; Bognaes A.; Botten C.; Coucheron S.; Halsne A.; Hansen H.;
Holthe T.; Husby E.; Iversen E.; Kvalvik A.; Landbakk T.; Lovseth E.; Moen
S.; Orvik E.; Ovrehus G.; Salater S.; Sorgard B.; Sorstrom A.; Tandberg
L.; Veiding B.; Vinje G.; Winge A.; Abquina G.; Patena B.; Reyes R.;
Tamondong A.; Vega A.; Vitug L.; Makuch M.; Torun A.; Adam A.; Basaraba
M.; Chira C.; Darida C.; Haica C.; Nedelcu A.; Patru D.; Patrut L.; Rau
I.; Rotaru N.; Szabo L.; Vrinceanu G.; Sovenko T.; Zatsevskaya O.;
Horynova Z.; Vankova L.; Barkhuizen M.; Barnard L.; Bekker D.; Botha D.;
Commerford A.; de Klerk A.; De Waal A.; Devchand S.; Drummond F.; Du Toit
A.; Du Toit S.; Ellis T.; Engelbrecht M.; Eramus T.; Fonda K.; Goosen A.;
Gopel E.; Govender P.; Hodge E.; Ismael F.; Jonker E.; Jonker L.; Joubert
A.; Kilian M.; Koegenlenberg N.; Lehner L.; Lingham R.; Llyod T.; Mangoeng
P.; Mapele S.; Meiring J.; Methusi P.; Mmethi M.; Mohamed K.; Moore A.;
Ndiweni H.; Parker F.; Schoneman J.; Smit M.; Steyn A.; Van Dongren J.;
Van Schalkwyk S.; Van Staden L.; van Wyngaard G.; Wolf A.; Ashbaugh R.;
Bande C.; Barquero R.; Gaspar R.; Martin E.; Megia B.; Rodriguez C.;
Seoane A.; Viaplana J.; Akesson Jacobsson I.; Andersson C.; Asperen M.;
Backlund M.; Berglund M.; Bjorck L.; Borjesson M.; Brolin G.; Danielsson
Frojd M.; Duckert A.; Eriksson K.; Fehling K.; Glaas A.; Hage C.; Hoglund
K.; Jernhed H.; Johansson K.; Johansson S.; Lidin M.; Lundell L.; Lundgren
C.; Magnusson K.; Matsson E.; Norman J.; Nystrom K.; Ojutkangas M.;
Olofsson M.; Olsson C.; Pettersson U.; Pramberg E.; Raschperger A.; Sjolin
M.; Soderlund M.; Stensgaard Nake E.; Torebo E.; Uggeldahl I.; Walldin C.;
Welin-Berger B.; Dwyer A.; Meyer-Lazzarini V.; Morello R.; Schefer M.;
Oney S.; Seker T.; Tavlayan S.; Appleby M.; Astin J.; Baker M.; Brann H.;
Brennan C.; Bryan L.; Campbell D.; Carey J.; Cox K.; Davis C.; Dyson B.;
Everdell R.; Gammon B.; Godden J.; Gray T.; Griffiths E.; Grimes Y.; Hall
D.; Hall K.; Holme A.; Howe J.; Lambley-Burke R.; Nation M.; Norcott K.;
Mitchell K.; Poxon S.; Quick C.; Shute C.; Thomas J.; Vinnell T.; Bawa S.;
Bogan C.; Fallye O.; Ginsberg J.; Gregory B.; House B.; Isonaga M.;
Keanne-Richmond P.; Kelly C.; Kimpel J.; Leiby A.; Lyons L.; McCoy B.;
Monk A.; Pelayo E.; Perron M.; Posey D.; Rehan M.; Suarez R.; Tilton L.;
Waite K.; White G.; Chacon R.; Meza Y.; Misticchio F.; Torres M.; Urbaneja
H.
Institution
(Gerstein, Yusuf) Department of Medicine, Population Health Research
Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON,
Canada
(Bosch) Population Health Research Institute and School of Rehabilitation
Science, McMaster University and Hamilton Health Sciences, Hamilton, ON,
Canada
(Dagenais) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Quebec, QC, Canada
(Diaz) Estudios Clinicos Latino America, Rosario, Argentina
(Jung) McMaster University and Hamilton Health Sciences, Hamilton, ON,
Canada
(Maggioni) Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO)
Research Center, Florence, Italy
(Pogue) Population Health Research Institute, McMaster University and
Hamilton Health Sciences, Hamilton, ON, Canada
(Probstfield) University of Washington, Seattle, United States
(Ramachandran) India Diabetes Research Foundation, Chennai, India
(Riddle) Oregon Health and Science University, Portland, United States
(Ryden) Department of Medicine, Karolinska Institute, Stockholm, Sweden
Publisher
Massachussetts Medical Society
Abstract
Background: The provision of sufficient basal insulin to normalize fasting
plasma glucose levels may reduce cardiovascular events, but such a
possibility has not been formally tested. <br/>Method(s): We randomly
assigned 12,537 people (mean age, 63.5 years) with cardiovascular risk
factors plus impaired fasting glucose, impaired glucose tolerance, or type
2 diabetes to receive insulin glargine (with a target fasting blood
glucose level of <=95 mg per deciliter [5.3 mmol per liter]) or standard
care and to receive n-3 fatty acids or placebo with the use of a 2-by-2
factorial design. The results of the comparison between insulin glargine
and standard care are reported here. The coprimary outcomes were nonfatal
myocardial infarction, nonfatal stroke, or death from cardiovascular
causes and these events plus revascularization or hospitalization for
heart failure. Microvascular outcomes, incident diabetes, hypoglycemia,
weight, and cancers were also compared between groups. <br/>Result(s): The
median follow-up was 6.2 years (interquartile range, 5.8 to 6.7). Rates of
incident cardiovascular outcomes were similar in the insulin-glargine and
standard-care groups: 2.94 and 2.85 per 100 person-years, respectively,
for the first coprimary outcome (hazard ratio, 1.02; 95% confidence
interval [CI], 0.94 to 1.11; P = 0.63) and 5.52 and 5.28 per 100
person-years, respectively, for the second coprimary outcome (hazard
ratio, 1.04; 95% CI, 0.97 to 1.11; P = 0.27). New diabetes was diagnosed
approximately 3 months after therapy was stopped among 30% versus 35% of
1456 participants without baseline diabetes (odds ratio, 0.80; 95% CI,
0.64 to 1.00; P = 0.05). Rates of severe hypoglycemia were 1.00 versus
0.31 per 100 person-years. Median weight increased by 1.6 kg in the
insulin-glargine group and fell by 0.5 kg in the standard-care group.
There was no significant difference in cancers (hazard ratio, 1.00; 95%
CI, 0.88 to 1.13; P = 0.97). <br/>Conclusion(s): When used to target
normal fasting plasma glucose levels for more than 6 years, insulin
glargine had a neutral effect on cardiovascular outcomes and cancers.
Although it reduced new-onset diabetes, insulin glargine also increased
hypoglycemia and modestly increased weight.<br/>Copyright &#xa9; 2012
Massachusetts Medical Society.

<40>
[Use Link to view the full text]
Accession Number
631132394
Title
A systematic review and meta-analysis of the effects of early mobilization
therapy in patients after cardiac surgery: A protocol for systematic
review.
Source
Medicine (United States). 99 (4) (no pagination), 2020. Article Number:
e18843. Date of Publication: 2020.
Author
Chen B.; You X.; Lin Y.; Dong D.; Xie X.; Zheng X.; Li D.; Lin W.
Institution
(Chen, You, Lin, Dong, Xie, Zheng, Li, Lin) Department of Rehabilitation,
Affiliated People's Hospital, Fujian University of Traditional Chinese
Medicine, No 602, 817 Middle Road, Fuzhou, Fujian Province 350004, China
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background:Prolonged hospitalization and immobility of critical care
patients elevates the risk of long-term physical and cognitive
impairments. However, the therapeutic effects of early mobilization have
been difficult to interpret due to variations in study populations,
interventions, and outcome measures. This systematic review and
meta-analysis aims to assess the effects of early mobilization therapy for
non-emergency cardiac surgery patients in the intensive care unit (ICU).
<br/>Method(s):The following databases will be used to search for relevant
keywords: PubMed, Embase, CINAHL, PEDro, and the Cochrane Library from
inception to September 2018 by 2 researchers independently. Randomized
controlled trials (RCTs), will be included if patients are adults (>=18
years) admitted to any ICU for cardiac surgery due to cardiovascular
disease and who are treated with experimental physiotherapy initiated in
the ICU (pre, post, or perioperative). The Review Manager 5.3 will be used
for meta-analysis and the evidence level will be assessed by using the
method for Grading of Recommendations Assessment, Development, and
Evaluation (GRADE). Continuous outcomes will be presented as the weighted
mean difference (WMD) or standardized mean difference (SMD) with 95%
confidence interval (CI), while dichotomous data will be expressed as
relative risk (RR) with 95% CI. If the included studies have existing
heterogeneity (P < 0.1), a random-effects model will be used. Otherwise,
we will calculate using a fixed effects model. <br/>Result(s):This review
will evaluate the effects of early mobilization on length of ICU and
hospital stay, physical function and adverse events in patients with
cardiac surgery patients in the ICU. <br/>Conclusion(s):This systematic
review will comprehensively provide conclusive evidence of the therapeutic
effect of early mobilization on cardiac surgery patients in the
ICU.PROSPERO Research registration identifying number:
CRD42019135338.<br/>Copyright &#xa9; 2020 the Author(s). Published by
Wolters Kluwer Health, Inc.

<41>
Accession Number
631113161
Title
Major Adverse Cardiovascular Events after 12 Months among Patients with
Acute Coronary Syndrome Receiving Loading Doses of Atorvastatin Prior to
Planned PCI.
Source
JAMA - Journal of the American Medical Association. 323 (8) (pp 787-789),
2020. Date of Publication: 25 Feb 2020.
Author
Lopes R.D.; De Barros E Silva P.G.M.; Damiani L.P.; Santos R.H.N.;
Alexander J.H.; Granger C.B.; Berwanger O.
Institution
(Lopes, Alexander, Granger) Duke Clinical Research Institute, Box 3850,
2400 Pratt St, Durham, NC 27705, United States
(De Barros E Silva) Brazilian Clinical Research Institute, Sao Paulo,
Brazil
(Damiani, Santos, Berwanger) Research Institute-Heart Hospital (HCor), Sao
Paulo, Brazil
Publisher
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)

<42>
[Use Link to view the full text]
Accession Number
631059608
Title
Is hospitalisation a risk factor for cognitive decline in the elderly?.
Source
Current Opinion in Psychiatry. 33 (2) (pp 170-177), 2020. Date of
Publication: 01 Mar 2020.
Author
Chinnappa-Quinn L.; Bennett M.; Makkar S.R.; Kochan N.A.; Crawford J.D.;
Sachdev P.S.
Institution
(Chinnappa-Quinn) School of Psychiatry, Faculty of Medicine, University of
New South Wales, Kensington, Australia
(Chinnappa-Quinn) Department of Anaesthesia, Eastern Health, Melbourne,
Australia
(Bennett) Prince of Wales Clinical School, Faculty of Medicine, University
of New South Wales, Kensington, Australia
(Bennett) Department of Anaesthesia and Hyperbaric Medicine, Prince of
Wales Hospital, Randwick, Australia
(Makkar, Kochan, Crawford, Sachdev) Centre for Healthy Brain and Ageing,
University of New South Wales, United States
(Sachdev) Neuropsychiatric Institute, Prince of Wales Hospital, Randwick,
Australia
Publisher
Lippincott Williams and Wilkins (E-mail: agents@lww.com)
Abstract
Purpose of reviewCognitive decline is frequently reported after
hospitalisation in the contexts of surgery, delirium and critical care.
The question not adequately addressed is whether all types of acute
hospitalisations increase the risk of cognitive decline. As acute
hospitalisations are common in the elderly, who are also vulnerable to
cognitive decline, this possible association is of significant
concern.Recent findingsThis review summarises cognitive outcomes from
recent observational studies investigating acute hospitalisation (emergent
and elective) in older age adults. Studies were identified from searching
Medline, Embase and PsycINFO databases and citations lists. The highest
incidence of cognitive decline has been reported following critical care
admissions and admissions complicated by delirium, although all types of
acute hospitalisations are implicated. Age is the most consistent risk
factor for cognitive decline. Several etiological and therapeutic aspects
are being investigated, particularly the measurement of inflammatory
biomarkers and treatment with anti-inflammatory medications.SummaryAcute
hospitalisation for any reason appears to increase the risk of cognitive
decline in older adults, but the cause remains elusive. Future research
must clarify the nature and modifiers of posthospitalisation cognitive
change, a priority in the face of an ageing population.<br/>Copyright
&#xa9; 2020 Lippincott Williams and Wilkins. All rights reserved.

<43>
Accession Number
631054418
Title
Ulinastatin reduces postoperative bleeding and red blood cell transfusion
in patients undergoing cardiac surgery: A PRISMA-compliant systematic
review and meta-analysis.
Source
Medicine (United States). 99 (7) (no pagination), 2020. Article Number:
e19184. Date of Publication: 2020.
Author
Yao Y.-T.; Fang N.-X.; Liu D.-H.; Li L.-H.
Institution
(Yao, Fang, Li) Department of Anesthesiology, Fuwai Hospital, National
Center for Cardiovascular Diseases, Peking Union Medical College, Chinese
Academy of Medical Sciences, Beijing, China
(Liu) Department of Clinical Laboratory, University-Town Hospital of
Chongqing Medical University, Chongqing, China
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background:Ulinastatin is a type of glycoprotein and a nonspecific
wide-spectrum protease inhibitor like antifibrinolytic agent aprotinin.
Whether Ulinastatin has similar beneficial effects on blood conservation
in cardiac surgical patients as aprotinin remains undetermined. Therefore,
a systematic review and meta-analysis were performed to evaluate the
effects of Ulinastatin on perioperative bleeding and transfusion in
patients who underwent cardiac surgery. <br/>Method(s):Electronic
databases were searched to identify all clinical trials comparing
Ulinastatin with placebo/blank on postoperative bleeding and transfusion
in patients undergoing cardiac surgery. Primary outcomes included
perioperative blood loss, blood transfusion, postoperative re-exploration
for bleeding. Secondary outcomes include perioperative hemoglobin level,
platelet counts and functions, coagulation tests, inflammatory cytokines
level, and so on. For continuous variables, treatment effects were
calculated as weighted mean difference (WMD) and 95% confidential interval
(CI). For dichotomous data, treatment effects were calculated as odds
ratio and 95% CI. Statistical significance was defined as P < .05.
<br/>Result(s):Our search yielded 21 studies including 1310 patients, and
617 patients were allocated into Ulinastatin group and 693 into Control
(placebo/blank) group. There was no significant difference in
intraoperative bleeding volume, postoperative re-exploration for bleeding
incidence, intraoperative red blood cell transfusion units, postoperative
fresh frozen plasma transfusion volumes and platelet concentrates
transfusion units between the 2 groups (all P > .05). Ulinastatin reduces
postoperative bleeding (WMD = -0.73, 95% CI: -1.17 to -0.28, P = .001) and
red blood cell (RBC) transfusion (WMD = -0.70, 95% CI: -1.26 to -0.14, P =
.01), inhibits hyperfibrinolysis as manifested by lower level of
postoperative D-dimer (WMD = -0.87, 95% CI: -1.34 to -0.39, P = .0003).
<br/>Conclusion(s):This meta-analysis has found some evidence showing that
Ulinastatin reduces postoperative bleeding and RBC transfusion in patients
undergoing cardiac surgery. However, these findings should be interpreted
rigorously. Further well-conducted trials are required to assess the
blood-saving effects and mechanisms of Ulinastatin.<br/>Copyright &#xa9;
2020 the Author(s). Published by Wolters Kluwer Health, Inc.

