EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 114

Results Generated From:
Embase <1980 to 2021 Week 29>
Embase (updates since 2021-07-16)

<1>
Accession Number
632798769
Title
Comparison of peres' formula and radiological landmark formula for optimal
depth of insertion of right internal jugular venous catheters.
Source
Indian Journal of Critical Care Medicine. 24 (7) (pp 527-530), 2020. Date
of Publication: 2020.
Author
Manudeep A.R.; Manjula B.P.; Dinesh Kumar U.S.
Institution
(Manudeep, Manjula) Department of Anesthesia, JSS Academy of Higher
Education and Research, Mysore, Karnataka, India
(Dinesh Kumar) Deparatment of Cardiothoracic and Vascular Anaesthesia, JSS
Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka,
India
Publisher
Jaypee Brothers Medical Publishers (P) Ltd
Abstract
Background: Central venous catheterization is a vital procedure for volume
resuscitation, infusion of drugs, and for central venous pressure
monitoring in the perioperative period and intensive care unit (ICU). It
is associated with position-related complications like arrhythmia's,
thrombosis, tamponade, etc. Several methods are used to calculate the
catheter insertion depth so as to prevent these position-related
complications. <br/>Objective(s): To compare Peres' formula and
radiological landmark formula for central venous catheter insertion depth
through right internal jugular vein (IJV) by the anterior approach.
<br/>Material(s) and Method(s): A total of 102 patients posted for
elective cardiac surgery were selected and divided into two equal
groups-Peres' group (group P) and radiological landmark group (group R).
Central venous catheterization of right IJV was done under ultrasound
(USG) guidance. In group P, central venous catheter insertion depth was
calculated as height (cm)/10. In group R, central venous catheter
insertion depth was calculated by adding the distances from the puncture
point to the right sternoclavicular joint and on chest X-ray the distance
from the right sternoclavicular joint to carina. After insertion, the
catheter tip position was confirmed using transesophageal echocardiography
(TEE) in both the groups. <br/>Result(s): About 49% of the catheters in
group P and 74.5% in group R were positioned optimally as confirmed by
TEE, which was statistically significant. No complications were observed
in both the groups. <br/>Conclusion(s): Radiological landmark formula is
superior to Peres' formula for measuring optimal depth of insertion of
right internal jugular venous catheter.<br/>Copyright &#xa9; The Author(s)
2020.

<2>
Accession Number
614112312
Title
Additional effects of topical tranexamic acid in on-pump cardiac surgery.
Source
Asian Cardiovascular and Thoracic Annals. 25 (1) (pp 24-30), 2017. Date of
Publication: January 2017.
Author
Taksaudom N.; Siwachat S.; Tantraworasin A.
Institution
(Taksaudom, Siwachat, Tantraworasin) Department of Surgery, Faculty of
Medicine, Chiang Mai University, Maharaj Nakorn Chiang Mai Hospital, 110
Suthep Rd, Chiang Mai 50200, Thailand
Publisher
SAGE Publications Inc.
Abstract
Objective Postoperative bleeding after cardiac surgery is commonly
associated with hyperfibrinolysis. This study was designed to evaluate the
efficacy of topical tranexamic acid in addition to intravenous tranexamic
acid in reducing bleeding in cardiac surgery cases. Methods From July 1,
2014 to September 30, 2015, 82 patients who underwent elective on-pump
cardiac surgery were randomized into a tranexamic acid group and a placebo
group. In the tranexamic acid group, 1 g of tranexamic acid dissolved in
100 mL of normal saline solution was poured into the pericardium during
sternal closure; the placebo group had 100 mL of saline only. Two patients
were excluded from the study due to obvious surgical bleeding. The primary
endpoint was total blood loss 24 h after surgery. Repeated measures with
mixed models was used to analyze bleeding over time. Results There was no
significant difference in demographic and intraoperative data except for a
significantly lower platelet count preoperatively in the tranexamic acid
group (p = 0.030). There was no significant difference in postoperative
drainage volumes at 8, 16, and 24 h, postoperative bleeding over time
(coefficient = 0.713, p = 0.709), or blood product transfusion between the
groups. There were no serious complications. Conclusions Topical
tranexamic acid is safe but it adds no additional efficacy to the
intravenous application in reducing postoperative blood loss. Intravenous
tranexamic acid administration alone is sufficient antifibrinolytic
treatment to enhance the hemostatic effects during on-pump cardiac
surgery.<br/>Copyright &#xa9; The Author(s) 2016.

<3>
Accession Number
608719832
Title
Theophylline Population Pharmacokinetics and Dosing in Children Following
Congenital Heart Surgery With Cardiopulmonary Bypass.
Source
Journal of Clinical Pharmacology. 56 (9) (pp 1084-1093), 2016. Date of
Publication: September 2016.
Author
Frymoyer A.; Su F.; Grimm P.C.; Sutherland S.M.; Axelrod D.M.
Institution
(Frymoyer, Su, Grimm, Sutherland, Axelrod) Department of Pediatrics,
Stanford University, Stanford, CA, United States
Abstract
Children undergoing cardiac surgery requiring cardiopulmonary bypass (CPB)
frequently develop acute kidney injury due to renal ischemia.
Theophylline, which improves renal perfusion via adenosine receptor
inhibition, is a potential targeted therapy. However, children undergoing
cardiac surgery and CPB commonly have alterations in drug
pharmacokinetics. To help understand optimal aminophylline (salt
formulation of theophylline) dosing strategies in this population, a
population-based pharmacokinetic model was developed using nonlinear
mixed-effects modeling (NONMEM) from 71 children (median age 5 months; 90%
range 1 week to 10 years) who underwent cardiac surgery requiring CPB and
received aminophylline as part of a previous randomized controlled trial.
A 1-compartment model with linear elimination adequately described the
pharmacokinetics of theophylline. Weight scaled via allometry was a
significant predictor of clearance and volume. In addition, allometric
scaled clearance increased with age implemented as a power maturation
function. Compared to prior reports in noncardiac children, theophylline
clearance was markedly reduced across age. In the final population
pharmacokinetic model, optimized empiric dosing regimens were developed
via Monte Carlo simulations. Doses 50% to 75% lower than those recommended
in noncardiac children were needed to achieve target serum concentrations
of 5 to 10 mg/L.<br/>Copyright &#xa9; 2016, The American College of
Clinical Pharmacology

<4>
Accession Number
601134084
Title
Video-assisted thoracic surgery for pneumothorax: republication of a
systematic review and a proposal by the guideline committee of the
Japanese Association for Chest Surgery 2014.
Source
General Thoracic and Cardiovascular Surgery. 63 (1) (pp 8-13), 2015. Date
of Publication: January 2015.
Author
Goto T.; Kadota Y.; Mori T.; Yamashita S.-I.; Horio H.; Nagayasu T.;
Iwasaki A.
Institution
(Goto, Kadota, Mori, Yamashita, Horio, Nagayasu, Iwasaki) Guidelines
Committees of Japanese Association for Chest Surgery, Kyoto, Japan
(Goto) Division of General Thoracic Surgery, Department of Surgery, School
of Medicine, Keio University, Shinjuku-ku, Tokyo 160-8582, Japan
(Kadota) Department of General Thoracic Surgery, Osaka Prefectural Medical
Center for Respiratory and Allergic Diseases, Osaka, Japan
(Mori) Department of Thoracic Surgery, Kumamoto University Hospital,
Kumamoto, Japan
(Yamashita, Iwasaki) Department of General Thoracic, Breast, and Pediatric
Surgery, Fukuoka University School of Medicine, Fukuoka, Japan
(Horio) Department of General Thoracic Surgery, Tokyo Metropolitan Cancer
and Infectious Diseases Center, Tokyo, Japan
(Nagayasu) Division of Surgical Oncology, Department of Surgery, Nagasaki
University Graduate School of Biomedical Sciences, Nagasaki, Japan
Publisher
Springer Japan
Abstract
Objective: The purpose of this consensus conference was to determine
whether video-assisted thoracic surgery (VATS) improves clinical outcomes
compared with conventional thoracotomy in patients undergoing surgery for
pneumothorax, and to outline evidence-based recommendations for the use of
VATS. <br/>Method(s): Before the consensus conference, the best available
evidence was reviewed, with systematic reviews, randomized trials, and
nonrandomized trials all taken into consideration in descending order of
validity and importance. At the consensus conference, evidence-based
interpretative statements were created, and consensus processes were used
to determine the ensuing recommendations. The Medical Information Network
Distribution Service in Japan (Minds) system was used to label the levels
of evidence for the references and the classes of recommendations. Results
and recommendations: The consensus panel agreed upon the following
statements and recommendations for patients with pneumothorax undergoing
surgery: 1. VATS is broadly indicated as surgery for pneumothorax. 2. VATS
is judged to be less invasive, as it results in minimal postoperative
pain, the periods of chest tube placement and hospitalization are short,
and it shows a trend toward early realization of social integration. 3.
There is no difference in terms of safety and complications between VATS
and open thoracotomy. 4. As it is anticipated that VATS will result in a
higher recurrence rate than open thoracotomy, it may be desirable to add a
supplemental procedure during surgery. In summary, VATS can be recommended
as pneumothorax surgery (Recommendation grade: Level B).<br/>Copyright
&#xa9; 2014, The Japanese Association for Thoracic Surgery.

<5>
Accession Number
52938292
Title
The effect of bone marrow mononuclear stem cell therapy on left
ventricular function and myocardial perfusion.
Source
Journal of Nuclear Cardiology. 21 (2) (pp 351-367), 2014. Date of
Publication: April 2014.
Author
Sadat K.; Ather S.; Aljaroudi W.; Heo J.; Iskandrian A.E.; Hage F.G.
Institution
(Sadat, Ather, Heo, Iskandrian, Hage) Division of Cardiovascular Disease,
University of Alabama, Birmingham Lyons-Harrison Research, 1900 University
Blvd, Birmingham, AL 35294, United States
(Aljaroudi) Division of Cardiovascular Disease, American University,
Beirut Medical Center, Beirut, Lebanon
(Hage) Section of Cardiology, Birmingham Veterans Affairs Medical Center,
Birmingham, AL, United States
Publisher
Springer Science and Business Media, LLC
Abstract
Background: Bone morrow stem cell (BMC) transfer is an emerging therapy
with potential to salvage cardiomyocytes during acute myocardial
infarction and promote regeneration and endogenous repair of damaged
myocardium in patients with left ventricular (LV) dysfunction. We
performed a meta-analysis to examine the association between
administration of BMC and LV functional recovery as assessed by imaging.
<br/>Methods and Results: Our meta-analysis included data from 32 trials
comprising information on 1,300 patients in the treatment arm and 1,006
patients in the control arm. Overall, BMC therapy was associated with a
significant increase in LV ejection fraction by 4.6% +/- 0.7% (P <.001)
(control-adjusted increase of 2.8% +/- 0.9%, P =.001), and a significant
decrease in perfusion defect size by 9.5% +/- 1.4% (P <.001)
(control-adjusted decrease of 3.8% +/- 1.2%, P =.002). The effect of BMC
therapy was similar whether the cells were administered via intra-coronary
or intra-myocardial routes and was not influenced by baseline ejection
fraction or perfusion defect size. <br/>Conclusion(s): BMC transfer
appears to have a positive impact on LV recovery in patients with acute
coronary syndrome and those with stable coronary disease with or without
heart failure. Most studies were small and a minority used a core
laboratory for image analysis. &#xa9; 2013 American Society of Nuclear
Cardiology.

<6>
Accession Number
2010280880
Title
Infective endocarditis - A review of current therapy and future
challenges.
Source
Hellenic Journal of Cardiology. 62 (3) (pp 190-200), 2021. Date of
Publication: 01 May 2021.
Author
Rezar R.; Lichtenauer M.; Haar M.; Hodl G.; Kern J.M.; Zhou Z.; Wuppinger
T.; Kraus J.; Strohmer B.; Hoppe U.C.; Wernly B.
Institution
(Rezar, Lichtenauer, Wuppinger, Kraus, Strohmer, Hoppe, Wernly) Clinic of
Internal Medicine II, Department of Cardiology, Paracelsus Medical
University of Salzburg, Austria
(Haar) Department of Cardiology, Paracelsus Medical University of
Nuremberg, Germany
(Hodl) Institute of Radiology, Academic Teaching Hospital
Wels-Grieskirchen, Austria
(Kern) Division of Medical Microbiology, Department of Laboratory
Medicine, Paracelsus Medical University of Salzburg, Austria
(Zhou) Department of Medicine, Division of Cardiology, Karolinska
Institutet, Karolinska University Hospital, Stockholm, Sweden
Publisher
Hellenic Cardiological Society
Abstract
Etiological, microbiological and epidemiological factors changed over
time, but mortality rates remain high in infective endocarditis (IE).
Healthcare-associated IE is nowadays responsible for a significant
proportion of cases due to increasing numbers of cardiac devices. Cardiac
implantable electronic devices, transcatheter aortic valve replacement,
and percutaneous valve repair are meanwhile used, especially in old and
sick patients. In suspected IE modified Duke criteria, integrating
clinical results, imaging, and biomarkers are traditionally applied. Newer
imaging technologies such as multi-slice computed tomography,
photon-emission computed tomography, and magnetic resonance imaging might
add value to conventional echocardiography in diagnosis and management of
IE. Treatment consists of long-term antibiotic therapy, infectiological
source control and/or cardiac surgery. Recently, antibiotic parenteral
outpatient regimens and partial oral treatment strategies were shown to
shorten hospital stays in patients suffering from IE. However, it remains
unclear how to best select patients for partial oral therapy. This review
describes new trends in diagnosing, imaging, and treating IE in a changing
patient collective with particular focus on patients with implantable
cardiac devices.<br/>Copyright &#xa9; 2020 Hellenic Society of Cardiology

<7>
Accession Number
2011063063
Title
Invasive methods for the diagnosis and management of intrathoracic
extramedullary hematopoiesis: A literature review.
Source
Respiratory Medicine and Research. 79 (no pagination), 2021. Article
Number: 100815. Date of Publication: May 2021.
Author
Georgakopoulou V.E.; Damaskos C.; Mantzouranis K.; Melemeni D.; Gkoufa A.;
Chlapoutakis S.; Garmpis N.; Sklapani P.; Aravantinou A.; Garmpi A.;
Trakas N.; Tsiafaki X.
Institution
(Georgakopoulou) Pulmonology Department, Laiko General Hospital, 17 Agiou
Thoma Street, Athens 11527, Greece
(Damaskos, Garmpis) Second Department of Propedeutic Surgery, Laiko
General Hospital, Medical School, National and Kapodistrian University of
Athens, Athens, Greece
(Damaskos, Garmpis) N.S. Christeas Laboratory of Experimental Surgery and
Surgical Research, Medical School, National and Kapodistrian University of
Athens, Athens, Greece
(Mantzouranis, Melemeni, Tsiafaki) 1st Pulmonology Department Sismanogleio
Hospital, Athens, Greece
(Gkoufa, Aravantinou) First Department of Internal Medicine, Laiko General
Hospital, Medical School, National and Kapodistrian University of Athens,
Athens, Greece
(Chlapoutakis) Department of Thoracic Surgery, Agios Savvas Hospital,
Athens, Greece
(Sklapani) Department of Cytology, Mitera Hospital, Athens, Greece
(Garmpi) First Department of Propedeutic Internal Medicine, Laiko General
Hospital, Medical School, National and Kapodistrian University of Athens,
Athens, Greece
(Trakas) Department of Biochemistry, Sismanogleio Hospital, Athens, Greece
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Extramedullary hematopoiesis is defined as hematopoiesis
occurring outside of the bone marrow. It usually compensates insufficient
bone marrow function or ineffective erythropoiesis and is observed mostly
in hematological disorders. Most common locations of extramedullary
hematopoiesis are the spleen, the liver and the lymph nodes. Intrathoracic
extramedullary hematopoiesis is rare presenting as bilateral lobulated
masses of lower paravertebral regions. This review summarizes the role of
invasive techniques in the diagnosis and management of intrathoracic EMH
and its complications. <br/>Method(s): An electronic search in PubMed and
Google Scholar was conducted with the keywords "intrathoracic
extramedullary hematopoiesis" AND "surgery" OR "video-assisted thoracic
surgery (VATS)" OR "medical thoracoscopy" OR "biopsy" OR "thoracotomy" OR
"image-guided biopsy" OR "median sternotomy", within 1970 to 2020 with the
limitation of English language to include those articles reporting data on
invasive techniques in intrathoracic extramedullary hematopoiesis.
<br/>Result(s): Overall, 93 articles were originally identified using our
search criteria and from the reference list of the previously identified
documents. Following elimination of duplicates, 29 were excluded after
title, abstract or full text screening, since they did not report the use
of invasive techniques in the diagnosis and management of intrathoracic
extramedullary hematopoiesis. <br/>Conclusion(s): Although in some cases
radiological features are typical for the diagnosis of intrathoracic
extramedullary hematopoeisis, invasive methods such as bronchoscopy with
transbronchial biopsy, image-guided fine needle aspiration, endobronchial
ultrasound-guided fine needle aspiration of the mass and mediastinoscopy,
medical thoracoscopy, median sternotomy, video-assisted thoracoscopic
surgery and thoracotomy, are essential for definite diagnosis and
management.<br/>Copyright &#xa9; 2021 SPLF and Elsevier Masson SAS

<8>
Accession Number
2004947306
Title
Melatonin's impact on antioxidative and anti-inflammatory reprogramming in
homeostasis and disease.
Source
Biomolecules. 10 (9) (pp 1-28), 2020. Article Number: 1211. Date of
Publication: September 2020.
Author
Chitimus D.M.; Popescu M.R.; Voiculescu S.E.; Panaitescu A.M.; Pavel B.;
Zagrean L.; Zagrean A.-M.
Institution
(Chitimus, Voiculescu, Pavel, Zagrean, Zagrean) Division of Physiology and
Neuroscience, Department of Functional Sciences, "Carol Davila" University
of Medicine and Pharmacy, Bucharest 010164, Romania
(Popescu) Department of Cardiology, "Carol Davila" University of Medicine
and Pharmacy, Elias University Hospital, Bucharest 010164, Romania
(Panaitescu) Department of Obstetrics and Gynecology, "Carol Davila"
University of Medicine and Pharmacy, Filantropia Clinical Hospital,
Bucharest 010164, Romania
Publisher
MDPI AG
Abstract
There is a growing consensus that the antioxidant and anti-inflammatory
properties of melatonin are of great importance in preserving the body
functions and homeostasis, with great impact in the peripartum period and
adult life. Melatonin promotes adaptation through allostasis and stands
out as an endogenous, dietary, and therapeutic molecule with important
health benefits. The anti-inflammatory and antioxidant effects of
melatonin are intertwined and are exerted throughout pregnancy and later
during development and aging. Melatonin supplementation during pregnancy
can reduce ischemia-induced oxidative damage in the fetal brain, increase
offspring survival in inflammatory states, and reduce blood pressure in
the adult offspring. In adulthood, disturbances in melatonin production
negatively impact the progression of cardiovascular risk factors and
promote cardiovascular and neurodegenerative diseases. The most studied
cardiovascular effects of melatonin are linked to hypertension and
myocardial ischemia/reperfusion injury, while the most promising ones are
linked to regaining control of metabolic syndrome components. In addition,
there might be an emerging role for melatonin as an adjuvant in treating
coronavirus disease 2019 (COVID 19). The present review summarizes and
comments on important data regarding the roles exerted by melatonin in
homeostasis and oxidative stress and inflammation related
pathologies.<br/>Copyright &#xa9; 2020 by the authors. Licensee MDPI,
Basel, Switzerland.

<9>
Accession Number
635435636
Title
A randomized parallel design trial of the efficacy and safety of
tranexamic acid, dexmedetomidine and nitroglycerin in controlling
intraoperative bleeding and improving surgical field quality during
septorhinoplasty under general anesthesia.
Source
Medical Gas Research. 11 (4) (pp 131-137), 2021. Date of Publication: 01
Oct 2021.
Author
Modir H.; Moshiri E.; Naseri N.; Faraji F.; Almasi-Hashiani A.
Institution
(Modir, Moshiri) Departments of Anesthesiology and Critical Care, Arak
University of Medical Sciences, Arak, Iran, Islamic Republic of
(Naseri) Department of Otorhinolaryngology, Arak University of Medical
Sciences, Arak, Iran, Islamic Republic of
(Faraji) Students Research Committee, Arak University of Medical Sciences,
Arak, Iran, Islamic Republic of
(Almasi-Hashiani) Department of Epidemiology, School of Health, Arak
University of Medical Sciences, Arak, Iran, Islamic Republic of
Publisher
Wolters Kluwer Medknow Publications
Abstract
In this blinded clinical trial, we attempted to compare the efficacy and
safety of administering tranexamic acid, dexmedetomidine and nitroglycerin
in preventing intraoperative bleeding and improving the quality of the
surgical field during septorhinoplasty under general anesthesia. A total
of 105 patients scheduled for septorhinoplasty were enrolled and randomly
assigned into three groups based on the balanced-block randomization
method. First group received 1 mug/kg intravenous injection
dexmedetomidine, second group received 10 mg/kg intravenous injection
tranexamic acid and third group received 0.5 mug/kg nitroglycerin,
intravenously. The study sample was composed of 105 participants with the
total mean age of 25.85 +/- 6.52 years, and 59.05% of participants were
female and the mean of body mass index was 24.34 +/- 2.57
kg/m². The results showed that there was no statistically
significant difference in terms of arterial oxygen saturation, mean
arterial pressure, heart rate, bleeding rate, duration of surgery, and
surgeon satisfaction among the three groups; however, there was a
significant difference in the extubation time, recovery time and the dose
of administered propofol among the three groups. Dexmedetomidine reduced
the dose of administered propofol while increasing the extubation time and
recovery time. In the tranexamic acid group compared with the other two
groups, the recovery time was shorter. However, all the three drugs could
reduce intraoperative bleeding and lead to surgeon satisfaction. It can be
concluded that all these three drugs can be utilized to control bleeding
and improve the quality of the surgical field but the ultimate decision
lies with the anesthesiologist's judgment and the conditions of the
patient. The study protocol was registered in the Iranian Registry of
Clinical Trials (registration No. IRCT20141209020258N121) on September 24,
2019 and it was ethically approved by the Ethical Committee of Arak
University of Medical Sciences (approval No. IR.ARAKMU.REC.1397.355) on
February 24, 2019. Modir Hesameddin 1 Departments of Anesthesiology and
Critical Care, Arak University of Medical Sciences, Arak Moshiri Esmail 2
Departments of Anesthesiology and Critical Care, Arak University of
Medical Sciences, Arak Naseri Narges 3 Department of Otorhinolaryngology,
Arak University of Medical Sciences, Arak Faraji Fatemeh 4 Students
Research Committee, Arak University of Medical Sciences, Arak
Almasi-Hashiani Amir 5 Department of Epidemiology, School of Health, Arak
University of Medical Sciences, Arak H1. Ofo E, Singh A, Marais J.
Steroids in rhinoplasty: a survey of current UK otolaryngologists'
practice. J Laryngol Otol. 2006;120:108-112. Blackwell KE, Ross DA, Kapur
P, Calcaterra TC. Propofol for maintenance of general anesthesia: a
technique to limit blood loss during endoscopic sinus surgery. Am J
Otolaryngol. 1993;14:262-266. Brull R, Macfarlane AJR, Chan VWS. Spinal,
epidural and caudal anesthesia. In: Miller R, ed. Miller's Anesthesia.
Churchill Livingstone: Elsvier; 2015:1684-1720. Ducloy-Bouthors AS, Jude
B, Duhamel A, et al. High-dose tranexamic acid reduces blood loss in
postpartum haemorrhage. Crit Care. 2011;15:R117. Taksaudom N, Siwachat S,
Tantraworasin A. Additional effects of topical tranexamic acid in on-pump
cardiac surgery. Asian Cardiovasc Thorac Ann. 2017;25:24-30. Kumsar S,
Dirim A, Toksoz S, Saglam HS, Adsan O. Tranexamic acid decreases blood
loss during transurethral resection of the prostate (TUR -P). Cent
European J Urol. 2011;64:156-158. Dobrovolsky AB, Titaeva EV. The
fibrinolysis system: regulation of activity and physiologic functions of
its main components. Biochemistry (Mosc). 2002;67:99-108. McCormack PL.
Tranexamic acid: a review of its use in the treatment of
hyperfibrinolysis. Drugs. 2012;72:585-617. Nielsen JD, Gram J, Fabrin K,
Holm-Nielsen A, Jespersen J. Lack of correlation between blood
fibrinolysis and the immediate or post-operative blood loss in
transurethral resection of the prostate. Br J Urol. 1997;80:105-110.
Sethna NF, Zurakowski D, Brustowicz RM, Bacsik J, Sullivan LJ, Shapiro F.
Tranexamic acid reduces intraoperative blood loss in pediatric patients
undergoing scoliosis surgery. Anesthesiology. 2005;102:727-732. Wong J, El
Beheiry H, Rampersaud YR, et al. Tranexamic Acid reduces perioperative
blood loss in adult patients having spinal fusion surgery. Anesth Analg.
2008;107:1479-1486. Mayur G, Purvi P, Ashoo G, Pankaj D. Efficacy of
tranexamic acid in decreasing blood loss during and after cesarean
section: A randomized case controlled prospective study. J Obstet Gynecol
India. 2007;57:227-230. Alimian M, Mohseni M. The effect of intravenous
tranexamic acid on blood loss and surgical field quality during endoscopic
sinus surgery: a placebo-controlled clinical trial. J Clin Anesth.
2011;23:611-615. White PF. The changing role of non-opioid analgesic
techniques in the management of postoperative pain. Anesth Analg.
2005;101:S5-22. Rezaee M, Safavi M, Monabati M. Complete guide to
anesthesia drugs. Tehran: Jame-e-Negar Publishing House. 2013. Guven DG,
Demiraran Y, Sezen G, Kepek O, Iskender A. Evaluation of outcomes in
patients given dexmedetomidine in functional endoscopic sinus surgery. Ann
Otol Rhinol Laryngol. 2011;120:586-592. Praveen DV, Pushparani A, Anand K,
Balachandran S, Umadevi. Comparison of dexmedetomidine with
nitroglycerinefor hypotensive anaesthesia in functional endoscopic sinus
surgery. Indian J Clin Anaesth. 2016;3:376-388. Modares M, Rahnama P. Side
effects of glyceryl trinitrate ointment for primary dysmenorrhea: a
randomized clinical trial. Tehran Univ Med J. 2008;65:61-66. Hadavi MR,
Zarei Y, Tarogh S. Comparison of effects of labetalol and nitroglycerine
on intraoperative blood loss and surgical field quality in rhinoplasty
surgery. World J Plast Surg. 2015;4:60-65. Srivastava U, Dupargude AB,
Kumar D, Joshi K, Gupta A. Controlled hypotension for functional
endoscopic sinus surgery: comparison of esmolol and nitroglycerine. Indian
J Otolaryngol Head Neck Surg. 2013;65:440-444. Mayhew D, Mendonca V,
Murthy BVS. A review of ASA physical status - historical perspectives and
modern developments. Anaesthesia. 2019;74:373-379. Fromme GA, MacKenzie
RA, Gould AB, Jr., Lund BA, Offord KP. Controlled hypotension for
orthognathic surgery. Anesth Analg. 1986;65:683-686. Bayram A, Ulgey A,
Gunes I, et al. Comparison between magnesium sulfate and dexmedetomidine
in controlled hypotension during functional endoscopic sinus surgery. Rev
Bras Anestesiol. 2015;65:61-67. Berenjian S, Hassani V, Farhadi M, Zaman
B, Alimian M. Comparing the effect of tranexamic acid and dexmedetomidine
on bleeding during rhinoplasty. J Anesthesiol Pain. 2017;7:36-43. Eghbal
A, Modir H, Moshiri E, Khalili M, Barsari F, Mohammadbeigi A. Hypotensive
effect of labetalol and dexmedetomidine blood loss and surgical conditions
in functional endoscopic sinus surgery: A double-blind randomized clinical
trial. Formos J Surg. 2018;51:98-104. Modir H, Modir A, Rezaei O,
Mohammadbeigi A. Comparing remifentanil, magnesium sulfate, and
dexmedetomidine for intraoperative hypotension and bleeding and
postoperative recovery in endoscopic sinus surgery and
tympanomastoidectomy. Med Gas Res. 2018;8:42-47. Moshiri E, Modir H, Yazdi
B, Susanabadi A, Salehjafari N. Comparison of the effects of propofol and
dexmedetomidine on controlled hypotension and bleeding during endoscopic
sinus surgery. Ann Trop Med Public Health. 2017;10:721. Ghavimi MA, Taheri
Talesh K, Ghoreishizadeh A, Chavoshzadeh MA, Zarandi A. Efficacy of
tranexamic acid on side effects of rhinoplasty: A randomized double-blind
study. J Craniomaxillofac Surg. 2017;45:897-902. Sankar D, Krishnan R,
Veerabahu M, Vikraman B. Evaluation of the efficacy of tranexamic acid on
blood loss in orthognathic surgery. A prospective, randomized clinical
study. Int J Oral Maxillofac Surg. 2012;41:713-717. Ghodraty M, Khatibi A,
Rokhtabnak F, Maleki M, Parsa F. Comparing labetalol and nitroglycerine on
inducing controlled hypotension and intraoperative blood loss in
rhinoplasty: a single-blinded clinical trial. Anesth Pain Med.
2017;7:e13677. Jalali MM, Moosavi S, Fatemi S, Banan RA. Comparison
between dexamethasone and tranexamic acid on postoperative edema and
ecchymosis after rhinoplasty operation. J Guilan Univ Med Sci.
2012;21:72-77. Ayoglu H, Yapakci O, Ugur MB, et al. Effectiveness of
dexmedetomidine in reducing bleeding during septoplasty and tympanoplasty
operations. J Clin Anesth. 2008;20:437-441.<br/>Copyright &#xa9; 2021 BMJ
Publishing Group. All rights reserved.

<10>
Accession Number
2013342741
Title
Comparison between intraoperative bleeding score and ROTEM measurements to
assess coagulopathy during major pediatric surgery.
Source
Transfusion and Apheresis Science. (no pagination), 2021. Article Number:
103191. Date of Publication: 2021.
Author
Restin T.; Schmugge M.; Cushing M.M.; Haas T.
Institution
(Restin) Newborn Research Zurich, Department of Neonatology, University
hospital Zurich, Zurich, Switzerland
(Restin) Institute of Physiology, Zurich Center for Integrative Human
Physiology, University of Zurich, Zurich, Switzerland
(Schmugge) Department of Hematology, Zurich University Children's
Hospital, Zurich, Switzerland
(Schmugge, Haas) Children's Research Center, University Children's
Hospital of Zurich, Zurich, Switzerland
(Cushing) Department of Pathology and Laboratory Medicine, Weill Cornell
Medical College, New York, NY, United States
(Haas) Department of Anesthesia, Zurich University Children's Hospital,
Zurich, Switzerland
Publisher
Elsevier Ltd
Abstract
Purpose: Intraoperative bleeding should be regularly assessed visually to
guide coagulation management. Whereas viscoelastic testing with ROTEM
measurement has been proven to be useful in detecting coagulopathies, the
visual assessment is not standardized. This study therefore aims to
compare a standardized visual assessment with ROTEM results.
<br/>Method(s): A 5-point bleeding score was created and applied in a
recently published randomized controlled trial in major pediatric
non-cardiac surgery. This score assesses overall bleeding tendency and the
occurrence of diffuse bleeding, aqueous bleeding, bleeding outside the
operative field, and the ability to control bleeding. Validity of this
score was tested by post hoc comparison to the results of simultaneously
performed ROTEM measurements. <br/>Result(s): Signs of coagulopathic
bleeding were assessed at 183 time points. Mild to moderate bleeding
intensity was judged at 103 time points, in 42 % abnormal ROTEM traces
were obtained simultaneously. When severe bleeding was scored, abnormal
ROTEM values occurred in 58 %, and FIBTEM-values were significantly lower
than in the "no bleeding group". Altogether, the correlation between
bleeding score and ROTEM measurements was not significant.
<br/>Conclusion(s): The standardized visual assessment did not correlate
well with ROTEM measurements, suggesting that it is not useful to detect
coagulopathy. Trial registry number: ClinicalTrials.gov identifier No.
NCT01487837.<br/>Copyright &#xa9; 2021

<11>
Accession Number
2013342731
Title
Variability and reproducibility of the SYNTAX score for triple-vessel
disease.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2021. Date of
Publication: 2021.
Author
Basman C.; Levine E.; Tejpal A.; Thampi S.; Rashid U.; Barry R.; Stoffels
G.; Kliger C.A.; Coplan N.; Patel N.; Scheinerman S.J.; Singh V.P.
Institution
(Basman, Levine, Tejpal, Thampi, Rashid, Barry, Stoffels, Kliger, Coplan,
Patel, Scheinerman, Singh) Department of Cardiothoracic Surgery and
Cardiovascular Medicine, Lenox Hill Heart and Lung, Northwell Health
System, 130 East 77th Street, Black Hall 4th floor, New York, NY 10075,
United States
(Basman, Rashid, Singh) Department of Cardiovascular Medicine, Northern
Westchester Hospital, Northwell Health System, 400 E. Main St, Mt Kisco,
NY 10549, United States
Publisher
Elsevier Inc.
Abstract
Background: The SYNTAX score (SX) is an angiographic grading system to
determine the burden and complexity of coronary artery disease (CAD) and
to guide operators as to the appropriateness of percutaneous coronary
intervention (PCI) vs coronary artery bypass grafting (CABG). However,
variability of the SX may exist since the assessment relies on individual
clinicians to visually interpret lesion severity and characteristics. We
therefore aimed to assess SX variability and reproducibility among
interpreting physicians. <br/>Method(s): Fifty patient angiograms were
randomly selected from a registry of patients with multi-vessel CAD
(treated with PCI or CABG) completed at our institution during the years
2011-2018. Each angiogram was evaluated by 6 clinicians on 2 separate
occasions (minimum 8 weeks between occasions) for a total of 600 SX. Our
goal was to evaluate both inter- and intra- observer reliability of SX
scores. Variation in both raw score as well as risk classification (low,
intermediate or high SX) was observed. Inter- and intra-observer
reliability were assessed using the intra-class correlation coefficient
(ICC), Cohen's weighted Kappa, and Fleiss' Kappa. <br/>Result(s): SYNTAX
scores on both assessments and across all 6 cardiologists had a mean score
of 25.3. On the first assessment, the ICC for the inter-observer
reliability of SX scores was 0.61 (95% CI: 0.50, 0.73). Across the 6
observers, only 16% of angiograms were classified in the same risk
classification by all observers. 34% of angiograms had less than a
majority agreement (3 or less observers) on risk classification. The
weighted Kappa for intra-observer reliability of risk classification
scores ranged from 0.30 to 0.81. Across the 6 observers, the proportion of
angiograms classified as the same risk classification between each
observer's 1st and 2nd assessment ranged from 46% to 84%.
<br/>Conclusion(s): This study shows a wide inter- and intra- user
variability in calculating SX. Our data indicates a significant limitation
in using the SX to guide revascularization strategies. Further studies are
needed to determine more reliable ways to quantitate burden of
CAD.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<12>
Accession Number
2013168814
Title
Impact of Optimal Medical Therapy on 10-Year Mortality After Coronary
Revascularization.
Source
Journal of the American College of Cardiology. 78 (1) (pp 27-38), 2021.
Date of Publication: 06 Jul 2021.
Author
Kawashima H.; Serruys P.W.; Ono M.; Hara H.; O'Leary N.; Mack M.J.; Holmes
D.R.; Morice M.-C.; Head S.J.; Kappetein A.P.; Thuijs D.J.F.M.; Milojevic
M.; Noack T.; Mohr F.-W.; Davierwala P.M.; Sharif F.; McEvoy J.W.; Onuma
Y.
Institution
(Kawashima, Serruys, Ono, Hara, O'Leary, Sharif, McEvoy, Onuma) Department
of Cardiology, National University of Ireland, Galway, Galway, Ireland
(Kawashima, Ono, Hara) Department of Cardiology, Academic Medical Center,
University of Amsterdam, Amsterdam, Netherlands
(Serruys) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Mack) Department of Cardiothoracic Surgery, Baylor Scott and White
Health, Dallas, TX, United States
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Morice) Hopital Prive Jacques Cartier, Ramsay Generale de Sante, Massy,
France
(Head, Kappetein, Thuijs, Milojevic) Department of Cardiothoracic Surgery,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
(Noack, Mohr, Davierwala) University Department of Cardiac Surgery, Heart
Centre Leipzig, Leipzig, Germany
Publisher
Elsevier Inc.
Abstract
Background: The benefit of optimal medical therapy (OMT) on 5-year
outcomes in patients with 3-vessel disease and/or left main disease after
percutaneous coronary intervention or coronary artery bypass grafting
(CABG) was demonstrated in the randomized SYNTAX (Synergy Between PCI With
Taxus and Cardiac Surgery) trial. <br/>Objective(s): The objective of this
analysis is to assess the impact of the status of OMT at 5 years on
10-year mortality after percutaneous coronary intervention or CABG.
<br/>Method(s): This is a subanalysis of the SYNTAXES (Synergy Between PCI
With Taxus and Cardiac Surgery Extended Survival) study, which evaluated
for up to 10 years the vital status of patients who were originally
enrolled in the SYNTAX trial. OMT was defined as the combination of 4
types of medications: at least 1 antiplatelet drug, statin,
angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, and
beta-blocker. After stratifying participants by the number of individual
OMT agents at 5 years and randomized treatment, a landmark analysis was
conducted to assess the association between treatment response and 10-year
mortality. <br/>Result(s): In 1,472 patients, patients on OMT at 5 years
had a significantly lower mortality at 10 years compared with those on <=2
types of medications (13.1% vs 19.9%; adjusted HR: 0.470; 95% CI:
0.292-0.757; P = 0.002) but had a mortality similar to those on 3 types of
medications. Furthermore, patients undergoing CABG with the individual OMT
agents, antiplatelet drug and statin, at 5 years had lower 10-year
mortality than those without. <br/>Conclusion(s): In patients with
3-vessel and/or left main disease undergoing percutaneous coronary
intervention or CABG, medication status at 5 years had a significant
impact on 10-year mortality. Patients on OMT with guideline-recommended
pharmacologic therapy at 5 years had a survival benefit. (Synergy Between
PCI With Taxus and Cardiac Surgery: SYNTAX Extended Survival [SYNTAXES];
NCT03417050; Taxus Drug-Eluting Stent Versus Coronary Artery Bypass
Surgery for the Treatment of Narrowed Arteries [SYNTAX];
NCT00114972)<br/>Copyright &#xa9; 2021 American College of Cardiology
Foundation

<13>
Accession Number
2013135387
Title
Effect of levosimendan on renal function in background of left ventricular
dysfunction: a meta-analysis of randomized trials.
Source
Expert Opinion on Drug Safety. (no pagination), 2021. Date of Publication:
2021.
Author
Long Y.-X.; Cui D.-Y.; Kuang X.; Hu Y.; Hu S.; Wang C.-P.; Liu Z.-Z.
Institution
(Long, Cui, Kuang, Hu, Hu, Wang, Liu) Department of Cardiology, The Second
Affiliated Hospital of Chongqing Medical University, Chongqing, China
Publisher
Taylor and Francis Ltd.
Abstract
Objective: Levosimendan, an inotrope, is widely used in the management of
heart failure (HF) and cardiac surgery, but it remains uncertain whether
levosimendan can improve renal function in patients with left ventricular
dysfunction (LVD). <br/>Method(s): PubMed, Embase, and Cochrane CENTRAL
from the inception to June 2020 were systematically screened for
randomized controlled trials (RCTs) to investigate whether levosimendan
offers kidney-related advantages in cardiovascular patients with LVD. We
pooled the effects using a random-effect model. <br/>Result(s):
Twenty-eight studies enrolling 5069 patients were included. Levosimendan
reduced the sCr (SMD -0.28, 95% CI (-0.48, -0.09), P = 0.005,
I² = 52.5%, high quality) and the risk of ARF (relative risk
0.75, 95%CI (0.60, 0.95), P = 0.017, I² = 11.3%,
moderate-quality) in patients with LVD compared with control group. The
reduction of sCr was more pronounced in patients with a relatively higher
baseline sCr level. For secondary outcomes, levosimendan therapy was
associated with the improvement of GFR (SMD 0.32, 95%CI (-0.05, 0.68), P =
0.092, I² = 55.1%, low-quality) and urine output (SMD 0.42,
95%CI (0.06, 0.79), P = 0.024, I² = 50.0%, very low-quality),
but there was no significant reduction in BUN (SMD -0.14, 95%CI (-0.97,
0.70), P = 0.774, I² = 77.9%, very low-quality).
<br/>Conclusion(s): Levosimendan might improve renal function of patients
with LVD.<br/>Copyright &#xa9; 2021 Informa UK Limited, trading as Taylor
& Francis Group.

