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<1>
Accession Number
2013796041
Title
Design and rationale of a clinical trial to increase cardiomyocyte
division in infants with tetralogy of Fallot.
Source
International Journal of Cardiology. 339 (pp 36-42), 2021. Date of
Publication: 15 Sep 2021.
Author
El Khoudary S.R.; Fabio A.; Yester J.W.; Steinhauser M.L.; Christopher
A.B.; Gyngard F.; Adams P.S.; Morell V.O.; Viegas M.; Da Silva J.P.; Da
Silva L.F.; Castro-Medina M.; McCormick A.; Reyes-Mugica M.; Barlas M.;
Liu H.; Thomas D.; Ammanamanchi N.; Sada R.; Cuda M.; Hartigan E.;
Groscost D.K.; Kuhn B.
Institution
(El Khoudary, Fabio) Epidemiology Data Center, Graduate School of Public
Health, University of Pittsburgh
(Yester, Christopher, Liu, Ammanamanchi, Groscost, Kuhn) Division of
Cardiology, UPMC Children's Hospital of Pittsburgh and Department of
Pediatrics, 4401 Penn Ave, Pittsburgh, PA 15224, United States
(Yester, Liu, Ammanamanchi, Kuhn) Pediatric Institute for Heart
Regeneration and Therapeutics (I-HRT), UPMC Children's Hospital of
Pittsburgh and Department of Pediatrics, 4401 Penn Ave, Pittsburgh, PA
15224, United States
(Steinhauser) Aging Institute, University of Pittsburgh, Bridgeside Point
1, 5th Floor, 100 Technology Drive, Pittsburgh, PA 15219, United States
(Steinhauser) UPMC Heart and Vascular Institute, UPMC Presbyterian, 200
Lothrop St., Pittsburgh, PA 15213, United States
(Gyngard) Center for NanoImaging, Division of Genetics, Department of
Medicine, Brigham and Women's Hospital, Harvard Medical School, 65
Landsdowne St, Rm 535, Cambridge, MA 02139, United States
(Adams) Department of Anesthesiology and Perioperative Medicine, UPMC
Children's Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA 15224,
United States
(Morell, Viegas, Da Silva, Da Silva, Castro-Medina) Pediatric
Cardiothoracic Surgery, UPMC Children's Hospital of Pittsburgh, 4401 Penn
Ave, Pittsburgh, PA 15224, United States
(McCormick) Vascular Anomaly Center, UPMC Children's Hospital of
Pittsburgh and Department of Pediatrics, 4401 Penn Ave, Pittsburgh, PA
15224, United States
(Reyes-Mugica) Division of Pediatric Pathology, UPMC Children's Hospital
of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA
15224, United States
(Barlas) Investigational Drug Service, UPMC Children's Hospital of
Pittsburgh and Department of Pediatrics, 4401 Penn Ave, Pittsburgh, PA
15224, United States
(Thomas, Sada, Cuda, Hartigan) Clinical Research Support Services (CRSS),
UPMC Children's Hospital of Pittsburgh and Department of Pediatrics, 4401
Penn Ave, Pittsburgh, PA 15224, United States
(Kuhn) McGowan Institute of Regenerative Medicine, University of
Pittsburgh School of Medicine, Pittsburgh, PA 15219, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Patients with Tetralogy of Fallot with pulmonary stenosis
(ToF/PS), the most common form of cyanotic congenital heart disease (CHD),
develop adverse right ventricular (RV) remodeling, leading to late heart
failure and arrhythmia. We recently demonstrated that overactive
beta-adrenergic receptor signaling inhibits cardiomyocyte division in
ToF/PS infants, providing a conceptual basis for the hypothesis that
treatment with the beta-adrenergic receptor blocker, propranolol, early in
life would increase cardiomyocyte division. No data are available in
ToF/PS infants on the efficacy of propranolol as a possible novel
therapeutic option to increase cardiomyocyte division and potentially
reduce adverse RV remodeling. Method(s): Using a randomized,
double-blind, placebo-controlled trial, we will evaluate the effect of
propranolol administration on reactivating cardiomyocyte proliferation to
prevent adverse RV remodeling in 40 infants with ToF/PS. Propranolol
administration (1 mg/kg po QID) will begin at 1 month of age and last
until surgical repair. The primary endpoint is cardiomyocyte division,
quantified after 15N-thymidine administration with
Multi-isotope Imaging Mass Spectrometry (MIMS) analysis of resected
myocardial specimens. The secondary endpoints are changes in RV myocardial
and cardiomyocyte hypertrophy. Conclusion(s): This trial will be the
first study in humans to assess whether cardiomyocyte proliferation can be
pharmacologically increased. If successful, the results could introduce a
paradigm shift in the management of patients with ToF/PS from a purely
surgical approach, to synergistic medical and surgical management. It will
provide the basis for future multi-center randomized controlled trials of
propranolol administration in infants with ToF/PS and other types of CHD
with RV hypertension. Clinical trial registration: The trial protocol was
registered at clinicaltrials.gov (NCT04713657). Copyright © 2021
Elsevier B.V.

<2>
Accession Number
2013598987
Title
Implications of the Landmark ISCHEMIA Trial on the Initial Management of
High-Risk Patients with Stable Ischemic Heart Disease.
Source
Current Atherosclerosis Reports. 23 (11) (no pagination), 2021. Article
Number: 70. Date of Publication: November 2021.
Author
Vafaei P.; Naderi S.; Ambrosy A.P.; Slade J.J.
Institution
(Vafaei, Naderi, Ambrosy, Slade) Department of Cardiology, Kaiser
Permanente San Francisco Medical Center, 2238 Geary Boulevard, San
Francisco, CA 94115, United States
(Ambrosy) Division of Research, Kaiser Permanente Northern California,
Oakland, CA, United States
Publisher
Springer
Abstract
Purpose of the Review: In the decades following the advent of percutaneous
coronary intervention, the optimal treatment strategy for managing stable
ischemic heart disease has remained a topic of debate. The purpose of this
review is to discuss current literature that provides insight into
preferred treatment strategies for managing stable coronary artery
disease. Recent Findings: The COURAGE trial (2007) compared patients with
stable coronary artery disease treated with percutaneous coronary
intervention plus optimal medical therapy versus optimal medical therapy
alone and found no difference in death from any cause and non-fatal
myocardial infarction at 4.6 years. The more recent ISCHEMIA trial (2020)
compared an initial invasive revascularization strategy with optimal
medical therapy to optimal medical therapy alone and similarly found no
difference in death from cardiovascular causes, myocardial infarction, or
hospitalization for unstable angina, heart failure, or resuscitated
cardiac arrest at 5 years. Summary: When applied to a broad
population with stable coronary artery disease, evidence suggests there is
no benefit to an initial invasive revascularization strategy relative to
optimal medical therapy alone. Further investigation is warranted to
determine whether there are subgroups of individuals that may benefit from
earlier revascularization. Copyright © 2021, The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<3>
Accession Number
635827228
Title
Comparison of Midterm Outcomes Associated with Aspirin and Ticagrelor vs
Aspirin Monotherapy after Coronary Artery Bypass Grafting for Acute
Coronary Syndrome.
Source
JAMA Network Open. 4 (8) (no pagination), 2021. Article Number: e2122597.
Date of Publication: 26 Aug 2021.
Author
Bjorklund E.; Malm C.J.; Nielsen S.J.; Hansson E.C.; Tygesen H.; Romlin
B.S.; Martinsson A.; Omerovic E.; Pivodic A.; Jeppsson A.
Institution
(Bjorklund, Malm, Nielsen, Hansson, Tygesen, Romlin, Martinsson, Omerovic,
Jeppsson) Department of Molecular and Clinical Medicine, Institute of
Medicine, Sahlgrenska Academy, Gothenburg University, Sweden
(Bjorklund, Tygesen) Department of Medicine, South Alvsborg Hospital,
Boras, Sweden
(Malm, Nielsen, Hansson, Jeppsson) Department of Cardiothoracic Surgery,
Sahlgrenska University Hospital, Gothenburg SE-41345, Sweden
(Romlin) Department of Anesthesiology and Intensive Care, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Martinsson, Omerovic) Department of Cardiology, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Pivodic) Statistiska Konsultgruppen, Gothenburg, Sweden
(Pivodic) Department of Ophthalmology, Institute of Neuroscience and
Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
Publisher
American Medical Association
Abstract
Importance: Guidelines recommend dual antiplatelet therapy after coronary
artery bypass grafting (CABG) for patients with acute coronary syndrome
(ACS). However, the evidence for these recommendations is weak.
 Objective(s): To compare midterm outcomes after CABG in patients with
ACS treated postoperatively with acetylsalicylic acid (ASA) and ticagrelor
or with ASA monotherapy. Design, Setting, and Participant(s): This
cohort study used merged data from several national registries of Swedish
patients who were diagnosed with ACS and subsequently underwent CABG. All
included patients underwent isolated CABG in Sweden between 2012 and 2017
with an ACS diagnosis less than 6 weeks before the procedure, survived 14
days after discharge from hospital, and were treated postoperatively with
ASA plus ticagrelor or ASA monotherapy. A multivariable Cox regression
model was used for the main analysis, and propensity score-matched models
were performed as sensitivity analysis. Data were analyzed between May and
September 2020. Exposures: Postoperative antiplatelet treatment, defined
as filled prescriptions, with either ASA and ticagrelor or ASA only.
 Main Outcomes and Measures: Major adverse cardiovascular events
(MACE), defined as all-cause mortality, myocardial infarction, and stroke,
and major bleeding, at 12 months and at the end of follow-up.
 Result(s): A total of 6558 patients (5281 [80.5%] men; mean [SD] age
at surgery, 67.6 [9.3] years) were included; 1813 (27.6%) were treated
with ASA plus ticagrelor and 4745 (72.4%) were treated with ASA
monotherapy. Crude MACE rate was 3.0 per 100 person years (95% CI, 2.5-3.6
per 100 person years) in the ASA plus ticagrelor group and 3.8 per 100
person years (95% CI, 3.5-4.1 per 100 person years) in the ASA group.
After adjustment, there was no significant difference in MACE risk between
ASA plus ticagrelor vs ASA only, neither during the first 12 months
(adjusted hazard ratio [aHR], 0.84; 95% CI, 0.58-1.21; P =.34) or during
total follow-up (aHR, 0.89; 95% CI, 0.71-1.11; P =.29). The use of ASA
plus ticagrelor was associated with a significantly increased risk for
major bleeding during the first 12 months (aHR, 1.90; 95% CI, 1.16-3.13; P
=.011). Sensitivity analyses confirmed the results. Conclusions and
Relevance: In patients with ACS who survived 2 weeks after CABG, no
significant difference in the risk of death or ischemic events could be
demonstrated between ASA plus ticagrelor and patients treated with ASA
only, while the risk for major bleeding was higher in patients treated
with ASA plus ticagrelor. Sufficiently powered prospective randomized
trials comparing different antiplatelet therapy strategies after CABG are
warranted. Copyright © 2021 Bjorklund E et al.

<4>
Accession Number
635827223
Title
Effect of Continuous Electrocardiogram Monitoring on Detection of
Undiagnosed Atrial Fibrillation after Hospitalization for Cardiac Surgery:
A Randomized Clinical Trial.
Source
JAMA Network Open. 4 (8) (no pagination), 2021. Article Number: e2121867.
Date of Publication: 27 Aug 2021.
Author
Ha A.C.T.; Verma S.; Mazer C.D.; Quan A.; Yanagawa B.; Latter D.A.; Yau
T.M.; Jacques F.; Brown C.D.; Singal R.K.; Yamashita M.H.; Saha T.; Teoh
K.H.; Lam B.-K.; Deyell M.W.; Wilson M.; Hibino M.; Cheung C.C.;
Kosmopoulos A.; Garg V.; Brodutch S.; Teoh H.; Zuo F.; Thorpe K.E.; Juni
P.; Bhatt D.L.; Verma A.
Institution
(Ha, Yau) Peter Munk Cardiac Centre, Toronto General Hospital, University
Health Network, University of Toronto, Toronto, ON, Canada
(Verma, Quan, Yanagawa, Latter, Wilson, Hibino, Kosmopoulos, Garg,
Brodutch, Teoh) Department of Cardiac Surgery, St Michael's Hospital,
University of Toronto, 30 Bond St, Toronto, ON M5B 1W8, Canada
(Mazer) Department of Anesthesiology, St Michael's Hospital, University of
Toronto, Toronto, ON, Canada
(Jacques) University Institute of Cardiology and Respirology of Quebec,
Quebec City, QC, Canada
(Brown) Division of Cardiac Surgery, New Brunswick, Saint John, NB, Canada
(Singal, Yamashita) Division of Surgery, Cardiac Science Program, St
Boniface General Hospital, Winnipeg, MB, Canada
(Saha) Department of Anesthesiology and Perioperative Medicine, Kingston
General Hospital, Kingston, ON, Canada
(Teoh, Verma) Southlake Regional Health Center, University of Toronto,
602-581 Davis Dr, Newmarket, ON L3Y 2P6, Canada
(Lam) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Deyell, Cheung) Division of Cardiology, St Paul's Hospital, Vancouver,
BC, Canada
(Zuo, Thorpe, Juni) Applied Health Research Centre, Li Ka Shing Knowledge
Institute, St Michael's Hospital, Toronto, ON, Canada
(Bhatt) Heart and Vascular Center, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
American Medical Association
Abstract
Importance: Postoperative atrial fibrillation (POAF) occurring after
cardiac surgery is associated with adverse outcomes. Whether POAF persists
beyond discharge is not well defined. Objective(s): To determine
whether continuous cardiac rhythm monitoring enhances detection of POAF
among cardiac surgical patients during the first 30 days after hospital
discharge compared with usual care. Design, Setting, and
Participant(s): This study is an investigator-initiated, open-label,
multicenter, randomized clinical trial conducted at 10 Canadian centers.
Enrollment spanned from March 2017 to March 2020, with follow-up through
September 11, 2020. As a result of the COVID-19 pandemic, enrollment
stopped on July 17, 2020, at which point 85% of the proposed sample size
was enrolled. Cardiac surgical patients with CHA2DS2-VASc (congestive
heart failure, hypertension, age >=75 years, diabetes, prior stroke or
transient ischemic attack, vascular disease, age 65-74 years, female sex)
score greater than or equal to 4 or greater than or equal to 2 with risk
factors for POAF, no history of preoperative AF, and POAF lasting less
than 24 hours during hospitalization were enrolled. Intervention(s):
The intervention group underwent continuous cardiac rhythm monitoring with
wearable, patch-based monitors for 30 days after randomization. Monitoring
was not mandated in the usual care group within 30 days after
randomization. Main Outcomes and Measures: The primary outcome was
cumulative AF and/or atrial flutter lasting 6 minutes or longer detected
by continuous cardiac rhythm monitoring or by a 12-lead electrocardiogram
within 30 days of randomization. Prespecified secondary outcomes included
cumulative AF lasting 6 hours or longer and 24 hours or longer within 30
days of randomization, death, myocardial infarction, ischemic stroke,
non-central nervous system thromboembolism, major bleeding, and oral
anticoagulation prescription. Result(s): Of the 336 patients
randomized (163 patients in the intervention group and 173 patients in the
usual care group; mean [SD] age, 67.4 [8.1] years; 73 women [21.7%];
median [interquartile range] CHA2DS2-VASc score, 4.0 [3.0-4.0] points),
307 (91.4%) completed the trial. In the intent-to-treat analysis, the
primary end point occurred in 32 patients (19.6%) in the intervention
group vs 3 patients (1.7%) in the usual care group (absolute difference,
17.9%; 95% CI, 11.5%-24.3%; P <.001). AF lasting 6 hours or longer was
detected in 14 patients (8.6%) in the intervention group vs 0 patients in
the usual care group (absolute difference, 8.6%; 95% CI, 4.3%-12.9%; P
<.001). Conclusions and Relevance: In post-cardiac surgical patients
at high risk of stroke, no preoperative AF history, and AF lasting less
than 24 hours during hospitalization, continuous monitoring revealed a
significant increase in the rate of POAF after discharge that would
otherwise not be detected by usual care. Studies are needed to examine
whether these patients will benefit from oral anticoagulation therapy.
Trial Registration: ClinicalTrials.gov Identifier:
NCT02793895. Copyright © 021 Ha ACT et al.

<5>
Accession Number
2013583145
Title
Is a block of the femoral and sciatic nerves an alternative to epidural
analgesia in sheep undergoing orthopaedic hind limb surgery? A
prospective, randomized, double blinded experimental trial.
Source
Animals. 11 (9) (no pagination), 2021. Article Number: 2567. Date of
Publication: September 2021.
Author
Stenger V.; Zeiter S.; Buchholz T.; Arens D.; Spadavecchia C.;
Schupbach-Regula G.; Rohrbach H.
Institution
(Stenger, Zeiter, Buchholz, Arens) AO Research Institute Davos,
Clavadelerstrase 8, Davos Platz 7270, Switzerland
(Spadavecchia, Rohrbach) Department of Clinical Veterinary Medicine,
Anaesthesia Section, Vetsuisse Faculty Bern, Bern 3012, Switzerland
(Schupbach-Regula) Veterinary Public Health Institute of the Vetsuisse
Faculty Bern, Bern 3012, Switzerland
Publisher
MDPI
Abstract
Peripheral nerve blocks are commonly used in human and veterinary
medicine. The aim of the study was to compare the analgesic efficacy of a
combined block of the femoral and sciatic nerves with an epidural
injection of ropivacaine in experimental sheep undergoing orthopaedic hind
limb surgery. Twenty-five sheep were assigned to two groups (peripheral
nerve block; sciatic and femoral nerves (P); epidural analgesia (E)). In
group P 10 mL ropivacaine 0.5% was injected around the sciatic and the
femoral nerves under sonographic guidance and 10 mL NaCl 0.9% into the
epidural space while in group E 10 mL ropivacaine 0.5% was injected into
the epidural space and 10 mL NaCl 0.9% to the sciatic and the femoral
nerves. During surgery, heart rate, respiratory rate and mean blood
pressure were used as indicators of nociception. In the postoperative
phase, nociception was evaluated every hour by use of a purposefully
adapted pain score until the animal showed painful sensation at the
surgical site. The mean duration of analgesia at the surgical wound was 6
h in group P and 8 h in group E. Mean time to standing was 4 h in group P
and 7 h in group E. In conclusion time to standing was significantly
shorter in group P while the duration of nociception was comparable in
both groups. The peripheral nerve block can be used as an alternative to
epidural analgesia in experimental sheep. Copyright © 2021 by the
authors. Licensee MDPI, Basel, Switzerland.