<44>
Accession Number
2003376600
Title
Prior Percutaneous Coronary Interventions May Be Associated With Increased
Mortality After Coronary Bypass Grafting: A Meta-Analysis.
Source
Seminars in Thoracic and Cardiovascular Surgery. 32 (1) (pp 59-74), 2020.
Date of Publication: Spring 2020.
Author
Luthra S.; Leiva-Juarez M.M.; Shine B.; Al-Attar N.; Ohri S.; Taggart D.P.
Institution
(Luthra, Ohri) Southampton University Hospitals, Southampton, United
Kingdom
(Leiva-Juarez) Department of Surgery, Brookdale University Hospital and
Medical Center, Brooklyn, NY, United States
(Shine, Taggart) University of Oxford, Oxford, United Kingdom
(Al-Attar) Golden Jubilee National Hospital, Glasgow, United Kingdom
Publisher
W.B. Saunders
Abstract
There is conflicting evidence for adverse outcomes after coronary artery
bypass surgery (CABG) with prior percutaneous intervention (PCI). A
literature search was performed from 1998 to 2017 and articles with
primary or secondary outcomes of survival, major adverse cardiovascular
events (MACE), and myocardial infarction in CABG patients with prior PCI
were included. Forest plots were generated from odds ratios for survival,
MACE, and myocardial infarction for unmatched and propensity-matched data.
Heterogeneity between studies was assessed for all outcomes using
I². Funnel plots were generated for early survival, survival at
5 years, survival at >5 years, and MACE. Thirty-one studies were included
over 18 years with 194,544 patients without PCI prior to CABG and 23,519
patients (12.09%) with prior PCI. Prior PCI did not adversely affect
survival among the included studies (inverse rate ratio: 1.12, 95%
confidence interval: 0.98-1.27, P = 0.110. MACE was significantly worse
for those with prior PCI (odds ratio: 1.26, confidence interval:
1.02-1.55, P = 0.03). The relative risk of mortality associated with prior
PCI has decreased significantly over the last 2 decades. Studies with
higher percentage of prior PCI patients had higher relative mortalities.
There was significant heterogeneity between studies for the treatment
effects. PCI prior to CABG in recent times does not adversely affect
survival despite adverse early and late MACE rates. However, high
institutional rates of prior PCI may be associated with increasing
mortality after CABG.<br/>Copyright &#xa9; 2019 Elsevier Inc.

<45>
Accession Number
2002303566
Title
Feasibility and acceptability of continuous postoperative pericardial
flushing for blood loss reduction in patients undergoing coronary artery
bypass grafting.
Source
General Thoracic and Cardiovascular Surgery. 68 (3) (pp 219-226), 2020.
Date of Publication: 01 Mar 2020.
Author
Kara H.; Erden T.
Institution
(Kara) Department of Cardiovascular Surgery, Giresun Ada Hospital,
Giresun, Turkey
(Erden) Department of Cardiovascular Surgery, Faculty of Medicine,
Karadeniz Technical University, Trabzon, Turkey
Publisher
Springer
Abstract
Introduction: Postoperative bleeding requires blood transfusion and
surgical re-exploration that can affect the short- and long-term
postoperative outcomes. Interventions that can be used in the
postoperative period to reduce blood loss should be developed. Continuous
postoperative pericardial flushing (CPPF) with an irrigation solution may
reduce blood loss by preventing the accumulation of clots. This study
examined the feasibility and acceptability of CPPF for reducing bleeding
after coronary artery bypass surgery. <br/>Method(s): This pilot study
adopted a prospective and group comparison design. Between January and
April 2018, 42 patients who underwent isolated coronary artery bypass
surgery received CPPF from sternal closure up to 8 h postoperative. The
mean actual blood loss in the CPPF group was compared to the mean of
retrospectively group (n = 58). In the CPPF group, an extra infusion
catheter was inserted through one of the tube incision holes and an
irrigation solution (0.9% NaCl at 38 degreeC) was delivered to the
pericardial cavity by using a volumetric pump. Safety aspects, feasibility
issues, and complications were documented. The primary outcome was blood
loss, and it was assessed 18 h after the surgery. <br/>Result(s): CPPF was
successfully completed in 40 patients (95.24%). Method-related
complications were not observed. Feasibility was good in this experimental
setting. Blood loss was lower in the CPPF group (257.24 mL) than non-CPPF
group (p < 0.001). <br/>Conclusion(s): CPPF after coronary artery bypass
grafting surgery is safe, effective, feasible, and acceptable. However,
standardized randomized clinical trials are necessary to draw definitive
conclusions.<br/>Copyright &#xa9; 2019, The Japanese Association for
Thoracic Surgery.

<46>
Accession Number
2002085697
Title
Thyroid Hormone (Triiodothyronine) Therapy in Children After Congenital
Heart Surgery: A Meta-Analysis.
Source
Seminars in Thoracic and Cardiovascular Surgery. 32 (1) (pp 87-95), 2020.
Date of Publication: Spring 2020.
Author
Flores S.; Loomba R.S.; Checchia P.A.; Graham E.M.; Bronicki R.A.
Institution
(Flores, Checchia, Bronicki) Section of Critical Care and Cardiology,
Department of Pediatrics, Texas Children's Hospital, Baylor College of
Medicine, Houston, TX, United States
(Loomba) Division of Cardiology, Advocate Children's Hospital, Oak Lawn,
IL, United States
(Graham) Division of Cardiology, Department of Pediatrics, Medical
University of South Carolina, Charleston, SC, United States
Publisher
W.B. Saunders
Abstract
Thyroid hormone modifies metabolic, immune and cardiovascular functions
and has been administered perioperatively to treat a relative reduction of
thyroid function in children following cardiopulmonary bypass (CPB) for
correction of congenital heart disease. However, it remains unclear
whether its use is associated with improved outcomes. We performed a
meta-analysis of studies that evaluated the impact of thyroid hormone
supplementation on clinical outcomes in children undergoing repair of
congenital heart disease using CPB. A systematic review of published
trials was conducted to identify studies of children randomized to thyroid
hormone supplementation or placebo undergoing congenital heart surgery. A
meta-analysis was then conducted to determine the clinical impact of
thyroid hormone replacement on cardiac function and postoperative
characteristics. The following outcomes were included for the study:
duration of mechanical ventilation, duration of intensive care unit (ICU)
stay, duration of postoperative hospital stay, inotrope score, cardiac
index at 24 hours postoperatively, and inpatient mortality. A total of 9
studies with 711 patients were included in the analyses. All included
studies were prospective and patients were randomized to either thyroid
hormone or placebo. There was wide variation in thyroid hormone dosing,
ranging from 0.4 mug/kg up to 5 mug/kg over a 24-hour period, and duration
of therapy, ranging from a single dose after cessation of CPB to continued
thyroid hormone for the duration of the ICU stay. There was a significant
difference in the mean inotrope score between the 2 groups of -1.249 (95%
confidence interval -1.570 to -0.929, P < 0.001), with the inotrope score
being significantly lower in the thyroid group. There was no difference in
duration of mechanical ventilation, duration of ICU stay, duration of
hospital stay, cardiac index, and mortality between groups. In this
meta-analysis, routine thyroid hormone replacement with approximately 1-5
mug/kg administered over 24 hours does not significantly alter the
postoperative course in children following CPB. However, given a
clinically small but significant difference in respect to lower inotrope
score and shorter duration of ICU and hospital stays with higher thyroid
replacement additional studies are warranted.<br/>Copyright &#xa9; 2019
Elsevier Inc.

<47>
Accession Number
2003909432
Title
Liraglutide for perioperative management of hyperglycaemia in cardiac
surgery patients: a multicentre randomized superiority trial.
Source
Diabetes, Obesity and Metabolism. 22 (4) (pp 557-565), 2020. Date of
Publication: 01 Apr 2020.
Author
Hulst A.H.; Visscher M.J.; Godfried M.B.; Thiel B.; Gerritse B.M.; Scohy
T.V.; Bouwman R.A.; Willemsen M.G.A.; Hollmann M.W.; Preckel B.; DeVries
J.H.; Hermanides J.
Institution
(Hulst, Visscher, Hollmann, Preckel, Hermanides) Department of
Anesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam,
Netherlands
(Hulst, Godfried, Thiel) Department of Anesthesiology, OLVG, Amsterdam,
Netherlands
(Hulst, Gerritse, Scohy) Department of Anesthesiology, Amphia Hospital,
Breda, Netherlands
(Bouwman, Willemsen) Department of Anesthesiology, Catharina Hospitals,
Eindhoven, Netherlands
(DeVries) Department of Endocrinology, Amsterdam UMC, University of
Amsterdam, Amsterdam, Netherlands
Publisher
Blackwell Publishing Ltd
Abstract
Aims: Most cardiac surgery patients, with or without diabetes, develop
perioperative hyperglycaemia, for which intravenous insulin is the only
therapeutic option. This is labour-intensive and carries a risk of
hypoglycaemia. We hypothesized that preoperative administration of the
glucagon-like peptide-1 receptor agonist liraglutide reduces the number of
patients requiring insulin for glycaemic control during cardiac surgery.
<br/>Material(s) and Method(s): In this randomized, blinded,
placebo-controlled, parallel-group, balanced (1:1), multicentre
randomized, superiority trial, adult patients undergoing cardiac surgery
in four Dutch tertiary hospitals were randomized to receive 0.6 mg
subcutaneous liraglutide on the evening before surgery and 1.2 mg after
induction of anaesthesia or matching placebo. Blood glucose was measured
hourly and controlled using an insulin-bolus algorithm. The primary
outcome was insulin administration for blood glucose >8.0 mmol/L in the
operating theatre. Research pharmacists used centralized, stratified,
variable-block, randomization software. Patients, care providers and study
personnel were blinded to treatment allocation. <br/>Result(s): Between
June 2017 and August 2018, 278 patients were randomized to liraglutide
(139) or placebo (139). All patients receiving at least one study drug
injection were included in the intention-to-treat analyses (129 in the
liraglutide group, 132 in the placebo group). In the liraglutide group, 55
(43%) patients required additional insulin compared with 80 (61%) in the
placebo group and absolute difference 18% (95% confidence interval
5.9-30.0, P = 0.003). Dose and number of insulin injections and mean blood
glucose were all significantly lower in the liraglutide group. We observed
no difference in the incidence of hypoglycaemia, nausea and vomiting,
mortality or postoperative complications. <br/>Conclusion(s): Preoperative
liraglutide, compared with placebo, reduces insulin requirements while
improving perioperative glycaemic control during cardiac
surgery.<br/>Copyright &#xa9; 2019 The Authors. Diabetes, Obesity and
Metabolism published by John Wiley & Sons Ltd.

<48>
Accession Number
2004254150
Title
Is nitric oxide the forgotten nephroprotective treatment during cardiac
surgery?.
Source
Annals of Intensive Care. 10 (1) (no pagination), 2020. Article Number:
22. Date of Publication: 01 Dec 2020.
Author
Khorashadi M.; Bokoch M.P.; Legrand M.
Institution
(Khorashadi, Bokoch, Legrand) Department of Anesthesiology and
Peri-Operative Medicine, University of California - UCSF Medical Center,
500 Parnassus Ave, San Francisco, CA 94143, United States
(Legrand) Institute National de la Sante et de la Recherche Medicale
(INSERM) 942, Lariboisiere Hospital & F-CRIN INI-CRCT, Paris, France
Publisher
Springer

<49>
Accession Number
2004130126
Title
Clinical agreement and interchangeability of TEG5000 and TEG6s during
cardiac surgery.
Source
Anaesthesia and Intensive Care. 48 (1) (pp 43-52), 2020. Date of
Publication: 01 Jan 2020.
Author
Wong Q.; Byrne K.P.; Robinson S.C.
Institution
(Wong, Byrne, Robinson) Department of Anaesthesia and Pain Medicine,
Waikato District Health Board, Hamilton, New Zealand
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
TEG6s is a new device introduced by the Haemonetics Corporation and
designed to provide the same information as TEG 5000 (Haemonetics
Corporation, Braintree, MA, USA) but with much greater ease of use. We
tested whether using citrated TEG6s gave reaction time, maximum amplitude
and percentage of clot that had lysed at 30 minutes values similar to a
non-citrated TEG5000, to allow clinical interchangeability using our
current thrombelastography management algorithm for cardiac surgery. We
also examined the agreement between the alpha-angle and functional
fibrinogen maximum amplitude in our cardiac surgical patients. In total,
243 paired arterial blood samples in 99 patients were tested, using
TEG5000 (non-citrated) and TEG6s (citrated) after induction of anaesthesia
(prior to heparin administration), following protamine administration at
the end of the cardiac bypass and whenever a TEG5000 was requested after
this by the attending anaesthetist. Bland-Altman plots and Lin's
concordance coefficient were used to compare agreement whereas modified
Bland-Altman plots and McNemar's test were used to illustrate the
differences in management recommendations between the two
thrombelastography devices. All 243 samples were compared for reaction
time and alpha-angle; 239 samples were compared for maximum amplitude; 136
samples were compared for the percentage of clot that had lysed at 30
minutes; 16 samples were compared for functional fibrinogen maximum
amplitude. Lin's concordance coefficient for these parameters was:
reaction time 0.63, alpha-angle 0.39, maximum amplitude 0.5, percentage of
clot that had lysed at 30 minutes 0.09 and functional fibrinogen maximum
amplitude 0.31. Differences between the two devices became more marked at
more abnormal values. Significant differences in median values, suggesting
a fixed bias, were found for maximum amplitude and functional fibrinogen
maximum amplitude. Differences in treatment recommendation could only be
calculated for reaction time and maximum amplitude. Maximum amplitude was
found to have a significant difference in treatment recommendation between
the two devices using our current thrombelastography management algorithm
for cardiac surgery with TEG6s recommending treatment in 11.5% more
patients than TEG5000. Using the TEG6s with our current TEG5000-based
thrombelastography management algorithm for cardiac surgery would result
in a change in treatment recommendation in at least 10% of our cardiac
surgical patients. Agreement between the two thrombelastography devices
appears to decrease with increasing patient coagulopathy. New algorithms
will need to be developed and tested to validate TEG6s for cardiac
surgical patients in our institution.<br/>Copyright &#xa9; The Author(s)
2020.