<14>
Accession Number
53213132
Title
Efficacy of isolated left ventricular and biventricular pacing is
differentially associated with baseline QRS duration in chronic heart
failure: a meta-analysis of randomized controlled trials.
Source
Heart Failure Reviews. 20 (1) (pp 81-88), 2015. Date of Publication:
January 2014.
Author
Chen J.; Zhuang X.; Liao L.; Liao X.; Wang L.
Institution
(Chen, Zhuang, Liao, Wang) Department of Cardiology, First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
(Liao) Department of Health, Guangzhou Higher Education Mega Center,
Guangdong Pharmaceutical University, Guangzhou, Guangdong 510006, China
Publisher
Kluwer Academic Publishers
Abstract
Cardiac resynchronization therapy can treat chronic heart failure through
either biventricular pacing (BVP) or isolated left ventricular pacing
(LVP), and the efficacy is depended on QRS duration. However, the optimal
therapeutic choice of pacing or how the QRS influences the efficacy
remains uncertain. To investigate this uncertainty, we searched available
publications in PubMed, EMBASE, and the Cochrane Central Register of
Controlled Trials databases regarding differentials in efficacy parameters
between BVP and LVP. A meta-analysis of eight randomized controlled trials
found that BVP and LVP were comparable with regard to quality-of-life
scores, left ventricular ejection fraction, left ventricular end-systolic
volume, and mortality or heart transplant rates. However, there was a
significant heterogeneity among the trials in 6-min walking distances.
Subsequent meta-regression indicated that the baseline QRS duration
significantly correlated with the standard mean difference between BVP and
LVP. As QRS duration increased, the gain in 6-min walking distance with
BVP became significantly greater than that of LVP. This suggests that it
is necessary to consider the QRS duration when comparing the clinical
effects of BVP and LVP.<br/>Copyright &#xa9; 2014, Springer
Science+Business Media New York.

<15>
Accession Number
2013639223
Title
Meta-computational techniques' for managing spare data: An application in
off-pump heart surgery.
Source
Computer Methods and Programs in Biomedicine. 208 (no pagination), 2021.
Article Number: 106267. Date of Publication: September 2021.
Author
Lai H.; Khan Y.A.; Abbas S.Z.; Chammam W.
Institution
(Lai) School of Information Engineering, Huanghuai University. China
(Khan, Abbas) Department of Mathematics and Statistics, Hazara University
Mansehra, Pakistan
(Chammam) Department of Mathematics, College of Science Al-Zulfi, Majmaah
University, PO Box 66, Al-Majmaah 11952, Saudi Arabia
Publisher
Elsevier Ireland Ltd
Abstract
Background and Objectives: This research looked at the key considerations
to remember when selecting a model for working with sparse data. In the
presence of sparse evidence, it proposes ideal conditions for conducting
meta-analysis. <br/>Method(s): Monte Carlo simulations were used to
produce study results, and three forms of continuity correction were used
in the research. Besides, meta-analytical approaches were used to measure
the cumulative effect of treatment and estimate each method's efficiency.
A clinical trial in off-pump surgery met the main objectives of this
research. Meta-analysis methods were used to determine the outcome of
postoperative risk results. After that, with a total population of 3030,
Monte Carlo simulations were used to produce research data to run fixed
and random-effect models with three continuity correction forms. The type
of consistency adjustment used, group imbalances, statistical analysis
used, and variance values between studies all affect meta-analytical
methods' results. <br/>Result(s): MSE values for balanced groups are
normally zero. While the Arc-sine variation approach does a decent job of
coping with inconsistent results on the effect of treatment, it has
concerns with boundary estimates of variance between tests. Furthermore,
using continuity correction methods introduces bias and imprecise
medication outcome calculations. The spectrum of statistical analysis,
such as fixed effects and random effects, can be inferred as completely
based on data in samples. The sensitivity analysis of correction decisions
could increase the reliability of meta-analysis approaches by enabling
researchers to analyze various effect estimation findings.
<br/>Conclusion(s): This research study can be expanded upon by
identifying alternative approaches to continuity correction methods and
resolving boundary estimate problems. The range of statistical analysis,
such as fixed effects and random effects, can be entirely dependent on the
samples' type of data. The sensitivity analysis of correction decisions
could improve the efficiency of meta-analysis methods by allowing
researchers to investigate a wide range of effect estimation
results.<br/>Copyright &#xa9; 2021

<16>
Accession Number
635508953
Title
Three-dimensional image reconstruction based on improved U-net network for
anatomy of pulmonary segmentectomy.
Source
Mathematical biosciences and engineering : MBE. 18 (4) (pp 3313-3322),
2021. Date of Publication: 13 Apr 2021.
Author
Deng X.; Liu Y.; Chen H.
Institution
(Deng, Liu) Department of Human Anatomy, School of Basic Medical Sciences,
Anhui Medical University, Hefei 230032, China
(Chen) Department of Thoracic Surgery, First Affiliated Hospital of Anhui
Medical University, Hefei 230022, China
Publisher
NLM (Medline)
Abstract
Pulmonary segmentectomy is one of the advanced techniques in thoracic
surgery, but it is difficult to understand and master because of its
complex anatomical structure. The purpose of this study is to explore the
application effect of three-dimensional (3D) image reconstruction based on
an improved U-net network in the anatomy of thoracic surgery. In this
study, a total of 40 standardization training residents of thoracic
surgery in our hospital were randomly divided into two groups. The control
group was taught by conventional thin-slice CT images, while the
observation group was taught by 3D image reconstruction based on the
improved U-net network. After the training process was completed, the
teaching effect was compared between these two groups. Using the improved
U-net network model, 3D reconstruction of pulmonary segments can be
realized quickly. Compared with the control group, the individual and
total objective scores in the observation group were higher. The
satisfaction of learning interest, content understanding, clinical
thinking mode, and understanding of operation process in the observation
group was higher than that of the control group. From the results, we
concluded that the 3D image reconstruction technology based on the
improved U-net network could help students master the anatomical structure
of pulmonary segments and improve their learning interest and clinical
thinking ability.

<17>
Accession Number
2013177737
Title
Angiotensin-converting enzyme inhibitor for post-transcatheter aortic
valve implantation patients: study protocol for a multicenter randomized,
open-label blinded endpoint control trial.
Source
Trials. 22 (1) (no pagination), 2021. Article Number: 462. Date of
Publication: December 2021.
Author
Liao Y.B.; Xia C.; Cheng Y.; Li Q.; Wei X.; Ou Y.; Chen F.; Li Y.; Liu Q.;
Xiong T.; Zhao Z.; Peng Y.; Wei J.; Feng Y.; Chen M.
Institution
(Liao, Xia, Cheng, Li, Wei, Ou, Chen, Li, Liu, Xiong, Zhao, Peng, Wei,
Feng, Chen) Department of Cardiology, West China Hospital, Sichuan
University, Chengdu, China
Publisher
BioMed Central Ltd
Abstract
Background: With the expanded utilization of transcatheter aortic valve
implantation (TAVI) to younger and lower surgical risk patients with
severe aortic stenosis (AS), optimal medical therapy after TAVI procedure
has become the main concern. Renin-angiotensin system inhibitors (RASi)
are widely utilized in the area of cardiovascular disease including heart
failure and myocardial infarction and revealed the ability to reverse left
ventricular (LV) remodeling. Interests have, thus, been drawn in
investigating whether the prescription of RASi after the TAVI procedure
can prevent or reverse cardiac remodeling and improve long-term clinical
outcomes. No recommendation regarding the prescription of RASi after TAVI
is proposed yet due to the lack of evidence from randomized controlled
trials, especially in the Chinese population. We, therefore, designed this
randomized controlled trial to explore the effect of adding fosinopril to
standard care in patients who underwent a successful TAVI procedure on the
LV remodeling. <br/>Method(s): A total of 200 post-TAVI patients from
seven academic hospitals across China will be recruited and randomized
with a ratio of 1:1 to receive standard care or standard care plus
fosinopril. Follow-up visits will take place at 30 days, 3 months, 6
months, 12 months, and 24 months from randomization to assess the clinical
symptoms, any adverse events, cardiac function, and quality of life.
Cardiac magnetic resonance will be performed at baseline and repeated at
the 24-month follow-up visit to assess LV remodeling. <br/>Discussion(s):
This study will provide evidence regarding medical therapy for AS patients
who underwent TAVI and filling the gap in the Chinese population. Trial
registration: Chinese Clinical Trial Registry ChiCTR2100042266. Registered
on 17 January 2021.<br/>Copyright &#xa9; 2021, The Author(s).

<18>
Accession Number
635491700
Title
Impact on quality of life from multimodality treatment for lung cancer: A
randomised controlled feasibility trial of surgery versus no surgery as
part of multimodality treatment in potentially resectable stage III-N2
NSCLC (the PIONEER trial).
Source
BMJ Open Respiratory Research. 8 (1) (no pagination), 2021. Article
Number: e000846. Date of Publication: 15 Jul 2021.
Author
Taylor S.; Yorke J.; Tsim S.; Navani N.; Baldwin D.; Woolhouse I.; Edwards
J.; Grundy S.; Robson J.; Rhodes S.; Gomes F.; Blackhall F.; Faivre-Finn
C.; Evison M.
Institution
(Taylor, Yorke, Gomes) Christie Patient Centred Research, The Christie NHS
Foundation Trust, Manchester, United Kingdom
(Taylor, Yorke) School of Nursing, Midwifery and Social Work, University
of Manchester, Manchester, United Kingdom
(Tsim) Glasgow Pleural Disease Unit, Queen Elizabeth University Hospital,
Glasgow, United Kingdom
(Tsim) Institute of Cancer Sciences, University of Glasgow, Glasgow,
United Kingdom
(Navani) Lungs for Living Research Centre, University College London and
Department of Thoracic Medicine, University College London Hospital,
London, United Kingdom
(Baldwin) Respiratory Medicine Unit, David Evans Research Centre,
Nottingham University Hospitals NHS Trust, Nottingham, Nottinghamshire,
United Kingdom
(Woolhouse) Department of Respiratory Medicine, University Hospitals
Birmingham NHS Foundation Trust, Birmingham, United Kingdom
(Edwards) Department of Cardiothoracic Surgery, Sheffield Teaching
Hospitals NHS Foundation Trust, Sheffield, Sheffield, United Kingdom
(Grundy) Respiratory Medicine, Salford Royal NHS Foundation Trust,
Salford, United Kingdom
(Robson) Leeds Teaching Hospital Trusts, Leeds, United Kingdom
(Rhodes, Blackhall, Faivre-Finn) University of Manchester, Manchester,
United Kingdom
(Gomes) Medical Oncology Department, The Christie NHS Foundation Trust,
Manchester, United Kingdom
(Blackhall, Faivre-Finn) The Christie NHS Foundation Trust, Manchester,
United Kingdom
(Evison) Lung Cancer and Thoracic Surgery Directorate, Wythenshawe
Hospital, Manchester University NHS Foundation Trust, Manchester, United
Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Optimal treatment for potentially resectable' stage III-N2
non-small cell lung cancer (NSCLC) requires multimodality treatment: local
treatment (surgery or radiotherapy) and systemic anticancer therapy. There
is no clear evidence of superiority for survival between the two
approaches and little research has explored quality of life (QOL). This
study will inform the design of a phase III randomised trial of surgery
versus no surgery as part of multimodality treatment for stage III-N2
NSCLC with QOL as a primary outcome. Methods and analysis Patient
participants will be randomised to receive multimodality treatment (1)
with surgery OR (2) without surgery. The Quintet Recruitment Intervention
will be used to maximise recruitment. Eligible patients will have
potentially resectable' N2 NSCLC and have received a multidisciplinary
team recommendation for multimodality treatment. Sixty-six patients and
their carers will be recruited from 8 UK centres. Patient/carer QOL
questionnaires will be administered at baseline, weeks 6, 9, 12 and month
6. Semistructured interviews will be conducted. Quantitative data will be
analysed descriptively and qualitative data will be analysed using
framework analysis. Ethics and dissemination Ethical approval has been
obtained. Results will be disseminated via publications, national bodies
and networks, and patient and public involvement groups. Trial
registration NCT04540757 <br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ.

<19>
Accession Number
2013626947
Title
Intravenous versus inhalational maintenance of anesthesia for quality of
recovery in adult patients undergoing non-cardiac surgery: A systematic
review with meta-analysis and trial sequential analysis.
Source
PLoS ONE. 16 (7 July) (no pagination), 2021. Article Number: e0254271.
Date of Publication: July 2021.
Author
Shui M.; Xue Z.; Miao X.; Wei C.; Wu A.
Institution
(Shui, Xue, Miao, Wei, Wu) Department of Anesthesiology, Beijing Chaoyang
Hospital, Capital Medical University, Beijing, China
Publisher
Public Library of Science
Abstract
Background Intravenous and inhalational agents are commonly used in
general anesthesia. However, it is still controversial which technique is
superior for the quality of postoperative recovery. This meta-analysis
aimed at comparing impact of total intravenous anesthesia (TIVA) versus
inhalational maintenance of anesthesia on the quality of recovery in
patients undergoing non-cardiac surgery. Methods We systematically
searched EMBASE, PubMed, and Cochrane library for randomized controlled
trials (RCTs), with no language or publication status restriction. Two
authors independently performed data extraction and assessed risk of bias.
The outcomes were expressed as mean difference (MD) with 95% confidence
interval (CI) based on a random-effect model. We performed trial
sequential analysis (TSA) for total QoR-40 scores and calculated the
required information size (RIS) to correct the increased type I error.
Results A total of 156 records were identified, and 9 RCTs consisting of
922 patients were reviewed and included in the meta-analysis. It revealed
a significant increase in total QoR-40 score on the day of surgery with
TIVA (MD, 5.91 points; 95% CI, 2.14 to 9.68 points; P = 0.002;
I² = 0.0%). The main improvement was in four dimensions,
including "physical comfort", "emotional status", "psychological support"
and "physical independence". There was no significant difference between
groups in total QoR-40 score (P = 0.120) or scores of each dimension on
POD1. The TSA showed that the estimated required information size for
total QoR-40 scores was not surpassed by recovered evidence in our
meta-analysis. And the adjusted Z-curves did not cross the conventional
boundary and the TSA monitoring boundary. Conclusion Low-certainty
evidence suggests that propofol-based TIVA may improve the QoR-40 score on
the day of surgery. But more evidence is needed for a firm conclusion and
clinical significance.<br/>Copyright &#xa9; 2021 Shui et al. This is an
open access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<20>
Accession Number
2013626921
Title
Prehabilitation to prevent complications after cardiac surgery - A
retrospective study with propensity score analysis.
Source
PLoS ONE. 16 (7 July) (no pagination), 2021. Article Number: e0253459.
Date of Publication: July 2021.
Author
Hartog J.; Mousavi I.; Dijkstra S.; Fleer J.; van der Woude L.H.V.; van
der Harst P.; Mariani M.A.
Institution
(Hartog, Mousavi, Dijkstra, Mariani) Department of Cardiothoracic Surgery,
University of Groningen, University Medical Center Groningen, Groningen,
Groningen, Netherlands
(Fleer) Department of Health Psychology, University of Groningen,
University Medical Center Groningen, Groningen, Groningen, Netherlands
(van der Woude) Center for Human Movement Sciences, University of
Groningen, University Medical Center Groningen, Groningen, Groningen,
Netherlands
(van der Woude) Department of Rehabilitation Medicine, University of
Groningen, University Medical Center Groningen, Groningen, Groningen,
Netherlands
(van der Harst) Department of Cardiology, University of Groningen,
University Medical Center Groningen, Groningen, Groningen, Netherlands
Publisher
Public Library of Science
Abstract
Background The rising prevalence of modifiable lifestyle-related risk
factors (e.g. overweight and physical inactivity) suggests the need for
effective and safe preoperative interventions to improve outcomes after
cardiac surgery. This retrospective study explored potential short-term
postoperative benefits and unintended consequences of a multidisciplinary
prehabilitation program regarding in-hospital complications. Methods Data
on patients who underwent elective cardiac surgery between January 2014
and April 2017 were analyzed retrospectively. Pearson's chi-squared tests
were used to compare patients who followed prehabilitation (three times
per week, at a minimum of three weeks) during the waiting period with
patients who received no prehabilitation. Sensitivity analyses were
performed using propensity-score matching, in which the propensity score
was based on the baseline variables that affected the outcomes. Results Of
1201 patients referred for elective cardiac surgery, 880 patients met the
inclusion criteria, of whom 91 followed prehabilitation (53.8% >= 65
years, 78.0% male, median Euroscore II 1.3, IQR, 0.9-2.7) and 789 received
no prehabilitation (60.7% >= 65 years, 69.6% male, median Euroscore II
1.6, IQR, 1.0-2.8). The incidence of atrial fibrillation (AF) was
significantly lower in the prehabilitation group compared to the unmatched
and matched standard care group (resp. 14.3% vs. 23.8%, P = 0.040 and
14.3% vs. 25.3%, P = 0.030). For the other complications, no between-group
differences were found. Conclusions Prehabilitation might be beneficial to
prevent postoperative AF. Patients participated safely in prehabilitation
and were not at higher risk for postoperative complications. However,
well-powered randomized controlled trials are needed to confirm and deepen
these results.<br/>Copyright &#xa9; 2021 Hartog et al. This is an open
access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<21>
Accession Number
2013650574
Title
Comparison of figure of eight and traditional simple wire closure method
to prevent dehiscence after sternal closure.
Source
Journal of the Pakistan Medical Association. 70 (11) (pp 2001-2006), 2020.
Date of Publication: November 2020.
Author
Asghar A.; Talha K.M.; Amanullah M.; Shahabuddin S.
Institution
(Asghar, Talha) Medical Student, Aga Khan University, Karachi, Pakistan
(Amanullah) National Institute of Cardiovascular Diseases, Karachi,
Pakistan
(Shahabuddin) Aga Khan University, Karachi, Pakistan
Publisher
Pakistan Medical Association
Abstract
Objective: To investigate significant differences, if any, between
figure-of-eight method and simple wire closure technique in reducing the
incidence of infectious and non-infectious sternal dehiscence in patients
undergoing sternal closure. <br/>Method(s): The systematic review was
conducted in the Cardiothoracic Surgery Department at Aga Khan University
from 1st December 2015 to 13th December 2017. The review was registered
with PROSPERO, the International Prospective Register of Systematic
Reviews. Pubmed, Cochrane Library (Wiley) and Scopus databases were
searched for articles published up to December 13, 2017. The search was
limited to randomised control trials, clinical trials, retrospective
cohort studies, journal analyses, systematic reviews and meta analyses.
Cadaveric or animal studies and articles published in languages other than
English were excluded. <br/>Result(s): Of the 286 articles retrieved,
265(92.6%) were excluded on the basis of study title and abstract. Another
15(5.2%) were excluded for being irrelevant to the topic n hand, and
6(2.1%) formed the final sample. Of them, 4(66.6%) studies showed no
significant difference between the two techniques, while 2(33.3%) found
figure-of-eight technique to be superior of the two. <br/>Conclusion(s):
There was no significant difference between the figure-of-eight method and
the simple wire technique in reducing the risk of dehiscence in patients
undergoing sternal closure.<br/>Copyright &#xa9; 2020 Pakistan Medical
Association. All rights reserved.

<22>
Accession Number
2013627775
Title
The effects of high-intensity interval training, Nordic walking and
moderate-to-vigorous intensity continuous training on functional capacity,
depression and quality of life in patients with coronary artery disease
enrolled in cardiac rehabilitation: A randomized controlled trial (CRX
study).
Source
Progress in Cardiovascular Diseases. (no pagination), 2021. Date of
Publication: 2021.
Author
Reed J.L.; Terada T.; Cotie L.M.; Tulloch H.E.; Leenen F.H.; Mistura M.;
Hans H.; Wang H.-W.; Vidal-Almela S.; Reid R.D.; Pipe A.L.
Institution
(Reed, Terada, Mistura, Hans, Vidal-Almela) Exercise Physiology and
Cardiovascular Health Lab, University of Ottawa Heart Institute, 40 Ruskin
Street, Ottawa, ON K1Y 4W7, Canada
(Reed) School of Epidemiology and Public Health, Faculty of Medicine,
University of Ottawa, Canada
(Reed, Vidal-Almela) School of Human Kinetics, Faculty of Health Sciences,
University of Ottawa, Canada
(Reed, Terada, Cotie, Tulloch, Mistura, Hans, Vidal-Almela, Reid, Pipe)
Division of Cardiac Prevention and Rehabilitation, University of Ottawa
Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada
(Tulloch, Leenen, Reid, Pipe) School of Medicine, Faculty of Medicine,
University of Ottawa, Ottawa, Canada
(Leenen, Wang) Brain and Heart Research Group, University of Ottawa Heart
Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada
(Vidal-Almela) Institut du savoir Montfort, Hopital Montfort, Ottawa,
Canada
Publisher
W.B. Saunders
Abstract
Background: Coronary artery disease (CAD) patients undergoing
revascularization procedures often experience ongoing, diminished
functional capacity, high rates of depression and markedly low quality of
life (QoL). In CAD patients, studies have demonstrated that high-intensity
interval training (HIIT) is superior to traditional moderate-to-vigorous
intensity continuous training (MICT) for improving functional capacity,
whereas no differences between Nordic walking (NW) and MICT have been
observed. Mental health is equally as important as physical health, yet
few studies have examined the impact of HIIT and NW on depression and QoL.
The purpose of this randomized controlled trial (RCT) was to compare the
effects of 12 weeks of HIIT, NW and MICT on functional capacity in CAD
patients. The effects on depression severity, brain-derived neurotrophic
factor (BDNF) and QoL were also examined. <br/>Method(s): CAD patients who
underwent coronary revascularization procedures were randomly assigned to:
(1) HIIT (4 x 4-min of high-intensity work periods at 85%-95% peak heart
rate [HR]), (2) NW (resting HR [RHR] + 20-40 bpm), or (3) MICT (RHR +
20-40 bpm) twice weekly for 12 weeks. Functional capacity (six-min walk
test [6MWT]), depression (Beck Depression Inventory-II [BDI-II]), BDNF
(from a blood sample), and general (Short-Form 36 [SF-36]) and
disease-specific (HeartQoL) QoL were measured at baseline and follow-up.
Linear mixed-effects models for repeated measures were used to test the
effects of time, group and time x group interactions. <br/>Result(s): N =
135 CAD patients (aged 61 +/- 7 years; male: 85%) participated. A
significant time x group interaction (p = 0.042) showed greater increases
in 6MWT distance (m) for NW (77.2 +/- 60.9) than HIIT (51.4 +/- 47.8) and
MICT (48.3 +/- 47.3). BDI-II significantly improved (HIIT: -1.4 +/- 3.7,
NW: -1.6 +/- 4.0, MICT: -2.3 +/- 6.0 points, main effect of time: p <
0.001) whereas BDNF concentrations did not change (HIIT: -2.5 +/- 9.6, NW:
-0.4 +/- 7.7, MICT: -1.2 +/- 6.4 ng/mL, main effect of time: p > 0.05).
Significant improvements in SF-36 and HeartQoL values were observed (main
effects of time: p < 0.05). HIIT, NW and MICT participants attended 17.7
+/- 7.5, 18.3 +/- 8.0 and 16.1 +/- 7.3 of the 24 exercise sessions,
respectively (p = 0.387). <br/>Conclusion(s): All exercise programmes
(HIIT, NW, MICT) were well attended, safe and beneficial in improving
physical and mental health for CAD patients. NW was, however,
statistically and clinically superior in increasing functional capacity, a
predictor of future cardiovascular events.<br/>Copyright &#xa9; 2021
Elsevier Inc.

<23>
Accession Number
635521569
Title
Prognostic relevance of exercise testing in hypertrophic cardiomyopathy. A
systematic review.
Source
International journal of cardiology. (no pagination), 2021. Date of
Publication: 29 Jun 2021.
Author
Rodrigues T.; Raposo S.C.; Brito D.; Lopes L.R.
Institution
(Rodrigues, Brito) Cardiology Department, Centro Hospitalar Universitario
Lisboa Norte, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal; CAML, CCUL,
Lisbon School of Medicine, Universidade de Lisboa, Av. Prof. Egas Moniz,
1649-028 Lisboa, Portugal
(Raposo) Unidade de Saude Familiar Reynaldo dos Santos, Agrupamento de
Centros de Saude Estuario do Tejo, Administracao Regional de Saude Lisboa
e Vale do Tejo, Portugal; Lisbon School of Medicine, Universidade de
Lisboa, Lisboa, Portugal; Cardiology Department, Centro Hospitalar
Universitario Lisboa Norte, Av. Prof. Egas Moniz, 1649-028 Lisboa,
Portugal
(Lopes) Barts Heart Centre, St. Bartholomew's Hospital, London, UK; Centre
for Heart Muscle Disease, Institute of Cardiovascular Science, University
College London, London, UK
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cardiopulmonary exercise test (CPET) is indicated as part of
the assessment in hypertrophic cardiomyopathy (HCM) patients and stress
echocardiography is often used to assess symptoms. However, the role of
exercise testing for prognostic stratification in HCM is still not
established. AIMS: To systematically review the evidence on the role of
exercise testing for prognostic stratification in hypertrophic
cardiomyopathy. <br/>METHOD(S): A systematic review was conducted for
eligible publications, between 2010 and 2020, that included evaluation of
outcomes and prognosis. In these studies, patients underwent exercise
echocardiography and/or cardiopulmonary exercise testing, performed
according to predefined protocols. Diverse parameters were assessed in
order to determine which were relevant for the prognosis. Analyzed
outcomes included death from any cause, sudden cardiac death (SCD) and
equivalents, cardiovascular death, heart failure requiring hospitalization
or progression to New York Heart Association classes III or IV, cardiac
transplantation, non-sustained ventricular tachycardia, stroke, myocardial
infarction and invasive septal reduction therapy. <br/>RESULT(S): Eighteen
publications were included, corresponding to a total of 7525 patients. The
mean follow-up period varied between 1 and 8years. The main findings of
these studies revealed that the major predictors of outcomes were abnormal
heart rate recovery, abnormal blood pressure response exercise induced
wall motion abnormalities, lower peak VO2, higher VE/VCO2, and pulmonary
hypertension/exercise-induced pulmonary hypertension. <br/>CONCLUSION(S):
Although most studies concluded that exercise test results are useful to
determine prognosis in HCM, further investigation is needed regarding
whether it adds independent value to the current risk stratification
strategies.<br/>Copyright &#xa9; 2021. Published by Elsevier B.V.

<24>
Accession Number
635517843
Title
'Ticagrelor alone vs. dual antiplatelet therapy from 1 month after
drug-eluting coronary stenting among patients with STEMI': a post hoc
analysis of the randomized GLOBAL LEADERS trial.
Source
European heart journal. Acute cardiovascular care. (no pagination), 2021.
Date of Publication: 02 Jul 2021.
Author
Gamal A.S.; Hara H.; Tomaniak M.; Lunardi M.; Gao C.; Ono M.; Kawashima
H.; Juni P.; Vranckx P.; Windecker S.; Hamm C.; Steg P.G.; Onuma Y.;
Serruys P.W.
Institution
(Gamal, Hara, Lunardi, Gao, Ono, Kawashima, Onuma, Serruys) Department of
Cardiology, National University of Ireland, Galway (NUIG), University
Road, Galway H91 TK33, Ireland
(Gamal) Department of Cardiology, North Cumbria University Hospital NHS
Trust, Newtown Road, Cumbria CA2 7HY, United Kingdom
(Gamal) Department of Cardiology, Zagazig University, Zagazig 44519, Egypt
(Hara, Ono, Kawashima) Department of Cardiology, Academic Medical Center,
University of Amsterdam, Meibergdreef 9, AZ Amsterdam 1105, Netherlands
(Tomaniak) Department of Cardiology, Erasmus University MC, Dr.
Molewaterplein 40 Street, GD Rotterdam 3015, Netherlands
(Tomaniak) First Department of Cardiology, Medical University of Warsaw,
Banacha 1a Street, Warsaw 02-097, Poland
(Lunardi) Division of Cardiology, University of Verona, Piazzale Stefani
1, Verona 37100, Italy
(Gao) Department of Cardiology, Radboud University Medical Center, Geert
Grooteplein Zuid 8, GA Nijmegen 6525, Netherlands
(Juni) Applied Health Research Centre, Li Ka Shing Knowledge Institute of
St. Michael's Hospital, 30 Bond Street Toronto, ON M5B 1W8, Canada
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Stadsomvaart 11, Hasselt 3500, Belgium
(Windecker) Department of Cardiology, Bern University Hospital,
Freiburgstrasse 4, Bern 3010, Switzerland
(Hamm) Department of Cardiology, Kerckhoff Heart and Thorax Center, Campus
Kerckhoff of the University of GiessenBenekestrasse 2-8, Bad Nauheim
61231, Germany
(Steg) Universite de Paris, FACT, Assistance Publique-Hopitaux de Paris
Hopital Bichat, AP-HP, 46 rue Henri Huchard, Paris 75018, France
(Serruys) Department of Cardiology, Imperial College London, Exhibition
Road, London SW7 2BX, United Kingdom
Publisher
NLM (Medline)
Abstract
AIM: To evaluate the efficacy and safety of ticagrelor monotherapy beyond
1 month and up to 24months vs. standard 12-month dual antiplatelet therapy
(DAPT) with aspirin and ticagrelor followed by aspirin monotherapy among
ST-elevation myocardial infarction (STEMI) patients undergoing
percutaneous coronary intervention (PCI) in the GLOBAL LEADERS trial.
METHODS AND RESULTS: We performed a post hoc analysis of STEMI patients in
the GLOBAL LEADERS trial comparing experimental ticagrelor monotherapy
(1062 patients) with standard 12-month DAPT (1030 patients). We evaluated
predefined primary and secondary endpoints in both treatment arms. Rates
of net adverse clinical events (NACE), patient-oriented composite
endpoints (POCE), and bleeding academic research consortium (BARC)-defined
bleeding Type 3 or 5 were also evaluated. At 2 years, there were no
significant differences in rates of primary endpoints in patients who had
STEMI [0.89 (0.61-1.31)]. There were similar rates of NACE and POCE in
both experimental and reference treatment groups at 2years post-PCI
[hazard ratio (HR) 0.96 (0.77-1.20) and 0.96 (0.77-1.21), respectively].
BARC 3 or 5 bleeding events were numerically less in experimental compared
to reference treatment groups at 1 year [HR 0.55 (0.27-1.13)] and 2years
[0.61 (0.32-1.16)]. <br/>CONCLUSION(S): Presentation with STEMI has not
influenced the incidence of GLOBAL LEADERS defined primary endpoints.
There were no significant differences in rates of NACE, POCE, and BARC
bleeding between the two treatment groups up to 2years of follow-up.
Although these findings should be viewed as exploratory, they expand the
evidence on potential safety of aspirin-free antiplatelet strategies after
PCI in STEMI.<br/>Copyright &#xa9; The Author(s) 2021. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<25>
Accession Number
635517497
Title
Geographical variations in left main coronary artery revascularisation: a
pre-specified analysis of the EXCEL trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2021. Date of Publication: 02 Jul 2021.
Author
Myat A.; Hildick-Smith D.; de Belder A.J.; Trivedi U.; Crowley A.; Morice
M.-C.; Kandzari D.E.; Lembo N.J.; Brown W.M.; Serruys P.W.; Kappetein
A.P.; Sabik J.F.; Stone G.W.
Institution
(Myat) Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS
Trust, Brighton, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: The EXCEL trial reported similar five-year rates of the
primary composite outcome of death, myocardial infarction (MI), or stroke
after percutaneous coronary intervention (PCI) compared with coronary
artery bypass grafting (CABG) for treatment of obstructive left main
coronary artery disease (LMCAD). AIMS: We sought to determine whether
these outcomes remained consistent regardless of geography of enrolment.
<br/>METHOD(S): We performed a pre-specified subgroup analysis based on
regional enrolment. <br/>RESULT(S): Among 1,905 patients randomised to PCI
(n=948) or CABG (n=957), 1,075 (56.4%) were recruited at 52 European Union
(EU) centres, and 752 (39.5%) were recruited at 67 North American (NA)
centres. EU versus NA patients varied according to numerous baseline
demographics, anatomy, pharmacotherapy and procedural characteristics.
Nonetheless, the relative rates of the primary endpoint after PCI versus
CABG were consistent across EU versus NA centres at 30 days and 5 years.
However, NA participants had substantially higher late rates of
ischaemia-driven revascularisation (IDR) after PCI, driven predominantly
by the need for greater target vessel and lesion revascularisation. This
culminated in a significant difference in the relative risk of the
secondary composite outcome of death, MI, stroke, or IDR at 5 years
(pinteraction=0.02). <br/>CONCLUSION(S): In the EXCEL trial, the relative
risks for the 30-day and five-year primary composite outcome of death, MI
or stroke after PCI versus CABG were consistent irrespective of geography.
However, five-year rates of IDR after PCI were significantly higher in NA
centres, a finding the Heart Team and patients should consider when making
treatment decisions. ClinicalTrials.gov identifier: NCT01205776.

<26>
Accession Number
635516869
Title
Effect of White Noise and Lullabies on Pain and Vital Signs in Invasive
Interventions Applied to Premature Babies.
Source
Pain management nursing : official journal of the American Society of Pain
Management Nurses. (no pagination), 2021. Date of Publication: 28 Jun
2021.
Author
Dora O.; Buyuk E.T.
Institution
(Dora) Faculty of Health Sciences, Ondokuz Mayis University, Samsun,
Turkey
(Buyuk) Department of Child Health Nursing, Ondokuz Mayis University,
Samsun, Turkey
Publisher
NLM (Medline)
Abstract
BACKGROUND: Preterm babies are exposed to many repetitive painful
interventions in NICU. AIMS: This study aimed to comparatively determine
the effect of white noise and lullabies on pain perception and vital signs
of premature babies during painful interventions. DESIGN: Randomised
controlled trialParticipants/Subjects; A sample group of 66 premature
babies with a gestational age of 3237 weeks and a weight more than 1000 g
were included in this study conducted between May and August 2019 in the
NICU of a university hospital. <br/>METHOD(S): The babies were randomly
divided into three groups: lullaby, white noise, and control. The
behavioral responses of the babies were recorded with a camera during the
whole procedure. Before, during, and after the procedure, the heart rate,
respiratory rate, and oxygen saturation level were measured and recorded,
and the pain was evaluated using the premature infant pain profile (PIPP)
after the procedure. The mean PIPP score, heart rate during and after the
procedure, mean respiratory rate, and oxygen saturation were significantly
lower in the white noise and lullaby groups compared with the control
group (P < 0.001). <br/>RESULT(S): The premature babies in the white noise
group were found to have the lowest mean PIPP score, mean heart rate, and
respiratory rate, and the highest mean oxygen saturation rate (p < 0.001).
<br/>CONCLUSION(S): The white noise and lullabies played to premature
babies during the blood collection process were effective in pain
reduction, and the pain score was lower in the white noise group than in
the lullaby group.<br/>Copyright &#xa9; 2021 Elsevier Ltd. All rights
reserved.

<27>
Accession Number
610366333
Title
Pre-Cardiac Transplant Amiodarone Use Increases Postoperative Mortality: A
Meta-analysis.
Source
Annals of Pharmacotherapy. 50 (6) (pp 514-515), 2016. Date of Publication:
June 2016.
Author
Baker W.L.; Jennings D.L.
Institution
(Baker) University of Connecticut, Storrs, CT, United States
(Jennings) New York-Presbyterian Hospital Columbia University Medical
Center, New York, NY, United States
Publisher
SAGE Publications Inc.

<28>
Accession Number
361488831
Title
Pre-operative trans-thoracic doppler ultrasonography evaluation and intra-
operative manual evaluation of the left internal thoracic artery in
patients with type 2 diabetes with coronary artery disease.
Source
Journal of International Medical Research. 39 (1) (pp 277-283), 2011. Date
of Publication: February 2011.
Author
Cihan H.B.; Erbas F.; Erdil N.; Sigirci A.; Battaloglu B.; Yologlu S.
Institution
(Cihan, Erdil, Battaloglu) Department of Cardiovascular Surgery, Turgut
Ozal Medical Centre, 44310 Malatya, Turkey
(Sigirci) Department of Radiology, Malatya, Turkey
(Yologlu) Department of Biostatistics, Inonu University Faculty of
Medicine, Turgut Ozal Medical Centre, Malatya, Turkey
(Erbas) Department of Cardiovascular Surgery, Yuksek Ihtisas Hospital of
Van, Van, Turkey
Publisher
SAGE Publications Ltd
Abstract
Patients with coronary artery disease, with (n = 25) and without (n = 59)
type 2 diabetes, who were scheduled to undergo coronary artery bypass
grafting were enrolled in this prospective study. The left internal
thoracic artery (LITA) was assessed for graft suitability before surgery
by trans-thoracic Doppler ultra- sonography and during surgery by manual
measurement. Significant differences were seen between pre- operative and
intra-operative LITA blood flow rates and LITA diameters, and the values
of each at the two time points showed significant correlation, suggesting
that pre-operative measurements largely related to intra-operative
conditions. The pre-operative and intra-operative LITA blood flow rates
and LITA diameters were not significantly different between patients with
and without type 2 diabetes. Pre-operative LITA blood flow was monophasic
in three patients without diabetes and the LITA grafts of these patients
were deemed unsuitable for implantation during surgery. It is concluded
that type 2 diabetes does not seem to have a negative effect on the
suitability of LITA grafts. In addition, trans-thoracic Doppler
ultrasonography is an easy, cost-effective, reproducible and non-invasive
examination method, which may help in the evaluation of LIMA function and
contribute to graft selection. &#xa9; 2011 Field House Publishing LLP.

