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<1>
Accession Number
632830806
Title
The role of fractional flow reserve in coronary artery bypass graft
surgery: A meta-analysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 30 (5) (pp 671-678),
2020. Date of Publication: 01 May 2020.
Author
Jayakumar S.; Bilkhu R.; Ayis S.; Nowell J.; Bogle R.; Jahangiri M.
Institution
(Jayakumar, Bilkhu, Nowell, Jahangiri) Department of Cardiothoracic
Surgery, St George's Hospital, London, United Kingdom
(Ayis) Department of Biostatistics, King's College London, London, United
Kingdom
(Bogle) Department of Cardiology, Clinical Academic Group, St George's
Hospital, London, United Kingdom
(Jahangiri) Department of Cardiothoracic Surgery, St George's Hospital,
Blackshaw Road, London SW17 0QT, United Kingdom
Publisher
Oxford University Press
Abstract
OBJECTIVES: Fractional flow reserve (FFR) measures the drop in perfusion
pressure across a stenosis, therefore representing its physiological
effect on myocardial blood flow. Its use is widespread in percutaneous
coronary interventions, though its role in coronary artery bypass graft
(CABG) surgery remains uncertain. This systematic review and meta-analysis
aims to evaluate current evidence on outcomes following FFR-guided CABG
compared to angiography-guided CABG. <br/>METHOD(S): A literature search
was conducted following PRISMA (Preferred Reporting Items for Systematic
Reviews and Meta-Analyses) guidelines to identify all relevant articles.
Patient demographics and characteristics were extracted. The following
outcomes were analysed: repeat revascularization, myocardial infarction
(MI) and all-cause mortality. Pooled relative risks were analysed and
their 95% confidence intervals (CIs) were estimated using random-effects
models; P-value <0.05 was considered statistically significant.
Heterogeneity was assessed with Cochran's Q score and quantified by
I² index. <br/>RESULT(S): Nine studies with 1146 patients (FFR:
574, angiography: 572) were included. There was no difference in MI or
repeat revascularization between the 2 groups (relative risk 0.76, 95% CI
0.41-1.43; P = 0.40, and relative risk 1.28, 95% CI 0.75-2.19; P = 0.36,
respectively). There was a significant reduction in all-cause mortality in
the FFR-guided CABG group compared to angiography-guided CABG, which was
not specifically cardiac related (relative risk 0.58, 95% CI 0.38-0.90; P
= 0.02). <br/>CONCLUSION(S): There was no reduction in repeat
revascularization or postoperative MI with FFR. In this fairly small
cohort, FFR-guided CABG provided a reduction in mortality, but this was
not reported to be due to cardiac causes. There may be a role for FFR in
CABG, but large-scale randomized trials are required to establish its
value.<br/>Copyright &#xa9; The Author(s) 2020. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<2>
Accession Number
607075138
Title
Effect of intravascular ultrasound-guided vs angiography- guided
everolimus-eluting stent implantation: The IVUS-XPL randomized clinical
trial.
Source
JAMA - Journal of the American Medical Association. 314 (20) (pp
2155-2163), 2015. Date of Publication: 24 Nov 2015.
Author
Hong S.-J.; Kim B.-K.; Shin D.-H.; Nam C.-M.; Kim J.-S.; Ko Y.G.; Choi D.;
Kang T.-S.; Kang W.-C.; Her A.-Y.; Kim Y.; Hur S.-H.; Hong B.-K.; Kwon H.;
Jang Y.; Hong M.K.; Yang J.-Y.; Cheon D.W.; Lee S.W.; Kim B.-O.; Ahn
C.-M.; Chang H.-J.; Choi S.-H.; Cho D.-K.; Choi E.-Y.; Shim J.-Y.; Yoon
S.-J.; Kim J.-Y.; Lee S.-G.; Yoon J.H.; Jeon D.-W.; Cho Y.-H.; Choi J.-W.;
Rhee S.-J.; Choi R.-K.; Lee S.-Y.; Kim W.-H.; Lee N.-H.; Hong Y.-J.; Choi
H.-H.; Park J.-P.; Lim S.-W.
Institution
(Hong) Department of Internal Medicine, Sanggye Paik Hospital, Inje
University, Seoul, South Korea
(Hong, Kim, Shin, Kim, Ko, Choi, Jang, Hong) Division of Cardiology,
Severance Cardiovascular Hospital, Yonsei University College of Medicine,
Seoul, South Korea
(Nam) Department of Preventive Medicine and Biostatistics, Yonsei
University College of Medicine, Seoul, South Korea
(Kang) Dankook University College of Medicine, Cheonan, South Korea
(Kang) Gil Hospital, Gachon University College of Medicine, Incheon, South
Korea
(Her, Kim) School of Medicine, Kangwon National University, Chuncheon,
South Korea
(Hur) Keimyung University College of Medicine, Daegu, South Korea
(Hong, Kwon) Kangnam Severance Hospital, Seoul, South Korea
(Jang, Hong) Severance Biomedical Science Institute, Yonsei University
College of Medicine, Division of Cardiology, Severance Cardiovascular
Hospital, 134 Sinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea
(Jang, Hong) Cardiovascular Research Institute, Yonsei University College
of Medicine, Seoul, South Korea
(Hong) Yonsei University College of Medicine, Seoul, South Korea
(Hong) GSH, Seoul, South Korea
(Lee) Ulsan University Hospital, Ulsan, South Korea
(Yoon) Wonju Christian Hospital, Wonju, South Korea
(Yoon) GGUH, Incheon, South Korea
(Jeon) DUH, Cheonan, South Korea
(Jeon) NHIC Ilsan Hospital, Ilsan, South Korea
(Cho) Myongji Hospital, Goyang, South Korea
(Choi) Seoul Eulji Hospital, Seoul, South Korea
(Rhee) Wonkwang University Hospital, Iksan, South Korea
(Choi) Sejong General Hospital, Bucheon, South Korea
(Lee) Inje University Ilsan Paik Hosital, Ilsan, South Korea
(Kim) KUDH, Daegu, South Korea
(Kim) Daejeon Eulji University Hospital, Dae-jeon, South Korea
(Lee) Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea
(Lee) KNUH, Chuncheon, South Korea
(Hong) Chunnam National University Hospital, Kwangju, South Korea
(Choi) Hallym University Chunchun Scared Hospital, Chuncheon, South Korea
(Park) Jeonnju Presbyterian Medical Center, Jeonju, South Korea
(Lim) CHA University Medical Center, Seongnam, South Korea
Publisher
American Medical Association
Abstract
IMPORTANCE:Use of intravascular ultrasound (IVUS) promotes better clinical
outcomes for coronary intervention in complex coronary lesions. However,
randomized data demonstrating the clinical usefulness of IVUS are limited
for lesions treated with drug-eluting stents. <br/>OBJECTIVE(S):To
determine whether the long-term clinical outcomes with IVUS-guided
drug-eluting stent implantation are superior to those with
angiography-guided implantation in patients with long coronary lesions.
DESIGN, SETTING, AND PARTICIPANTS: The Impact of Intravascular Ultrasound
Guidance on Outcomes of Xience Prime Stents in Long Lesions (IVUS-XPL)
randomized, multicenter trial was conducted in 1400 patients with long
coronary lesions (implanted stent>=28 mmin length) between October 2010
and July 2014 at 20 centers in Korea. INTERVENTIONS: Patients were
randomly assigned to receive IVUS-guided (n = 700) or angiography-guided
(n = 700) everolimus-eluting stent implantation. MAIN OUTCOMES AND
MEASURES: Primary outcome measure was the composite of major adverse
cardiac events, including cardiac death, target lesion-related myocardial
infarction, or ischemia-driven target lesion revascularization at 1 year,
analyzed by intention-to-treat. <br/>RESULT(S): One-year follow-up was
complete in 1323 patients (94.5%). Major adverse cardiac events at 1 year
occurred in 19 patients (2.9%) undergoing IVUS-guided and in 39 patients
(5.8%) undergoing angiography-guided stent implantation (absolute
difference, -2.97% [95% CI, -5.14%to -0.79%]) (hazard ratio [HR], 0.48
[95% CI, 0.28 to 0.83], P = .007). The difference was driven by a lower
risk of ischemia-driven target lesion revascularization in patients
undergoing IVUS-guided (17 [2.5%]) compared with angiography-guided (33
[5.0%]) stent implantation (HR, 0.51 [95% CI, 0.28 to 0.91], P = .02).
Cardiac death and target lesion-related myocardial infarction were not
significantly different between the 2 groups. For cardiac death, there
were 3 patients (0.4%) in the IVUS-guided group and 5 patients (0.7%) in
the angiography-guided group (HR, 0.60 [95% CI, 0.14 to 2.52], P = .48).
Target lesion-related myocardial infarction occurred in 1 patient (0.1%)
in the angiography-guided stent implantation group (P = .32). CONCLUSIONS
AND RELEVANCE: Among patients requiring long coronary stent implantation,
the use of IVUS-guided everolimus-eluting stent implantation, compared
with angiography-guided stent implantation, resulted in a significantly
lower rate of the composite of major adverse cardiac events at 1 year.
These differences were primarily due to lower risk of target lesion
revascularization.<br/>Copyright &#xa9; 2015 American Medical Association.
All rights reserved.

<3>
Accession Number
2011016391
Title
Rational and design of the ROTAS study: A randomized study for the optimal
treatment of symptomatic patients with low-gradient severe aortic valve
stenosis and preserved left ventricular ejection fraction.
Source
European Heart Journal Cardiovascular Imaging. 22 (2) (pp 229-235), 2021.
Date of Publication: 01 Feb 2021.
Author
Galli E.; Le Ven F.; Coisne A.; Sportouch C.; Le Tourneau T.; Bernard A.;
Biere L.; Habib G.; Lancellotti P.; Lederlin M.; Tribouilloy C.; Oger E.;
Donal E.
Institution
(Galli, Donal) University of Rennes, CHU Rennes, Inserm, LTSI, UMR 1099,
Rennes F-35000, France
(Le Ven) Service de Cardiologie, Hopital Cavale Blanche, CHRU Brest, Brest
29200, France
(Coisne) Department of Clinical Physiology and Echocardiography, CHU
Lille, Heart Valve Center, Univ. Lille, U1011 - EGID, Institut Pasteur de
Lille, Lille F-59000, France
(Sportouch) Clinique du Millenaire, Montpellier 34000, France
(Le Tourneau) Department of Cardiology, Thorax Institute, Centre
Hospitalier Universitaire de Nantes, Site Hotel-Dieu-Hme 1, Place Alexis
Ricordeau, Nantes, France
(Bernard) Cardiology Department, Trousseau Hospital, University of Tours,
Tours, France
(Biere) Institut MITOVASC, UMR INSERM U1083, CNRS 6015, Service de
Cardiologie, CHU Angers, Universite Angers, Angers, France
(Habib) Aix Marseille Universite, IRD, APHM, MEPHI, IHU-Mediterranee
Infection, France
(Lancellotti) Department of Cardiology, Heart Valve Clinic, University of
Liege Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Belgium
(Lederlin) Imagerie Medicale, CHU de Rennes, Rennes 35000, France
(Tribouilloy) Department of Cardiology, Amiens University Hospital, 1 Rue
du Professeur Christian Cabrol, Amiens, France
(Oger) Pharmacologie Clinique et CIC-IP 1414, CHU Rennes, Universite
Rennes-1, Rennes, France
Publisher
Oxford University Press
Abstract
Aims: Fifteen to thirty percentage of patients with severe aortic stenosis
(AS) have preserved left ventricular ejection fraction (LVEF) and a
discordant AS pattern at Doppler echocardiography, which is characterized
by a small (<1 cm2) aortic area and low mean aortic gradient (<40 mmHg).
The 'Randomized study for the Optimal Treatment of symptomatic patients
with low-gradient severe Aortic Stenosis and preserved left ventricular
ejection fraction' (ROTAS trial) aims at demonstrating the superiority of
aortic valve replacement vs. a 'watchful waiting strategy' in symptomatic
patients with low-gradient (LS), severe AS, and preserved LVEF, stratified
according to indexed stroke volume, in terms of all-cause mortality or
cardiovascular-related hospitalization during follow-up (FU). <br/>Methods
and Results: The ROTAS trial will be a multicentre randomized non-blinded
study involving 16 reference centres. AS severity will be confirmed by a
multimodality approach (rest and stress echocardiography, calcium scoring,
and cardiac magnetic resonance imaging for optimally characterize the
population), which could provide important inputs to improve the
pathophysiological understanding of this complex disease.
Well-characterized patients will be randomized according to the management
strategy. The primary endpoint will be the occurrence of all-cause
mortality or cardiac related-hospitalizations during 2-year FU. One
hundred and eighty subjects per group will be included.
<br/>Conclusion(s): The management of patients with LS severe AS and
preserved LVEF is largely debated. ROTAS trial will allow a comprehensive
evaluation of this particular pattern of AS and will establish which is
the most appropriate management of these patients.<br/>Copyright &#xa9;
2020 Published on behalf of the European Society of Cardiology. All rights
reserved.