<6>
Accession Number
2012255731
Title
Comorbid conditions and percutaneous coronary intervention in elderly
patients with acute coronary syndrome.
Source
Rational Pharmacotherapy in Cardiology. 17 (2) (pp 221-227), 2021. Date of
Publication: 2021.
Author
Gilyarov M.Yu.; Konstantinova E.V.; Atabegashvili M.R.; Solntseva T.D.;
Anichkov D.A.; Kostina A.N.; Polybin R.V.; Udovichenko A.E.; Svet A.V.
Institution
(Gilyarov, Konstantinova, Atabegashvili, Udovichenko, Svet) City Clinical
Hospital, No1 n.a. N.I. Pirogov, Moscow, Russian Federation
(Gilyarov, Konstantinova, Anichkov, Udovichenko) Pirogov Russian National
Research Medical University, Moscow, Russian Federation
(Gilyarov, Kostina, Polybin, Udovichenko, Svet) I.M. Sechenov First Moscow
State Medical University (Sechenov University), Moscow, Russian Federation
(Solntseva) Research Institute of Cardiology Named after A.L. Myasnikov,
National Medical Research Center of Cardiology, Moscow, Russian Federation
Publisher
Stolichnaya Izdatelskaya Kompaniya
Abstract
Aim. To assess the severity of comorbid conditions in elderly patients
with acute coronary syndrome (ACS) and to analyze subgroups with different
treatment strategies for patients in the daily work of the Regional
Vascular Center (RVC). Material and methods. The prospective study
included 205 patients aged 75 years and older with a confirmed diagnosis
of ACS, and if they signed an informed consent. The average age of the
patients included in the study was 81.6 4.9 years, among them there were
65 (32%) men and 140 (68%) women. 46 patients (22.4%) were diagnosed with
ACS with ST-segment elevation (ST-ACS), and 159 (77.6%)-ACS without
ST-segment elevation (NST-ACS). Comorbidity index (CCI) was calculated.
The immediate results of treatment were assessed during the period of
hospitalization, and the long-Term results of treatment were assessed 6
months after the patient was discharged from the hospital by phone calls
and/or clinic visits. Results. Interventional treatment was performed in
42% of cases (n=86). Percutaneous coronary intervention (PCI) was
performed in 69.6% of patients with ST-ACS, and in 32% of patients with
NST-ACS. The average CCI was 7.9 points, for men-7.6 points, for
women-8.04 points. A higher CCI was noted in the group of patients with
ST-ACS, which was 8.1, compared with the group of NST-ACS, where the
average value in the group was 7.1 (p 0.01). The group of patients with
the invasive strategy noted a lower CCI of 7.2 compared with patients
without PCI, where the mean CCI was 8.2 (p 0.05), patients with ST-ACS in
the same groups also noted a statistically significant difference CCI
values of 7.4 and 8.4, respectively (p 0.05). The average CCI among
patients who died in hospital was 8.5, and among discharged patients-7.6
points (p0.01). After 6 months from the onset of the disease, 13 patients
(6.3%) died, their average age was 84.9 years, the mean CCI value in this
group was 9 points, PCI was performed in 3 (23%) patients. Conclusion.
Elderly patients with ACS have a significant severity of comorbid
pathology, which was assessed using the CCI. The CCI value is correlated
with the failure to perform PCI in elderly patients with ACS in real
clinical practice. Senile patients with NST-ACS have a higher CCI value
compared to patients with ST-ACS, which significantly correlates with
their failure to perform PCI. In patients who died in hospital and after 6
months from the development of ACS, there are higher CCI values in
comparison with other elderly patients with ACS. Copyright © 2021
Stolichnaya Izdatelskaya Kompaniya. All rights reserved.

<7>
Accession Number
2011259271
Title
Evidence for the efficacy of an opioid-sparing effect of intravenous
acetaminophen in the surgery patient: A systematic review.
Source
Pain Medicine (United States). 21 (12) (pp 3301-3313), 2020. Date of
Publication: 2020.
Author
Hilleman D.E.; Malesker M.A.; Aurit S.J.; Morrow L.
Institution
(Hilleman, Malesker) Department of Pharmacy Practice, Creighton University
School of Pharmacy and Health Professions, Omaha, NE, United States
(Aurit, Morrow) Department of Medicine, Creighton University School of
Medicine, Omaha, NE, United States
Publisher
Oxford University Press
Abstract
Background. Intravenous (IV) acetaminophen is used in multimodal analgesia
to reduce the amount and duration of opioid use in the postoperative
setting. Methods. A systematic review of published randomized controlled
trials was conducted to define the opioid-sparing effect of IV
acetaminophen in different types of surgeries. Eligible studies included
prospective, randomized, double-blind trials of IV acetaminophen compared
with either a placebo- or active-treatment group in adult (age >18 years)
patients undergoing surgery. Trials had to be published in English in a
peer-reviewed journal. Results. A total of 44 treatment cohorts included
in 37 studies were included in the systematic analysis. Compared with
active- or placebo-control treatments, IV acetaminophen produced a
statistically significant opioid-sparing effect in 14 of 44 cohorts (32%).
An opioid-sparing effect was more common in placebo-controlled
comparisons. Of the 28 placebo treatment comparisons, IV acetaminophen
produced an opioid-sparing effect in 13 (46%). IV acetaminophen produced
an opioid-sparing effect in only 6% (one out of 16) of the active-control
groups. Among the 16 active-control groups, opioid consumption was
significantly greater with IV acetaminophen than the active comparator in
seven cohorts and not significantly different than the active comparator
in eight cohorts. Conclusions. The results of this systematic analysis
demonstrate that IV acetaminophen is not effective in reducing opioid
consumption compared with other adjuvant analgesic agents in the
postoperative patient. In patients where other adjuvant analgesic agents
are contraindicated, IV acetaminophen may be an option. Copyright
© The Author(s) 2020. Published by Oxford University Press on behalf
of the American Academy of Pain Medicine. All rights reserved.

<8>
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Accession Number
632692819
Title
Perioperative ADministration of Dexamethasone And blood Glucose
concentrations in patients undergoing elective non-cardiac surgery - the
randomised controlled PADDAG trial.
Source
European journal of anaesthesiology. 38 (9) (pp 932-942), 2021. Date of
Publication: 01 Sep 2021.
Author
Corcoran T.B.; O'Loughlin E.; Chan M.T.V.; Ho K.M.
Institution
(Corcoran) From the Department of Anaesthesia and Pain Medicine, Royal
Perth Hospital (TBC), School of Medicine and Pharmacology, University of
Western Australia, Perth, Western Australia (TBC, EOL), Department of
Epidemiology and Preventive Medicine, Monash University, Melbourne,
Victoria (TBC), Department of Anaesthesia and Pain Medicine, Fiona Stanley
Hospital, Perth, Western Australia, Australia (EOL), Department of
Anaesthesia and Intensive Care, The Chinese University of Hong Kong,
Shatin, New Territories, Hong Kong Special Administrative Region, China
(MAC), Department of Intensive Care Medicine, Royal Perth Hospital (KMH),
Medical School, University of Western Australia (KMH) and School of
Veterinary & Life Sciences, Murdoch University, Perth, Western Australia,
Australia (KMH)
Publisher
NLM (Medline)
Abstract
BACKGROUND: The hyperglycaemic effect of dexamethasone in diabetic and
nondiabetic patients in the peri-operative period is unknown.
 OBJECTIVE(S): To assess the effect of a single dose of
intra-operative dexamethasone on peri-operative blood glucose. DESIGN:
Multicentre, stratified, randomised trial. SETTING: University hospitals
in Australia and Hong Kong. PATIENTS: A total of 302 adults scheduled for
elective, noncardiac and nonobstetric surgical procedures under general
anaesthesia, stratified by diabetes mellitus status, were randomised to
receive placebo, 4 or 8 mg dexamethasone administered intravenously after
induction of anaesthesia. MAIN OUTCOME MEASURES: Maximum blood glucose
within 24 h of surgery, and the interaction between glycated haemoglobin
(HbA1c) and dexamethasone were the primary and secondary outcomes.
 RESULT(S): The median [IQR] baseline blood glucose in the nondiabetes
stratum in the placebo (n=81), 4 mg (n=81) and 8 mg dexamethasone (n=77)
trial arms were respectively 5.3 [4.6 to 5.8], 5.0 [4.7 to 5.4] and 5.0
[4.2 to 5.9] mmol l-1. In the diabetes stratum these values were 6.6 [6.0
to 8.3]; (n=22), 6.1 [5.5 to 10.4]; (n=22) and 6.7 [5.6 to 8.3]; (n=19)
mmol l-1. The median [IQR] maximum peri-operative blood glucose values in
the nondiabetes stratum were 6.0 [5.3 to 6.8], 6.3 [5.5 to 7.3] and 6.3
[5.8 to 7.4] mmol l-1 in the control, dexamethasone 4 mg and dexamethasone
8 mg arms, respectively. In the diabetes stratum these values were 10.3
[8.1 to 12.4], 12.6 [10.3 to 18.3] and 13.6 [11.2 to 20.1] mmol l-1. There
was a significant interaction between pre-operative HbA1c value and 8 mg
dexamethasone: every 1% increment in HbA1c produced a 4.0 mmol l-1
elevation in maximal peri-operative glucose concentration.
 CONCLUSION(S): Dexamethasone 4 mg or 8 mg did not induce greater
hyperglycaemia compared with placebo for nondiabetic and well controlled
diabetic patients. Maximal peri-operative blood glucose concentrations in
patients with diabetes were related to baseline HbA1c values in a
concentration-dependent fashion after 8 mg of dexamethasone. TRIAL
REGISTRATION: Australia and New Zealand Clinical Trials Registry
(ACTRN12614001145695): URL:
https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367272.Copyright © 2020 European Society of Anaesthesiology and Intensive
Care. Unauthorized reproduction of this article is prohibited.

<9>
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Accession Number
632986297
Title
Corynebacterium Jeikeium Endocarditis: A Review of the Literature.
Source
Cardiology in review. 29 (5) (pp 259-262), 2021. Date of Publication: 01
Sep 2021.
Author
Gupta R.; Popli T.; Ranchal P.; Khosla J.; Aronow W.S.; Frishman W.H.; El
Khoury M.Y.
Institution
(Gupta, Ranchal, Khosla, Aronow, Frishman) From the Department of Internal
Medicine, Westchester Medical Center and New York Medical College,
Valhalla, NY
(Popli, El Khoury) Division of Infectious Disease, Westchester Medical
Center and New York Medical College, Valhalla, NY
(Aronow, Frishman) Division of Cardiology, Westchester Medical Center and
New York Medical College, Valhalla, NY
Publisher
NLM (Medline)
Abstract
Corynebacterium jeikeium is a gram-positive, aerobic, pleomorphic,
nonspore forming bacillus, commonly present on the skin surface. Infective
endocarditis secondary to C. jeikeium most commonly affects left-sided
heart valves and has a higher likelihood to require valve replacement
compared to other Corynebacterium endocarditis. C. jeikeium endocarditis
is extremely difficult to treat as it is characteristically resistant to
penicillin, cephalosporins and aminoglycosides, and sensitivity to
quinolones, macrolides, tetracyclines and rifampin is variable. Despite
treatment, mortality rates as high as 33% have been reported. We hereby
review the literature regarding the epidemiology, diagnosis and treatment
of this deadly microorganism. Copyright © 2020 Wolters Kluwer
Health, Inc. All rights reserved.

<10>
Accession Number
2012008231
Title
Comparison of High-Flow Humidified Oxygen With Conventional Continuous
Positive Airway Pressure in Nonventilated Lungs During Thoracic Surgery: A
Randomized Cross-Over Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (10) (pp 2945-2951),
2021. Date of Publication: October 2021.
Author
Sawasdiwipachai P.; Weerayutwattana R.; Thongcharoen P.; Suksompong S.
Institution
(Sawasdiwipachai, Suksompong) Department of Anesthesiology, Faculty of
Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
(Weerayutwattana) Department of Anesthesiology, Faculty of Medicine,
Vajira Hospital, Bangkok, Thailand
(Thongcharoen) Division of Cardiothoracic Surgery, Department of Surgery,
Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok,
Thailand
Publisher
W.B. Saunders
Abstract
Objective: This study assessed the efficacy of high-flow humidified oxygen
(HFHO) as an alternative to continuous positive airway pressure (CPAP) for
improving oxygenation while preserving nonventilated lung collapse during
one-lung ventilation. Design(s): A prospective randomized cross-over
trial. Setting(s): A tertiary medical center. Participant(s):
The study comprised 28 patients undergoing elective thoracotomy with
one-lung ventilation using a double-lumen endobronchial tube placement.
 Intervention(s): The patients received prophylactic CPAP or HFHO to
the nonventilated lung for 20 minutes and were then crossedover to the
other oxygenation modality for 20 minutes, with a 20-minute recovery
interval between the two modalities. Measurements and Main Results:
Changes in respiratory parameters and lung deflation quality were
recorded. Both CPAP and HFHO increased the partial pressure of arterial
oxygen in either sequence in both groups, ranging from 31.8-to-66.0 mmHg.
However, the increments from these two interventions were not
statistically significant (95% confidence interval -12.84 to 21.87; p =
0.597). There were no differences in other parameters. Half the patients
receiving CPAP experienced worsening of the surgical condition, whereas
the HFHO patients experienced no change or reported a better lung
deflation (p < 0.001). Conclusion(s): HFHO could be an alternative
method to CPAP for improving arterial oxygenation while preserving lung
deflation during one-lung ventilation. However, additional studies are
warranted in regard to its cost-effectiveness and establishment as a
routine treatment. Copyright © 2021 Elsevier Inc.

<11>
Accession Number
635266114
Title
Alternatives for Vitamin K Antagonists as Thromboprophylaxis for
Mechanical Heart Valves and Mechanical Circulatory Support Devices: A
Systematic Review.
Source
Seminars in Thrombosis and Hemostasis. 47 (6) (pp 724-734), 2021. Date of
Publication: 01 Sep 2021.
Author
Liesdek O.C.D.; Urbanus R.T.; De Heer L.M.; Fischer K.; Suyker W.J.L.;
Schutgens R.E.G.
Institution
(Liesdek, De Heer, Suyker) Department of Cardiothoracic Surgery,
University Medical Center Utrecht, Utrecht University, Utrecht,
Netherlands
(Liesdek, Urbanus, Fischer, Schutgens) Van Creveldkliniek, University
Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
Publisher
Thieme Medical Publishers, Inc.
Abstract
The holy grail of anticoagulation in patients with intracardiac devices,
such as mechanical heart valves (MHVs) and left ventricular assist devices
(LVADs), comprises safe prevention of thrombosis without interrupting
normal hemostasis. Device-induced thrombosis and anticoagulant-related
bleeding problems are dreaded complications that may cause a significantly
reduced quality of life and increased morbidity and mortality. Vitamin K
antagonists are the current standard for oral anticoagulation therapy in
patients with MHVs and LVADs. Even within the therapeutic range,
hemorrhage is the primary complication of these drugs, which emphasizes
the need for safer anticoagulants for the prevention of device-induced
thrombosis. Device-induced thrombosis is a complex multifactorial
phenomenon that likely requires anticoagulant therapy targeting multiple
pathways. Here, we review the preclinical and clinical data describing the
efficacy of a variety of anticoagulants as thromboprophylaxis after
implantation of intracardiac devices. Copyright © 2021 American
Institute of Physics Inc.. All rights reserved.

<12>
[Use Link to view the full text]
Accession Number
635004678
Title
Does a balanced colloid decrease perioperative blood loss in paediatric
cardiac surgery: A double-blinded randomized controlled trial?.
Source
European journal of anaesthesiology. 38 (9) (pp 923-931), 2021. Date of
Publication: 01 Sep 2021.
Author
Willems A.; De Groote F.; Schmartz D.; Fils J.-F.; Van der Linden P.
Institution
(Willems) From the Paediatric Intensive Care Unit, Department of Intensive
Care, Leiden University Medical Centre, Leiden, The Netherlands (AW),
Department of Anaesthesiology, University Hospital Brugmann and Queen
Fabiola University Children's Hospital, Brussels, Belgium (F-DG, DS,
P-VdL) and Ars Statistica, Nivelles, Belgium (JF-F)
Publisher
NLM (Medline)
Abstract
BACKGROUND: Unbalanced fluid solutions cause metabolic acidosis and could
be associated with impaired coagulation and increased blood loss.
 OBJECTIVE(S): To investigate whether the use of a balanced colloid
compared with a saline colloid for peri-operative fluid therapy in
children undergoing cardiac surgery is associated with decreased blood
loss and exposure to blood products. DESIGN: Double-blinded randomised
controlled trial. SETTING: Tertiary children's hospital from 2013 to 2016.
PATIENTS: Children older than 29 days and younger than 3 years admitted
for cardiac surgery with cardiopulmonary bypass (CPB). Exclusion criteria
were emergency cardiac surgery, moribund (American Society of
Anesthesiologists 5), Jehovah's witnesses, coagulopathy, renal failure,
liver injury, intracranial haemorrhage and electrolyte disturbances. From
the 128 patients eligible, 88 were included in the study. INTERVENTION:
Random assignment of patients to either a saline colloid (6% hydroxyethyl
starch 130/0.4 in 0.9% NaCl) or a balanced-electrolyte colloid (6%
hydroxyethyl starch 130/0.4 in an isotonic solution) for CPB priming and
intra- and postoperative fluid therapy during the first postoperative 48
h. MAIN OUTCOME MEASURE: The primary outcome measure was calculated blood
loss until the third postoperative day (POD3). RESULT(S): A total of
44 patients were included in each study arm. Calculated blood loss at POD3
was not significantly different between the groups (saline colloid 19.9
[IQR 13.8 to 26.1] ml kg-1 versus balanced colloid 15.9 [IQR 9.0 to 25.3
ml kg-1], P = 0.409). Secondary outcomes related to bleeding, exposure to
blood products and coagulation were not different between groups. There
was also no difference in length of mechanical ventilation, intensive care
and hospital length of stay between groups. CONCLUSION(S): The use of
a balanced colloid for peri-operative fluid therapy compared with a saline
one is not associated with decreased blood loss or exposure to blood
products. TRIAL REGISTRATION: EudraCT identifier: 2012-006034-17 and
ClinicalTrial.gov identifier: NCT02584868. Copyright © 2021
European Society of Anaesthesiology and Intensive Care. Unauthorized
reproduction of this article is prohibited.