<29>
Accession Number
634492872
Title
Intermediate-Term Outcomes of Endoscopic or Open Vein Harvesting for
Coronary Artery Bypass Grafting: The REGROUP Randomized Clinical Trial.
Source
JAMA Network Open. 4 (3) (no pagination), 2021. Article Number: 1439. Date
of Publication: 15 Mar 2021.
Author
Zenati M.A.; Bhatt D.L.; Stock E.M.; Hattler B.; Wagner T.H.; Bakaeen
F.G.; Biswas K.
Institution
(Zenati) Division of Cardiac Surgery, Department of Surgery, Veterans
Affairs Boston Healthcare System, Brigham and Women's Hospital, Harvard
Medical School, 1400 VFW Pkwy, Boston, MA 02132, United States
(Bhatt) Brigham and Women's Hospital, Harvard Medical School, Boston, MA,
United States
(Stock) Cooperative Studies Program, Perry Point/Baltimore Coordinating
Center, Office of Research and Development, US Department of Veterans
Affairs, Perry Point, MD, United States
(Hattler) VA Eastern Colorado Healthcare System, Denver, United States
(Wagner) VA Health Economics Resource Center, Department of Surgery,
Stanford University, Palo Alto, CA, United States
(Bakaeen) Cleveland Clinic, Cleveland, OH, United States
(Biswas) Perry Point Cooperative Studies Program Coordinating Center,
Office of Research and Development, US Department of Veterans Affairs,
Perry Point, MD, United States
(Biswas) Department of Epidemiology and Public Health, University of
Maryland, School of Medicine, Baltimore, United States
Publisher
American Medical Association

<30>
Accession Number
2007712626
Title
Optimal strategy for side branch treatment in patients with left main
coronary bifurcation lesions.
Source
Revista Espanola de Cardiologia. 74 (8) (pp 691-699), 2021. Date of
Publication: August 2021.
Author
Kim J.; Lee J.M.; Park T.K.; Yang J.H.; Hahn J.-Y.; Choi J.-H.; Choi
S.-H.; Seung K.B.; Hur S.-H.; Rha S.-W.; Kim J.-H.; Choi R.K.; Oh J.H.;
Kim H.-S.; Lee S.-H.; Park J.-S.; Jeon D.W.; Jeong M.H.; Lee J.-H.; Lee
S.Y.; Park W.-J.; Song Y.B.; Gwon H.-C.
Institution
(Kim, Lee, Park, Yang, Hahn, Choi, Choi, Song, Gwon) Division of
Cardiology, Department of Internal Medicine, Heart Vascular Stroke
Institute, Samsung Medical Center, Sungkyunkwan University School of
Medicine, Seul, South Korea
(Seung) Division of Cardiology, Seoul St. Mary's Hospital, Catholic
University of Korea, Seul, South Korea
(Hur) Division of Cardiology, Keimyung University Dongsan Medical Center,
Daegu, South Korea
(Rha) Division of Cardiology, Korea University Guro Hospital, Seul, South
Korea
(Kim) Division of Cardiology, Pusan National University Yangsan Hospital,
Pusan, South Korea
(Choi) Division of Cardiology, Mediplex Sejong Hospital, Incheon, South
Korea
(Oh) Division of Cardiology, Samsung Changwon Hospital, Sungkyunkwan
University School of Medicine, Changwon, South Korea
(Kim) Division of Cardiology, Seoul National University Hospital, Seul,
South Korea
(Lee) Division of Cardiology, Yonsei University Wonju Christian Hospital,
Wonju, South Korea
(Park) Division of Cardiology, Yeungnam University Medical Center, Daegu,
South Korea
(Lee) Division of Cardiology, Inje University Ilsan Paik Hospital, Ilsan,
South Korea
(Jeon) Division of Cardiology, National Health Insurance Service Ilsan
Hospital, Ilsan, South Korea
(Jeong) Division of Cardiology, Chonnam National University Hospital,
Gwangju, South Korea
(Lee) Division of Cardiology, Chungnam National University Hospital,
Daejeon, South Korea
(Lee) Division of Cardiology, Chungbuk National University Hospital,
Cheongju, South Korea
(Park) Division of Cardiology, Hallym University Sacred Heart Hospital,
Anyang, South Korea
Publisher
Ediciones Doyma, S.L.
Abstract
Introduction and objectives: There are no guidelines regarding the most
appropriate approach for provisional side branch (SB) intervention in left
main (LM) bifurcation lesions. <br/>Method(s): The present prospective,
randomized, open-label, multicenter trial compared conservative vs
aggressive strategies for provisional SB intervention during LM
bifurcation treatment. Although the trial was designed to enroll 700
patients, it was prematurely terminated due to slow enrollment. For 160
non-true bifurcation lesions, a 1-stent technique without kissing balloon
inflation was applied in the conservative strategy, whereas a 1-stent
technique with mandatory kissing balloon inflation was applied in the
aggressive strategy. For 46 true bifurcation lesions, a stepwise approach
was applied in the conservative strategy (after main vessel stenting, SB
ballooning when residual stenosis > 75%; then, SB stenting if residual
stenosis > 50% or there was a dissection). An elective 2-stent technique
was applied in the aggressive strategy. The primary outcome was a 1-year
target lesion failure (TLF) composite of cardiac death, myocardial
infarction, or target lesion revascularization. <br/>Result(s): Among
non-true bifurcation lesions, the conservative strategy group used a
smaller amount of contrast dye than the aggressive strategy group. There
were no significant differences in 1-year TLF between the 2 strategies
among non-true bifurcation lesions (6.5% vs 4.9%; HR, 1.31; 95%CI,
0.35-4.88; P = .687) and true bifurcation lesions (17.6% vs 21.7%; HR,
0.76; 95%CI, 0.20-2.83; P = .683). <br/>Conclusion(s): In patients with a
LM bifurcation lesion, conservative and aggressive strategies for a
provisional SB approach have similar 1-year TLF rates.<br/>Copyright
&#xa9; 2020 Sociedad Espanola de Cardiologia

<31>
Accession Number
2011016078
Title
Outcomes after surgery for functional tricuspid regurgitation: A
systematic review and meta-analysis.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 6 (1) (pp
10-18), 2020. Date of Publication: 01 Jan 2020.
Author
Veen K.M.; Etnel J.R.G.; Quanjel T.J.M.; Mokhles M.M.; Huygens S.A.;
Rasheed M.; Oei F.B.S.; Ten Cate F.J.; Bogers A.J.J.C.; Takkenberg J.J.M.
Institution
(Veen, Etnel, Quanjel, Mokhles, Huygens, Rasheed, Oei, Bogers, Takkenberg)
Department of Cardiothoracic Surgery, Thoraxcenter, Rg-619, Erasmus Mc,
University Medical Center Rotterdam, Dr Molewaterplein 40, Rotterdam 3015
GD, Netherlands
(Ten Cate) Department of Cardiology, Thoraxcenter, Rg-619, Erasmus Mc,
University Medical Center Rotterdam, Dr Molewaterplein 40, Rotterdam 3015
GD, Netherlands
Publisher
Oxford University Press
Abstract
Aims: This study aims to provide a contemporary overview of outcomes after
tricuspid valve (TV) surgery for functional tricuspid regurgitation (TR).
<br/>Methods and Results: The literature was systematically searched for
papers published between January 2005 and December 2017 reporting on
clinical/echocardiographic outcomes after TV surgery for functional TR. A
random effects meta-analysis was conducted for outcome variables, and late
outcomes are visualized by pooled Kaplan-Meier curves. Subgroup analyses
were performed for studies with a within-study comparison of suture vs.
ring repair and flexible vs. rigid ring repair. Eighty-seven publications
were included, encompassing 13 184 patients (mean age: 62.1 +/- 11.8
years, 55% females). A mitral valve procedure was performed in 92% of
patients. Pooled mean follow-up was 4.0 +/- 2.8 years. Pooled early
mortality was 3.9% (95% CI: 3.2-4.6), and late mortality rate was
2.7%/year (95% CI: 2.0-3.5), of which approximately half was
cardiac-related 1.2%/year (95% CI: 0.8-1.9). Pooled risk of early
moderate-to-severe TR at discharge was 9.4% (95% CI: 7.0-12.1). Late
moderate-to-severe TR rate after discharge was 1.9%/year (95% CI:
1.0-3.5). Late reintervention rate was 0.3%/year (95% CI: 0.2-0.4).
Mortality and overall (early and late) TR rate were comparable between
suture vs. ring annuloplasty (14 studies), whereas overall TR rate was
higher after flexible ring vs. rigid ring annuloplasty (6 studies)
(7.5%/year vs. 3.9%/year, P = 0.002). <br/>Conclusion(s): This study shows
that patients undergoing surgery for functional tricuspid regurgitation
(FTR) have an acceptable early and late mortality. However, TR remains
prevalent after surgery. The results of this study can be used to inform
patients and clinicians about the expected outcome after surgery for FTR
and can results serve as a benchmark for the performance of emerging
transcatheter TV interventions.<br/>Copyright &#xa9; 2019 Published on
behalf of the European Society of Cardiology. All rights reserved.

<32>
Accession Number
2011933593
Title
Does bariatric surgery improve cardiac autonomic modulation assessed by
heart rate variability? A systematic review.
Source
Surgery for Obesity and Related Diseases. 17 (8) (pp 1497-1509), 2021.
Date of Publication: August 2021.
Author
Benjamim C.J.R.; Pontes Y.M.D.M.; de Sousa Junior F.W.; Porto A.A.; Bueno
Junior C.R.; Marcelino da Silva A.A.; Ferro Cavalcante T.C.; Garner D.M.;
Valenti V.E.
Institution
(Benjamim, Marcelino da Silva, Ferro Cavalcante) Development, Nutrition,
Phytotherapy and Hygiene Research Group, University of Pernambuco,
Petrolina, Brazil
(Benjamim, Porto, Valenti) Autonomic Nervous System Center, Sao Paulo
State University, Marilia, Brazil
(Pontes, de Sousa Junior) Physiological and Collective Sciences Nucleus,
School of Juazeiro do Norte, Juazeiro do Norte, Brazil
(Porto) Department of Physical Therapy, Faculty of Sciences and
Technologies, UNESP, Presidente Prudente, Brazil
(Bueno Junior) Ribeirao Preto Medical School, Department of Medical
Clinic, University of Sao Paulo, Ribeirao Preto, Brazil
(Garner) Cardiorespiratory Research Group, Department of Biological and
Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes
University, Headington Campus, Oxford, United Kingdom
Publisher
Elsevier Inc.
Abstract
Our study aimed to explore the influence of bariatric surgery (BS) on
heart rate (HR) variability (HRV) through a systematic review. Manuscripts
were selected based on electronic searches of the MEDLINE, EMBASE, and
CINAHL databases from the inception of each database up to year 2020, and
followed the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) protocol. Searching of these studies was
systematized using the Population Intervention Comparison Outcome Study
Design strategy. We selected randomized and nonrandomized controlled
trials and cohorts from prospective studies that reported the influence of
BS on HRV. We assessed the quality rating using the Black and Downs
questionnaire. Following the screening and eligibility stages, 14 studies
were included in the review. All studies agreed that BS promotes an
increase in parasympathetic HR control and HRV and a decrease in HR. Yet
the literature does not provide evidence that these outcomes are directly
caused by the surgical procedure. There is limited evidence to support
that patients with type 2 diabetes have greater improvement in HRV as an
interim measure, to individuals without. The decrease in insulin
resistance was correlated with the increase in HRV in some studies, but,
other studies are unsupportive of this outcome. Improvements in 2
metabolic parameters (e.g., leptin, N-terminal pro B-type natriuretic
peptide) were connected with superior increases in HRV. This review
demonstrated that BS promotes an increase in HRV, indicating improved
autonomic control of HR.<br/>Copyright &#xa9; 2021 American Society for
Bariatric Surgery

<33>
[Use Link to view the full text]
Accession Number
635417495
Title
Effects of patient characteristics on the efficacy of complete
revascularization for treatment of ST-segment elevation myocardial
infarction with multivessel disease: A meta-analysis.
Source
Medicine. 100 (25) (pp e26251), 2021. Date of Publication: 25 Jun 2021.
Author
Li L.-F.; Qiu M.; Liu S.-Y.; Zhou H.-R.
Institution
(Li, Qiu, Zhou) Department of General Medicine, Shenzhen Longhua District
Central Hospital, Shenzhen, China
(Liu) Department of Cardiology, Second Affiliated Hospital of Kunming
Medical University, Kunming, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Several randomized controlled trials (RCTs) have evaluated the
efficacy of complete vs culprit-only revascularization for treatment of
ST-segment elevation myocardial infarction (STEMI) with multivessel
disease. However, the efficacy of complete revascularization vs
culprit-only revascularization in some STEMI patient subgroups remains
unclear. <br/>METHOD(S): We searched PubMed and Embase for related RCTs
from the start date of databases to January 3, 2020. The endpoint assessed
in this meta-analysis was major adverse cardiac events (MACE).
Random-effects meta-analysis was conducted stratified by each of the 5
factors of interest (i.e., sex, age, history of diabetes, ECG infarct
location, and the number of arteries with stenosis) to estimate pooled
hazard ratio and 95% confidence interval. Random-effects meta-regression
was conducted to assess subgroup differences. We examined publication bias
by drawing funnel plots and performing Egger test. This meta-analysis is
reported according to the PRISMA statement. <br/>RESULT(S): Six RCTs were
included for pooled analysis. Compared with culprit-only
revascularization, complete revascularization significantly reduced the
risk of MACE (hazard ratio 0.48, 95% confidence interval 0.42-0.55; I2 =
0%; P for relative effect < .001). This significant reduction in the risk
of MACE exhibited by complete revascularization was observed in most of
the subgroups of interest. All of the subgroup effects based on the 5
factors of interest were not statistically significant (Psubgroup ranged
from 0.198 to 0.556). Publication bias was not suggested by funnel plots
and Egger test. <br/>CONCLUSION(S): Compared with culprit-only
revascularization, complete revascularization significantly reduces the
MACE risk in patients with STEMI and multivessel disease, which is
independent of sex, age, history of diabetes, ECG infarct location, and
the number of arteries with stenosis.<br/>Copyright &#xa9; 2021 the
Author(s). Published by Wolters Kluwer Health, Inc.

<34>
Accession Number
634950161
Title
Application and effects of an early childhood education machine on
analgesia and sedation in children after cardiothoracic surgery.
Source
Journal of cardiothoracic surgery. 16 (1) (pp 118), 2021. Date of
Publication: 01 May 2021.
Author
Chen L.-L.; Lei Y.-Q.; Liu J.-F.; Cao H.; Yu X.-R.; Chen Q.
Institution
(Chen, Lei, Liu, Cao, Yu, Chen) Department of Cardiac Surgery, Fujian
Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical
University, Fuzhou, China
(Chen, Lei, Liu, Cao, Yu, Chen) Fujian Key Laboratory of Women and
Children's Critical Diseases Research, Fujian Maternity and Child Health
Hospital, Fuzhou, China
(Chen, Lei, Liu, Cao, Yu, Chen) Fujian Branch of Shanghai Children's
Medical Center, Fuzhou, China
(Chen, Lei, Liu, Cao, Yu, Chen) Fujian Children's Hospital, Fuzhou, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To study the effect of an early childhood education machine on
sedation and analgesia in children after cardiothoracic surgery.
<br/>METHOD(S): A prospective randomized controlled study was conducted in
a provincial hospital in China. Fifty-two patients (aged from 1 to 5years)
underwent cardiothoracic surgery (including: ventricular septal defect,
patent ductus arteriosus, atrial septal defect, pulmonary stenosis,
pulmonary sequestration and congenital cystic adenomatoid lung
malformation) were divided into the study group (n=26) and the control
group (n=26). The patients in the study group underwent intervention with
an early childhood education machine (uniform type) in addition to routine
standard treatment and nursing, while the patients in the control group
only received routine standard treatment and nursing. Richmond agitation
sedation score (RASS) and face, legs, activity, cry, consolability (FLACC)
score of all of the patients were evaluated, and the negative emotions
(self-rating anxiety scale (SAS) score and self-rating depression scale
(SDS) score) of the parents of the two groups were compared.
<br/>RESULT(S): There was no significant difference in the general
clinical data between the two groups. The RASS and FLACC scores in the
study group were significantly lower than those in the control group, and
the SAS and SDS scores of the parents in the study group were
significantly lower than those in the control group. <br/>CONCLUSION(S):
The application of an early childhood education machine for children after
cardiothoracic surgery can effectively reduce postoperative agitation,
improve sedation and analgesia of the patients, and ease the pessimistic
mood of the patients' parents.

<35>
Accession Number
634864436
Title
Dexmedetomidine combined with sufentanil and dezocine-based
patient-controlled intravenous analgesia increases female patients' global
satisfaction degree after thoracoscopic surgery.
Source
Journal of cardiothoracic surgery. 16 (1) (pp 102), 2021. Date of
Publication: 21 Apr 2021.
Author
Li Q.; Yao H.; Xu M.; Wu J.
Institution
(Li, Yao, Xu, Wu) Department of Anesthesiology of Shanghai Chest Hospital,
Shanghai Jiaotong University, No. 241 Huaihai Rd. West, Shanghai 200025,
China
Publisher
NLM (Medline)
Abstract
BACKGROUND: There are no studies on the use of dexmedetomidine combined
with sufentanil and dezocine-based patient-controlled intravenous
analgesia (PCIA) in females undergoing thoracic surgery. We postulate that
introducing dexmedetomidine to a combination of dezocine-based PCA drugs
and sufentanil will increase female patients' global satisfaction degree.
<br/>METHOD(S): One hundred fifty-two female patients with physical
classification type I or II according to the American Society of
Anesthesiologists undergoing thoracoscopic surgery were arbitrarily
classified into two categories, either receiving sufentanil and
dezocine-based PCIA (group C) or incorporating dexmedetomidine with
sufentanil and dezocine-based PCIA (group D). The patients' global
satisfaction degree, postoperative nausea and vomiting (PONV), PCA bolus,
rescue analgesia requirements, drug-related adverse effects, rest and
coughing visual analogue scale (VAS) ratings, and Ramsay sedation scores
(RSS) were measured at 6, 12, 24, 36 and 48h after surgery.
<br/>RESULT(S): Compared with the C group, the patient satisfaction degree
was significantly higher; pain scores at rest and coughing were
significantly different at 6, 12, 24, 36 and 48h postoperatively; less
rescue analgesia and PCA bolus were required; and a lower incidence of
PONV was found in the D group. There were non-significant trends for the
sedation scores and drug-related adverse effects in both groups.
<br/>CONCLUSION(S): Dexmedetomidine combined with sufentanil and dezocine
increased female patients' global satisfaction degree after thoracoscopic
surgery. This effect could be linked to the improvement in postoperative
analgesia and reduction in postoperative nausea and vomiting; the combined
treatment did not increase drug-related adverse effects in female
patients. TRIAL REGISTRATION: Chinese Clinical Trial Registry number,
ChiCTR2000030429 . Registered on March 1, 2020.

<36>
Accession Number
635506049
Title
St-elevation myocardial infarction in Subsaharan Africa: The need for
better data.
Source
Heart. Conference: British Cardiovascular Society Annual Conference,
'Cardiology and the Environment'. Virtual. 107 (SUPPL 1) (pp A37-A39),
2021. Date of Publication: June 2021.
Author
Hudson J.
Institution
(Hudson) London School of Hygiene and Tropical Medicine, London, United
Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction There is growing evidence that cardiovascular disease (CVD)
prevalence is increasing in Sub-Saharan Africa (SSA) (1). Historically the
prevalence of MI in SSA has been thought to be low (2). However, this may
be changing as parts of SSA undergo urbanization, and the rates of CVD
increase(1), there is a growing awareness of the need to have health
systems in place that can manage a time-sensitive cardiovascular emergency
like STEMI. The acute management of STEMI presents significant challenges
to health systems in SSA. A systematic review was conducted to explore
theoutcomes and rates of emergency coronary reperfusion therapy in adult
patients with STEMI in SSA. Methods A literature search of two databases
(MEDLINE & EMBASE) was performed up to March 1st, 2021 around the keywords
'ST-segment elevation myocardial infarction' and 'Sub-saharan Africa'.
Studies were included if they were performed in SSA and reported the
in-hospital mortality and emergency management of patients with STEMI. The
quality of the studies was appraised using a structured checklist. All
analyses were performed using STATA. The Freeman-Turkey double arcsine
transformation was used to pool the data by random-effects meta-analysis.
This produced a pooled prevalence of in-hospital mortality in patients
with STEMI. Heterogeneity between the studies was assessed using the I2
measure. Results Study selection: A total of 12 studies from six different
countries were included in the final analysis. 1096 records were retrieved
from the database search and screened. 30 full texts were retrieved for
consideration. STEMI outcomes: A total of 2279 patients with STEMI were
included across 12 studies (table 1 & table 2). The pooled in-hospital
mortality was 12.8% (95% CI 8.41, 17.92) (figure 1). When stratified by
income level of the country (figure 2), STEMI in-hospital mortality
decreases as income level increases (Low-income countries (LIC) = 17.79%
[95% CI 9.16,28.39]), lower middle- income countries (LMIC)= 11.28% [95%
CI 6.91, 16.50], upper middle income (UMIC)= 5.4% [95% CI 3.62, 7.97]).
The pooled proportion of STEMI patients receiving emergency coronary
reperfusion was 29.54% (CI 11.65, 51.11) (Fig2). Thrombolysis was the most
common reperfusion therapy used. Primary PCI was rarely used as the method
of coronary reperfusion with only 87 patients receiving it across all
studies. Significant delays in presentation to hospital may be
contributing to poor outcomes (table 2). In Burkina Faso, the average time
from onset of symptoms to admission was 48hrs with 82% arriving >12hrs
after symptoms onset. Two studies from Ethiopia reported an average time
from onset of symptoms to admission of >90hrs. Conclusion This systematic
review demonstrates high variability in the management and outcomes of
patients with STEMI in SSA and has three key findings. First, the pooled
in-hospital mortality of patients with STEMI in SSA is high, at 12.8%.
Second, a low proportion of patients with STEMI receive emergency coronary
reperfusion. Thirdly, for patients with STEMI, there exist long delays
between symptom onset and presentation to hospital. This is the first
meta-analysis attempting to pool the in-hospital mortality and emergency
treatment of patients with STEMI in SSA. The studies included were of
moderate to poor quality and suffered from small sample sizes. As the
burden of IHD increases in SSA, health systems must adapt to be able to
produce better outcomes for patients presenting with STEMI.

<37>
Accession Number
635506004
Title
The impact of cardiovascular disease on sexspecific adverse outcomes
following intact abdominal aortic aneurysm repair: A systematic review,
meta-analysis & metaregression.
Source
Heart. Conference: British Cardiovascular Society Annual Conference,
'Cardiology and the Environment'. Virtual. 107 (SUPPL 1) (pp A30-A32),
2021. Date of Publication: June 2021.
Author
Pouncey A.L.; David M.; Morris R.; Ulug P.; Martin G.; Bicknell C.; Powell
J.
Institution
(Pouncey, David, Ulug, Martin, Bicknell, Powell) Imperial College London,
London, United Kingdom
(Morris) Kings College London
Publisher
BMJ Publishing Group
Abstract
Introduction Cardiovascular disease is a major cause of death in men with
an AAA. Women experience higher operative mortality than men for open
(OAR) and endovascular (EVAR) repair of intact abdominal aortic aneurysm
(AAA), but the reason for this is not yet established. This study aimed to
define differences in cardiovascular pre-operative co-morbidity and
peri/post-operative complications for men and women under-going OAR and
EVAR, to explore the impact of cardiovascular disease on adverse outcomes
following intact AAA repair. Methods A systematic review, meta-analysis
and meta-regression of sex-specific differences in mortality and
complications was conducted and reported according to PRISMA and Cochrane
guidance, and registered with Prospero (CRD42020176398). Papers reporting
outcomes for men and women, following intact primary AAA repair, from
2000-2020 world-wide were included. Separate analyses were conducted for
EVAR and OAR. Data sources included: Medline, Embase and CENTRAL databases
2005-2020 searched using ProQuest DialogTM.Results A total of 26 studies
(371,215 men, 65,465 women) were included. Risk of 30-day mortality was
higher in women for OAR and more so for EVAR (OR [95%CI] 1.49 [1.37,1.61]
and 1.86 [1.59,2.17] respectively), and remained following multivariate
risk factor adjustment. Although assessment of pre-operative
co-morbidities was limited by heterogeneity, cardiac disease was more
commonly diagnosed in men (OAR OR 0.72 [0.59,0.88]; EVAR OR 0.65
[0.48,0.87]) no differences in peripheral vascular disease or smoking
history were observed. However, following OAR, the likelihood of acute
coronary complications was similar for both sexes (OR 1.18 [0.98-1.42])
and following EVAR, for women, the likelihood of acute coronary
complication was significantly higher (OR 1.19 [1.03,1.37]). Renal injury,
arterial injury and limb ischemia were also more common in women
undergoing EVAR (ORs 1.46 [1.22-1.72], 3.02 [1.62-5.65], 2.13 [1.48- 3.06]
respectively) (figure 1). Meta-regression revealed cardiac complications
were significantly associated with greater mortality risk differential
between men and women (Figure 2); the association of renal complications
with death was of borderline significance. Conclusions The excess risk of
30-day mortality for women following AAA repair has not abated with time,
with an increased risk differential for EVAR over OAR. Although our
meta-analysis identified a lower prevalence in pre-operative diagnosis of
coronary artery disease amongst women, acute coronary complications were
significantly higher for women following EVAR, and similar to men
following OAR. An increase in acute coronary complications for women
compared to men was associated with a higher mortality risk differential.
Women were also at greater risk of additional arterial complications
leading to renal injury and limb ischaemia. These findings suggest that
cardiovascular disease has significant impact on adverse outcomes for
women after AAA repair. Further work to improve identification and
treatment of cardiovascular disease in women is needed and has the
potential to address disparity in outcomes for AAA repair. Figure 1.
Comparison of 30-day complications for men and women following (a) OAR and
(b) EVAR. Figure 2. (a) Meta-regression of log odds of (a) cardiac
complications and (b) renal complications against log odds of
30-day/in-hospital mortality for women (vs. men) following endovascular
repair of AAA (EVAR). (Cardiac: n= 8, bi =2.96 (se =1.27), p=0.02, tau2 =
0.00; renal: n=8, bi =2.50 (se =1.31), p=0.056, tau2 = 0.01).

<38>
Accession Number
635505847
Title
Amiodarone follow-up in 'tracker clinic'.
Source
Heart. Conference: British Cardiovascular Society Annual Conference,
'Cardiology and the Environment'. Virtual. 107 (SUPPL 1) (pp A85-A86),
2021. Date of Publication: June 2021.
Author
Tanzil-Al-Imran T.; Yung L.; Wilcox J.
Institution
(Tanzil-Al-Imran, Yung) Torbay and South Devon NHS Foundation Trust,
Torquay, United Kingdom
(Wilcox) Kingston Hospital NHS Foundation Trust
Publisher
BMJ Publishing Group
Abstract
Amiodarone, a class III antiarrhythmic, one of the most widely used drugs
for arrhythmia management. The common indications are rhythm control in
AF/flutter (including peri- DCCV) in those with structural heart disease
Post cardiac surgery, Ventricular arrhythmias, etc. However, it has a
number of serious adverse effects including corneal microdeposits, optic
neuropathy/neuritis, blue-gray skin discoloration, photosensitivity,
hypothyroidism, hyperthyroidism, pulmonary toxicity, peripheral
neuropathy, and hepatotoxicity. Therefore, amiodarone should be used with
close follow-up. Some evidence suggests amiodarone is not monitored
appropriately, less than one-third of Welsh study's patients monitored for
side effects, 13% and 17% of Scottish patients had no ALT or TSH testing
in a retrospective analysis, 1413 patients, over 22 years, 27.3% of South
Worcestershire patients had no thyroid function tests recorded over 5
years. The study also suggested that when randomized to a computerized
system vs usual care, amiodarone baseline monitoring increased from 51 to
79%7. In Torbay and South Devon NHS Foundation Trust, the arrhythmia
nurses follow up the patients for potential side effects who are on
Amiodarone. We investigated the clinic follow- up process required for the
patients who are on Amiodarone, the proportion of total arrhythmia
nurse-led clinics were related to Amiodarone, the tests are done in the
follow-up clinics, adverse effect identified, the outcome of the
appointments. Between 2nd October 2019 to 27th December 2020, there were
total of 562 appointments in arrhythmia nurse-led clinics.
Amiodarone-related appointments were 17% (95 of 562). The mean age of the
patient was 75 with a range of 40-93 and an SD of 9.9. The most common
indication was AF 74.7%, Atrial Flutter 14.9%, and VT 10.3% (table 1). The
mean duration of prescription was 272 days. Complications were noted in
14.7% of cases (14 of 95). Complications were related to the duration of
treatment (no complication vs complications- 8.23 vs 11.33 months) (figure
2). 60% (57 of 95) outcomes were to continue ongoing monitoring of
amiodarone (table 3). We have noticed 10%(57 of 562) of arrhythmia
nurse-led clinics are related to Amiodarone monitoring only. A new setup
for Amiodarone clinic titled 'Amiodarone Tracker clinic' is developed. An
automated clinic letter will be generated 4 monthly requesting patients to
provide a blood sample for renal function and liver function tests. One of
the team members from Arrhythmia nurses will review the blood test results
and will send a letter to the patient and his/her GP with the outcome.
This 'Tracker clinic will open up 10% of the face-to-face clinic
appointments, reduce patient's inconvenience for frequent visits to the
hospital. There remains a question of clinical identification of adverse
effects but effective patient education will subside the risk.

<39>
Accession Number
2013627977
Title
Efficacy and safety of dexmedetomidine in maintaining hemodynamic
stability in pediatric cardiac surgery: a systematic review and
meta-analysis.
Source
Jornal de Pediatria. (no pagination), 2021. Date of Publication: 2021.
Author
Wang Q.; Chen C.; Wang L.
Institution
(Wang, Chen) Hainan Women and Children's Medical Center, Department of
Anesthesiology, Haikou, China
(Wang) The First Hospital of Hebei Medical University, Department of
Anesthesiology, Shijiazhuang, China
Publisher
Elsevier Editora Ltda
Abstract
Objectives: Dexmedetomidine (DEX) is a highly selective alpha-2 adrenergic
receptor agonist, which is the main sedative in the intensive care unit.
This study aims to investigate the effectiveness and adverse events of DEX
in maintaining hemodynamic stability in pediatric cardiac surgery.
Sources: Databases such as PubMed, Cochrane, Web of Science, WANFANG STATA
and China National Knowledge Infrastructure were searched for articles
about the application of DEX in maintaining hemodynamic stability during
and after pediatric cardiac surgery up to 18th Feb. 2021. Only randomized
controlled trials were included and random-effects model meta-analysis was
applied to calculate the standardized mean deviation (SMD), odds ratio
(OR) and 95% confidence interval (CI). Summary of the findings: Fifteen
articles were included for this meta-analysis, and 9 articles for
qualitative analysis. The results showed that preoperative prophylaxis and
postoperative recovery of DEX in pediatric patients undergoing cardiac
surgery were effective in maintaining systolic blood pressure (SBP), mean
arterial pressure (MAP), diastolic blood pressure (DBP) and reducing heart
rate (HR) (SBP: SMD = -0.35,95% CI: -0.72, 0.01; MAP: SMD = -0.83, 95% CI:
-1.87,0.21; DBP: SMD = -0.79,95% CI: -1.66,0.08; HR: SMD = -1.71,95% CI:
-2.29, -1.13). In addition, the frequency of Junctional Ectopic
Tachycardia in the DEX treatment group was lower than that in the placebo
group. <br/>Conclusion(s): The application of DEX for preoperative
prophylaxis and postoperative recovery in pediatric cardiac surgery
patients are effective in maintaining hemodynamic stability, and the
clinical dose of DEX is not significantly related to the occurrence of
pediatric adverse events which may be related to individual
differences.<br/>Copyright &#xa9; 2021 Sociedade Brasileira de Pediatria

<40>
Accession Number
2013593990
Title
Transcatheter aortic valve replacement in low-risk bicuspid and tricuspid
patients: Meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2021. Date of
Publication: 2021.
Author
Medranda G.A.; Rogers T.; Doros G.; Zhang C.; Case B.C.; Yerasi C.; Shults
C.C.; Waksman R.
Institution
(Medranda, Rogers, Doros, Zhang, Case, Yerasi, Waksman) Section of
Interventional Cardiology, MedStar Washington Hospital Center, Washington,
DC, United States
(Rogers) Cardiovascular Branch, Division of Intramural Research, National
Heart, Lung and Blood Institute, National Institutes of Health, Bethesda,
MD, United States
(Shults) Department of Cardiac Surgery, MedStar Washington Hospital
Center, Washington, DC, United States
Publisher
Elsevier Inc.
Abstract
Background: Most pivotal transcatheter aortic valve replacement (TAVR)
trials have excluded patients with bicuspid aortic stenosis (AS). This
study compared TAVR in low-risk patients with bicuspid AS to those with
tricuspid AS, incorporating data from prospective trials. <br/>Method(s):
We selected prospective US low-risk TAVR trials containing a bicuspid arm
for this meta-analysis, examining outcomes at 30 days. Study results were
pooled using a hierarchical Bayesian random-effects model. <br/>Result(s):
Included were 3 Food and Drug Administration (FDA)-approved
investigational device exemption (IDE) trials that enrolled a total of
1810 low-risk patients with symptomatic severe AS for TAVR. We compared
380 bicuspid patients with 1430 tricuspid patients. Event rates at 30 days
overall were low, with similar mortality (odds ratio [OR], 0.38; 95%
credible interval [CrI]: 0.08, 1.78; I², 0%), non-disabling
stroke (OR, 0.45; 95% CrI: 0.15, 1.07; I², 9%), and permanent
pacemaker implantation (OR, 0.86; 95% CrI: 0.41, 1.47; I²,
59%). There were statistically significant differences in disabling stroke
(OR, 0.16; 95% CrI: 0.01, 0.90; I², NA) and coronary
obstruction (OR, 0.21; 95% CrI: 0.05, 0.91) that disappeared after
sensitivity analysis by adding a single event to the tricuspid arm.
Hemodynamics were similar at 30 days. <br/>Conclusion(s): Preliminary data
from the FDA-approved IDE trials of low-risk patients with bicuspid AS
undergoing TAVR demonstrated 30-day outcomes comparable to low-risk
tricuspid patients, except for a trend toward higher stroke in bicuspid
patients. Randomized trials are warranted to reassure the safety and
long-term outcome of TAVR in patients with severe bicuspid
AS.<br/>Copyright &#xa9; 2021

<41>
Accession Number
2013589163
Title
Endovascular treatment of the tricuspid valve: current status.
Source
Cirugia Cardiovascular. (no pagination), 2021. Date of Publication: 2021.
Author
Parody-Cuerda G.; Rodriguez-Caulo E.; Barquero-Aroca J.M.
Institution
(Parody-Cuerda, Rodriguez-Caulo, Barquero-Aroca) Departamento de Cirugia
Cardiovascular, Area del Corazon, Hospital Universitario Virgen Macarena,
Sevilla, Spain
Publisher
Elsevier Doyma
Abstract
According to the latest studies, the surgical intervention rate of the
tricuspid valve is very low, despite the large number of patients with
severe tricuspid regurgitation withindication for surgery according to
clinical practice guidelines. Likewise, recent data demonstrate that
isolated tricuspid valve surgery is significantly and independently
associated withhigh mortality. New transcatheter therapies are emerging to
solve these issues. In the present work, a non-systematic review of the
state of the art of the different percutaneous devices currently on the
market was carried out, organized into three groups: valve with implant in
orthotopic or heterotopic position, annuloplasty systems and coaptation
systems. Thus, this document aims to offer a global vision of the current
landscape and future perspectives of endovascular treatments of tricuspid
valve disease, a field of great interest in full expansion.<br/>Copyright
&#xa9; 2021 Sociedad Espanola de Cirugia Cardiovascular y Endovascular

<42>
Accession Number
2013158667
Title
The use of diflunisal for transthyretin cardiac amyloidosis: a review.
Source
Heart Failure Reviews. (no pagination), 2021. Date of Publication: 2021.
Author
Ibrahim M.; Saint Croix G.R.; Lacy S.; Fattouh M.; Barillas-Lara M.I.;
Behrooz L.; Mechanic O.
Institution
(Ibrahim, Behrooz) Department Medicine, Division of Cardiovascular
Medicine, Boston University Hospital, 801 Massachusetts Avenue Suite 400,
Boston, MA 02118, United States
(Saint Croix, Mechanic) Division of Cardiology At Mount Sinai Medical
Center, Columbia University, 4300 Alton Rd, Miami Beach, FL 33140, United
States
(Lacy) Department of Medicine, University of Miami Miller School of
Medicine, 1120 NW 14th Street, Clinical Research Building, Miami, FL
33136, United States
(Fattouh, Barillas-Lara) Department of Internal Medicine Boston Medical
Center, Boston University School of Medicine, 72 East Concord St, Boston,
MA 02118, United States
Publisher
Springer
Abstract
Transthyretin cardiac amyloidosis (ATTR-CM) is caused by the accumulation
of misfolded transthyretin (TTR) protein in the myocardium. Diflunisal, an
agent that stabilizes TTR, has been used as an off-label therapeutic for
ATTR-CM. Given limited data surrounding the use of diflunisal, a
systematic review of the literature is warranted. We searched the PubMed,
MEDLINE, and Embase databases for studies that reported on the use of
diflunisal therapy for patients with ATTR-CM. We included English language
studies which assessed the effect of diflunisal in adult patients with
ATTR-CM who received diflunisal as primary treatment and reported clinical
outcomes with emphasis on studies that noted the safety and efficacy of
diflunisal in cardiac manifestations of ATTR amyloidosis. We excluded
studies which did not use diflunisal therapy or used diflunisal therapy
for non-cardiac manifestations of TTR amyloidosis. We also excluded case
reports, abstracts, oral presentations, and studies with fewer than 10
subjects. Our search yielded 316 records, and we included 6 studies
reporting on 400 patients. Non-comparative single-arm small non-randomized
trials for diflunisal comprised 4 of the included studies. The 2 studies
that compared diflunisal versus no treatment found improvements in TTR
concentration, left atrial volume index, cardiac troponin I, and global
longitudinal strain. Overall, diflunisal use was associated with decreased
mortality and number of orthotopic heart transplant in ATTR-CM patients.
Although a smaller number of patients had to stop treatment due to
gastrointestinal side effects and transient renal dysfunction, there were
no severe reactions reported in the studies included in our review. This
systematic review supports the use of diflunisal for ATTR-CM. Additional
long-term analyses and randomized clinical trials are needed to confirm
these results.<br/>Copyright &#xa9; 2021, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<43>
Accession Number
2005711035
Title
Effect of Low-dose ColchiciNe on the InciDence of Atrial Fibrillation in
Open Heart Surgery Patients: END-AF Low Dose Trial.
Source
Journal of International Medical Research. 48 (7) (no pagination), 2020.
Date of Publication: July 2020.
Author
Tabbalat R.A.; Alhaddad I.; Hammoudeh A.; Khader Y.S.; Khalaf H.A.;
Obaidat M.; Barakat J.
Institution
(Tabbalat, Khalaf, Obaidat) Abdali Clemenceau Hospital, Amman, Jordan
(Alhaddad) Jordan Hospital, Amman, Jordan
(Hammoudeh) Istishari Hospital, Amman, Jordan
(Khader) Jordan University of Science and Technology, Irbid, Jordan
(Barakat) Al Khalidi Hospital and Medical Center, Amman, Jordan
Publisher
SAGE Publications Ltd
Abstract
Background: Studies using 1 mg of colchicine to prevent postoperative
atrial fibrillation (POAF) reported conflicting results. Moreover,
colchicine was associated with significant gastrointestinal (GI) side
effects. This study examined whether low-dose colchicine effectively
prevents POAF and whether low-dose therapy is associated with lower rates
of colchicine-induced GI side effects. <br/>Method(s): In this
prospective, randomized, double-blind, placebo-controlled study,
consecutive adult patients admitted for elective cardiac surgeries
randomly received a 1-mg dose of colchicine (n = 81) or placebo (n = 71)
orally 12 to 24 hours before surgery followed by a daily dose of 0.5 mg
until hospital discharge. The primary efficacy endpoint was the
development of at least one episode of POAF of >=5 minutes. The primary
safety endpoint was the development of adverse events, especially
diarrhea. <br/>Result(s): The in-hospital mortality rate was 3.9%. POAF
occurred in 13 patients (16.1%) in the colchicine group and 13 patients
(18.3%) in the placebo group (odds ratio 0.85 [95% Confidence Interval =
0.37-1.99]). Diarrhea occurred in two patients in each group and
necessitated treatment discontinuation in one patient in each group.
<br/>Conclusion(s): Low-dose colchicine did not prevent POAF in patients
undergoing cardiac surgery. These results should be interpreted cautiously
because of the small sample size and early study termination.
ClinicalTrials.gov Unique Identifier number: NCT03015831<br/>Copyright
&#xa9; The Author(s) 2020.