<4>
Accession Number
2010942184
Title
Meta-Analysis of Population Characteristics and Outcomes of Patients
Undergoing Pericardiectomy for Constrictive Pericarditis.
Source
American Journal of Cardiology. 146 (pp 120-127), 2021. Date of
Publication: 01 May 2021.
Author
Tzani A.; Doulamis I.P.; Tzoumas A.; Avgerinos D.V.; Koudoumas D.; Siasos
G.; Vavuranakis M.; Klein A.; Kampaktsis P.N.
Institution
(Tzani) Brigham and Women's Hospital Heart and Vascular Center, Harvard
Medical School, Boston, MA, United States
(Doulamis) Department of Cardiac Surgery, Boston Children's Hospital,
Harvard Medical School, Boston, MA, United States
(Tzoumas) Medical School, Aristotle University of Thessaloniki,
Thessaloniki, Greece
(Avgerinos) Onassis Cardiac Surgery Center, Athens, Greece
(Koudoumas) Department of Surgery, Division of Cardiothoracic Surgery,
University of Utah, Salt lake city, UT, United States
(Siasos, Vavuranakis) 1st Cardiology Clinic, National and Kapodistrian
University of Athens Medical School, Greece
(Klein) Department of Cardiovascular Medicine, Cleveland Clinic,
Cleveland, OH, United States
(Kampaktsis) Division of Cardiology, New York University Langone Medical
Center, NY, NY, United States
Publisher
Elsevier Inc.
Abstract
We sought to systematically describe the epidemiology, etiology, clinical
and operative characteristics as well as outcomes of patients who
underwent pericardiectomy for constrictive pericarditis in the
contemporary era. We conducted a systematic search of the MEDLINE, Embase,
and Cochrane databases from their inception to April 1, 2020 for studies
assessing the outcomes of pericardiectomy in patients with constrictive
pericarditis. Studies with patients enrolled before 1985, pediatric
patients or studies including >10% tuberculous pericarditis were excluded.
The impact of pericarditis etiology on outcomes was evaluated with a
meta-analysis. We analyzed 27 eligible studies and 2,114 patients.
Etiology was most commonly idiopathic (50.2%), followed by after-cardiac
surgery (26.2%) and radiation (6.9%). Patients were mostly men (76%), mean
age 58 and with advanced symptoms (NYHA III/IV 70.1%). Total
pericardiectomy was preferred (85.8%) and concomitant cardiac surgery was
relatively common (23.8%). Operative mortality was 6.9% and 5-year
mortality was 32.7%. Radiation and after-cardiac surgery patients had 3
and 2 times higher long-term risk for mortality respectively compared with
idiopathic. A sensitivity analysis did not result in changes in the
results. Thirty percent of included studies had more than low bias
primarily originating from follow up and selection. Pericardiectomy is
therefore performed mostly in middle-aged men with advanced symptoms and
low co-morbidity burden and still caries significant operative mortality.
Radiation and after-cardiac surgery patients have a significantly higher
mortality risk compared with idiopathic. Several methodological issues and
significant heterogeneity limit the generalization of these data and
randomized controlled trials may have to be considered.<br/>Copyright
&#xa9; 2021 Elsevier Inc.

<5>
Accession Number
2006038667
Title
Transcatheter aortic valve implantation: The new challenges of cardiac
rehabilitation.
Source
Journal of Clinical Medicine. 10 (4) (pp 1-10), 2021. Article Number: 810.
Date of Publication: 02 Feb 2021.
Author
Sperlongano S.; Renon F.; Bigazzi M.C.; Sperlongano R.; Cimmino G.;
D'andrea A.; Golino P.
Institution
(Sperlongano, Renon, Bigazzi, Cimmino, Golino) Department of Translational
Medical Sciences, Division of Cardiology, University of Campania Luigi
Vanvitelli, Monaldi Hospital, Naples 80131, Italy
(Sperlongano) Department of Experimental Sciences, University of Campania
Luigi Vanvitelli, Naples 80138, Italy
(D'andrea) Department of Cardiology and Intensive Coronary Care, Umberto I
Hospital, Nocera Inferiore 84014, Italy
Publisher
MDPI AG
Abstract
Transcatheter aortic valve implantation (TAVI) is an increasingly
widespread percutaneous intervention of aortic valve replacement (AVR).
The target population for TAVI is mainly composed of elderly, frail
patients with severe aortic stenosis (AS), multiple comorbidities, and
high perioperative mortality risk for surgical AVR (sAVR). These
vulnerable patients could benefit from cardiac rehabilitation (CR)
programs after percutaneous intervention. To date, no major guidelines
currently recommend CR after TAVI. However, emerging scientific evidence
shows that CR in patients undergoing TAVI is safe, and improves exercise
tolerance and quality of life. Moreover, preliminary data prove that a CR
program after TAVI has the potential to reduce mortality during follow-up,
even if randomized clinical trials are needed for confirmation. The
present review article provides an overview of all scientific evidence
concerning the potential beneficial effects of CR after TAVI, and suggests
possible fields of research to improve cardiac care after
TAVI.<br/>Copyright &#xa9; 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<6>
Accession Number
2005074857
Title
Transthyretin cardiac amyloidosis and aortic stenosis: Connection and
therapeutic implications.
Source
Current Cardiology Reviews. 16 (3) (pp 221-230), 2020. Date of
Publication: 2020.
Author
Penalver J.; Ambrosino M.; Jeon H.D.; Agrawal A.; Kanjanahat-Takij N.;
Pitteloud M.; Stempel J.; Amanullah A.
Institution
(Penalver, Ambrosino, Jeon, Agrawal, Kanjanahat-Takij, Pitteloud, Stempel)
Department of Medicine, Einstein Medical Center, Philadelphia, PA 19141,
United States
(Amanullah) Department of Medicine, Cardiovascular Disease, Einstein
Medical Center, PA 19141, United States
Publisher
Bentham Science Publishers
Abstract
Background: There is a growing interest in the observed significant
incidence of transthyretin cardiac amyloidosis in elderly patients with
aortic stenosis. Approximately, 16% of patients with severe aortic
stenosis undergoing aortic valve replacement have transthyretin cardiac
amyloidosis. Outcomes after aortic valve replacement appear to be worst in
patients with concomi-tant transthyretin cardiac amyloidosis.
<br/>Method(s): Publications in PubMed, Cochrane Library, and Embase
databases were systematically searched from January 2012 to September 2018
using the keywords transthyretin, amyloidosis, and aortic stenosis. All
studies published in English that reported the prevalence, association and
outcomes of transthyretin cardiac amyloidosis in patients with aortic
stenosis undergoing were in-cluded. Results/Conclusion: The relationship
between aortic stenosis and transthyretin cardiac amyloidosis is not well
understood. A few studies have proven successful surgical management when
both conditions coexist. This systematic review suggests that
transthyretin cardiac amyloidosis is common in elderly patients with
aortic stenosis and tend to have high mortality rates after AVR. The
significant incidence of the two diseases occurring simultaneously
warrants further investigation to improve management strategies in the
future.<br/>Copyright &#xa9; 2020 Bentham Science Publishers.

<7>
Accession Number
2008476891
Title
Clinical Outcomes of the Self-Expandable Evolut R Valve Versus the
Balloon-Expandable SAPIEN 3 Valve in Transcatheter Aortic Valve
Implantation: A Meta-Analysis and Systematic Review.
Source
Cardiovascular Revascularization Medicine. 25 (pp 57-62), 2021. Date of
Publication: April 2021.
Author
Al-abcha A.; Saleh Y.; Charles L.; Prasad R.; Baloch Z.Q.; Hasan M.A.;
Abela G.S.
Institution
(Al-abcha, Charles, Prasad) Department of Internal Medicine, Michigan
State University, East Lansing, MI, United States
(Saleh) Department of Cardiology, Houston Methodist Hospital, Houston, TX,
United States
(Baloch, Abela) Department of Internal Medicine, Division of Cardiology,
Michigan State University, East Lansing, MI, United States
(Hasan) Department of Cardiology, Ochsner Clinic, New Orleans, LA, United
States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is now indicated
in patients with symptomatic aortic stenosis and low, moderate, and high
surgical risk. There are multiple types of valves available in TAVR.
SAPIEN 3, and Evolut R are two of the most commonly used valves.
<br/>Method(s): We conducted a systematic review and meta-analysis of all
studies that compared SAPIEN 3 vs Evolut R in patients undergoing TAVR.
The primary endpoint of this meta-analysis was 30-day mortality. Secondary
outcomes included major of life-threatening bleeding, risk of stroke, need
of permanent pacemaker implantation, and risk of moderate to severe
paravalvular regurgitation (PVR). <br/>Result(s): We included a total of 9
studies. One study was a randomized clinical trial, five were prospective
observational studies and three were retrospective. 30-day mortality rate
was similar between SAPIEN 3 and Evolut R (odds ratio (OR) 1.19; 95%
confidence interval (CI) 0.72 to 1.93; p = 0.47). The risk of major or
life-threatening bleeding (OR of 0.83, 95% CI 0.50 to 1.39; p = 0.48), and
the risk of stroke (OR of 0.82, 95% CI 0.38 to 1.78; p = 0.62) were also
similar between the two types of valves. Compared to SAPIEN 3, Evolut R
was associated with statistically significant risk of permanent pacemaker
implantation (OR of 1.40, 95% CI 1.15 to 1.70; p = 0.0007), and moderate
to severe PVR (OR of 2.56, 95% CI 1.14 to 5.74; p = 0.02).
<br/>Conclusion(s): At 30 day follow up, both Evolut R and SAPIEN 3 shared
similar risks of 30-day mortality, major or life-threatening bleeding, and
stroke; however greater odds of pacemaker placement implantation and
moderate to severe PVR were associated with Evolut R.<br/>Copyright &#xa9;
2020 Elsevier Inc.

<8>
Accession Number
2006844143
Title
Constrictive pericarditis: 21 years' experience and review of literature.
Source
Pan African Medical Journal. 38 (no pagination), 2021. Article Number:
141. Date of Publication: 08 Feb 2021.
Author
Karima T.; Nesrine B.Z.; Hatem L.; Skander B.O.; Raouf D.; Selim C.
Institution
(Karima, Nesrine, Hatem, Selim) Department of Cardiac Surgery, Military
Hospital of Tunis, Tunis, Tunisia
(Skander, Raouf) Department of Cardiac Surgery, La Rabta Hospital, Tunis,
Tunisia
Publisher
African Field Epidemiology Network
Abstract
To the best of our knowledge there are no publications about Tunisian
experience in constrictive pericarditis (CP); the aim of this study was
therefore to review our twenty-one years' experience in terms of clinical
and surgical outcomes and risk factors of death after pericardiectomy. An
analytic bicentric and retrospective study carried out on 25 patients (20
male) with CP underwent pericardiectomy, collected over a 21-years period.
The mean age was 40.46+/-16.74 years [7.5-72]. The commonest comorbid
factor was tabagism (52%). The most common etiology was tuberculosis (n =
11, 44%). Dyspnea was the most common functional symptom (n = 21, 84%).
Pericardiectomy was performed in all our patients within 2.9+/-3.19 months
after confirmation of diagnosis. It was subtotal in 96% of cases. The
commonest postoperative complications are pleural effusion (20%). Dyspnea
was regressed within 1.8 months in 80% of cases and clinical signs of
right heart failure within a mean duration of 1.62 months in 53% of cases.
Perioperative mortality was 12% (3 deaths), late mortality was 4% (1
patient). Cardiopulmonary bypass, New York Heart Association (NYHA) over
class II and right ventricular dysfunction are the prognostic factors of
mortality (p = 0.001, 0.046, 0.019). Tuberculosis as etiology of CP had no
impact on mortality. CP is a rare disease, with non-specific clinical
signs. Pericardiectomy is effective with a significant improvement of the
functional status of patients and favorable outcome at short and long term
nevertheless hospital mortality is not negligible and depends on many
factors.<br/>Copyright &#xa9; Taamallah Karima et al.