<50>
Accession Number
2005118652
Title
Nonculprit Lesion Myocardial Infarction Following Percutaneous Coronary
Intervention in Patients With Acute Coronary Syndrome.
Source
Journal of the American College of Cardiology. 75 (10) (pp 1095-1106),
2020. Date of Publication: 17 March 2020.
Author
Scirica B.M.; Bergmark B.A.; Morrow D.A.; Antman E.M.; Bonaca M.P.; Murphy
S.A.; Sabatine M.S.; Braunwald E.; Wiviott S.D.
Institution
(Scirica, Bergmark, Morrow, Antman, Bonaca, Murphy, Sabatine, Braunwald,
Wiviott) TIMI Study Group, Cardiovascular Division, Department of
Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston,
MA, United States
(Bonaca) CPC Clinical Research, University of Colorado School of Medicine,
Denver, Colorado, United States
Publisher
Elsevier USA
Abstract
Background: Recent emphasis on reduced duration and/or intensity of
antiplatelet therapy following percutaneous coronary intervention (PCI)
irrespective of indication for PCI may fail to account for the substantial
risk of subsequent nontarget lesion events in acute coronary syndrome
(ACS) patients. <br/>Objective(s): The authors sought to examine the
effect of more potent antiplatelet therapy on the basis of the timing and
etiology of recurrent myocardial infarction (MI) or cardiovascular death
following PCI for ACS. <br/>Method(s): In the TRITON-TIMI 38 study (Trial
to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet
Inhibition With Prasugrel-Thrombolysis In Myocardial Infarction 38), which
randomized patients to prasugrel or clopidogrel, 12,844 patients with ACS
received at least 1 stent. MI and cardiovascular death were categorized
as: 1) procedural (related to revascularization); 2) definite or probable
stent thrombosis (ST); or 3) spontaneous (non-ST or
non-procedure-related). Median follow-up was 14.5 months. <br/>Result(s):
Among the first events occurring within 30 days, 584 (69.0%) were
procedural, 126 (14.9%) ST-related, and 136 (16.1%) spontaneous. After 30
days, 22 (4.7%) were procedural, 63 (13.5%) were ST-related, and 383
(81.8%) spontaneous. Prasugrel significantly reduced the incidence of MI
or cardiovascular death for ST-related (1.0% vs. 2.1%; p < 0.001) and
spontaneous events (3.9% vs. 4.8%; p = 0.012), with a directionally
consistent numerical reduction for procedural events (4.4% vs. 5.1%; p =
0.078). Prasugrel increased spontaneous, but not procedural, major
bleeding. <br/>Conclusion(s): Long-term potent antithrombotic therapy
reduces de novo (spontaneous) atherothrombotic events in addition to
preventing complications associated with stenting of the culprit lesion
following ACS. In patients undergoing PCI for ACS, spontaneous events
predominate after 30 days, with the later-phase cardiovascular benefit of
potent dual antiplatelet therapy driven largely by reducing de novo
atherothrombotic ischemic events. (Comparison of Prasugrel [CS-747] and
Clopidogrel in Acute Coronary Syndrome Subjects Who Are to Undergo
Percutaneous Coronary Intervention; NCT00097591)<br/>Copyright &#xa9; 2020
American College of Cardiology Foundation

<51>
Accession Number
2004361795
Title
Disagreement Between Randomized and Observational Evidence on the Use of
Bilateral Internal Thoracic Artery Grafting: A Meta-Analytic Approach.
Source
Journal of the American Heart Association. 8 (23) (no pagination), 2019.
Article Number: e014638. Date of Publication: 03 Dec 2019.
Author
Gaudino M.; Rahouma M.; Hameed I.; Khan F.M.; Taggart D.P.; Flather M.;
Biondi-Zoccai G.; Fremes S.E.
Institution
(Gaudino, Rahouma, Hameed, Khan) Department of Cardiothoracic Surgery,
Weill Cornell Medicine, New York City, NY, United States
(Taggart) Nuffield Department of Surgical Sciences, University of Oxford,
United Kingdom
(Flather) University of East Anglia, Norwich, United Kingdom
(Biondi-Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Napoli, Italy
(Fremes) Schulich Heart Centre, Division of Cardiac Surgery, Department of
Surgery, Sunnybrook Health Sciences Centre, University of Toronto, ON,
Canada
Publisher
American Heart Association Inc.
Abstract
Background: The ART (Arterial Revascularization Trial) showed no
difference in survival at 10 years between patients assigned to the single
versus bilateral internal thoracic artery grafting strategies. This
finding is in contrast with the results of most observational studies,
where the use of 2 internal thoracic arteries has been associated with
improved survival. <br/>Methods and Results: We selected
propensity-matched studies from the most comprehensive observational
meta-analysis on the long-term outcomes of patients receiving 1 versus 2
internal thoracic arteries. Individual participant survival data from each
study and the ART were reconstructed using an iterative algorithm that was
applied to solve the Kaplan-Meier equations. The reconstructed individual
participant survival data were aggregated to obtain combined survival
curves and Cox regression hazard ratios with 95% CIs. Individual
participant survival data were obtained from 14 matched observational
studies (24 123 patients) and the ART. The 10-year survival of the control
group of ART was significantly higher than that of the matched
observational studies (hazard ratio, 0.86; 95% CI, 0.80-0.93). The 10-year
survival of the experimental group of ART was significantly lower than
that of the bilateral internal thoracic artery group of the observational
studies (hazard ratio, 1.11; 95% CI, 1.03-1.20). <br/>Conclusion(s): Both
the improved outcome of the control arm and the lower beneficial effect of
the intervention had played a role in the difference between observational
evidence and ART.<br/>Copyright &#xa9; 2019 The Authors. Published on
behalf of the American Heart Association, Inc., by Wiley.

<52>
Accession Number
2004361545
Title
Five-Year Outcomes in Patients With Diabetes Mellitus Treated With
Biodegradable Polymer Sirolimus-Eluting Stents Versus Durable Polymer
Everolimus-Eluting Stents.
Source
Journal of the American Heart Association. 8 (22) (no pagination), 2019.
Article Number: e013607. Date of Publication: 19 Nov 2019.
Author
Iglesias J.F.; Heg D.; Roffi M.; Tuller D.; Lanz J.; Rigamonti F.; Muller
O.; Moarof I.; Cook S.; Weilenmann D.; Kaiser C.; Cuculi F.; Valgimigli
M.; Juni P.; Windecker S.; Pilgrim T.
Institution
(Iglesias, Roffi, Rigamonti) Division of Cardiology, Geneva University
Hospitals, Geneva, Switzerland
(Heg) Institute of Social and Preventive Medicine and Clinical Trials
Unit, Bern University Hospital, Bern, Switzerland
(Tuller) Department of Cardiology, Triemlispital, Zurich, Switzerland
(Lanz, Valgimigli, Windecker, Pilgrim) Department of Cardiology, Bern
University Hospital, Bern, Switzerland
(Muller) Department of Cardiology, Lausanne University Hospital, Lausanne,
Switzerland
(Moarof) Department of Cardiology, Kantonsspital Aarau, Switzerland
(Cook) Department of Cardiology, University and Hospital Fribourg,
Switzerland
(Weilenmann) Department of Cardiology, Kantonsspital St Gallen,
Switzerland
(Kaiser) Department of Cardiology, Basel University Hospital, Basel,
Switzerland
(Cuculi) Department of Cardiology, Kantonsspital, Luzern, Switzerland
(Juni) Department of Medicine and Institute of Health Policy, Management
and Evaluation, Applied Health Research Centre, Li Ka Shing Knowledge
Institute of St Michael's Hospital, University of Toronto, Canada
Publisher
American Heart Association Inc.
Abstract
Background: The choice of optimal drug-eluting stent therapy for patients
with diabetes mellitus (DM) undergoing percutaneous coronary intervention
remains uncertain. We aimed to assess the long-term clinical outcomes
after percutaneous coronary intervention with biodegradable polymer
sirolimus-eluting stents (BP-SES) versus durable polymer
everolimus-eluting stents (DP-EES) in patients with DM. <br/>Methods and
Results: In a prespecified subgroup analysis of the BIOSCIENCE (Ultrathin
Strut Biodegradable Polymer Sirolimus-Eluting Stent Versus Durable Polymer
Everolimus-Eluting Stent for Percutaneous Coronary Revascularization)
trial (NCT01443104), patients randomly assigned to ultrathin-strut BP-SES
or thin-strut DP-EES were stratified according to diabetic status. The
primary end point was target lesion failure, a composite of cardiac death,
target vessel myocardial infarction, and clinically indicated target
lesion revascularization, at 5 years. Among 2119 patients, 486 (22.9%)
presented with DM. Compared with individuals without DM, patients with DM
were older and had a greater baseline cardiac risk profile. In patients
with DM, target lesion failure at 5 years occurred in 74 patients
(cumulative incidence, 31.0%) treated with BP-SES and 57 patients (25.8%)
treated with DP-EES (risk ratio, 1.23; 95% CI, 0.87-1.73 [P=0.24]). In
individuals without DM, target lesion failure at 5 years occurred in 124
patients (16.8%) treated with BP-SES and 132 patients (16.8%) treated with
DP-EES (risk ratio, 0.98; 95% CI, 0.77-1.26 [P=0.90; P for
interaction=0.31]). Cumulative 5-year incidence rates of cardiac death,
target vessel myocardial infarction, clinically indicated target lesion
revascularization, and definite stent thrombosis were similar among
patients with DM treated with BP-SES or DP-EES. There was no interaction
between diabetic status and treatment effect of BP-SES versus DP-EES.
<br/>Conclusion(s): In a prespecified subgroup analysis of the BIOSCIENCE
trial, we found no difference in clinical outcomes throughout 5 years
between patients with DM treated with ultrathin-strut BP-SES or thin-strut
DP-EES. Clinical Trial Registration: URL: https://www.clinicaltrials.gov/.
Unique identifier: NCT01443104.<br/>Copyright &#xa9; 2019 The Authors.
Published on behalf of the American Heart Association, Inc., by Wiley.

<53>
Accession Number
2004361381
Title
Net Clinical Benefit of Left Atrial Appendage Closure Versus Warfarin in
Patients With Atrial Fibrillation: A Pooled Analysis of the Randomized
PROTECT-AF and PREVAIL Studies.
Source
Journal of the American Heart Association. 8 (23) (no pagination), 2019.
Article Number: e013525. Date of Publication: 03 Dec 2019.
Author
Brouwer T.F.; Whang W.; Kuroki K.; Halperin J.L.; Reddy V.Y.
Institution
(Brouwer, Whang, Kuroki, Halperin, Reddy) Mount Sinai Heart, The Zena and
Michael A. Wiener Cardiovascular Institute, and The Marie-Josee and Henry
R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Brouwer) Department of Clinical and Experimental Cardiology, Amsterdam
Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart
Center, Amsterdam, Netherlands
Publisher
American Heart Association Inc.
Abstract
Background: The PROTECT-AF (Watchman Left Atrial Appendage Closure
Technology for Embolic Protection in Patients With Atrial Fibrillation)
and PREVAIL (Evaluation of the Watchman LAA Closure Device in Patients
With Atrial Fibrillation Versus Long Term Warfarin Therapy) trials
demonstrated noninferiority of left atrial appendage closure (LAAC) to
warfarin for the composite end point of stroke, systemic embolism, or
cardiovascular death. This study aims to quantify the net clinical benefit
(NCB) of LAAC versus warfarin, accounting for differences in clinical
impact of different event types. <br/>Methods and Results: We performed a
post hoc analysis of the PROTECT-AF and PREVAIL trials, which randomized
atrial fibrillation patients to LAAC or warfarin in a 2:1 fashion. The
trials enrolled patients in the United States and Europe between 2005 and
2012 with paroxysmal, persistent, or permanent atrial fibrillation and
CHADS<inf>2</inf> risk scores >=1. Relative to an index weight for death
(1.0), events were assigned weights based on their disabling effect: (1)
stroke event weights were based on modified Rankin scores in the base case
analyses, and (2) major bleed (0.05) and pericardial effusion (0.05). NCB
was calculated as the sum of weight-adjusted events per 100 patient-years.
Among 1114 randomized subjects, the NCB of LAAC was 1.42% per year (95% CI
0.01-2.82, P=0.04) and a relative risk of 0.74 (95% CI 0.56-1.00). NCB
point estimates favored warfarin early in follow-up, but trended in favor
of LAAC after 1 to 2 years. The benefit of LAAC was preserved across
subgroups, with particular benefit observed in the subgroup of prior
stroke and without diabetes mellitus. <br/>Conclusion(s): This analysis
demonstrates long-term NCB of LAAC with Watchman over warfarin therapy, as
the upfront risk of periprocedural events is counterbalanced over time by
reduced bleeding events and mortality. Clinical Trial Registration: UR:
http://www.clinicaltrials.gov. Unique identifiers: NCT01182441 and
NCT00129545.<br/>Copyright &#xa9; 2019 The Authors. Published on behalf of
the American Heart Association, Inc., by Wiley.

<54>
Accession Number
629403781
Title
Impact of Lung Expansion Therapy Using Positive End-Expiratory Pressure in
Mechanically Ventilated Patients Submitted to Coronary Artery Bypass
Grafting.
Source
Brazilian journal of cardiovascular surgery. 34 (6) (pp 699-703), 2020.
Date of Publication: 01 Jan 2020.
Author
Cordeiro A.L.L.; Carvalho S.; Leite M.C.; Vila-Flor A.; Freitas B.; Sousa
L.; Oliveira Q.; Guimaraes A.R.
Institution
(Cordeiro) Escola Bahiana de Medicina e Saude Publica (Bahiana) Unidade
Academica Brotas Salvador Bahia Brazil Escola Bahiana de Medicina e Saude
Publica (Bahiana) - Unidade Academica Brotas, Salvador, Bahia, Brazil
(Cordeiro) Faculdade Nobre Feira de Santana Bahia Brazil Faculdade Nobre
(FAN), Feira de Santana, Bahia, Brazil
(Carvalho, Leite, Vila-Flor, Freitas, Sousa, Oliveira, Guimaraes)
Instituto Nobre de Cardiologia Feira de Santana Bahia Brazil Instituto
Nobre de Cardiologia (INCARDIO), Feira de Santana, Bahia, Brazil
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To evaluate the impact of different levels of positive
end-expiratory pressure (PEEP) on gas exchange in patients undergoing
coronary artery bypass grafting (CABG). <br/>METHOD(S): A randomized
clinical trial was conducted with patients undergoing CABG surgery.
Patients were randomized into three groups: Group 10, PEEP of 10 cmH2O;
Group 12, PEEP of 12 cmH2O; and Group 15, PEEP of 15 cmH2O. After the
randomization, all patients underwent gas analysis at three moments: (1)
before lung expansion therapy (LET); (2) 30 minutes after LET; and (3) one
hour after extubation. <br/>RESULT(S): Sixty-six patients were studied, of
which 61.7% were men, with mean age of 64 +/- 8.9 years. Patients
allocated to Group 15 showed a significant improvement in gas exchange
comparing pre- and post-expansion values (239+/-21 vs. 301+/-19, P<0,001)
and the increase was maintained after extubation (278+/-26). Despite the
use of high levels of PEEP, no significant hemodynamic change was
evidenced. <br/>CONCLUSION(S): It is concluded that high levels of PEEP
(15 cmH2O) are beneficial for the improvement of gas exchange in patients
undergoing CABG.

<55>
Accession Number
628520090
Title
Neuroprotective Effect of Low Mean Arterial Pressure on Postoperative
Cognitive Deficit Attenuated by Prolonged Coronary Artery Bypass Time: A
Meta-Analysis.
Source
Brazilian journal of cardiovascular surgery. 34 (6) (pp 739-748), 2020.
Date of Publication: 01 Jan 2020.
Author
Kiabi F.H.; Soleimani A.; Habibi M.R.
Institution
(Kiabi, Soleimani, Habibi) Mazandaran University of Medical Sciences
Faculty of Medicine Department of Anesthesiology Sari Iran Department of
Anesthesiology, Faculty of Medicine, Mazandaran University of Medical
Sciences, Sari, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
INTRODUCTION: The true influence of the low mean arterial pressure (low
MAP) during coronary artery bypass grafting (CABG) on the development of
postoperative cognitive deficit (POCD) remains controversial. We aimed to
perform a meta-analysis and meta-regression to determine the effect of low
MAP on POCD, as well as moderator variables between low MAP and POCD.
<br/>METHOD(S): The Web of Science, PubMed database, Scopus and the
Cochrane Library database (up to June 2018) were searched and retrieved
articles systematically reviewed. Only randomized controlled trials (RCTs)
comparing maintenance of low MAP (<80 mmHg) and high MAP (>80 mmHg) during
cardiopulmonary bypass (CPB) were included in our final review.
Statistical analysis of the risk ratio (RR) and corresponding 95%
confidence interval (CI) was used to report the overall effect. The
overall effect and meta-regression analysis were done using
Mantel-Haenszel risk ratio (MHRR) and the corresponding 95% confidence
interval (CI). <br/>RESULT(S): A total of 731 patients in three RCTs were
included in this study. POCD occurred in 6.4% of all cases. Maintenance of
low MAP did not reduce the occurrence of POCD (MHRR 1.012 [95% CI
0.277-3.688]; Z=0.018; P=0.986; I2=66%). Shorter CPB time reduced the
occurrence of POCD regardless of group assignment (MH log risk ratio
-0.519 [95% CI -0.949 - -0.089]; Z= -2.367; P=0.017). <br/>CONCLUSION(S):
POCD is a common event among CABG patients. The neuroprotective effect of
low MAP on POCD was attenuated by the prolonged CPB time.