<13>
Accession Number
635918278
Title
Urinary ngal:hepcidin-25 ratio versus urinary ngal for early
identification of patients at risk for acute renal replacement therapy and
death after cardiac surgery.
Source
Nephrology Dialysis Transplantation. Conference: 58th ERA-EDTA Congress.
Virtual. 36 (SUPPL 1) (pp i270), 2021. Date of Publication: May 2021.
Author
Elitok S.; Haase-Fielitz A.; Ernst M.; Haase M.
Institution
(Elitok, Ernst) Hospital Ernst-von-Bergmann, Department of Nephrology,
Potsdam, Germany
(Haase-Fielitz) Heart Center Brandenburg, Department of Cardiology,
Bernau, Germany
(Haase) Otto-von-Guericke University Magdeburg, Medical Faculty,
Magdeburg, Germany
(Haase) Diaverum, Kidney Care Center, Potsdam, Germany
Publisher
Oxford University Press
Abstract
BACKGROUND AND AIMS: Acute kidney injury requiring renal replacement
therapy (AKI-RRT) is strongly associated with mortality after cardiac
surgery, however, options for early identification of patients at
high-risk for AKI-RRT are extremely limited. Early after cardiac surgery,
the predictive ability for AKI-RRT even of one of the most extensively
evaluated novel urinary biomarkers, neutrophil gelatinase-associated
lipocalin (NGAL), appears to be only moderate. We aimed to determine
whether the discriminatory power and reclassification indices of
NGAL:hepcidin-25-ratio (urinary concentrations of NGAL divided by that of
hepcidin-25) within 60 min after end of surgery compare favorably to NGAL
alone for identification of high-risk patients after cardiac surgery. We
also aimed to determine whether an increased NGAL:hepcidin-25-ratio can
detect subclinical AKI (no serum creatinine- or urine output-based
criteria for AKI). METHOD(S): This is a prospective substudy of the
BICARBONATE trial, a multicenter parallel-randomized controlled trial
comparing perioperative bicarbonate infusion for AKI prevention to usual
patient care. At a tertiary referral center, 198 patients at increased
kidney risk undergoing cardiac surgery with cardiopulmonary bypass were
included into the present study. The primary outcome measure was defined
as AKIRRT. Secondary outcomes were in-hospital mortality and ratio-defined
subclinical AKI characterized by increased odds for AKI-RRT or in-hospital
mortality. We compared biomarkers' area-under-the-curve of the
receiver-operating-characteristic and performed cross-validated
reclassification statistics and regression analysis adjusted to Cleveland
risk score/EuroScore, cross-clamp time, age and volume of packed red blood
cells. RESULT(S): Patients with AKI-RRT (n=13) had 13.7-times higher
NGAL and 3.3-times lower hepcidin-25 concentrations resulting in
46.9-times higher NGAL:hepcidin-25- ratio early after surgery compared to
patients without AKI-RRT (Figure 1). The NGAL:hepcidin-25-ratio had higher
discriminatory power compared with NGAL for risk of AKI-RRT and
in-hospital mortality (area-under-the-curve difference 0.087, 95% CI,
0.036 to 0.138, P<0.001; 0.082, 95% CI, 0.018 to 0.146, P=0.012). The
NGAL:hepcidin-25-ratio, but not NGAL, was independently associated with
AKI-RRT (adjusted OR per 1-SD higher lnNGAL:hepcidin-25-ratio, 1.524, 95%
CI, 1.046 to 2.222, P=0.028). The NGAL:hepcidin-25-ratio increased
category-free netreclassification- improvement for AKI-RRT (0.690, 95% CI,
0.146 to 1.234, P=0.013) and in-hospital mortality (cfNRI 0.744, 95% CI,
0.201 to 1.288, P=0.007). NGAL:hepcidin-25-ratio-positive subclinical AKI
was associated with increased AKIRRT (OR 10.02, 95% CI, 1.59 to 63.39;
P<0.001) and in-hospital mortality rates (OR 41.07, 95% CI, 4.31 to
391.40; P<0.001). MO410. CONCLUSION(S): The urinary
NGAL:hepcidin-25-ratio appears to early identify highrisk patients and
outperform NGAL after cardiac surgery. Also, the urinary NGAL:hepcidin-25
ratio can detect subclinical AKI. Confirmation of our findings in other
cardiac surgery centers is now needed.

<14>
Accession Number
635917479
Title
Substantial cardiovascular risk reduction with icosapent ethyl regardless
of diabetes status or BMI: Reduce-it BMI.
Source
Diabetes. Conference: 81st Scientific Sessions of the American Diabetes
Association, ADA 2021. Virtual. 70 (SUPPL 1) (no pagination), 2021. Date
of Publication: June 2021.
Author
Bhatt D.L.; Brinton E.A.; Steg P.G.; Ketchum S.B.; Juliano R.A.; Jiao L.;
Doyle R.T.; Granowitz C.; Tardif J.-C.; Ballantyne C.M.
Institution
(Bhatt, Brinton, Steg, Ketchum, Juliano, Jiao, Doyle, Granowitz, Tardif,
Ballantyne) Boston, MA, Salt Lake City, UT, Paris, France, Bridgewater,
NJ, Montreal, QC, Canada, Houston, TX
Publisher
American Diabetes Association Inc.
Abstract
Background: REDUCE-IT, a multinational, double-blind trial, randomized
8179 statin-treated patients with controlled low density lipoprotein
cholesterol, elevated triglycerides, and cardiovascular (CV) risk, to
icosapent ethyl (IPE) 4 grams daily or placebo. IPE reduced the primary
(CV death, myocardial infarction [MI], stroke, coronary revascularization,
hospitalization for unstable angina) and key secondary (CV death, MI,
stroke) endpoints 25% and 26%, respectively (each p<0.000001). At
baseline, median body mass index (BMI) was 30.8 kg/m2 , and
58.5% of REDUCE-IT patients had diabetes mellitus (DM). In patients with
DM, the primary and key secondary endpoints were reduced 23% and 30%,
respectively (each p<=0.00005). Method(s): We evaluated if BMI
modulated CV risk reduction with IPE in patients with or without DM.
 Result(s): In the full cohort, similar CV risk reduction was observed
across the prespecified endpoint testing hierarchy (interaction p=ns for
all), and relative safety between treatment groups was generally
consistent. In persons with or without DM, similar reductions in the
primary endpoint were observed across BMI categories (Figure), with
similar findings in the key secondary endpoint (interaction p=ns for all).
 Conclusion(s): The significant cardiovascular risk reduction provided
by IPE 4g/day is consistent across BMI in patients with and without DM.

<15>
Accession Number
635917198
Title
Efficacy of intravenous ferric carboxymaltose in patients with iron
deficiency following acute heart failure, according to baseline EGFR: A
subgroup analysis of the AFFIRM-AHF trial.
Source
Nephrology Dialysis Transplantation. Conference: 58th ERA-EDTA Congress.
Virtual. 36 (SUPPL 1) (pp i16), 2021. Date of Publication: May 2021.
Author
Macdougall I.; Jankowska E.A.; Metra M.; Filippatos G.; Kirwan B.-A.; Van
Der Meer P.; Ruschitzka F.; Fabien V.; Waechter S.; Butler J.; Anker S.D.;
Ponikowski P.
Institution
(Macdougall) King's College Hospital, Department of Renal Medicine,
London, United Kingdom
(Jankowska, Ponikowski) Wroclaw Medical University, Department of Heart
Diseases, Wroclaw, Poland
(Metra) University and Civil Hospital, Department of Cardiology, Brescia,
Italy
(Filippatos) University of Athens, Department of Cardiology, Athens,
Greece
(Kirwan) SOCAR Research, Department of Clinical Research, Nyon,
Switzerland
(Van Der Meer) University Medical Center Groningen, Department of
Cardiology, Groningen, Netherlands
(Ruschitzka) UniversitatsSpietal Zurich, Klinik fur Kardiologie, Zurich,
Switzerland
(Fabien, Waechter) Vifor Pharma AG, Glattbrugg, Switzerland
(Butler) University of Mississippi Medical Center, Jackson, United States
(Anker) Charite, Campus Virchow-Klinikum, Berlin, Germany
Publisher
Oxford University Press
Abstract
BACKGROUND AND AIMS: In the AFFIRM-AHF trial, treatment with intravenous
(IV) ferric carboxymaltose (FCM) reduced the risk of heart failure (HF)
hospitalisations vs placebo in patients with iron deficiency after an
episode of acute HF. Of these patients, 41% had a medical history of
chronic kidney disease (CKD). This prespecified subanalysis of AFFIRM-AHF
data was performed to investigate the effect of renal function on FCM
efficacy. METHOD(S): In AFFIRM-AHF, patients stabilised following
hospitalisation for acute HF with concomitant iron deficiency (defined as
ferritin <100 lg/L, or 100-299 lg/L with transferrin saturation <20%) were
randomised to receive either IV FCM or placebo before discharge for the
index hospitalisation. In this analysis, patients who had received at
least one dose of the study drug, and who had at least one
postrandomisation data point and a baseline value for estimated glomerular
filtration rate (eGFR; calculated using the CKD-EPI formula and baseline
creatinine value), were stratified into tertiles according to baseline
eGFR. The primary outcome was a composite of total HF hospitalisations and
CV death. Secondary outcomes included total HF hospitalisations, CV death,
time to first HF hospitalisation or CV death, composite of total CV
hospitalisations and CV death, and days lost due to HF hospitalisations or
CV death. All outcomes were evaluated up to 52 weeks postrandomisation.
 RESULT(S): Of the 1,108 patients included in primary AFFIRM-AHF
analyses, 967 (FCM: 487; placebo: 480) had a baseline eGFR value and were
included in this analysis. In both groups, 60% of patients had an eGFR <60
mL/min/1.73 m2 following the index acute HF episode. Patients
were divided into eGFR tertiles 1, 2 and 3, with corresponding respective
baseline eGFR values of <42.96, 42.96 to <64.32, and >=64.32 mL/min/1.73
m2. At baseline, the mean age, proportion of females, and
proportions of patients with ischaemic HF aetiology, a documented history
of HF, and a medical history of percutaneous coronary intervention,
coronary artery bypass graft and/or cardiac resynchronisation therapy,
were highest in eGFR tertile 1 and lowest in eGFR tertile 3. In eGFR
tertiles 1, 2 and 3, the number of total HF hospitalisations and CV deaths
in the FCM group vs placebo group were, respectively, 115 vs 152, 76 vs
83, and 56 vs 79, with respective annualised rate ratios (95% confidence
interval [CI]) of 0.76 (0.50, 1.16), 0.76 (0.48, 1.22) and 0.69 (0.42,
1.12) (Figure). In eGFR tertile 3, the total number of CV hospitalisations
and CV deaths was significantly lower in the FCM group vs the placebo
group (69 vs 107; rate ratio [95% CI] 0.60 [0.39, 0.93]), with a nominally
lower number of total HF hospitalisations with FCM vs placebo (44 vs 66;
rate ratio [95% CI] 0.62 [0.38, 1.01]). In the time to first event
analysis, FCM significantly reduced HF hospitalisation or CV death vs
placebo in eGFR tertile 3 (hazard ratio [95% CI] 0.64 [0.42, 0.98]). In
eGFR tertiles 1 and 2, differences between FCM and placebo arms for
secondary endpoints did not reach statistical significance. The p-trend
for treatment by baseline eGFR subgroup was non-significant for the
primary outcome (0.941) and also for the secondary outcomes specified
here. CONCLUSION(S): In patients with iron deficiency who were
stabilised after an episode of acute HF, numerically fewer primary and
secondary events, endpoints or outcomes were consistently observed with
FCM vs placebo across the eGFR tertiles. In addition, no significant
interaction between kidney function and FCM efficacy was noted. Given that
this analysis was limited by small patient numbers following subgroup
stratification, further studies in larger cohorts with CKD may help to
clarify the effect of IV FCM in this patient population. (Table
Presented).

<16>
Accession Number
635916573
Title
The importance of addressing multiple risk markers in type 2 diabetes:
Results from the leader and sustain 6 trials.
Source
Nephrology Dialysis Transplantation. Conference: 58th ERA-EDTA Congress.
Virtual. 36 (SUPPL 1) (pp i41-i42), 2021. Date of Publication: May 2021.
Author
Zobel E.; Von Scholten B.J.; Hansen T.; Persson F.; Rasmussen S.; Wolthers
B.; Rossing P.
Institution
(Zobel, Von Scholten, Hansen, Persson, Rossing) Steno Diabetes Center
Copenhagen, Gentofte, Denmark
(Von Scholten, Rasmussen, Wolthers) Novo Nordisk A/S, Soborg, Denmark
(Rossing) University of Copenhagen, Copenhagen, Denmark
Publisher
Oxford University Press
Abstract
BACKGROUND AND AIMS: The extent to which improvements in multiple risk
markers affect outcomes in type 2 diabetes is unclear. Our aim was to
investigate whether clinically relevant improvement in multiple risk
markers confers lower risk of micro- and macrovascular disease in a
contemporary type 2 diabetes population with cardiovascular disease or
high risk for cardiovascular disease, independent of specific treatments.
 METHOD(S): Exploratory post-hoc analysis of the two cardiovascular
outcome trials in patients with type 2 diabetes LEADER (NCT01179048;
n=8638 with baseline and year 1 assessment of at least one of the
parameters of interest; patients randomised to the glucagon like peptide-1
receptor agonist [GLP-1 RA] liraglutide or placebo [1:1]; median
observation time: 3.8 years) and SUSTAIN 6 (NCT01720446; n=3040 with
baseline and year 1 assessment of at least one of the parameters of
interest; patients randomised to the GLP-1 RA semaglutide or placebo
[1:1]; median observation time: 2.1 years). We pooled all participants,
including the active (liraglutide/semaglutide) and placebo-treated groups.
We categorised patients according to number of risk markers with a
clinically relevant change 1 year after randomisation and investigated
subsequent risk of major adverse cardiovascular events (MACE:
cardiovascular death, nonfatal myocardial infarction and nonfatal stroke),
expanded MACE (MACE plus coronary revascularisation and hospitalisation
for heart failure or unstable angina pectoris), cardiovascular death or
nephropathy (new onset of macroalbuminuria or doubling of the serum
creatinine level and an estimated glomerular filtration rate [eGFR] >=45
ml/min/1.73 m2, or the need for continuous renal-replacement
therapy, or death from renal disease). We defined clinically relevant
change as: body weight loss >=5%, glycated haemoglobin reduction >=1%,
systolic blood pressure reduction >=5 mmHg, low-density lipoprotein
cholesterol reduction >=0.5 mmol/L, eGFR reduction >=0
ml/min/1.73m2 and urinary albumin-to-creatinine ratio reduction
>=30% of baseline value. Numbers of risk markers with change were
classified as: none (group G0), 1 (G1), 2 (G2), 3 (G3) and >=4 (G4). Cox
regression analysed risk of each outcome and tested for trends; models
were adjusted for continuous baseline levels of the risk markers and
treatment group (liraglutide/semaglutide and placebo) and stratified by
trial. RESULT(S): The Table contains baseline characteristics of
patients in each risk marker group. Compared to patients with no
risk-marker improvement, patients with 2, 3 or >=4 improved risk markers
had reduced risk of expanded MACE [hazard ratio (95% CI): 0.80
(0.67-0.96); 0.80 (0.66-0.97); 0.82 (0.66-1.02)], cardiovascular death
[0.66 (0.45-0.96); 0.67 (0.45-0.99); 0.60 (0.38-0.94)] and nephropathy
[(0.71 (0.52-0.97); 0.48 (0.34-0.68); 0.43 (0.29-0.65)] (Figure). One
improved risk marker conferred no risk reduction. The trend of decreased
risk for each additional risk marker improvement was significant for
expanded MACE (p=0.004), cardiovascular death (p=0.005) and nephropathy
(p<0.0001). We observed a stepwise higher number of patients on GLP-1 RA
treatment in the groups with 0, 1, 2, 3 or >=4 risk marker improvements as
follows: 30.5% in G0, 38.0% in G1, 48.8% in G2, 61.6% in G3 and 75.3% in
G4. We observed similar results in separate analyses of the LEADER and
SUSTAIN 6 trials. CONCLUSION(S): In patients with type 2 diabetes,
improvements in two or more risk markers confer reduced risk of
cardiovascular disease and nephropathy as compared with none or one
improved risk marker, most notably for nephropathy. Our findings stress
the importance of multifactorial intervention and underscore the benefit
of pleiotropic antidiabetic treatments. (Table Presented).

<17>
Accession Number
635915957
Title
Digital insulin therapy protocol in the postoperative period of coronary
artery bypass graft surgery: A prospective randomized study.
Source
Diabetes. Conference: 81st Scientific Sessions of the American Diabetes
Association, ADA 2021. Virtual. 70 (SUPPL 1) (no pagination), 2021. Date
of Publication: June 2021.
Author
De souza A.B.C.; Toyoshima M.T.
Institution
(De souza, Toyoshima) Sao PauloBrazil
Publisher
American Diabetes Association Inc.
Abstract
Introduction: Adequate glycemic control with intravenous insulin therapy
in the postoperative period of coronary artery bypass grafting (CABG) in
an intensive care unit (ICU) reduces unfavorable clinical outcomes, such
as mortality, acute kidney injury (AKI), arrhythmias and nosocomial
infection. After discharge from ICU, even still hospitalized, adherence to
consensus on inpatient insulin therapy is low, and about 50% of patients
do not receive adequate subcutaneous insulin therapy in the ward,
consequently in-hospital hyperglycemia (IH) is frequent. Medical apps are
increasingly facilitating the medical routine. InsulinAPP is a digital
protocol for inpatient glycemic management and already validated. A 16%
reduction in blood glucose (BG) has been demonstrated in clinical patients
with this protocol. Method(s): Prospective randomized trial was
performed on diabetic patients in CABG postoperative period, after
discharge from ICU. The groups were randomized according to the glycemic
control protocol: InsulinAPP group (APP) or protocol defined by the
assistant team (ST -standard group). The aim is to compare the groups
regarding the composite outcome of AKI, nosocomial infection and atrial
fibrillation. Result(s): A total of 41 patients were evaluated (15 in
APP and 26 in ST). There was no difference between APP vs. ST group in age
(65.1+/-9.8 vs. 65.1+/-9.8 years), female gender (40 vs. 46%), body mass
index (28.5+/-4.9 vs. 27.3+/-5.1 Kg/m2) and estimated
glomerular function (68.0+/-24.1 vs. 69.1+/-24.5 mL/min, respectively).
APP had better BG than ST group (162+/-28.6 mg/dL vs. 183+/-34.4 mg/dL,
respectively; p = 0.036). Besides, in APP there was a significant
reduction of the composite outcome (27% vs. 77%, p=0.002), infection (20%
vs. 61%, p<0.001) and AKI (13% vs. 50%, p=0.019). Conclusion(s): The
InsulinAPP protocol was more effective in glycemic control and in reducing
unfavorable outcomes in the postoperative period of cardiac surgery after
discharge from the ICU.

<18>
Accession Number
635900511
Title
Nasal High-Frequency Oscillatory Ventilation vs. Nasal Continuous Positive
Airway Pressure as Therapy for Postextubation Respiratory Failure in
Infants After Congenital Heart Surgery.
Source
Frontiers in Pediatrics. 9 (no pagination), 2021. Article Number: 700632.
Date of Publication: 16 Aug 2021.
Author
Wu H.-L.; Lei Y.-Q.; Xie W.-P.; Chen Q.; Zheng Y.-R.
Institution
(Wu, Lei, Xie, Chen, Zheng) Department of Cardiac Surgery, Fujian Branch
of Shanghai Children's Medical Center, Fuzhou, China
(Wu, Lei, Xie, Chen, Zheng) Fujian Children's Hospital, Fuzhou, China
(Wu, Lei, Xie, Chen, Zheng) Fujian Maternity and Child Health Hospital,
Affiliated Hospital of Fujian Medical University, Fuzhou, China
(Wu, Lei, Xie, Chen, Zheng) Fujian Key Laboratory of Women and Children's
Critical Diseases Research, Fujian Maternity and Child Health Hospital,
Fuzhou, China
Publisher
Frontiers Media S.A.
Abstract
Objective: This study aimed to evaluate the effects of nasal
high-frequency oscillatory ventilation (NHFOV) vs. nasal continuous
positive airway pressure (NCPAP) on postextubation respiratory failure
(PRF) in infants after congenital heart surgery (CHS). Method(s):
Eighty infants underwent postoperative invasive mechanical ventilation for
more than 12 h and planned extubation. The infants were randomized to
undergo either NHFOV or NCPAP after extubation. Primary outcomes were the
incidence of PRF and reintubation, the average PaCO<inf>2</inf> level, the
average oxygenation index (OI), and pulmonary recruitment in the early
extubation phase. Secondary outcomes included the NCPAP/NHFOV time, length
of hospital stay, treatment intolerance, signs of discomfort,
pneumothorax, adverse hemodynamic effects, nasal trauma, and mortality.
 Result(s): Except for PaCO<inf>2</inf> within 12 after extubation
(39.3 +/- 5.8 vs. 43.6 +/- 7.3 mmHg, p = 0.05), there was no statistically
significant difference for any of the primary outcome measure (PRF,
reintubation within 12 h after extubation, oxygenation index within 12 h
after extubation, or lung volumes on X-ray after extubation) or secondary
outcome measures (duration of non-invasive ventilation, duration of
hospital stay, ventilation intolerance, signs of discomfort, pneumothorax,
nasal trauma, adverse hemodynamic effects, or death prior to discharge), p
> 0.1 for each comparison. Conclusion(s): NHFOV therapy after
extubation in infants after CHS was more efficient in improving
CO<inf>2</inf> cleaning than NCPAP therapy, but there was no difference in
other outcomes (PRF, reintubation, oxygenation index, and pulmonary
recruitment). © Copyright © 2021 Wu, Lei, Xie, Chen and
Zheng.