<9>
Accession Number
634807496
Title
A device category economic model of electrosurgery technologies across
procedure types: a U.S. hospital budget impact analysis.
Source
Journal of medical economics. 24 (1) (pp 524-535), 2021. Date of
Publication: 01 Jan 2021.
Author
Ferko N.; Wright G.W.J.; Syed I.; Naoumtchik E.; Tommaselli G.A.; Gangoli
G.
Institution
(Ferko, Wright, Syed) BurlingtonCanada
(Naoumtchik, Tommaselli, Gangoli) Johnson & Johnson Medical Devices
Companies, Cincinnati, OH, USA
Publisher
NLM (Medline)
Abstract
AIMS: The electrosurgical technology category is used widely, with a
diverse spectrum of devices designed for different surgical needs.
Historically, hospitals are supplied with electrosurgical devices from
several manufacturers, and those devices are often evaluated separately;
it may be more efficient to evaluate the category holistically. This study
assessed the health economic impact of adopting an electrosurgical
device-category from a single manufacturer. <br/>METHOD(S): A budget
impact model was developed from a U.S. hospital perspective. The uptake of
electrosurgical devices from EES (Ethicon Electrosurgery), including
ultrasonic, advanced bipolar, smoke evacuators, and reusable dispersive
electrodes were compared with similar MED (Medical Energy Devices) from
multiple manufacturers. It was assumed that an average hospital performed
10,000 annual procedures 80% of which involved electrosurgery. Current
utilization assumed 100% MED use, including advanced energy, conventional
smoke mitigation options (e.g. ventilation, masks), and single-use
disposable dispersive electrode devices. Future utilization assumed 100%
EES use, including advanced energy devices, smoke evacuators (i.e. 80%
uptake), and reusable dispersive electrodes. Surgical specialties included
colorectal, bariatric, gynecology, thoracic and general surgery.
Systematic reviews, network meta-analyses, and meta-regressions informed
operating room (OR) time, hospital stay, and transfusion model inputs.
Costs were assigned to model parameters, and price parity was assumed for
advanced energy devices. The costs of disposables for dispersive
electrodes and smoke-evacuators were included. <br/>RESULT(S): The
base-case analysis, which assessed the adoption of EES instead of MED for
an average U.S. hospital predicted an annual savings of $824,760 ($101 per
procedure). Savings were attributable to associated reductions with EES in
OR time, days of hospital stay, and volume of disposable electrodes.
Sensitivity analyses were consistent with these base-case findings.
<br/>CONCLUSION(S): Category-wide adoption of electrosurgical devices from
a single manufacturer demonstrated economic advantages compared with
disaggregated product uptake. Future research should focus on informing
comparisons of innovative electrosurgical devices.

<10>
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Accession Number
634799852
Title
A systematic review and meta-analysis of the effects of early mobilization
therapy in patients after cardiac surgery.
Source
Medicine. 100 (15) (pp e25314), 2021. Date of Publication: 16 Apr 2021.
Author
Chen B.; Xie G.; Lin Y.; Chen L.; Lin Z.; You X.; Xie X.; Dong D.; Zheng
X.; Li D.; Lin W.
Institution
(Chen, Lin, Chen, Lin, You, Xie, Dong, Zheng, Li, Lin) Affiliated People's
Hospital of Fujian University of Traditional Chinese Medicine
(Chen, Lin) National Clinical Research Base of Traditional Chinese
Medicine, Fujian Province, Fuzhou 350004, China
(Xie) Yunnan University of Traditional Chinese Medicine, Yunnan Province,
Kunming 650500, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Prolonged hospitalization and immobility of critical care
patients elevate 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. We conducted a meta-analysis to assess the effects of
early mobilization therapy on cardiac surgery patients in the intensive
care unit (ICU). <br/>METHOD(S): PubMed, Excerpta Medica database
(EMBASE), Cumulative Index of Nursing and Allied Health Literature
(CINAHL), Physiotherapy Evidence Database (PEDro), and the Cochrane
Library were comprehensively searched from their inception to September
2018. Randomized controlled trials were included if patients were adults
(>=18 years) admitted to any ICU for cardiac surgery due to cardiovascular
disease and who were treated with experimental physiotherapy initiated in
the ICU (pre, post, or peri-operative). Data were extracted by 2 reviewers
independently using a pre-constructed data extraction form. Length of ICU
and hospital stay was evaluated as the primary outcomes. Physical function
and adverse events were assessed as the secondary outcomes. Review Manager
5.3 (RevMan 5.3) was used for statistical analysis. For all dichotomous
variables, relative risks or odds ratios with 95% confidence intervals
(CI) were presented. For all continuous variables, mean differences (MDs)
or standard MDs with 95% CIs were calculated. <br/>RESULT(S): The 5
studies with a total of 652 patients were included in the data synthesis
final meta-analysis. While a slight favorable effect was detected in 3 out
of the 5 studies, the overall effects were not significant, even after
adjusting for heterogeneity. <br/>CONCLUSION(S): This population-specific
evaluation of the efficacy of early mobilization to reduce hospitalization
duration suggests that intervention may not universally justify the labor
barriers and resource costs in patients undergoing non-emergency cardiac
surgery. PROSPERO RESEARCH REGISTRATION IDENTIFYING NUMBER:
CRD42019135338.<br/>Copyright &#xa9; 2021 the Author(s). Published by
Wolters Kluwer Health, Inc.

<11>
Accession Number
631144489
Title
Long-term prognostic value of stress myocardial perfusion echocardiography
in patients with coronary artery disease: a meta-analysis.
Source
European heart journal. Cardiovascular Imaging. 22 (5) (pp 553-562), 2021.
Date of Publication: 28 Apr 2021.
Author
Qian L.; Xie F.; Xu D.; Porter T.R.
Institution
(Qian, Xu) Department of Geriatrics, First Affiliated Hospital of Nanjing
Medical University, Nanjing, China
(Xie, Porter) Division of Cardiovascular Medicine, University of Nebraska
Medical Center, Omaha, NE, 69198-1165, USA
Publisher
NLM (Medline)
Abstract
AIMS : To evaluate the prognostic value of myocardial perfusion (MP)
imaging during contrast stress echocardiography (cSE) in patients with
known or suspected coronary artery disease (CAD). METHODS AND RESULTS : A
search in PubMed, Embase databases, and the Cochrane library was conducted
through May 2019. The Cochran Q statistic and the I2 statistic were used
to assess heterogeneity, and the results were analysed by RevMan V5.3 and
Stata V15.1 software. Twelve studies (seven dipyridamole and five
exercise/dobutamine) without evidence of patient overlap (same institution
publishing results over a similar time period) enrolling 5953 subjects
(47% female, 8-80months of follow-up) were included in the analysis. In
all studies, total adverse cardiovascular events were defined as either
cardiac death, non-fatal myocardial infarction (NFMI), or need for urgent
revascularization. Hazard ratios (HRs) revealed that a MP abnormality
[pooled HR 4.75; 95% confidence interval (CI) 2.47-9.14] was a higher
independent predictor of total events than abnormal wall motion (WM,
pooled HR 2.39; 95% CI 1.58-3.61) and resting left ventricular ejection
fraction (LVEF, pooled HR 1.92; 95% CI 1.44-2.55) with significant
subgroup differences (P=0.002 compared with abnormal WM and 0.01 compared
with abnormal LVEF). Abnormal MP was associated with higher risks for
death [Risk ratio (RR) 5.24; 95% CI 2.91-9.43], NFMI (RR 3.09; 95% CI
1.84-5.21), and need for coronary revascularization (RR 16.44; 95% CI
6.14-43.99). CONCLUSION : MP analysis during stress echocardiography is an
effective prognostic tool in patients with known or suspected CAD and
provides incremental value over LVEF and WM in predicting clinical
outcomes.<br/>Copyright Published on behalf of the European Society of
Cardiology. All rights reserved. &#xa9; The Author(s) 2020. For
permissions, please email: journals.permissions@oup.com.

<12>
Accession Number
2011901063
Title
Incidence and impact of primary graft dysfunction in adult heart
transplant recipients: A systematic review and meta-analysis.
Source
Journal of Heart and Lung Transplantation. (no pagination), 2021. Date of
Publication: 2021.
Author
Buchan T.A.; Moayedi Y.; Truby L.K.; Guyatt G.; Posada J.D.; Ross H.J.;
Khush K.K.; Alba A.C.; Foroutan F.
Institution
(Buchan, Moayedi, Posada, Ross, Alba, Foroutan) Peter Munk Cardiac Center,
Toronto General Hospital-University Health Network, Toronto, Canada
(Buchan, Guyatt, Foroutan) Department of Health Research Methods,
Evidence, and Impact, McMaster University, Ontario, Canada
(Truby) Division of Cardiology, Department of Medicine, Duke University
Medical Center, North Carolina, United States
(Khush) Division of Cardiovascular Medicine, Department of Medicine,
Stanford University, California, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Primary graft dysfunction (PGD) is a leading cause of early
mortality after heart transplant (HTx). To identify PGD incidence and
impact on mortality, and to elucidate risk factors for PGD, we
systematically reviewed studies using the ISHLT 2014 Consensus Report
definition and reporting the incidence of PGD in adult HTx recipients.
<br/>Method(s): We conducted a systematic search in January 2020 including
studies reporting the incidence of PGD in adult HTx recipients. We used a
random effects model to pool the incidence of PGD among HTx recipients
and, for each PGD severity, the mortality rate among those who developed
PGD. For prognostic factors evaluated in >=2 studies, we used random
effects meta-analyses to pool the adjusted odds ratios for development of
PGD. The GRADE framework informed our certainty in the evidence.
<br/>Result(s): Of 148 publications identified, 36 observational studies
proved eligible. With moderate certainty, we observed pooled incidences of
3.5%, 6.6%, 7.7%, and 1.6% and 1-year mortality rates of 15%, 21%, 41%,
and 35% for mild, moderate, severe and isolated right ventricular-PGD,
respectively. Donor factors (female sex, and undersized), recipient
factors (creatinine, and pre-HTx use of amiodarone, and temporary or
durable mechanical support), and prolonged ischemic time proved associated
with PGD post-HTx. <br/>Conclusion(s): Our review suggests that the
incidence of PGD may be low but its risk of mortality high, increasing
with PGD severity. Prognostic factors, including undersized donor,
recipient use of amiodarone pre-HTx and recipient creatinine may guide
future studies in exploring donor and/or recipient selection and risk
mitigation strategies.<br/>Copyright &#xa9; 2021 International Society for
Heart and Lung Transplantation

<13>
Accession Number
634915382
Title
Does preoperative pulmonary rehabilitation/physiotherapy improve patient
outcomes following lung resection?.
Source
Interactive cardiovascular and thoracic surgery. (no pagination), 2021.
Date of Publication: 28 Apr 2021.
Author
Bibo L.; Goldblatt J.; Merry C.
Institution
(Bibo, Merry) Department of Cardiothoracic Surgery, Fiona Stanley
Hospital, Perth, Australia
(Goldblatt) Department of Cardiothoracic Surgery, Alfred Hospital,
Melbourne, Australia
Publisher
NLM (Medline)
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was whether preoperative
physiotherapy (pulmonary prehabilitation) is beneficial for patients
undergoing lung resection. Altogether 177 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. A meta-analysis by Li et al. showed that patients
who received a preoperative rehabilitation programme (PRP) had reduced
incidence of postoperative pulmonary complications (PPCs) (odds ratio
0.44, 95% CI 0.27-0.71), reduced length of stay (LOS) (-4.23days, 95% CI
-6.14 to -2.32days) and improved 6-min walking distance (71.25 m, 95% CI
39.68-102.82) and peak oxygen uptake consumption (VO2 peak) (3.26, 95% CI
2.17-4.35). A meta-analysis by Steffens et al. showed that PPCs were
reduced in patients with PRP (relative risk 0.49, 95% CI 0.33-0.73) and
reduced LOS (-2.86days, 95% CI -5.40 to -0.33). The results of 3
additional meta-analyses, 4 randomized controlled trials and 1
observational study all provide further support to PRP in enhanced
recovery after surgery and the improvement in exercise capacity. We
conclude that PRP improves exercise capacity in patients undergoing
surgical resection for lung cancer. Moderate quality evidence supports
preoperative exercise providing significant reduction in PPCs and hospital
LOS. Referral to exercise programmes should be considered in patients
awaiting lung resection, particularly those deemed borderline for
suitability for surgical resection.<br/>Copyright &#xa9; The Author(s)
2021. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<14>
Accession Number
634913928
Title
Redefining the Risk of Surgery for Clinical Stage IIIA (N2) Non-Small Cell
Lung Cancer: A Pooled Analysis of the STS GTSD and ESTS Registry.
Source
Lung. (no pagination), 2021. Date of Publication: 28 Apr 2021.
Author
Arndt A.T.; Brunelli A.; Cicconi S.; Falcoz P.-E.; Salati M.; Kozower B.;
Liptay M.J.; Rocco G.; Karush J.M.; Geissen N.; Basu S.; Seder C.W.
Institution
(Arndt) Department of Cardiovascular and Thoracic Surgery, Rush University
Medical Center, Professional Building, Chicago 60612, United States
(Brunelli) Department of Thoracic Surgery, St. James's University
Hospital, Leeds, United Kingdom
(Cicconi) Molecular and Clinical Cancer Medicine, University of Liverpool,
Liverpool, United Kingdom
(Falcoz) Department of Thoracic Surgery, Nouvel Hopital Civil, Strasbourg,
France
(Salati) Unit of Thoracic Surgery, AOU Ospedali Riuniti, Ancona, Italy
(Kozower) Division of Cardiothoracic Surgery, Washington University School
of Medicine, St. Louis, MO, USA
(Liptay, Karush, Geissen, Basu, Seder) Department of Cardiovascular and
Thoracic Surgery, Rush University Medical Center, Chicago 60612, United
States
(Rocco) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, NY, NY, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Management of clinical stage IIIA-N2 (cIIIA-N2) non-small cell
lung cancer (NSCLC) remains controversial. We evaluated treatment
strategies and outcomes in cIIIA-N2 NSCLC patients who underwent pulmonary
resection in The Society of Thoracic Surgeons General Thoracic Surgery
Database (STS GTSD) and the European Society of Thoracic Surgeons (ESTS)
Registry. <br/>METHOD(S): The STS GTSD and ESTS Registry were queried for
patients who underwent pulmonary resection for cIIIA-N2 NSCLC between 2012
and 2016. Demographic variables, treatment strategies, and outcome
measures were collected and analyzed. Significance of differences was
determined using the chi2 test for categorical variables and the Wilcoxon
rank sum test for continuous variables. <br/>RESULT(S): Pulmonary
resection was performed in 4279 cIIIA-N2 NSCLC patients (2928 STS GTSD;
1351 ESTS). Induction therapy was administered to 49%. Lobectomy was
performed in 67.1% and pneumonectomy in 13%. Lobectomy was associated with
19.2% major morbidity and 1.6% operative mortality, while pneumonectomy
was associated with 34.1% and 5%, respectively. Induction therapy was
associated with a higher rate of major morbidity or mortality than upfront
surgery (23.2% vs 19.5%, p=0.004), driven by pneumonectomy (40.7% vs
30.3%, p=0.012) rather than lobectomy (20.3% vs 18.8%, p=0.31).
<br/>CONCLUSION(S): Pulmonary resection for cIIIA-N2 NSCLC is associated
with low rates of operative morbidity and mortality, with lobectomy having
lower morbidity and mortality than pneumonectomy. Induction therapy,
particularly chemoradiotherapy, is associated with a higher rate of
composite morbidity or mortality than upfront surgery in pneumonectomy
patients but not lobectomy patients.