<44>
Accession Number
2004744322
Title
Complete 2-Year Results Confirm Bayesian Analysis of the SURTAVI Trial.
Source
JACC: Cardiovascular Interventions. 13 (3) (pp 323-331), 2020. Date of
Publication: 10 February 2020.
Author
Van Mieghem N.M.; Popma J.J.; Deeb G.M.; Yakubov S.J.; Serruys P.W.;
Windecker S.; Sondergaard L.; Gada H.; Chetcuti S.; Kleiman N.S.; Kodali
S.; George I.; Teefy P.; Kiaii B.; Oh J.K.; Kappetein A.P.; Chang Y.;
Mugglin A.S.; Reardon M.J.; Sorajja P.; Sun B.; Agarwal H.; Langdon T.;
den Heijer P.; Bentala M.; O'Hair D.; Bajwa T.; Byrne T.; Caskey M.;
Paulus B.; Garrett E.; Stoler R.; Hebeler R.; Khabbaz K.; Lim D.S.;
Bladergroen M.; Fail P.; Feinberg E.; Rinaldi M.; Skipper E.; Chawla A.;
Hockmuth D.; Makkar R.; Cheng W.; Aji J.; Bowen F.; Schreiber T.; Henry
S.; Hengstenberg C.; Bleiziffer S.; Harrison J.K.; Hughes C.; Joye J.;
Gaudiani V.; Babaliaros V.; Thourani V.; van Mieghem N.; Dauerman H.;
Schmoker J.; Skelding K.; Casale A.; Kovac J.; Spyt T.; Seshiah P.; Smith
J.M.; McKay R.; Hagberg R.; Matthews R.; Starnes V.; O'Neill W.; Paone G.;
Hernandez Garcia J.M.; Such M.; Moris de la Tassa C.; Llosa Cortina J.C.;
Carrel T.; Whisenant B.; Doty J.; Resar J.; Conte J.; Aharonian V.;
Pfeffer T.; Ruck A.; Corbascio M.; Blackman D.; Kaul P.; Kliger C.;
Brinster D.; Leya F.; Bakhos M.; Sandhu G.; Pochettino A.; Piazza N.; de
Varennes B.; van Boven A.; Boonstra P.; Waksman R.; Bafi A.; Asgar A.;
Cartier R.; Kipperman R.; Brown J.; Lin L.; Rovin J.; Sharma S.; Adams D.;
Katz S.; Hartman A.; Al-Jilaihawi H.; Williams M.; Crestanello J.; Lilly
S.; Ghani M.; Bodenhamer R.M.; Rajagopal V.; Kauten J.; Mumtaz M.;
Bachinsky W.; Nickenig G.; Welz A.; Olsen P.S.; Yakubov S.; Watson D.;
Chhatriwalla A.; Allen K.; Teirstein P.; Tyner J.; Mahoney P.; Newton J.;
Merhi W.; Keiser J.; Yeung A.; Miller C.; ten Berg J.; Heijmen R.;
Petrossian G.; Robinson N.; Brecker S.; Jahangiri M.; Davis T.; Batra S.;
Hermiller J.; Heimansohn D.; Radhakrishnan S.; Fremes S.; Maini B.; Bethea
B.; Brown D.; Ryan W.; Reardon M.; Kleiman N.; Spies C.; Lau J.; Herrmann
H.; Bavaria J.; Horlick E.; Feindel C.; Neumann F.-J.; Beyersdorf F.;
Binder R.; Maisano F.; Costa M.; Markowitz A.; Tadros P.; Zorn G.; de
Marchena E.; Salerno T.; Labinz M.; Ruel M.; Sup Lee J.; Gleason T.; Ling
F.; Knight P.; Robbins M.; Ball S.; Giacomini J.; Burdon T.; Applegate R.;
Kon N.; Schwartz R.; Schubach S.; Forrest J.; Mangi A.
Institution
(Van Mieghem) Department of Interventional Cardiology, Erasmus University
Medical Centre, Rotterdam, Netherlands
(Popma) Department of Interventional Cardiology, Beth Israel Deaconess
Medical Center, Boston, MA, United States
(Deeb) Cardiac Surgery, University of Michigan, Ann Arbor, MI, United
States
(Yakubov) Interventional Cardiology, OhioHealth Riverside Methodist
Hospital, Columbus, OH, United States
(Serruys) Cardiovascular Science Division of the National Heart and Lung
Institute, Imperial College London, London, United Kingdom
(Windecker) Department of Interventional Cardiology, University Hospital
Bern, Bern, Switzerland
(Sondergaard) The Heart Center, Rigshospitalet, University of Copenhagen,
Copenhagen, Denmark
(Mumtaz) Cardiac Surgery, University of Pittsburgh Medical Center Pinnacle
Health, Harrisburg, PA, United States
(Gada) Interventional Cardiology, University of Pittsburgh Medical Center
Pinnacle Health, Harrisburg, PA, United States
(Chetcuti) Interventional Cardiology, University of Michigan, Ann Arbor,
MI, United States
(Kleiman) Cardiology, Methodist DeBakey Heart and Vascular Center,
Houston, TX, United States
(Kodali, George) Structural Heart and Valve Center, Columbia University
Medical Center, New York, NY, United States
(Teefy) Department of Medicine, Cardiology Division, London Health
Sciences Centre, University Hospital, London, Ontario, Canada
(Kiaii) Department of Cardiovascular and Thoracic Surgery, London Health
Sciences Centre, University Hospital, London, Ontario, Canada
(Oh) Echocardiography Core Laboratory, Mayo Clinic, Rochester, MN, United
States
(Kappetein) Baaken Research Center, Medical Affairs, Medtronic,
Maastricht, Netherlands
(Chang) Clinical, Medtronic, Mounds View, MN, United States
(Mugglin) Paradigm Biostatistics, Anoka, MN, United States
(Reardon) Department of Cardiothoracic Surgery, Methodist DeBakey Heart
and Vascular Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to report the 2-year results of the
SURTAVI (Surgical Replacement and Transcatheter Aortic Valve Implantation)
trial and confirm the interim Bayesian analysis. <br/>Background(s):
Transcatheter aortic valve replacement (TAVR) with a self-expanding valve
was noninferior to surgery in patients with severe aortic stenosis and
intermediate operative risk using Bayesian statistical methods. Novel
Bayesian designs have been used to shorten the time to primary endpoint
analysis in randomized clinical trials, although the predictive value of
Bayesian analysis compared with frequentist approaches remains debated.
<br/>Method(s): The SURTAVI trial randomized 1,660 patients. An interim
analysis was performed 1 year after the 1,400th patient was treated to
estimate the primary 2-year endpoint of all-cause mortality or disabling
strokes for all patients. <br/>Result(s): The Kaplan-Meier rate for the
complete 2-year primary endpoint was 12.7% in the TAVR group and 12.6% in
the surgery group (0.0% difference; 95% confidence interval: -3.4% to
3.5%), compared with 12.6% with TAVR and 14.0% with surgery (-1.4%
difference; Bayesian credible interval: -5.2% to 2.3%) in the interim
Bayesian analysis. A comparison of individual clinical, hemodynamic, and
quality-of-life endpoints using Bayesian and frequentist methods found no
significant differences. <br/>Conclusion(s): The complete analysis of all
patients with aortic stenosis at intermediate risk for surgery in the
SURTAVI trial confirmed the noninferiority, with respect to the frequency
of all-cause mortality or disabling stroke, of TAVR to surgery, as
determined in the interim Bayesian analysis. Follow-up will extend out to
10 years.<br/>Copyright &#xa9; 2020 American College of Cardiology
Foundation

<45>
Accession Number
616226313
Title
Psychological mediators related to clinical outcome in cognitive
behavioural therapy for coronary heart disease: A sub-analysis from the
SUPRIM trial.
Source
European Journal of Preventive Cardiology. 24 (9) (pp 917-925), 2017. Date
of Publication: June 2017.
Author
Norlund F.; Olsson E.M.G.; Pingel R.; Held C.; Svardsudd K.; Gulliksson
M.; Burell G.
Institution
(Norlund, Olsson) Department of Women's and Children's Health, Uppsala
University, Box 564, Uppsala SE-751 22, Sweden
(Pingel, Svardsudd, Gulliksson, Burell) Department of Public Health and
Caring Sciences, Uppsala University, Sweden
(Held) Department of Medical Sciences, Cardiology, Uppsala Clinical
Research Centre, Uppsala University, Sweden
Publisher
SAGE Publications Inc.
Abstract
Background The Secondary Prevention in Uppsala Primary Healthcare Project
(SUPRIM) was a randomized controlled trial of a group-based cognitive
behavioural therapy stress management programme for patients with coronary
heart disease. The project was successful in reducing the risk of fatal or
non-fatal first recurrent cardiovascular events. The aim of this study was
to analyse the effect of cognitive behavioural therapy on self-rated
stress, somatic anxiety, vital exhaustion and depression and to study the
associations of these factors with the reduction in cardiovascular events.
Methods A total of 362 patients were randomly assigned to intervention or
usual care groups. The psychological outcomes were assessed five times
during 24 months and analysed using linear mixed models. The mediating
roles of the outcomes were analysed using joint modelling of the
longitudinal and time to event data. Results The intervention had a
positive effect on somatic anxiety (p < 0.05), reflecting a beneficial
development over time compared with the controls. Stress, vital exhaustion
and depression did not differ between the groups over time. Mediator
analysis suggested that somatic anxiety may have mediated the effect of
treatment on cardiovascular events. Conclusions The intervention had a
small positive effect on somatic anxiety, but did not affect stress, vital
exhaustion or depression in patients with coronary heart disease. Somatic
anxiety was associated with an increased risk of cardiovascular events and
might act as a partial mediator in the treatment effect on cardiovascular
events. However, the mechanisms between the intervention and the
protective cardiovascular outcome remain to be identified.<br/>Copyright
&#xa9; European Society of Cardiology 2017.

<46>
Accession Number
621766577
Title
Continuous paravertebral block for post-cardiothoracic surgery analgesia:
A systematic review and meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 50 (6) (pp 1010-1018), 2016.
Date of Publication: December 2016.
Author
Scarfe A.J.; Schuhmann-Hingel S.; Duncan J.K.; Ma N.; Atukorale Y.N.;
Cameron A.L.
Institution
(Scarfe, Duncan, Ma, Atukorale, Cameron) Australian Safety and Efficacy
Register of New Interventional Procedures - Surgical (ASERNIP-S), Royal
Australasian College of Surgeons, Adelaide, SA, Australia
(Schuhmann-Hingel) KAGes - Styrian Hospitals Holding, Graz, Australia
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
A continuous paravertebral block is used when pain relief is required
beyond the duration of a single-injection paravertebral block. Surgical
procedures requiring an incision into the pleural cavity are some of the
most painful procedures postoperatively and, if not managed appropriately,
can lead to chronic pain. The current gold standard for
post-cardiothoracic surgery pain management is epidural analgesia, which
has contraindications, a failure rate of up to 12% and risk of
complications such as epidural abscess and spinal haematoma. This
systematic review and meta-analysis aimed to investigate the use of a
continuous paravertebral block for post-cardiothoracic surgery analgesia.
Randomized controlled trials evaluating the continuous paravertebral block
against epidural analgesia, wound infiltration, placebo or standard care
(intravenous opioids) for post-cardiothoracic surgery analgesia were
considered for inclusion in the systematic review. PubMed, EMBASE, The
Cochrane Library and the University of York Centre for Reviews and
Dissemination databases were searched from inception to 15 September 2014.
Risk of bias and generalizability were assessed using a modified Downs and
Black checklist. A meta-analysis was conducted on suitable studies
comparing the continuous paravertebral nerve block with epidural
anaesthesia, with fixed-effects models being used to pool the effects.
Twenty-three randomized controlled trials with 1120 participants were
included. The continuous paravertebral block was associated with a
significant improvement in incidence of nausea and vomiting (odds ratio =
0.29, 95% confidence interval = [0.16, 0.56]), hypotension (odds ratio =
0.16, 95% confidence interval = [0.06, 0.41]) and urinary retention (odds
ratio = 0.22, 95% confidence interval = [0.09, 0.52]) compared with the
epidural block. No statistically significant difference in pain relief was
reported. The continuous paravertebral block has equivalent analgesic
effects to epidural analgesia, wound infiltration and standard care, but
is associated with a lower incidence of nausea and vomiting, hypotension
and urinary retention than epidural analgesia.<br/>Copyright &#xa9; The
Author 2016. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<47>
Accession Number
609705156
Title
Procalcitonin level for prediction of postoperative infection in cardiac
surgery.
Source
Asian Cardiovascular and Thoracic Annals. 24 (4) (pp 344-349), 2016. Date
of Publication: May 2016.
Author
Sharma P.; Patel K.; Baria K.; Lakhia K.; Malhotra A.; Shah K.; Patel S.
Institution
(Sharma, Patel, Baria, Lakhia, Malhotra) Department of Cardiovascular and
Thoracic Surgery, U N Mehta Institute of Cardiology and Research Center,
Asarwa, Ahmedabad, Gujarat, India
(Shah, Patel) Department of Research, U N Mehta Institute of Cardiology
and Research Center, Asarwa, Ahmedabad, Gujarat, India
Publisher
SAGE Publications Inc.
Abstract
Background Diagnosing infection after cardiac surgery remains difficult
due to the systemic inflammatory response induced by cardiopulmonary
bypass. We compared procalcitonin levels with white blood cell counts as
predictors of infection after cardiac surgery. Methods We prospectively
enrolled 100 consecutive adult cardiac patients. Postoperative white blood
cell counts, serum procalcitonin levels, and blood cultures were examined.
Result The sensitivity and specificity of white blood cell count and
procalcitonin > 2 ng mL^-1 were 60% and 100%, 58.8% and 42.5%,
respectively. Procalcitonin > 7 ng mL^-1 had 95% sensitivity and
80% specificity. Receiver-operating characteristic analysis showed a
greater area under the curve for procalcitonin level (p < 0.0001) compared
to white blood cell count (p = 0.31). Patients with positive blood
cultures had significantly higher procalcitonin levels (51.97 +/- 39.62
vs. 6.67 +/- 10.73 ng mL^-1), Acute Physiology and Chronic
Health Evaluation-II scores (16.95 +/- 3.24 vs. 13.60 +/- 2.98), and
intensive care unit stay (6.35 +/- 3.42 vs. 4.6 +/- 2.2 days).
Non-survivors had significantly higher Acute Physiology and Chronic Health
Evaluation-II scores (19.09 +/- 1.30 vs. 13.67 +/- 2.97) and procalcitonin
levels (43.83 +/- 52.15 vs. 12.26 +/- 19.89 ng mL^-1) but on
logistic regression analysis, only Acute Physiology and Chronic Health
Evaluation-II score was an independent risk factor for mortality.
Conclusion The diagnostic accuracy of procalcitonin for bacterial
infection is fairly high. Acute Physiology and Chronic Health
Evaluation-II score is a better predictor of mortality and morbidity than
absolute procalcitonin level. Procalcitonin > 7 ng mL^-1 can
prognosticate and identify the high-risk group.<br/>Copyright &#xa9; SAGE
Publications.

<48>
Accession Number
608459506
Title
The changing management of chylothorax in the modern era.
Source
European Journal of Cardio-thoracic Surgery. 49 (1) (pp 18-24), 2016. Date
of Publication: January 2016.
Author
Bender B.; Murthy V.; Chamberlain R.S.
Institution
(Bender, Chamberlain) Saint George's University School of Medicine,
Grenada
(Bender) Department of Internal Medicine, Hahnemann University Hospital,
Philadelphia, PA, United States
(Murthy, Chamberlain) Department of Surgery, Saint Barnabas Medical
Center, Livingston, NJ, United States
(Chamberlain) Department of Surgery, Rutgers University, New Jersey
Medical School, Newark, NJ, United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Initial conservative therapy is applied to all cases of chylothorax (CTx)
with expected excellent outcomes. The indication for aggressive surgical
treatment of early CTx remains uncertain and requires rigorous scientific
scrutiny. Lymphangiography and lymphoscintigraphy are useful to localize
the leak and assess thoracic duct patency as well as to differentiate
partial from complete thoracic duct transection. The aetiology of the CTx,
flow rate and patient condition dictate the preferred management.
Octreotide/somatostatin and etilefrine therapy is highly efficacious in
the conservative management of CTx. For patients in whom conservative
management fails, those who are good surgical candidates, and those in
whom the site of the leak is well identified, surgical repair and/or
ligation using minimally invasive techniques is highly successful with
limited adverse outcomes. Similarly, if the site of the chylous effusion
cannot be well visualized, a thoracic duct ligation via video-assisted
thoracic surgery is the gold standard approach. A pleuroperitoneal or less
often a pleurovenous shunt is a final option and may be curative in some
patients.<br/>Copyright &#xa9; The Author 2015.

<49>
Accession Number
611311228
Title
A meta-analysis of randomized trials for repeat revascularization
following off-pump versus on-pump coronary artery bypass grafting.
Source
Interactive Cardiovascular and Thoracic Surgery. 17 (5) (pp 878-880),
2013. Date of Publication: November 2013.
Author
Takagi H.; Mizuno Y.; Niwa M.; Goto S.-N.; Umemoto T.
Institution
(Takagi, Mizuno, Niwa, Goto, Umemoto) Department of Cardiovascular
Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shizuoka, Shimizu-cho,
Sunto-gun 411-8611, Japan
Publisher
Oxford University Press
Abstract
To determine whether repeat revascularization rates are increased
following off-pump coronary artery bypass grafting (CABG), we performed a
meta-analysis of randomized controlled trials of off-pump vs on-pump CABG.
Databases including MEDLINE, EMBASE and the Cochrane Central Register of
Controlled Trials were searched through March 2013 using web-based search
engines (PubMed, OVID). Studies considered for inclusion met the following
criteria: The design was a prospective randomized controlled clinical
trial; the study population was patients undergoing CABG; patients were
randomly assigned to off-pump vs on-pump CABG and outcomes included repeat
revascularization rates at >=1 year. Our exhaustive search identified 12
prospective randomized controlled trials of off-pump vs onpump CABG.
Pooled analysis demonstrated a statistically significant 38% increase in
repeat revascularization rates with off-pump relative to on-pump CABG in
the fixed-effects model (odds ratio, 1.38; 95% confidence interval,
1.09-1.76; P = 0.008). In general, exclusion of any single trial from the
analysis did not substantively alter the overall result of our analysis.
There was no evidence of significant publication bias. The results of our
analysis suggest that off-pump CABG may increase repeat revascularization
rates by 38% over on-pump CABG.

<50>
Accession Number
51882167
Title
Cocaine-using patients with a normal or nondiagnostic electrocardiogram:
Single-photon emission computed tomography myocardial perfusion imaging
and outcome.
Source
Clinical Cardiology. 35 (6) (pp 354-358), 2012. Date of Publication: June
2012.
Author
Hendel R.C.; Ruthazer R.; Chaparro S.; Martinez C.; Selker H.P.; Beshansky
J.R.; Udelson J.E.
Institution
(Hendel, Chaparro, Martinez) Division of Cardiovascular Medicine,
Department of Medicine, University of Miami Miller School of Medicine,
1120 14th Street, CRB #1123, Miami, FL 33136, United States
(Ruthazer, Selker, Beshansky, Udelson) Department of Medicine, Tufts
Medical Center, Boston, MA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Few trials have examined the outcomes of patients who use
cocaine with chest pain and who have a normal or nondiagnostic
electrocardiogram (ECG) and the use of single-photon emission computed
tomography (SPECT) myocardial perfusion imaging (MPI). Hypothesis: We
sought to compare the characteristics and overall outcomes in cocaine
users vs non-cocaine users presenting to the emergency department with a
normal/nondiagnostic ECG and to assess the value of rest MPI in both of
these populations. <br/>Method(s): Patients with symptoms compatible with
myocardial ischemia, suspected acute coronary syndrome (ACS), and a
normal/nondiagnostic ECG were enrolled in the Emergency Room Assessment of
Sestamibi for Evaluation of Chest Pain (ERASE Chest Pain) trial, a
randomized controlled trial designed to evaluate the impact of rest MPI on
triage decisions. Cocaine users (n = 294) were compared to non-cocaine
users (n = 2180). Cocaine users were younger than non-cocaine users, and
72% were male. <br/>Result(s): Among the cocaine users, 2.4% had a
myocardial infarction, 1.4% required percutaneous coronary intervention,
and none of the patients underwent coronary artery bypass graft surgery.
Among cocaine users with a final diagnosis of not ACS, randomization of
patients to rest SPECT MPI resulted in an appropriate reduction in
hospital admissions in both the cocaine users (P = 0.011) and the
non-cocaine users (P < 0.001), suggesting improved triage when MPI was
used. <br/>Conclusion(s): Cocaine users with a normal/nondiagnostic ECG
are at low risk of cardiac events. Even though cocaine users are at low
risk of cardiac events, SPECT MPI remains effective in the risk
stratification and improves triage management decisions resulting in lower
admission rates and more discharges to home. &#xa9; 2012 Wiley
Periodicals, Inc.

<51>
Accession Number
2007495540
Title
Effectivity of dexamethasone in patients undergoing off-pump coronary
artery bypass surgery.
Source
Asian Cardiovascular and Thoracic Annals. 29 (5) (pp 388-393), 2021. Date
of Publication: June 2021.
Author
Hanafy D.A.; Harta I.K.A.P.; Prasetya I.M.I.; Busroh P.W.; Soetisna T.W.;
Sugisman; Wartono D.A.; Tjubandi A.; Herlambang B.
Institution
(Hanafy, Harta, Busroh, Soetisna, Sugisman, Wartono, Tjubandi, Herlambang)
National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Prasetya) RSUP Sanglah Hospital, Denpasar, Bali, Indonesia
Publisher
SAGE Publications Inc.
Abstract
Background: Based on our previous pilot study, systemic inflammatory
response syndrome is more common in off-pump compared to on-pump coronary
artery bypass. Therefore, we conducted a clinical trial of dexamethasone
in patients undergoing off-pump coronary artery bypass. <br/>Method(s):
Sixty consecutive patients undergoing off-pump coronary artery bypass were
enrolled from August 2018 to January 2019 and randomized to a
dexamethasone or placebo group of 30 each. Clinical outcomes were
analyzed. <br/>Result(s): There was a lower incidence of major adverse
cardiac events in the dexamethasone group compared to the placebo group
(17% versus 43%, p = 0.024). Clinical outcomes in the dexamethasone group
were better than those in the placebo group, in terms of duration of
mechanical ventilation (p = 0.029), intensive care unit stay (p = 0.028),
hospital stay (p = 0.04), and vasoactive-inotropic score (p = 0.045).
There were significant differences in inflammatory markers between the two
groups: interleukin-6 (p = 0.0001), procalcitonin (p = 0.0001), and
C-reactive protein (p = 0.0001) were lower in the dexamethasone group.
There was a significant association between the incidence of major adverse
cardiac events and both interleukin-6 (p = 0.005) and procalcitonin (p =
0.007). <br/>Conclusion(s): Preoperative dexamethasone in patients
undergoing off-pump coronary artery bypass is effective in improving
clinical outcomes and controlling the postoperative inflammatory
reaction.<br/>Copyright &#xa9; The Author(s) 2020.

<52>
Accession Number
2010573203
Title
Ticagrelor as compared to conventional antiplatelet agents in coronary
artery disease: A comprehensive meta-analysis of 15 randomized trials.
Source
Vascular Pharmacology. 137 (no pagination), 2021. Article Number: 106828.
Date of Publication: April 2021.
Author
Verdoia M.; Savonitto S.; Dudek D.; Kedhi E.; De Luca G.
Institution
(Verdoia, De Luca) Division of Cardiology, Azienda
Ospedaliera-Universitaria "Maggiore della Carita", Eastern Piedmont
University, Novara, Italy
(Savonitto) Cardiovascular Department, Ospedale Alessandro Manzoni, Lecco,
Italy
(Dudek) Institute of Cardiology, Jagiellonian University Medical College,
Krakow, Poland
(Kedhi) Department of Cardiology, ISALA Hospital, Zwolle, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Ticagrelor has been shown to offer potential outcome benefits
in acute coronary syndromes and for the long-term cardiovascular
prevention, reducing mortality and the recurrence of ischemic events.
However, data from real-world and recent meta-analyses have suggested that
the anti-ischemic benefits of ticagrelor could be lower than expected,
potentially outweighed by an increased risk of bleeding complications.
Therefore, the aim of the present meta-analysis was to evaluate the
prognostic impact of ticagrelor as compared to the conventional
antiplatelet agents (ASA and clopidogrel) in patients with coronary artery
disease (CAD), enclosing patients with acute coronary syndromes and stable
CAD. <br/>Method(s): Literature and main scientific session abstracts were
searched for studies comparing a ticagrelor-based antiplatelet regimen vs
different antiplatelet agents in patients with CAD. The primary efficacy
endpoint was mortality, and the primary safety endpoint was the occurrence
of major bleedings. Secondary endpoints were cardiovascular mortality,
myocardial infarction, stroke and intracranial hemorrhage (ICH).
<br/>Result(s): We included 15 randomized clinical trials, with a total
population of 73,402 patients (55% randomized to ticagrelor). At a mean
follow-up of 15 +/- 11.3 months, the ticagrelor based strategy did not
significantly reduce mortality as compared to the traditional therapy
(OR[95%CI] = 0.88[0.70,1.09], p = 0.24; phet<0.00001), with comparable
results and no interaction according to patients' presentation (p
interaction = 0.80). A similar result was achieved for cardiovascular
mortality, whereas the reduction of recurrent myocardial infarction was
significant (OR[95%CI] = 0.84[0.78,0.90], p < 0.00001; phet = 0.76). As
for the risk of stroke, the largest reduction was observed in stable
patients, while a neutral effect was observed in the ACS subgroup (p int =
0.35). Major bleeding events were increased in ticagrelor-treated patients
(OR [95%CI] = 1.40 [1.06, 1.84], p = 0.02; phet<0.00001), especially ICH
(OR [95% CI] = 1.45[1.13,1.84], p = 0.003; phet = 0.93), and mainly among
non-ACS patient. No interaction for any outcome endpoint was observed
according to patients' age. <br/>Conclusion(s): Based on the current
meta-analysis, a ticagrelor-based strategy for the treatment of patients
with coronary artery disease is associated to a significant increase in
major bleeding complications and especially for intracranial hemorrhage,
as compared to a strategy based on conventional antiplatelet agents, while
resulting in a neutral effect on survival. However, a significant
reduction of recurrent myocardial infarction was observed with
ticagrelor.<br/>Copyright &#xa9; 2020

<53>
Accession Number
2013097946
Title
Non-steroidal anti-inflammatory drugs and bone healing in animal models-a
systematic review and meta-analysis.
Source
Systematic Reviews. 10 (1) (no pagination), 2021. Article Number: 201.
Date of Publication: December 2021.
Author
Al-Waeli H.; Reboucas A.P.; Mansour A.; Morris M.; Tamimi F.; Nicolau B.
Institution
(Al-Waeli) Faculty of Dentistry, Dalhousie University, 5981 University
Ave, Halifax, NS B3H 4R2, Canada
(Reboucas) Faculty of Dentistry, Federal University of Minas Gerais, Minas
Gerais, Brazil
(Mansour) School of Dental Medicine, University at Buffalo, Buffalo, NY
14214, United States
(Morris) Schulich Library, McGill University, 2001 Avenue McGill College
Suite 500, Montreal, QC H3A 1G1, Canada
(Reboucas, Tamimi) College of Dental Medicine, Qatar University,
University Street, Doha, Qatar
(Nicolau) Faculty of Dentistry, McGill University, 2001 Avenue McGill
College Suite 500, Montreal, QC H3A 1G1, Canada
Publisher
BioMed Central Ltd
Abstract
Background: Non-steroidal anti-inflammatory drugs (NSAID) have excellent
anti-inflammatory and analgesic properties and are extensively used to
treat post-traumatic or surgical musculoskeletal pain. Although an
extensive literature exists on the administration of NSAID on animal bone
healing, no systematic review and meta-analysis of animal studies that
investigate the effect of NSAID administration on bone fracture healing.
Objective of this study is to conduct a systematic review and
meta-analysis to estimate the effect of NSAIDs administration on bone
healing biomechanical and histomorphometric measurements in different
animal models after bone fracture surgery. <br/>Method(s): We performed a
systematic review and meta-analysis of animal studies to estimate the
effect of NSAID administration after bone fracture on healing outcomes. We
searched eight databases without limiting the search to starting date up
to 1 February 2021 for articles on fractured bone healing in animal models
in which NSAID were administered. <br/>Result(s): Out of 6732 articles
screened, 47 were included and 3 common bone healing outcomes were
analysed: biomechanical properties (maximum force to break, stiffness, and
work-to-failure), micro-computed tomography (mu-CT), and histomorphometric
measurements. The studies were generally of low-quality scores because
crucial information, especially concerning randomization, blinding, and
allocation concealment, was poorly reported. Our results show that the
negative effects of NSAID after bone fracture on certain biomechanical
properties of the healing bones was not statistically significant in mice
compared with other animals, in females compared with males, and in
younger compared with older animals. <br/>Conclusion(s): The findings
demonstrated that NSAIDs administration decreased the biomechanical
properties of healing bones after fracture surgery in comparison to the
control group. Moreover, different effect on certain outcomes was detected
among different sites, sex of the animals, and the time of assessment.
Trial registration: Protocol published and registered in SYstematic Review
Center for Laboratory animal Experimentation (SYRCLE) in 2017,
https://www.radboudumc.nl/getmedia/757ec408-7a9e-4635-8233-ae951effea54/No
n-Steroidal-Anti-inflammatory-Drugs-and-bone-healing-in-animal-Models-Syst
ematic-Review-and-Meta-Analysis.aspx<br/>Copyright &#xa9; 2021, The
Author(s).

<54>
Accession Number
2013096483
Title
Optimal treatment strategies for coronary artery disease in patients with
advanced kidney disease: a meta-analysis.
Source
Therapeutic Advances in Chronic Disease. 12 (no pagination), 2021. Date of
Publication: 2021.
Author
Yong J.; Tian J.; Zhao X.; Yang X.; Xing H.; He Y.; Song X.
Institution
(Yong, Tian, Zhao, Yang, Xing) Department of Cardiology, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
(He) Department of Radiology, Beijing Friendship Hospital, Capital Medical
University, Yongan Road 95, Beijing City 100050, China
(Song) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical
University, Chaoyang District, Anzhen Road No. 2, Beijing City 100029,
China
Publisher
SAGE Publications Ltd
Abstract
Background: Coronary artery disease (CAD) is the leading cause of death in
advanced kidney disease. However, its best treatment has not been
determined. <br/>Method(s): We searched PubMed and Cochrane databases and
scanned references to related articles. Studies comparing the different
treatments for patients with CAD and advanced CKD (estimated glomerular
filtration rate <30 ml/min/1.73 m² or dialysis) were selected.
The primary result was all-cause death, classified according to the
follow-up time: short-term (<1 month), medium-term (1 month-1 year), and
long-term (>1 year). <br/>Result(s): A total of 32 studies were selected
to enroll 84,498 patients with advanced kidney disease. Compared with
medical therapy (MT) alone, percutaneous coronary intervention (PCI) was
associated with low risk of short-, medium-term and long-term all-cause
death (more than 3 years). For AMI patients, compared with MT, PCI was not
associated with low risk of short- and medium-term all-cause death. For
non-AMI patients, compared with MT, PCI was associated with low risk of
long-term mortality (more than 3 years). Compared with MT, coronary artery
bypass surgery (CABG) had no significant advantages in each follow-up
period of all-cause death. Compared with PCI, CABG was associated with a
high risk of short-term death, but low risk of long-term death: 1-3 years;
more than 3 years. CABG could also reduce the risk of long-term risk of
cardiac death, major adverse cardiovascular events (MACEs), myocardial
infarction (MI), and repeat revascularization. <br/>Conclusion(s): In
patients with advanced kidney disease and CAD, PCI reduced the risk of
short-, medium- and long- term (more than 3 years) all-cause death
compared with MT. Compared with PCI, CABG was associated with a high risk
of short-term death and a low risk of long-term death and adverse
events.<br/>Copyright &#xa9; The Author(s), 2021.

<55>
Accession Number
2012040012
Title
Cardiovascular risk management in type 2 diabetes mellitus: A joint
position paper of the Italian Cardiology (SIC) and Italian Diabetes (SID)
Societies.
Source
Nutrition, Metabolism and Cardiovascular Diseases. 31 (6) (pp 1671-1690),
2021. Date of Publication: 07 Jun 2021.
Author
Avogaro A.; Barilla F.; Cavalot F.; Consoli A.; Federici M.; Mancone M.;
Paolillo S.; Pedrinelli R.; Perseghin G.; Perrone Filardi P.; Scicali R.;
Sinagra G.; Spaccarotella C.; Indolfi C.; Purrello F.
Institution
(Avogaro) Dipartimento di Medicina, Sezione di Diabete e Malattia del
Metabolismo, Universita di Padova, Italy
(Barilla, Federici) Dipartimento di Medicina dei Sistemi, Universita di
Roma Tor Vergata, Italy
(Cavalot) SSD Malattie Metaboliche e Diabetologia, AOU San Luigi Gonzaga,
Orbassano (Torino), Italy
(Consoli) Department of Medicine and Ageing Sciences and CeSI-Met,
University D'Annunzio, Chieti, Italy
(Mancone) Dipartimento di Scienze Cliniche, Internistiche,
Anestesiologiche e Cardiovascolari, Sapienza Universita di Roma,
Policlinico Umberto I (Roma), Italy
(Paolillo, Perrone Filardi) Dipartimento di Scienze Biomediche Avanzate,
Sezione di Cardiologia, Universita degli Studi di Napoli Federico II,
Italy
(Pedrinelli) Dipartimento di Patologia Chirurgica, Medica, Molecolare e
dell'Area Critica, Universita di Pisa, Italy
(Perseghin) Dipartimento di Medicina e Riabilitazione, Policlinico di
Monza, Universita degli Studi di Milano Bicocca, Italy
(Scicali, Purrello) Dipartimento di Medicina Clinica e Sperimentale,
Universita di Catania, Italy
(Sinagra) Cardiovascular Department 'Ospedali Riuniti' and University of
Trieste, Trieste, Italy
(Spaccarotella, Indolfi) Division of Cardiology, University Magna Graecia,
Catanzaro, Italy
(Paolillo, Perrone Filardi, Indolfi) Mediterranea Cardiocentro, Napoli,
Italy
Publisher
Elsevier B.V.
Abstract
Aim: This review represents a joint effort of the Italian Societies of
Cardiology (SIC) and Diabetes (SID) to define the state of the art in a
field of great clinical and scientific interest which is experiencing a
moment of major cultural advancements, the cardiovascular risk management
in type 2 diabetes mellitus. Data synthesis: Consists of six chapters that
examine various aspects of pathophysiology, diagnosis and therapy which in
recent months have seen numerous scientific innovations and several
clinical studies that require extensive sharing. <br/>Conclusion(s): The
continuous evolution of our knowledge in this field confirms the great
cultural vitality of these two cultural spheres, which requires, under the
leadership of the scientific Societies, an ever greater and effective
collaboration.<br/>Copyright &#xa9; 2021 The Italian Diabetes Society, the
Italian Society for the Study of Atherosclerosis, the Italian Society of
Human Nutrition and the Department of Clinical Medicine and Surgery,
Federico II University

<56>
Accession Number
2007567764
Title
An analysis of the cost-effectiveness of transcatheter mitral valve repair
for people with secondary mitral valve regurgitation in the UK.
Source
Journal of Medical Economics. 23 (12) (pp 1425-1434), 2020. Date of
Publication: 2020.
Author
Shore J.; Russell J.; Frankenstein L.; Candolfi P.; Green M.
Institution
(Shore, Russell, Green) York Health Economics Consortium, Enterprise
House, Innovation Way, University of York, Heslington, York, United
Kingdom
(Frankenstein) Department of Cardiology, Angiology, Pulmology, University
Hospital Heidelberg, Heidelberg, Germany
(Candolfi) Edwards Lifesciences SA, Nyon, Switzerland
Publisher
Taylor and Francis Ltd.
Abstract
Background and aims: A proportion of chronic heart failure (CHF) patients
will experience regurgitation secondary to ventricular remodeling in CHF,
known as functional mitral (MR) or tricuspid (TR) regurgitation. Its
presence adversely impacts the prognosis and healthcare utilization in CHF
patients. The advent of interventional devices for both atrioventricular
valves modifies both aspects. We present an economic model structure
suitable for comparing interventions used in MR and TR, and assess the
cost-effectiveness of transcatheter mitral valve repair (TMVr) plus
guideline directed medical therapy (GDMT) compared with GDMT alone in
people with MR. <br/>Method(s): An economic model with a lifetime time
horizon was developed based on extrapolated survival data and using New
York Heart Association classifications to describe disease severity in
people with functional MR at high risk of surgical mortality or deemed
inoperable. Cost and utility values (describing health-related
quality-of-life) were assigned to patients dependent on their disease
severity. The analysis was conducted from a UK National Health Service
perspective. An incremental cost per additional quality-adjusted life year
(QALY) was estimated, and sensitivity (one-way and probabilistic) and
scenario analyses conducted. <br/>Result(s) and Conclusion(s): Compared
with GDMT, the use of TMVr results in an additional 1.07 QALYs and an
increase in costs of 32,267 per patient over a lifetime time horizon. The
estimated incremental cost per QALY gained is 30,057 and would therefore
be on the threshold of cost-effectiveness at 30,000 per quality adjusted
life year. Thus, from a UK reimbursement perspective, in patients with
severe functional MR who are at high risk of surgical mortality or deemed
inoperable with conventional surgery, TMVr plus medical therapy is likely
to represent a cost-effective treatment option compared with GDMT alone.
The choice of device (MitraClip or PASCAL) will need to be confirmed once
further clinical data are reported.<br/>Copyright &#xa9; 2020 The
Author(s). Published by Informa UK Limited, trading as Taylor & Francis
Group.

<57>
[Use Link to view the full text]
Accession Number
635499245
Title
Long-term survival after combined epidural-general anesthesia or general
anesthesia alone: Follow-up of a randomized trial.
Source
Anesthesiology. (pp 233-245), 2021. Date of Publication: 2021.
Author
Du Y.-T.; Li Y.-W.; Zhao B.-J.; Guo X.-Y.; Feng Y.; Zuo M.-Z.; Fu C.; Zhou
W.-J.; Liu Y.-F.; Cheng T.; Mu D.-L.; Zeng Y.; Liu P.-F.; Li Y.; An H.-Y.;
Zhu S.-N.; Li X.-Y.; Li H.-J.; Wu Y.-F.; Wang D.-X.; Sessler D.I.
Institution
(Du, Li, Fu, Zhou, Li, Liu, Cheng, Mu, Zeng, Wang) Department of
Anesthesiology and Critical Care Medicine, Peking University First
Hospital, Beijing, China
(Zhao, Liu) Department of Anesthesiology, Beijing Shijitan Hospital,
Capital Medical University, Beijing, China
(Guo, Li) Department of Anesthesiology, Peking University Third Hospital,
Beijing, China
(Feng, An) Department of Anesthesiology, Peking University People's
Hospital, Beijing, China
(Zuo) Department of Anesthesiology, Beijing Hospital, National Center of
Gerontology, Beijing, China
(Zhu, Li) Department of Biostatistics, Peking University First Hospital,
Beijing, China
(Li, Wu) Peking University Clinical Research Institute, Peking University
Health Science Center, Beijing, China
(Wang, Sessler) Outcomes Research Consortium, Cleveland, OH, United States
(Sessler) Department of Outcomes Research, Cleveland Clinic, Cleveland,
OH, United States
(Zuo) Institute of Geriatric Medicine, Chinese Academy of Medical
Sciences, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Experimental and observational research suggests that combined
epidural-general anesthesia may improve long-term survival after cancer
surgery by reducing anesthetic and opioid consumption and by blunting
surgery-related inflammation. This study therefore tested the primary
hypothesis that combined epidural-general anesthesia improves long-term
survival in elderly patients. <br/>Method(s): This article presents a
long-term follow-up of patients enrolled in a previous trial conducted at
five hospitals. Patients aged 60 to 90 yr and scheduled for major
noncardiac thoracic and abdominal surgeries were randomly assigned to
either combined epidural-general anesthesia with postoperative epidural
analgesia or general anesthesia alone with postoperative intravenous
analgesia. The primary outcome was overall postoperative survival.
Secondary outcomes included cancer-specific, recurrence-free, and
event-free survival. <br/>Result(s): Among 1,802 patients who were
enrolled and randomized in the underlying trial, 1,712 were included in
the long-term analysis; 92% had surgery for cancer. The median follow-up
duration was 66 months (interquartile range, 61 to 80). Among patients
assigned to combined epidural-general anesthesia, 355 of 853 (42%) died
compared with 326 of 859 (38%) deaths in patients assigned to general
anesthesia alone: adjusted hazard ratio, 1.07; 95% CI, 0.92 to 1.24; P =
0.408. Cancer-specific survival was similar with combined epidural-general
anesthesia (327 of 853 [38%]) and general anesthesia alone (292 of 859
[34%]): adjusted hazard ratio, 1.09; 95% CI, 0.93 to 1.28; P = 0.290.
Recurrence-free survival was 401 of 853 [47%] for patients who had
combined epidural-general anesthesia versus 389 of 859 [45%] with general
anesthesia alone: adjusted hazard ratio, 0.97; 95% CI, 0.84 to 1.12; P =
0.692. Event-free survival was 466 of 853 [55%] in patients who had
combined epidural-general anesthesia versus 450 of 859 [52%] for general
anesthesia alone: adjusted hazard ratio, 0.99; 95% CI, 0.86 to 1.12; P =
0.815. <br/>Conclusion(s): In elderly patients having major thoracic and
abdominal surgery, combined epidural-general anesthesia with epidural
analgesia did not improve overall or cancer-specific long-term mortality.
Nor did epidural analgesia improve recurrence-free survival. Either
approach can therefore reasonably be selected based on patient and
clinician preference. <br/>Copyright &#xa9; 2021, the American Society of
Anesthesiologists. All Rights Reserved.