<56>
Accession Number
628325494
Title
Outcomes of Chronic Total Occlusions in Coronary Arteries According to
Three Therapeutic Strategies: A Meta-analysis with 6985 Patients from 8
Published Observational Studies.
Source
Brazilian journal of cardiovascular surgery. 34 (6) (pp 645-652), 2020.
Date of Publication: 01 Jan 2020.
Author
Zheng Y.-Y.; Gao Y.; Chen Y.; Wu T.-T.; Ma Y.-T.; Zhang J.-Y.; Xie X.
Institution
(Zheng, Zhang) Zhengzhou University First Affiliated Hospital Department
of Cardiology Zhengzhou People's Republic of China Department of
Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou,
China
(Gao) Xinjiang Medical University First Affiliated Hospital Department of
Cadre Ward Urumqi Xinjiang People's Republic of China Department of Cadre
Ward, First Affiliated Hospital of Xinjiang Medical University, Urumqi,
Xinjiang, China
(Chen, Wu, Ma, Xie) Xinjiang Medical University First Affiliated Hospital
Heart Center Urumqi Xinjiang People's Republic of China Heart Center,
First Affiliated Hospital of Xinjiang Medical University, Urumqi,
Xinjiang, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To perform a systematic review and meta-analysis of studies
comparing coronary artery bypass grafting (CABG), percutaneous coronary
intervention (PCI), and medical treatment (MT) in patients with chronic
total occlusions (CTOs). <br/>METHOD(S): We identified eligible
observational studies published in the China National Knowledge
Infrastructure database, PubMed, Excerpta Medica database, Google Scholar,
Cochrane Library, Web of Science, and "Clinical trials" registration from
1999 to October 2018. Main outcome measures were all-cause mortality,
cardiac death, major adverse cardiac events (MACEs), and myocardial
infarction (MI). <br/>RESULT(S): There were eight observational studies
including 6985 patients. Patients' mean age was 64.4 years. Mean follow-up
time was 4.3 years. Comparing with MT (2958 patients), PCI (3157 patients)
presented decreased all-cause mortality (odd ratio [OR]: 0.46, 95%
confidence interval [CI]: 0.36-0.60; P<0.001), cardiac death (OR: 0.40,
95% CI: 0.31-0.52; P<0.001), MACE (OR: 0.55, 95% CI: 0.43-0.71; P<0.001),
and MI (OR: 0.40, 95% CI: 0.26-0.62; P<0.001). Comparing with MT, CABG
(613 patients) presented lower all-cause mortality (OR: 0.50, 95% CI:
0.36-0.69; P<0.001) and MACE (OR: 0.50, 95% CI: 0.26-0.96; P=0.04), but
not lower MI (OR: 0.23, 95% CI: 0.03-1.54; P=0.13) and cardiac death (OR:
0.83, 95% CI: 0.51-1.35). Comparing with CABG, PCI did not present
decreased risk for those outcomes. <br/>CONCLUSION(S): PCI or CABG was
associated with better clinical outcome in patients with CTO than MT. PCI
is not better than CABG in decreasing mortality, MI, cardiac death, and
MACE in coronary CTO patients.

<57>
Accession Number
631192877
Title
Combined non-intubated anaesthesia and paravertebral nerve block in
comparison with intubated anaesthesia in children undergoing
video-assisted thoracic surgery.
Source
Acta anaesthesiologica Scandinavica. (no pagination), 2020. Date of
Publication: 07 Mar 2020.
Author
Wei W.; Fan Y.; Liu W.; Zhao T.; Tian H.; Xu Y.; Tan Y.; Song X.; Ma D.
Institution
(Wei, Fan, Zhao, Tian, Xu, Tan, Song) Department of Anaesthesiology,
Guangzhou Women and Children's Medical Center, Guangzhou Medical
University, Guangzhou, China
(Liu) Department of Thoracic Surgery, Guangzhou Women and Children's
Medical Center, Guangzhou Medical University, Guangzhou, China
(Ma) Pain Medicine and Intensive Care, Department of Surgery and Cancer,
Faculty of Medicine, Imperial College London, Chelsea and Westminster
Hospital, London, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: This study is to investigate if non-intubated anaesthesia
combined with paravertebral nerve block (PVNB) can enhance recovery in
children undergoing video-assisted thoracic surgery (VATS).
<br/>METHOD(S): A randomized controlled trial including 60 patients aged 3
to 8 years old who underwent elective VATS was performed. They were
randomly assigned to receive non-intubated anaesthesia combined with PVNB
or general anaesthesia with tracheal intubation (1:1 ratio). The primary
outcome was the length of postoperative in-hospital stay. The secondary
outcomes included emergence time, the incidence of emergence delirium,
time to first feeding, time to first out-of-bed activity, pain score and
in-hospital complications. <br/>RESULT(S): The non-intubated group had
shorter postoperative in-hospital stay than the control group (4 days
[IQR, 4 - 6] vs 5 days [IQR, 5 - 8], 95% CI 0 - 2; P = 0.013). When
compared to the control group, the incidence of emergence delirium (odds
ratio [OR] 3.39, 95% CI 1.01 - 11.41; P = 0.043), emergence time, duration
in the PACU, time to first eating food, first out-of-bed activity, pain
score and consumption of sufentanil (at 6 and 12 hours after surgery) were
decreased in the intervention group. In contrast, the incidence of airway
complications was higher in the control than the intervention group (27.6%
vs. 6.9%, P = 0.037). There was no statistical significance in the
occurrence of PONV, pneumothorax and other complications between two
groups. <br/>CONCLUSION(S): Non-intubated anaesthesia combined with PVNB
enhances recovery in paediatric patients for video-assisted thoracic
surgery although further multi-centre study is needed.<br/>Copyright This
article is protected by copyright. All rights reserved.

<58>
Accession Number
631165456
Title
Anxiety Administrated by Dexmedetomidine to Prevent New-Onset of
Postoperative Atrial Fibrillation in Patients Undergoing Off-Pump Coronary
Artery Bypass Graft.
Source
International heart journal. (no pagination), 2020. Date of Publication:
04 Mar 2020.
Author
Zi J.; Fan Y.; Dong C.; Zhao Y.; Li D.; Tan Q.
Institution
(Zi, Dong, Zhao, Li, Tan) Department of Cardiovascular Surgery, Shandong
Provincial Hospital Affiliated to Shandong First Medical University
(Zi, Dong, Zhao, Li, Tan) Department of Cardiovascular Surgery, Shandong
Provincial Hospital Affiliated to Shandong University
(Fan) Department of Toxicological and Functional Test, Shandong Centers
for Disease Control and Prevention
Publisher
NLM (Medline)
Abstract
This study aims to evaluate the effect of dexmedetomidine (DEX) sedation
for relieving anxiety and the incidence of atrial fibrillation (AF) after
off-pump coronary artery bypass graft (OPCABG).This randomized,
double-blind, controlled trial was conducted on 196 patients who underwent
OPCABG in Shandong Provincial Hospital from July 2017 to June 2018. The
patients were randomly assigned to two groups, intervention of DEX group
and Propofol (PROP) group. Episodes of postoperative AF (POAF) were
identified within 5 days after OPCABG. Perioperative anxiety status was
assessed using Zung's Self-Rating Anxiety Scale (SAS). The baseline
demographic and surgical characteristics of the population and other
outcome variables were evaluated.We analyzed 62 patients in the DEX group
and 61 patients in the PROP group. There was no significant difference in
SAS anxiety scores between two groups before surgery (P = 0.104), while
SAS had significantly after surgery (P = 0.018). The incidence of POAF in
the DEX group was lower than that of the PROP group (16.1% versus 32.8%, P
= 0.037), and a total of 30 patients (30/123, 24.4%) manifested POAF after
OPCABG. Some univariable predictors of POAF were detected. The conceptual
model of mediator analyses showed DEX was not only directly related to
POAF but was also indirectly related through the independent effect of
anxiety level.The findings indicated that patients receiving DEX were more
likely to have less incidence of POAF, also uniquely showed DEX
administration and POAF processes as a function of anxiety status.

<59>
Accession Number
631192599
Title
Melatonin and its analogues for the prevention of postoperative delirium:
A systematic review and meta-analysis.
Source
Journal of pineal research. (pp e12644), 2020. Date of Publication: 07 Mar
2020.
Author
Han Y.; Wu J.; Qin Z.; Fu W.; Zhao B.; Li X.; Wang W.; Sha T.; Sun M.; Li
J.; Zeng Z.; Chen Z.
Institution
(Han, Qin, Zhao) Department of Anaesthesiology, Nanfang Hospital, Southern
Medical University, Guangzhou 510515, China
(Wu, Fu, Wang, Sha, Sun, Li, Zeng, Chen) Department of Critical Care
Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515,
China
(Li) Department of Anaesthesiology, People's Hospital of Ningxia Hui
Autonomous Region, Northwest University for Nationalities, Yinchuan
750002, China
Publisher
NLM (Medline)
Abstract
It remains unclear whether melatonin and its analogues prevent
postoperative delirium (POD). Therefore, we conducted a systematic review
and meta-analysis to evaluate the effect of melatonin and its analogues on
POD prevention. PubMed, Cochrane Library, Web of Science, Embase, and
CINAHL databases were searched. Primary outcome was the incidence of POD.
Six randomized controlled trials, 2 cohort studies, and 1 case-control
study were included in this meta-analysis. Results showed that melatonin
and its analogue ramelteon decreased the incidence of POD in the entire
adult surgical population (odds ratio [OR]=0.45, 95% confidence interval
[CI] 0.24-0.84, P=0.01). When administered at a higher dose (5 mg),
melatonin was effective in reducing the POD incidence (OR=0.32, 95% CI
0.20-0.52, P<0.00001). Melatonin administered less than 5 elimination
half-lives before the surgery significantly reduced the POD incidence
(OR=0.31, 95% CI 0.19-0.49, P<0.00001).-Current literature supports the
effectiveness of melatonin and its analogue ramelteon in POD prevention.
However, the present study was limited by the significant heterogeneity of
the included studies. More studies are needed to ascertain the preventive
effect of melatonin and its analogues on the incidence of delirium after
cardiac and non-cardiac surgeries.<br/>Copyright This article is protected
by copyright. All rights reserved.

<60>
Accession Number
631179806
Title
Comparison of the efficacy of two doses of dexmedetomidine in attenuating
the hemodynamic response to intubation in patients undergoing elective
cardiac surgery: A randomized double-blinded study.
Source
Journal of Anaesthesiology Clinical Pharmacology. 36 (1) (pp 83-87), 2020.
Date of Publication: January-March 2020.
Author
Silpa A.R.; Koshy K.A.; Subramanian A.; Pradeep K.K.
Institution
(Silpa) Department of Anesthesia, Lourdes Hospital, Kochi, Kerala, India
(Koshy, Subramanian) Department of Cardiac Anesthesia, Lourdes Hospital,
Kochi, Kerala, India
(Pradeep) Department of Cardiac Surgery, Lourdes Hospital, Kochi, Kerala,
India
Publisher
Wolters Kluwer Medknow Publications (B9, Kanara Business Centre, off Link
Road, Ghatkopar (E), Mumbai 400 075, India)
Abstract
Background and Aims: Transient tachycardia and hypertension associated
with laryngoscopy and intubation may be hazardous to patients presenting
for cardiac surgery. The alpha 2 agonist dexmedetomidine may blunt this
stress response, but the optimal dose which will accomplish this without
causing hypotension and bradycardia is not well established. The primary
objective of this study was to compare the efficacy of two doses of
dexmedetomidine (0.5 and 1 mug/kg) as a 15 min infusion in attenuating the
hemodynamic stress response to laryngoscopy and endotracheal intubation in
elective cardiac surgery. <br/>Material(s) and Method(s): Seventy six
patients scheduled for elective cardiac surgery received a single
preoperative dose of dexmedetomidine of either 0.5 mug/kg (low dose) or 1
mug/kg (high dose) as a 15-min infusion prior to induction. The
hemodynamic response to laryngoscopy and endotracheal intubation (heart
rate, systolic blood pressure, mean arterial pressure, and diastolic blood
pressure) were recorded at different times. Independent sample t-test,
Chi-square test of association, and repeated measures analysis of variance
were used to analyze the collected data. <br/>Result(s): The incidence of
hypertension following intubation was significantly more in the low-dose
group. Administration of 1 mug/kg dexmedetomidine was not accompanied by
hypotension or bradycardia. <br/>Conclusion(s): Dexmedetomidine in a dose
of 1 mug/kg is more effective than 0.5 mug/kg for attenuation of
hemodynamic stress response to intubation in cardiac surgery. A more
graded increase in the dose of dexmedetomidine may lead to an optimum dose
in attenuating the hemodynamic response to intubation.<br/>Copyright
&#xa9; 2020 Wolters Kluwer Medknow Publications. All rights reserved.