<19>
Accession Number
2014436138
Title
Non-Governmental Organizations Delivering Global Cardiac Surgical Care: A
Quantitative Impact Assessment.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2021.
Date of Publication: 2021.
Author
Vervoort D.; Guetter C.R.; Munyaneza F.; Trager L.E.; Argaw S.T.; Abraham
P.J.; Dayan V.
Institution
(Vervoort, Guetter) Department of Health Policy and Management, Johns
Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
(Munyaneza) College of Medicine and Health Sciences, University of Rwanda,
Kigali, Rwanda
(Trager) School of Medicine, University of Minnesota, Minneapolis, MN,
United States
(Argaw) Feinberg School of Medicine, Northwestern University, Chicago, IL,
United States
(Abraham) Department of Surgery, University of Alabama at Birmingham,
Birmingham, AL, United States
(Dayan) Centro Cardiovascular Universitario, Hospital de Clinicas,
Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
Publisher
W.B. Saunders
Abstract
In low- and middle-income countries (LMICs), 93% of the population lacks
safe, timely, and affordable access to cardiac surgical care when needed.
As countries slowly build or expand local, independent cardiac centers,
non-governmental organizations (NGOs) partially bridge the gap in cardiac
surgical care delivery in LMICs. However, little is known about the
current scope of cardiac NGOs. Here, we perform an analysis of active NGOs
involved with the delivery of cardiac surgical services in LMICs or for
patients from LMICs. Cardiac surgery NGOs were identified from medical
literature, established NGO databases, and Google Scholar searches. The
search was performed between December 2019 and May 2020. NGOs whose
websites were not updated or described missions or projects taking place
no later than 2015 were considered inactive. Eighty-six NGOs are actively
providing cardiac surgery services in LMICs or treating patients from
LMICs. Five NGOs performed adult cardiac surgery only, 56 performed
pediatric cardiac surgery only, and 25 performed both adult and pediatric
cardiac surgery. NGOs originated from 23 different countries and were
operational in a total of 111 countries, 96 of them being LMICs.
Fifty-three NGOs reported data on annual surgical volume, of which half
performed less than 50 operations per year. NGOs effectively address the
burden of cardiac surgical disease in LMICs and contribute to local
capacity-building. Increased, more detailed, and standardized reporting of
the impact and outcomes of NGOs is necessary to better understand annual
cardiac surgical volume and to support local centers working towards
independent services. Copyright © 2021 Elsevier Inc.

<20>
Accession Number
2014435538
Title
Coronary artery revascularizations and cognitive decline - A systematic
review.
Source
Current Problems in Cardiology. (no pagination), 2021. Article Number:
100960. Date of Publication: 2021.
Author
Lappalainen L.; Rajamaki B.; Tolppanen A.-M.; Hartikainen S.
Institution
(Lappalainen, Rajamaki, Tolppanen, Hartikainen) School of Pharmacy,
University of Eastern Finland, Kuopio, FI, Finland
(Rajamaki, Tolppanen, Hartikainen) Kuopio Research Center of Geriatric
Care, University of Eastern Finland, Kuopio, FI, Finland
Publisher
Mosby Inc.
Abstract
Coronary artery disease (CAD) is a risk factor for cognitive decline. The
aim of this study was to systematically review recent literature on
whether coronary artery revascularizations are associated to cognitive
decline and dementia. Pubmed, Scopus, and CINAHL (EBSCO) were searched
systematically from January 2009 to September 2020. Studies were conducted
on persons with CAD undergoing coronary artery bypass grafting (CABG) or
percutaneous coronary intervention (PCI) procedure compared to other
coronary artery disease treatments, and the outcome was cognitive decline
or dementia. Altogether four of the 680 reviewed articles met inclusion
criteria. Results were inconsistent, and the outcome measurements
heterogeneous between studies. Our findings indicate an evidence gap in
the current understanding of long-term outcomes following coronary artery
revascularization. However, evidence of long-term effects on cognition
would complement our understanding of their benefits. There is a need for
more studies on long-term cognitive outcomes after coronary artery
revascularizations. Copyright © 2021 The Authors

<21>
Accession Number
2013642346
Title
Alternate accesses for transcatheter aortic valve replacement: A network
meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Hameed I.; Oakley C.T.; Hameed N.U.F.; Ahmed A.; Naeem N.; Singh S.;
Rizwana K.; Brackett A.; Forrest J.K.; Kaple R.; Mangi A.; Salemi A.;
Geirsson A.; Gaudino M.; Vallabhajosyula P.
Institution
(Hameed, Singh, Mangi, Geirsson, Vallabhajosyula) Department of Surgery,
Section of Cardiac Surgery, Yale School of Medicine, New Haven, CT, United
States
(Oakley, Hameed, Ahmed, Naeem, Rizwana, Gaudino) Department of
Cardiothoracic Surgery, Weill Cornell Medical College, New York, NY,
United States
(Brackett) Cushing/Whitney Medical Library, Yale School of Medicine, New
Haven, CT, United States
(Forrest, Kaple) Department of Internal Medicine, Division of Cardiology,
Yale School of Medicine, New Haven, CT, United States
(Salemi) Department of Cardiothoracic Surgery, Robert Wood
Johnson/Barnabas Health, West Orange, NJ, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: When transfemoral (TF) access is contraindicated in patients
undergoing transcatheter aortic valve replacement (TAVR), alternate access
strategies are considered. The choice of one alternate access over the
other remains controversial. Method(s): Following a comprehensive
literature search, studies comparing any combination of TF, transapical
(TA), transaortic (TAo), transcarotid (TC), and trans-subclavian (TS) TAVR
were identified. Data were pooled using fixed- and random-effects network
meta-analysis. Rank scores with probability ranks of different treatment
groups were calculated. Result(s): Eighty-four studies (26,449
patients) were included. Compared to TF access, TA and TAo accesses were
associated with higher 30-day mortality (odds ratio [OR] 1.60, 95%
confidence interval [CI] 1.31-1.94; OR 1.79, 95% CI 1.21-2.66,
respectively), while the TC and TS showed no difference (OR 1.12, 95% CI
0.64-1.95; OR 1.23, 95% CI 0.67-2.27, respectively); TF access ranked best
followed by TC. There was no significant difference in 30-day stroke; TC
access ranked best followed by TS. At a weighted mean follow-up of 1.6
years, TA and TAo accesses were associated with higher long-term mortality
versus TF (incidence rate ratio [IRR] 1.31, 95% CI 1.18-1.45; IRR 1.41,
95% CI 1.11-1.79, respectively); there was no difference between TC and TS
versus TF access (IRR 1.02, 95% CI 0.70-1.47; IRR 1.16, 95% CI 0.82-1.66,
respectively); TF access ranked best followed by TC. At a weighted mean
follow-up of 1.4 years, only TA access was associated with higher
long-term stroke compared to TF (IRR 3.01, 95% CI 1.15-7.87); TF access
ranked as the best strategy followed by TAo. Conclusion(s): TC and TS
approaches are associated with superior postoperative outcomes compared to
other TAVR alternate access strategies. Randomized trials definitively
assessing the safety and efficacy of alternate access strategies are
needed. Copyright © 2021 Wiley Periodicals LLC

<22>
Accession Number
2013642333
Title
Clinical and hemodynamic outcomes of the Dor procedure in adults with
ischemic cardiomyopathy.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Fatehi Hassanabad A.; Wiebe K.; Ali I.S.
Institution
(Fatehi Hassanabad, Ali) Section of Cardiac Surgery, Department of Cardiac
Sciences, Libin Cardiovascular Institute, Cumming School of Medicine,
University of Calgary, Calgary, AB, Canada
(Wiebe) Cumming School of Medicine, University of Calgary, Calgary, AB,
Canada
Publisher
John Wiley and Sons Inc
Abstract
Ischemic cardiomyopathy continues to be a major contributor to congestive
heart failure, which places a significant burden on our healthcare system.
Improving medications and different coronary revascularization strategies
are the mainstays in the management of ischemic cardiomyopathy. Although
medications and mechanical circulatory support are playing an
ever-increasing role, cardiac transplantation remains the gold standard
for treating advanced heart failure. Given the small number of available
and suitable donor hearts, transplantation is limited for the majority of
patients. Surgical ventricular restoration has repeatedly been suggested
as a viable alternative in managing heart failure in select patients, as
it is believed that surgically returning the ventricle to its original
dimensions is possible and associated with favorable outcomes. The purpose
of this manuscript is to comprehensively review the current literature on
various surgical strategies for ventricular restoration. We also
contextualize the published data with respect to ventricular function,
volume, structure, arrhythmias, mitral regurgitation, and clinical
outcomes. Copyright © 2021 Wiley Periodicals LLC

<23>
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
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. Copyright © 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<24>
Accession Number
2007134768
Title
High flow oxygen therapy at two initial flow settings versus conventional
oxygen therapy in cardiac surgery patients with postextubation hypoxemia:
A single-center, unblinded, randomized, controlled trial.
Source
Journal of Clinical Medicine. 10 (10) (no pagination), 2021. Article
Number: 2079. Date of Publication: 02 May 2021.
Author
Theologou S.; Ischaki E.; Zakynthinos S.G.; Charitos C.; Michopanou N.;
Patsatzis S.; Mentzelopoulos S.D.
Institution
(Theologou, Charitos, Michopanou, Patsatzis) Department of Cardiac
Surgery, Evaggelismos General Hospital, Athens 10675, Greece
(Ischaki, Zakynthinos, Mentzelopoulos) First Department of Intensive Care
Medicine, National and Kapodistrian University of Athens Medical School,
Evaggelismos General Hospital, Athens 10675, Greece
Publisher
MDPI
Abstract
In cardiac surgery patients with pre-extubation PaO<inf>2</inf> /inspired
oxygen fraction (FiO<inf>2</inf> ) < 200 mmHg, the possible benefits and
optimal level of high-flow nasal cannula (HFNC) support are still unclear;
therefore, we compared HFNC support with an initial gas flow of 60 or 40
L/min and conventional oxygen therapy. Ninety nine patients were randomly
allocated (respective ratio: 1:1:1) to I = intervention group 1 (HFNC
initial flow = 60 L/min, FiO<inf>2</inf> = 0.6), intervention group 2
(HFNC initial flow = 40 L/min, FiO<inf>2</inf> = 0.6), or control group
(Venturi mask, FiO<inf>2</inf> = 0.6). The primary outcome was occurrence
of treatment failure. The baseline characteristics were similar. The
hazard for treatment failure was lower in intervention group 1 vs. control
(hazard ratio (HR): 0.11, 95% CI: 0.03-0.34) and intervention group 2 vs.
control (HR: 0.30, 95% CI: 0.12-0.77). During follow-up, the probability
of peripheral oxygen saturation (SpO<inf>2</inf> ) > 92% and respiratory
rate within 12-20 breaths/min was 2.4-3.9 times higher in intervention
group 1 vs. the other 2 groups. There was no difference in PaO<inf>2</inf>
/FiO<inf>2</inf>, patient comfort, intensive care unit or hospital stay,
or clinical course complications or adverse events. In hypoxemic cardiac
surgery patients, postextubation HFNC with an initial gas flow of 60 or 40
L/min resulted in less frequent treatment failure vs. conventional
therapy. The results in terms of SpO<inf>2</inf> /respiratory rate targets
favored an initial HFNC flow of 60 L/min. Copyright © 2021 by the
authors. Licensee MDPI, Basel, Switzerland.

<25>
Accession Number
2006747342
Title
Left ventricular noncompaction-a systematic review of risk factors in the
pediatric population.
Source
Journal of Clinical Medicine. 10 (6) (pp 1-18), 2021. Article Number:
1232. Date of Publication: 02 Mar 2021.
Author
Luczak-Wozniak K.; Werner B.
Institution
(Luczak-Wozniak) Department of Pediatric Cardiology and General
Pediatrics, Doctoral School, Medical University of Warsaw, Warsaw 02-091,
Poland
(Werner) Department of Pediatric Cardiology and General Pediatrics,
Medical University of Warsaw, Warsaw 02-091, Poland
Publisher
MDPI
Abstract
Left ventricular noncompaction (LVNC) is a heterogeneous, often hereditary
group of diseases, which may have diverse clinical manifestations. This
article reviews the risk factors for unfavorable outcomes of LVNC in
children, as well as discuss the diagnostic methods and the differences
between pediatric and adult LVNC. Through a systematic review of the
literature, a total of 1983 articles were outlined; 23 of them met the
inclusion criteria. In echocardiography the following have been associated
with adverse outcomes in children: Left ventricular ejection fraction,
end-diastolic dimension, left ventricular posterior wall compaction, and
decreased strains. T-wave abnormalities and increased spatial peak QRS-T
angle in ECG, as well as arrhythmia, were observed in children at greater
risk. Cardiac magnetic resonance is a valuable tool to identify those with
systolic dysfunction and late gadolinium enhancement. Genetic testing
appears to help identify children at risk, because mutations in particular
genes have been associated with worse outcomes. ECG and imaging tests,
such as echocardiography and magnetic resonance, help outline risk factors
for unfavorable outcomes of LVNC in children and in identifying
outpatients who require more attention. Refining the current diagnostic
criteria is crucial to avoid inadequate restrain from physical
activity. Copyright © 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<26>
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
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. Copyright © 2021 by the authors. Licensee MDPI,
Basel, Switzerland.

<27>
Accession Number
2006144373
Title
Cardiac rupture-the most serious complication of takotsubo syndrome: A
series of five cases and a systematic review.
Source
Journal of Clinical Medicine. 10 (5) (pp 1-11), 2021. Article Number:
1066. Date of Publication: 01 Mar 2021.
Author
Zalewska-Adamiec M.; Bachorzewska-Gajewska H.; Dobrzycki S.
Institution
(Zalewska-Adamiec, Bachorzewska-Gajewska, Dobrzycki) Department of
Invasive Cardiology, Medical University of Bialystok, Bialystok 15-276,
Poland
(Bachorzewska-Gajewska) Department of Clinical Medicine, Medical
University of Bialystok, Bialystok 15-295, Poland
Publisher
MDPI
Abstract
Background: The most serious complication of the acute Takotsubo phase is
a myocardial perforation, which is rare, but it usually results in the
death of the patient. Method(s): In the years 2008-2020, 265 patients
were added to the Podlasie Takotsubo Registry. Cardiac rupture was
ob-served in five patients (1.89%), referred to as the Takotsubo syndrome
with complications of cardiac rupture (TS+CR) group. The control group
consisted of 50 consecutive patients with uncomplicated TS. The diagnosis
of TS was based on the Mayo Clinic Criteria. Result(s): Cardiac
rupture was observed in women with TS aged 74-88 years. Patients with TS
and CR were older (82.20 vs. 64.84; p = 0.011), than the control group,
and had higher troponin, creatine kinase, aspartate aminotransferase, and
blood glucose levels (168.40 vs. 120.67; p = 0.010). The TS+CR group
demonstrated a higher heart rate (95.75 vs. 68.38; p <0.0001) and the
Global Registry of Acute Coronary Events (GRACE) scores (186.20 vs.
121.24; p <0.0001) than the control group. In patients with CR, ST segment
elevation was recorded significantly more often in the III, V4, V5 and V6
leads. Left ventricular free wall rupture was noted in four patients, and
in one case, rupture of the ventricular septum. In a multi-variate
logistic regression, the factors that increase the risk of CR in TS were
high GRACE scores, and the presence of ST segment elevation in lead III.
 Conclusion(s): Cardiac rupture in TS is rare but is the most severe
mechanical complication and is associated with a very high risk of death.
The main risk factors for left ventricular perforation are female gender,
older age, a higher concentration of cardiac enzymes, higher GRACE scores,
and ST elevations shown using electrocardiogram (ECG). Copyright
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