<58>
[Use Link to view the full text]
Accession Number
635498339
Title
Delirium in older patients after combined epidural-general anesthesia or
general anesthesia for major surgery: A randomized trial.
Source
Anesthesiology. (pp 218-232), 2021. Date of Publication: 2021.
Author
Li Y.-W.; Li H.-J.; Zhao B.-J.; Guo X.-Y.; Feng Y.; Zuo M.-Z.; Yu Y.-P.;
Kong H.; Zhao Y.; Huang D.; Deng C.-M.; Hu X.-Y.; Liu P.-F.; Li Y.; An
H.-Y.; Zhang H.-Y.; Wang M.-R.; Wu Y.-F.; Wang D.-X.; Sessler D.I.
Institution
(Li, Li, Kong, Zhao, Huang, Deng, Wang) Department of Anesthesiology and
Critical Care Medicine, Peking University First Hospital, Beijing, China
(Li, Yu, Wang, Wu) Peking University Clinical Research Institute, Peking
University Health Science Center, Beijing, China
(Zhao, Hu, Liu) Department of Anesthesiology, Beijing Shijitan Hospital,
Capital Medical University, Beijing, China
(Guo, Li) Department of Anesthesiology, Peking University Third Hospital,
Beijing, China
(Feng, An) Department of Anesthesiology, Peking University People's
Hospital, Beijing, China
(Zuo, Zhang) Department of Anesthesiology, Beijing Hospital, National
Center of Gerontology, Beijing, China
(Zuo, Zhang) Institute of Geriatric Medicine, Chinese Academy of Medical
Sciences, Beijing, China
(Wang, Sessler) Outcomes Research Consortium, Cleveland, OH, United States
(Sessler) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Delirium is a common and serious postoperative complication,
especially in the elderly. Epidural anesthesia may reduce delirium by
improving analgesia, reducing opioid consumption, and blunting stress
response to surgery. This trial therefore tested the hypothesis that
combined epidural-general anesthesia reduces the incidence of
postoperative delirium in elderly patients recovering from major
noncardiac surgery. <br/>Method(s): Patients aged 60 to 90 yr scheduled
for major noncardiac thoracic or abdominal surgeries expected to last 2 h
or more were enrolled. Participants were randomized 1:1 to either combined
epidural-general anesthesia with postoperative epidural analgesia or
general anesthesia with postoperative intravenous analgesia. The primary
outcome was the incidence of delirium, which was assessed with the
Confusion Assessment Method for the Intensive Care Unit twice daily during
the initial 7 postoperative days. <br/>Result(s): Between November 2011
and May 2015, 1,802 patients were randomized to combined epidural-general
anesthesia (n = 901) or general anesthesia alone (n = 901). Among these,
1,720 patients (mean age, 70 yr; 35% women) completed the study and were
included in the intention-to-treat analysis. Delirium was significantly
less common in the combined epidural-general anesthesia group (15 [1.8%]
of 857 patients) than in the general anesthesia group (43 [5.0%] of 863
patients; relative risk, 0.351; 95% CI, 0.197 to 0.627; P < 0.001; number
needed to treat 31). Intraoperative hypotension (systolic blood pressure
less than 80 mmHg) was more common in patients assigned to epidural
anesthesia (421 [49%] vs. 288 [33%]; relative risk, 1.47, 95% CI, 1.31 to
1.65; P < 0.001), and more epidural patients were given vasopressors (495
[58%] vs. 387 [45%]; relative risk, 1.29; 95% CI, 1.17 to 1.41; P <
0.001). <br/>Conclusion(s): Older patients randomized to combined
epidural-general anesthesia for major thoracic and abdominal surgeries had
one third as much delirium but 50% more hypotension. Clinicians should
consider combining epidural and general anesthesia in patients at risk of
postoperative delirium, and avoiding the combination in patients at risk
of hypotension. <br/>Copyright &#xa9; 2021, the American Society of
Anesthesiologists.

<59>
Accession Number
635396863
Title
Efficacy and Safety of Antifibrinolytic Drugs in Pediatric Surgery: A
Systematic Review.
Source
Seminars in Thrombosis and Hemostasis. 47 (5) (pp 538-568), 2021. Date of
Publication: 01 Jul 2021.
Author
Hovgesen N.T.; Larsen J.B.; Fenger-Eriksen C.; Hansen A.K.; Hvas A.-M.
Institution
(Hovgesen, Larsen, Hvas) Thrombosis and Hemostasis Research Unit,
Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus,
Denmark
(Fenger-Eriksen) Department of Anesthesiology, Aarhus University Hospital,
Aarhus, Denmark
(Hansen) Neonatal Intensive Care Unit, Department of Pediatrics and
Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
(Hvas) Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
Publisher
Thieme Medical Publishers, Inc.
Abstract
Antifibrinolytic drugs are used to reduce blood loss and subsequent
transfusions during surgery and following trauma, but the optimal dosing
regimen in the pediatric population is still unresolved. The aim of this
systematic review was to evaluate efficacy and safety of antifibrinolytic
drugs in pediatric surgery and trauma to determine the optimal dosing
regimen. A literature search was performed in PubMed, Embase, Cochrane,
and Web of Science on May 3, 2020. We included randomized controlled
studies investigating the effect of tranexamic acid (TXA), aprotinin, and
epsilon-aminocaproic acid, in terms of reducing blood loss, blood
transfusions, reoperations, and rebleeds in pediatric patients aged 0 to
18 years undergoing cardiac surgery, noncardiac surgery, or trauma. Fifty
randomized controlled trials (RCTs) were included; 28 RCTs investigated
cardiac surgery and 22 investigated noncardiac surgery. No RCTs regarding
trauma met the inclusion criteria. All antifibrinolytic drugs reduced
postoperative blood loss and transfusions when used in pediatric surgery.
The dosing regimen varied between studies, but similar effect sizes were
found in terms of reduced blood loss regardless of the cumulative dose
used. Few studies found adverse events, and no difference in incidence or
type of adverse events was seen between the antifibrinolytic and the
placebo group. In conclusion, use of antifibrinolytics is efficient and
safe in children undergoing surgery. We propose TXA as the drug of choice
based on its level of evidence and safety profile; we recommend a dosing
regimen composed of a loading dose of 10 to 15 mg/kg prior to surgery
followed by 1 to 5 mg/kg/h as continuous infusion throughout
surgery.<br/>Copyright &#xa9; 2021 SPIE. All rights reserved.

<60>
Accession Number
2007840140
Title
Cardiomyopathies: An overview.
Source
International Journal of Molecular Sciences. 22 (14) (no pagination),
2021. Article Number: 7722. Date of Publication: 02 Jul 2021.
Author
Ciarambino T.; Menna G.; Sansone G.; Giordano M.
Institution
(Ciarambino) Internal Emergency Department, Hospital of Marcianise, ASL,
Caserta 81037, Italy
(Menna, Sansone, Giordano) Department of Medical Science, University of
Campania, L. Vanvitelli, Naples 81100, Italy
Publisher
MDPI AG
Abstract
Background: Cardiomyopathies are a heterogeneous group of pathologies
characterized by structural and functional alterations of the heart.
<br/>Aim(s): The purpose of this narrative review is to focus on the most
important cardiomyopathies and their epidemiology, diagnosis, and
manage-ment. <br/>Method(s): Clinical trials were identified by Pubmed
until 30 March 2021. The search keywords were "cardiomyopathies, sudden
cardiac arrest, dilated cardiomyopathy (DCM), hypertrophic car-diomyopathy
(HCM), restrictive cardiomyopathy, arrhythmogenic cardiomyopathy (ARCV),
tako-tsubo syndrome". <br/>Result(s): Hypertrophic cardiomyopathy (HCM) is
the most common primary car-diomyopathy, with a prevalence of 1:500
persons. Dilated cardiomyopathy (DCM) has a prevalence of 1:2500 and is
the leading indication for heart transplantation. Restrictive
cardiomyopathy (RCM) is the least common of the major cardiomyopathies,
representing 2% to 5% of cases. Arrhythmogenic cardiomyopathy (ARCV) is a
pathology characterized by the substitution of the myocardium by
fibrofatty tissue. Takotsubo cardiomyopathy is defined as an abrupt onset
of left ventricular dysfunction in response to severe emotional or
physiologic stress. <br/>Conclusion(s): In particular, it has been
reported that HCM is the most important cause of sudden death on the
athletic field in the United States. It is needless to say how important
it is to know which changes in the heart due to physical activity are
normal, and when they are pathological.<br/>Copyright &#xa9; 2021 by the
authors. Licensee MDPI, Basel, Switzerland.

<61>
Accession Number
2013157768
Title
Del Nido cardioplegia for myocardial protection in adult cardiac surgery:
a systematic review and update meta-analysis.
Source
Perfusion (United Kingdom). (no pagination), 2021. Date of Publication:
2021.
Author
Zhai K.; Cheng X.; Zhang P.; Wei S.; Huang J.; Wu X.; Gao B.; Li Y.
Institution
(Zhai, Cheng, Zhang, Wei, Huang, Wu, Gao, Li) Department of Cardiac
Surgery, Lanzhou University Second Hospital, Lanzhou University, Lanzhou,
China
(Zhai, Cheng, Zhang, Wei, Huang, Li) Laboratory of Extracorporeal Life
Support, Lanzhou University Second Hospital, Lanzhou University, Lanzhou,
China
Publisher
SAGE Publications Ltd
Abstract
Objective: Although the application of del Nido cardioplegia solution
(DNC) in adult cardiac surgery is accumulating, the feasibility and safety
of this myocardial protection strategy in adults remains controversial. We
aimed to update our previous meta-analysis to determine the myocardial
protective effect of DNC versus conventional cardioplegia (CC) in adult
cardiac surgery. <br/>Method(s): A comprehensive literature search was
performed using PubMed, EMBASE, the Cochrane Library, and International
Clinical Trials Registry Platform databases through November 2020.
<br/>Result(s): Thirty-seven observational studies and four randomized
controlled trials (RCTs) including 21,779 patients were identified. The
DNC group was associated with decreased postoperative cardiac enzymes
[troponin T (cTnT) and creatine kinase-MB (CK-MB)] [standardized mean
differences (SMD): -0.59, 95% confidence interval (CI): -0.99 to -0.19, p
= 0.004], cardiopulmonary bypass (CPB) time (MD: -9.31, 95% CI: -13.10 to
-5.51, p < 0.00001), aortic cross-clamp (ACC) time (MD: -7.20, 95% CI:
-10.31 to -4.09, p < 0.00001), and cardioplegia volume (SMD: -1.95, 95%
CI: -2.46 to -1.44, p < 0.00001). Intraoperative defibrillation
requirement was less in the DNC group [relative risk (RR): 0.50, 95% CI:
0.33 to 0.75, p = 0.0007]. The pooled analysis revealed no significant
difference in operative mortality among the patients assigned to DNC and
those undergoing CC. <br/>Conclusion(s): In adult cardiac surgery,
compared to CC, myocardial protection used with DNC yield similar or
better short-term clinical outcomes. More high-quality trials and RCTs
reflecting long-term follow-up morbidity and mortality are required in the
future to confirm these findings.<br/>Copyright &#xa9; The Author(s) 2021.

<62>
Accession Number
2013147668
Title
Pericarditis as a manifestation of IgG4-related disease.
Source
Rheumatology International. (no pagination), 2021. Date of Publication:
2021.
Author
Doumen M.; Vankelecom B.; Westhovens R.; Michiels S.
Institution
(Doumen, Westhovens) Department of Development and Regeneration, Skeletal
Biology and Engineering Research Centre, KU Leuven, ON IV Herestraat
49-bus 805, Leuven 3000, Belgium
(Doumen, Westhovens) Rheumatology, University Hospitals Leuven, Leuven,
Belgium
(Vankelecom) Cardiology, Imelda Hospital, Bonheiden, Belgium
(Michiels) Rheumatology, Imelda Hospital, Bonheiden, Belgium
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
IgG4-related disease (IgG4-RD) is a systemic, immune-mediated
fibro-inflammatory disease that can affect virtually every organ system.
It is usually insidious in onset and often mimics malignant or other
inflammatory disorders. Diagnosis frequently requires a combination of
clinical, serological, radiographic, and histopathological features,
including increased serum-IgG4 levels and tissue infiltration of
IgG4-positive plasma cells with associated fibrosis. Unlike more
frequently affected sites, including the hepatobiliary system, salivary
glands and retroperitoneum, pericardial involvement of IgG4-RD has only
rarely been described. We report the case of a 76-year-old woman
presenting with refractory pericarditis and imminent cardiac tamponade,
successfully treated with therapeutic pericardiectomy. A diagnosis of
IgG4-RD was made based on elevated serum-IgG4 levels and the presence of
typical pericardial histopathological findings, meeting all 3 of the 2011
comprehensive diagnostic criteria for IgG4-RD. Following pericardiectomy,
the patient remained in remission without a need for glucocorticoids or
additional immunosuppressive therapy. Adding to this case, we reviewed the
literature for previously described cases of IgG4-RD presenting with
pericarditis and described their characteristics and the available
treatment options. Our case-based literature review provides a clear
overview of the diagnostic process for IgG4-RD and the need to apply
classification criteria with the necessary caution, particularly in the
case of rare disease manifestations, including pericarditis.<br/>Copyright
&#xa9; 2021, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<63>
Accession Number
2013350156
Title
Rheumatic heart disease in pregnancy and neonatal outcomes: A systematic
review and meta-analysis.
Source
PLoS ONE. 16 (6 June) (no pagination), 2021. Article Number: e0253581.
Date of Publication: June 2021.
Author
Liaw J.; Walker B.; Hall L.; Gorton S.; White A.V.; Heal C.
Institution
(Liaw, Walker, Hall, Heal) College of Medicine and Dentistry, James Cook
University, Mackay, QLD, Australia
(Gorton, White) College of Medicine and Dentistry, James Cook University,
Townsville, QLD, Australia
Publisher
Public Library of Science
Abstract
Purpose Associations between rheumatic heart disease (RHD) in pregnancy
and fetal outcomes are relatively unknown. This study aimed to review
rates and predictors of major adverse fetal outcomes of RHD in pregnancy.
Methods Medline (Ovid), Pubmed, EMcare, Scopus, CINAHL, Informit, and
WHOICTRP databases were searched for studies that reported rates of
adverse perinatal events in women with RHD during pregnancy. Outcomes
included preterm birth, intra-uterine growth restriction (IUGR), low-birth
weight (LBW), perinatal death and percutaneous balloon mitral
valvuloplasty intervention. Meta-analysis of fetal events by the New-York
Heart Association (NYHA) heart failure classification, and the
Mitral-valve Area (MVA) severity score was performed with unadjusted
random effects models and heterogeneity of risk ratios (RR) was assessed
with the I² statistic. Quality of evidence was evaluated using
the GRADE approach. The study was registered in PROSPERO (CRD42020161529).
Findings The search identified 5949 non-duplicate records of which 136
full-text articles were assessed for eligibility and 22 studies included,
11 studies were eligible for meta-analyses. In 3928 pregnancies, high
rates of preterm birth (9.35%-42.97%), LBW (12.98%-39.70%), IUGR
(6.76%-22.40%) and perinatal death (0.00%-9.41%) were reported. NYHA
III/IV pre-pregnancy was associated with higher rates of preterm birth (5
studies, RR 2.86, 95%CI 1.54-5.33), and perinatal death (6 studies, RR
3.23, 1.92-5.44). Moderate /severe mitral stenosis (MS) was associated
with higher rates of preterm birth (3 studies, RR 2.05, 95%CI 1.02-4.11)
and IUGR (3 studies, RR 2.46, 95%CI 1.02-5.95). Interpretation RHD during
pregnancy is associated with adverse fetal outcomes. Maternal NYHA III/IV
and moderate/severe MS in particular may predict poor
prognosis.<br/>Copyright: &#xa9; 2021 Liaw et al. This is an open access
article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original author and source are credited.

<64>
Accession Number
2008363299
Title
Systematic review and consensus definitions for the Standardized Endpoints
in Perioperative Medicine (StEP) initiative: cardiovascular outcomes.
Source
British Journal of Anaesthesia. 126 (1) (pp 56-66), 2021. Date of
Publication: January 2021.
Author
Beattie W.S.; Lalu M.; Bocock M.; Feng S.; Wijeysundera D.N.; Nagele P.;
Fleisher L.A.; Kurz A.; Biccard B.; Leslie K.; Howell S.; Grocott H.; Lamy
A.; Richards T.; Myles P.; Gan T.J.; Peyton P.; Sessler D.; Tramer M.;
Cyna A.; De Oliveira G.S.; Wu C.; Jensen M.; Kehlet H.; Botti M.; Boney
O.; Haller G.; Grocott M.; Cook T.; Fleisher L.; Neuman M.; Story D.;
Gruen R.; Bampoe S.; Evered L.; Scott D.; Silbert B.; van Dijk D.; Kalkman
C.; Chan M.; Eckenhoff R.; Rasmussen L.; Eriksson L.; Wijeysundera D.;
Landoni G.; Bartlett R.J.; McMonnies R.; Gerstl J.; Jay M.; Kishlyansky
D.; Machina M.; Bobcock M.; Pearse R.; Mythen M.; Canet J.; Moller A.; Gin
T.; Schultz M.; Pelosi P.; Gabreu M.; Futier E.; Creagh-Brown B.; Abbott
T.; Klein A.; Corcoran T.; Cooper D.J.; Dieleman S.; Diouf E.; McIlroy D.;
Bellomo R.; Shaw A.; Prowle J.; Karkouti K.; Billings J.; Mazer D.;
Jayarajah M.; Murphy M.; Bartoszko J.; Sneyd R.; Morris S.; George R.;
Moonesinghe R.; Shulman M.; Lane-Fall M.; Nilsson U.; Stevenson N.; Cooper
J.D.; van Klei W.; Cabrini L.; Miller T.; Pace N.; Jackson S.; Buggy D.;
Short T.; Riedel B.; Gottumukkala V.; Alkhaffaf B.; Johnson M.
Institution
(Beattie) Cardiovascular Anesthesia, University Health Network, University
of Toronto, Toronto, ON, Canada
(Lalu, Bocock, Feng) Department of Anesthesia, University of Ottawa,
Ottawa, ON, Canada
(Wijeysundera) Li Ka Shing Knowledge Institute, St Michaels Hospital,
University of Toronto, Toronto, ON, Canada
(Nagele) Department of Anesthesia and Critical Care, University of
Chicago, Chicago, IL, United States
(Fleisher) Department of Anesthesiology and Critical Care, University of
Pennsylvania Health System, Philadelphia, PA, United States
(Kurz) Outcomes Research, Cleveland Clinic, Cleveland, OH, United States
(Biccard) Department of Anesthesia and Perioperative Medicine, University
of Cape Town, Cape Town, South Africa
(Leslie) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, Vic., Australia
(Howell) University of Leeds School of Medicine, Leeds, United Kingdom
(Landoni) Center for Intensive Care and Anesthesiology, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Grocott) Department of Anesthesia and Perioperative Medicine, University
of Manitoba, Winnipeg, MB, Canada
(Lamy) Department of Surgery, McMaster University, Hamilton, ON, Canada
(Richards) University of Western Australia, Perth, Australia
(Myles) Alfred Health and Monash University Department of Anaesthesia and
Perioperative Medicine, Melbourne, Vic., Australia
Publisher
Elsevier Ltd
Abstract
Background: Adverse cardiovascular events are a leading cause of
perioperative morbidity and mortality. The definitions of perioperative
cardiovascular adverse events are heterogeneous. As part of the
international Standardized Endpoints in Perioperative Medicine initiative,
this study aimed to find consensus amongst clinical trialists on a set of
standardised and valid cardiovascular outcomes for use in future
perioperative clinical trials. <br/>Method(s): We identified currently
used perioperative cardiovascular outcomes by a systematic review of the
anaesthesia and perioperative medicine literature (PubMed/Ovid, Embase,
and Cochrane Library). We performed a three-stage Delphi consensus-gaining
process that involved 55 clinician researchers worldwide. Cardiovascular
outcomes were first shortlisted and the most suitable definitions
determined. These cardiovascular outcomes were then assessed for validity,
reliability, feasibility, and clarity. <br/>Result(s): We identified 18
cardiovascular outcomes. Participation in the three Delphi rounds was 100%
(n=19), 71% (n=55), and 89% (n=17), respectively. A final list of nine
cardiovascular outcomes was elicited from the consensus: myocardial
infarction, myocardial injury, cardiovascular death, non-fatal cardiac
arrest, coronary revascularisation, major adverse cardiac events,
pulmonary embolism, deep vein thrombosis, and atrial fibrillation. These
nine cardiovascular outcomes were rated by the majority of experts as
valid, reliable, feasible, and clearly defined. <br/>Conclusion(s): These
nine consensus cardiovascular outcomes can be confidently used as
endpoints in clinical trials designed to evaluate perioperative
interventions with the goal of improving perioperative
outcomes.<br/>Copyright &#xa9; 2020 British Journal of Anaesthesia

<65>
Accession Number
2005603837
Title
Efficacy and safety of riociguat in combination therapy for patients with
pulmonary arterial hypertension (PATENT studies).
Source
Pulmonary Circulation. 10 (3) (no pagination), 2020. Date of Publication:
July 2020.
Author
Ghofrani H.-A.; Grunig E.; Jansa P.; Langleben D.; Rosenkranz S.; Preston
I.R.; Rahaghi F.; Sood N.; Busse D.; Meier C.; Humbert M.
Institution
(Ghofrani) University of Giessen and Marburg Lung Center, Member of German
Center for Lung Research, Giessen, Germany
(Ghofrani) Department of Medicine, Imperial College London, London, United
Kingdom
(Grunig) Center for Pulmonary Hypertension, Thoraxklinic, University
Hospital Heidelberg, Member of the German Center for Lung Research (DZL,
Heidelberg, Germany
(Jansa) First Faculty of Medicine and General Teaching Hospital, Charles
University, Prague, Czechia
(Langleben) Center for Pulmonary Vascular Disease and Lady Davis
Institute, Jewish General Hospital, McGill University, Montreal, QC,
Canada
(Rosenkranz) Klinik III fur Innere Medizin, Herzzentrum der Universitat zu
Koln, Koln, Germany
(Preston) Critical Care and Sleep Division, Tufts Medical Center, Tufts
University School of Medicine, Boston, MA, United States
(Rahaghi) Department of Pulmonary and Critical Care Medicine, Cleveland
Clinic Florida, Weston, FL, United States
(Sood) The Lung Center, The Ohio State University, Columbus, OH, United
States
(Busse) Chrestos Concept GmbH Co. KG, Essen, Germany
(Meier) Bayer AG, Berlin, Germany
(Humbert) Assistance Publique-Hopitaux de Paris, Service de Pneumologie,
Hopital Bicetre, Universite Paris-Sud, Laboratoire d'Excellence en
Recherche sur le Medicament et Innovation Therapeutique, Institut National
de la Sante et de la Recherche Medicale Unite 999, Le Kremlin-Bicetre,
France
Publisher
SAGE Publications Ltd
Abstract
Many patients with pulmonary arterial hypertension do not achieve
treatment goals with monotherapy, and therefore combination therapy is
becoming the standard of care. The soluble guanylate cyclase stimulator
riociguat is licensed for the treatment of pulmonary arterial
hypertension; here we present findings from patients who were receiving
combined riociguat plus endothelin receptor antagonists or non-intravenous
prostanoids in the randomized, placebo-controlled PATENT-1 study and its
open-label extension (PATENT-2). Moreover, we include new data from
patients receiving early sequential combination therapy (three to six
months of endothelin receptor antagonist treatment) or long-term
background endothelin receptor antagonist therapy (>6 months). Patients
were randomized to riociguat 2.5 mg-maximum (N = 131 pretreated patients)
and placebo (N = 60 pretreated patients). Riociguat improved 6-min walking
distance (PATENT-1 primary endpoint), functional capacity, and
hemodynamics after 12 weeks in pretreated patients. The placebo-corrected
changes in 6-min walking distance were +24 m in endothelin receptor
antagonist-pretreated patients and +106 m in the small group of
prostanoid-pretreated patients. In the early sequential combination and
long-term background endothelin receptor antagonist groups, the
placebo-corrected changes in 6-min walking distance were +65 m (95% CI: 17
to 113 m) and +13 m (95% CI: -8 to 33 m), respectively. In conclusion,
these data suggest that early sequential combination of an endothelin
receptor antagonist plus riociguat is a feasible treatment option. Both
early sequential therapy and long-term background endothelin receptor
antagonist plus riociguat were well tolerated in the PATENT
studies.<br/>Copyright &#xa9; The Author(s) 2020.

<66>
Accession Number
608459507
Title
Efficacy of wound analgesia for controlling post-thoracotomy pain: A
randomized double-blind study.
Source
European Journal of Cardio-thoracic Surgery. 49 (1) (pp 339-347), 2016.
Date of Publication: January 2016.
Author
Fiorelli A.; Izzo A.C.; Frongillo E.M.; Prete A.D.; Liguori G.; Di
Costanzo E.; Vicidomini G.; Santini M.
Institution
(Fiorelli, Izzo, Frongillo, Prete, Vicidomini, Santini) Thoracic Surgery
Unit, Second University of Naples, Naples, Italy
(Liguori) Anestesiology and Intensive Care Unit, Cardarelli Hospital,
Naples, Italy
(Di Costanzo) Anestesiology and Intensive Care Unit, Monaldi Hospital,
Naples, Italy
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Continuous wound infusion of local anaesthetics has been
successfully applied for postoperative pain control in several procedures
but, surprisingly, it is underused in thoracic surgery. We aimed to
investigate the effects of wound analgesia associated with systemic
patient-controlled analgesia in patients undergoing lung cancer resection
with muscle-sparing thoracotomy. <br/>METHOD(S): Sixty consecutive
patients undergoing lung cancer resection via standard muscle-sparing
thoracotomy were randomized into two groups (wound analgesia and placebo
groups). Bupivacaine in the wound group and free-saline solution in the
placebo group were injected using a multiholed catheter connected to an
elastomeric pump inserted at the end of operation between the pericostal
sutures and the serratus muscle and removed 48 h after. The inter-group
differences were assessed by the following criteria: (i) level of
cytokines [IL-6, IL-10 and tumour necrosis factor-alpha (TNF-alpha)]; (ii)
pain on a visual analogue scale at rest and after coughing; (iii) recovery
of respiratory functions (flow expiratory volume in 1 s % and forced vital
capacity %) and (iv) narcotic medication consumption at different time
points of the postoperative course. <br/>RESULT(S): Five out of a total of
60 patients were excluded from the final analysis. Thus, the wound and
placebo groups comprised 27 and 28 patients, respectively. The wound group
compared with the placebo group had a significant decrease of IL-6 (P <
0.001), IL-10 (P < 0.001) and TNF-alpha (P < 0.001) blood concentration
levels, pain scores at rest (P < 0.001) and after coughing (P = 0.01), and
a reduction of additional morphine intake (P = 0.03) and Ketorolac (P =
0.01) during the entire postoperative course. The recovery of the flow
expiratory volume in one second % (P = 0.01) and the forced vital capacity
% (P = 0.02) was also better in the wound than in the placebo group.
<br/>CONCLUSION(S): Our data prove that wound analgesia is an effective,
easy and safe procedure. It significantly reduces systemic inflammatory
markers, pain scores and opioid intake; and accelerates the recovery of
respiratory function. Catheter placement does not require particular
manoeuvres by the surgeon nor does the elastomeric pump need any
adjustment or care by physicians or nurses.<br/>Copyright &#xa9; The
Author 2015.

<67>
Accession Number
611311239
Title
E-Comment: Conducting meta-analyses of off-pump versus on-pump coronary
artery bypass surgery: Where we stand.
Source
Interactive Cardiovascular and Thoracic Surgery. 17 (5) (pp 881), 2013.
Date of Publication: November 2013.
Author
Tourmousoglou C.; Lalos S.
Institution
(Tourmousoglou, Lalos) Department of Cardiothoracic Surgery, Hippokratio
General Hospital, Athens, Greece
Publisher
Oxford University Press

<68>
Accession Number
52729534
Title
Efficacy and safety evaluation of intensive statin therapy in older
patients with coronary heart disease: A systematic review and
meta-analysis.
Source
European Journal of Clinical Pharmacology. 69 (12) (pp 2001-2009), 2013.
Date of Publication: December 2013.
Author
Yan Y.L.; Qiu B.; Hu L.J.; Jing X.D.; Liu Y.J.; Deng S.B.; Du J.L.; She Q.
Institution
(Yan, Qiu, Hu, Jing, Liu, Deng, Du, She) Cardiovascular Department, Second
Affiliated Hospital, Chongqing Medical University, No.76, Linjiang Road
Yuzhong district, Chongqing, China
Publisher
Springer Verlag
Abstract
Purpose: To reveal and evaluate the efficacy and safety of intensive
statin therapy in older patients (age >=65 years) with coronary heart
disease (CHD). <br/>Method(s): Electronic databases were searched for
randomized controlled trials (RCTs) that involved intensive statin therapy
use in older patients with CHD. Data was extracted and used to calculate
risk ratios (RR) by software Revman 5.1. <br/>Result(s): Five RCTs and
11,132 patients were included in. Compared with non-intensive statin
therapy, intensive statin therapy had significant effect on reducing low
density lipoprotein cholesterol (LDL-C) levels (55.4 %) and total
cholesterol (TC) and triglyceride (Tg). Although the results showed that
intensive statin therapy had no superior effect on reduction of mortality
(both all-cause mortality [RR=0.97, p=0.65] and cardiac death [RR=0.95,
p=0.57]) and cardiac arrest (RR=1.09, p=0.81), it possessed significant
effects on prevention of nonfatal myocardial infarction (MI) (RR=0.78,
p=0.008), stroke (RR=0.72, p=0.02) and coronary revascularization
(RR=0.69, p=0.007). In terms of side effects, intensive statin therapy was
associated with small absolute increase in incidence of drug
discontinuation, due to adverse events (3.9 %) and liver enzymes
abnormalities (1.7 %). And the occurrence rates of myopathy,
rhabdomyolysis and creatine kinase (CK) elevation were very low.
<br/>Conclusion(s): This results show that intensive statin therapy has
excellent effects on reduction of serum lipid level including LDL-C, TC,
Tg, and also on prevention of nonfatal MI, stroke and coronary
revascularization with small absolute increased risk of side effects. Our
analysis supports the use of intensive statin therapy in patients >=65
years old with CHD. &#xa9; Springer-Verlag Berlin Heidelberg 2013.

<69>
Accession Number
51904722
Title
A pilot study investigating the effects of remote ischemic preconditioning
in high-risk cardiac surgery using a randomized controlled double-blind
protocol.
Source
Basic Research in Cardiology. 107 (3) (no pagination), 2012. Article
Number: 0256. Date of Publication: May 2012.
Author
Young P.J.; Dalley P.; Garden A.; Horrocks C.; La Flamme A.; Mahon B.;
Miller J.; Pilcher J.; Weatherall M.; Williams J.; Young W.; Beasley R.
Institution
(Young, Dalley, Garden, Horrocks, Mahon, Young, Beasley) Wellington
Hospital, Capital and Coast District Health Board, Private Bag 7902,
Wellington 6242, New Zealand
(Young, Pilcher, Weatherall, Beasley) Medical Research Institute of New
Zealand, Private Bag 7902, Wellington 6242, New Zealand
(Garden, La Flamme, Miller, Williams, Beasley) School of Biological
Sciences, Victoria University of Wellington, PO Box 600, Wellington 6140,
New Zealand
(Weatherall) University of Otago, Wellington, PO Box 7343, Wellington
South, Wellington 6021, New Zealand
Publisher
Dr. Dietrich Steinkopff Verlag GmbH and Co. KG
Abstract
The efficacy of remote ischemic preconditioning (RIPC) in high-risk
cardiac surgery is uncertain. In this study, 96 adults undergoing
high-risk cardiac surgery were randomised to RIPC (3 cycles of 5 min of
upper-limb ischemia induced by inflating a blood pressure cuff to 200 mmHg
with 5 min of reperfusion) or control. Main endpoints were plasma
high-sensitivity troponin T (hsTNT) levels at 6 and 12 h, worst
post-operative acute kidney injury (AKI) based on RIFLE criteria, and
noradrenaline duration. hsTNT levels were log-normally distributed and
higher with RIPC than control at 6-h post cross-clamp removal [810 ng/ml
(IQR 527-1,724) vs. 634 ng/ml (429-1,012); ratio of means 1.41 (99.17% CI
0.92-2.17); P=0.04] and 12 h [742 ng/ml (IQR 427-1,700) vs. 514 ng/ml (IQR
356-833); ratio of means 1.56 (99.17% CI 0.97-2.53); P=0.01]. After
adjustment for baseline confounders, the ratio of means of hsTNT at 6 h
was 1.23 (99.17% CI 0.88-1.72; P=0.10) and at 12 h was 1.30 (99.17%CI
0.92-1.84; P=0.05). In the RIPC group, 35/48 (72.9%) had no AKI, 5/48
(10.4%) had AKI risk, and 8/48 (16.7%) had either renal injury or failure
compared to the control group where 34/48 (70.8%) had noAKI, 7/48 (14.6%)
hadAKI risk, and 7/48 (14.6%) had renal injury or failure (Chi-squared
0.41; two degrees of freedom; P = 0.82). RIPC increased post-operative
duration of noradrenaline support [21 h (IQR 7-45) vs. 9 h (IQR 3-19);
ratio of means 1.70 (99.17% CI 0.86-3.34); P=0.04]. RIPC does not reduce
hsTNT, AKI, or ICU-support requirements in high-risk cardiac surgery.
&#xa9; 2012 Springer-Verlag.

<70>
Accession Number
362453992
Title
Preoperative insertion of an intra-aortic balloon pump improved the
prognosis of high-risk patients undergoing off-pump coronary artery bypass
grafting.
Source
Journal of International Medical Research. 39 (4) (pp 1163-1168), 2011.
Date of Publication: August 2011.
Author
Shi M.; Huang J.; Pang L.; Wang Y.
Institution
(Shi, Huang, Pang, Wang) Department of Cardiac and Chest Surgery, Huashan
Hospital Affiliated to Fudan University, Shanghai, China
Publisher
SAGE Publications Ltd
Abstract
This study investigated the efficacy and safety of preoperative insertion
of an intra-aortic balloon pump (IABP) in highrisk coronary
atherosclerotic disease patients undergoing off-pump coronary artery
bypass grafting (OPCAB). A total of 232 patients were recruited to the
study, of whom 107 underwent percutaneous insertion of an IABP prior to
OPCAB. The remaining 125 patients underwent OPCAB alone. Pre-, peri- and
postoperative parameters were compared between the two groups.
Preoperative insertion of an IABP was associated with a shorter stay in
intensive care, decreased incidence of postoperative dialysis and acute
heart failure, and a reduction in postoperative mortality compared with
OPCAB alone. There were no between-group differences in terms of
haematocrit level, number of distal anastomoses, volume of postoperative
drainage or incidence of reoperation for bleeding and postoperative
stroke/cerebrovascular accident. In conclusion, preoperative insertion of
an IABP improved the prognosis of high-risk CAD patients undergoing OPCAB.
&#xa9; 2011 Field House Publishing LLP.

<71>
Accession Number
2010468340
Title
Anesthetic protocol for right ventricular dysfunction management in heart
transplantation: systematic review, development and validation.
Source
BMC Anesthesiology. 21 (1) (no pagination), 2021. Article Number: 46. Date
of Publication: December 2021.
Author
Barros L.N.; Uchoa R.B.; Mejia J.A.C.; Nunes R.R.; Barros D.A.S.N.;
Rodrigues Filho F.
Institution
(Barros, Mejia, Rodrigues Filho) State University of Ceara, Fortaleza,
Brazil
(Barros, Uchoa, Mejia, Rodrigues Filho) Dr Carlos Alberto Studart Gomes -
Messejana Hospital, Fortaleza, Brazil
(Barros, Nunes, Barros) Fortaleza General Hospital, Fortaleza, Brazil
(Rodrigues Filho) Professor in Professional Master's in Transplants, State
University of Ceara, Fortaleza, Brazil
Publisher
BioMed Central Ltd
Abstract
Background: Right Ventricular Dysfunction (RVD) is the most frequent
intraoperative hemodynamic complication in Heart Transplantation (HTx).
RVD occurs in 0.04-1.0% of cardiac surgeries with cardiotomy and in 20-50%
of HTx, with mortality up to 75%. No consensus has been established for
how anesthesiologists should manage RVD, with management methods many
times remaining unvalidated. <br/>Method(s): We conducted a systematic
review, following PRISMA guidelines, to create an anesthetic protocol to
manage RVD in HTx, using databases that include PubMed and Embase, until
September 2018 based on inclusion and exclusion criteria. The articles
screening for the systematic review were done two independent reviewers,
in case of discrepancy, we consulted a third independent reviewer. Based
on the systematic review, the anesthetic protocol was developed. The
instrument selected to perform the validation of the protocol was AGREE
II, for this purpose expert anesthetists were recruited to do this
process. The minimum arbitration score for domains validation cutoff of
AGREE II is arbitered to 70%. This study was registered at PROSPERO
(115600). <br/>Result(s): In the systematic review, 152 articles were
included. We present the protocol in a flowchart with six steps based on
goal-directed therapy, invasive monitoring, and transesophageal
echocardiogram. Six experts judged the protocol and validated it.
<br/>Conclusion(s): The protocol has been validated by experts and new
studies are needed to assess its applicability and potential benefits on
major endpoints.<br/>Copyright &#xa9; 2021, The Author(s).

<72>
Accession Number
2007163048
Title
Pre-bypass levosimendan in ventricular dysfunction-effect on right
ventricle.
Source
Asian Cardiovascular and Thoracic Annals. 29 (4) (pp 260-267), 2021. Date
of Publication: May 2021.
Author
Kumar D.; Yadava O.P.; Ahlawat V.; Kundu A.; Yadav A.; Prakash A.
Institution
(Kumar, Yadava, Ahlawat, Kundu, Yadav, Prakash) Department of Cardiac
Surgery, National Heart Institute, New Delhi, India
Publisher
SAGE Publications Inc.
Abstract
Background: Levosimendan is an effective calcium sensitizer with
complementary mechanisms of action: calcium sensitization and opening of
adenosine triphosphate-dependent potassium channels, both on the
sarcolemma of the smooth muscle cells in the vasculature and on the
mitochondria of cardiomyocytes. Levosimendan has a long-acting metabolite
with a half-life of approximately 80 h. There have been a few small
studies on this drug regarding right ventricular function. In view of
this, we investigated the effect of levosimendan on right ventricular
function in patients with coronary artery disease. <br/>Method(s): This
was a prospective, randomized, double-blind study on 50 patients with
coronary artery disease and severe left ventricular dysfunction (left
ventricular ejection fraction <=35%) undergoing elective off-pump coronary
artery bypass. <br/>Result(s): Levosimendan had an inotropic effect on
right ventricular myocardium and a vasodilatory effect on blood vessels.
It caused a decline in pulmonary vascular resistance (p < 0.018), right
ventricular systolic pressure (p < 0.001), and pulmonary artery systolic
pressure (p < 0.001), and improved right ventricular diastolic function as
shown by the decrease in right ventricular Tei index (p < 0.001), right
ventricular end-diastolic pressure, and the ratio of early diastolic
tricuspid inflow to tricuspid lateral annular velocity (p < 0.006).
However, we found no beneficial effects on intensive care unit or hospital
stay (p = 0.164, p = 0.349, respectively) nor a mortality benefit.
<br/>Conclusion(s): Levosimendan has salutary effects on right ventricular
function in patients with severe left ventricular dysfunction undergoing
coronary artery bypass, in terms of improved hemodynamic
parameters.<br/>Copyright &#xa9; The Author(s) 2020.