<61>
Accession Number
2005197866
Title
Impact of ultrasound-guided erector spinae plane block on postoperative
quality of recovery in video-assisted thoracic surgery: A prospective,
randomized, controlled trial.
Source
Journal of Clinical Anesthesia. 63 (no pagination), 2020. Article Number:
109783. Date of Publication: August 2020.
Author
Yao Y.; Fu S.; Dai S.; Yun J.; Zeng M.; Li H.; Zheng X.
Institution
(Yao, Dai, Zeng, Li, Zheng) Department of Anesthesiology, Shengli Clinical
Medical College of Fujian Medical University, Fuzhou, China
(Fu) Department of Pathology, Union Hospital of Fujian Medical University,
Fuzhou, Fujian, China
(Yun) The 95th Clinical Department, The 900th Hospital of Joint Service
Support Force of the PLA, Putian, China
(Zheng) Department of Anesthesiology, Fujian Provincial Hospital, Fuzhou,
China
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Study objective: Regional anesthesia improves postoperative analgesia and
enhances the quality of recovery (QoR) after surgery. We examine the
efficacy of ultrasound-guided erector spinae plane block (ESPB) on QoR
after video-assisted thoracic surgery (VATS). <br/>Design(s): Prospective,
randomized, double-blinded, placebo-controlled trial. <br/>Setting(s):
Single institution, tertiary university hospital. <br/>Patient(s): Adult
patients who scheduled for VATS under general anesthesia were enrolled in
the study. <br/>Intervention(s): We randomly allocated patients to receive
preoperative ultrasound-guided ESPB with 25 ml of either 0.5% ropivacaine
(ESPB group) or normal saline (Control group). Measurements: The primary
outcome was QoR as measured by the 40-item QoR questionnaire (QoR-40)
score at postoperative day 1. Secondary results were post-anesthesia care
unit (PACU) discharge time, acute postoperative pain, cumulative opioid
consumption, the incidence of postoperative nausea or vomiting (PONV), and
patient satisfaction. <br/>Main Result(s): The global QoR-40 score at
postoperative day 1 (median, interquartile range) was significantly higher
in the ESPB group (174, 170 to 177) than the control group (161.5, 160 to
165), estimated median difference 11 (95% CI 9 to 13, P < 0.001). Compared
with the control group, single-injection of ESPB reduced PACU discharge
time, acute postoperative pain, and cumulative opioid consumption.
Correspondingly, the median patient satisfaction scores were higher in the
ESPB group than the control group (9 versus 7, P < 0.001).
<br/>Conclusion(s): Preoperative single-injection thoracic ESPB with
ropivacaine improves QoR, postoperative analgesia, and patient
satisfaction after VATS.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<62>
Accession Number
2005166577
Title
Atorvastatin reload down regulates TLR-2 expression and reduces the acute
inflammatory response in patients undergoing percutaneous coronary
intervention.
Source
Systematic Reviews in Pharmacy. 11 (2) (pp 347-355), 2020. Date of
Publication: 2020.
Author
Jasim A.E.; Majeed S.A.; Hadi N.R.; Amber K.I.; Jawad H.
Institution
(Jasim) College of Medicine, Iraqi University, Iraq
(Majeed, Hadi) Department of Pharmacology and Therapeutics, Kufa
University of Medicine, Iraq
(Amber) Al Najaf Cardiac Centre, Kufa University of Medicine, Iraq
(Jawad) Kufa University of Medicine, Iraq
Publisher
EManuscript Technologies (E-mail: journals@emanuscript.in)
Abstract
Coronary artery disease (CAD) is the single most common cause of morbidity
and mortality in developed world. PCI with stent implantation is a widely
used, safe and effective technique for the treatment of symptomatic
ischemic heart disease. Stenting, however, causes significant injury to
the vascular wall, resulting in a repair process that requires
inflammatory process activation. This study was done to assess the effect
of pre PCI atorvastatin reload on toll like receptor 2 expressions with
its downstream signaling. A double blind randomized prospective trail in
which 60 patients with stable angina pectoris, who are scheduled for an
elective PCI at Al-Najaf Center for Cardiac Surgery and Trans Catheter
were enrolled and were assigned randomly1:1 into two groups, after an
ethical committee of the University of Kufa/Faculty of medicine approval,
30 patients who received low dose atorvastatin 40mg daily without reload
(control group). Stent implantation was associated with an elevation in
TLR 2 expression in peripheral monocyte in both study groups after
stenting but significantly higher expression level was observed among
control group than atorvastatin reload group (p<0.05) at 4hrand 12hr post
PCI. Inflammatory cytokine (MMP9, MCP-1, and IL-6) were significantly
increased after stenting in both study groups (p<0.005) but higher in
control group than atorvastatin reload group (p<0.05) also myocardial
injury markers (CKMB, troponin I) were significantly higher in control
group than atorvastatin reload group (p<0.05). We conclude that
atorvastatin reload before coronary artery interventions attenuate toll
like receptor 2 expression on peripheral monocyte and significantly reduce
serum level of MMP9, MCP-1 and IL-6and cardiac injury markers(CK-MB and
cardiac troponin I).<br/>Copyright &#xa9; Advanced Scientific Research.
All rights reserved.

<63>
Accession Number
2005166561
Title
Impact of trimetazidine on incidence of contrast induced nephropathy in
diabetic patients with renal insufficiency undergoing percutaneous
coronary intervention.
Source
Systematic Reviews in Pharmacy. 11 (2) (pp 329-341), 2020. Date of
Publication: 2020.
Author
Hadi N.R.; Amber K.I.; Alsalkhi H.A.; Muhammad-Baqir B.M.; Ahmed M.H.
Institution
(Hadi) Department of Pharmacology & Therapeutics, Faculty of Medicine,
University of Kufa, Iraq
(Amber) Al-Sader Teaching Hospital, Al-Najaf Center for Cardiac Surgery
and Trans Catheter Therapy, Iraq
(Alsalkhi) Department of Pediatric Cardiology, Faculty of Medicine,
University of Kufa, Iraq
(Muhammad-Baqir) Department of Clinical Pharmacy, Faculty of Pharmacy,
University of Kufa, Iraq
(Ahmed) Al-Sader Teaching Hospital, Specialist Centre for Nephrology and
Kidney Transplantation, Iraq
Publisher
EManuscript Technologies (E-mail: journals@emanuscript.in)
Abstract
The main objective of this study is to assess the possible protective role
of Trimetazidine in the prevention of contrast induced nephropathy in
patients with renal impairment undergoing coronary angiography or
percutaneous coronary intervention. This was a randomized single-blind
clinical trial study. A total of 100 consecutive diabetic patients with
symptomatic ischemic heart disease and chronic kidney disease (CKD) were
subjected to an elective percutaneous coronary intervention, at ALSADR
teaching hospital/Al-Najaf Center for Cardiac surgery and Tran Catheter
Therapy, Najaf, Iraq, in period between May and December 2018. The
Patients were divided into two groups: Group I-Control Group (n=45) these
patients with chronic kidney disease and critical coronary stenosis and
they were needed to be subjected to coronary intervention. Group
II-Treatment Group (n=44) also these patients with chronic kidney disease
and critical coronary stenosis and they were need to be subjected to
coronary intervention and treated with 35 mg tablet/twice daily of
Trimetazidine for the period of three days, starting 48 hours before
surgical procedure and for 24 hours post the procedure. Trimetazidine
significantly reduce the elevation in serum levels of nuclear factor kappa
B, high-mobility group box 1, expression of Tolllike receptor 2 (p<0.05)
while insignificantly reduce the elevation in serum levels of creatinine
and urine level of Neutrophils gelatinase-associated lipocalinis (p >
0.05). Our study concluded that Trimetazidine reduce the acute kidney
injury response and systemic inflammatory response induced by contrast
administration after coronary intervention.<br/>Copyright &#xa9; Advanced
Scientific Research. All rights reserved.

<64>
Accession Number
2004416980
Title
Mortality after transcatheter versus surgical aortic valve replacement: an
updated meta-analysis of randomised trials.
Source
Netherlands Heart Journal. (no pagination), 2020. Date of Publication:
2020.
Author
Takagi H.; Hari Y.; Nakashima K.; Kuno T.; Ando T.
Institution
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Shizuoka
Medical Center, Shizuoka, Japan
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Kitasato
University School of Medicine, Sagamihara, Japan
(Kuno) Department of Medicine, Mount Sinai Beth Israel Medical Center, New
York, NY, United States
(Ando) Division of Interventional Cardiology, Department of Cardiology,
New York Presbyterian Hospital/Columbia University Medical Center, New
York, NY, United States
Publisher
Bohn Stafleu van Loghum (E-mail: e.smid@ntvg.nl)
Abstract
Background: To determine whether transcatheter aortic valve implantation
(TAVI) improves early (30-day) and midterm (1-year) mortality compared
with surgical aortic valve replacement (SAVR), we performed an updated
meta-analysis of all the currently available randomised controlled trials
(RCTs). <br/>Method(s): To identify all RCTs providing both 30-day and
1-year mortality after TAVI versus SAVR, PubMed and ClinicalTrials.gov
were searched up to and including July 2019. A risk difference (RD) and
its 95% confidence interval were generated using data of prespecified
outcomes in both the TAVI and SAVR groups. Study-specific estimates were
pooled using inverse variance-weighted averages of RDs in the
random-effects model. <br/>Result(s): We identified seven eligible
high-quality RCTs including a total of 7631 as-treated patients. Pooled
analyses demonstrated significantly lower 30-day (RD -0.60%; p= 0.046) and
1-year all-cause mortality (RD -1.12%; p= 0.03) after TAVI than after
SAVR. No funnel plot asymmetry was detected for 30-day and 1-year
mortality. Meta-regression analyses indicated that RDs of 30-day and
1-year mortality between TAVI and SAVR were not modulated by mean Society
of Thoracic Surgeons Predicted Risk of Mortality score. Bleeding
complications at 30 days and 1 year and stage 2/3 acute kidney injury at
30 days were significantly less frequent after TAVI than after SAVR,
whereas major vascular complications and new permanent pacemaker
implantation at 30 days and 1 year were significantly more frequent after
TAVI than after SAVR. <br/>Conclusion(s): The best evidence from the
present meta-analysis of all the currently available RCTs suggests that
TAVI may reduce 30-day and 1-year all-cause mortality compared with
SAVR.<br/>Copyright &#xa9; 2020, The Author(s).

<65>
Accession Number
2004400997
Title
Prognostic impact of baseline C-reactive protein levels on mortality after
transcatheter aortic valve implantation.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Takagi H.; Kuno T.; Hari Y.; Nakashima K.; Yokoyama Y.; Ueyama H.; Ando T.
Institution
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Shizuoka
Medical Center, Shizuoka, Japan
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Kitasato
University School of Medicine, Sagamihara, Japan
(Kuno, Ueyama) Department of Medicine, Mount Sinai Beth Israel Medical
Center, New York, NY, United States
(Yokoyama) Department of Surgery, Easton Hospital, Easton, PA, United
States
(Ando) Division of Interventional Cardiology, Department of Cardiology,
New York-Presbyterian Hospital, Columbia University Medical Center, New
York, NY, United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Objectives: To determine whether baseline C-reactive protein (CRP) levels
can predict mortality after transcatheter aortic valve implantation
(TAVI), we performed a meta-analysis of currently available studies.
<br/>Method(s): All studies investigating the prognostic impact of
baseline (preprocedural) CRP levels on all-cause mortality after TAVI were
identified by means of searching PubMed and Google Scholar through May
2019. For each study, (preferentially, adjusted rather than unadjusted)
odds/hazard ratios (ORs/HRs) with corresponding 95% confidence intervals
of mortality per standard-deviation (SD) (or unit) increase in CRP levels
or those for high vs low CRP levels. <br/>Result(s): Our search identified
14 eligible studies including a total of 3449 patients undergoing TAVI and
reporting early (in-hospital to 3-month) and midterm (1-year to 3-year)
all-cause mortality after TAVI. Pooled analyses demonstrated associations
of high-baseline CRP levels with a marginal, but statistically
nonsignificant increase in early mortality (pooled OR/HR per SD increase
in CRP levels, 2.72; P =.09 and pooled OR/HR for high vs low CRP levels,
3.32; P =.07) and a statistically significant increase in midterm
mortality after TAVI (pooled OR/HR per SD increase in CRP levels, 1.45; P
<.0001 and pooled OR/HR for high vs low CRP levels, 1.78; P <.00001).
Excluding HRs for high-sensitivity CRP, combining ORs/HRs of 1-year
mortality, pooling HRs of >=2-year mortality, and combining adjusted HRs
did not alter the primary results. <br/>Conclusion(s): High-baseline CRP
levels may predict increased midterm, but not early, mortality after
TAVI.<br/>Copyright &#xa9; 2020 Wiley Periodicals, Inc.

<66>
Accession Number
2004400913
Title
Meta-analysis of results of subvalvular repair for severe ischemic mitral
regurgitation.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Meco M.; Lio A.; Montisci A.; Panisi P.; Ferrarini M.; Miceli A.; Glauber
M.
Institution
(Meco, Panisi) Cardiac Centre, Humanitas Gavazzeni Hospital, Bergamo,
Italy
(Lio, Glauber) Department of Cardiac Surgery and Transplantation, S.
Camillo Hospital, Rome, Italy
(Lio, Montisci, Ferrarini, Miceli, Glauber) Cardiothoracic Center,
Istituto Clinico Sant'Ambrogio, Gruppo Ospedaliero San Donato, Milan,
Italy
(Montisci) University of Milan, Milan, Italy
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background and Aim of the Study: The aim of this meta-analysis was to
compare short- and long-term outcomes of patients undergoing mitral
annuloplasty (MA) with or without papillary muscle surgery (PMS) for the
treatment of ischemic mitral regurgitation (IMR). <br/>Method(s): A
systematic review and meta-analysis in accordance with the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
statement were performed. <br/>Result(s): Nine studies met the inclusion
criteria. This meta-analysis identified 478 patients: 228 patients
underwent MA alone and 250 patients underwent concomitant PMS. Early
mortality was similar between two groups (odds ratio [OR] 1.14, 95%
confidence interval [CI], 0.51-2.53; P =.75). PMS was associated at
follow-up with a higher freedom from cardiac-related events (P =.050);
moreover, although both surgical techniques had a positive impact on
ventricular remodeling, the PMS group showed a significant higher
reduction of left ventricle end-diastolic diameter (OR, 4.89, 95% CI,
2.77-7.01; P <.001) and left ventricle end-systolic diameter values (OR,
4.11, 95% CI, 1.98-6.24; P <.001). Finally, PMS compared with MA alone was
associated with a significant reduction of recurrent mitral regurgitation
at follow-up (OR, 3.25, 95% CI, 1.60-6.59; P =.001). <br/>Conclusion(s):
This meta-analysis demonstrated superiority in terms of ventricular
remodeling of a combined approach encompassing PMS and MA over MA alone in
IMR. Moreover, the association of subvalvular surgery with restrictive MA
decreases the incidence of mitral regurgitation recurrence and
cardiac-related events at follow-up.<br/>Copyright &#xa9; 2020 Wiley
Periodicals, Inc.

<67>
Accession Number
2004388861
Title
Concomitant atrial fibrillation ablation in patients undergoing coronary
artery bypass and cardiac valve surgery.
Source
Journal of Cardiovascular Electrophysiology. (no pagination), 2020. Date
of Publication: 2020.
Author
Churyla A.; Desai A.; Jane K.; Cox J.; McCarthy P.
Institution
(Churyla, Desai, Jane, Cox, McCarthy) Division of Cardiac Surgery,
Department of Surgery, Northwestern Medicine Bluhm Cardiovascular
Institute, Northwestern Memorial Hospital, Chicago, IL, United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Surgical ablation of atrial fibrillation (AF) in conjunction with other
cardiac surgery is now a class I guideline recommendation. Multiple
studies have demonstrated that the concomitant surgical ablation of AF can
be performed safely and effectively during valve and coronary artery
bypass grafting (CABG) resulting in a return to sinus rhythm
postoperatively and improved long-term results. However, the surgical
ablation of AF at the time of other cardiac surgery is performed less
often than it should be, especially in patients undergoing CABG and aortic
valve surgery. Randomized-controlled trials designed to determine the
effect of treating AF concomitantly with other cardiac surgical procedures
have lacked long-term follow up, but multiple, large observational studies
have demonstrated an improved quality of life, a decrease in long-term
strokes, and improved late survival in patients who undergo AF ablation.
However, the potential survival benefit of concomitant AF ablation was not
addressed by either the Society of Thoracic Surgery or American
Association for Thoracic Surgery guideline committees. Left atrial
appendage closure is an important part of the surgical ablation of AF as
it significantly reduces the long-term risk of stroke following cardiac
surgery and improves the success of AF treatment. In this study, we update
the electrophysiology and surgical community on the recommended surgical
techniques for AF ablation and its effect on perioperative morbidity,
perioperative mortality, as well as its long-term effects on stroke,
quality of life, and survival.<br/>Copyright &#xa9; 2020 Wiley
Periodicals, Inc.