<28>
Accession Number
2006134466
Title
Comprehensive comparisons among inotropic agents on mortality and risk of
renal dysfunction in patients who underwent cardiac surgery: A network
meta-analysis of randomized controlled trials.
Source
Journal of Clinical Medicine. 10 (5) (pp 1-12), 2021. Article Number:
1032. Date of Publication: 01 Mar 2021.
Author
Chen W.-C.; Lin M.-H.; Chen C.-L.; Chen Y.-C.; Chen C.-Y.; Lin Y.-C.; Hung
C.-C.
Institution
(Chen) Graduate Institute of Biomedical Sciences, China Medical
University, No. 91, Hsueh-Shih Road, Taichung 40402, Taiwan (Republic of
China)
(Chen, Chen, Chen, Lin) Division of Pulmonary and Critical Care Medicine,
Department of Internal Medicine, China Medical University Hospital, No. 2,
Yude Rd., North Dist., Taichung 404332, Taiwan (Republic of China)
(Chen) Department of Education, China Medical University Hospital, No. 2,
Yude Rd., North Dist., Taichung 404332, Taiwan (Republic of China)
(Lin, Hung) Department of Pharmacy, China Medical University, No. 100,
Sec. 1, Jingmao Rd., Beitun Dist., Taichung 406040, Taiwan (Republic of
China)
(Chen) Department of Pharmacy, China Medical University Hsinchu Hospital,
China Medical University, No. 199, Sec. 1, Xinglong Rd., Hsinchu County,
Zhubei 30272, Taiwan (Republic of China)
(Lin) School of Medicine, China Medical University, No. 91, Hsueh-Shih
Road, Taichung 40402, Taiwan (Republic of China)
(Hung) Department of Pharmacy, China Medical University Hospital, No. 2
Yude Road, Taichung 40447, Taiwan (Republic of China)
(Hung) Department of Healthcare Administration, Asia University, 500,
Lioufeng Rd., Wufeng, Taichung 41354, Taiwan (Republic of China)
Publisher
MDPI
Abstract
Several kinds of inotropes have been used in critically ill patients to
improve hemodynamics and renal dysfunction after cardiac surgery; however,
the treatment strategies for reducing mortality and increasing renal
protection in patients who underwent cardiac surgery remain controversial.
Therefore, we performed a comprehensive network meta-analysis to overcome
the lack of head-to-head comparisons. A systematic database was searched
up to 31 December 2020, for randomized controlled trials that compared
different inotropes on mortality outcomes and renal protective effects
after cardiac surgery. A total of 29 trials were included and a
frequentist network meta-analysis was performed. Inconsistency analyses,
publication bias, and subgroup analyses were also conducted. Compared with
placebo, use of levosimendan significantly decreased the risks of
mortality (odds ratio (OR): 0.74; 95% confidence interval (CI): 0.56-0.97)
and risk of acute renal injury (OR: 0.61; 95% CI: 0.45-0.82), especially
in low systolic function patients. Use of levosimendan also ranked the
best treatment based on the P-score (90.1%), followed by placebo (64.5%),
milrinone (49.6%), dopamine (49.5%), dobutamine (29.1%), and fenoldopam
(17.0%). Taking all the available data into consideration, levosimendan
was a safe renal-protective choice for the treatment of patients
undergoing cardiac surgery, especially for those with low systolic
function. Copyright © 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<29>
Accession Number
2006038667
Title
Transcatheter aortic valve implantation: The new challenges of cardiac
rehabilitation.
Source
Journal of Clinical Medicine. 10 (4) (pp 1-10), 2021. Article Number: 810.
Date of Publication: 02 Feb 2021.
Author
Sperlongano S.; Renon F.; Bigazzi M.C.; Sperlongano R.; Cimmino G.;
D'andrea A.; Golino P.
Institution
(Sperlongano, Renon, Bigazzi, Cimmino, Golino) Department of Translational
Medical Sciences, Division of Cardiology, University of Campania Luigi
Vanvitelli, Monaldi Hospital, Naples 80131, Italy
(Sperlongano) Department of Experimental Sciences, University of Campania
Luigi Vanvitelli, Naples 80138, Italy
(D'andrea) Department of Cardiology and Intensive Coronary Care, Umberto I
Hospital, Nocera Inferiore 84014, Italy
Publisher
MDPI
Abstract
Transcatheter aortic valve implantation (TAVI) is an increasingly
widespread percutaneous intervention of aortic valve replacement (AVR).
The target population for TAVI is mainly composed of elderly, frail
patients with severe aortic stenosis (AS), multiple comorbidities, and
high perioperative mortality risk for surgical AVR (sAVR). These
vulnerable patients could benefit from cardiac rehabilitation (CR)
programs after percutaneous intervention. To date, no major guidelines
currently recommend CR after TAVI. However, emerging scientific evidence
shows that CR in patients undergoing TAVI is safe, and improves exercise
tolerance and quality of life. Moreover, preliminary data prove that a CR
program after TAVI has the potential to reduce mortality during follow-up,
even if randomized clinical trials are needed for confirmation. The
present review article provides an overview of all scientific evidence
concerning the potential beneficial effects of CR after TAVI, and suggests
possible fields of research to improve cardiac care after
TAVI. Copyright © 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<30>
Accession Number
2005928593
Title
Ecmo in cardiac arrest: A narrative review of the literature.
Source
Journal of Clinical Medicine. 10 (3) (pp 1-15), 2021. Article Number: 534.
Date of Publication: 01 Feb 2021.
Author
De Charriere A.; Assouline B.; Scheen M.; Mentha N.; Banfi C.; Bendjelid
K.; Giraud R.
Institution
(De Charriere, Assouline, Scheen, Bendjelid, Giraud) Intensive Care Unit,
Geneva University Hospitals, Geneva 1205, Switzerland
(De Charriere, Assouline, Scheen, Mentha, Banfi, Bendjelid, Giraud)
Faculty of Medicine, University of Geneva, Geneva 1205, Switzerland
(Banfi, Bendjelid, Giraud) Geneva Hemodynamic Research Group, Geneva 1206,
Switzerland
(Banfi) Department of Cardio-Thoracic Surgery, Istituto Clinico
Sant'Ambrogio, Gruppo Ospedaliero San Donato, Milan, and Chair of Cardiac
Surgery, University of Milan, Milan 20149, Italy
Publisher
MDPI
Abstract
Cardiac arrest (CA) is a frequent cause of death and a major public health
issue. To date, conventional cardiopulmonary resuscitation (CPR) is the
only efficient method of resuscitation available that positively impacts
prognosis. Extracorporeal membrane oxygenation (ECMO) is a complex and
costly technique that requires technical expertise. It is not considered
standard of care in all hospitals and should be applied only in
high-volume facilities. ECMO combined with CPR is known as ECPR
(extracorporeal cardiopulmonary resuscitation) and permits hemodynamic and
respiratory stabilization of patients with CA refractory to conventional
CPR. This technique allows the parallel treatment of the underlying
etiology of CA while maintaining organ perfusion. However, current
evidence does not support the routine use of ECPR in all patients with
refractory CA. Therefore, an appropriate selection of patients who may
benefit from this procedure is key. Reducing the duration of low blood
flow by means of performing high-quality CPR and promoting access to ECPR,
may improve the survival rate of the patients presenting with refractory
CA. Indeed, patients who benefit from ECPR seem to carry better
neurological outcomes. The aim of this present narrative review is to
present the most recent literature available on ECPR and to clarify its
potential therapeutic role, as well as to provide an in-depth explanation
of equipment and its set up, the patient selection process, and the
patient management post-ECPR. Copyright © 2021 by the authors.
Licensee MDPI, Basel, Switzerland.

<31>
Accession Number
2005928580
Title
Low-intensity resistance training with moderate blood flow restriction
appears safe and increases skeletal muscle strength and size in
cardiovascular surgery patients: A pilot study.
Source
Journal of Clinical Medicine. 10 (3) (pp 1-13), 2021. Article Number: 547.
Date of Publication: 01 Feb 2021.
Author
Ogawa H.; Nakajima T.; Shibasaki I.; Nasuno T.; Kaneda H.; Katayanagi S.;
Ishizaka H.; Mizushima Y.; Uematsu A.; Yasuda T.; Yagi H.; Toyoda S.;
Hortobagyi T.; Mizushima T.; Inoue T.; Fukuda H.
Institution
(Ogawa, Shibasaki, Fukuda) Department of Cardiovascular Surgery, School of
Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293,
Japan
(Nakajima, Nasuno, Kaneda, Yagi, Toyoda, Inoue) Department of
Cardiovascular Medicine, School of Medicine, Dokkyo Medical University,
Shimotsuga-gun, Tochigi 321-0293, Japan
(Nakajima) Department of Medical KAATSU Training, Dokkyo Medical
University, Shimotsuga-gun, Tochigi 321-0293, Japan
(Katayanagi, Ishizaka, Mizushima, Mizushima) Department of Rehabilitation,
Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi 321-0293,
Japan
(Uematsu) Department of Health and Sport Sciences, Premedical Sciences,
Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
(Yasuda) School of Nursing, Seirei Christopher University, Shizuoka,
Hamamatsu 433-8558, Japan
(Hortobagyi) University Medical Center Groningen, University of Groningen,
Groningen, Groningen 9713 GZ, Netherlands
Publisher
MDPI
Abstract
We examined the safety and the effects of low-intensity resistance
training (RT) with moderate blood flow restriction (KAATSU RT) on muscle
strength and size in patients early after cardiac surgery. Cardiac
patients (age 69.6 +/- 12.6 years, n = 21, M = 18) were randomly assigned
to the control (n = 10) and the KAATSU RT group (n = 11). All patients had
received a standard aerobic cardiac rehabilitation program. The KAATSU RT
group additionally executed low-intensity leg extension and leg press
exercises with moderate blood flow restriction twice a week for 3 months.
RT-intensity and volume were increased gradually. We evaluated the
anterior mid-thigh thickness (MTH), skeletal muscle mass index (SMI),
handgrip strength, knee extensor strength, and walking speed at baseline,
5-7 days after cardiac surgery, and after 3 months. A physician monitored
the electrocardiogram, rate of perceived exertion, and the color of the
lower limbs during KAATSU RT. Creatine phosphokinase (CPK) and D-dimer
were measured at baseline and after 3 months. There were no side effects
during KAATSU RT. CPK and D-dimer were normal after 3 months. MTH, SMI,
walking speed, and knee extensor strength increased after 3 months with
KAATSU RT compared with baseline. Relatively low vs. high physical
functioning patients tended to increase physical function more after 3
months with KAATSU RT. Low-intensity KAATSU RT as an adjuvant to standard
cardiac rehabilitation can safely increase skeletal muscle strength and
size in cardiovascular surgery patients. Copyright © 2021 by the
authors. Licensee MDPI, Basel, Switzerland.

<32>
Accession Number
2005866690
Title
Impact of chronic kidney disease on chronic total occlusion
revascularization outcomes: A meta-analysis.
Source
Journal of Clinical Medicine. 10 (3) (pp 1-9), 2021. Article Number: 440.
Date of Publication: 01 Feb 2021.
Author
Lee W.-C.; Wu P.-J.; Fang C.-Y.; Chen H.-C.; Wu C.-J.; Fang H.-Y.
Institution
(Lee, Wu, Fang, Chen, Wu, Fang) Division of Cardiology, Department of
Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung
University College of Medicine, Kaohsiung 83301, Taiwan (Republic of
China)
(Lee) Institute of Clinical Medicine, College of Medicine, National Cheng
Kung University, Tainan 83301, Taiwan (Republic of China)
Publisher
MDPI
Abstract
Objectives: To examine the impact of revascularization and associated
clinical outcomes of chronic kidney disease (CKD) chronic total occlusion
(CTO) and non-CKD CTO groups. Background(s): The influence of CKD on
clinical outcomes after percutaneous coronary intervention (PCI) for CTO
lesions is unknown, and there is no systemic review of this topic to date.
 Method(s): We searched the PubMed, Embase, ProQuest, ScienceDirect,
Cochrane Library, ClinicalKey, Web of Science, and ClinicalTrials.gov
databases for articles published between 1 January 2010 and 31 March 2020.
CKD was defined as estimated glomerular filtration rate of <60 mL/min/1.73
m2 according to the Modification of Diet in Renal Disease
formula. Data included demographics, lesion distributions, incidence of
contrast-induced nephropathy (CIN), acute kidney injury (AKI), procedural
success rate, mortality, and target lesion revascularization (TLR)/target
vessel revascularization (TVR). Result(s): Six studies were
ultimately included in this systematic review. A high prevalence (25.5%;
range, 19.6-37.9%) of CKD was noted in the CTO population. In the non-CKD
group, outcomes were better: less incidence of CIN or AKI (odds ratio
(OR), 2.860; 95% confidence interval (CI), 1.775-4.608), higher procedural
success rate (OR, 1.382; 95% CI, 1.036-1.843), and lower long-term
mortality (OR, 4.502; 95% CI, 3.561-5.693). The incidence of TLR/TVR (OR,
1.118; 95% CI, 0.888-1.407) did not differ between groups.
 Conclusion(s): In the CKD CTO PCI population, a lower procedural
success rate, a higher incidence of CIN or AKI, and higher in-hospital and
long-term mortality rate were noted due to more complex lesions and more
comorbidities. However, the incidence of TLR/TVR did not differ between
groups. Copyright © 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<33>
Accession Number
2005860894
Title
Perioperative individualized goal directed therapy for cardiac surgery: A
historical-prospective, comparative effectiveness study.
Source
Journal of Clinical Medicine. 10 (3) (pp 1-11), 2021. Article Number: 400.
Date of Publication: January 2021.
Author
Ramsingh D.; Hu H.; Yan M.; Lauer R.; Rabkin D.; Gatling J.; Floridia R.;
Martinez M.; Dorotta I.; Razzouk A.
Institution
(Ramsingh, Hu, Yan, Lauer, Gatling, Martinez, Dorotta) Department of
Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA
92354, United States
(Rabkin, Floridia, Razzouk) Department of Cardiothoracic Surgery, Loma
Linda University Medical Center, Loma Linda, CA 92354, United States
Publisher
MDPI
Abstract
Introduction: Cardiac surgery patients are at increased risk for
post-operative complications and prolonged length of stay. Perioperative
goal directed therapy (GDT) has demonstrated utility for non-cardiac
surgery, however, GDT is not common for cardiac surgery. We initiated a
quality improvement (QI) project focusing on the implementation of a GDT
protocol, which was applied from the immediate post-bypass period into the
intensive care unit (ICU). Our hypothesis was that this novel GDT protocol
would decrease ICU length of stay and possibly improve postoperative
outcomes. Method(s): This was a historical prospective, QI study for
patients undergoing cardiac surgery requiring cardiopulmonary bypass
(CPB). Integral to the QI project was education towards all associated
providers on the concepts related to GDT. The protocol involved
identifying patient specific targets for cardiac index and mean arterial
pressure. These targets were maintained from the post-CPB period to the
first 12 h in the ICU. Statistical comparisons were performed between the
year after GDT therapy was launched to the last two years prior to
protocol implementation. The primary outcome was ICU length of stay.
 Result(s): There was a significant decrease in ICU length of stay
when comparing the year after the protocol initiation to years prior, from
a median of 6.19 days to 4 days (2017 vs. 2019, p < 0.0001), and a median
of 5.88 days to 4 days (2018 vs. 2019, p < 0.0001). Secondary outcomes
demonstrated a significant reduction in total administered volumes of
inotropic medication(milrinone). All other vasopressors demonstrated no
differences across years. Hospital length of stay comparisons did not
demonstrate a significant reduction. Conclusion(s): These results
suggest that an individualized goal directed therapy for cardiac surgery
patients can reduce ICU length of stay and decrease amount of inotropic
therapy. Copyright © 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<34>
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
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. Copyright © 2021 by the authors.
Licensee MDPI, Basel, Switzerland.

<35>
Accession Number
2005631348
Title
Effect of obstructive sleep apnea and CPAP treatment on cardiovascular
outcomes in acute coronary syndrome in the RICCADSA trial.
Source
Journal of Clinical Medicine. 9 (12) (pp 1-12), 2020. Article Number:
4051. Date of Publication: December 2020.
Author
Peker Y.; Thunstrom E.; Glantz H.; Eulenburg C.
Institution
(Peker) Department of Pulmonary Medicine, Koc University School of
Medicine, Istanbul TR 34010, Turkey
(Peker, Thunstrom) Department of Molecular and Clinical Medicine,
Sahlgrenska Academy, University of Gothenburg, Gothenburg SE 40530, Sweden
(Peker) Department of Clinical Sciences, Respiratory Medicine and
Allergology, Faculty of Medicine, Lund University, Lund SE 22185, Sweden
(Peker) Division of Pulmonary, Allergy, and Critical Care Medicine,
University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, United
States
(Thunstrom) Department of Cardiology, Sahlgrenska University
Hospital/Ostra, Gothenburg 41345, Sweden
(Glantz) Department of Internal Medicine, Skaraborg Hospital, Lidkoping SE
53185, Sweden
(Eulenburg) Department for Epidemiology, University of Groningen,
Groningen 9712 CP, Netherlands
Publisher
MDPI
Abstract
We aimed to address the impact of OSA and its treatment with continuous
positive airway pressure (CPAP) on major adverse cardiovascular and
cerebrovascular events (MACCE) in patients with acute coronary syndrome
(ACS). In this current analysis of the revascularized ACS subgroup (n =
353) of the Randomized Intervention with CPAP in Coronary Artery Disease
and Obstructive Sleep Apnea (RICCADSA) trial (Trial Registry:
ClinicalTrials.gov; No: NCT 00519597), participants with non-sleepy OSA
(apnea-hypopnea-index [AHI] >= 15 events/h on a home sleep apnea testing,
and Epworth Sleepiness Scale [ESS] score < 10; n = 171) were randomized to
CPAP (n = 86) or no-CPAP (n = 85). The sleepy OSA patients (AHI >= 15
events/h and ESS >= 10) who were offered CPAP, and the ones with no-OSA
(AHI < 5 events/h) were included in the observational arm. A post-hoc
analysis was done to compare untreated OSA (no-CPAP; n = 78) and
nonadherent sleepy/non-sleepy OSA (n = 96) with the reference group
without OSA (n = 81). The primary endpoint (the first event of repeat
revascularization, myocardial infarction, stroke or cardiovascular
mortality) during a median 4.7-year follow-up was evaluated in
time-dependent Cox proportional hazards models adjusted for confounding
factors. The incidence of MACCE did not differ significantly in
intention-to-treat population. On-treatment analysis showed a significant
risk reduction in those who used CPAP for >=4 vs. <4 h/day or did not
receive treatment (adjusted hazard ratio [HR] 0.17; 95% confidence
interval [CI] 0.03-0.81; p = 0.03). Compared with the reference group,
nonadherent/untreated OSA was associated with an increased cardiovascular
risk (adjusted HR 1.97, 95% CI 1.03-3.77; p = 0.04). We conclude that OSA
is an independent risk factor for adverse cardiovascular outcomes in
patients with ACS. CPAP treatment may reduce this risk, if the device is
used at least 4 h/day. Copyright © 2020 by the authors. Licensee
MDPI, Basel, Switzerland.

<36>
Accession Number
2005551875
Title
Outcomes of mechanical circulatory support for giant cell myocarditis: A
systematic review.
Source
Journal of Clinical Medicine. 9 (12) (pp 1-11), 2020. Article Number:
3905. Date of Publication: December 2020.
Author
Patel P.M.; Saxena A.; Wood C.T.; O'malley T.J.; Maynes E.J.; Entwistle
J.W.C.; Massey H.T.; Pirlamarla P.R.; Alvarez R.J.; Cooper L.T.; Eduardo
Rame J.; Tchantchaleishvili V.
Institution
(Patel, Saxena, Wood) Sidney Kimmel Medical College, Thomas Jefferson
University, Philadelphia, PA 19107, United States
(O'malley, Maynes, Entwistle, Massey, Eduardo Rame, Tchantchaleishvili)
Division of Cardiac Surgery, Department of Surgery, Thomas Jefferson
University, Philadelphia, PA 19107, United States
(Pirlamarla, Alvarez) Division of Cardiology, Department of Medicine,
Thomas Jefferson University, Philadelphia, PA 19107, United States
(Cooper) Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville,
FL 32224, United States
Publisher
MDPI
Abstract
Treatment of giant cell myocarditis (GCM) can require bridging to
orthotopic heart transplantation (OHT) or recovery with mechanical
circulatory support (MCS). Since the roles of MCS and immunotherapy are
not well-defined in GCM, we sought to analyze outcomes of patients with
GCM who required MCS. A systematic search was performed in June 2019 to
identify all studies of biopsy-proven GCM requiring MCS after 2009. We
identified 27 studies with 43 patients. Patient-level data were extracted
for analysis. Median patient age was 45 (interquartile range (IQR): 32-57)
years. 42.1% (16/38) were female. 34.9% (15/43) presented in acute heart
failure. 20.9% (9/43) presented in cardiogenic shock. Biventricular
(BiVAD) MCS was required in 76.7% (33/43) of cases. Of the 62.8% (27/43)
of patients who received immunotherapy, 81.5% (22/27) used steroids
combined with at least one other immunosuppressant. Cyclosporine was the
most common non-steroidal agent, used in 40.7% (11/27) of regimens.
Immunosuppression was initiated before MCS in 59.3% (16/27) of cases,
after MCS in 29.6% (8/27), and not specified in 11.1% (3/27).
Immunosuppression started prior to MCS was associated with significantly
better survival than MCS alone (p = 0.006); 60.5% (26/43) of patients
received bridge-to-transplant MCS; 39.5% (17/43) received
bridge-to-recovery MCS; 58.5% (24/41) underwent OHT a median of 104
(58-255) days from diagnosis. GCM recurrence after OHT was reported in
8.3% (2/24) of transplanted cases. BiVAD predominates in mechanically
supported patients with GCM. Survival and bridge to recovery appear better
in patients on immunosuppression, especially if initiated before
MCS. Copyright © 2020 by the authors. Licensee MDPI, Basel,
Switzerland.