<73>
Accession Number
2006707404
Title
Temporal trends of bleeding episodes during half-vs. Standard-dose
ticagrelor in acute coronary syndrome patients with low platelet
reactivity: A randomized bleeding-acs trial.
Source
Journal of Clinical Medicine. 10 (6) (pp 1-12), 2021. Article Number:
1159. Date of Publication: 02 Mar 2021.
Author
Kim L.; Choe J.C.; Ahn J.H.; Lee H.W.; Oh J.-H.; Choi J.H.; Lee H.C.; Cha
K.S.; Hong T.J.; Jeong Y.-H.; Park J.S.
Institution
(Kim, Choe, Ahn, Lee, Oh, Choi, Lee, Cha, Hong, Park) Department of
Cardiology and Medical Research Institute, Pusan National University
Hospital, Busan 49241, South Korea
(Jeong) Department of Internal Medicine, Gyeongsang National University
School of Medicine, Jinju 52727, South Korea
(Jeong) Cardiovascular Center, Gyeongsang National University Changwon
Hospital, Changwon 51472, South Korea
Publisher
MDPI AG
Abstract
To assess the temporal trends of bleeding episodes during half-vs.
standard-dose ticagrelor in acute coronary syndrome (ACS) patients with
low platelet reactivity (LPR) during standard-dose ticagrelor (90 mg bid).
ACS Patients with LPR (<85 P2Y<inf>12</inf> reaction units) (n = 122) were
randomly assigned to receive either half-dose (45 mg bid) or standard-dose
ticagrelor (90 mg bid). The primary endpoint was incidence of Bleeding
Academic Research Consortium (BARC) bleeding at 1 week, 1, 3 and 6 months.
Dyspnea and ischemic events were also evaluated. Bleeding episodes were
most commonly observed at 1 month and then decreased over time. Half-dose
ticagrelor did not reduce any BARC bleeding (odds ratio [OR] 0.900, 95%
confidence interval [CI] 0.563-1.440, p = 0.661). However, serious
bleeding (BARC type >=2) occurred less often in half-dose ticagrelor (OR
0.284, 95% CI 0.088-0.921, p = 0.036). The rate of moderate-to-severe
dyspnea was highest at 1 month, then decreased over time. Half-dose
ticagrelor did not decrease moderate-to-severe dyspnea (Borg scale >= 3)
(OR 1.066, 95% CI 0.322-3.530, p = 0.916). The risk of ischemic events was
also similar between the groups. In conclusions, compared with
standard-dose ticagrelor, half-dose ticagrelor reduced serious bleeding
events during early period of dual-antiplatelet therapy in ACS patients
with LPR; however, the risk of any bleeding events and dyspnea did not
differ according to ticagrelor dose. Clinical registration:
KCT0004640.<br/>Copyright &#xa9; 2021 by the authors. Licensee MDPI,
Basel, Switzerland.

<74>
Accession Number
2006052740
Title
Clinical outcomes after transcatheter aortic valve replacement in South
America: A centre-level systematic review and meta-analysis of
observational data.
Source
Journal of Evaluation in Clinical Practice. 27 (4) (pp 785-798), 2021.
Date of Publication: August 2021.
Author
Boissonnet C.P.; Giorgi M.A.; Carosella L.; Brescacin C.; Pissinis J.;
Guetta J.N.
Institution
(Boissonnet, Giorgi, Guetta) Health Economics and Technology Assessment
Unit, Instituto Universitario CEMIC, Centro de Educacion Medica e
Investigaciones Clinicas "Norberto Quirno" (CEMIC), Buenos Aires,
Argentina
(Boissonnet, Giorgi, Guetta) Cardiology Section, Department of Internal
Medicine, Centro de Educacion Medica e Investigaciones Clinicas "Norberto
Quirno" (CEMIC), Buenos Aires, Argentina
(Giorgi) Department of Pharmacology, Instituto Universitario CEMIC, Buenos
Aires, Argentina
(Carosella, Brescacin, Pissinis) Department of Internal Medicine, Centro
de Educacion Medica e Investigaciones Clinicas "Norberto Quirno" (CEMIC),
Buenos Aires, Argentina
Publisher
Blackwell Publishing Ltd
Abstract
Objectives: To estimate in-hospital and 30-day outcomes after
transcatheter aortic valve replacement (TAVR) in South America through a
systematic review and meta-analysis of observational data. <br/>Method(s):
We comprehensively searched for papers published in peer-reviewed medical
journals and for abstracts presented in medical conferences of the region
from 1 September 2008, through 29 June 2020, using predefined criteria. We
included single-centre studies on TAVR populations with >=10 patients from
South America reporting any in-hospital or 30-day clinical outcome.
<br/>Result(s): Fifty-five cohorts from seven countries, pooling 3001
patients, were included in a random-effects meta-analysis. Self-expandable
prostheses were the most frequently implanted. Pooled estimate of
procedure success by VARC2 criteria was 90.0% (95%CI 81.8%-94.7%;
I² 75.0%). The pooled estimate rates of the outcomes were as
follow: post-procedure moderate or severe aortic regurgitation, 9.7%
(95%CI 6.0%-15.4%; I² 65.4%), in-hospital cardiac tamponade,
4.0% (95%CI 2.5%-6.6%; I² 0%), in-hospital stroke, 4.1% (95%CI
2.9%-5.7%; I² 0%), in-hospital major vascular complication,
7.8% (95%CI 5.2%-11.5%; I² 22.3%), in-hospital permanent
pacemaker implantation, 19.4% (95%CI 15.9%-23.4%; I² 53.8%),
in-hospital mortality, 8.0% (95%CI 6.7%-9.6%; I² 0%), and
30-day mortality, 9.7% (95%CI 7.9%-11.8%; I² 26.4%).
<br/>Conclusion(s): As compared with published international registries,
the overall results of TAVR in South America seemed underrated.
Significant heterogeneity was observed in procedural success, pacemaker
requirement, and post-procedure moderate or severe aortic regurgitation.
This study provides a real-life framework for the analysis of the
performance of this technology in the region, intended to be a starting
point for quality improvement.<br/>Copyright &#xa9; 2020 John Wiley & Sons
Ltd

<75>
[Use Link to view the full text]
Accession Number
2007393685
Title
Comparison of external jugular vein-based surface landmark approach and
ultrasound-guided approach for internal jugular venous cannulation: A
randomised crossover clinical trial.
Source
International Journal of Clinical Practice. 75 (3) (no pagination), 2021.
Article Number: e13783. Date of Publication: March 2021.
Author
Vinayagamurugan A.; Badhe A.S.; Jha A.K.
Institution
(Vinayagamurugan, Badhe, Jha) Anesthesiology and Critical Care, Jawaharlal
Institute of Postgraduate Medical Education and Research, Puducherry,
India
Publisher
Blackwell Publishing Ltd
Abstract
Background and objective: Historically, landmark techniques for central
venous access through the internal jugular vein (IJV) have yielded a
lesser success rate and higher complication rate than the ultrasound
(US)-guided approach. The purpose of this study is to assess the success
and safety of a novel external jugular vein (EJV)-based landmark (EJV-LM)
approach compared with the real-time US-guided approach for central venous
access through the IJV. <br/>Method(s): This was a prospective,
randomised, crossover trial performed in patients during elective cardiac
and non-cardiac surgery. Each resident randomly inserted a central venous
catheter using EJV-LM approach and real-time US-guided approach. The
primary outcome was first-attempt success. Secondary outcomes included
overall success rate, number of puncture attempts, cannulation time,
haematoma and mechanical complications. <br/>Result(s): A total of 188
patients were randomly assigned to the EJV-LM and US groups. The
demographic characteristics of the groups were comparable. The
first-attempt success was not different between EJV-LM and US-guided
techniques (79.8%; [95% CI: 70.2-87.4] vs 89.4% [95% CI 81.3-94.8]; P
=.06). The overall success rate was 100% with both techniques. There were
no differences in the number of puncture attempts with introducer needle
(1[1-3] vs 1[1-2]; P =.07). Cannulation time was longer in the EJV-LM
group compared with the US group (58.11 +/- 6.6 vs 44.27 +/- 5.28 seconds;
P =.0001). EJV-LM technique was associated with a higher occurrence of
overall complications compared with the US technique (12.8% [95% CI: 6.7-
21.2] vs 4.2% [95% CI: 1.1-10.5]; P =.03). No major mechanical
complications were observed with either techniques. <br/>Conclusion(s): In
patients with non-distorted neck anatomy and a visible EJV, IJV
catheterisation using the EJV-based LM approach and standard US-guided
technique yielded similar first-attempt and overall success rates.
Cannulation time was longer and complications occurred more frequently in
the EJV-based LM compared with the standard US-guided
technique.<br/>Copyright &#xa9; 2020 John Wiley & Sons Ltd

<76>
Accession Number
2005561487
Title
Stenting techniques for coronary bifurcation lesions: Evidence from a
network meta-analysis of randomized clinical trials.
Source
Catheterization and Cardiovascular Interventions. 97 (3) (pp E306-E318),
2021. Date of Publication: 15 Feb 2021.
Author
Chiabrando J.G.; Lombardi M.; Vescovo G.M.; Wohlford G.F.; Koenig R.A.;
Abbate A.; Guzman L.A.; Berrocal D.H.; Biondi-Zoccai G.
Institution
(Chiabrando, Berrocal) Interventional Cardiology Department, Hospital
Italiano de Buenos Aires, Buenos Aires, Argentina
(Chiabrando, Lombardi, Wohlford, Abbate, Guzman) VCU Pauley Heart Center,
Virginia Commonwealth University, Richmond, VA, United States
(Lombardi) Department of Cardiovascular Sciences, Campus Bio-Medico
University of Rome, Rome, Italy
(Vescovo) Department Cardiac Thoracic, Vascular Sciences and Public
Health, University of Padua, Padua, Italy
(Koenig) Tompkins-McCaw Library for the Health Sciences, VCU Libraries
Virginia Commonwealth University, Richmond, VA, United States
(Biondi-Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) Mediterranea - Cardiocentro, Naples, Italy
Publisher
John Wiley and Sons Inc
Abstract
Objectives: We conducted a systematic review and network meta-analysis of
available randomized clinical trials (RCTs) to compare cardiovascular
outcomes involving stenting techniques in coronary bifurcation lesions.
<br/>Background(s): Although provisional stenting of the main branch and
balloon angioplasty of the side branch is considered the standard
approach, the use of two stents is often pursued with a wide variety of
bifurcation stenting techniques available. <br/>Method(s): We searched
PubMed, Embase, the Cochrane Central Register of Controlled Trials
(CENTRAL), and Clinicaltrials.gov from inception to December 2018. We
performed a frequentist network meta-analysis to estimate relative risks
(RR) of death, major adverse cardiovascular events (MACE), target vessel
revascularization (TVR), target lesion revascularization (TLR), and stent
thrombosis (ST) among different two stent bifurcation techniques.
<br/>Result(s): We identified 14 studies, yielding data on 4,285 patients.
Double Kissing (DK) Crush and Mini-crush were associated with significant
reductions in MACE, TVR, and TLR when compared with the Provisional
stenting (RR 0.31-0.55 [all p <.01] and RR 0.42-0.45 [all p <.02],
respectively) and with the remaining bifurcation techniques (RR 0.44-0.55
[all p <.05] for DK Crush and RR 0.37-0.45 [all p <.05] for Mini-crush).
In addition, Culotte and Crush were associated with an increased risk for
ST compared to Provisional stenting (RR 3.25-4.27 [both p <.05]) and to DK
crush (RR 3.02-3.99 [both p <.05]). <br/>Conclusion(s): DK crush and
mini-crush were found to be associated with fewer events and complications
compared to the other techniques reviewed, including the Provisional
approach. Further, Culotte and Crush were associated with an increased
risk of stent thrombosis when compared to the Provisional
approach.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC.

<77>
Accession Number
634192869
Title
Effect of a Restrictive vs Liberal Blood Transfusion Strategy on Major
Cardiovascular Events among Patients with Acute Myocardial Infarction and
Anemia: The REALITY Randomized Clinical Trial.
Source
JAMA - Journal of the American Medical Association. 325 (6) (pp 552-560),
2021. Date of Publication: 09 Feb 2021.
Author
Ducrocq G.; Gonzalez-Juanatey J.R.; Puymirat E.; Lemesle G.; Cachanado M.;
Durand-Zaleski I.; Arnaiz J.A.; Martinez-Selles M.; Silvain J.; Ariza-Sole
A.; Ferrari E.; Calvo G.; Danchin N.; Avendano-Sola C.; Frenkiel J.;
Rousseau A.; Vicaut E.; Simon T.; Steg P.G.
Institution
(Ducrocq, Steg) Universite de Paris, AP-HP, French Alliance for
Cardiovascular Trials (FACT), INSERM U1148, Paris, France
(Gonzalez-Juanatey) Cardiology Department, University Hospital, IDIS,
CIBERCV, University of Santiago de Compostela, Santiago de Compostela,
Spain
(Puymirat, Danchin) Universite de Paris, AP-HP, Hopital Europeen Georges
Pompidou, French Alliance for Cardiovascular Trials (FACT), Paris, France
(Lemesle) Institut Coeur Poumon, Centre Hospitalier Universitaire de
Lille, Faculte de Medecine de Lille, Universite de Lille, Institut Pasteur
de Lille, Inserm U1011, Lille, France
(Lemesle) French Alliance for Cardiovascular Trials (FACT), Paris, France
(Cachanado, Rousseau, Simon) Department of Clinical Pharmacology and
Clinical Research Platform of the East of Paris, AP-HP, Hopital St
Antoine, Paris, France
(Durand-Zaleski, Frenkiel) AP-HP Health Economics Research Unit, Hotel
Dieu Hospital, INSERM UMR 1153 CRESS, Paris, France
(Arnaiz, Martinez-Selles) Clinical Trials Unit, Clinical Pharmacology
Department, Hospital Clinic, Barcelona, Spain
(Arnaiz, Martinez-Selles) Servicio de Cardiologia, Hospital Universitario
Gregorio Maranon, CIBERCV, Universidad Europea, Universidad Complutense,
Madrid, Spain
(Silvain) Sorbonne Universite, ACTION Study Group, Institut de
Cardiologie, Hopital Pitie-Salpetriere (AP-HP), INSERM UMRS 1166, Paris,
France
(Ariza-Sole) University Hospital Bellvitge, Heart Disease Institute,
Barcelona, Spain
(Ferrari) Universite Cote d'Azur, CHU de Nice, Hopital Pasteur 1, Service
de Cardiologie, Nice, France
(Calvo) Area Del Medicament, Hospital Clinic of Barcelona, University of
Barcelona, Barcelona, Spain
(Avendano-Sola) Clinical Pharmacology Service, Hospital Universitario
Puerta de Hierro-Majadahonda, Madrid, Spain
(Vicaut) AP-HP, Department of Biostatistics, Universite Paris-Diderot,
Sorbonne-Paris Cite, Fernand Widal Hospital, France
(Simon) Department of Clinical Pharmacology-Clinical Research Platform
(URCEST-CRB-CRCEST), AP-HP, Hopital Saint Antoine, French Alliance for
Cardiovascular Trials (FACT), Sorbonne-Universite, Paris, France
(Steg) Royal Brompton Hospital, Imperial College, London, United Kingdom
Publisher
American Medical Association
Abstract
Importance: The optimal transfusion strategy in patients with acute
myocardial infarction and anemia is unclear. <br/>Objective(s): To
determine whether a restrictive transfusion strategy would be clinically
noninferior to a liberal strategy. <br/>Design, Setting, and
Participant(s): Open-label, noninferiority, randomized trial conducted in
35 hospitals in France and Spain including 668 patients with myocardial
infarction and hemoglobin level between 7 and 10 g/dL. Enrollment could be
considered at any time during the index admission for myocardial
infarction. The first participant was enrolled in March 2016 and the last
was enrolled in September 2019. The final 30-day follow-up was accrued in
November 2019. <br/>Intervention(s): Patients were randomly assigned to
undergo a restrictive (transfusion triggered by hemoglobin <=8; n = 342)
or a liberal (transfusion triggered by hemoglobin <=10 g/dL; n = 324)
transfusion strategy. <br/>Main Outcomes and Measures: The primary
clinical outcome was major adverse cardiovascular events (MACE; composite
of all-cause death, stroke, recurrent myocardial infarction, or emergency
revascularization prompted by ischemia) at 30 days. Noninferiority
required that the upper bound of the 1-sided 97.5% CI for the relative
risk of the primary outcome be less than 1.25. The secondary outcomes
included the individual components of the primary outcome. <br/>Result(s):
Among 668 patients who were randomized, 666 patients (median
[interquartile range] age, 77 [69-84] years; 281 [42.2%] women) completed
the 30-day follow-up, including 342 in the restrictive transfusion group
(122 [35.7%] received transfusion; 342 total units of packed red blood
cells transfused) and 324 in the liberal transfusion group (323 [99.7%]
received transfusion; 758 total units transfused). At 30 days, MACE
occurred in 36 patients (11.0% [95% CI, 7.5%-14.6%]) in the restrictive
group and in 45 patients (14.0% [95% CI, 10.0%-17.9%]) in the liberal
group (difference, -3.0% [95% CI, -8.4% to 2.4%]). The relative risk of
the primary outcome was 0.79 (1-sided 97.5% CI, 0.00-1.19), meeting the
prespecified noninferiority criterion. In the restrictive vs liberal
group, all-cause death occurred in 5.6% vs 7.7% of patients, recurrent
myocardial infarction occurred in 2.1% vs 3.1%, emergency
revascularization prompted by ischemia occurred in 1.5% vs 1.9%, and
nonfatal ischemic stroke occurred in 0.6% of patients in both groups.
<br/>Conclusions and Relevance: Among patients with acute myocardial
infarction and anemia, a restrictive compared with a liberal transfusion
strategy resulted in a noninferior rate of MACE after 30 days. However,
the CI included what may be a clinically important harm. Trial
Registration: ClinicalTrials.gov Identifier: NCT02648113.<br/>Copyright
&#xa9; 2021 American Medical Association. All rights reserved.

<78>
Accession Number
2013342302
Title
Novel risk score for predicting recurrence of atrial fibrillation after
the Cryo-Maze procedure.
Source
European Journal of Cardio-thoracic Surgery. 59 (6) (pp 1218-1225), 2021.
Date of Publication: 01 Jun 2021.
Author
Kakuta T.; Fukushima S.; Minami K.; Saito T.; Kawamoto N.; Tadokoro N.;
Ikuta A.; Kobayashi J.; Fujita T.
Institution
(Kakuta, Fukushima, Saito, Kawamoto, Tadokoro, Ikuta, Kobayashi, Fujita)
Department of Cardiovascular Surgery, National Cerebral and Cardiovascular
Research Center, Suita, Osaka, Japan
(Minami) Department of Surgical Intensive Care, National Cerebral and
Cardiovascular Research Center, Suita, Osaka, Japan
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
A predictive model for atrial fibrillation recurrence and the rate of
freedom from atrial fibrillation recurrence by each score OBJECTIVES: This
study aimed to develop a novel risk score model for quantitative
prediction of the rate of atrial fibrillation (AF) recurrence after the
Cryo-Maze procedure in patients with persistent AF. <br/>METHOD(S): We
enrolled 450 consecutive patients who underwent the Cryo-Maze procedure
for persistent AF concomitant with other cardiac procedures in our
institute between 2001 and 2019. We randomly divided the cohort into two
groups. We derived a model in a 'development cohort' (270 patients; 60%)
and validated it in a 'test cohort' (180 patients; 40%) by receiver
operating characteristic curve analysis. <br/>RESULT(S): The median
follow-up was 5.2 (interquartile range: 2.0-9.9) years. The 1-, 5-, 10-
and 15-year rates of freedom from AF recurrence in the entire cohort were
91.4%, 83.5%, 76.2% and 57.1%, respectively. Risk factors for AF
recurrence examined by logistic regression analysis included F-wave
voltage in V1 < 0.2 mV, preoperative AF duration >5 years and left atrial
volume index >100 ml/m2. Points were assigned to each risk factor
according to its odds ratio. A novel risk score model was developed using
these three variables and age, with a range up to 10 points. High score
(>7) predicted high rates of AF recurrence after the Cryo-Maze procedure.
The area under the receiver operating characteristic curve of the novel
risk model score was 0.78 (95% confidence interval: 0.65-0.91) in the test
cohort. <br/>CONCLUSION(S): Use of the Cryo-Maze procedure should be
carefully considered in patients with a higher model score because of a
higher risk of AF recurrence.<br/>Copyright &#xa9; 2021 The Author(s)
2021. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<79>
Accession Number
2010148709
Title
Short-term vs long-term dual antiplatelet therapy after drug-eluting stent
implantation in patients undergoing percutaneous coronary intervention: A
systematic review and meta-analysis.
Source
International Journal of Clinical Practice. 75 (7) (no pagination), 2021.
Article Number: e13938. Date of Publication: July 2021.
Author
Li J.; He K.; Ge J.; Li C.; Jing Z.
Institution
(Li) Department of Chinese pharmacy, Hebei Maternity Hospital, Hebei
Province, Shijiazhuang, China
(He, Ge, Li, Jing) Department of Pharmacy, The Fourth Hospital of
Shijiazhuang, Hebei Province, Shijiazhuang, China
Publisher
Blackwell Publishing Ltd
Abstract
Objective: The optimal duration of dual antiplatelet therapy (DAPT) after
percutaneous coronary intervention (PCI) is under controversial. The aim
of the present systematic review and meta-analysis was to evaluate the
safety and efficacy of short-term (<=6 months) DAPT vs long-term (>=12
months) DAPT after PCI with a drug-eluting stent (DES). <br/>Method(s): We
systematically searched the Cochrane Library, PubMed and Embase databases
to identify randomised controlled trials (RCTs) that compared short-term
(<=6 months) and long-term (>=12 months) DAPT. The endpoints included
major bleeding, any bleeding, death from any cause, cardiac death,
myocardial infarction, stroke, stent thrombosis and target vessel
revascularisation. The primary outcome was major bleeding. A fixed-effects
model was used to calculate the risk ratio (RR) and 95% confidence
interval (CI) of each endpoint. <br/>Result(s): Eighteen trials involving
57,940 patients were included. Compared with long-term DAPT, short-term
DAPT resulted in lower rates of major bleeding [RR 0.75, 95% CI 0.65-0.87,
P =.0002] and any bleeding [RR 0.61, 95% CI 0.54-0.69, P <.00001]. No
significant difference was observed in the outcomes of death from any
cause, cardiac death, myocardial infarction, stroke, stent thrombosis, or
target vessel revascularisation. The subgroup analysis according to
different DAPT durations, mono antiplatelet therapies (MAPTs), countries
and P2Y12 inhibitors produced similar outcomes as comprehensive outcomes.
<br/>Conclusion(s): Compared with long-term DAPT, short-term DAPT did not
increase the risk of ischemic complications but did reduce the risks of
major bleeding and any bleeding by over 25%. This study showed that
short-term DAPT could be considered for most patients after DES
implantation.<br/>Copyright &#xa9; 2020 John Wiley & Sons Ltd

<80>
Accession Number
2010719386
Title
Randomized controlled trial of energy healing effects on pain and anxiety
in AIS posterior surgery: a pilot study.
Source
Spine Deformity. 9 (4) (pp 1029-1034), 2021. Date of Publication: July
2021.
Author
McNeil N.; Bastrom T.P.; Bartley C.E.; Yaszay B.; Upasani V.V.; Newton
P.O.
Institution
(McNeil, Bastrom, Bartley, Yaszay, Upasani, Newton) Rady Children's
Hospital, 3020 Children's Way, MC 5063, San Diego, CA 92123, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objectives: Energy healing (EH) is a part of the diverse group of
Complementary and Alternative Medicines (CAM). The purpose of this study
was to evaluate the effects of EH therapy prior to and following posterior
surgical correction for adolescent idiopathic scoliosis (AIS) compared to
controls. <br/>Method(s): Patients were prospectively randomized to one of
two groups: standard operative care for surgery (controls) vs. standard
care with the addition of three EH sessions. The outcomes included visual
analog scales (VAS) for pain and anxiety (0-10), days until conversion to
oral pain medication, and length of hospital stay. For the experimental
group, VAS was assessed pre- and post-EH session. <br/>Result(s): Fifty
patients were enrolled-28 controls and 22 EH patients. The controls had a
median of 12 levels fused vs. 11 in the EH group (p = 0.04). Pre-operative
thoracic and lumbar curve magnitudes were similar (p > 0.05). Overall VAS
pain scores increased from pre- to post-operative (p < 0.001), whereas the
VAS anxiety scores decreased immediately post-operative (p < 0.001). The
control and pre-EH assessments were statistically similar. Significant
decreases in VAS pain and anxiety scores from pre to post-EH assessment
were noted for the EH group. Both groups transitioned to oral pain
medication a median of 2 days post-operative (p = 0.11). The median days
to discharge was four in the controls and three in the EH group (p =
0.07). <br/>Conclusion(s): In this pilot study, EH therapy resulted in a
decrease in patient's pre-operative anxiety. Offering this CAM modality
may enhance the wellbeing of the patient and their overall recovery when
undergoing posterior surgical correction for AIS. <br/>Level of Evidence:
Therapeutic Level II.<br/>Copyright &#xa9; 2021, Scoliosis Research
Society.

<81>
Accession Number
634396081
Title
Effect of nurse-initiated forced-air warming blanket on the reduction of
hypothermia complications following coronary artery bypass grafting: a
randomized clinical trial.
Source
European journal of cardiovascular nursing : journal of the Working Group
on Cardiovascular Nursing of the European Society of Cardiology. 20 (5)
(pp 445-453), 2021. Date of Publication: 29 Jun 2021.
Author
Bezerra A.S.M.; Santos V.B.; Lopes C.T.; de Barros A.L.B.L.
Institution
(Bezerra, Santos, Lopes, de Barros) Escola Paulista de Enfermagem,
Universidade Federal de Sao Paulo (EPE-UNIFESP), Departamento de
Enfermagem Clinica e Cirurgica and Programa de Pos Graduacao em
Enfermagem, 754 Napoleao de Barros St, Vila Clementino 04024-002, Brazil
(Bezerra) Instituto Dante Pazzanese de Cardiologia (IDPC), Divisao de
Enfermagem. 500 Dr Dante Pazzanese Av 04012-909, Brazil
Publisher
NLM (Medline)
Abstract
AIMS: To evaluate the effect of postoperative forced-air warming (FAW) on
the incidence of excessive bleeding (ExB), arrhythmia, acute myocardial
infarction (AMI), and blood product transfusion in hypothermic patients
following on-pump CABG and compare temperatures associated with the use of
FAW and warming with a sheet and wool blanket. METHODS AND RESULTS: A
randomized clinical trial conducted with 200 patients undergoing isolated
on-pump CABG from January to November 2018. Patients were randomly
assigned into an Intervention Group (IG, FAW, n=100) and Control Group
(CG, sheet and blanket, n=100). The tympanic temperature of all patients
was measured over a 24-h period. ExB was the primary outcome, while
arrhythmia, AMI, and blood product transfusion were secondary outcomes.
The effect of the interventions on the outcomes was investigated through
using bivariate logistic regression, with a level of significance of 5%.
The IG was 79% less likely to experience bleeding than the CG [odds ratio
(OR)=0.21, confidence interval (CI) 95% 0.12-0.39, P<0.001]; the
occurrence of AMI in the IG was 94% lower than that experienced by the CG
(OR=0.06, CI 95% 0.01-0.48, P<0.001); and the IG was also 77% less likely
to experience arrhythmia than the CG (OR=0.23, CI 95% 0.12-0.47, P<0.001);
no difference was found between groups in terms of blood product
transfusion (P<0.279). <br/>CONCLUSION(S): These findings show that FAW
can be used following CABG until patients reach normothermia to avoid
undesirable clinical outcomes. TRIAL REGISTRATION: REBeC
RBR-5t582g.<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.

<82>
Accession Number
633558834
Title
Risk Factors of Postoperative Delirium in Older Adult Spine Surgery
Patients: A Meta-Analysis.
Source
AORN journal. 112 (6) (pp 650-661), 2020. Date of Publication: 01 Dec
2020.
Author
Baek W.; Kim Y.M.; Lee H.
Publisher
NLM (Medline)
Abstract
This literature review identifies factors that may place older adult
patients at risk for developing delirium after spine surgery. We conducted
a meta-analysis according to PRISMA (Preferred Reporting Items for
Systematic Reviews and Meta-Analyses) guidelines. Using a variety of
electronic databases, we identified five studies for inclusion that
represent 645 patients who were 65 years or older. The pooled incidence
rate of postoperative delirium was 13.0%. Factors associated with
developing postoperative delirium included preoperative opioid use,
cervical spine surgery versus lumbar or thoracic spine surgery, spine
fusion versus simple spine surgery, hypertension, cerebrovascular disease,
pulmonary disease, duration of surgery, and infused IV fluid volume.
Nurses who provide perioperative care for older adult patients undergoing
spine surgery should be aware of the potential risk factors of delirium to
ensure patient safety. Further research is required to clearly delineate
the risk factors for postoperative delirium in older adults.<br/>Copyright
&#xa9; AORN, Inc, 2020.

<83>
Accession Number
635487979
Title
Cardioprotective effects of ivabradine after coronary revascularization: A
systematic review.
Source
Circulation. Conference: American Heart Association's Epidemiology and
Prevention/Lifestyle and Cardiometabolic Health 2021 Scientific Sessions.
Virtual. 143 (SUPPL 1) (no pagination), 2021. Date of Publication: May
2021.
Author
Moon J.; Moon H.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The perioperative management of cardiac risk for patients
undergoing coronary revascularization has mostly centered around
beta-blockers (BB). Ivabradine is a much newer drug that has been approved
for stable angina and heart failure not fully controlled by BB. Emerging
evidence suggests that it may have cardioprotective effects in high-risk
cardiac patients. The objective of this study was to summarize the
evidence on the use and effects of ivabradine in coronary
revascularization patients. <br/>Method(s): We performed a systematic
review using the PubMed, EMBASE, and Google Scholar databases for studies
published between 2010 and 2020. Two independent investigators reviewed
studies reporting information on ivabradine use following coronary
revascularization. We excluded articles written in languages other than
English. <br/>Result(s): Eleven studies met our inclusion criteria,
including a total of 3,847 patients (1994 with percutaneous coronary
intervention [51.8%], 1680 with coronary artery bypass graft [43.7%], and
173 with other type of intervention [4.5%]). The studies were from seven
different countries: Egypt, France, Germany, Greece, Italy, Romania, and
Spain. The mean age ranged from 56.5 to 74.3. Males accounted for 70.9% of
the patients, resulting in an M:F ratio of 1.4:1. For studies that
compared the use of ivabradine to placebo/control, the latter being
defined as standard medical therapy that either did or did not include BB,
the results showed that the use of ivabradine resultedin significant
reduction of heart rate, decreased number of angina attacks, lower
nitrateconsumption, improvement in quality of life, and increased cardiac
index. Studies that compared theeffects of ivabradine monotherapy to BB
monotherapy showed that the former was associated with a higher rate of
atrial fibrillation, but an overall better quality of life as measured by
the EuroQolquestionnaire. When combined therapy with ivabradine and BB was
compared to BB monotherapy, the former was associated with a significant
increase in diastolic function, improvement in leftventricular ejection
fraction, and a decrease in incidence of arrhythmias. Eight of the eleven
studiesreported adverse events related to ivabradine use, the most
frequent being bradycardia (range: 0 to7.1%), phosphenes (range: 0 to
0.3%), and blurred vision (range: 0 to 0.2%). <br/>Conclusion(s): This
study demonstrates that ivabradine may be used alone or in addition to BB
toreduce adverse cardiac events and improve the quality of life in
patients undergoing coronaryrevascularization. However, there is no
evidence that ivabradine is superior to BB when used alone.Further studies
are needed to determine the optimal medical management for patients
undergoingcoronary revascularization.

<84>
Accession Number
635487953
Title
Hospital readmission after pediatric congenital heart surgery: A
systematic review and metaanalysis of potential risk factors.
Source
Circulation. Conference: American Heart Association's Epidemiology and
Prevention/Lifestyle and Cardiometabolic Health 2021 Scientific Sessions.
Virtual. 143 (SUPPL 1) (no pagination), 2021. Date of Publication: May
2021.
Author
Stabler M.E.; Parker D.M.; Kothari S.; Dalmage M.; Johnson H.; Morgan M.;
Brown J.R.
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: Over 40,000 infants are born annually with a heart defect; 25%
require surgery and of those 20% result in hospital readmissions. We
sought to identify risk factors for short-and long-term readmission
following pediatric congenital heart surgery (CHS) to reduce avoidable
future admissions. <br/>Method(s): A systematic approach was used to
search four electronic databases and retrieve articles published through
05/2020. We included observational and experimental studies that observed
factors associated with 30-day or 1-year readmission after CHS. Studies
with a composite outcome of readmission and death were excluded. For each
independent risk factor, we assessed the pooled effect size and
heterogeneity using a random-effects model. Risk of bias was assessed via
the Newcastle-Ottawa scale. <br/>Result(s): After removing 970 duplicates,
we screened 5,084 studies; 17 were included in the systematic review and
15 (N= 82,794; 9,856 readmitted) in the meta-analysis. Hospital
readmission was significantly and positively associated with gestational
age, non-white race, Hispanic ethnicity, government insurance, genetic
abnormality, renal dysfunction, failure to thrive, mechanical ventilation,
intraoperative ventricular dysfunction, RACHS score, STAT mortality score,
cross clamptime, gastroesophageal reflux disease, postoperative
arrhythmia, valve regurgitation, feedingdifficulties, and ICU and hospital
length of stay (LOS). Readmission definition (i.e., 1-yr vs 30-day)and LOS
dichotomization (i.e., >= 10 or >= 14) resulted in significant subgroup
differences for age atsurgery and LOS. Five studies had higher potential
for risk of bias. <br/>Conclusion(s): This is the first meta-analysis to
identify patient and clinical factors associated with short and long-term
readmission after pediatric CHS. Findings may support clinical decisions
beforeundergoing surgery and identify patients that may benefit from
receiving more aggressive caretransitions prior to discharge to reduce
avoidable hospital readmissions.

<85>
Accession Number
635486376
Title
Functional outcomes associated with physical rehabilitation in lung
transplant candidates: A systematic review and meta-analysis.
Source
Cardiopulmonary Physical Therapy Journal. Conference: Combined Sections
Meeting of the American Physical Therapy Association, CSM 2021. Virtual.
32 (3) (pp e5), 2021. Date of Publication: July 2021.
Author
Luzar B.; Fylstra J.; Quigg S.; McLaughlin J.; Buck K.A.; Weinhold J.;
Snyder L.D.; Byrd R.K.; Smith P.J.; Pastva A.M.
Publisher
Lippincott Williams and Wilkins
Abstract
PURPOSE/HYPOTHESIS: Lung transplantation is a treatment option for select
patients with end-stage lung disease. Pre-transplant physical capacity
predicts transplant eligibility, waitlist survival, and post-transplant
physical capacity.1,2 A 2016 expert review statement and a 2017 systematic
review concluded that pre-transplant rehabilitation is associated with
improvements in physical capacity and QOL; however, these conclusions were
based on limited studies and to-date, pre-transplant physical
rehabilitation is not yet the standard of care.3-5 The purpose of this
study is to identify different types of physical rehabilitation programs
(aerobic, resistance, or combined) and evaluate their impact on
patientcentered and clinically-important functional outcomes [physical
capacity, quality of life (QOL)] in transplant candidates. NUMBER OF
SUBJECTS: Total of 1,633 lung transplant candidates (mean age 50.9, 50%
male) across 12 studies. MATERIALS AND METHODS: Studies were identified by
searching MEDLINE, CINAHL, Cochrane, Web of Science, EMBASE, and PsycINFO
from 1968-2019. Included studies met the following criteria: adult
patients awaiting either single or double lung transplant and
participating in a structured exercise program. Studies were excluded if
they were case reports or only included cystic fibrosis, heart-lung
transplantation, re-transplantation, or lung resections. Two investigators
independently extracted data (study design, participant characteristics,
rehabilitation protocols, and outcomes) and assessed methodological
quality using a Modified Downs and Black'sQuality Checklist (MDB) for all
studies and the Physiotherapy Evidence Database (PEDro) for randomized
controlled trials.6-8 RESULTS: Of 775 identified, 12 studies were included
in the review and meta-analysis. ThemeanMDB score was 17.9+/-2.7/27 (range
14-23/27) and themean PEDro score was 8+/-1.4/11 (range 6-9/11). Using
random-effect modeling, the meta-analysis showed that pre-transplant
physical rehabilitation had a medium positive effect on physical capacity
as measured by Six-Minute Walk Distance, 6MWD, (Hedges g 5 0.422+/-0.180,
with 95% CI: 0.242, 0.602, P<0.0001) and a small positive effect on
physical (Hedges g 5 0.226+/-0.115, with 95% CI: 0.111, 0.341, P<0.001)
and mental QOL (Hedges g = 0.174, +/-0.129, with 95% CI: 0.044, 0.303, P =
0.009). The average increase in 6MWD was 75meters and 11/12 studies
exceeded the 6MWD MCID of 26 m.9 All studies included aerobic training and
eight included resistance training; parameters (mode, duration, frequency)
were highly variable. <br/>CONCLUSION(S): Evidence supports the use of
pre-transplant physical rehabilitation to improve physical capacity and
QOL. Further studies are needed to establish recommendations for protocol
parameters that optimize functional outcomes. CLINICAL RELEVANCE: Evidence
is growing that physical rehabilitation favorably impacts physical
capacity and QOL in lung transplant candidates. Given that transplant
candidates generally have poor fitness, the average 3.6 month
pre-transplant waiting period presents an opportunity to implement a
physical rehabilitation program.2,10.