<68>
Accession Number
631175774
Title
An Appraisal of the Association of Clinical Outcomes with the Severity of
Regurgitant Volume Relative to End-Diastolic Volume in Patients with
Secondary Mitral Regurgitation.
Source
JAMA Cardiology. (no pagination), 2020. Date of Publication: 2020.
Author
Gaasch W.H.; Aurigemma G.P.; Meyer T.E.
Institution
(Gaasch, Aurigemma, Meyer) Department of Cardiovascular Medicine, Lahey
Hospital and Medical Center, Burlington, MA, United States
(Gaasch, Aurigemma, Meyer) Tufts University, School of Medicine, Boston,
MA, United States
(Gaasch, Aurigemma, Meyer) University of Massachusetts, Medical School,
Worcester, United States
Publisher
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)
Abstract
Importance: Two randomized clinical trials of transcatheter edge-to-edge
mitral valve repair in patients with secondary mitral regurgitation (the
Multicentre Randomized Study of Percutaneous Mitral Valve Repair MitraClip
Device in Patients With Severe Secondary Mitral Regurgitation [MITRA-FR]
and the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous
Therapy for Heart Failure Patients with Functional Mitral Regurgitation
[COAPT]) report clinical outcome disparities that are largely unexplained.
This appraisal sought to provide insight and an explanation for the
differences in clinical outcomes (survival and hospitalization rates) in
the 2 clinical trials. The mean echocardiogram Doppler results (and
derived volume parameters) from each of the 2 clinical trials were
compared and examined relative to the clinical outcomes. Special emphasis
was placed on the assessment of mitral regurgitation proportionality
coefficients that were determined as the ratio of effective regurgitant
orifice area (EROA) to end-diastolic volume and the ratio of mitral
regurgitant volume to end-diastolic volume. Observations: In this analysis
of the differences in the clinical outcomes of the MITRA-FR and COAPT
clinical trials, the ratio of the EROA to the end-diastolic volume in the
COAPT study was found to be twice that of the MITRA-FR study (0.002
cm^-¹ vs 0.001 cm^-¹,
respectively). The finding of a larger proportional EROA in the COAPT
study suggests more severe mitral regurgitation compared with the MITRA-FR
study, thereby providing a potential explanation for the different
outcomes in the 2 clinical trials. In contrast, the ratio of the mitral
regurgitant volume to the end-diastolic volume in the COAPT study was
similar to (but slightly lower than) that of the MITRA-FR study (0.15 vs
0.18, respectively), indicating that the proportional mitral regurgitant
volume was comparable in the 2 clinical trials. This finding contradicts
the conclusions of the EROA analysis. <br/>Conclusions and Relevance: The
results of proportionality analyses based on EROA differ from those based
on a volume analysis. This disparity casts doubt on the notion that an
EROA analysis alone can explain the different results of the 2 randomized
clinical trials.<br/>Copyright &#xa9; 2020 Cambridge University Press. All
rights reserved.

<69>
Accession Number
631171823
Title
New Evidence Supporting a Novel Conceptual Framework for Distinguishing
Proportionate and Disproportionate Functional Mitral Regurgitation.
Source
JAMA Cardiology. (no pagination), 2020. Date of Publication: 2020.
Author
Packer M.; Grayburn P.A.
Institution
(Packer, Grayburn) Baylor Scott and White Heart and Vascular Hospital,
Division of Cardiology, Department of Internal Medicine, Baylor University
Medical Center, Dallas, TX, United States
Publisher
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)
Abstract
Importance: Traditionally, physicians distinguished between mitral
regurgitation (MR) as a determinant of outcomes and MR as a biomarker of
left-ventricular (LV) dysfunction by designating the lesions as primary or
secondary, respectively. In primary MR, leaflet abnormalities cause the
MR, resulting in modest increases in LV end-diastolic volume over time,
whereas in patients with classic secondary MR, LV dysfunction and
dilatation lead to MR without structural leaflet abnormalities. However,
certain patients with global LV disease (eg, those with left bundle branch
block or regional wall motion abnormalities) have the features of primary
MR and might respond favorably to interventions that aim to restore the
proper functioning of the mitral valve apparatus. Observations: A novel
conceptual framework is proposed, which classifies patients with
meaningful LV disease based on whether the severity of MR is proportionate
or disproportionate to the LV end-diastolic volume. Treatments that reduce
LV volumes (eg, neurohormonal antagonists) are effective in proportionate
MR but not disproportionate MR. Conversely, procedures that restore mitral
valve function (eg, cardiac resynchronization and mitral valve repair) are
effective in patients with disproportionate MR but not in those with
proportionate MR. The proposed framework explains the discordant findings
in the Multicentre Randomized Study of Percutaneous Mitral Valve Repair
MitraClip Device in Patients With Severe Secondary Mitral Regurgitation
(MITRA-FR) and the Cardiovascular Outcomes Assessment of the MitraClip
Percutaneous Therapy for Heart Failure Patients with Functional Mitral
Regurgitation (COAPT) trials; differences in procedural success and
medical therapy in the 2 studies cannot explain the different results. In
addition, the small group of patients in the COAPT trial who had the
features of proportionate MR and were similar to those enrolled in the
MITRA-FR trial did not respond favorably to transcatheter mitral valve
repair. <br/>Conclusions and Relevance: The characterization of patients
with functional MR into proportionate and disproportionate subtypes may
explain the diverse range of responses to drug and device interventions
that have been observed.<br/>Copyright &#xa9; 2020 Cambridge University
Press. All rights reserved.

<70>
[Use Link to view the full text]
Accession Number
629626178
Title
Five-Year Clinical and Echocardiographic Outcomes from the NOTION
Randomized Clinical Trial in Patients at Lower Surgical Risk.
Source
Circulation. 139 (24) (pp 2714-2723), 2019. Date of Publication: 11 Jun
2019.
Author
Thyregod H.G.H.; Ihlemann N.; Jorgensen T.H.; Nissen H.; Kjeldsen B.J.;
Petursson P.; Chang Y.; Franzen O.W.; Engstrom T.; Clemmensen P.; Hansen
P.B.; Andersen L.W.; Steinbruuchel D.A.; Olsen P.S.; Sondergaard L.
Institution
(Thyregod, Steinbruuchel, Olsen) Department of Cardiothoracic Surgery
,Heart Centre, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej
9, Copenhagen DK-2100, Denmark
(Ihlemann, Jorgensen, Franzen, Engstrom, Sondergaard) Department of
Cardiology, Heart Centre, Rigshospitalet, Copenhagen University Hospital,
Denmark
(Hansen, Andersen) Department of Cardiac Anesthesia, Heart Centre,
Rigshospitalet, Copenhagen University Hospital, Denmark
(Nissen) Department of Cardiology, Odense University Hospital, Denmark
(Kjeldsen) Department of Cardiothoracic and Vascular Surgery, Odense
University Hospital, Denmark
(Petursson) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Chang) Coronary and Structural Heart Disease Clinical Department,
Medtronic Plc, Mounds View, MN, United States
(Clemmensen) Department of General and Interventional Cardiology,
University Heart Center Hamburg Eppendorf, Germany
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: The NOTION trial (Nordic Aortic Valve Intervention) was
designed to compare transcatheter aortic valve replacement (TAVR) with
surgical aortic valve replacement (SAVR) in patients >=70 years old with
isolated severe aortic valve stenosis. Clinical and echocardiographic
outcomes are presented after 5 years. <br/>Method(s): Patients were
enrolled at 3 Nordic centers and randomized 1:1 to TAVR using the
self-expanding CoreValve prosthesis (n=145) or SAVR using any stented
bioprostheses (n=135). The primary composite outcome was the rate of
all-cause mortality, stroke, or myocardial infarction at 1 year defined
according to Valve Academic Research Consortium-2 criteria.
<br/>Result(s): Baseline characteristics were similar. The mean age was
79.1+/-4.8 years and mean Society of Thoracic Surgeons Predicted Risk of
Mortality score was 3.0%+/-1.7%. After 5 years, there were no differences
between TAVR and SAVR in the composite outcome (Kaplan-Meier estimates
38.0% versus 36.3%, log-rank test P=0.86) or any of its components. TAVR
patients had larger prosthetic valve area (1.7 cm² versus 1.2
cm², P<0.001) with a lower mean transprosthetic gradient (8.2
mm Hg versus 13.7 mm Hg, P<0.001), both unchanged over time. More TAVR
patients had moderate/severe total aortic regurgitation (8.2% versus 0.0%,
P<0.001) and a new pacemaker (43.7% versus 8.7%, P<0.001). Four patients
had prosthetic reintervention and no difference was found for functional
outcomes. <br/>Conclusion(s): These are currently the longest follow-up
data comparing TAVR and SAVR in lower risk patients, demonstrating no
statistical difference for major clinical outcomes 5 years after TAVR with
a self-expanding prosthesis compared to SAVR. Higher rates of prosthetic
regurgitation and pacemaker implantation were seen after TAVR. Clinical
Trial Registration: URL: Https://clinicaltrials.gov. Unique identifier:
NCT01057173.<br/>Copyright &#xa9; 2019 Lippincott Williams and Wilkins.
All rights reserved.

<71>
[Use Link to view the full text]
Accession Number
53077690
Title
Tight glycemic control after pediatric cardiac surgery in high-risk
patient populations: A secondary analysis of the safe pediatric euglycemia
after cardiac surgery trial.
Source
Circulation. 129 (22) (pp 2297-2304), 2014. Date of Publication: 03 Jun
2014.
Author
Agus M.S.D.; Asaro L.A.; Alexander J.L.; Wypij D.; Costello J.M.; Curley
M.A.Q.; Del Nido P.; Duggan C.; Jaksic T.; Laussen P.C.; Langer M.;
Newburger J.W.; Pigula F.A.; Sadhwani A.; Shukla A.; Silverman M.; Steil
G.M.; Ware J.; Gaies M.G.; Charpie J.R.; Goldberg C.S.; Ohye R.G.
Institution
(Agus, Steil, Alexander, Silverman) Division of Medicine Critical Care,
Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave,
Boston, MA 02115, United States
(Asaro, Wypij) Department of Cardiology, Boston Children's Hospital,
Harvard Medical School, Boston, MA, United States
(Wypij) Department of Biostatistics, Harvard School of Public Health,
Boston, MA, United States
(Wypij, Gaies, Del Nido, Duggan, Jaksic, Laussen, Langer, Newburger,
Pigula, Sadhwani, Shukla, Silverman, Steil, Ware) Division of Pediatric
Cardiology, C.S. Mott Children's Hospital, University of Michigan Medical
School, Ann Arbor, United States
(Costello, Curley) University of Pennsylvania, School of Nursing, United
States
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
BACKGROUND - : Our previous randomized, clinical trial showed that
postoperative tight glycemic control (TGC) for children undergoing cardiac
surgery did not reduce the rate of health care-associated infections
compared with standard care (STD). Heterogeneity of treatment effect may
exist within this population. METHODS AND RESULTS - : We performed a post
hoc exploratory analysis of 980 children from birth to 36 months of age at
the time of cardiac surgery who were randomized to postoperative TGC or
STD in the intensive care unit. Significant interactions were observed
between treatment group and both neonate (age <=30 days; P=0.03) and
intraoperative glucocorticoid exposure (P=0.03) on the risk of infection.
The rate and incidence of infections in subjects <=60 days old were
significantly increased in the TGC compared with the STD group (rate: 13.5
versus 3.7 infections per 1000 cardiac intensive care unit days, P=0.01;
incidence: 13% versus 4%, P=0.02), whereas infections among those >60 days
of age were significantly reduced in the TGC compared with the STD group
(rate: 5.0 versus 14.1 infections per 1000 cardiac intensive care unit
days, P=0.02; incidence: 2% versus 5%, P=0.03); the interaction of
treatment group by age subgroup was highly significant (P=0.001).
Multivariable logistic regression controlling for the main effects
revealed that previous cardiac surgery, chromosomal anomaly, and delayed
sternal closure were independently associated with increased risk of
infection. CONCLUSIONS - : This exploratory analysis demonstrated that TGC
may lower the risk of infection in children >60 days of age at the time of
cardiac surgery compared with children receiving STD. Meta-analyses of
past and ongoing clinical trials are necessary to confirm these findings
before clinical practice is altered. &#xa9; 2014 American Heart
Association, Inc.

<72>
Accession Number
2004282367
Title
Acute wound infections management: the 'Don'ts' from a multidisciplinary
expert panel.
Source
Expert Review of Anti-Infective Therapy. 18 (3) (pp 231-240), 2020. Date
of Publication: 03 Mar 2020.
Author
Sganga G.; Pea F.; Aloj D.; Corcione S.; Pierangeli M.; Stefani S.;
Rossolini G.M.; Menichetti F.
Institution
(Sganga) Emergency Surgery, Fondazione Policlinico Universitario A.
Gemelli IRCCS, Universita Cattolica Del Sacro Cuore, Rome, Italy
(Pea) Department of Medicine, University of Udine, Udine, Italy
(Pea) Institute of Clinical Pharmacology, Santa Maria Della Misericordia
University Hospital, Azienda Sanitaria, Universitaria Integrata Di Udine,
Udine, Italy
(Aloj) Department of Traumatology, Hospital of Vercelli, Vercelli, Italy
(Corcione) Department of Medical Sciences, Infectious Diseases, University
of Turin, Turin, Italy
(Pierangeli) S.O.D. Clinica di Chirurgia Plastica e Ricostruttiva,
Ospedale Riuniti of Ancona, Ancona, Italy
(Stefani) Department of Biomedical and Biotechnological Sciences, Section
of Microbiology, University of Catania, Catania, Italy
(Rossolini) Department of Experimental and Clinical Medicine, University
of Florence, Florence, Italy
(Rossolini) Microbiology and Virology, Florence Careggi University
Hospital, Florence, Italy
(Menichetti) Infectious Diseases Unit, Azienda Ospedaliera Universitaria
Pisana, Pisa, Italy
Publisher
Taylor and Francis Ltd
Abstract
Introduction: The management of acute wounds may be affected by
malpractices leading to poor outcome, prolonged hospital stay and
inappropriate use of antibiotic therapy. Areas covered: Acute wound
infections are represented by surgical site and post-traumatic infections.
The aim of this expert opinion is to identify a list of inadvisable
actions and to provide a guide for an optimal management of acute wound
infections. A literature search using Pubmed/MEDLINE database was
performed. Articles pertaining to areas covered published until December
2019 were selected. We identified the most common malpractices in this
setting and, using the Choosing Wisely methodology, we proposed a list of
"Don'ts" for an easy use in clinical practice. Expert opinion:
Malpractices may occur from the surgical prophylaxis to the discharge of
patient. A prolonged surgical prophylaxis, the underestimation of signs
and symptoms, the omission of source control, the inappropriate collection
of wound swab, the improper use of clinical microbiology and pharmacology,
the lack of hygiene measures and the delay of discharge are all factors
that may lead to unfavorable outcome. A multidisciplinary approach is
needed to optimally manage these patients. The "Don'ts" refer to all
professional figures involved in the management of patients with acute
wound infections.<br/>Copyright &#xa9; 2020, &#xa9; 2020 Informa UK
Limited, trading as Taylor & Francis Group.

<73>
Accession Number
2003941892
Title
Smart mode of mechanical lung ventilation during early activation of
cardiosurgical patients.
Source
Obshchaya Reanimatologiya. 16 (1) (pp 4-15), 2020. Date of Publication:
2020.
Author
Eremenko A.A.; Komnov R.D.
Institution
(Eremenko, Komnov) Petrovsky National Research Center for Surgery, 2
Abrikosovsky Lane, Moscow 119991, Russian Federation
Publisher
V.A. Negovsky Research Institute of General Reanimatology (E-mail:
journal_or@mail.ru)
Abstract
Purpose of the study: a comparative assessment of safety and quality of
respiratory support carried out using the ASV mode vs. conventional
protocol, in which ventilation parameters are set by an ICU physician
during early postoperative period in cardiosurgical patients. Materials
and methods. The modes of a respiratory support included automated ASV
ventilation (40 pa-tients) versus conventional ventilation (38 patients)
managed by 8 ICU physicians were compared in a cohort of cardiosurgical
patients in a randomized controlled study. The comparison included
ventilation parameters, all efforts of physicians to adjust ventilator
settings and time it took, duration of respiratory support in ICU,
incidence of adverse events in the course of weaning, total time in ICU
and hospital, postoperative complications and mortality. Results. There
was no reliable difference in the duration of postoperative trachea
intubation, which was equal to 267+/-76 minutes (the ASV group) and
271+/-80 minutes (the control group). The number of manual adjustments,
which was 2 vs. 4 (P<0.00001), and the time spent by a clinical physician
near a ventilator, which was 99+/-35 seconds vs. 166+/-70 seconds, were
reliably lower in the ASV group (P=0.00001). The time between restoration
of patient's own respiratory activity and transfer to the assisted
breathing mode was longer in the control group and amounted to 30 (0-90)
min. while in the smart mode, the transfer took place immediately after
restoration (P=0.004969). When ASV was used, the driving pressure was
reliably lower during all phases of respiratory support: P 7.2+/-1.6 vs.
9.3+/-2.1 cm H<inf>2</inf>O, (P=0.000001); there was no reliable
difference in the tidal volume: 7.0 (6-8.5) (ASV) vs. 7 (6-10) ml/kg/ideal
body mass (the control group). Conclusion. ASV represents a
lung-protective ventilation that reduces physician's time cost and medical
staff efforts in ALV management without compromising patient's safety and
respiratory support quality.<br/>Copyright &#xa9; 2020, V.A. Negovsky
Research Institute of General Reanimatology. All rights reserved.