<37>
Accession Number
2005551743
Title
The pharmacological approach to oncologic patients with acute coronary
syndrome.
Source
Journal of Clinical Medicine. 9 (12) (pp 1-15), 2020. Article Number:
3926. Date of Publication: December 2020.
Author
Radmilovic J.; Di Vilio A.; D'andrea A.; Pastore F.; Forni A.; Desiderio
A.; Ragni M.; Quaranta G.; Cimmino G.; Russo V.; Scherillo M.; Golino P.
Institution
(Radmilovic, Di Vilio, D'andrea, Pastore, Forni, Desiderio, Ragni,
Quaranta) Unit of Cardiology and Intensive Coronary Care, "Umberto I"
Hospital, Nocera Inferiore 84014, Italy
(Di Vilio, D'andrea, Cimmino, Russo, Golino) Unit of Cardiology,
Department of Translational Medical Sciences, University of Campania
"Luigi Vanvitelli", Monaldi Hospital, Naples 80131, Italy
(Scherillo) Unit of Cardiology and Intensive Coronary Care, "San Pio"
Hospital, Benevento 82100, Italy
Publisher
MDPI
Abstract
Among acute coronary syndrome (ACS) patients, 15% have concomitant cancer,
especially in the first 6 months after their diagnosis, as well as in
advanced metastatic stages. Lung, gastric, and pancreatic cancers are the
most frequent malignancies associated with ACS. Chemotherapy and
radiotherapy exert prothrombotic, vasospastic, and proinflammatory
actions. The management of cancer patients with ACS is quite challenging:
percutaneous revascularization is often underused, and antiplatelet and
anticoagulant pharmacological therapy should be individually tailored to
the thrombotic risk and to the bleeding complications. Sometimes
oncological patients also show different degrees of thrombocytopenia,
which further complicates the pharmacological strategies. The aim of this
review is to summarize the current evidence regarding the treatment of ACS
in cancer patients and to suggest the optimal management and therapy to
reduce the risk of adverse coronary events after ACS in this high-risk
population. Copyright © 2020 by the authors. Licensee MDPI,
Basel, Switzerland.

<38>
Accession Number
2005213288
Title
Ticagrelor versus clopidogrel in older patients with nste-acs using oral
anticoagulation: A sub-analysis of the popular age trial.
Source
Journal of Clinical Medicine. 9 (10) (pp 1-9), 2020. Article Number: 3249.
Date of Publication: October 2020.
Author
Gimbel M.E.; Tavenier A.H.; Bor W.; Hermanides R.S.; de Vrey E.;
Heestermans T.; Gin M.T.J.; Waalewijn R.; Hofma S.; Den Hartog F.; Jukema
W.; von Birgelen C.; Voskuil M.; Kelder J.; Deneer V.; Ten Berg J.M.
Institution
(Gimbel, Bor, Kelder, Ten Berg) Department of Cardiology, St. Antonius
Hospital, Nieuwegein 3435CM, Netherlands
(Tavenier, Hermanides) Department of Cardiology, Isala, Zwolle 8025AB,
Netherlands
(de Vrey) Department of Cardiology, Meander Medical Centre, Amersfoort
3813TZ, Netherlands
(Heestermans) Department of Cardiology, Noord-west Hospital group, Alkmaar
1815JD, Netherlands
(Gin) Department of Cardiology, Rijnstate, Arnhem 6815AD, Netherlands
(Waalewijn) Department of Cardiology, Gelre Hospitals, Apeldoorn 7334DZ,
Netherlands
(Hofma) Department of Cardiology, Medical Centre Leeuwarden, Leeuwarden
8934AD, Netherlands
(Den Hartog) Department of Cardiology, Gelderse Vallei Hospital, Ede
6716RP, Netherlands
(Jukema) Department of Cardiology, Leids University Medical Centre, Leiden
2333ZA, Netherlands
(von Birgelen) Department of Cardiology, Medisch Spectrum Twente, Enschede
7512KZ, Netherlands
(Voskuil) Department of Cardiology, University Medical Centre Utrecht,
Utrecht 3584CX, Netherlands
(Deneer) Department of Clinical Pharmacy, Division of Laboratories,
Pharmacy, and Biomedical Genetics University, Medical Center Utrecht and
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht
Institute for Pharmaceutical Sciences, Utrecht University, Utrecht 3584CX,
Netherlands
Publisher
MDPI
Abstract
There are no randomised data on which antiplatelet agent to use in elderly
patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and an
indication for oral anticoagulation (OAC). The randomised POPular Age
trial, in patients of 70 years or older with NSTE-ACS, showed a reduction
in bleeding without increasing thrombotic events in patients using
clopidogrel as compared to ticagrelor. In this sub-analysis of the POPular
AGE trial, we compare clopidogrel with ticagrelor in patients with a need
for oral anticoagulation. The follow-up duration was one year. The primary
bleeding outcome was Platelet Inhibition and Patient Outcomes (PLATO)
major and minor bleeding. The primary thrombotic outcome consisted of
cardiovascular death, myocardial infarction and stroke. The primary net
clinical benefit outcome was a composite of all-cause death, myocardial
infarction, stroke, and PLATO major and minor bleeding. A total of
184/1011 (18.2%) patients on OAC were included in this subanalysis; 83
were randomized to clopidogrel and 101 to ticagrelor. The primary bleeding
outcome was lower in the clopidogrel group (17/83, 20.9%) compared to the
ticagrelor group (33/101, 33.5%; p = 0.051), as was the thrombotic outcome
(7/83, 8.4% vs. 19/101, 19.2%; p = 0.035) and the primary net clinical
benefit outcome (23/83, 27.7% vs. 49/101, 48.5%; p = 0.003). In this
subgroup of patients using OAC, clopidogrel reduced PLATO major and minor
bleeding compared to ticagrelor without increasing thrombotic risk. This
analysis therefore suggests that, in line with the POPular Age trial,
clopidogrel is a better option than ticagrelor in NSTE-ACS patients >=70
years using OAC. Copyright © 2020 by the authors. Licensee MDPI,
Basel, Switzerland.

<39>
Accession Number
2005155531
Title
Investigating association between intraoperative hypotension and
postoperative neurocognitive disorders in non-cardiac surgery: A
comprehensive review.
Source
Journal of Clinical Medicine. 9 (10) (pp 1-24), 2020. Article Number:
3183. Date of Publication: October 2020.
Author
Krzych L.J.; Pluta M.P.; Putowski Z.; Czok M.
Institution
(Krzych) Department of Anaesthesiology and Intensive Care, Faculty of
Medical Sciences in Katowice, Medical University of Silesia, Katowice
40752, Poland
(Pluta, Putowski, Czok) Students' Scientific Society, Department of
Anaesthesiology and Intensive Care, Faculty of Medical Sciences in
Katowice, Medical University of Silesia, Katowice 40752, Poland
Publisher
MDPI
Abstract
Postoperative delirium (POD) and postoperative cognitive decline (deficit)
(POCD) are related to a higher risk of postoperative complications and
long-term disability. Pathophysiology of POD and POCD is complex, elusive
and multifactorial. Intraoperative hypotension (IOH) constitutes a
frequent and vital health hazard in the perioperative period.
Unfortunately, there are no international recommendations in terms of
diagnostics and treatment of neurocognitive complications which may arise
from hypotension-related hypoperfusion. Therefore, we performed a
comprehensive review of the literature evaluating the association between
IOH and POD/POCD in the non-cardiac setting. We have concluded that
available data are quite inconsistent and there is a paucity of
high-quality evidence convincing that IOH is a risk factor for POD/POCD
development. Considerable heterogeneity between studies is the major
limitation to set up reliable recommendations regarding intraoperative
blood pressure management to protect the brain against hypotension-related
hypoperfusion. Further well-designed and effectively-performed research is
needed to elucidate true impact of intraoperative blood pressure
variations on postoperative cognitive functioning. Copyright ©
2020 by the authors. Licensee MDPI, Basel, Switzerland.

<40>
Accession Number
2005122865
Title
Alcohol septal ablation versus septal myectomy treatment of obstructive
hypertrophic cardiomyopathy: A systematic review and meta-analysis.
Source
Journal of Clinical Medicine. 9 (10) (pp 1-12), 2020. Article Number:
3062. Date of Publication: October 2020.
Author
Bytyci I.; Nistri S.; Morner S.; Henein M.Y.
Institution
(Bytyci, Morner, Henein) Institute of Public Health and Clinical Medicine,
Umea University, Umea 90187, Sweden
(Bytyci) Universi College, Bardhosh, Prishtina, Kosovo 10000
(Bytyci) Clinic of Cardiology, University Clinical Centre of Kosovo,
Prishtina, Kosovo 10000
(Nistri) Cardiology Service, CMSR-Veneto Medica, Altavilla Vicentina
204-36077, Italy
(Henein) Molecular and Clinic Research Institute, St George University,
Brunel University, London SW17 0QT, United Kingdom
(Henein) Institute of Fluid Dynamics, Brunel University, London UB8 3PH,
United Kingdom
Publisher
MDPI
Abstract
Surgical myectomy (SM) and alcohol septal ablation (ASA) are two invasive
therapies for symptomatic patients with hypertrophic obstructive
cardiomyopathy (HOCM), despite medical therapy. This meta-analysis aims to
compare the efficacy of the two procedures. We searched all electronic
databases until February 2020 for clinical trials and cohorts comparing
clinical outcomes of ASA and SM treatment of patients with HOCM. The
primary endpoint was all-cause mortality, cardiovascular (CV) mortality,
sudden cardiac death (SCD), re-intervention, and complications. Secondary
endpoints included relief of clinical symptoms and drop of left
ventricular outflow tract (LVOT) gradient. Twenty studies (4547 patients;
2 CTs and 18 cohorts) comparing ASA vs. SM with a mean follow-up of 47 +/-
28.7 months were included. Long term (8.72 vs. 7.84%, p = 0.42) and short
term (1.12 vs. 1.27%, p = 0.93) all-cause mortality, CV mortality (2.48
vs. 3.66%, p = 0.26), SCD (1.78 vs. 0.76%, p = 0.20) and stroke (0.36 vs.
1.01%, p = 0.64) were not different between procedures. ASA was associated
with lower peri-procedural complications (5.57 vs. 10.5%, p = 0.04) but
higher rate of re-interventions (10.1 vs. 0.27%; p < 0.001) and pacemaker
dependency (12.4 vs. 4.31%, p = 0.0004) compared to SM. ASA resulted in
less reduction in LVOT gradient (-47.8 vs. -58.4 mmHg, p = 0.01) and less
improvement of clinical symptoms compared to SM (New York Heart
Association (NYHA) class III/IV, 82.4 vs. 94.5%, p <; 0.001, angina 53.2
vs. 84.2%, p = 0.02). Thus, ASA and SM treatment of HOCM carry a similar
risk of mortality. Peri-procedural complications are less in alcohol
ablation but re-intervention and pacemaker implantations are more common.
These results might impact the procedure choice in individual patients,
for the best clinical outcome. Copyright © 2020 by the authors.
Licensee MDPI, Basel, Switzerland.

<41>
Accession Number
2004935770
Title
Optimal antithrombotic treatment of patients with atrial fibrillation
early after an acute coronary syndrome-triple therapy, dual antithrombotic
therapy with an anticoagulant ... or, rather, temporary dual antiplatelet
therapy?.
Source
Journal of Clinical Medicine. 9 (8) (pp 1-11), 2020. Article Number: 2673.
Date of Publication: August 2020.
Author
Limbruno U.; de Sensi F.; Cresti A.; Picchi A.; Lena F.; de Caterina R.
Institution
(Limbruno, de Sensi, Cresti, Picchi) Cardioneurovascular Department,
Azienda USL Toscana Sudest, Grosseto 58100, Italy
(Lena) Pharmacy Department, Azienda USL Toscana Sudest, Grosseto 58100,
Italy
(de Caterina) Cardio-Thoracic and Vascular Department, Pisa University
Hospital and University of Pisa, Pisa 56124, Italy
(de Caterina) Fondazione VillaSerena per la Ricerca, Citta Sant'Angelo,
Pescara 65013, Italy
Publisher
MDPI
Abstract
The combination of atrial fibrillation (AF) and acute coronary syndrome
(ACS) is a complex situation in which a three-dimensional
risk-cardioembolic, coronary, and hemorrhagic-has to be carefully managed.
Triple antithrombotic therapy (TAT) is burdened with a high risk of
serious bleeding, while dual antithrombotic therapy with an anticoagulant
(DAT) likely provides only suboptimal coronary protection early after
stent implantation. Moreover, TAT precludes the advantages provided by the
use of the latest and more potent P2Y<inf>12</inf> inhibitors in ACS
patients. Here, we aimed to simulate and compare the expected coronary,
cardioembolic, and hemorrhagic outcomes offered by DAT, TAT, or modern
dual antiplatelet therapy (DAPT) with aspirin plus one of the latest
P2Y<inf>12</inf> inhibitors in AF patients early after an ACS. The
comparison of numbers needed to treat to prevent major adverse events with
the various antithrombotic regimens suggests that AF-ACS patients at high
ischemic and hemorrhagic risk and at moderately low embolic risk
(CHA<inf>2</inf> DS<inf>2</inf> VASc score 2-4) might safely withhold
anticoagulation after revascularization for one month taking advantage of
a modern DAPT, with a favorable risk-to-benefit ratio. In conclusion, this
strategy, not sufficiently addressed in recent European and North American
guidelines or consensus documents, adds to the spectrum of treatment
options in these difficult patients; it might be the best choice in a
substantial number of patients; and should be prospectively tested in a
randomized controlled trial. Copyright © 2020 by the authors.
Licensee MDPI, Basel, Switzerland.

<42>
Accession Number
2004831397
Title
Translating evidence from clonal hematopoiesis to cardiovascular disease:
A systematic review.
Source
Journal of Clinical Medicine. 9 (8) (pp 1-20), 2020. Article Number: 2480.
Date of Publication: August 2020.
Author
Papa V.; Marracino L.; Fortini F.; Rizzo P.; Campo G.; Vaccarezza M.;
Dalla Sega F.V.
Institution
(Papa) Department of Motor Sciences and Wellness (DiSMeB), Universita
Degli Studi di Napoli "Parthenope, Napoli " 80133, Italy
(Papa) FAPAB Research Center, Avola, SR 96012, Italy
(Marracino, Rizzo, Vaccarezza) Department of Morphology, Surgery and
Experimental Medicine, Laboratory for Technologies of Advanced Therapies
(LTTA), University of Ferrara, Via Fossato di Mortara 64/B, Ferrara 44121,
Italy
(Fortini, Rizzo, Campo, Dalla Sega) Translational Research Center, Maria
Cecilia Hospital, GVM Care & Research, Cotignola, Ravenna 44124, Italy
(Campo) Department of Medical Sciences, Cardiovascular Institute, Azienda
Ospedaliero-Universitaria of Ferrara, University of Ferrara, Cona 30010,
Italy
(Vaccarezza) School of Pharmacy and Biomedical Sciences, Faculty of Health
Sciences, Curtin University, Curtin Perth Campus, Bentley, Perth, WA 6102,
Australia
Publisher
MDPI
Abstract
Some random mutations can confer a selective advantage to a hematopoietic
stem cell. As a result, mutated hematopoietic stem cells can give rise to
a significant proportion of mutated clones of blood cells. This event is
known as "clonal hematopoiesis." Clonal hematopoiesis is closely
associated with age, and carriers show an increased risk of developing
blood cancers. Clonal hematopoiesis of indeterminate potential is defined
by the presence of clones carrying a mutation associated with a blood
neoplasm without obvious hematological malignancies. Unexpectedly, in
recent years, it has emerged that clonal hematopoiesis of indeterminate
potential carriers also have an increased risk of developing
cardiovascular disease. Mechanisms linking clonal hematopoiesis of
indeterminate potential to cardiovascular disease are only partially
known. Findings in animal models indicate that clonal hematopoiesis of
indeterminate potential-related mutations amplify inflammatory responses.
Consistently, clinical studies have revealed that clonal hematopoiesis of
indeterminate potential carriers display increased levels of inflammatory
markers. In this review, we describe progress in our understanding of
clonal hematopoiesis in the context of cancer, and we discuss the most
recent findings linking clonal hematopoiesis of indeterminate potential
and cardiovascular diseases. Copyright © 2020 by the authors.
Licensee MDPI, Basel, Switzerland.

<43>
Accession Number
2004717212
Title
Long-term outcomes of patients with unprotected left main coronary artery
disease treated with percutaneous angioplasty versus bypass grafting: A
meta-analysis of randomized controlled trials.
Source
Journal of Clinical Medicine. 9 (7) (pp 1-10), 2020. Article Number: 2231.
Date of Publication: July 2020.
Author
Bajraktari G.; Zhubi-bakija F.; Ndrepepa G.; Alfonso F.; Elezi S.; Rexhaj
Z.; Bytyci I.; Bajraktari A.; Poniku A.; Henein M.Y.
Institution
(Bajraktari, Bytyci, Bajraktari, Henein) Department of Public Health and
Clinical Medicine, Umea University, Umea 90737, Sweden
(Bajraktari, Zhubi-bakija, Rexhaj, Bytyci, Poniku) Clinic of Cardiology,
University Clinical Centre of Kosova, Pristina 10000, Serbia
(Bajraktari, Elezi, Poniku) Medical Faculty, University of Prishtina
"Hasan Prishtina", Pristina 10000, Serbia
(Ndrepepa) Deutsches Herzzentrum Munchen, Technische Universitat, Munich
80636, Germany
(Alfonso) Cardiac Department, La Princesa University Hospital, Institute
of Health Research, IIS-IP, CIBER-CV University Autonoma of Madrid, Madrid
28029, Spain
Publisher
MDPI
Abstract
Background and Aim: Treatment of patients with left main coronary artery
disease (LMCA) with percutaneous coronary intervention (PCI) or coronary
artery bypass grafting (CABG) remains controversial. The aim of this
meta-analysis was to compare the long-term clinical outcomes of patients
with unprotected LMCA treated randomly by PCI or CABG. Method(s):
PubMed, MEDLINE, Embase, Scopus, Google Scholar, CENTRAL and
ClinicalTrials.gov database searches identified five randomized trials
(RCTs) including 4499 patients with unprotected LMCA comparing PCI (n =
2249) vs. CABG (n = 2250), with a minimum clinical follow-up of five
years. Random effect risk ratios were used for efficacy and safety
outcomes. The study was registered in PROSPERO. The primary outcome was
major adverse cardiac events (MACE), defined as a composite of death from
any cause, myocardial infarction or stroke. Result(s): Compared to
CABG, patients assigned to PCI had a similar rate of MACE (risk ratio
(RR): 1.13; 95% CI: 0.94 to 1.36; p = 0.19), myocardial infarction (RR:
1.48; 95% CI: 0.97 to 2.25; p = 0.07) and stroke (RR: 0.87; 95% CI: 0.62
to 1.23; p = 0.42). Additionally, all-cause mortality (RR: 1.07; 95% CI:
0.89 to 1.28; p = 0.48) and cardiovascular (CV) mortality (RR: 1.13; 95%
CI: 0.89 to 1.43; p = 0.31) were not different. However, the risk of any
repeat revascularization (RR: 1.70; 95% CI: 1.34 to 2.15; p < 0.00001) was
higher in patients assigned to PCI. Conclusion(s): The findings of
this meta-analysis suggest that the long-term survival and MACE of
patients who underwent PCI for unprotected LMCA stenosis were comparable
to those receiving CABG, despite a higher rate of repeat
revascularization. Copyright © 2020 by the authors. Licensee
MDPI, Basel, Switzerland.