<86>
Accession Number
2007825121
Title
Surgical aortic mitral curtain replacement: Systematic review and
metanalysis of early and long-term results.
Source
Journal of Clinical Medicine. 10 (14) (no pagination), 2021. Article
Number: 3163. Date of Publication: 02 Jul 2021.
Author
Giambuzzi I.; Bonalumi G.; Di Mauro M.; Roberto M.; Corona S.; Alamanni
F.; Zanobini M.
Institution
(Giambuzzi, Bonalumi, Roberto, Corona, Alamanni, Zanobini) IRCCS Centro
Cardiologico Monzino, Department of Cardiovascular Surgery, Milan 20100,
Italy
(Giambuzzi, Corona, Alamanni) DISCCO Department, University of Milan,
Milan 20100, Italy
(Di Mauro) Heart and Vascular Centre, Cardio-Thoracic Surgery Unit,
Maastricht University Medical Centre (MUMC), 9 Cardiovascular Research
Institute Maastricht (CARIM), Maastricht 6221, Netherlands
Publisher
MDPI AG
Abstract
The Commando procedure is challenging, and aims to replace the mitral
valve, the aortic valve and the aortic mitral curtain, when the latter is
severely affected by pathological processes (such as infective
endocarditis or massive calcification). Given the high complexity, it is
seldomly performed. We aim to review the literature on early
(hospitalization and up to 30 days) and long-term (at least 3 years of
follow-up) results. Bibliographical research was performed on PubMed and
Cochrane with a dedicated string. Papers regarding double valve
replacement or repair in the con-text of aortic mitral curtain disease
were included. The metaprop function was used to assess early survival and
complications (pacemaker implantation, stroke and bleeding). Nine papers
(540 pa-tients, median follow-up 41 (IQR 24.5-51.5) months) were included
in the study. Pooled proportion of early mortality, stroke, pacemaker
implant and REDO for bleeding were, respectively 16.2%, 7.8%, 25.1% and
13.1%. The long-term survival rate ranged from 50% to 92.2%. Freedom from
re-intervention was as high as 90.9% when the endocarditis was not the
first etiology and 78.6% in case of valvular infection (one author had
100%). Freedom from IE recurrences reached 85% at 10 years. Despite the
high mortality, the rates of re-intervention and infective endocarditis
recurrences following the Commando procedure are satisfactory and confirm
the need for an aggressive strategy to improve long-term
outcomes.<br/>Copyright &#xa9; 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<87>
Accession Number
2013491464
Title
2-Year Outcomes for Transcatheter Repair in Patients With Mitral
Regurgitation From the CLASP Study.
Source
JACC: Cardiovascular Interventions. 14 (14) (pp 1538-1548), 2021. Date of
Publication: 26 Jul 2021.
Author
Szerlip M.; Spargias K.S.; Makkar R.; Kar S.; Kipperman R.M.; O'Neill
W.W.; Ng M.K.C.; Smith R.L.; Fam N.P.; Rinaldi M.J.; Raffel O.C.; Walters
D.L.; Levisay J.; Montorfano M.; Latib A.; Carroll J.D.; Nickenig G.;
Windecker S.; Marcoff L.; Cohen G.N.; Schafer U.; Webb J.G.; Lim D.S.
Institution
(Szerlip, Smith) Department of Cardiology, Baylor Scott and White The
Heart Hospital Plano, Plano, TX, United States
(Spargias) Department of Cardiology, Hygeia Hospital, Athens, Greece
(Makkar) Department of Interventional Cardiology, Cedars-Sinai Medical
Center, Los Angeles, CA, United States
(Kar) Department of Cardiology, Los Robles Regional Medical Center,
Thousand Oaks, CA, United States
(Kipperman, Marcoff) Department of Cardiology, Atlantic Health System
Morristown Medical Center, Morristown, NJ, United States
(O'Neill) Department of Cardiology, Henry Ford Hospital, Detroit, MI,
United States
(Ng) Department of Interventional Cardiology, Royal Prince Alfred
Hospital, Camperdown, New South Wales, Australia
(Fam) Department of Cardiology, St. Michael's Hospital, Toronto, ON,
Canada
(Rinaldi) Department of Interventional Cardiology, Sanger Heart and
Vascular Institute, Charlotte, NC, United States
(Raffel, Walters) Department of Interventional Cardiology, The Prince
Charles Hospital, Chermside, Queensland, Australia
(Levisay) Department of Interventional Cardiology, NorthShore University
Health System, Evanston Hospital, Evanston, IL, United States
(Montorfano) Department of Interventional Cardiology, San Raffaele
Institute, Milan, Italy
(Latib) Department of Interventional Cardiology, Montefiore Medical
Center, Bronx, NY, United States
(Carroll) Department of Interventional Cardiology, University of Colorado,
Aurora, CO, United States
(Nickenig) Department of Internal Medicine, University Hospital Bonn,
Bonn, Germany
(Windecker) Department of Cardiology, Bern University Hospital, Bern,
Switzerland
(Cohen) Department of Cardiac Surgery, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Schafer) Department of Internal Medicine, Marienkrankenhaus, Hamburg,
Germany
(Webb) Department of Interventional Cardiology, St. Paul's Hospital,
Vancouver, BC, Canada
(Lim) Department of Cardiovascular Medicine, University of Virginia Health
System Hospital, Charlottesville, VA, United States
Publisher
Elsevier Inc.
Abstract
Objectives: This study reports 2-year outcomes from the multicenter,
prospective, single-arm CLASP study with functional mitral regurgitation
(FMR) and degenerative MR (DMR) analysis. <br/>Background(s):
Transcatheter repair is a favorable option to treat MR. Long-term
prognostic impact of the PASCAL transcatheter valve repair system in
patients with clinically significant MR remains to be established.
<br/>Method(s): Patients had clinically significant MR >=3+ as evaluated
by the echocardiographic core laboratory and were deemed candidates for
transcatheter repair by the heart team. Assessments were performed by
clinical events committee to 1 year (site-reported thereafter) and core
laboratory to 2 years. <br/>Result(s): A total of 124 patients (69% FMR,
31% DMR) were enrolled with a mean age of 75 years, 56% were male, 60%
were New York Heart Association functional class III to IVa, and 100% had
MR >=3+. At 2 years, Kaplan-Meier estimates showed 80% survival (72% FMR,
94% DMR) and 84% freedom from heart failure (HF) hospitalization (78% FMR,
97% DMR), with 85% reduction in annualized HF hospitalization rate (81%
FMR, 98% DMR). MR <=1+ was achieved in 78% of patients (84% FMR, 71% DMR)
and MR <=2+ was achieved in 97% (95% FMR, 100% DMR) (all p < 0.001). Left
ventricular end-diastolic volume decreased by 33 ml (p < 0.001); 93% of
patients were in New York Heart Association functional class I to II (p <
0.001). <br/>Conclusion(s): The PASCAL repair system demonstrated
sustained favorable outcomes at 2 years in FMR and DMR patients. Results
showed high survival and freedom from HF rehospitalization rates with a
significantly reduced annualized HF hospitalization rate. Durable MR
reduction was achieved with evidence of left ventricular reverse
remodeling and significant improvement in functional status. The CLASP
IID/IIF randomized pivotal trial is ongoing.<br/>Copyright &#xa9; 2021
American College of Cardiology Foundation

<88>
Accession Number
2013491396
Title
Postoperative Atrial Fibrillation or Flutter Following Transcatheter or
Surgical Aortic Valve Replacement: PARTNER 3 Trial.
Source
JACC: Cardiovascular Interventions. 14 (14) (pp 1565-1574), 2021. Date of
Publication: 26 Jul 2021.
Author
Shahim B.; Malaisrie S.C.; George I.; Thourani V.H.; Biviano A.B.; Russo
M.; Brown D.L.; Babaliaros V.; Guyton R.A.; Kodali S.K.; Nazif T.M.;
Kapadia S.; Pibarot P.; McCabe J.M.; Williams M.; Genereux P.; Lu M.; Yu
X.; Alu M.; Webb J.G.; Mack M.J.; Leon M.B.; Kosmidou I.
Institution
(Shahim, Alu, Leon, Kosmidou) Cardiovascular Research Foundation, New
York, NY, United States
(Malaisrie) Division of Cardiac Surgery, Northwestern University, Chicago,
IL, United States
(George, Biviano, Kodali, Nazif, Alu, Leon, Kosmidou) NewYork-Presbyterian
Hospital/Columbia University Irving Medical Center, New York, NY, United
States
(Thourani) Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta,
GA, United States
(Russo) Division of Cardiac Surgery, Rutgers-Robert Wood Johnson Medical
School, New Brunswick, NJ, United States
(Brown, Mack) Baylor Scott & White Health, Plano, TX, United States
(Babaliaros, Guyton) Emory University Medical Center, Atlanta, GA, United
States
(Kapadia) Cleveland Clinic, Cleveland, OH, United States
(Pibarot) Quebec Heart and Lung Institute, Laval University, Quebec, QC,
Canada
(McCabe) University of Washington, Seattle, WA, United States
(Williams) NYU Langone Medical Center, New York, NY, United States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Lu, Yu) Edwards Lifesciences, Irvine, CA, United States
(Webb) St. Paul's Hospital, Vancouver, BC, Canada
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to assess the incidence and
prognostic impact of early and late postoperative atrial fibrillation or
flutter (POAF) in patients with severe aortic stenosis (AS) treated with
transcatheter aortic valve replacement (TAVR) or surgical aortic valve
replacement (SAVR). <br/>Background(s): There is an ongoing controversy
regarding the incidence, recurrence rate, and prognostic impact of early
(in-hospital) POAF and late (postdischarge) POAF in patients with AS
undergoing TAVR or SAVR. <br/>Method(s): In the PARTNER (Placement of
Aortic Transcatheter Valve) 3 trial, patients with severe AS at low
surgical risk were randomized to TAVR or SAVR. Analyses were performed in
the as-treated population excluding patients with preexistent atrial
fibrillation or flutter. <br/>Result(s): Among 781 patients included in
the analysis, early POAF occurred in 152 (19.5%) (18 of 415 [4.3%] and 134
of 366 [36.6%] following TAVR and SAVR, respectively). Following
discharge, 58 new or recurrent late POAF events occurred within 1 year
following the index procedure in 55 of 781 patients (7.0%). Early POAF was
not an independent predictor of late POAF following discharge (odds ratio:
1.04; 95% CI: 0.52-2.08; P = 0.90). Following adjustment, early POAF was
not an independent predictor of the composite outcome of death, stroke, or
rehospitalization (hazard ratio: 1.10; 95% CI: 0.64-1.92; P = 0.72),
whereas late POAF was associated with an increased adjusted risk for the
composite outcome (hazard ratio: 8.90; 95% CI: 5.02-15.74; P < 0.0001),
irrespective of treatment modality. <br/>Conclusion(s): In the PARTNER 3
trial, early POAF was more frequent following SAVR compared with TAVR.
Late POAF, but not early POAF, was significantly associated with worse
outcomes at 2 years, irrespective of treatment modality.<br/>Copyright
&#xa9; 2021 The Authors

<89>
Accession Number
2013380040
Title
Preoperative inflammatory mediators and postoperative delirium: systematic
review and meta-analysis.
Source
British Journal of Anaesthesia. (no pagination), 2021. Date of
Publication: 2021.
Author
Noah A.M.; Almghairbi D.; Evley R.; Moppett I.K.
Institution
(Noah, Almghairbi, Evley, Moppett) Anaesthesia and Critical Care, Academic
Unit of Injury, Inflammation and Recovery Science, University of
Nottingham, Nottingham, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: Postoperative delirium has eluded attempts to define its
complex aetiology and describe specific risk factors. The role of
neuroinflammation as a risk factor, determined by measuring blood levels
of preoperative 'innate' inflammatory mediator levels, has been
investigated. However, results have been conflicting. We conducted a
systematic review and meta-analysis of the evidence on associations
between preoperative blood levels of inflammatory mediators and
postoperative delirium in the older person. Influence of type of surgery
was also assessed. <br/>Method(s): Original, low risk of bias studies,
published in peer-reviewed journals, which fulfilled the eligibility
criteria were included. Seventeen articles fulfilled study criteria. Data
extraction, synthesis, and risk of bias analysis were guided by Preferred
Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and
quality in prognostic studies guidelines. Meta-analyses used a
random-effects model. Inflammatory mediators included C-reactive protein,
interleukin-6, -8, and -10, tumour necrosis factor-alpha, insulin-like
growth factor-1, cortisol, and neopterin. Surgical groups were cardiac,
noncardiac, and hip fracture. <br/>Result(s): Higher preoperative
interleukin-6 was associated with postoperative delirium with a
standardised mean difference (95% confidence interval) of 0.33 (0.11-0.56)
and P=0.003. Higher neopterin was also associated with postoperative
delirium. <br/>Conclusion(s): The association of preoperative blood levels
of inflammatory mediators with postoperative delirium may be influenced by
the type of surgery and the specific mediator. The potential modulating
effect of type of surgery, intrinsic brain vulnerability, and the complex
interactions between inflammatory mediators and binding proteins will need
to be considered in future studies. Clinical trial registration:
CRD42019159471 (PROSPERO).<br/>Copyright &#xa9; 2021 British Journal of
Anaesthesia

<90>
Accession Number
2013137603
Title
Aortic valve myxoma-A systematic review of published cases.
Source
International Journal of Clinical Practice. (no pagination), 2021. Date of
Publication: 2021.
Author
Sachdeva S.; Desai R.; Shamim S.; Gandhi Z.; Shrivastava A.; Patel D.;
Uzair Lodhi M.; Raina J.; Itare V.; Mahmood A.; Sachdeva R.; Kumar G.
Institution
(Sachdeva) Section of Cardiovascular Medicine, Department of Medicine,
Boston University School of Medicine, MA, United States
(Desai, Sachdeva, Kumar) Division of Cardiology, Atlanta VA Medical
Center, Decatur, GA, United States
(Shamim) Internal Medicine, AIM Medical Center, Snellville, GA, United
States
(Gandhi) Department of Medicine, C.U. Shah Medical College, Surendranagar,
Gujarat, India
(Shrivastava) Department of Pediatrics, Children's Hospital of
Michigan/Detroit Medical Center, Detroit, MI, United States
(Patel) Department of Internal Medicine, Texas Tech University Health
Sciences Center El Paso, El Paso, TX, United States
(Uzair Lodhi, Mahmood) Department of Internal Medicine, Eastern Idaho
Regional Medical Center, Idaho Falls, ID, United States
(Raina, Itare) Department of Internal Medicine, Brookdale University
Hospital and Medical Center, New York, NY, United States
(Kumar) Division of Cardiology, Emory University School of Medicine,
Atlanta, GA, United States
Publisher
Blackwell Publishing Ltd
Abstract
Background: Aortic valve myxoma is the rarest location of the most common
primary tumour of cardiac origin. Because of the paucity of data, there is
little known about their clinical presentation, diagnosis and
complications. <br/>Method(s): PUBMED, EMBASE, SCOPUS and WEB OF SCIENCE
were systematically searched to identify all published cases of aortic
valve myxoma through October 2020. Descriptive statistics were used to
report the data. <br/>Result(s): Aortic valve myxomas were more prevalent
in young (mean age 41 years) male (75%) patients. It most commonly
involved the right coronary cusp (50%). Cerebrovascular events (25%),
dyspnoea (18.8%), and distal embolisation (18.8%) were found to be the
most frequent complications. Echocardiography remains the diagnostic
modality of choice in all cases, histopathology is used for confirmation.
Most cases were treated with surgical excision (94%); concomitant aortic
valve repair and mechanical aortic valve replacement were performed in 25%
and 37.5% cases respectively. Sudden cardiac death was noted in one
patient. <br/>Conclusion(s): Aortic valve myxomas are more often than not
discovered in the context of embolic phenomenon or dyspnoea. The most
feared complication is stroke, although mortality remains low in
surgically managed cases.<br/>Copyright &#xa9; 2021 John Wiley & Sons Ltd

<91>
Accession Number
635492769
Title
Unique Challenges of Randomized Controlled Trials in Pediatric Cardiology.
Source
The Canadian journal of cardiology. (no pagination), 2021. Date of
Publication: 26 Jun 2021.
Author
Harris K.C.; Mackie A.S.; Dallaire F.; Khoury M.; Singer J.; Mahle W.T.;
Klassen T.P.; McCrindle B.W.
Institution
(Harris) Children's Heart Centre, BC Children's Hospital & University of
British Columbia, Vancouver, Canada
(Mackie, Khoury) Division of Pediatric Cardiology, Department of
Pediatrics Stollery Children's Hospital, University of Alberta, AB,
Edmonton, Canada
(Dallaire) Division of Pediatric Cardiology, Department of Pediatrics,
Sherbrooke University, QC, Sherbrooke, Canada
(Singer) School of Population and Public Health, University of British
Columbia, Vancouver, Canada
(Mahle) Division of Pediatric Cardiology, Emory University, Atlanta,
United States
(Klassen) Children's Hospital Research Institute of Manitoba and
Department of Pediatrics, University of Manitoba, MB, Winnipeg, Canada
(McCrindle) Labatt Family Heart Centre, Hospital for Sick Children &
University of Toronto, ON, Toronto, Canada
Publisher
NLM (Medline)
Abstract
Pediatric cardiology has evolved over time with reductions in childhood
mortality due to congenital heart disease. Surgical innovation drove early
changes in care. Increasingly, the need for more robust evidence provided
by randomized controlled trials (RCTs) has been recognized. While the
number of RCTs increased, there remains a relative paucity of truly
impactful trials in the field. However, those trials that have changed
practice have demonstrated the potential and importance of this work.
Examples include the PRIMACORP trial, which established the safety and
efficacy of milrinone after cardiac surgery, and the Single Ventricle
Reconstruction trial, which was the first multicentre pediatric cardiac
surgical RCT. The successful conduct and important findings emanating from
these trials serve as a beacon as clinicians strive to improve the
evidence base in this field. The establishment of national and
international networks such as the Pediatric Heart Network and the
Canadian Pediatric Cardiology Research Network provide a strong foundation
for future collaborative work. Despite this progress, there remain
important challenges to designing and executing RCTs in pediatric
cardiology. These include issues of greater disease and patient
heterogeneity and increased costs. The use of innovative study designs and
analytic methods, and the establishment of core outcome measures have the
potential to overcome some of the issues related to the smaller patient
numbers relative to adult disciplines. As pediatric cardiologists look to
the future, it is imperative that we work together to derive the maximum
benefit from the considerable efforts directed towards conducting
impactful clinical trials in pediatric cardiology.<br/>Copyright &#xa9;
2021. Published by Elsevier Inc.

<92>
Accession Number
616464043
Title
Improvement of Subjective Well-Being by Ranolazine in Patients with
Chronic Angina and Known Myocardial Ischemia (IMWELL Study).
Source
Cardiology and Therapy. 6 (1) (pp 81-88), 2017. Date of Publication: 01
Jun 2017.
Author
Bavry A.A.; Park K.E.; Choi C.Y.; Mahmoud A.N.; Wen X.; Elgendy I.Y.
Institution
(Bavry, Park, Choi, Mahmoud, Wen, Elgendy) Department of Medicine,
University of Florida, Gainesville, FL, United States
(Bavry, Park, Choi) North Florida/South Georgia Veterans Health System,
Gainesville, FL, United States
(Wen) Health Outcomes, College of Pharmacy, University of Rhode Island,
Kingston, RI, United States
Publisher
Springer Healthcare
Abstract
Introduction: We aimed to assess if ranolazine would improve angina
symptoms among patients with documented myocardial ischemia.
<br/>Method(s): Eligible subjects had chronic stable angina and at least
one coronary stenosis with fractional flow reserve (FFR) <=0.80 or at
least one chronic total occlusion (CTO) without attempted
revascularization. Subjects were randomized to oral ranolazine 500 mg
twice daily for 1 week, then ranolazine 1000 mg twice daily for 15 weeks
versus matching placebo. The primary end point was change in angina at 16
weeks as assessed by the Seattle Angina Questionnaire (SAQ).
<br/>Result(s): Between September 2014 and January 2016, 25 subjects were
randomized to ranolazine versus 25 to placebo. The most common reason for
eligibility was CTO (72%), while the remainder had myocardial ischemia
documented by low FFR. The mean FFR was 0.57 +/- 0.12. Sixty-eight percent
of subjects were on two or more anti-angina medications at baseline. Study
medication was discontinued in 32% (eight of 25) of the ranolazine group
versus 36% (nine of 25) of the placebo group. By intention-to-treat, 46
subjects had baseline and follow-up SAQ data completed. Ranolazine was not
associated with an improvement in angina compared with placebo at 16
weeks. The results were similar among 33 subjects that completed study
medication. The incidence of ischemia-driven hospitalization or
catheterization was 12% (three of 25) of the ranolazine group versus 20%
(five of 25) in the placebo group (p > 0.05). <br/>Conclusion(s): In
subjects with chronic stable angina and documented myocardial ischemia,
ranolazine did not improve angina symptoms at 16 weeks. <br/>Funding(s):
Gilead. Clinical trial registration: The study was registered at
ClinicalTrials.gov (NCT02265796).<br/>Copyright &#xa9; 2016, The
Author(s).

<93>
Accession Number
607093676
Title
Is salvage surgery for recurrent non-small-cell lung cancer after
definitive non-operative therapy associated with reasonable survival?.
Source
Interactive Cardiovascular and Thoracic Surgery. 21 (5) (pp 682-684),
2015. Date of Publication: November 2015.
Author
Schreiner W.; Dudek W.; Sirbu H.
Institution
(Schreiner, Dudek, Sirbu) Department of Thoracic Surgery, University
Hospital Erlangen, Erlangen, Germany
Publisher
Oxford University Press
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was whether salvage pulmonary
resection is possible and worthwhile for patients with recurrence of
non-small-cell lung cancer (NSCLC) after prior definitive non-operative
therapy. A total of nine reports were identified using the reported
search, of which four represented the best available 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. All studies were retrospective. In
total, 48 pulmonary salvage resections were performed in 47 patients after
prior definitive radiation, chemoradiation or stereotactic body radiation
therapy, of which 28 were lobectomies (including 1 sleeve lobectomy), 12
pneumonectomies, 4 bilobectomies and 4 sublobar resections (2
segmentectomies and 2 wedge resections). Postoperative complications
ranged from 0 to 58% (mean from four studies 42.5%). Only one study
reported any mortality (4%), the other three had zero mortality. Median
postoperative survival was reported in two studies and ranged from 9 to 30
months. Experience with salvage lung resection for locally recurrent
NSCLC, after prior definitive non-surgical treatment, remains limited.
Therefore, this analysis was based on only 48 resections in 47 patients
from four retrospective studies. Nevertheless, the published data suggest
that salvage lung surgery for recurrent, previously non-operatively
managed non-small-cell lung cancer is a worthwhile treatment option with
good survival, acceptable morbidity and low mortality.<br/>Copyright
&#xa9; The Author 2015. Published by Oxford University Press on behalf of
the European Association for Cardio-Thoracic Surgery. All rights reserved.

<94>
Accession Number
52412681
Title
Stem cell therapy: Promising treatment in heart failure?.
Source
Current Heart Failure Reports. 10 (1) (pp 73-80), 2013. Date of
Publication: March 2013.
Author
Loughran J.H.; Chugh A.R.; Ismail I.; Bolli R.
Institution
(Loughran, Chugh, Bolli) Division of Cardiovascular Medicine, University
of Louisville, ACB Bldg, 550 S Jackson Street, Louisville KY 40202, United
States
(Ismail) School of Medicine, University of Louisville, Louisville KY,
United States
Publisher
Current Science Inc.
Abstract
Cardiac repair through the use of regenerative medicine has been a
considerable research focus over the last decade. Several stem cell types
have been investigated over this timeframe as potential candidates to
target post-infarction heart failure. The progression of investigation
through the rigors of clinical trial design has provided some answers as
to the potential clinical utility of this therapy; although there are many
questions that remain. This review will concentrate on the clinical trial
results of stem cell therapy for cardiac repair since the turn of the
century and discuss some of the points that need clarification before this
form of therapy can be considered for widespread applicability. &#xa9;
2013 Springer Science+Business Media New York.

<95>
Accession Number
2005604918
Title
Safety and efficacy of minimum-or zero-contrast ivus-guided percutaneous
coronary interventions in chronic kidney disease patients: A systematic
review.
Source
Journal of Clinical Medicine. 10 (9) (no pagination), 2021. Article
Number: 1996. Date of Publication: 01 May 2021.
Author
Burlacu A.; Tinica G.; Brinza C.; Crisan-Dabija R.; Popa I.V.; Covic A.
Institution
(Burlacu, Tinica, Brinza) Institute of Cardiovascular Diseases "Prof. Dr.
George I.M. Georgescu", Iasi 700503, Romania
(Burlacu, Tinica, Crisan-Dabija, Popa, Covic) Faculty of Medicine,
University of Medicine and Pharmacy "Grigore T Popa", Iasi 700115, Romania
(Burlacu, Covic) Medical Sciences Academy, Bucharest 030167, Romania
(Crisan-Dabija) Pulmonology Department, Clinic of Pulmonary Diseases, Iasi
700115, Romania
(Covic) Nephrology Clinic, Dialysis, Renal Transplant Center, C.I. Parhon"
University Hospital, Iasi 700503, Romania
Publisher
MDPI AG
Abstract
Conventional percutaneous coronary interventions (PCIs) frequently cause
severe complications in chronic kidney disease (CKD) patients. Low-to-zero
contrast intravascular ultrasound (IVUS) guided PCIs are promising
alternatives in the CKD setting. We aim to systematically review
up-to-date literature that have reported data and outcomes of low-to-zero
contrast PCIs performed in CKD patients. We searched Embase, PubMed, and
Cochrane databases for full-text articles that reported original data
regarding efficacy and/or safety outcomes of IVUSguided PCIs in patients
with CKD. The quality of non-randomized trials included was assessed using
the Newcastle-Ottawa scale. Six papers were included in the present
systematic review: One non-randomized trial, two case series, and three
case reports. Given the literature reported so far, contrast-free and
IVUS-guided PCI procedures in patients with CKD appear to be safe (both in
cardiac and renal outcomes) with a comparable efficacy to the conventional
procedure, even in complex atherosclerotic lesions. No patient included in
the mentioned studies showed renal function deterioration and did not need
renal replacement therapy after the zero-contrast IVUSguided percutaneous
procedures. From a cardiovascular point of view, this technique proved to
be safe in terms of cardiovascular outcomes. The undesirable consequences
of conventional PCI in the CKD population might soon be effectively
hampered by safer low-to-zero contrast IVUS-guided PCI procedures after a
mandatory and rigorous evidence-based validation in long-awaited
randomized controlled trials.<br/>Copyright &#xa9; 2021 by the authors.
Licensee MDPI, Basel, Switzerland.

<96>
Accession Number
634902245
Title
Association of 1-Year Blood Pressure Variability with Long-term Mortality
among Adults with Coronary Artery Disease: A Post Hoc Analysis of a
Randomized Clinical Trial.
Source
JAMA Network Open. 4 (4) (no pagination), 2021. Article Number: 8418. Date
of Publication: 29 Apr 2021.
Author
Dasa O.; Smith S.M.; Howard G.; Cooper-Dehoff R.M.; Gong Y.; Handberg E.;
Pepine C.J.
Institution
(Dasa) Department of Internal Medicine and Epidemiology, College of Public
Health and Health Professions, College of Medicine, University of Florida,
Gainesville, United States
(Dasa, Smith, Cooper-Dehoff, Pepine) Center for Integrative Cardiovascular
and Metabolic Diseases, University of Florida, Gainesville, United States
(Smith, Cooper-Dehoff, Gong) Department of Pharmacotherapy and
Translational Research, University of Florida, College of Pharmacy,
Gainesville, United States
(Howard) Department of Biostatistics, University of Alabama at Birmingham,
Birmingham, United States
(Cooper-Dehoff, Handberg, Pepine) Division of Cardiovascular Medicine,
Department of Medicine, College of Medicine, University of Florida,
Gainesville, United States
Publisher
American Medical Association
Abstract
Importance: Accumulating evidence indicates that higher blood pressure
(BP) variability from one physician office visit to the next (hereafter
referred to as visit-to-visit BP variability) is associated with poor
outcomes. Short-term measurement (throughout 1 year) of visit-to-visit BP
variability in high-risk older patients may help identify patients at
increased risk of death. <br/>Objective(s): To evaluate whether short-term
visit-to-visit BP variability is associated with increased long-term
mortality risk. <br/>Design, Setting, and Participant(s): The US cohort of
the International Verapamil SR-Trandolapril Study (INVEST), a randomized
clinical trial of 16688 patients aged 50 years or older with hypertension
and coronary artery disease, was conducted between September 2, 1997, and
December 15, 2000, with in-trial follow-up through February 14, 2003. The
study evaluated a calcium antagonist (sustained-release verapamil plus
trandolapril) vs beta-blocker (atenolol plus hydrochlorothiazide)
treatment strategy. Blood pressure measurement visits were scheduled every
6 weeks for the first 6 months and biannually thereafter. Statistical
analysis was performed from September 2, 1997, to May 1, 2014. Exposures:
Visit-to-visit systolic BP (SBP) and diastolic BP variability during the
first year of enrollment using 4 different BP variability measures:
standard deviation, coefficient of variation, average real variability,
and variability independent of the mean. <br/>Main Outcomes and Measures:
All-cause death, assessed via the US National Death Index, beginning after
the exposure assessment period through May 1, 2014. <br/>Result(s): For
the present post hoc analysis, long-term mortality data were available on
16688 patients (9001 women [54%]; mean [SD] age, 66.5 [9.9] years; 45%
White patients, 16% Black patients, and 37% Hispanic patients). During a
mean (SD) follow-up of 10.9 (4.2) years, 5058 patients (30%) died. All 4
variability measures for SBP were significantly associated with long-term
mortality after adjustment for baseline demographic characteristics and
comorbidities. After comparison of lowest vs highest variability measure
quintiles, the magnitude of the association with death remained
statistically significant even after adjustment for baseline demographic
characteristics and comorbidities (average real variability: adjusted
hazard ratio [aHR], 1.18; 95% CI, 1.08-1.30; standard deviation: aHR,
1.14; 95% CI, 1.04-1.24; coefficient of variation: aHR, 1.15; 95% CI,
1.06-1.26; variability independent of the mean: aHR, 1.15; 95% CI,
1.05-1.25). The signal was stronger in women compared with men.
Associations of diastolic BP variability measures with death were weaker
than for SBP and were not significant after adjustment. <br/>Conclusions
and Relevance: This study suggests that, in a large population of older
patients with hypertension and coronary artery disease, short-term
visit-to-visit SBP variability was associated with excess long-term
mortality, especially for women. Efforts to identify and minimize
visit-to-visit SBP variability may be important in reducing excess
mortality later in life. Trial Registration: ClinicalTrials.gov
Identifier: NCT00133692.<br/>Copyright &#xa9; 2021 American Medical
Association. All rights reserved.

<97>
Accession Number
634493053
Title
Effectiveness of standard local anesthetic bupivacaine and liposomal
bupivacaine for postoperative pain control in patients undergoing truncal
incisions: A randomized clinical trial.
Source
JAMA Network Open. 4 (3) (no pagination), 2021. Article Number: e210753.
Date of Publication: 16 Mar 2021.
Author
Sandhu H.K.; Miller C.C.; Tanaka A.; Estrera A.L.; Charlton-Ouw K.M.
Institution
(Sandhu, Miller, Tanaka, Estrera, Charlton-Ouw) McGovern Medical School,
University of Texas Health Science Center at Houston, United States
(Tanaka, Estrera) Memorial Hermann Hospital, Texas Medical Center,
Houston, United States
(Charlton-Ouw) HCA Houston Healthcare, Gulf Coast Division, Houston, TX,
United States
(Charlton-Ouw) Department of Clinical Sciences, University of Houston
College of Medicine, Houston, TX, United States
Publisher
American Medical Association
Abstract
Importance: Liposomal bupivacaine for pain relief is purported to last 3
days compared with 8 hours with standard bupivacaine. However, its
effectiveness is unknown in truncal incisions for cardiothoracic or
vascular operations. <br/>Objective(s): To compare the effectiveness of
single-administration standard bupivacaine vs liposomal bupivacaine in
patients undergoing truncal incisions. <br/>Design, Setting, and
Participant(s): This randomized clinical trial enrolled patients
undergoing sternotomy, thoracotomy, minithoracotomy, and laparotomy from a
single cardiovascular surgery department in an academic medical center
between November 2012 and June 2018. The study was powered to detect a
Cohen effect size of 0.35 with a power of greater than 80%. Data analysis
was performed from July to December 2018. <br/>Intervention(s): Patients
were randomized to standard bupivacaine or liposomal bupivacaine.
<br/>Main Outcomes and Measures: Pain was assessed over 3 postoperative
days by the Numeric Rating Scale (NRS). Adjunctive opioids were converted
to morphine equivalents units (MEU). NRS scores were compared using
Wilcoxon rank-sum (3-day area under the curve) and 2-way nonparametric
mixed models (daily scale score) to assess time-by-group interaction.
Secondary outcomes included cumulative opioid consumption. <br/>Result(s):
A total of 280 patients were analyzed, with 140 in each group
(single-administration standard bupivacaine vs liposomal bupivacaine).
Mean (SD) age was 60.2 (14.4) years, and 101 of 280 patients (36%) were
women. Irrespective of treatment assignment, pain decreased by a mean of
approximately 1 point per day over 3 days (beta = -0.87; SE = 0.11; mixed
model regression P <.001). Incision type was associated with pain with
patients undergoing thoracotomy (including minithoracotomy) reporting
highest median (interquartile range [IQR]) pain scores on postoperative
days 1 (liposomal vs standard bupivacaine, 6 [4-8] vs 5 [3-7]; P =.049,
Wilcoxon rank-sum) and 2 (liposomal vs standard bupivacaine, 5 [4-7] vs 4
[2-6]; P =.003, Wilcoxon rank-sum) but not day 3 (liposomal vs standard
bupivacaine, 3 [2-6] vs 3 [1-5]; P =.10, Wilcoxon rank-sum), irrespective
of treatment group. Median (IQR) 3-day cumulative NRS was 12.0 (8.0-16.5)
for bupivacaine and 13.5 (9.0-17.0) for liposomal bupivacaine (P =.15,
Wilcoxon rank-sum) Furthermore, use of opioids was greater following
liposomal bupivacaine compared with standard bupivacaine (median [IQR],
41.5 [21.3-73.8] MEU vs 33.0 [17.8-62.5] MEU; P =.03, Wilcoxon rank-sum).
On multivariable analysis, no interaction by incision type was observed
for mean pain scores or opioid use. <br/>Conclusions and Relevance: In
this randomized clinical trial involving truncal incisions for
cardiovascular procedures, liposomal bupivacaine did not provide improved
pain control and did not reduce adjunctive opioid use compared with
conventional bupivacaine formulation over 3 postoperative days. Trial
Registration: ClinicalTrials.gov Identifier: NCT02111746.<br/>Copyright
&#xa9; 2021 American Medical Association. All rights reserved.

<98>
Accession Number
2011111840
Title
10-Year Follow-Up of Patients With Everolimus-Eluting Versus Bare-Metal
Stents After ST-Segment Elevation Myocardial Infarction.
Source
Journal of the American College of Cardiology. 77 (9) (pp 1165-1178),
2021. Date of Publication: 09 Mar 2021.
Author
Brugaletta S.; Gomez-Lara J.; Ortega-Paz L.; Jimenez-Diaz V.; Jimenez M.;
Jimenez-Quevedo P.; Diletti R.; Mainar V.; Campo G.; Silvestro A.;
Maristany J.; Flores X.; Oyarzabal L.; De Miguel-Castro A.; Iniguez A.;
Serra A.; Nombela-Franco L.; Ielasi A.; Tespili M.; Lenzen M.; Gonzalo N.;
Bordes P.; Tebaldi M.; Biscaglia S.; Rodriguez-Arias J.J.; Al-Shaibani S.;
Arevalos V.; Romaguera R.; Gomez-Hospital J.A.; Serruys P.W.; Sabate M.
Institution
(Brugaletta, Ortega-Paz, Rodriguez-Arias, Arevalos, Sabate) Hospital
Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer,
University of Barcelona, Barcelona, Spain
(Gomez-Lara, Oyarzabal, Romaguera, Gomez-Hospital) Hospital Universitari
de Bellvitge, Institut d'Investigacio Biomedica de Bellvitge, L'Hospitalet
de Llobregat, Spain
(Jimenez-Diaz, De Miguel-Castro, Iniguez) Hospital Alvaro Cunqueiro, Vigo,
Spain
(Jimenez, Serra) University Hospital of Sant Pau, Barcelona, Spain
(Jimenez-Quevedo, Nombela-Franco, Gonzalo) University Hospital San Carlos,
Madrid, Spain
(Diletti, Lenzen, Al-Shaibani) Thoraxcenter, Rotterdam, Netherlands
(Mainar, Bordes) Hospital General of Alicante, Alicante, Spain
(Campo, Tebaldi, Biscaglia) Cardiology Unit, Azienda Ospedaliera
Universitaria di Ferrara, Cona, Italy
(Silvestro, Ielasi, Tespili) University Hospital Bolognini Seriate;,
Bergamo;, Italy
(Maristany) Hospital Son Dureta, Palma de Mallorca, Spain
(Flores) Hospital Universitario, A Coruna, Spain
(Serruys) International Center of Circulatory Health, Imperial College
London, London, United Kingdom
(Serruys) Department of Cardiology, National University of Ireland,
Galway, Galway, Ireland
(Sabate) CIBER-CV, Instituto de Salud Carlos III, Spain, Spain
Publisher
Elsevier Inc.
Abstract
Background: Outcomes data for a durable-polymer everolimus-eluting stent
(EES) at extended long-term follow-up in patients with ST-segment
elevation myocardial infarction (STEMI) are unknown. <br/>Objective(s):
The aim of this study was to assess the 10-year outcomes of patients
enrolled in the EXAMINATION (A Clinical Evaluation of Everolimus Eluting
Coronary Stents in the Treatment of Patients With ST-Segment Elevation
Myocardial Infarction) trial. <br/>Method(s): The EXAMINATION-EXTEND
(10-Years Follow-Up of the EXAMINATION Trial) study is an
investigator-driven 10-year follow-up of the EXAMINATION trial, which
randomly assigned 1,498 patients with STEMI in a 1:1 ratio to receive
either EES (n = 751) or bare-metal stents (n = 747). The primary endpoint
was a patient-oriented composite endpoint of all-cause death, any
myocardial infarction, or any revascularization. Secondary endpoints
included a device-oriented composite endpoint of cardiac death, target
vessel myocardial infarction, or target lesion revascularization; the
individual components of the combined endpoints; and stent thrombosis.
<br/>Result(s): Complete 10-year clinical follow-up was obtained in 94.5%
of the EES group and 95.9% of the bare-metal stent group. Rates of the
patient-oriented composite endpoint and device-oriented composite endpoint
were significantly reduced in the EES group (32.4% vs. 38.0% [hazard
ratio: 0.81; 95% confidence interval: 0.68 to 0.96; p = 0.013] and 13.6%
vs. 18.4% [hazard ratio: 0.72; 95% confidence interval: 0.55 to 0.93; p =
0.012], respectively), driven mainly by target lesion revascularization
(5.7% vs. 8.8%; p = 0.018). The rate of definite stent thrombosis was
similar in both groups (2.2% vs. 2.5%; p = 0.590). No differences were
found between the groups in terms of target lesion revascularization (1.4%
vs. 1.3%; p = 0.963) and definite or probable stent thrombosis (0.6% vs.
0.4%; p = 0.703) between 5 and 10 years. <br/>Conclusion(s): At 10-year
follow-up, EES demonstrated confirmed superiority in combined patient- and
device-oriented composite endpoints compared with bare-metal stents in
patients with STEMI requiring primary percutaneous coronary intervention.
Between 5- and 10-year follow-up, a low incidence of adverse
cardiovascular events related to device failure was found in both groups.
(10-Years Follow-Up of the EXAMINATION Trial; NCT04462315)<br/>Copyright
&#xa9; 2021 American College of Cardiology Foundation

<99>
Accession Number
2011068139
Title
Blood pressure and brain injury in cardiac surgery: A secondary analysis
of a randomized trial.
Source
European Journal of Cardio-thoracic Surgery. 58 (5) (pp 1035-1044), 2020.
Date of Publication: 2020.
Author
Vedel A.G.; Holmgaard F.; Danielsen E.R.; Langkilde A.; Paulson O.B.; Ravn
H.B.; Rasmussen L.S.; Nilsson J.C.
Institution
(Vedel, Holmgaard, Ravn, Nilsson) Department of Cardiothoracic
Anaesthesiology, Heart Center, Rigshospitalet, University of Copenhagen,
Copenhagen, Denmark
(Vedel, Rasmussen) Department of Anaesthesia, Center of Head and
Orthopedics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
(Danielsen, Langkilde) Department of Radiology, Diagnostic Center,
Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
(Paulson) Neurobiology Research Unit, Neuroscience Center, Rigshospitalet,
University of Copenhagen, Copenhagen, Denmark
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Brain dysfunction is a serious complication after cardiac
surgery. In the Perfusion Pressure Cerebral Infarcts trial, we allocated
cardiac surgery patients to a mean arterial pressure of either 70-80 or
40-50 mmHg during cardiopulmonary bypass (CPB). In this secondary
analysis, we compared selected cerebral metabolites using magnetic
resonance spectroscopy hypothesizing that a postoperative decrease in
occipital grey matter (GM) N-acetylaspartate-to-total-creatine ratio,
indicative of ischaemic injury, would be found in the high-target group.
<br/>METHOD(S): Of the 197 patients randomized in the Perfusion Pressure
Cerebral Infarcts trial, 55 and 42 patients had complete and useful data
from GM and white matter (WM), respectively. Spectroscopies were done
preoperatively and on postoperative days 3-6. Cognitive function was
assessed prior to surgery, at discharge and at 3 months. We predefined the
statistical significance level to be 0.01. <br/>RESULT(S): A postoperative
decrease was found in GM N-acetylaspartate-to-total-creatine ratio in the
high-target group [mean difference -0.09 (95% confidence interval -0.14 to
-0.04), P = 0.014]. No significant differences were found in other
metabolite ratios investigated in GM or WM. No significant association was
found between changes in metabolite ratios and new cerebral infarcts, WM
lesion score or cognitive dysfunction. <br/>CONCLUSION(S): A higher mean
arterial pressure during CPB was associated with signs of impaired
cerebral metabolism, though not at the predefined significance level of
0.01. No significant association was found between metabolite ratio
changes and neuroradiological pathology or change in cognitive
function.<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.