<74>
Accession Number
630345265
Title
A single-dose of stellate ganglion block for the prevention of
postoperative dysrhythmias in patients undergoing thoracoscopic surgery
for cancer: A randomised controlled double-blind trial.
Source
European journal of anaesthesiology. 37 (4) (pp 323-331), 2020. Date of
Publication: 01 Apr 2020.
Author
Wu C.-N.; Wu X.-H.; Yu D.-N.; Ma W.-H.; Shen C.-H.; Cao Y.
Institution
(Wu) From the Department of Anaesthesiology, First Affiliated Hospital of
Guangzhou University of Chinese Medicine, Guangzhou (C-NW, W-HM),
Department of Anesthesiology, Peking University Shenzhen Hospital,
Shenzhen (W-HW), Department of Anesthesiology, Guangdong Provincial
People's Hospital (D-NY), Department of Thoracic Surgery, First Affiliated
Hospital of Guangzhou University of Chinese Medicine (C-HS) and Department
of Cardiovascular Pharmacology, School of Pharmacological Science,
Southern Medical University, Guangzhou, China (YC)
Publisher
NLM (Medline)
Abstract
BACKGROUND: New-onset arrhythmias and sleep disturbances are frequently
observed during the postoperative period in patients undergoing thoracic
surgery. <br/>OBJECTIVE(S): We evaluated the effectiveness of a
single-dose stellate ganglion block (SGB) to prevent the occurrence of
arrhythmias in patients undergoing thoracic surgery for cancer. DESIGN:
Randomised controlled double-blind study. SETTING: Single university
hospital. PATIENTS: Ninety patients with lung cancer or oesophagal cancer
scheduled for elective video-assisted thoracoscopic surgery were randomly
randomised into one of two equal groups (the SGB group and control group,
n = 40 each). INTERVENTIONS: Patients received a single dose of 5 ml of
0.5% ropivacaine during ultrasound-guided SGB before induction of general
anaesthesia in the SGB group. MAIN OUTCOME MEASURES: Holter ECG was
continuously monitored during the first 48 postoperative hours, and sleep
state was monitored during the first two postoperative nights.
<br/>RESULT(S): The incidences of postoperative supraventricular
tachycardias were lower in the SGB group compared with the control group
during the first 48 postoperative hours; 11.6 (5/43) vs. 31.8% (14/44),
respectively, P = 0.023 (odds ratio 0.28, 95% confidence interval 0.09 to
0.87). The SGB also prolonged the total sleep time and increased the sleep
efficiency during the first two postoperative nights. The duration of
stage N2 sleep was longer in the SGB group compared with the control group
[28 (interquartile range, 14 to 58) to 94 (interquartile range, 69 to 113)
min, P = 0.016] on the first postoperative night. There were no
differences in the duration of stage N1 and N3 sleep (P = 0.180, 0.086,
respectively) on the first postoperative night, and the duration of stage
N1, N2 and N3 sleep (P = 0.194, 0.057, 0.405, respectively) on the second
postoperative night between the groups. <br/>CONCLUSION(S): A
pre-operative SGB effectively prevented the occurrence of postoperative
supraventricular tachycardias and improves the objective sleep quality in
patients undergoing thoracic surgery for cancer. TRIAL REGISTRATION
NUMBER: ChiCTR-1900023064.

<75>
Accession Number
630831316
Title
Treatment targets based on autoregulation parameters in neurocritical care
patients.
Source
Current opinion in critical care. 26 (2) (pp 109-114), 2020. Date of
Publication: 01 Apr 2020.
Author
Czosnyka M.; Hutchinson P.; Smielewski P.
Institution
(Czosnyka) Division of Neurosurgery, Department of Clinical Neurosciences,
Cambridge University Hospitals, Biomedical Campus, Cambridge, United
Kingdom
Publisher
NLM (Medline)
Abstract
PURPOSE OF REVIEW: This review summarizes the physiological basis of
autoregulation-oriented therapy in critically ill patients, with a
particular emphasis on individual targets based on parameters that
describe autoregulation of cerebral blood flow. RECENT FINDINGS: The
concepts of optimal cerebral perfusion (CPPopt) and arterial pressures
(ABPopt), which both take advantage of continuous measures of cerebral
autoregulation, recently have been introduced into clinical practice. It
is hypothesized that if both pressures are used as individual targets and
followed, the incidence and severity of dysautoregulation will diminish
sufficiently to improve outcomes across the spectrum of acute neurological
illnesses. These parameters have not been tested in randomized trials.
However, a Phase II trial for CPPopt in Traumatic Brain Injury (COGITATE)
is underway. Clinical series suggest that delirium following cardiac
surgery may be reduced if blood pressure is actively regulated above the
lower limit of autoregulation. In traumatic brain injury, using CPPopt as
a single target allows monitoring of the upper and lower limits of
autoregulation that provide a well tolerated 'corridor' for treatment.
Pilot studies in which ABPopt is monitored in preterm newborns suggest
fewer haemorrhagic events if blood pressure is closer to its optimal
target. Brain imaging studies suggest worse tissue outcomes when blood
pressure is below ABPopt. SUMMARY: Targeted control of brain and systemic
blood pressures to optimize cerebral autoregulation is of substantial
interest to the neurocritical care and anaesthesia community, as this
strategy may help to avoid secondary brain insults associated with
ischemia or hyperaemia. The same strategy can be used outside the ICU
(e.g. cardiac surgery, or in stroke patients after mechanical
thrombectomy); this requires further research.

<76>
Accession Number
2005098927
Title
The Use of Bivalirudin in Pediatric Cardiac Surgery and in the
Interventional Cardiology Suite.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
Goswami D.; DiGiusto M.; Wadia R.; Barnes S.; Schwartz J.; Steppan D.;
Nelson-McMillan K.; Ringel R.; Steppan J.
Institution
(Goswami, DiGiusto, Wadia, Barnes, Schwartz, Steppan, Nelson-McMillan,
Steppan) Department of Anesthesiology and Critical Care Medicine, Johns
Hopkins University, School of Medicine, Baltimore, MD, United States
(DiGiusto, Nelson-McMillan, Ringel) Department of Pediatrics, Johns
Hopkins University, School of Medicine, Baltimore, MD, United States
Publisher
W.B. Saunders
Abstract
Anticoagulation is an essential component for patients undergoing
cardiopulmonary bypass or extracorporeal membrane oxygenation and for
those with ventricular assist devices. However, thrombosis and bleeding
are common complications. Heparin continues to be the agent of choice for
most patients, likely owing to practitioners' comfort and experience and
the ease with which the drug's effects can be reversed. However,
especially in pediatric cardiac surgery, there is increasing interest in
using bivalirudin as the primary anticoagulant. This drug circumvents
certain problems with heparin administration, such as heparin resistance
and heparin-induced thrombocytopenia, but it comes with additional
challenges. In this manuscript, the authors review the literature on the
emerging role of bivalirudin in pediatric cardiac surgery, including its
use with cardiopulmonary bypass surgery, extracorporeal membrane
oxygenation, ventricular assist devices, and interventional cardiology.
Moreover, they provide an overview of bivalirudin's pharmacodynamics and
monitoring methods.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<77>
Accession Number
631083284
Title
Postoperative pain treatment with erector spinae plane block and
pectoralis nerve blocks in patients undergoing mitral/tricuspid valve
repair - A randomized controlled trial.
Source
BMC Anesthesiology. 20 (1) (no pagination), 2020. Article Number: 51. Date
of Publication: 27 Feb 2020.
Author
Gaweda B.; Borys M.; Belina B.; Bak J.; Czuczwar M.; Woloszczuk-Gebicka
B.; Kolowca M.; Widenka K.
Institution
(Gaweda, Bak, Kolowca, Widenka) Division of Cardiovascular Surgery, St.
Jadwiga Provincial Clinical Hospital, ul. Lwowska 60, Rzeszow 35-301,
Poland
(Borys, Czuczwar) Second Department of Anesthesia and Intensive Care,
Medical University of Lublin, ul. Staszica 16, Lublin 20-081, Poland
(Belina, Woloszczuk-Gebicka) Anesthesiology and Intensive Care Department,
Center for Acute Poisoning, St. Jadwiga Provincial Clinical Hospital, ul.
Lwowska 60, Rzeszow 35-301, Poland
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Effective postoperative pain control remains a challenge for
patients undergoing cardiac surgery. Novel regional blocks may improve
pain management for such patients and can shorten their length of stay in
the hospital. To compare postoperative pain intensity in patients
undergoing cardiac surgery with either erector spinae plane (ESP) block or
combined ESP and pectoralis nerve (PECS) blocks. <br/>Method(s): This was
a prospective, randomized, controlled, double-blinded study done in a
tertiary hospital. Thirty patients undergoing mitral/tricuspid valve
repair via mini-thoracotomy were included. Patients were randomly
allocated to one of two groups: ESP or PECS + ESP group (1:1
randomization). Patients in both groups received a single-shot,
ultrasound-guided ESP block. Participants in PECS + ESP group received
additional PECS blocks. Each patient had to be extubated within 2 h from
the end of the surgery. Pain was treated via a patient-controlled
analgesia (PCA) pump. The primary outcome was the total oxycodone
consumption via PCA during the first postoperative day. The secondary
outcomes included pain intensity measured on the visual analog scale
(VAS), patient satisfaction, Prince Henry Hospital Pain Score (PHHPS), and
spirometry. <br/>Result(s): Patients in the PECS + ESP group used
significantly less oxycodone than those in the ESP group: median 12
[interquartile range (IQR): 6-16] mg vs. 20 [IQR: 18-29] mg (p = 0.0004).
Moreover, pain intensity was significantly lower in the PECS + ESP group
at each of the five measurements during the first postoperative day.
Patients in the PECS + ESP group were more satisfied with pain management.
No difference was noticed between both groups in PHHPS and spirometry.
<br/>Conclusion(s): The addition of PECS blocks to ESP reduced consumption
of oxycodone via PCA, reduced pain intensity on the VAS, and increased
patient satisfaction with pain management in patients undergoing
mitral/tricuspid valve repair via mini-thoracotomy. Trial registration:
The study was registered on the 19th July 2018 (first posted) on the
ClinicalTrials.gov identifier: NCT03592485.<br/>Copyright &#xa9; 2020 The
Author(s).

<78>
Accession Number
2004382434
Title
Ventricular arrhythmias following continuous-flow left ventricular assist
device implantation: A systematic review.
Source
Artificial Organs. (no pagination), 2020. Date of Publication: 2020.
Author
Gordon J.S.; Maynes E.J.; Choi J.H.; Wood C.T.; Weber M.P.; Morris R.J.;
Massey H.T.; Tchantchaleishvili V.
Institution
(Gordon, Maynes, Choi, Wood, Weber, Morris, Massey, Tchantchaleishvili)
Division of Cardiac Surgery, Thomas Jefferson University Hospital,
Philadelphia, PA, United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Ventricular arrhythmias (VA) are not uncommon after continuous-flow left
ventricular assist device (CF-LVAD) implantation. In this systematic
review, we sought to identify the patterns of VA that occurred following
CF-LVAD implantation and evaluate their outcomes. An electronic search was
performed to identify all articles reporting the development of VA
following CF-LVAD implantation. VA was defined as any episode of
ventricular fibrillation (VF) or sustained (>30 seconds) ventricular
tachycardia (VT). Eleven studies were pooled for the analysis that
included 393 CF-LVAD patients with VA. The mean patient age was 57 years
[95%CI: 54; 61] and 82% [95%CI: 73; 88] were male. Overall, 37% [95%CI:
19; 60] of patients experienced a new onset VA after CF-LVAD implantation,
while 60% [95%CI: 51; 69] of patients had a prior history of VA. Overall,
88% of patients [95%CI: 78; 94] were supported on HeartMate II CF-LVAD, 6%
[95%CI: 3; 14] on HeartWare HVAD, and 6% [95%CI: 2; 13] on other CF-LVADs.
VA was symptomatic in 47% [95%CI: 28; 68] of patients and in 50% [95%CI:
37; 52], early VA (<30 days from CF-LVAD) was observed. The 30-day
mortality rate was 7% [95%CI: 5; 11]. Mean follow-up was 22.9 months
[95%CI: 4.8; 40.8], during which 27% [95%CI: 17; 39] of patients underwent
heart transplantation. In conclusion, approximately a third of patients
had new VA following CF-LVAD placement. VA in CF-LVAD patients is often
symptomatic, necessitates treatment, and carries a worse
prognosis.<br/>Copyright &#xa9; 2020 International Center for Artificial
Organs and Transplantation and Wiley Periodicals, Inc.