<15>
Accession Number
634913831
Title
Impact of anemia on short-term outcomes after TAVR: A subgroup analysis
from the BRAVO-3 randomized trial.
Source
Catheterization and cardiovascular interventions : official journal of the
Society for Cardiac Angiography & Interventions. (no pagination), 2021.
Date of Publication: 28 Apr 2021.
Author
Razuk V.; Camaj A.; Cao D.; Nicolas J.; Hengstenberg C.; Sartori S.; Zhang
Z.; Power D.; Beerkens F.; Chiarito M.; Meneveau N.; Tron C.; Dumonteil
N.; Widder J.D.; Ferrari M.; Violini R.; Stella P.R.; Jeger R.;
Anthopoulos P.; Mehran R.; Dangas G.D.
Institution
(Razuk, Camaj, Cao, Nicolas, Sartori, Zhang, Power, Beerkens, Chiarito,
Mehran, Dangas) Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, NY
(Hengstenberg) Department of Internal Medicine II, Division of Cardiology,
Medical University of Vienna, Vienna, Austria
(Meneveau) Department of Cardiology, EA3920, University Hospital Jean
Minjoz, Besancon, France
(Tron) Division of Cardiology, Rouen University Hospital, Rouen, France
(Dumonteil) Groupe CardioVasculaire Interventionnel, Clinique Pasteur,
Toulouse, France
(Widder) Department of Cardiology and Angiology, Hannover Medical School,
Hannover, Germany
(Ferrari) Helios Dr. Horst Schmidt Kliniken Wiesbaden, Germany
(Violini) Interventional Cardiology Unit, San Camillo Hospital, Via
Circonvallazione Gianicolense, Rome, Italy
(Stella) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Jeger) Department of Cardiology, University Hospital Basel, University of
Basel, Switzerland
(Anthopoulos) Arena Pharmaceuticals Inc, European Medical, Zurich,
Switzerland
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To determine the prognostic impact of anemia in patients
randomized to bivalirudin or unfractionated heparin (UFH) during
transcatheter aortic valve replacement (TAVR). BACKGROUND: Whether the
periprocedural use of bivalirudin as compared with UFH in anemic patients
undergoing TAVR has an impact on outcomes remains unknown. <br/>METHOD(S):
The BRAVO-3 trial compared the use of bivalirudin versus UFH in 802 high
risk patients undergoing transfemoral TAVR for severe symptomatic aortic
stenosis. Patients were stratified according to the presence (defined as
hemoglobin levels <13 g/dL in men and <12 g/dL in women) or absence of
anemia. The primary outcomes were net adverse cardiac events (NACE; a
composite of all-cause mortality, myocardial infarction, stroke, or
bleeding) and major bleeding (BARC >=3b) at 30days. <br/>RESULT(S): Among
798 patients with available baseline hemoglobin levels, 427 (54%) were
anemic of whom 221 (52%) received bivalirudin. There were no significant
differences in NACE and major bleeding at 30-days between patients with
and without anemia, irrespective of the type of anticoagulant used
(pinteraction =0.71 for NACE, pinteraction =1.0 for major bleeding).
However, anemic patients had a higher risk of major vascular complications
(adjusted OR 2.43, 95% CI 1.42 - 4.16, p=0.001), and acute kidney injury
(adjusted OR 1.74, 95% CI 1.16 - 2.59, p=0.007) compared to non-anemic
patients at 30-days. <br/>CONCLUSION(S): Anemia was not associated with a
higher risk of NACE or major bleeding at 30days after TAVR without
modification of the treatment effects of periprocedural anticoagulation
with bivalirudin versus UFH. This article is protected by copyright. All
rights reserved.

<16>
Accession Number
632466012
Title
Early prediction of acute kidney injury in neonates with cardiac surgery.
Source
World Journal of Pediatric Surgery. 3 (2) (no pagination), 2020. Article
Number: e000107. Date of Publication: 25 Jun 2020.
Author
Shi S.; Fan J.; Shu Q.
Institution
(Shi, Fan) Cardiac Intensive Care Unit, Children's Hospital, Zhejiang
University, School of Medicine, Hangzhou, China
(Shu) Department of Thoracic and Cardiovascular Surgery, Children's
Hospital, Zhejiang University, School of Medicine, Hangzhou, China
Publisher
BMJ Publishing Group
Abstract
Background Acute kidney injury (AKI) occurs in 42-64 of the neonatal
patients experiencing cardiac surgery, contributing to postoperative
morbidity and mortality. Current diagnostic criteria, which are mainly
based on serum creatinine and hourly urine output, are not sufficiently
sensitive and precise to diagnose neonatal AKI promptly. The purpose of
this review is to screen the recent literature, to summarize the novel and
cost-effective biomarkers and approaches for neonatal AKI after cardiac
surgery (CS-AKI), and to provide a possible research direction for future
work. Data sources We searched PubMed for articles published before
November 2019 with pertinent terms. Sixty-seven articles were found and
screened. After excluding 48 records, 19 articles were enrolled for final
analysis. Results Nineteen articles were enrolled, and 18 possible urinary
biomarkers were identified and evaluated for their ability to diagnose
CS-AKI. Urinary neutrophil gelatinase-associated lipocalin (uNGAL), serum
cystatin C (sCys), urinary human kidney injury molecule-1 (uKIM-1),
urinary liver fatty acid-binding protein (uL-FABP) and interleukin-18
(uIL-18) were the most frequently described as the early predictors of
neonatal CS-AKI. Conclusions Neonates are vulnerable to CS-AKI. UNGAL,
sCys, uL-FABP, uKIM-1 and uIL-18 are potential biomarkers for early
prediction of neonatal CS-AKI. Renal regional oxygen saturation by
near-infrared spectroscopy is a non-invasive approach for early
identification of neonatal AKI. Further work should focus on exploring a
sensitive and specific combined diagnostic model that includes novel
biomarkers and other complementary methods.<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.

<17>
Accession Number
2005489713
Title
Clinical outcomes and serologic response in solid organ transplant
recipients with COVID-19: A case series from the United States.
Source
American Journal of Transplantation. 20 (11) (pp 3225-3233), 2020. Date of
Publication: 01 Nov 2020.
Author
Fung M.; Chiu C.Y.; DeVoe C.; Doernberg S.B.; Schwartz B.S.; Langelier C.;
Henrich T.J.; Yokoe D.; Davis J.; Hays S.R.; Chandran S.; Kukreja J.; Ng
D.; Prostko J.; Taylor R.; Reyes K.; Bainbridge E.; Bond A.; Chin-Hong P.;
Babik J.M.
Institution
(Fung, Chiu, DeVoe, Doernberg, Schwartz, Langelier, Henrich, Yokoe, Davis,
Bainbridge, Bond, Chin-Hong, Babik) Division of Infectious Disease,
Department of Medicine, University of California San Francisco, San
Francisco, CA, United States
(Chiu, Ng, Reyes) Department of Laboratory Medicine, University of
California, San Francisco, CA, United States
(Chiu) UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco,
CA, United States
(Langelier) Chan Zuckerberg Biohub, San Francisco, CA, United States
(Henrich) Division of Experimental Medicine, University of California San
Francisco, San Francisco, CA, United States
(Hays) Division of Pulmonary, Critical Care, Allergy and Sleep Medicine,
Department of Medicine, University of California San Francisco, San
Francisco, CA, United States
(Chandran) Division of Nephrology, Department of Medicine, University of
California San Francisco, San Francisco, CA, United States
(Kukreja) Division of Adult Cardiothoracic Surgery, Department of Surgery,
University of California San Francisco, San Francisco, CA, United States
(Prostko, Taylor) Abbott Laboratories, Inc, Abbott Park, IL, United States
Publisher
Blackwell Publishing Ltd
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by SARS
coronavirus 2 (SARS-CoV-2) has caused significant morbidity and mortality
for patients and stressed healthcare systems worldwide. The clinical
features, disease course, and serologic response of COVID-19 among
immunosuppressed patients such as solid organ transplant (SOT) recipients,
who are at presumed risk for more severe disease, are not well
characterized. We describe our institutional experience with COVID-19
among 10 SOT patients, including the clinical presentation, treatment
modalities, and outcomes of 7 renal transplant recipients, 1 liver
transplant recipient, 1 heart transplant recipient, and 1 lung transplant
recipient. In addition, we report the serologic response in SOT
recipients, documenting a positive IgG response in all 7 hospitalized
patients. We also review the existing literature on COVID-19 in SOT
recipients to consolidate the current knowledge on COVID-19 in the SOT
population for the transplant community.<br/>Copyright &#xa9; 2020 The
American Society of Transplantation and the American Society of Transplant
Surgeons

<18>
Accession Number
2011657114
Title
Colchicine for Secondary Prevention of Cardiovascular Disease: A
Systematic Review and Meta-analysis of Randomized Controlled Trials.
Source
Canadian Journal of Cardiology. 37 (5) (pp 776-785), 2021. Date of
Publication: May 2021.
Author
Samuel M.; Tardif J.-C.; Bouabdallaoui N.; Khairy P.; Dube M.-P.; Blondeau
L.; Guertin M.-C.
Institution
(Samuel, Tardif, Bouabdallaoui, Khairy, Dube) Montreal Heart Institute,
Universite de Montreal, Montreal, Quebec, Canada
(Blondeau, Guertin) Montreal Health Innovations Coordinating Center,
Montreal, Quebec, Canada
Publisher
Elsevier Inc.
Abstract
Background: Reduction of inflammation with colchicine has emerged as a
therapeutic option for secondary prevention of cardiovascular disease
(CVD) in patients with coronary artery disease (CAD). Our objective was to
consolidate evidence from randomized controlled trials (RCTs) evaluating
the efficacy and safety of low-dose colchicine for secondary prevention of
CVD among patients with CAD on standard medical therapy. <br/>Method(s):
RCTs comparing the incidence of cardiovascular (CV) events between
patients with clinically manifest CAD randomized to colchicine vs placebo
(or no colchicine) were included. The primary composite efficacy endpoint
included CV mortality, myocardial infarction (MI), ischemic stroke, and
urgent coronary revascularization. The DerSimonian and Laird
random-effects model was used to calculate pooled hazard ratios (HRs) and
95% confidence intervals (CIs). <br/>Result(s): Four RCTs, with a pooled
sample size of 11,594 patients, were included (colchicine n = 5774;
placebo/no colchicine n = 5820). Included RCTs studied populations with
stable CAD (N = 2) and acute coronary syndrome (N = 2). Compared with
placebo or no colchicine, colchicine was associated with a statistically
significant reduction in the incidence of the primary composite endpoint
(pooled HR, 0.68; 95% CI, 0.54-0.81; I² = 37.7%). The reduction
in CV events among patients randomized to colchicine was driven by
statistically significant reductions in MIs, ischemic strokes, and urgent
coronary revascularizations (P < 0.05 for all) and was relatively
consistent among subgroups. The incidence of safety outcomes did not
differ between groups (P > 0.05). <br/>Conclusion(s): In secondary
prevention of CV events, the addition of low-dose colchicine to standard
medical therapy reduces the incidence of major CV events-except CV
mortality-when compared with standard medical therapy alone.<br/>Copyright
&#xa9; 2020 Canadian Cardiovascular Society