<100>
Accession Number
631972714
Title
Cochrane corner: transcatheter aortic valve implantation versus surgical
aortic valve replacement for severe aortic stenosis in people with low
surgical risk.
Source
Heart (British Cardiac Society). 106 (14) (pp 1043-1045), 2020. Date of
Publication: 01 Jul 2020.
Author
Kolkailah A.A.; Doukky R.; Pelletier M.P.; Volgman A.S.; Kaneko T.; Nabhan
A.F.
Institution
(Kolkailah, Doukky) Department of Medicine, Cook County Health, Chicago,
IL, United States
(Pelletier) Division of Cardiac Surgery, Case Western Reserve University,
University Hospitals, Cleveland, OH, United States
(Volgman) Division of Cardiology, Rush University Medical Center, Chicago,
IL, United States
(Kaneko) Division of Cardiac Surgery, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Nabhan) Department of Obstetrics and Gynaecology, Faculty of Medicine,
Ain Shams University, Cairo, Egypt
Publisher
NLM (Medline)

<101>
Accession Number
2013533004
Title
Percutaneous Coronary Revascularization: JACC Historical Breakthroughs in
Perspective.
Source
Journal of the American College of Cardiology. 78 (4) (pp 384-407), 2021.
Date of Publication: 27 Jul 2021.
Author
Serruys P.W.; Ono M.; Garg S.; Hara H.; Kawashima H.; Pompilio G.;
Andreini D.; Holmes D.R.; Onuma Y.; King III S.B.
Institution
(Serruys, Ono, Hara, Kawashima, Onuma) Department of Cardiology, National
University of Ireland, Galway (NUIG), Galway, Ireland
(Serruys, Ono, Hara, Kawashima, Onuma) CURAM-SFI Centre for Research in
Medical Devices, Galway, Ireland
(Serruys) NHLI, Imperial College London, London, United Kingdom
(Ono, Hara, Kawashima) Department of Cardiology, Academic Medical Center,
University of Amsterdam, Amsterdam, Netherlands
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Pompilio, Andreini) Centro Cardiologico Monzino, IRCCS, Milan, Italy
(Pompilio) Department of Biomedical, Surgical and Dental Sciences,
University of Milan, Milan, Italy
(Andreini) Department of Clinical Sciences and Community Health,
University of Milan, Milan, Italy
(Holmes) Department of Cardiovascular Diseases, Mayo Clinic, Rochester,
MN, United States
(King III) Division of Cardiology, Department of Medicine, Emory
University School of Medicine, Atlanta, GA, United States
Publisher
Elsevier Inc.
Abstract
Over the last 4 decades, percutaneous coronary intervention has evolved
dramatically and is now an acceptable treatment option for patients with
advanced coronary artery disease. However, trialists have struggled to
establish the respective roles for percutaneous coronary intervention and
coronary artery bypass graft surgery, especially in patients with
multivessel disease and unprotected left-main stem coronary artery
disease. Several pivotal trials and meta-analyses comparing these 2
revascularization strategies have enabled the relative merits of each
technique to be established with regard to the type of ischemic syndrome,
the coronary anatomy, and the patient's overall comorbidity. Precision
medicine with individualized prognosis is emerging as an important method
of selecting treatment. However, the never-ending advancement of
technology, in conjunction with the emergence of novel pharmacological
agents, will in the future continue to force us to reconsider the evolving
question: "Which treatment strategy is better and for which
patient?"<br/>Copyright &#xa9; 2021 American College of Cardiology
Foundation

<102>
Accession Number
2013528468
Title
Kidney Transplant List Status and Outcomes in the ISCHEMIA-CKD Trial.
Source
Journal of the American College of Cardiology. 78 (4) (pp 348-361), 2021.
Date of Publication: 27 Jul 2021.
Author
Herzog C.A.; Simegn M.A.; Xu Y.; Costa S.P.; Mathew R.O.; El-Hajjar M.C.;
Gulati S.; Maldonado R.A.; Daugas E.; Madero M.; Fleg J.L.; Anthopolos R.;
Stone G.W.; Sidhu M.S.; Maron D.J.; Hochman J.S.; Bangalore S.
Institution
(Herzog, Simegn) Department of Medicine, Hennepin Healthcare, Minneapolis,
MN, United States
(Herzog, Simegn) University of Minnesota, Minneapolis, MN, United States
(Xu, Anthopolos, Hochman, Bangalore) NYU Grossman School of Medicine, New
York, NY, United States
(Costa) Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, United
States
(Mathew) Columbia V.A. Health Care System, Columbia, SC, United States
(El-Hajjar, Sidhu) Albany Medical College and Albany Medical Center,
Albany, NY, United States
(Gulati) Fortis Flt Lt Rajan Dhall Hospital, New Delhi, Delhi, India
(Maldonado) Velez Sarsfield Clinic, Cordoba, Argentina
(Daugas) Department of Nephrology, Bichat, Assistance Publique-Hopitaux,
Paris, France
(Madero) Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City,
Mexico
(Fleg) National Heart, Lung, and Blood Institute, Bethesda, MD, United
States
(Stone) Icahn School of Medicine at Mount Sinai, Cardiovascular Research
Foundation, New York, NY, United States
(Maron) Department of Medicine, Stanford University, Stanford, CA, United
States
Publisher
Elsevier Inc.
Abstract
Background: Patients with chronic kidney disease (CKD) and coronary artery
disease frequently undergo preemptive revascularization before kidney
transplant listing. <br/>Objective(s): In this post hoc analysis from
ISCHEMIA-CKD (International Study of Comparative Health Effectiveness of
Medical and Invasive Approaches-Chronic Kidney Disease), we compared
outcomes of patients not listed versus those listed according to
management strategy. <br/>Method(s): In the ISCHEMIA-CKD trial (n = 777),
194 patients (25%) with chronic coronary syndromes and at least moderate
ischemia were listed for transplant. The primary (all-cause mortality or
nonfatal myocardial infarction) and secondary (death, nonfatal myocardial
infarction, hospitalization for unstable angina, heart failure,
resuscitated cardiac arrest, or stroke) outcomes were analyzed using Cox
multivariable modeling. Heterogeneity of randomized treatment effect
between listed versus not listed groups was assessed. <br/>Result(s):
Compared with those not listed, listed patients were younger (60 years vs
65 years), were less likely to be of Asian race (15% vs 29%), were more
likely to be on dialysis (83% vs 44%), had fewer anginal symptoms, and
were more likely to have coronary angiography and coronary
revascularization irrespective of treatment assignment. Among patients
assigned to an invasive strategy versus conservative strategy, the
adjusted hazard ratios for the primary outcome were 0.91 (95% confidence
interval [CI]: 0.54-1.54) and 1.03 (95% CI: 0.78-1.37) for those listed
and not listed, respectively (p<inf>interaction</inf>= 0.68). Adjusted
hazard ratios for secondary outcomes were 0.89 (95% CI: 0.55-1.46) in
listed and 1.17 (95% CI: 0.89-1.53) in those not listed
(p<inf>interaction</inf> = 0.35). <br/>Conclusion(s): In ISCHEMIA-CKD, an
invasive strategy in kidney transplant candidates did not improve outcomes
compared with conservative management. These data do not support routine
coronary angiography or revascularization in patients with advanced CKD
and chronic coronary syndromes listed for transplant. (ISCHEMIA-Chronic
Kidney Disease Trial [ISCHEMIA-CKD]; NCT01985360)<br/>Copyright &#xa9;
2021 American College of Cardiology Foundation

<103>
Accession Number
2007809863
Title
The effects of melatonin on the oxidative stress and duration of atrial
fibrillation after coronary artery bypass graft surgery: A randomized
controlled trial.
Source
Endocrine, Metabolic and Immune Disorders - Drug Targets. 21 (6) (pp
1142-1149), 2021. Date of Publication: 2021.
Author
Barati S.; Jahangirifard A.; Ahmadi Z.H.; Tavakoli-Ardakani M.; Dastan F.
Institution
(Barati, Dastan) Department of Clinical Pharmacy, School of Pharmacy,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Jahangirifard, Ahmadi) Lung Transplantation Research Center, National
Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Tavakoli-Ardakani) Department of Clinical Pharmacy, School of Pharmacy
and Pharmaceutical Sciences Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Dastan) Chronic Respiratory Diseases Research center, National Research
Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Bentham Science Publishers
Abstract
Background: Atrial Fibrillation (AF) is a common complication following
Coronary artery bypass graft (CABG) Surgery, which may be due to oxidative
stress, necrosis and inflammation during CABG and can lead to increases
the length of hospital stay and the risk of morbidity and mortality.
Melatonin is a hormone with anti-oxidant and anti-inflammatory properties
in the cardiovascular sys-tem. This study assessed the efficacy of
sublingual consumption of melatonin in reducing necrosis and inflammation,
in patients undergoing CABG with respect to C-reactive protein (hs-CRP),
Creatine Kinase-Muscle-Brain subunits (CK-MB) and cardiac Troponin T
(cTnT) levels. <br/>Method(s): One hundred and two patients were enrolled
and twenty-six patients were excluded during the study process and finally
seventy-six patients undergoing CABG surgery randomly assigned to
melatonin group (n = 38, 12 mg sublingual melatonin the evening before and
1 hour before surgery, or the control group which did not receive
Melatonin, n = 38). Three patients in the melatonin group and three
patients in the control group were excluded from the study because of
discontinued intervention and lost to follow up. The samples were
collected before and 24 hours after surgery. hs-CRP, CK-MB, and cTnT
levels were measured in all patients with the Elisa method.
<br/>Result(s): There was no significant difference in influencing
variables among the groups at the baseline. The incidence of AF following
CABG surgery was not statistically significant between the two groups,
(p-value = 0.71). However, the duration of AF (p-value = 0.01), the levels
of hs-CRP (p-value = 0.001) and CK-MB (p-value = 0.004) measured, 24 hours
after surgery were significantly lower in the melatonin group. cTnT levels
measured 24 hours post-CABG did not show any significant difference in
both groups (p-value = 0.52). <br/>Conclusion(s): Our findings suggest
that the administration of melatonin may help modulate oxidative stress,
based on the reduction of the levels of hs-CRP, CK-MB, and the duration of
AF following CABG surgery.<br/>Copyright &#xa9; 2021, Bentham Science
Publishers. All rights reserved.

<104>
Accession Number
2007791432
Title
NGAL in trans-catheter aortic valve implantation on and off renalguard.
Source
Signa Vitae. 17 (4) (pp 55-59), 2021. Date of Publication: July 2021.
Author
Sadon S.; Arbel Y.; Banai A.; Rozenfeld K.-L.; Taieb P.; Hochstadt A.;
Shacham Y.; Banai S.; Finkelstein A.; Merdler I.
Institution
(Sadon, Arbel, Banai, Rozenfeld, Taieb, Hochstadt, Shacham, Banai,
Finkelstein, Merdler) Department of Cardiology, Tel Aviv Sourasky Medical
Center, Israel
(Sadon, Arbel, Banai, Rozenfeld, Taieb, Hochstadt, Shacham, Banai,
Finkelstein, Merdler) Affiliated to Sackler School of Medicine, Tel Aviv
University, Tel Aviv, Israel
Publisher
Pharmamed Mado Ltd
Abstract
Introduction: Acute kidney injury (AKI) is a well-known complication post
invasive cardiac procedures. RenalGuard system has been shown to reduce
the risk of AKI in high-risk patients by evacuating iodine-based contrast
material rapidly. Neutrophil gelatinase-associated lipocalin (NGAL) is a
glycoprotein stored in granules of mature neutrophils and is released to
the blood stream due to acute tubular damage. This report examined the
biomarker as a sub study of the randomized sham control study REDUCE-AKI
in the setting of Trans-Aortic Valve Implantation (TAVI). <br/>Method(s):
Venous blood was drawn from 27 patients. Blood was drawn at designated
time intervals: before the procedure, after 12 hours and after 24 hours.
Patients were randomly allocated to active versus sham RenalGuard
activity. <br/>Result(s): There was no difference between baseline and 24
hours levels in NGAL values (ng/mL) in the sham group (median 70.3 IQ
21.5, 176.6) versus the active group (median 46.9, IQR 1.3, 127.7) (P =
0.259). There was also no association between NGAL and clinical
complications. <br/>Conclusion(s): Forced diuresis with matched hydration
does not prevent AKI in patients undergoing TAVI and measuring NGAL
correlates with these findings.<br/>Copyright &#xa9; 2021 The Authors.
Published by MRE Press.

<105>
Accession Number
635476708
Title
Comparison of the Effect of Breast Milk and Sodium Bicarbonate Solution
for Oral Care in Infants with Tracheal Intubation after Cardiothoracic
Surgery.
Source
Breastfeeding Medicine. 16 (7) (pp 568-572), 2021. Date of Publication:
July 2021.
Author
Yu X.-R.; Huang S.-T.; Xu N.; Dai W.-S.; Wang Z.-C.; Cao H.; Chen Q.
Institution
(Yu, Huang, Xu, Dai, Wang, Cao, Chen) Department of Cardiac Surgery,
Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian
Medical University, Fuzhou, China
(Yu, Huang, Xu, Dai, Wang, Cao, Chen) Fujian Key Laboratory of Women,
Children's Critical Diseases Research, Fujian Maternity and Child Health
Hospital, Fuzhou, China
(Wang, Chen) Department of Cardiovascular Surgery, Union Hospital, Fujian
Medical University, Fuzhou, China
Publisher
Mary Ann Liebert Inc.
Abstract
Background: This study aimed to explore the effect of breast milk and
sodium bicarbonate solution used in oral care of infants with tracheal
intubation after cardiothoracic surgery. <br/>Method(s): A randomized
clinical controlled trial was conducted in a provincial hospital in China.
Fifty infantile patients were randomly divided into two groups: the
patients in the study group (n = 25) used breast milk for oral care and
the patients in the control group (n = 25) used sodium bicarbonate
solution for oral care. The relevant clinical data were recorded,
including the mechanical ventilation duration, length of intensive care
unit (ICU) stay, length of hospital stay, and complications.
<br/>Result(s): The length of ICU stay, length of hospital stay, and
duration of mechanical ventilation were shorter in the study group, but
the difference was not statistically significant (p > 0.05). However, the
incidence of thrush and ventilator-associated pulmonary infection in the
study group was significantly lower than that in the control group (p <
0.05). <br/>Conclusion(s): The use of breast milk for oral care has a
positive effect on the prevention of thrush and ventilator-associated
pulmonary infection in infants with tracheal intubation after
cardiothoracic surgery. <br/>Copyright &#xa9; 2021, Mary Ann Liebert,
Inc., publishers.

<106>
Accession Number
2013506146
Title
A randomized controlled clinical trial on therapeutic effects of
teicoplanin and vancomycin after cardiac surgery due to MRSA infective
endocarditis in ICU patients.
Source
Iranian Red Crescent Medical Journal. 23 (1) (no pagination), 2020.
Article Number: e69. Date of Publication: 2020.
Author
Khoundabi B.; Behzadnia N.; Ahmadi Z.H.; Chitsazan M.; Tabarsi P.; Jamaati
H.; Bahadorbeigi A.; Hashemian S.M.R.
Institution
(Khoundabi) Iran Helal Institute of Applied Science and Technology,
Tehran, Iran, Islamic Republic of
(Khoundabi) Research Center for Health Management in Mass Gathering, Red
Crescent Society of the Islamic Republic of Iran, Tehran, Iran, Islamic
Republic of
(Behzadnia, Ahmadi) Lung Transplant Research Center, National Research
Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Chitsazan, Jamaati, Bahadorbeigi, Hashemian) Chronic Respiratory Diseases
Research Center, National Research Institute of Tuberculosis and Lung
Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Tabarsi) Clinical Tuberculosis and Epidemiology Research Center, National
Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Kowsar Medical Institute
Abstract
Background: Infective endocarditis (IE) is a relatively rare disease but
with significant rates of morbidity and mortality. Vancomycin and
teicoplanin are bacteriostatic glycopeptide antibiotics used for the
treatment of methicillin-resistant Staphylococcus aureus (MRSA)
infections. <br/>Objective(s): The current study aimed to compare the
efficacy and adverse effects of vancomycin and teicoplanin in the
treatment of patients with MRSA-IE. <br/>Method(s): This parallel,
randomized, and controlled trial study was carried out on the efficacy and
safety of teicoplanin versus vancomycin in the treatment of MRSA
endocarditis within August 2012 and April 2017. The present study
recruited adult patients with a definite or possible diagnosis of IE based
on the Modified Duke Criteria. Vancomycin was intravenously administered
at a dose of 30 mg/kg/day in two doses. Teicoplanin was administered at a
loading dose of 6-12 mg/kg every 12 h in four doses and then continued
once a day. <br/>Result(s): Out of 86 patients with suspected IE, 66
patients were randomly assigned to the vancomycin (n=33) and teicoplanin
(n=33) groups. The mean age values of the study subjects were 41+/-11.8
and 39+/-13.1 years in the vancomycin and teicoplanin groups,
respectively. In addition, 27 patients (81.8%) in the vancomycin group met
the criteria for microbiological cure, compared to 25 subjects (89.3%) in
the teicoplanin group. In this regard, the observed difference was not
statistically significant (P=0.41). Overall, the patients in the
vancomycin group experienced more adverse events in comparison to those of
the teicoplanin group (P=0.04). The rate of acute kidney injury over time,
especially in the first week of therapy, was higher in the vancomycin
group than that reported for the teicoplanin group (P=0.05).
<br/>Conclusion(s): It was concluded that the administration of vancomycin
or teicoplanin does not significantly change the outcome of patients
undergoing empirical treatment for MRSA-IE.<br/>Copyright &#xa9; 2021,
Author(s).

<107>
Accession Number
2007801153
Title
Early experience with transcatheter mitral valve replacement: A systematic
review.
Source
Journal of the American Heart Association. 8 (17) (no pagination), 2019.
Article Number: e013332. Date of Publication: 03 Sep 2019.
Author
Del Val D.; Ferreira-Neto A.N.; Wintzer-Wehekind J.; Dagenais F.; Paradis
J.-M.; Bernier M.; O'connor K.; Beaudoin J.; Freitas-Ferraz A.B.;
Rodes-Cabau J.
Institution
(Del Val, Ferreira-Neto, Wintzer-Wehekind, Dagenais, Paradis, Bernier,
O'connor, Beaudoin, Freitas-Ferraz, Rodes-Cabau) Quebec Heart & Lung
Institute, Laval University, Quebec City, QC, Canada
Publisher
American Heart Association Inc.
Abstract
Background--Transcatheter mitral valve replacement (TMVR) has emerged as
an alternative therapeutic option for the treatment of severe mitral
regurgitation in patients with prohibitive or high surgical risk. The aim
of this systematic review is to evaluate the clinical procedural
characteristics and outcomes associated with the early TMVR experience.
Methods and Results--Published studies and international conference
presentations reporting data on TMVR systems were identified. Only records
including clinical characteristics, procedural results, and 30-day and
midterm outcomes were analyzed. A total of 16 publications describing 308
patients were analyzed. Most patients (65.9%) were men, with a mean age of
75 years (range: 69-81 years) and Society for Thoracic Surgery Predicted
Risk of Mortality score of 7.7% (range: 6.1-8.6%). The etiology of mitral
regurgitation was predominantly secondary or mixed (87.1%), and 81.5% of
the patients were in New York Heart Association class III or IV. A
transapical approach was used in 81.5% of patients, and overall technical
success was high (91.7%). Postprocedural mean transmitral gradient was 3.5
mm Hg (range: 3-5.5 mm Hg), and only 4 cases (1.5%) presented residual
moderate to severe mitral regurgitation. Procedural and all-cause 30-day
mortality were 4.6% and 13.6%, respectively. Left ventricular outflow
obstruction and conversion to open heart surgery were reported in 0.3% and
4% of patients, respectively. All-cause and cardiovascular-related
mortality rates were 27.6% and 23.3%, respectively, after a mean follow-up
of 10 (range: 3 to 24) months. Conclusions--TMVR was a feasible, less
invasive alternative for treating severe mitral regurgitation in patients
with high or prohibitive surgical risk. TMVR was associated with a high
rate of successful valve implantation and excellent hemodynamic results.
However, periprocedural complications and all-cause mortality were
relatively high.<br/>Copyright 2019 The Authors.

<108>
Accession Number
2013148920
Title
Incidence of herpes zoster in adult solid organ transplant recipients: A
meta-analysis and comprehensive review.
Source
Transplant Infectious Disease. (no pagination), 2021. Date of Publication:
2021.
Author
Kwon D.E.; Lee H.S.; Lee K.H.; La Y.; Han S.H.; Song Y.G.
Institution
(Kwon, Lee, La, Han, Song) Division of Infectious Disease, Department of
Internal Medicine, Yonsei University College of Medicine, Seoul, South
Korea
(Lee) Biostatistics Collaboration Unit, Yonsei University College of
Medicine, Seoul, South Korea
Publisher
Blackwell Publishing Inc.
Abstract
Background: Chronic immunosuppressive therapy in solid organ transplant
(SOT) recipients can trigger latent varicella zoster virus reactivation
even in those with stable graft function. The inactivated herpes zoster
(HZ) vaccine can be effective in preventing post-transplant HZ, which can
cause severe neuralgia or disseminated disease. This meta-analysis aims to
assess the incidences of HZ across transplant organs in SOT recipients.
<br/>Method(s): We included 12 observational studies (6560 recipients)
from a PubMed and EMBASE search of articles through October 2019 and
collected data from single-center dating from January 2001 to December
2017 (3498 recipients). The pooled HZ incidence and its differences
between subgroups were obtained from random-effect models and
meta-analysis of variance tests using R package. <br/>Result(s): The
overall pooled crude incidence was 9.1% (95% confidence interval [CI],
7.6%-10.8%). The pooled incidence was similar between sexes but
significantly different between transplanted organs (P <.001). Heart
transplants (HT) (n = 644) have the highest pooled incidence with 15.2%
(95% CI, 12.7%-18.2%), followed by lung transplants (LTX) (n = 780) with
11.0% (8.3%-14.4%). Kidney transplants (n = 5435) have the lowest
incidence of 6.7 (5.1%-8.8%). The meta-regression analysis revealed that
HZ development had a relationship with past graft rejection (P =.024).
<br/>Conclusion(s): These data support the need for subunit HZ vaccination
in SOT recipients with a high risk for HZ, especially HT and LTX
recipients, without respect to the late post-transplant
period.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<109>
Accession Number
2013080682
Title
Influence of fractional flow reserve on grafts patency: Systematic review
and patient-level meta-analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2021.
Date of Publication: 2021.
Author
G. Toth G.; Collet C.; Langhoff Thuesen A.; Mizukami T.; Casselman F.;
Riber L.P.; Van Praet F.; Junker A.; Nagumo S.; De Bruyne B.; Okkels
Jensen L.; Barbato E.
Institution
(G. Toth) Division of Cardiology, University Heart Center Graz, Medical
University of Graz, Graz, Austria
(Collet, Mizukami, Nagumo, De Bruyne, Barbato) Cardiovascular Center
Aalst, OLV Clinic, Aalst, Belgium
(Langhoff Thuesen, Riber) Department of Cardiothoracic Surgery, Odense
University Hospital, Odense, Denmark
(Langhoff Thuesen, Junker, Okkels Jensen) Department of Cardiology, Odense
University Hospital, Odense, Denmark
(Mizukami) Clinical Research Institute for Clinical Pharmacology and
Therapeutics, Showa University, Tokyo, Japan
(Casselman, Van Praet) Departement of Cardiovascular and Thoracic Surgery,
OLV Hospital Aalst, Aalst, Belgium
(Nagumo) Division of Cardiology, Department of Internal medicine, Showa
University Fujigaoka Hospital, Kanagawa, Japan
(De Bruyne) Department of Cardiology, Universtiy Hospital Center Lausanne,
Lausanne, Switzerland
(Barbato) Department of Advanced Biomedical Sciences, University Federico
II, Naples, Italy
Publisher
John Wiley and Sons Inc
Abstract
Objective: To investigate the impact of invasive functional guidance for
coronary artery bypass graft surgery (CABG) on graft failure.
<br/>Background(s): Data on the impact of fractional flow reserve (FFR) in
guiding CABG are still limited. <br/>Method(s): Systematic review and
individual patient data meta-analysis were performed. Primary objective
was the risk of graft failure, stratified by FFR. Risk estimates are
reported as odds ratios (ORs) derived from the aggregated data using
random-effects models. Individual patient data were analyzed using mixed
effect model to assess relationship between FFR and graft failure. This
meta-analysis is registered in PROSPERO (CRD42020180444). <br/>Result(s):
Four prospective studies comprising 503 patients referred for CABG, with
1471 coronaries, assessed by FFR were included. Graft status was available
for 1039 conduits at median of 12.0 [IQR 6.6; 12.0] months. Risk of graft
failure was higher in vessels with preserved FFR (OR 5.74, 95% CI
1.71-19.29). Every 0.10 FFR units decrease in the coronaries was
associated with 56% risk reduction of graft failure (OR 0.44, 95% CI 0.34
to 0.59). FFR cut-off to predict graft failure was 0.79.
<br/>Conclusion(s): Surgical grafting of coronaries with functionally
nonsignificant stenoses was associated with higher risk of graft
failure.<br/>Copyright &#xa9; 2021 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<110>
[Use Link to view the full text]
Accession Number
635476134
Title
Prevention of Cardiac Surgery-Associated Acute Kidney Injury by
Implementing the KDIGO Guidelines in High-Risk Patients Identified by
Biomarkers: The PrevAKI-Multicenter Randomized Controlled Trial.
Source
Anesthesia and Analgesia. (pp 292-302), 2021. Date of Publication: 2021.
Author
Zarbock A.; Kullmar M.; Ostermann M.; Lucchese G.; Baig K.; Cennamo A.;
Rajani R.; McCorkell S.; Arndt C.; Wulf H.; Irqsusi M.; Monaco F.; Di
Prima A.L.; Garcia Alvarez M.; Italiano S.; Miralles Bagan J.; Kunst G.;
Nair S.; L'Acqua C.; Hoste E.; Vandenberghe W.; Honore P.M.; Kellum J.A.;
Forni L.G.; Grieshaber P.; Massoth C.; Weiss R.; Gerss J.; Wempe C.;
Meersch M.
Institution
(Zarbock, Kullmar, Massoth, Weiss, Wempe, Meersch) Department of
Anesthesiology, Intensive Care Medicine and Pain Medicine, University
Hospital Munster, Munster, Germany
(Ostermann, Lucchese, Baig, Cennamo, Rajani, McCorkell) Department of
Critical Care, Guy's and St Thomas' National Health Service Foundation
Hospital, London, United Kingdom
(Arndt, Wulf) Department of Anesthesiology and Intensive Care Medicine
(Irqsusi) Department of Cardiac Surgery, University Hospital Marburg,
Marburg, Germany
(Monaco, Di Prima) Department of Anesthesia and Intensive Care, Istituto
di Ricovero e Cura A Carattere Scientifico, San Raffaele Scientific
Institute, Milan, Italy
(Garcia Alvarez, Italiano, Miralles Bagan) Department of Anesthesiology,
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
(Kunst, Nair) Department of Anesthetics, King's College Hospital, Denmark
Hill, London, United Kingdom
(L'Acqua) Department of Anesthesia and Critical Care, Centro Cardiologico
Monzino Istituto di Ricovero e Cura A Carattere Scientifico, Milan, Italy
(Hoste, Vandenberghe) Department of Intensive Care Medicine, University
Hospital Gent, Gent, Belgium
(Honore) Department of Intensive Care, Chu Brugmann University Hospital,
Brussels, Belgium
(Kellum) Center for Critical Care Nephrology, Department of Critical Care
Medicine, University of Pittsburgh, Pittsburgh, PA, United States
(Forni) Department of Intensive Care Medicine, Royal Surrey County
Hospital, Faculty of Health Sciences, University of Surrey, Guildford,
United Kingdom
(Grieshaber) Department of Cardiac Surgery, University Hospital Giessen,
Giessen, Germany
(Gerss) Institute of Biostatistics and Clinical Research, University of
Munster, Munster, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Prospective, single-center trials have shown that the
implementation of the Kidney Disease: Improving Global Outcomes (KDIGO)
recommendations in high-risk patients significantly reduced the
development of acute kidney injury (AKI) after surgery. We sought to
evaluate the feasibility of implementing a bundle of supportive measures
based on the KDIGO guideline in high-risk patients undergoing cardiac
surgery in a multicenter setting in preparation for a large definitive
trial. <br/>METHOD(S): In this multicenter, multinational, randomized
controlled trial, we examined the adherence to the KDIGO bundle consisting
of optimization of volume status and hemodynamics, functional hemodynamic
monitoring, avoidance of nephrotoxic drugs, and prevention of
hyperglycemia in high-risk patients identified by the urinary biomarkers
tissue inhibitor of metalloproteinases-2 [TIMP-2] and insulin growth
factor-binding protein 7 [IGFBP7] after cardiac surgery. The primary end
point was the adherence to the bundle protocol and was evaluated by the
percentage of compliant patients with a 95% confidence interval (CI)
according to Clopper-Pearson. Secondary end points included the
development and severity of AKI. <br/>RESULT(S): In total, 278 patients
were included in the final analysis. In the intervention group, 65.4% of
patients received the complete bundle as compared to 4.2% in the control
group (absolute risk reduction [ARR] 61.2 [95% CI, 52.6-69.9]; P <.001).
AKI rates were statistically not different in both groups (46.3%
intervention versus 41.5% control group; ARR -4.8% [95% CI, -16.4 to 6.9];
P =.423). However, the occurrence of moderate and severe AKI was
significantly lower in the intervention group as compared to the control
group (14.0% vs 23.9%; ARR 10.0% [95% CI, 0.9-19.1]; P =.034). There were
no significant effects on other specified secondary outcomes.
<br/>CONCLUSION(S): Implementation of a KDIGO-derived treatment bundle is
feasible in a multinational setting. Furthermore, moderate to severe AKI
was significantly reduced in the intervention group.<br/>Copyright &#xa9;
2021 Georg Thieme Verlag. All rights reserved.

<111>
Accession Number
635470436
Title
From Other Journals: A Review of Recent Articles by Our Editorial Team.
Source
Pediatric cardiology. (no pagination), 2021. Date of Publication: 28 Jun
2021.
Author
Alsaied T.; Ashfaq A.
Institution
(Alsaied) Heart Institute, Pittsburgh Children's Hospital Medical Center,
PA, 4401 Penn Avenue, Pittsburgh, United States
(Alsaied) Department of Pediatrics, University of Pittsburgh, PA,
Pittsburgh, United States
(Ashfaq) Heart Institute, Johns Hopkins All Children's All Children's
Hospital, FL, St. Petersburg, United States
Publisher
NLM (Medline)
Abstract
In this review, we provide a brief description of recently published
articles addressing topics relevant to pediatric cardiologists. Our hope
is to provide a summary of the latest articles published recently in other
journals in our field. The articles reviewed in this manuscript address
(1) long-term fate of the truncal valve, (2) comparison of combined
heart-liver vs heart-only transplantation in pediatric and young adult
Fontan recipients showing non-inferior survival of heart-liver transplant
in a small sample, (3) impact of palliation strategy on interstage feeding
and somatic growth for infants with ductal-dependent pulmonary blood flow
showing no difference in growth between ductal stenting and
Blalock-Taussig shunt, (4) biventricular repair in interrupted aortic arch
and ventricular septal defect with a small left ventricular outflow tract,
(5) a randomized controlled trial comparing controlled reoxygenation and
standard cardiopulmonary bypass in pediatric cardiac surgery, and (6)
tricuspid valve and right ventricular function throughout the hybrid
palliation strategy for hypoplastic left heart syndrome and variants.

<112>
Accession Number
635470313
Title
Traditional versus extended hybrid cardiac rehabilitation based on the
continuous care model for coronary artery bypass surgery patients in a
middle-income country: A Randomized Clinical Trial.
Source
Archives of physical medicine and rehabilitation. (no pagination), 2021.
Date of Publication: 24 Jun 2021.
Author
Pakrad F.; Ahmadi F.; Grace S.L.; Oshvandi K.; Kazemnejad A.
Institution
(Pakrad) Department of Nursing, Faculty of Medical Sciences, Tarbiat
Modares University, PhD Candidate of Nursing, Tehran, Iran, Islamic
Republic of
(Ahmadi) Department of Nursing, Faculty of Medical Sciences, Tarbiat
Modares University, Tehran, Iran, Islamic Republic of
(Grace) Faculty of Health, York University, Toronto, Canada; KITE- Toronto
Rehabilitation Institute, & Peter Munk Cardiac Centre, University Health
Network, University of Toronto, Canada
(Oshvandi) Department of Nursing, Faculty of Nursing and Midwifery,
Hamadan University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Kazemnejad) Department of Biostatistics, Faculty of Medical Sciences,
Tarbiat Modares University, Tehran, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To compare traditional (1-month supervised) versus hybrid
cardiac rehabilitation (CR; usual care) with an additional 3 months
offered remotely based on the continuous care model (CCM; intervention),
in coronary artery bypass graft (CABG) patients. DESIGN: randomized
controlled trial, with blinded outcome assessment. SETTING: A major heart
center in a middle-income country. PARTICIPANTS: Of 107 eligible patients
that were referred to CR during the period of study, 88 (82.2%) were
enrolled (target sample size). Participants were randomly assigned 1:1
(concealed; 44 per parallel arm). There was 92.0% retention. INTERVENTION:
After CR, participants were given an app and communicated biweekly with
the nurse from months 1-4 to control risk factors. MAIN OUTCOME MEASURES:
Quality of life (QoL; SF-36; primary outcome), functional capacity
(treadmill test), depression, anxiety and stress (DASS-21) were evaluated
pre-CR, after one month, and three months after CR (end of intervention),
as well as re-hospitalization. <br/>RESULT(S): The analysis of variance
interaction effects for the physical and mental component summary scores
of QoL were <.001, favoring intervention (per protocol); there were also
significant increases from pre-CR to 1 month, and from 1 month to the
final assessment in the intervention arm (p-values<.001), with change in
the control arm only to 1 month. The effect sizes were 0.115 and 0.248,
respectively. Similarly, the interaction effect for functional capacity
was significant (p<.001), with a clinically-significant 1.5 MET increase
in the intervention arm. There were trends for group effects for the
psychosocial indicators, with paired t-tests revealing significant
increases in each at both assessment points in the intervention arm. At 4
months, there were 4 (10.3%) re-hospitalizations in the control arm, and
none in intervention (p=.049). Intended theoretical mechanisms were also
impacted by the intervention. <br/>CONCLUSION(S): Extending CR in this
accessible manner, rendering it more comprehensive, was effective in
improving outcomes.<br/>Copyright &#xa9; 2021. Published by Elsevier Inc.

<113>
Accession Number
635468983
Title
Eight-year outcomes for patients with aortic valve stenosis at low
surgical risk randomized to transcatheter vs. surgical aortic valve
replacement.
Source
European heart journal. (no pagination), 2021. Date of Publication: 28 Jun
2021.
Author
Jorgensen T.H.; Thyregod H.G.H.; Ihlemann N.; Nissen H.; Petursson P.;
Kjeldsen B.J.; Steinbruchel D.A.; Olsen P.S.; Sondergaard L.
Institution
(Jorgensen, Sondergaard) Department of Cardiology, Heart Centre,
Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen
2100, Denmark
(Thyregod, Olsen) Department of Cardiothoracic Surgery, Heart Centre,
Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen
2100, Denmark
(Ihlemann, Nissen) Department of Cardiology, Odense University Hospital,
J. B. Winslows Vej 4, Odense 5000, Denmark
(Petursson) Department of Cardiology, Sahlgrenska University Hospital, Bla
straket 5, Gothenburg 413 45, Sweden
(Kjeldsen) Department of Cardiothoracic and Vascular Surgery, Odense
University Hospital, J. B. Winslows Vej 4, Odense 5000, Denmark
(Steinbruchel) Department of Medicine, Nykoebing F Hospital and University
of Southern Denmark, J. B. Winslows Vej 4, Odense 5000, Denmark
Publisher
NLM (Medline)
Abstract
AIMS: The aims of the study were to compare clinical outcomes and valve
durability after 8 years of follow-up in patients with symptomatic severe
aortic valve stenosis at low surgical risk treated with either
transcatheter aortic valve implantation (TAVI) or surgical aortic valve
replacement (SAVR). METHODS AND RESULTS: In the NOTION trial, patients
with symptomatic severe aortic valve stenosis were randomized to TAVI or
SAVR. Clinical status, echocardiography, structural valve deterioration,
and failure were assessed using standardized definitions. In total, 280
patients were randomized to TAVI (n=145) or SAVR (n=135). Baseline
characteristics were similar, including mean age of 79.1+/-4.8 years and a
mean STS score of 3.0+/-1.7%. At 8-year follow-up, the estimated risk of
the composite outcome of all-cause mortality, stroke, or myocardial
infarction was 54.5% after TAVI and 54.8% after SAVR (P=0.94). The
estimated risks for all-cause mortality (51.8% vs. 52.6%; P=0.90), stroke
(8.3% vs. 9.1%; P=0.90), or myocardial infarction (6.2% vs. 3.8%; P=0.33)
were similar after TAVI and SAVR. The risk of structural valve
deterioration was lower after TAVI than after SAVR (13.9% vs. 28.3%;
P=0.0017), whereas the risk of bioprosthetic valve failure was similar
(8.7% vs. 10.5%; P=0.61). <br/>CONCLUSION(S): In patients with severe
aortic valve stenosis at low surgical risk randomized to TAVI or SAVR,
there were no significant differences in the risk for all-cause mortality,
stroke, or myocardial infarction, as well as the risk of bioprosthetic
valve failure after 8 years of follow-up. CLINICAL TRIAL REGISTRATION:
URL: http://www.ClinicalTrials.gov. Unique identifier:
NCT01057173.<br/>Copyright &#xa9; The Author(s) 2021. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<114>
Accession Number
635468704
Title
Timing of Intervention in Asymptomatic Aortic Stenosis.
Source
Circulation journal : official journal of the Japanese Circulation
Society. (no pagination), 2021. Date of Publication: 25 Jun 2021.
Author
Lee S.-A.; Kang D.-H.
Institution
(Lee, Kang) Division of Cardiology, Asan Medical Center, College of
Medicine, University of Ulsan
Publisher
NLM (Medline)
Abstract
The decision to perform an intervention for asymptomatic severe aortic
stenosis (AS) requires careful weighing of the risks of early intervention
against those of watchful observation, and the optimal timing of
intervention remains controversial. With improvements in surgical and
postoperative care, long-term survival after surgical aortic valve (AV)
replacement (AVR) is excellent in low-risk patients, and the emergence of
transcatheter AVR may change the thresholds for early preemptive
intervention, although a durability issue has to be resolved. A watchful
observation strategy also has a risk of sudden death, irreversible
myocardial damage, and increase in operative risk while waiting for
symptoms to develop. We have been waiting for a prospective randomized
trial to solve the intense debate between early AVR and watchful
observation, and the RECOVERY (Randomized Comparison of Early Surgery
versus Conventional Treatment in Very Severe Aortic Stenosis) trial
provides the evidence to support early AVR for asymptomatic severe AS.
Risk assessment with severity of AS and staging classification may help to
facilitate the identification of patients who may benefit from early
intervention. Based on the results of the RECOVERY trial, early surgical
AVR is reasonable for asymptomatic patients with very severe AS (aortic
jet velocity >=4.5 m/s) and low surgical risk. Further evidence is
required to extend the indications of surgical AVR and to consider
transcatheter AVR in asymptomatic patients with severe AS.