<44>
Accession Number
2004711389
Title
Assessment of mortality and factors affecting outcome of use of
paclitaxel-coated stents and bare metal stents in femoropopliteal pad.
Source
Journal of Clinical Medicine. 9 (7) (pp 1-11), 2020. Article Number: 2221.
Date of Publication: July 2020.
Author
Falkowski A.; Bogacki H.; Szemitko M.
Institution
(Falkowski, Bogacki, Szemitko) Department of Interventional Radiology,
Pomeranian Medical University, Szczecin 70-111, Poland
Publisher
MDPI
Abstract
The use of drug-coated devices in intravascular therapy is aimed at
preventing neointimal hyperplasia caused by excessive proliferation of
vascular smooth muscle and thereby restenosis. Although its use seemed
initially promising, a recent publication has shown an increased risk of
mortality with paclitaxel-coated devices, and there is an urgent need to
reaffirm assessments of drug-eluting stents (DES). Objective(s): The
aim of the study was to compare mortality and effectiveness of
paclitaxel-coated stents and bare-metal stents (BMS) in the treatment of
peripheral arterial disease (PAD) with long-term follow-up.
 Material(s) and Method(s): In a single center randomized study, 256
patients with PAD were treated intravascularly with stent implantation.
Patients were randomized into two groups: the first (n = 126) were treated
with DES, and the second (n = 130) were treated with BMS. The study
included evaluation after the procedure, after about 6 months and 36
months. Co-morbidities, with risks for atherosclerosis, were analyzed in
all patients. Patients were evaluated for clinical outcome, restenosis
frequency, and safety (complications and total mortality). Result(s):
Clinical benefit at the end of the investigation was statistically
significantly better in the DES group compared with the BMS group: 85.7%
versus 66.2% (p = 0.0003), respectively. Restenosis occurred significantly
less frequently in patients with DES: 16.0% versus BMS: 35.0%, p = 0.012.
There was no significant effect of comorbidities on the frequency of
restenoses. There were no differences in all-cause mortality over the
three years with paclitaxel and no-paclitaxel stents cohorts (8.7% versus
7.1%; long-rank p = 0.575). No association was found with mortality and
treatment with DES or BMS. Conclusion(s): The use of
paclitaxel-coated stents gave good clinical benefit and caused a
significantly lower frequency of restenosis compared to bare-metal stents.
The use of paclitaxel-coated stents did not increase
mortality. Copyright © 2020 by the authors. Licensee MDPI, Basel,
Switzerland.

<45>
Accession Number
2004639825
Title
Vasopressors and inotropes in acute myocardial infarction related
cardiogenic shock: A systematic review and meta-analysis.
Source
Journal of Clinical Medicine. 9 (7) (pp 1-12), 2020. Article Number: 2051.
Date of Publication: July 2020.
Author
Karami M.; Hemradj V.V.; Ouweneel D.M.; Den Uil C.A.; Limpens J.;
Otterspoor L.C.; Vlaar A.P.; Lagrand W.K.; Henriques J.P.S.
Institution
(Karami, Ouweneel, Henriques) Heart Center, Department of Interventional
Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University
of Amsterdam, Amsterdam 1105 AZ, Netherlands
(Hemradj) Department of Cardiology, Isala, Zwolle 8025 AB, Netherlands
(Den Uil) Departments of Cardiology and Intensive Care Medicine, Erasmus
MC, University Medical Center, Rotterdam 3015 GD, Netherlands
(Limpens) Medical Library, Amsterdam UMC, University of Amsterdam,
Amsterdam 1105 AZ, Netherlands
(Otterspoor) Heart Center Catharina Hospital, Eindhoven 5623 EJ,
Netherlands
(Vlaar, Lagrand) Department of Intensive Care, Amsterdam UMC, University
of Amsterdam, Amsterdam 1105 AZ, Netherlands
Publisher
MDPI
Abstract
Vasopressors and inotropes are routinely used in acute myocardial
infarction (AMI) related cardiogenic shock (CS) to improve hemodynamics.
We aimed to investigate the effect of routinely used vasopressor and
inotropes on mortality in AMI related CS. A systematic search of MEDLINE,
EMBASE and CENTRAL was performed up to 20 February 2019. Randomized and
observational studies reporting mortality of AMI related CS patients were
included. At least one group should have received the vasopressor/inotrope
compared with a control group not exposed to the vasopressor/inotrope.
Exclusion criteria were case reports, correspondence and studies including
only post-cardiac surgery patients. In total, 19 studies (6 RCTs) were
included, comprising 2478 CS patients. The overall quality of evidence was
graded low. Treatment with adrenaline, noradrenaline, vasopressin,
milrinone, levosimendan, dobutamine or dopamine was not associated with a
difference in mortality between therapy and control group. We found a
trend toward better outcome with levosimendan, compared with control (RR
0.69, 95% CI 0.47-1.00). In conclusion, we found insufficient evidence
that routinely used vasopressors and inotropes are associated with reduced
mortality in patients with AMI related CS. Considering the limited
evidence, this study emphasizes the need for randomized trials with
appropriate endpoints and methodology. Copyright © 2020 by the
authors. Licensee MDPI, Basel, Switzerland.

<46>
Accession Number
2004604425
Title
Antithrombotic strategy for patients with acute coronary syndrome: A
perspective from east asia.
Source
Journal of Clinical Medicine. 9 (6) (pp 1-19), 2020. Article Number: 1963.
Date of Publication: June 2020.
Author
Numasawa Y.; Sawano M.; Fukuoka R.; Ejiri K.; Kuno T.; Shoji S.; Kohsaka
S.
Institution
(Numasawa) Department of Cardiology, Japanese Red Cross Ashikaga Hospital,
Ashikaga 326-0843, Japan
(Sawano, Fukuoka, Shoji, Kohsaka) Department of Cardiology, Keio
University School of Medicine, Tokyo 160-8582, Japan
(Ejiri) Department of Cardiovascular Medicine, Okayama University Graduate
School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama
700-8558, Japan
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, New York, NY 10003, United States
Publisher
MDPI
Abstract
Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention
has become the standard of care, particularly in patients with acute
coronary syndrome (ACS). Current clinical guidelines recommend novel P2Y12
inhibitors (e.g., prasugrel or ticagrelor) in addition to aspirin based on
the results of representative randomized controlled trials conducted
predominantly in Western countries. These agents were superior to
clopidogrel in reducing the composite ischemic events, with a trade-off of
the increased bleeding events. However, multiple differences exist between
East Asian and Western patients, especially with respect to their
physique, thrombogenicity, hemorrhagic diathesis, and on-treatment
platelet reactivity. Recent studies from East Asian countries (e.g., Japan
or South Korea) have consistently demonstrated that use of novel P2Y12
inhibitors is associated with a higher risk of bleeding events than use of
clopidogrel, despite borderline statistical difference in the incidence of
composite ischemic events. Additionally, multiple studies have shown that
the optimal duration of DAPT may be shorter in East Asian than Western
patients. This review summarizes clinical studies of antithrombotic
strategies in East Asian patients with ACS. Understanding these
differences in antithrombotic strategies including DAPT and their impacts
on clinical outcomes will aid in selection of the optimal tailored
antithrombotic therapy for patients with ACS. Copyright © 2020 by
the authors. Licensee MDPI, Basel, Switzerland.

<47>
Accession Number
2004339017
Title
A randomized comparison of plasma levobupivacaine concentrations following
thoracic epidural analgesia and subpleural paravertebral analgesia in open
thoracic surgery.
Source
Journal of Clinical Medicine. 9 (5) (no pagination), 2020. Article Number:
1395. Date of Publication: May 2020.
Author
Matek J.; Cernohorsky S.; Trca S.; Krska Z.; Hoskovec D.; Bruthans J.;
Sima M.; Michalek P.
Institution
(Matek, Cernohorsky, Trca, Krska, Hoskovec) 1st Department of
Surgery-Department of Abdominal, Thoracic Surgery and Traumatology, First
Faculty of Medicine, Charles University in Prague and General University
Hospital in Prague, Prague 128 00, Czechia
(Matek) Medical Faculty, Masaryk University, Brno 625 00, Czechia
(Bruthans, Michalek) Department of Anaesthesia and Intensive Care, First
Faculty of Medicine, Charles University in Prague and General University
Hospital in Prague, Prague 128 00, Czechia
(Sima) Institute of Pharmacology, First Faculty of Medicine, Charles
University in Prague and General University Hospital in Prague, Prague 128
00, Czechia
(Michalek) Department of Anaesthesia, Antrim Area Hospital, Antrim BT41
2RL, United Kingdom
Publisher
MDPI
Abstract
Background: The aim of this study was to compare plasma levobupivacaine
concentrations in thoracic epidural and subpleural paravertebral
analgesia. Method(s): Forty-four patients indicated for open lung
resection had an epidural catheter inserted preoperatively or a subpleural
catheter surgically. A bolus of 0.25% levobupivacaine at a dosage of 0.5
mg x kg-1 was given after the thoracotomy closure. Plasma
levobupivacaine level at 30 min was the primary outcome. Pharmacokinetic
modeling was performed subsequently. Secondary outcomes included the
quality of analgesia, complications, and patients'mobility.
 Result(s): Plasma concentrations were similar 30 min after
application-0.389 mg x L-1 in the epidural and 0.318 mg x
L-1 in the subpleural group (p = 0.33) and lower in the
subpleural group at 120 min (p = 0.03). The areas under the curve but not
maximum concentrations were lower in the subpleural group. The time to
reach maximum plasma level was similar in both groups-27.6 vs. 24.2 min.
No clinical symptoms of local anesthetic toxicity were recorded.
 Conclusion(s): Levobupivacaine systemic concentrations were low in
both groups without the symptoms of toxicity. This dosage should be safe
for postoperative analgesia after thoracotomy. Copyright © 2020
by the authors. Licensee MDPI, Basel, Switzerland.

<48>
Accession Number
2004225719
Title
The effects of granulocyte colony-stimulating factor in patients with a
large anterior wall acute myocardial infarction to prevent left
ventricular remodeling: A 10-year follow-up of the rigenera study.
Source
Journal of Clinical Medicine. 9 (4) (no pagination), 2020. Article Number:
1214. Date of Publication: April 2020.
Author
Leone A.M.; D'amario D.; Cannata F.; Graziani F.; Borovac J.A.; Leone G.;
De Stefano V.; Basile E.; Siracusano A.; Galiuto L.; Locorotondo G.; Porto
I.; Vergallo R.; Canonico F.; Restivo A.; Rebuzzi A.G.; Crea F.
Institution
(Leone, D'amario, Graziani, Locorotondo, Porto) Department of
Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino
Gemelli, IRCCS, Universita Cattolica del Sacro Cuore, Largo A. Gemelli 8,
Rome 00168, Italy
(Cannata, Borovac, Leone, De Stefano, Basile, Siracusano, Galiuto,
Vergallo, Canonico, Restivo, Rebuzzi, Crea) Universita Cattolica del Sacro
Cuore, Rome 00168, Italy
Publisher
MDPI
Abstract
Background: the RIGENERA trial assessed the efficacy of granulocyte-colony
stimulating factor (G-CSF) in the improvement of clinical outcomes in
patients with severe acute myocardial infarction. However, there is no
evidence available regarding the long-term safety and efficacy of this
treatment. Method(s): in order to evaluate the long-term effects on
the incidence of major adverse events, on the symptom burden, on the
quality of life and the mean life expectancy and on the left ventricular
(LV) function, we performed a clinical and echocardiographic evaluation
together with an assessment using the Minnesota Living with Heart Failure
Questionnaire (MLHFQ) and the Seattle Heart Failure Model (SHFM) at
10-years follow-up, in the patients cohorts enrolled in the RIGENERA
trial. Result(s): thirty-two patients were eligible for the
prospective clinical and echocardiography analyses. A significant
reduction in adverse LV remodeling was observed in G-CSF group compared to
controls, 9% vs. 48% (p = 0.030). The New York Heart Association (NYHA)
functional class was lower in G-CSF group vs. controls (p = 0.040), with
lower burden of symptoms and higher quality of life (p = 0.049). The mean
life expectancy was significantly higher in G-CSF group compared to
controls (15 +/- 4 years vs. 12 +/- 4 years, p = 0.046. No difference was
found in the incidence of major adverse events. Conclusion(s): this
longest available follow-up on G-CSF treatment in patients with severe
acute myocardial infarction (AMI) showed that this treatment was safe and
associated with a reduction of adverse LV remodeling and higher quality of
life, in comparison with standard-of-care treatment. Copyright ©
2020 by the authors. Licensee MDPI, Basel, Switzerland.

<49>
Accession Number
2004184271
Title
RNAs and gene expression predicting postoperative atrial fibrillation in
cardiac surgery patients undergoing coronary artery bypass grafting.
Source
Journal of Clinical Medicine. 9 (4) (no pagination), 2020. Article Number:
1139. Date of Publication: April 2020.
Author
Khan M.S.; Yamashita K.; Sharma V.; Ranjan R.; Dosdall D.J.
Institution
(Khan, Yamashita, Ranjan, Dosdall) Nora Eccles Harrison Cardiovascular
Research and Training Institute, The University of Utah, Salt Lake City,
UT 84112, United States
(Yamashita, Ranjan, Dosdall) Division of Cardiovascular Medicine, The
University of Utah-Health, Salt Lake City, UT 84132, United States
(Sharma, Dosdall) Division of Cardiothoracic Surgery, The University of
Utah-Health, Salt Lake City, UT 84132, United States
(Ranjan, Dosdall) Department of Biomedical Engineering, The University of
Utah, Salt Lake City, UT 84112, United States
Publisher
MDPI
Abstract
Postoperative atrial fibrillation (POAF) is linked with increased
morbidity, mortality rate and financial liability. About 20-50% of
patients experience POAF after coronary artery bypass graft (CABG)
surgery. Numerous review articles and meta-analyses have investigated
links between patient clinical risk factors, demographic conditions, and
pre-, peri-and post-operative biomarkers to forecast POAF incidence in
CABG patients. This narrative review, for the first time, summarize the
role of micro-RNAs, circular-RNAs and other gene expressions that have
shown experimental evidence to accurately predict the POAF incidence in
cardiac surgery patients after CABG. We envisage that identifying specific
genomic markers for predicting POAF might be a significant step for the
prevention and effective management of this type of post-operative
complication and may provide critical perspective into arrhythmogenic
substrate responsible for POAF. Copyright © 2020 by the authors.
Licensee MDPI, Basel, Switzerland.

<50>
Accession Number
2004159031
Title
Antithrombotic strategies in patients with atrial fibrillation following
percutaneous coronary intervention: A systemic review and network
meta-analysis of randomized controlled trials.
Source
Journal of Clinical Medicine. 9 (4) (no pagination), 2020. Article Number:
1062. Date of Publication: April 2020.
Author
Chua S.-K.; Chen L.-C.; Shyu K.-G.; Cheng J.-J.; Hung H.-F.; Chiu C.-Z.;
Lin C.-M.
Institution
(Chua, Lin) School of Medicine, Fu Jen Catholic University, New Taipei
City 242, Taiwan (Republic of China)
(Chua, Chen, Shyu, Cheng, Hung, Chiu) Division of Cardiology, Department
of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111,
Taiwan (Republic of China)
(Chua, Chen, Shyu, Cheng, Hung, Chiu) Department of Internal Medicine,
Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan (Republic of
China)
(Lin) Department of Emergency Medicine, Shin Kong Wu Ho-Su Memorial
Hospital, Taipei 111, Taiwan (Republic of China)
Publisher
MDPI
Abstract
Up to 10% of patients with atrial fibrillation (AF) undergo percutaneous
coronary intervention (PCI). A systematic review and network meta-analysis
were conducted by searching PubMed, Embase, and the Cochrane database of
systematic reviews for randomized control trials that studied the safety
and efficacy of different antithrombotic strategies in these patients. Six
studies, including 12,158 patients were included. Compared to that in the
triple antithrombotic therapy group (vitamin K antagonist (VKA) plus P2Y12
inhibitor and aspirin), thrombolysis in myocardial infarction (TIMI) major
bleeding was significantly reduced in the dual antithrombotic therapy
(non-vitamin K oral anticoagulants (NOACs) plus P2Y<inf>12</inf>
inhibitor) group by 47% (Odds ratio (OR), 0.53; 95% credible interval
[CrI], 0.35-0.78; I<inf>2</inf> = 0%). Besides, NOAC plus a
P2Y<inf>12</inf> inhibitor was associated with less intracranial
hemorrhage compared to VKA plus single antiplatelet therapy (OR: 0.20, 95%
CrI: 0.05-0.77). There was no significant difference in the trial-defined
major adverse cardiac events or the individual outcomes of all-cause
mortality, cardiovascular death, myocardial infarction, stroke or stent
thrombosis among all antithrombotic strategies. In conclusion,
antithrombotic strategy of NOACs plus P2Y<inf>12</inf> inhibitor is safer
than, and as effective as, the strategies including aspirin when used in
AF patients undergoing PCI. Copyright © 2020 by the authors.
Licensee MDPI, Basel, Switzerland.

<51>
Accession Number
2004153841
Title
Intracoronary injection of autologous CD34+ cells improves one-year left
ventricular systolic function in patients with diffuse coronary artery
disease and preserved cardiac performance-a randomized, open-label,
controlled phase ii clinical trial.
Source
Journal of Clinical Medicine. 9 (4) (no pagination), 2020. Article Number:
1043. Date of Publication: April 2020.
Author
Sung P.-H.; Li Y.-C.; Lee M.S.; Hsiao H.-Y.; Ma M.-C.; Pei S.-N.; Chiang
H.-J.; Lee F.-Y.; Yip H.-K.
Institution
(Sung, Li, Hsiao, Yip) Division of Cardiology, Department of Internal
Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University,
College of Medicine, Kaohsiung 83301, Taiwan (Republic of China)
(Sung, Yip) Center for Shockwave Medicine and Tissue Engineering,
Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan (Republic
of China)
(Lee) Department of Orthopedics, Kaohsiung Chang Gung Memorial Hospital,
Chang Gung University, College of Medicine, Kaohsiung 83301, Taiwan
(Republic of China)
(Ma) Division of Hema-Oncology, Department of Internal Medicine, Kaohsiung
Chang Gung Memorial Hospital, Chang Gung University College of Medicine,
Kaohsiung 83301, Taiwan (Republic of China)
(Pei) Department of Hematology Oncology, E-Da Cancer Hospital, I-Shou
University, College of Medicine, Kaohsiung 82445, Taiwan (Republic of
China)
(Chiang) Department of Obstetrics and Gynecology, Kaohsiung Chang Gung
Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung
83301, Taiwan (Republic of China)
(Chiang) Chung Shan Medical University School of Medicine, Taichung 40201,
Taiwan (Republic of China)
(Lee) Division of Thoracic and Cardiovascular Surgery, Department of
Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University
College of Medicine, Kaohsiung 83301, Taiwan (Republic of China)
(Lee) Division of Cardiovascular Surgery, Department of Surgery,
Tri-Service General Hospital, National Defense Medical Center, Taipei
11490, Taiwan (Republic of China)
(Yip) Department of Nursing, Asia University, Taichung 41354, Taiwan
(Republic of China)
(Yip) Institute for Translational Research in Biomedicine, Kaohsiung Chang
Gung Memorial Hospital, Chang Gung University, College of Medicine,
Kaohsiung 83301, Taiwan (Republic of China)
(Yip) Department of Medical Research, China Medical University Hospital,
China Medical University, Taichung 40402, Taiwan (Republic of China)
Publisher
MDPI
Abstract
This phase II randomized controlled trial tested whether intracoronary
autologous CD34+ cell therapy could further improve left ventricular (LV)
systolic function in patients with diffuse coronary artery disease (CAD)
with relatively preserved LV ejection fraction (defined as LVEF >40%)
unsuitable for coronary intervention. Between December 2013 and November
2017, 60 consecutive patients were randomly allocated into group 1 (CD34+
cells, 3.0 x 107/vessel/n = 30) and group 2 (optimal medical
therapy; n = 30). All patients were followed for one year, and preclinical
and clinical parameters were compared between two groups.
Three-dimensional echocardiography demonstrated no significant difference
in LVEF between groups 1 and 2 (54.9% vs. 51.0%, respectively, p = 0.295)
at 12 months. However, compared with baseline, 12-month LVEF was
significantly increased in group 1 (p < 0.001) but not in group 2 (p =
0.297). From baseline, there were gradual increases in LVEF in group 1
compared to those in group 2 at 1-month, 3-months, 6-months and 12 months
(+1.6%, +2.2%, +2.9% and +4.6% in the group 1 vs. -1.6%, -1.5%, -1.4% and
-0.9% in the group 2; all p < 0.05). Additionally, one-year angiogenesis
(2.8 +/- 0.9 vs. 1.3 +/- 1.1), angina (0.4 +/- 0.8 vs. 1.8 +/- 0.9) and HF
(0.7 +/- 0.8 vs. 1.8 +/- 0.6) scores were significantly improved in group
1 compared to those in group 2 (all p < 0.001). In conclusion, autologous
CD34+ cell therapy gradually and effectively improved LV systolic function
in patients with diffuse CAD and preserved LVEF who were non-candidates
for coronary intervention (Trial registration: ISRCTN26002902 on the
website of ISRCTN registry). Copyright © 2020 by the authors.
Licensee MDPI, Basel, Switzerland.