<19>
Accession Number
2010703944
Title
Hyper-oncotic vs. Hypo-oncotic Albumin Solutions: a Systematic Review of
Clinical Efficacy and Safety.
Source
SN Comprehensive Clinical Medicine. 3 (5) (pp 1137-1147), 2021. Date of
Publication: May 2021.
Author
Haynes G.R.; Bassiri K.
Institution
(Haynes) Department of Anesthesiology, Tulane University School of
Medicine, 1430 Tulane Ave, New Orleans, LA 70112, United States
(Bassiri) Meridian HealthComms, Plumley Moor Road, Plumley, United Kingdom
Publisher
Springer Nature
Abstract
Several albumin solutions are available for volume expansion.
Hyper-oncotic solutions (>= 20%) are more effective than hypo-oncotic (<=
5%) as they recruit endogenous extracellular fluid into blood vessels
rather than adding volume. The latter may cause volume overload, with
several associated complications. This systematic review aimed to evaluate
evidence on the efficacy and safety of hyper-oncotic vs. hypo-oncotic
albumin solutions across different clinical settings. The review was
conducted according to PRISMA guidelines. Ninety articles were retained
(58 randomized controlled trials). Four studies directly compared albumin
solutions. SWIPE showed that cumulative fluid balance at 48 h was
significantly lower with 20% vs. 5% albumin (mean - 576 mL; P = 0.01).
Twenty percent albumin was also associated with decreased chloride load
vs. 4% albumin in critically ill patients. All 10 pre-/intraoperative
studies evaluated 4-5% solutions; 14 studies evaluated 4-5% albumin in
postoperative patients. Renal injury was reported in some studies;
however, hydroxyethyl starch was associated with higher incidence vs.
albumin. Importantly, 20% albumin preserved cumulative organ function in
liver transplantation, and 25% albumin was more beneficial than saline in
cardiac surgery patients. Thirty-two studies were performed in critically
ill patients. Several studies reported increased risk of positive fluid
balance and chloride load with hypo-oncotic albumin, whereas multiple
benefits were associated with 20% albumin, including improved endothelial
function and perfusion. Of 18 pediatric studies that evaluated <= 10%
albumin, benefits such as correction of hypotension and improved cardiac
output were noted. In conclusion, hyper-oncotic albumin solutions should
be more routinely used to avoid potential risks associated with
hypo-oncotic solutions.<br/>Copyright &#xa9; 2021, The Author(s).

<20>
Accession Number
2010580298
Title
Meta-Analysis Comparing the Safety and Efficacy of Dual Versus Single
Antiplatelet Therapy After Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiovascular Drugs. 21 (3) (pp 373-376), 2021. Date
of Publication: May 2021.
Author
Shahid I.; Nizam M.A.; Usman M.S.; Khan M.S.; Fudim M.; Michos E.D.
Institution
(Shahid, Nizam) Department of Medicine, Ziauddin Medical University,
Shahra-e-Ghalib, Clifton, Karachi, Pakistan
(Usman) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Khan) Department of Medicine, University of Mississippi Medical Center,
Jackson, MS, United States
(Fudim) Division of Cardiology, Duke University Medical Center, Durham,
NC, United States
(Michos) Division of Cardiology, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
Publisher
Adis

<21>
Accession Number
632237880
Title
Incidence and risk factors for new-onset atrial fibrillation following
coronary artery bypass grafting: A systematic review and meta-analysis.
Source
Intensive & critical care nursing. 60 (pp 102897), 2020. Date of
Publication: 01 Oct 2020.
Author
Higgs M.; Sim J.; Traynor V.
Institution
(Higgs) School of Nursing, Faculty of Science, Medicine and Health,
University of Wollongong, NSW, Wollongong, Australia
(Sim, Traynor) School of Nursing, Faculty of Science, Medicine and Health,
University of Wollongong, NSW, Wollongong, Australia
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To estimate the incidence of new-onset post-operative atrial
fibrillation after isolated coronary artery bypass surgery and summarise
the evidence on risk factors that predispose people to developing the
complication. STUDY DESIGN/METHODS: A systematic review was conducted to
identify studies from the CINAHL, MEDLINE and Cochrane databases. A title
and abstract review was conducted by one reviewer. Full text review and
quality assessment processes were conducted by two reviewers. Incidence
data was combined in meta-analysis using the 'metaprop' routine in Stata
and risk factor data were synthesised in narrative and table format.
<br/>RESULT(S): Ten studies, including 6173 participants, were included in
the review. The estimated pooled incidence of post-operative atrial
fibrillation was 25% (CI 0.19-0.30). In a secondary meta-analysis
including studies that only included first time bypass surgery recipients
the estimated pooled incidence was 26% (CI 0.14-0.41). Due to high levels
of heterogeneity these results should be interpreted with caution. Risk
factors with the strongest associations to post-operative atrial
fibrillation were chronic obstructive pulmonary disease, decreased partial
pressure of oxygen on air, congestive heart failure, right coronary artery
disease, male gender, prolonged cross clamp time and port-operative
inotropic exposure. <br/>CONCLUSION(S): Further prospective studies are
needed to strengthen the current evidence base.<br/>Copyright &#xa9; 2020
Elsevier Ltd. All rights reserved.

<22>
Accession Number
631971919
Title
Long-term mortality after percutaneous coronary intervention with
drug-eluting stents compared with coronary artery bypass grafting for
multivessel and left main disease: a meta-analysis.
Source
Kardiologia polska. 78 (7-8) (pp 759-761), 2020. Date of Publication: 25
Aug 2020.
Author
Kowalewski M.; Gozdek M.; Zielinski K.; Raffa G.M.; Suwalski P.; Lorusso
R.
Institution
(Kowalewski) Department of Cardiac Surgery, Central Clinical Hospital of
the Ministry of the Interior and Administration, Centre of Postgraduate
Medical Education, Warsaw, Poland; Thoracic Research Centre, Collegium
Medicum, Nicolaus Copernicus University, Innovative MedicalForum,
Bydgoszcz, Poland; Cardiothoracic Surgery Department, Heart and Vascular
Centre, Maastricht University Medical Centre, Maastricht,The Netherlands
(Gozdek) Department of Cardiology and Internal Medicine, Collegium
Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
(Zielinski) Medical University of Warsaw, Warsaw, Poland
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and CardiothoracicTransplantation, Palermo, Italy
(Suwalski) Department of Cardiac Surgery, Central Clinical Hospital of the
Ministry of the Interior and Administration, Centre of Postgraduate
Medical Education, Warsaw, Poland
(Lorusso) Cardiothoracic Surgery Department, Heart and Vascular Centre,
Maastricht University Medical Centre, Maastricht, Netherlands
Publisher
NLM (Medline)

<23>
Accession Number
624377409
Title
Randomized trial of the Carpentier-Edwards supra-annular prosthesis versus
the Medtronic Mosaic aortic prosthesis: 10-year results.
Source
European Journal of Cardio-thoracic Surgery. 54 (2) (pp 281-287), 2018.
Date of Publication: 01 Aug 2018.
Author
Zibdeh O.; Bugg I.; Patel S.; Twine G.; Unsworth-White J.
Institution
(Zibdeh, Bugg, Patel) Plymouth University, Peninsula School of Medicine,
Plymouth, United Kingdom
(Twine, Unsworth-White) South West Cardiothoracic Unit, Derriford
Hospital, Plymouth PL6 8DH, United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: We performed a prospective randomized study comparing the
clinical performance of the Carpentier-Edwards supraannular valve (CE-SAV)
(Edwards Lifesciences, Irvine, CA, USA) and the newer Mosaic (Medtronic
Corporation, Minneapolis, MN, USA) porcine bioprostheses in the aortic
position over a 10-year period. <br/>METHOD(S): Between January 2001 and
March 2005, 394 patients undergoing bioprosthetic aortic valve replacement
were randomized to receive either the CE-SAV (n = 191) or the Mosaic (n =
203) prosthesis. The preoperative demographics, EuroSCORE and
intraoperative characteristics concerning cardiopulmonary bypass of the 2
groups were comparable. All patients were followed annually for 10 years.
<br/>RESULT(S): There were 77 (40.3%) deaths in the CE-SAV group and 93
(45.8%) deaths in the Mosaic group. The 10-year survival rate in the 2
groups was 59.7% and 54.2%, respectively (P = 0.27). There were no
statistically significant differences between the 2 groups in terms of
structural valve deterioration (P = 0.08), endocarditis (P = 0.95),
thromboembolism (P = 0.06) and major bleeds (P = 0.09). However, the
incidence of paravalvular leaks and valve-related reoperations were higher
in the Mosaic group, with 5 leaks and 6 reoperations when compared to none
in the CE-SAV group, (P=0.02) and (P = 0.01) respectively.
<br/>CONCLUSION(S): At 10 years after implantation, freedom from
reoperation was greater in the CE-SAV group with no incidences of
paravalvular leaks. There were no other statistically significant
differences between CE-SAV and Mosaic aortic prostheses.<br/>Copyright
&#xa9; The Author(s) 2018.

<24>
Accession Number
2010556044
Title
Endomyocardiofibrosis: A Systematic Review.
Source
Current Problems in Cardiology. 46 (4) (no pagination), 2021. Article
Number: 100784. Date of Publication: April 2021.
Author
Scatularo C.E.; Posada Martinez E.L.; Saldarriaga C.; Ballesteros O.A.;
Baranchuk A.; Sosa Liprandi A.; Wyss F.; Sosa Liprandi M.I.
Institution
(Scatularo, Ballesteros) Division of Cardiology, Sanatorio de la Trinidad
Palermo, Buenos Aires, Argentina
(Posada Martinez) Echocardiography department, Instituto Nacional de
Cardiologia Ignacio Chavez, Ciudad de Mexico, Mexico
(Saldarriaga) Department of Cardiology and Heart Failure Clinic,
Cardiovascular Clinic Santa Maria, University of Antioquia, Medellin,
Colombia
(Baranchuk) Division of Cardiology, Kingston Health Science Center,
Queen's University, Kingston, ON, Canada
(Sosa Liprandi) Division of Cardiology, Sanatorio Guemes, Buenos Aires,
Argentina
(Wyss) Cardiovascular Services and Technology of Guatemala -
Cardiosolutions, Guatemala City, Guatemala
(Sosa Liprandi) Department of Cardiology and Heart Failure Unit, Sanatorio
Guemes, Buenos Aires, Argentina
Publisher
Mosby Inc.
Abstract
Endomyocardiofibrosis was described first time in Uganda as an infrequent
restrictive cardiomyopathy with a poor prognosis, characterized by
fibrosis of the ventricular subendocardium and severe restrictive
physiology leading to difficult therapeutic management and frequently
associated with hypereosinophilic syndrome. Its higher prevalence in the
tropics and its relationship in some cases with hypereosinophilic
endocarditis has led to the search for genetic, infectious, autoimmune and
nutritional causes, but its etiology remains unclear. It is a rare
cardiomyopathy, difficult to diagnose and with a nonexistent effective
treatment. Imaging methods such as echocardiography and cardiac magnetic
resonance are essential for the initial diagnosis, although endomyocardial
biopsy establishes the definitive diagnosis. Immunosuppressive treatment
is only useful in the early stages of the disease and usually ineffective
if installed late when signs of heart failure are present. Surgical
treatment is generally palliative.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<25>
Accession Number
631235516
Title
Meta-Analysis of cardiovascular superiority trials published in the New
England Journal of Medicine to elucidate the concept of superiority
margin.
Source
Postgraduate Medical Journal. 97 (1146) (pp 227-233), 2021. Date of
Publication: 01 Apr 2021.
Author
Gamad N.; Shafiq N.; Malhotra S.
Institution
(Gamad, Shafiq, Malhotra) Department of Pharmacology, Institute of Medical
Education and Research, Chandigarh, India
Publisher
BMJ Publishing Group
Abstract
Objective To show that overpowered trials claim statistical significance
detouring clinical relevance and warrant the need of superiority margin to
avoid such misinterpretation. Design Selective review of articles
published in the New England Journal of Medicine between 1 January 2015
and 31 December 2018 and meta-Analysis following Preferred Reporting Items
for Systematic Reviews and Meta-Analyses checklist. Eligibility criteria
for selecting studies and methods Published superiority trials evaluating
cardiovascular diseases and diabetes mellitus with positive efficacy
outcome were eligible. Fixed effects meta-Analysis was performed using
RevMan V.5.3 to calculate overall effect estimate, pooled HR and it was
compared with mean clinically significant difference. Results Thirteen
eligible trials with 164 721 participants provided the quantitative data
for this review. Largely, the primary efficacy endpoint in these trials
was the composite of cardiovascular death, non-fatal myocardial
infarction, unstable angina requiring rehospitalisation, coronary
revascularisation and fatal or non-fatal stroke. The pooled HR was 0.86
(95% CI 0.84 to 0.89, I 2 =45%) which was lower than the mean clinically
significant difference of 0.196 (19.6%, range: 0.09375-0.35) of these
studies. There was a wide 95% CI in these studies from 0.56 to 0.99. The
upper margin of CI in most of the studies was close to the line of no
difference. Absolute risk reduction was small (1.19% to 2.3%) translating
to a high median number needed to treat of 63 (range: 43 to 84) over a
follow-up duration of 2.95 years. Conclusions The results of this
meta-Analysis indicate that overpowered trials give statistically
significant results undermining clinical relevance. To avoid such misuse
of current statistical tools, there is a need to derive superiority
margin. We hope to generate debate on considering clinically significant
difference, used to calculate sample size, as superiority
margin.<br/>Copyright &#xa9;