<79>
Accession Number
2003305329
Title
Percutaneous coronary intervention versus coronary artery bypass grafting
in patients with three-vessel or left main coronary artery disease:
10-year follow-up of the multicentre randomised controlled SYNTAX trial.
Source
The Lancet. 394 (10206) (pp 1325-1334), 2019. Date of Publication: 12 Oct
2019.
Author
Thuijs D.J.F.M.; Kappetein A.P.; Serruys P.W.; Mohr F.-W.; Morice M.-C.;
Mack M.J.; Holmes D.R.; Curzen N.; Davierwala P.; Noack T.; Milojevic M.;
Dawkins K.D.; da Costa B.R.; Juni P.; Head S.J.; Casselman F.; de Bruyne
B.; Hoj Christiansen E.; Ruiz-Nodar J.M.; Vermeersch P.; Schultz W.;
Sabate M.; Guagliumi G.; Grubitzsch H.; Stangl K.; Darremont O.; Bentala
M.; den Heijer P.; Preda I.; Stoler R.; Szerafin T.; Buckner J.K.; Guber
M.S.; Verberkmoes N.; Akca F.; Feldman T.; Beyersdorf F.; Drieghe B.;
Oldroyd K.; Berg G.; Jeppsson A.; Barber K.; Wolschleger K.; Heiser J.;
van der Harst P.; Mariani M.A.; Reichenspurner H.; Stark C.; Laine M.; Ho
P.C.; Chen J.C.; Zelman R.; Horwitz P.A.; Bochenek A.; Krauze A.;
Grothusen C.; Dudek D.; Heyrich G.; Kolh P.; LeGrand V.; Coelho P.;
Ensminger S.; Nasseri B.; Ingemansson R.; Olivecrona G.; Escaned J.; Guera
R.; Berti S.; Chieffo A.; Burke N.; Mooney M.; Spolaor A.; Hagl C.;
Nabauer M.; Suttorp M.J.; Stine R.A.; McGarry T.; Lucas S.; Endresen K.;
Taussig A.; Accola K.; Canosi U.; Horvath I.; Cannon L.; Talbott J.D.;
Akins C.W.; Kramer R.; Aschermann M.; Killinger W.; Narbute I.; Burzotta
F.; Bogers A.; Zijlstra F.; Eltchaninoff H.; Berland J.; Stefanini G.;
Cruz Gonzalez I.; Hoppe U.; Kiesz S.; Gora B.; Ahlsson A.; Corbascio M.;
Bilfinger T.; Carrie D.; Tchetche D.; Hauptman K.-E.; Stahle E.; James S.;
Sandner S.; Laufer G.; Lang I.; Witkowski A.; Thourani V.; Suryapranata
H.; Redwood S.; Knight C.; MacCarthy P.; de Belder A.; Banning A.;
Gershlick A.
Institution
(Thuijs, Kappetein, Milojevic, Head) Department of Cardiothoracic Surgery,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Kappetein) Medtronic, Maastricht, Netherlands
(Serruys) Department of Cardiology, Imperial College London, London,
United Kingdom
(Mohr, Davierwala, Noack) University Department of Cardiac Surgery, Heart
Centre Leipzig, Leipzig, Germany
(Morice) Department of Cardiology, Cardiovascular Institute Paris-Sud,
Hopital Prive Jacques Cartier, Ramsay Generale de Sante, Massy, France
(Mack) Department of Cardiothoracic Surgery, Baylor University Medical
Centre, Dallas, TX, United States
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Curzen) University Hospital Southampton NHS Foundation Trust and School
of Medicine, University of Southampton, Southampton, United Kingdom
(Dawkins) Shockwave Medical Inc., Santa Clara, CA, United States
(da Costa, Juni) Applied Health Research Centre, Li Ka Shing Knowledge
Institute of St Michael's Hospital, University of Toronto, Toronto, ON,
Canada
(Juni) Department of Medicine, Institute of Health Policy, Management and
Evaluation, University of Toronto, Toronto, ON, Canada
(da Costa) Institute of Primary Health Care, University of Bern, Bern,
Switzerland
(Head) Medtronic, Minneapolis, MN, United States
Publisher
Lancet Publishing Group (E-mail: cususerv@lancet.com)
Abstract
Background: The Synergy between PCI with Taxus and Cardiac Surgery
(SYNTAX) trial was a non-inferiority trial that compared percutaneous
coronary intervention (PCI) using first-generation paclitaxel-eluting
stents with coronary artery bypass grafting (CABG) in patients with
de-novo three-vessel and left main coronary artery disease, and reported
results up to 5 years. We now report 10-year all-cause death results.
<br/>Method(s): The SYNTAX Extended Survival (SYNTAXES) study is an
investigator-driven extension of follow-up of a multicentre, randomised
controlled trial done in 85 hospitals across 18 North American and
European countries. Patients with de-novo three-vessel and left main
coronary artery disease were randomly assigned (1:1) to the PCI group or
CABG group. Patients with a history of PCI or CABG, acute myocardial
infarction, or an indication for concomitant cardiac surgery were
excluded. The primary endpoint of the SYNTAXES study was 10-year all-cause
death, which was assessed according to the intention-to-treat principle.
Prespecified subgroup analyses were performed according to the presence or
absence of left main coronary artery disease and diabetes, and according
to coronary complexity defined by core laboratory SYNTAX score tertiles.
This study is registered with ClinicalTrials.gov, NCT03417050.
<br/>Finding(s): From March, 2005, to April, 2007, 1800 patients were
randomly assigned to the PCI (n=903) or CABG (n=897) group. Vital status
information at 10 years was complete for 841 (93%) patients in the PCI
group and 848 (95%) patients in the CABG group. At 10 years, 244 (27%)
patients had died after PCI and 211 (24%) after CABG (hazard ratio 1.17
[95% CI 0.97-1.41], p=0.092). Among patients with three-vessel disease,
151 (28%) of 546 had died after PCI versus 113 (21%) of 549 after CABG
(hazard ratio 1.41 [95% CI 1.10-1.80]), and among patients with left main
coronary artery disease, 93 (26%) of 357 had died after PCI versus 98
(28%) of 348 after CABG (0.90 [0.68-1.20], p<inf>interaction</inf>=0.019).
There was no treatment-by-subgroup interaction with diabetes
(p<inf>interaction</inf>=0.66) and no linear trend across SYNTAX score
tertiles (p<inf>trend</inf>=0.30). <br/>Interpretation(s): At 10 years, no
significant difference existed in all-cause death between PCI using
first-generation paclitaxel-eluting stents and CABG. However, CABG
provided a significant survival benefit in patients with three-vessel
disease, but not in patients with left main coronary artery disease.
<br/>Funding(s): German Foundation of Heart Research (SYNTAXES study,
5-10-year follow-up) and Boston Scientific Corporation (SYNTAX study,
0-5-year follow-up).<br/>Copyright &#xa9; 2019 Elsevier Ltd

<80>
Accession Number
622992525
Title
Prognostic effect and modulation of cardiac sympathetic function in heart
failure patients treated with cardiac resynchronization therapy.
Source
Journal of Nuclear Cardiology. 27 (1) (pp 283-290), 2020. Date of
Publication: 01 Feb 2020.
Author
Moreira R.I.; Abreu A.; Portugal G.; Oliveira L.; Oliveira M.; Rodrigues
I.; Cruz M.C.; Cunha P.S.; Santos V.; Clara H.S.; Carmo M.M.; Ferreira
R.C.
Institution
(Moreira, Abreu, Portugal, Oliveira, Rodrigues, Cruz, Cunha, Carmo,
Ferreira) Department of Cardiology, Hospital de Santa Marta, Centro
Hospitalar de Lisboa Central, Rua de Santa Marta, no. 50, Lisbon 1169-024,
Portugal
(Oliveira) Nuclear Medicine Department, Medical and Diagnosis Clinic
Quadrantes, Lisbon, Portugal
(Santos, Clara) CIPER, Human Kinetics Faculty, University of Lisbon,
Lisbon, Portugal
(Carmo) NOVA Medical School, New University of Lisbon, Lisbon, Portugal
Publisher
Springer
Abstract
Background: Cardiac autonomic dysfunction as assessed by
¹²³I-metaiodobenzylguanidine (¹²³I-mIBG)
scintigraphy is associated with poor prognosis in heart failure (HF)
patients. Although cardiac resynchronization therapy (CRT) has emerged as
an effective therapy in improving outcomes on HF patients, its effect on
cardiac sympathetic nervous function is still not fully understood. We
aimed to study the value of pre-implantation ¹²³I-mIBG late
heart-to-mediastinum ratio (HMR) as a predictor of response and outcomes
after CRT and to correlate modification in this parameter with CRT
response and functional improvement. <br/>Methods and Results: BETTER-HF
(Benefit of exercise training therapy and cardiac resynchronization in HF
patients) is a prospective randomized clinical trial including HF patients
submitted CRT (mean LVEF 24 +/- 8%, 74% NYHA class >= III) who underwent a
clinical, echocardiographic, and scintigraphic assessment before and 6
months after CRT. One-hundred and twenty-one patients were included.
Echocardiographic response was observed in 54% and composite outcome of
cardiac mortality, cardiac transplant or heart failure hospitalization in
24% of patients. Baseline late HMR was an independent predictor of CRT
response (regression coefficient 2.906, 95% CI 0.293-3.903, P.029) and
outcomes (HR 0.066 95% CI 0.005-0.880, P.040). At follow-up,
¹²³I-mIBG imaging showed positive changes in cardiac
sympathetic nerve activity only in responders to CRT (1.36 +/- 0.14 prior
vs. 1.42 +/- 0.16 after CRT, P.039). There was a significant correlation
between improvement in late HMR and improvement in peak oxygen consumption
(r 0.547, P <.001). <br/>Conclusion(s): In our study, baseline cardiac
denervation predicted response and clinical outcomes after CRT
implantation. Cardiac sympathetic function was improved only in patients
who responded to CRT and these positive changes were correlated with
improvement in functional capacity.<br/>Copyright &#xa9; 2018, American
Society of Nuclear Cardiology.

<81>
Accession Number
2004704469
Title
Outcome of pitavastatin versus atorvastatin therapy in patients with
hypercholesterolemia at high risk for atherosclerotic cardiovascular
disease.
Source
International Journal of Cardiology. 305 (pp 139-146), 2020. Date of
Publication: 15 April 2020.
Author
Moroi M.; Nagayama D.; Hara F.; Saiki A.; Shimizu K.; Takahashi M.; Sato
N.; Shiba T.; Sugimoto H.; Fujioka T.; Chiba T.; Nishizawa K.; Usui S.;
Iwasaki Y.; Tatsuno I.; Sugi K.; Yamasaki J.; Yamamura S.; Shirai K.
Institution
(Moroi, Sugi) Division of Cardiovascular Medicine (Ohashi), Department of
Internal Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
(Nagayama) Nagayama Clinic, Oyama City, Tochigi, Japan
(Hara, Yamasaki) Division of Cardiovascular Medicine (Omori), Department
of Internal Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
(Saiki, Tatsuno, Shirai) Division of Diabetes, Endocrinology and
Metabolism (Sakura), Department of Internal Medicine, Faculty of Medicine,
Toho University, Chiba, Japan
(Shimizu, Takahashi) Division of Cardiovascular Medicine (Sakura),
Department of Internal Medicine, Faculty of Medicine, Toho University,
Chiba, Japan
(Sato) Pharmaceutical Unit, Toho University Sakura Medical Center, Chiba,
Japan
(Shiba) Division of Diabetes and Metabolism (Ohashi), Department of
Internal Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
(Sugimoto, Fujioka) Division of Neurology (Ohashi), Department of Internal
Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
(Chiba, Nishizawa) Department of Pharmacy, Toho University Omori Medical
Center, Tokyo, Japan
(Usui) Division of Diabetes, Endocrinology and Metabolism (Omori),
Department of Internal Medicine, Faculty of Medicine, Toho University,
Tokyo, Japan
(Iwasaki) Division of Neurology (Omori), Department of Internal Medicine,
Faculty of Medicine, Toho University, Tokyo, Japan
(Yamamura) Faculty of Pharmaceutical Sciences, Josai International
University, Chiba, Japan
Publisher
Elsevier Ireland Ltd
Abstract
Background: There has been no report about outcome of pitavastatin versus
atorvastatin therapy in high-risk patients with hypercholesterolemia.
<br/>Method(s): Hypercholesterolemic patients with one or more risk
factors for atherosclerotic diseases (n = 664, age = 65, male = 54%,
diabetes = 76%, primary prevention = 74%) were randomized to receive
pitavastatin 2 mg/day (n = 332) or atorvastatin 10 mg/day (n = 332).
Follow-up period was 240 weeks. The primary end point was a composite of
cardiovascular death, sudden death of unknown origin, nonfatal myocardial
infarction, nonfatal stroke, transient ischemic attack, or heart failure
requiring hospitalization. The secondary end point was a composite of the
primary end point plus clinically indicated coronary revascularization for
stable angina. <br/>Result(s): The mean low-density lipoprotein
cholesterol (LDL-C) level at baseline was 149 mg/dL. The mean LDL-C levels
at 1 year were 95 mg/dL in the pitavastatin group and 94 mg/dL in the
atorvastatin group. There were no differences in LDL-C levels between both
groups, however, pitavastatin significantly reduced the risk of the
primary end point, compared to atorvastatin (pitavastatin = 2.9% and
atorvastatin = 8.1%, HR, 0.366; 95% CI 0.170-0.787; P = 0.01 by
multivariate Cox regression) as well as the risk of the secondary end
point (pitavastatin = 4.5% and atorvastatin = 12.9%, HR = 0.350; 95%CI =
0.189-0.645, P = 0.001). The results for the primary and secondary end
points were consistent across several prespecified subgroups. There were
no differences in incidence of adverse events between the statins.
<br/>Conclusion(s): Pitavastatin therapy compared with atorvastatin more
may prevent cardiovascular events in hypercholesterolemic patients with
one or more risk factors for atherosclerotic diseases despite similar
effects on LDL-C levels.<br/>Copyright &#xa9; 2020 The Authors

<82>
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. 37 (2) (pp 302-309), 2020. Date of Publication: 01 Feb
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.

<83>
Accession Number
2003716133
Title
Patient blood management (PBM) in pregnancy and childbirth: literature
review and expert opinion.
Source
Archives of Gynecology and Obstetrics. 301 (2) (pp 627-641), 2020. Date of
Publication: 01 Feb 2020.
Author
Surbek D.; Vial Y.; Girard T.; Breymann C.; Bencaiova G.A.; Baud D.;
Hornung R.; Taleghani B.M.; Hosli I.
Institution
(Surbek) Department of Obstetrics and Gynaecology, Bern University
Hospital, Insel Hospital, University of Bern, Friedbuhlstrasse 19, Bern
3010, Switzerland
(Bencaiova, Hosli) Clinic of Obstetrics and Gynaecology, University
Hospital Basel, Basel, Switzerland
(Vial, Baud) Service of Obstetrics, Department Woman-Mother-Child,
University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne,
Switzerland
(Girard) Department of Anaesthesiology, University Hospital Basel, Basel,
Switzerland
(Breymann) Obstetric Research-Feto Maternal Haematology Unit, University
Hospital Zurich, Zurich, Switzerland
(Hornung) Department of Obstetrics and Gynaecology, St. Gallen Cantonal
Hospital, St. Gallen, Switzerland
(Taleghani) Department of Haematology, Inselspital, University and
University Hospital Bern, Bern, Switzerland
Publisher
Springer
Abstract
Purpose: Patient blood management [PBM] has been acknowledged and
successfully introduced in a wide range of medical specialities, where
blood transfusions are an important issue, including anaesthesiology,
orthopaedic surgery, cardiac surgery, or traumatology. Although pregnancy
and obstetrics have been recognized as a major field of potential
haemorrhage and necessity of blood transfusions, there is still little
awareness among obstetricians regarding the importance of PBM in this
area. This review, therefore, summarizes the importance of PBM in
obstetrics and the current evidence on this topic. <br/>Method(s): We
review the current literature and summarize the current evidence of PBM in
pregnant women and postpartum with a focus on postpartum haemorrhage (PPH)
using PubMed as literature source. The literature was reviewed and
analysed and conclusions were made by the Swiss PBM in obstetrics working
group of experts in a consensus meeting. <br/>Result(s): PBM comprises a
series of measures to maintain an adequate haemoglobin level, improve
haemostasis and reduce bleeding, aiming to improve patient outcomes.
Despite the fact that the WHO has recommended PBM early 2010, the majority
of hospitals are in need of guidelines to apply PBM in daily practice. PBM
demonstrated a reduction in morbidity, mortality, and costs for patients
undergoing surgery or medical interventions with a high bleeding
potential. All pregnant women have a significant risk for PPH. Risk
factors do exist; however, 60% of women who experience PPH do not have a
pre-existing risk factor. Patient blood management in obstetrics must,
therefore, not only be focused on women with identified risk factor for
PPH, but on all pregnant women. Due to the risk of PPH, which is inherent
to every pregnancy, PBM is of particular importance in obstetrics.
Although so far, there is no clear guideline how to implement PBM in
obstetrics, there are some simple, effective measures to reduce anaemia
and the necessity of transfusions in women giving birth and thereby
improving clinical outcome and avoiding complications. <br/>Conclusion(s):
PBM in obstetrics is based on three main pillars: diagnostic and/or
therapeutic interventions during pregnancy, during delivery and in the
postpartum phase. These three main pillars should be kept in mind by all
professionals taking care of pregnant women, including obstetricians,
general practitioners, midwifes, and anaesthesiologists, to improve
pregnancy outcome and optimize resources.<br/>Copyright &#xa9; 2019, The
Author(s).