<26>
Accession Number
2005924501
Title
The Use of Topical Nitroglycerin to Facilitate Radial Arterial Catheter
Insertion in Children: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 34 (12) (pp 3354-3360),
2020. Date of Publication: December 2020.
Author
Hasanin A.; Aboelela A.; Mostafa M.; Mansour R.M.; Kareem A.
Institution
(Hasanin, Aboelela, Mostafa, Mansour, Kareem) Department of Anesthesia and
Critical Care Medicine, Cairo University, Cairo, Egypt
Publisher
W.B. Saunders
Abstract
Objectives: To determine whether the use of topical nitroglycerin patch
increases radial artery diameter and facilitate cannulation in children.
<br/>Design(s): Randomized controlled trial. <br/>Setting(s): Cairo
University Hospital. <br/>Participant(s): Children aged 2 to 8 years old
scheduled for cardiac surgery. <br/>Intervention(s): In the nitroglycerin
group (n = 20), a gauze-covered, half-sized nitroglycerin patch (5 mg) was
applied at the site of radial pulsation 1 hour before induction of
anesthesia. In the control group (n = 20), a gauze pad was applied to the
bare skin at the site of radial pulsation with no intervention.
<br/>Measurements and Main Results: The primary outcome was the diameter
of the radial artery in both limbs using ultrasonography. Other outcomes
included the degree of arterial palpability, number of arterial punctures,
and incidence of successful first puncture cannulation. The radial artery
diameter increased after 30 minutes and 60 minutes compared with the
baseline value in the nitroglycerin group in both limbs, whereas no change
was reported in the radial artery diameter in the control group. The
nitroglycerin group showed a greater incidence of successful first
cannulation trial, a fewer number of trials, and a shorter cannulation
time compared with the control group. There were no significant
hypotensive episodes in any patient. <br/>Conclusion(s): Local application
of a half-sized, 5 mg nitroglycerin patch for 60 minutes in children
increased the radial artery diameter bilaterally, increased the rate of
first trial success, and decreased the time needed for arterial
cannulation without significant hypotensive episodes.<br/>Copyright &#xa9;
2020 Elsevier Inc.

<27>
Accession Number
2010475566
Title
Association of Obstructive Sleep Apnea With the Risk of Repeat Adverse
Cardiovascular Events in Patients With Newly Diagnosed Acute Coronary
Syndrome: A Systematic Review and Meta-Analysis.
Source
Ear, Nose and Throat Journal. 100 (4) (pp 260-270), 2021. Date of
Publication: May 2021.
Author
Yang S.-H.; Xing Y.-S.; Wang Z.-X.; Liu Y.-B.; Chen H.-W.; Ren Y.-F.; Chen
J.-L.; Li S.-B.; Wang Z.-F.
Institution
(Yang, Liu, Wang) Department of Cardiology, Xinxiang Central Hospital, The
Fourth Clinical College of Xinxiang Medical University, Henan Province,
China
(Xing, Wang, Chen, Ren, Chen, Li) Department of Intensive Care Unit,
Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical
University, Henan Province, China
Publisher
SAGE Publications Ltd
Abstract
Background: The impact of obstructive sleep apnea (OSA) on subsequent
cardiovascular events in patients with acute coronary syndrome (ACS)
remains inconclusive. <br/>Aim(s): Our aim was to systematically assess
the relationship between preexisting OSA and adverse cardiovascular events
in patients with newly diagnosed ACS by conducting a systematic review and
meta-analysis. <br/>Method(s): We systematically searched PubMed, EMBASE,
and Cochrane library for studies published up to May 1, 2020, that
reported any association between OSA and cardiovascular events in patients
with newly diagnosed ACS. The main outcomes were a composite of all-cause
or cardiovascular death, recurrent myocardial infarction, stroke, repeat
revascularization, or heart failure. We conducted a pooled analysis using
the random-effects model. We also performed subgroup, sensitivity,
heterogeneity analysis, and the assessment of publication bias.
<br/>Result(s): We identified 10 studies encompassing 3350 participants.
The presence of OSA was associated with increased risk of adverse
cardiovascular events in newly prognosed ACS (risk ratio [RR] 2.18, 95%
confidence interval [CI]: 1.45-3.26, P <.001, I² = 64%).
Between-study heterogeneity was partially explained by a multicenter study
(9 single-center studies, RR 2.33 95% CI 1.69-3.19, I² =18%),
and I² remarkably decreased from 64% to 18%. Moreover, OSA
significantly increased the incidence of repeat revascularization (8
studies) and heart failure (6 studies) in patients with newly diagnosed
ACS. <br/>Conclusion(s): Patients with preexisting OSA are at greater risk
of subsequent cardiovascular events after onset of ACS. Further studies
should investigate the treatment of OSA in patient with ACS.<br/>Copyright
&#xa9; The Author(s) 2021.

<28>
Accession Number
2010133649
Title
Effects of intraoperative goal-directed fluid therapy and restrictive
fluid therapy combined with enhanced recovery after surgery protocol on
complications after thoracoscopic lobectomy in high-risk patients: study
protocol for a prospective randomized controlled trial.
Source
Trials. 22 (1) (no pagination), 2021. Article Number: 36. Date of
Publication: December 2021.
Author
Guan Z.; Gao Y.; Qiao Q.; Wang Q.; Liu J.
Institution
(Guan, Gao, Qiao, Wang) Department of Anesthesiology, the First Affiliated
Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
(Liu) Department of Neurology, the Second Affiliated Hospital of Xi'an
Jiaotong University, Xi'an, Shaanxi, China
Publisher
BioMed Central Ltd
Abstract
Background: Acute kidney injury (AKI) is a common complication after
thoracoscopic lobectomy in high-risk patients due to insufficient
intraoperative infusion. Goal-directed fluid therapy (GDFT) is an
individualized fluid infusion strategy; the fluid infusion strategy is
adjusted according to the patient's fluid response. GDFT during operation
can reduce the incidence of AKI after major surgery. Enhanced recovery
after surgery (ERAS) protocol optimizes perioperative interventions to
decrease the postoperative complications after surgery. In ERAS protocol
of lobectomy, intraoperative restrictive fluid therapy is recommended. In
this study, we will compare the effects of intraoperative GDFT with
restrictive fluid therapy combined with an ERAS protocol on the incidence
of AKI after thoracoscopic lobectomy in high-risk patients.
Methods/design: This is a prospective single-center single-blind
randomized controlled trial. Two hundred seventy-six patients scheduled
for thoracoscopic lobectomy are randomly allocated to receive either GDFT
or restrictive fluid therapy combined with an ERAS protocol at a 1:1
ratio. The primary outcome is the incidence of AKI after operation. The
secondary outcomes include (1) the incidence of renal replacement therapy,
(2) the length of intensive care unit stay after operation, (3) the length
of hospital stay after operation, and (4) the incidence of other
complications including infection, acute lung injury, pneumonia,
arrhythmia, heart failure, myocardial injury after noncardiac surgery, and
cardiac infarction. <br/>Discussion(s): This is the first study to compare
intraoperative GDFT with restrictive fluid therapy combined with an ERAS
protocol on the incidence of AKI after thoracoscopic lobectomy in
high-risk patients. The hypothesis is that the restrictive fluid therapy
is noninferior to GDFT in reducing the incidence of AKI, but restrictive
fluid therapy is simpler to apply than GDFT. Trial registration:
ClinicalTrials.govNCT04302467. Registered on 26 February
2020<br/>Copyright &#xa9; 2021, The Author(s).

<29>
Accession Number
2011216497
Title
Cardiovascular hiccups: A meta-analysis of comprehensively retrieved
worldwide literature.
Source
Acta Medica Mediterranea. 37 (1) (pp 51-57), 2021. Date of Publication:
2021.
Author
Yuan S.-M.
Institution
(Yuan) Department of Cardiothoracic Surgery, First Hospital of Putian,
Teaching Hospital, Fujian Medical University, Putian, Fujian Province,
China
Publisher
A. CARBONE Editore
Abstract
Objective: The concept, etiology, management and outcomes of
cardiovascular hiccups have not been sufficiently described. The aim of
this article is to present a meta-analysis of cardiovascular hiccups.
<br/>Method(s): By comprehensive retrieval of the pertinent literature
published since 1970, 223 articles with 1,251 patients were recruited into
this study. <br/>Result(s): Cardiovascular etiologies of hiccups can be
classified into four types: cardiogenic, vasogenic, iatrogenic and
cardiovascular drug-induced. The cardiogenic type is the most common, and
it is prevailed by an acute myocardial infarction etiology. Patients with
symptomatic treatment were associated with a significantly higher
improvement rate and a lower recurrent rate in comparison to the patients
receiving etiological treatment. Chinese medicine treatment was superior
to Western medicine concerning the cured and improvement rates.
<br/>Conclusion(s): When patients show poor responses to symptomatic
treatments, a diagnosis of cardiovascular hiccup due to acute myocardial
infarction should be suspected. Chinese medicinal or integrated treatment
is a treatment of choice when non-pharmaceutical or Western medicinal
treatment is ineffective.<br/>Copyright &#xa9; 2021 A. CARBONE Editore.
All rights reserved.

<30>
Accession Number
633371190
Title
Effectiveness of Home-Based Mobile Guided Cardiac Rehabilitation as
Alternative Strategy for Nonparticipation in Clinic-Based Cardiac
Rehabilitation among Elderly Patients in Europe: A Randomized Clinical
Trial.
Source
JAMA Cardiology. 6 (4) (pp 463-468), 2021. Date of Publication: April
2021.
Author
Snoek J.A.; Prescott E.I.; Van Der Velde A.E.; Eijsvogels T.M.H.;
Mikkelsen N.; Prins L.F.; Bruins W.; Meindersma E.; Gonzalez-Juanatey
J.R.; Pena-Gil C.; Gonzalez-Salvado V.; Moatemri F.; Iliou M.-C.; Marcin
T.; Eser P.; Wilhelm M.; Van'T Hof A.W.J.; De Kluiver E.P.
Institution
(Snoek, Van Der Velde, De Kluiver) Isala Heart Center, Zwolle, Netherlands
(Snoek) Sports Medicine Department Isala, Zwolle, Netherlands
(Prescott, Mikkelsen) Department of Cardiology, Bispebjerg Frederiksberg
University Hospital, Copenhagen, Denmark
(Eijsvogels) Radboud Institute for Health Sciences, Department of
Physiology, Radboud University Medical Center, Nijmegen, Netherlands
(Prins) Diagram, Zwolle, Netherlands
(Meindersma) Department of Cardiology, Radboud University Medical Center,
Nijmegen, Netherlands
(Gonzalez-Juanatey, Pena-Gil, Gonzalez-Salvado) Department of Cardiology,
Hospital Clinico Universitario de Santiago, Instituto de Investigacion
Sanitaria, CIBER CV, Madrid, Spain
(Moatemri, Iliou) Department of Cardiac Rehabilitation, Assistance
Publique Hopitaux de Paris, Paris, France
(Marcin, Eser, Wilhelm) Department of Cardiology, Inselspital Bern
University Hospital, University of Bern, Bern, Switzerland
(Van'T Hof) Department of Cardiology, Maastricht University Medical Center
and Cardiovascular Research Institute Maastricht (CARIM), Maastricht,
Netherlands
(Van'T Hof) Department of Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
Publisher
American Medical Association
Abstract
Importance: Although nonparticipation in cardiac rehabilitation is known
to increase cardiovascular mortality and hospital readmissions, more than
half of patients with coronary artery disease in Europe are not
participating in cardiac rehabilitation. <br/>Objective(s): To assess
whether a 6-month guided mobile cardiac rehabilitation (MCR) program is an
effective therapy for elderly patients who decline participation in
cardiac rehabilitation. <br/>Design, Setting, and Participant(s): Patients
were enrolled in this parallel multicenter randomized clinical trial from
November 11, 2015, to January 3, 2018, and follow-up was completed on
January 17, 2019, in a secondary care system with 6 cardiac institutions
across 5 European countries. Researchers assessing primary outcome were
masked for group assignment. A total of 4236 patients were identified with
a recent diagnosis of acute coronary syndrome, coronary revascularization,
or surgical or percutaneous treatment for valvular disease, or documented
coronary artery disease, of whom 996 declined to start cardiac
rehabilitation. Subsequently, 179 patients who met the inclusion and
exclusion criteria consented to participate in the European Study on
Effectiveness and Sustainability of Current Cardiac Rehabilitation
Programmes in the Elderly trial. Data were analyzed from January 21 to
October 11, 2019. <br/>Intervention(s): Six months of home-based cardiac
rehabilitation with telemonitoring and coaching based on motivational
interviewing was used to stimulate patients to reach exercise goals.
Control patients did not receive any form of cardiac rehabilitation
throughout the study period. <br/>Main Outcomes and Measures: The primary
outcome parameter was peak oxygen uptake (Vo<inf>2</inf>peak) after 6
months. <br/>Result(s): Among 179 patients randomized (145 male [81%];
median age, 72 [range, 65-87] years), 159 (89%) were eligible for primary
end point analysis. Follow-up at 1 year was completed for 151 patients
(84%). Peak oxygen uptake improved in the MCR group (n = 89) at 6 and 12
months (1.6 [95% CI, 0.9-2.4] mL/kg^-1/min^-1and 1.2
[95% CI, 0.4-2.0] mL/kg^-1/min^-1, respectively),
whereas there was no improvement in the control group (n = 90) (+0.2 [95%
CI, -0.4 to 0.8] mL/kg^-1/min^-1and +0.1 [95% CI, -0.5
to 0.7] mL/kg^-1/min^-1, respectively). Changes in
Vo<inf>2</inf>peak were greater in the MCR vs control groups at 6 months
(+1.2 [95% CI, 0.2 to 2.1] mL/kg^-1/min^-1) and 12
months (+0.9 [95% CI, 0.05 to 1.8] mL/kg^-1/min^-1).
The incidence of adverse events was low and did not differ between the MCR
and control groups. <br/>Conclusions and Relevance: These results suggest
that a 6-month home-based MCR program for patients 65 years or older with
coronary artery disease or a valvular intervention was safe and beneficial
in improving Vo<inf>2</inf>peak when compared with no cardiac
rehabilitation. Trial Registration: trialregister.nl Identifier:
NL5168.<br/>Copyright &#xa9; 2021 American Medical Association. All rights
reserved.

<31>
Accession Number
2007865847
Title
A randomized trial of surgery alone versus surgery plus compression in the
treatment of venous leg ulcers in patients with primary venous
insufficiency.
Source
Vojnosanitetski Pregled. 77 (8) (pp 811-815), 2020. Date of Publication:
2020.
Author
Milic D.; Zivic S.; Golubovic M.; Bogdanovic D.; Lazarevic M.; Lazarevic
K.
Institution
(Milic, Zivic, Lazarevic) Clinical Center Nis, Clinic for Cardiovascular
and Transplant Surgery
(Golubovic, Bogdanovic) Center for Anesthesiology, Nis, Serbia
(Lazarevic) State University of Novi Pazar, Department of Biomedical
Sciences, Novi Pazar, Serbia
(Milic) University of Nis, Faculty of Medicine, Nis, Serbia
Publisher
Inst. Sci. inf., Univ. Defence in Belgrade
Abstract
Background/Aim.Venous leg ulcers (VLU) are a significant health problem
worldwide. It is well known that VLU are difficult to treat and that they
have high tendency for recurrence. Compression therapy is the preferred
treatment modality but there is growing evidence that correction of
underlying venous disorder in early stages of the disease in addition to
compression treatment may improve ulcer healing and reduce recurrence
rate. Methods. An open, prospective, randomized, single-center study, with
a 6-months follow-up was performed to determine the efficacy of two
different treatment modalities (surgery alone versus surgery plus
compression) in the treatment of VLU in patients with primary venous
insufficiency. Patients with secondary venous insufficiency and/or
thrombosis were excluded from the study. Overall, 71 patients were
randomized (37 men, 34 women; mean age 60 years) into two groups: the
group A - 34 patients who underwent surgical intervention (stripping) and
postoperatively were treated with simple wound dressing only, and the
group B - 37 patients who underwent surgical intervention (stripping) and
wore a heelless open-toed elastic class III compression device knitted in
tubular form -Tubulcus (Laboratoires Innothera, Arcueil,
France). All patients in group B were instructed to wear compression
device continuously during the day and night. The study was performed at
the Clinic for Cardiovascular and Transplant Surgery, Clinical Centre Nis
(Serbia) with primary endpoint of the study being complete ulcer healing
at 180 days. Results. The healing rate was 29.41% (10/34) in the group A,
and 56.76% (21/37) in the group B (p < 0.01). Mean healing time in the
group A was 141 +/- 15 days, and in the group B it was 98 +/- 12 days
(Log-rank life table analysis: p < 0.001). Conclusion. This study suggests
that for VLU in patients with primary venous insufficiency, surgery plus
compression therapy provides higher healing rate and faster healing time
compared to surgery only.<br/>Copyright &#xa9; 2020 Inst. Sci. inf., Univ.
Defence in Belgrade. All rights reserved.

<32>
Accession Number
2007011784
Title
Intravascular ultrasound imaging-guided versus coronary angiography-guided
percutaneous coronary intervention: A systematic review and meta-analysis.
Source
Journal of the American Heart Association. 9 (5) (no pagination), 2020.
Article Number: e013678. Date of Publication: 2020.
Author
Darmoch F.; Alraies M.C.; Al-Khadra Y.; Pacha H.M.; Pinto D.S.; Osborn
E.A.
Institution
(Darmoch, Pinto, Osborn) Beth Israel Deaconess Medical Center/Harvard
School of Medicine, Boston, MA, United States
(Alraies) Detroit Medical Center, Wayne State University, Detroit, MI,
United States
(Al-Khadra) Cleveland Clinic, Cleveland, OH, United States
(Pacha) MedStar Washington Hospital Center, Washington, DC, United States
Publisher
American Heart Association Inc.
Abstract
Background--Intravascular ultrasound (IVUS) guidance during percutaneous
coronary intervention (PCI) offers tomographic images of the coronary
vessels, allowing optimization of stent implantation at the time of PCI.
However, the long-term beneficial effect of IVUS over PCI guided by
coronary angiography (CA) alone remains under question. We sought to
investigate the outcomes of IVUS-guided compared with CA-guided PCI.
Methods and Results--We performed a comprehensive search of PubMed,
Medline, and Cochrane Central Register, looking for randomized controlled
trials and observational studies that compared PCI outcomes of IVUS with
CA. Data were aggregated for the primary outcome measure using the
random-effects model as pooled risk ratio (RR). The primary outcomes were
the rate of cardiovascular death, need for target lesion
revascularization, occurrence of myocardial infarction, and rate of stent
thrombosis. A total of 19 studies met the inclusion criteria, comprising
27 610 patients divided into IVUS (n=11 513) and CA (n=16 097). Compared
with standard CA-guided PCI, we found that the risks of cardiovascular
death (RR, 0.63; 95% CI, 0.54-0.73), myocardial infarction (RR, 0.71; 95%
CI, 0.58-0.86), target lesion revascularization (RR, 0.81; 95% CI,
0.70-0.94), and stent thrombosis (RR, 0.57; 95% CI, 0.41-0.79) were all
significantly lower using IVUS guidance. Conclusions--Compared with
standard CA-guided PCI, the use of IVUS imaging guidance to optimize stent
implantation is associated with a reduced risk of cardiovascular death and
major adverse events, such as myocardial infarction, target lesion
revascularization, and stent thrombosis.<br/>Copyright &#xa9; 2020 The
Authors. Published on behalf of the American Heart Association, Inc., by
Wiley.

<33>
Accession Number
2005082603
Title
Effect of sequential compression device on hemodynamic changes after
spinal anesthesia for caesarean section: A randomized controlled trial.
Source
Anesthesiology and Pain Medicine. 10 (5) (pp 1-6), 2020. Article Number:
e104705. Date of Publication: 2020.
Author
Javaherforooshzadeh F.; Pipelzadeh M.R.; Akhondzadeh R.; Adarvishi S.;
Alghozat M.
Institution
(Javaherforooshzadeh, Pipelzadeh, Akhondzadeh, Adarvishi) Ahvaz
Anesthesiology and Pain Research Center, Ahvaz Jundishapur University of
Medical Sciences, Ahvaz, Iran, Islamic Republic of
(Alghozat) Menopause Andropause Research Center, Ahvaz Jundishapur
University of Medical Sciences, Ahvaz, Iran, Islamic Republic of
Publisher
Kowsar Medical Institute
Abstract
Background: The benefit of sequential compression device (SCD) for the
prevention of hypotension after spinal anesthesia in cesarean sections has
not been determined. <br/>Objective(s): In this study, an attempt was made
to determine whether SCD can prevent hemodynamic changes following spinal
anesthesia for cesarean sections. <br/>Method(s): In a prospective
clinical trial, 76 parturient women undergoing elective cesarean sections
under spinal anesthesia were randomly divided into SCD or control groups.
The maternal hemodynamic changes within 75 min after spinal anesthesia,
nausea, vomiting, and neonatal Apgar score at 1 and 5 min were compared
between the groups. <br/>Result(s): There were no significant differences
between the groups in the patients' characteristics, maximum sensory
block, skin incision to delivery time, spinal anesthesia to delivery time
(min), and the total duration of surgery. Concerning heart rate changes,
RM ANOVA showed a significant difference in the effect of time, groups,
and the interaction of the two factors (P < 0.0001, P < 0.0001, and P <
0.0001, respectively). Tukey post hoc test showed that 3 min after spinal
anesthesia, diastolic blood pressure was significantly higher in the SCD
group than in the control group (P < 0.05). The SCD group had meaningfully
lower rates of nausea (P = 0.005) and vomiting (P = 0.001) than the
control group. The SCD group also demonstrated a significantly lower mean
ephedrine dosage per patient (4.1 mg against 17.1 mg, P = 0.001). However,
no significant difference was observed between the groups in terms of
neonatal Apgar scores at 1 and 5 minutes. <br/>Conclusion(s): This study
showed that SCD could reduce extensive changes in diastolic blood pressure
as an important hemodynamic parameter and the incidence of nausea and
vomiting. Thus, SCD can be used in spinal anesthesia care practices for
elective cesarean sections.<br/>Copyright &#xa9; 2020, Author(s).

<34>
Accession Number
2006861292
Title
Reoperative mitral surgery versus transcatheter mitral valve replacement:
A systematic review.
Source
Journal of the American Heart Association. 10 (6) (no pagination), 2021.
Article Number: e019854. Date of Publication: 2021.
Author
Sengupta A.; Yazdchi F.; Alexis S.L.; Percy E.; Premkumar A.; Hirji S.;
Bapat V.N.; Bhatt D.L.; Kaneko T.; Tang G.H.L.
Institution
(Sengupta, Alexis, Tang) Department of Cardiovascular Surgery, Mount Sinai
Hospital, New York, NY, United States
(Yazdchi, Percy, Premkumar, Hirji, Kaneko) Division of Cardiac Surgery,
Brigham and Women's Hospital, Boston, MA, United States
(Bapat) Minneapolis Heart Institute Foundation, Minneapolis, MN, United
States
(Bhatt) Brigham and Women's Heart & Vascular Center, Harvard Medical
School, Boston, MA, United States
Publisher
American Heart Association Inc.
Abstract
Bioprosthetic mitral structural valve degeneration and failed mitral valve
repair (MVr) have traditionally been treated with reoperative mitral valve
surgery. Transcatheter mitral valve-in-valve (MVIV) and valve-in-ring
(MVIR) replacement are now feasible, but data comparing these approaches
are lacking. We sought to compare the outcomes of (1) reoperative mitral
valve replacement (redo-MVR) and MVIV for structural valve degeneration,
and (2) reoperative mitral valve repair (redo-MVr) or MVR and MVIR for
failed MVr. A literature search of PubMed, Embase, and the Cochrane
Library was conducted up to July 31, 2020. Thirty-two studies involving 25
832 patients were included. Redo-MVR was required in =35% of patients
after index surgery at 10 years, with 5% to 15% 30-day mortality. MVIV
resulted in >95% procedural success with 30-day and 1-year mortality of 0%
to 8% and 11% to 16%, respectively. Recognized complications included left
ventricular outflow tract obstruction (0%-6%), valve migration (0%-9%),
and residual regurgitation (0%-6%). Comparisons of redo-MVR and MVIV
showed no statistically significant differences in mortality (11.3% versus
11.9% at 1 year, P=0.92), albeit higher rates of major bleeding and
arrhythmias with redo-MVR. MVIR resulted in 0% to 34% mortality at 1 year,
whereas both redo-MVr and MVR for failed repairs were performed with
minimal mortality and durable long-term results. MVIV is therefore a
viable alternative to redo-MVR for structural valve degeneration, whereas
redo-MVr or redo-MVR is preferred for failed MVr given the suboptimal
results with MVIR. However, not all patients will be candidates for
MVIV/MVIR because anatomical restrictions may preclude transcatheter
options from adequately addressing the underlying pathology.<br/>Copyright
&#xa9; 2021 The Authors. Published on behalf of the American Heart
Association, Inc., by Wiley.

<35>
Accession Number
2010482651
Title
Hepatitis E seroprevalence and viremia rate in immunocompromised patients:
a systematic review and meta-analysis.
Source
Liver International. 41 (3) (pp 449-455), 2021. Date of Publication: March
2021.
Author
Buescher G.; Ozga A.-K.; Lorenz E.; Pischke S.; May J.; Addo M.M.;
Horvatits T.
Institution
(Buescher, Pischke, Addo, Horvatits) Department of Medicine, University
Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Ozga) Institute of Medical Biometry and Epidemiology, University Medical
Center Hamburg-Eppendorf, Hamburg, Germany
(Lorenz, May) Department of Infectious Disease Epidemiology, Bernhard
Nocht Institute for Tropical Medicine, Hamburg, Germany
(Lorenz, Pischke, May, Addo, Horvatits) German Center for Infection
Research (DZIF), Hamburg-Lubeck-Borstel and Heidelberg Partner sites,
Germany
(Lorenz) Institute of Medical Biostatistics, Epidemiology and Informatics,
University Medical Centre of the Johannes Gutenberg University Mainz,
Mainz, Germany
Publisher
Blackwell Publishing Ltd
Abstract
Background and Aims: Hepatitis E is an infectious disease of the liver
caused by the hepatitis E virus (HEV). Immunocompromised patients present
a particular risk group, as chronification of hepatitis E leading to
life-threatening cirrhosis occurs when these patients are infected.
Therefore, this study aims to estimate and compare the anti-HEV
seroprevalence and the rate of HEV RNA positivity in transplant recipients
and patients with human immunodeficiency virus (HIV). <br/>Method(s): This
systematic review and meta-analysis involved a literature search (PubMed,
Scopus; 1,138 studies) including 120 studies from 1996 to 2019, reporting
anti-HEV seroprevalence and/or HEV-RNA positivity. Statistical analysis
was performed using a linear mixed-effects meta regression model.
<br/>Result(s): Anti-HEV seroprevalence in 14 626 transplant recipients
ranged from 6% (95% CI: 1.9-17.2) to 29.6% (95% CI: 21.6-39.) in different
commercially available assays and did not differ significantly compared to
20 825 HIV positive patients (range: 3.5% (95% CI: 0.9-12.8) - 19.4% (95%
CI: 13.5-26.9). In contrast, HEV-RNA positivity rate was significantly
higher in transplant recipients than in HIV positive patients (1.2% (95%
CI: 0.9-1.6) vs 0.39% (95% CI: 0.2-0.7); P-value = 0.0011).
<br/>Conclusion(s): Anti-HEV seroprevalence did not differ significantly
between transplant recipients and HIV positive patients. Interestingly,
rates of HEV-RNA positivity, indicating ongoing infection, were
significantly higher in transplant recipients. These findings demonstrate
that transplant patients have an elevated risk of chronic infection in
comparison to HIV patients at comparable risk of
HEV-exposure.<br/>Copyright &#xa9; 2020 The Authors. Liver International
published by John Wiley & Sons Ltd

<36>
Accession Number
2007978431
Title
Estimates of Geriatric Delirium Frequency in Noncardiac Surgeries and Its
Evaluation Across the Years: A Systematic Review and Meta-analysis.
Source
Journal of the American Medical Directors Association. 22 (3) (pp
613-620.e9), 2021. Date of Publication: March 2021.
Author
Silva A.R.; Regueira P.; Albuquerque E.; Baldeiras I.; Cardoso A.L.;
Santana I.; Cerejeira J.
Institution
(Silva, Baldeiras, Cardoso, Santana, Cerejeira) Centre for Neuroscience
and Cell Biology, University of Coimbra, Coimbra, Portugal
(Silva, Regueira, Baldeiras, Cardoso, Cerejeira) Coimbra Institute for
Clinical and Biomedical Research (iCBR), Coimbra, Portugal
(Regueira, Albuquerque, Cerejeira) Department of Psychiatry, Centro
Hospitalar Universitario de Coimbra, Coimbra, Portugal
(Regueira, Baldeiras, Santana, Cerejeira) Faculty of Medicine, Coimbra
University, Coimbra, Portugal
(Santana) Department of Neurology, Centro Hospitalar Universitario de
Coimbra, Coimbra, Portugal
Publisher
Elsevier Inc.
Abstract
Objectives: Delirium is an acute neuropsychiatric syndrome associated with
poor outcomes. Older adults undergoing surgery have a higher risk of
manifesting perioperative delirium, particularly those having associated
comorbidities. It remains unclear whether delirium frequency varies across
surgical settings and if it has remained stable across the years. We
conducted a systematic review to (1) determine the overall frequency of
delirium in older people undergoing noncardiac surgery; (2) explore
factors explaining the variability of the estimates; and (3) determine the
changing of the estimates over the past 2 decades. <br/>Design(s):
Systematic review and meta-analysis. Literature search was performed in
MEDLINE, PubMed, ISI Web of Science, EBSCO, ISRCTN registry,
ScienceDirect, and Embase in January 2020 for studies published from 1995
to 2020. <br/>Setting(s): Noncardiac surgical settings.
<br/>Participant(s): Forty-nine studies were included with a total of
26,865 patients screened for delirium. <br/>Method(s): We included
observational and controlled trials reporting incidence, prevalence, or
proportion of delirium in adults aged >=60 years undergoing any noncardiac
surgery requiring hospitalization. Data extracted included sample size,
reported delirium frequencies, surgery type, anesthesia type, delirium
diagnosis method, length of hospitalization, and year of assessment.
(PROSPERO registration no.: CRD42020160045). <br/>Result(s): We found an
overall pooled frequency of preoperative delirium of 17.9% and
postoperative delirium (POD) of 23.8%. The POD estimates increased between
1995 and 2020 at an average rate of 3% per year. Pooled estimates of POD
were significantly higher in studies not excluding patients with lower
cognitive performance before surgery (28% vs 16%) and when general
anesthesia was used in comparison to local, spinal, or epidural anesthesia
(28% vs 20%). Conclusions and Implications: Type of anesthesia and
preoperative cognitive status were significant moderators of delirium
frequency. POD in noncardiac surgery has been increasing across the years,
suggesting that more resources should be allocated to delirium prevention
and management.<br/>Copyright &#xa9; 2020 AMDA - The Society for
Post-Acute and Long-Term Care Medicine

<37>
Accession Number
2006842568
Title
Impact of renin-angiotensin system inhibitors on outcomes after surgical
or transcatheter aortic valve replacement. A meta-analysis.
Source
Revista Espanola de Cardiologia. 74 (5) (pp 421-426), 2021. Date of
Publication: May 2021.
Author
Amat-Santos I.J.; Santos-Martinez S.; Julca F.; Catala P.;
Rodriguez-Gabella T.; Redondo-Dieguez A.; Hinojosa W.; Veras C.; Campo A.;
Serrador Frutos A.; Carrasco-Moraleja M.; San Roman J.A.
Institution
(Amat-Santos, Santos-Martinez, Julca, Catala, Rodriguez-Gabella,
Redondo-Dieguez, Hinojosa, Veras, Campo, Serrador Frutos, San Roman)
Departamento de Cardiologia, Hospital Clinico Universitario de Valladolid,
CIBERCV, Valladolid, Spain
(Amat-Santos, Carrasco-Moraleja, San Roman) Departamento de Cardiologia,
Hospital Clinico Universitario de Valladolid, Valladolid, Spain
Publisher
Ediciones Doyma, S.L.
Abstract
Introduction and objectives: To determine whether renin-angiotensin system
inhibitor (RASi) prescription is associated with better outcomes after
transcatheter aortic valve implantation (TAVI) and surgical aortic valve
replacement (SAVR). <br/>Method(s): All comparative studies of RASi vs no
RASi prescription in patients undergoing TAVI/SAVR were gathered from
PubMed, Web of Science, and Google Scholar through August, 2019. We
extracted hazard ratios (HRs) with their confidence intervals (CIs) for
mortality from each study and combined study-specific estimates using
inverse variance-weighted averages of logarithmic HRs in the random
effects model. <br/>Result(s): We identified 6 eligible studies with a
total of 21 390 patients (TAVI: 17 846; SAVR: 3544) and included them in
the present meta-analysis. The 6 studies were observational comparative
studies (including 3 propensity score matched and 3 cohort studies) of
RASi vs no RASi prescription. The analysis demonstrated that RASi
prescription was associated with significantly lower mortality in the
whole group of patients undergoing aortic valve intervention (HR, 0.64;
95%CI, 0.47-0.88; P < .001). However, subgroup analysis suggested
differences according to the selected therapy, with TAVI showing better
mortality rates in the RASi group (HR, 0.67; 95%CI, 0.49-0.93) but not in
the SAVR group (HR, 0.61; 95%CI, 0.29-1.30). No funnel plot asymmetry was
identified, suggesting minimum publication bias. Sensitivity analyses
sequentially eliminating dissimilar studies did not substantially alter
the primary result favoring RASI prescription. <br/>Conclusion(s): These
findings suggest a mortality benefit of RASi in patients with AS treated
with aortic valve replacement that might be particularly relevant
following TAVI. Future randomized studies are warranted to confirm this
relevant finding.
Introduccion y objetivos: Determinar si la prescripcion de inhibidores del
sistema renina-angiotensina (iSRA) se asocia a mejores resultados tras
implante percutaneo de valvula aortica (TAVI) o recambio valvular aortico
quirurgico (RVAQ). Metodos: Se seleccionaron de PubMed, Web of Science, y
Google Scholar hasta agosto de 2019 estudios comparativos de iSRA vs
no-iSRA en pacientes sometidos a TAVI/RVAQ. Se extrajeron las hazard
ratios (HR) con sus intervalos de confianza para mortalidad de cada
estudio y estimadores especificos en el modelo de efectos aleatorios.
Resultados: Se incluyeron 6 estudios con un total de 21.390 pacientes
(TAVI: 17.846, RVAQ: 3.544). Los 6 fueron estudios comparativos (3
analisis de propension y 3 de cohortes) comparando iSRA vs no-iSRA. Se
demostro que la prescripcion de iSRA se asocia con una mortalidad
significativamente menor en pacientes sometidos a intervencion valvular
aortica (HR = 0,64; IC95%, 0,47-0,88; p < 0,001). Sin embargo, el analisis
por subgrupos sugirio diferencias en funcion de la terapia seleccionada,
con menor mortalidad en los sometidos a TAVI tratados con iSRA (HR = 0,67;
IC95%, 0,49-0,93) pero no en los tratados con RVAQ (HR = 0,61; IC95%,
0,29-1,30). No se identifico asimetria en el analisis funnel plot,
sugiriendo bajo riesgo de sesgo de publicacion. El analisis de
sensibilidad eliminando sucesivamente diferentes estudios no altero de
forma substancial el resultado. Conclusiones: Estos resultados sugieren
reduccion de la mortalidad con la prescripcion de iSRA en pacientes con
estenosis aortica sometidos a recambio valvular aortico, en particular
tras TAVI. Futuros estudios aleatorizados deberan confirmar o refutar este
relevante hallazgo.<br/>Copyright &#xa9; 2020 Sociedad Espanola de
Cardiologia