<52>
Accession Number
2004143085
Title
A randomized controlled trial comparing novel triple-cuffed double-lumen
endobronchial tubes with conventional double-lumen endobronchial tubes for
lung isolation.
Source
Journal of Clinical Medicine. 9 (4) (no pagination), 2020. Article Number:
977. Date of Publication: April 2020.
Author
Kim N.; Byon H.-J.; Kim G.E.; Park C.; Joe Y.E.; Suh S.M.; Oh Y.J.
Institution
(Kim, Byon, Kim, Joe, Suh, Oh) Department of Anesthesiology and Pain
Medicine, Anesthesia and Pain Research Institute, Yonsei University
College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, South
Korea
(Park) Department of Anesthesiology and Pain Medicine, Gil Medical Center,
Gachon University College of Medicine, 21 Namdong-daero 774 beon-gil,
Namdong-gu, Incheon 21565, South Korea
Publisher
MDPI
Abstract
Placing a double-lumen endobronchial tube (DLT) in an appropriate position
to facilitate lung isolation is essential for thoracic procedures. The
novel ANKOR DLT is a DLT developed with three cuffs with a newly added
carinal cuff designed to prevent further advancement by being blocked by
the carina when the cuff is inflated. In this prospective study, the
direction and depth of initial placement of ANKOR DLT were compared with
those of conventional DLT. Patients undergoing thoracic surgery (n = 190)
with one-lung ventilation (OLV) were randomly allocated into either
left-sided conventional DLT group (n = 95) or left-sided ANKOR DLT group
(n = 95). The direction and depth of DLT position were compared via
fiberoptic bronchoscopy (FOB) after endobronchial intubation between the
groups. There was no significant difference in the number of right
mainstem endobronchial intubations between the two groups (p = 0.468). The
difference between the initial depth of DLT placement and the target depth
confirmed by FOB was significantly lower in the ANKOR DLT group than in
the conventional DLT group (1.8 +/- 1.8 vs. 12.9 +/- 9.7 mm; p < 0.001).
In conclusion, the ANKOR DLT facilitated its initial positioning at the
optimal depth compared to the conventional DLT. Copyright © 2020
by the authors. Licensee MDPI, Basel, Switzerland.

<53>
Accession Number
2004096284
Title
Prevalence of depression in coronary artery bypass surgery: A systematic
review and meta-analysis.
Source
Journal of Clinical Medicine. 9 (4) (no pagination), 2020. Article Number:
909. Date of Publication: April 2020.
Author
Correa-Rodriguez M.; Ejheisheh M.A.; Suleiman-Martos N.; Membrive-Jimenez
M.J.; Velando-Soriano A.; Schmidt-Riovalle J.; Gomez-Urquiza J.L.
Institution
(Correa-Rodriguez, Ejheisheh, Schmidt-Riovalle, Gomez-Urquiza) Faculty of
Health Sciences, University of Granada, Avenida de la Ilustracion N. 60,
Granada 18016, Spain
(Correa-Rodriguez) Instituto de Investigacion Biosanitaria, IBS, Granada
18012, Spain
(Suleiman-Martos) Faculty of Health Sciences, University of Granada,
Campus Universitario de Ceuta, C/Cortadura del Valle s/n, Ceuta 51001,
Spain
(Membrive-Jimenez) University Hospital of Ceuta, Institute of Health
Management, C/Colmenar s/n, Ceuta 51003, Spain
(Velando-Soriano) University Hospital Virgen de las Nieves, Andalusian
Health Service, Av. de las Fuerzas Armadas 2, Granada 18014, Spain
Publisher
MDPI
Abstract
Coronary artery bypass graft surgery (CABG) might adversely affect the
health status of the patients, producing cognitive deterioration, with
depression being the most common symptom. The aim of this study is to
analyse the prevalence of depression in patients before and after coronary
artery bypass surgery. A systematic review and meta-analysis was carried
out, involving a study of the past 10 years of the following databases:
CINAHL, LILACS, MEDLINE, PsycINFO, SciELO, Scopus, and Web of Science. The
total sample comprised n = 16,501 patients. The total number of items was
n = 65, with n = 29 included in the meta-analysis. Based on the different
measurement tools used, the prevalence of depression pre-CABG ranges from
19-37%, and post-CABG from 15- 33%. There is a considerable presence of
depression in this type of patient, but this varies according to the
measurement tool used and the quality of the study. Systematically
detecting depression prior to cardiac surgery could identify patients at
potential risk. Copyright © 2020 by the authors. Licensee MDPI,
Basel, Switzerland.

<54>
Accession Number
2003730690
Title
Transcatheter versus surgical aortic valve replacement in low-risk
patients for the treatment of severe aortic stenosis.
Source
Journal of Clinical Medicine. 9 (2) (no pagination), 2020. Article Number:
439. Date of Publication: February 2020.
Author
Polimeni A.; Sorrentino S.; De Rosa S.; Spaccarotella C.; Mongiardo A.;
Sabatino J.; Indolfi C.
Institution
(Polimeni, Sorrentino, De Rosa, Spaccarotella, Mongiardo, Sabatino,
Indolfi) Division of Cardiology, Department of Medical and Surgical
Sciences, "Magna Graecia" University, Catanzaro 88100, Italy
(Indolfi) URT-CNR, Department of Medicine, Consiglio Nazionale delle
Ricerche, Catanzaro 88100, Italy
Publisher
MDPI
Abstract
Recently, two randomized trials, the PARTNER 3 and the Evolut Low Risk
Trial, independently demonstrated that transcatheter aortic valve
replacement (TAVR) is non-inferior to surgical aortic valve replacement
(SAVR) for the treatment of severe aortic stenosis in patients at low
surgical risk, paving the way to a progressive extension of clinical
indications to TAVR. We designed a meta-analysis to compare TAVR versus
SAVR in patients with severe aortic stenosis at low surgical risk. The
study protocol was registered in PROSPERO (CRD42019131125). Randomized
studies comparing one-year outcomes of TAVR or SAVR were searched for
within Medline, Scholar and Scopus electronic databases. A total of three
randomized studies were selected, including nearly 3000 patients. After
one year, the risk of cardiovascular death was significantly lower with
TAVR compared to SAVR (Risk Ratio (RR) = 0.56; 95% CI 0.33-0.95; p =
0.03). Conversely, no differences were observed between the groups for
one-year all-cause mortality (RR = 0.67; 95% CI 0.42-1.07; p = 0.10).
Among the secondary endpoints, patients undergoing TAVR have lower risk of
new-onset of atrial fibrillation compared to SAVR (RR = 0.26; 95% CI
0.17-0.39; p < 0.00001), major bleeding (RR = 0.30; 95% CI 0.14-0.65; p <
0.002) and acute kidney injury stage II or III (RR = 0.28; 95% CI 0.14-
0.58; p = 0.0005). Conversely, TAVR was associated to a higher risk of
aortic regurgitation (RR = 3.96; 95% CI 1.31-11.99; p = 0.01) and
permanent pacemaker implantation (RR = 3.47; 95% CI 1.33-9.07; p = 0.01)
compared to SAVR. No differences were observed between the groups in the
risks of stroke (RR= 0.71; 95% CI 0.41-1.25; p = 0.24), transient ischemic
attack (TIA; RR = 0.98; 95% CI 0.53-1.83; p = 0.96), and MI (RR = 0.75;
95% CI 0.43-1.29; p = 0.29). In conclusion, the present meta-analysis,
including three randomized studies and nearly 3000 patients with severe
aortic stenosis at low surgical risk, shows that TAVR is associated with
lower CV death compared to SAVR at one-year follow-up. Nevertheless,
paravalvular aortic regurgitation and pacemaker implantation still
represent two weak spots that should be solved. Copyright © 2020
by the author. Licensee MDPI, Basel, Switzerland.

<55>
Accession Number
2003713328
Title
Clinical interventions and all-cause mortality of patients with chronic
kidney disease: An umbrella systematic review of meta-analyses.
Source
Journal of Clinical Medicine. 9 (2) (no pagination), 2020. Article Number:
394. Date of Publication: February 2020.
Author
Kim J.Y.; Steingroever J.; Lee K.H.; Oh J.; Choi M.J.; Lee J.; Larkins
N.G.; Schaefer F.; Hong S.H.; Jeong G.H.; Shin J.I.; Kronbichler A.
Institution
(Kim, Choi) Yonsei University College of Medicine, Seoul 03722, South
Korea
(Steingroever, Oh) Department of Pediatric Nephrology, University Medical
Center Hamburg-Eppendorf, Martinistrase 52, Hamburg 20251, Germany
(Lee, Shin) Department of Pediatrics, Yonsei University College of
Medicine, Yonsei-ro 50, Seodaemun-gu, C.P.O. Box 8044, Seoul 03722, South
Korea
(Lee, Shin) Division of Pediatric Nephrology, Severance Children's
Hospital, Seoul 03722, South Korea
(Lee) Department of Pediatric Nephrology, Chungnam National University
Hospital, Daejeon 35015, South Korea
(Larkins) Department of Nephrology, Perth Children's Hospital, 15 Hospital
Ave, Nedlands, WA 6909, Australia
(Larkins) Centre for Kidney Research, Kids Research Institute, Westmead,
NSW 2031, Australia
(Schaefer) Division of Pediatric Nephrology, Center for Pediatrics and
Adolescent Medicine, Heidelberg University Hospital, Heidelberg 69120,
Germany
(Hong) Department of Global Health and Population, Harvard T. H. Chan
School of Public Health, 677 Huntington Ave, Boston, MA 02115, United
States
(Jeong) College of Medicine, Gyeongsang National University, Jinju 52727,
South Korea
(Kronbichler) Department of Internal Medicine IV (Nephrology and
Hypertension), Medical University Innsbruck, Anichstrase 35, Innsbruck
6020, Austria
Publisher
MDPI
Abstract
Patients with chronic kidney disease (CKD) have altered physiologic
processes, which result in different treatment outcomes compared with the
general population. We aimed to systematically evaluate the efficacy of
clinical interventions in reducing mortality of patients with CKD. We
searched PubMed, MEDLINE, Embase, and Cochrane Database of Systematic
Reviews for meta-analyses of randomized controlled trials (RCT) or
observational studies (OS) studying the effect of treatment on all-cause
mortality of patients with CKD. The credibility assessment was based on
the random-effects summary estimate, heterogeneity, 95% prediction
intervals, small study effects, excess significance, and credibility
ceilings. Ninety-two articles yielded 130 unique meta-analyses. Convincing
evidence from OSs supported mortality reduction with three treatments:
angiotensin-converting-enzyme inhibitors or angiotensin II receptor
blockers for patients not undergoing dialysis, warfarin for patients with
atrial fibrillation not undergoing dialysis, and (at short-term)
percutaneous coronary intervention compared to coronary artery bypass
grafting for dialysis patients. Two treatment comparisons were supported
by highly credible evidence from RCTs in terms of all-cause mortality.
These were high-flux hemodialysis (HD) versus low-flux HD as a maintenance
HD method and statin versus less statin or placebo for patients not
undergoing dialysis. Most significant associations identified in OSs
failed to be replicated in RCTs. Associations of high credibility from
RCTs were in line with current guidelines. Given the heterogeneity of CKD,
it seems hard to assume mortality reductions based on findings from
OSs. Copyright © 2020 by the authors. Licensee MDPI, Basel,
Switzerland.

<56>
Accession Number
2003713325
Title
Transcatheter aortic valve replacement with self-expandable ACURATE neo as
compared to balloon-expandable SAPIEN 3 in patients with severe aortic
stenosis: Meta-analysis of randomized and propensity-matched studies.
Source
Journal of Clinical Medicine. 9 (2) (no pagination), 2020. Article Number:
397. Date of Publication: February 2020.
Author
Gozdek M.; Zielinski K.; Pasierski M.; Matteucci M.; Fina D.; Jiritano F.;
Meani P.; Raffa G.M.; Malvindi P.G.; Pilato M.; Paparella D.; Slomka A.;
Kubica J.; Jagielak D.; Lorusso R.; Suwalski P.; Kowalewski M.
Institution
(Gozdek, Kubica) Department of Cardiology and Internal Medicine, Nicolaus
Copernicus University, Collegium Medicum, Bydgoszcz 85067, Poland
(Gozdek, Zielinski, Pasierski, Slomka, Kowalewski) Thoracic Research
Centre, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz,
Innovative Medical Forum, Bydgoszcz 85067, Poland
(Zielinski) Department of Cardiology, Warsaw Medical University, Warsaw
02091, Poland
(Pasierski, Suwalski, Kowalewski) Clinical Department of Cardiac Surgery,
Central Clinical Hospital of the Ministry of Interior and Administration,
Centre of Postgraduate Medical Education, Warsaw 02607, Poland
(Matteucci, Fina, Jiritano, Meani, Lorusso, Kowalewski) Department of
Cardio-Thoracic Surgery, Heart and Vascular Centre, Maastricht University
Medical Centre, Maastricht 6229 HX, Netherlands
(Matteucci) Department of Cardiac Surgery, Circolo Hospital, University of
Insubria, Varese 21100, Italy
(Fina) Department of Cardiology, IRCCS Policlinico San Donato, University
of Milan, Milan 20097, Italy
(Jiritano) Department of Cardiac Surgery, University Magna Graecia of
Catanzaro, Catanzaro 88100, Italy
(Meani) Department of Intensive Care Unit, Maastricht University Medical
Centre (MUMC+), Maastricht 6229 HX, Netherlands
(Raffa, Pilato) Department for the Treatment and Study of Cardiothoracic
Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Instituto
Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo
90127, Italy
(Malvindi) Wessex Cardiothoracic Centre, University Hospital Southampton,
Southampton SO16 6YD, United Kingdom
(Paparella) GVM Care & Research, Department of Cardiovascular Surgery,
Santa Maria Hospital, Bari 70124, Italy
(Paparella) Department of Emergency and Organ Transplant, University of
Bari Aldo Moro, Bari 70121, Italy
(Slomka) Department of Pathophysiology, Nicolaus Copernicus University,
Collegium Medicum, Bydgoszcz 85067, Poland
(Jagielak) Department of Cardiac Surgery, Gdansk Medical University,
Gdansk 80210, Poland
Publisher
MDPI
Abstract
Frequent occurrence of paravalvular leak (PVL) after transcatheter aortic
valve replacement (TAVR) was the main concern with earlier-generation
devices. Current meta-analysis compared outcomes of TAVR with
next-generation devices: ACURATE neo and SAPIEN 3. In random-effects
meta-analysis, the pooled incidence rates of procedural, clinical and
functional outcomes according to VARC-2 definitions were assessed. One
randomized controlled trial and five observational studies including 2818
patients (ACURATE neo n = 1256 vs. SAPIEN 3 n = 1562) met inclusion
criteria. ACURATE neo was associated with a 3.7-fold increase of
moderate-to-severe PVL (RR (risk ratio): 3.70 (2.04-6.70); P < 0.0001),
which was indirectly related to higher observed 30-day mortality with
ACURATE valve (RR: 1.77 (1.03-3.04); P = 0.04). Major vascular
complications, acute kidney injury, periprocedural myocardial infarction,
stroke and serious bleeding events were similar between devices. ACURATE
neo demonstrated lower transvalvular pressure gradients both at discharge
(P < 0.00001) and at 30 days (P < 0.00001), along with lower risk of
patient-prosthesis mismatch (RR: 0.29 (0.10-0.87); P = 0.03) and pacemaker
implantation (RR: 0.64 (0.50-0.81); P = 0.0002), but no differences were
observed regarding composite endpoints early safety and device success. In
conclusion, ACURATE neo, as compared with SAPIEN 3, was associated with
higher rates of moderate-to-severe PVL, which were indirectly linked with
increased observed 30-day all-cause mortality. Copyright © 2020
by the authors. Licensee MDPI, Basel, Switzerland.

<57>
Accession Number
2003557913
Title
Impact of right atrial physiology on heart failure and adverse events
after myocardial infarction.
Source
Journal of Clinical Medicine. 9 (1) (no pagination), 2020. Article Number:
210. Date of Publication: January 2020.
Author
Schuster A.; Backhaus S.J.; Stiermaier T.; Navarra J.-L.; Uhlig J.; Rommel
K.-P.; Koschalka A.; Kowallick J.T.; Bigalke B.; Kutty S.; Gutberlet M.;
Hasenfuss G.; Thiele H.; Eitel I.
Institution
(Schuster, Backhaus, Navarra, Koschalka, Hasenfus) Department of
Cardiology and Pneumology, University Medical Center Gottingen,
Georg-August University, German Center for Cardiovascular Research (DZHK),
Gottingen 37075, Germany
(Schuster) Department of Cardiology, Royal North Shore Hospital, The
Kolling Institute, Northern Clinical School, University of Sydney, Sydney,
NSW 2065, Australia
(Stiermaier, Eitel) University Heart Center Lubeck, Medical Clinic II
(Cardiology/Angiology/Intensive Care Medicine), University Hospital
Schleswig-Holstein, German Center for Cardiovascular Research (DZHK),
Lubeck 23538, Germany
(Uhlig, Kowallick) University Medical Center Gottingen, Institute for
Diagnostic and Interventional Radiology, Georg-August University, German
Center for Cardiovascular Research (DZHK), Gottingen 37075, Germany
(Rommel, Thiele) Department of Internal Medicine/Cardiology, Heart Center
Leipzig at University of Leipzig, Leipzig Heart Institute, Leipzig 04289,
Germany
(Bigalke) Department of Cardiology and Pneumology, Charite Campus Benjamin
Franklin, University Medical Center Berlin, Berlin 12203, Germany
(Kutty) Taussig Heart Center, Johns Hopkins Hospital, Baltimore, MD 21287,
United States
(Gutberlet) Department of Radiology, Heart Center Leipzig, University of
Leipzig, Leipzig 04289, Germany
Publisher
MDPI
Abstract
Background: Right ventricular (RV) function is a known predictor of
adverse events in heart failure and following acute myocardial infarction
(AMI). While right atrial (RA) involvement is well characterized in
pulmonary arterial hypertension, its relative contributions to adverse
events following AMI especially in patients with heart failure and
congestion need further evaluation. Method(s): In this cardiovascular
magnetic resonance (CMR)-substudy of AIDA STEMI and TATORT NSTEMI, 1235
AMI patients underwent CMR after primary percutaneous coronary
intervention (PCI) in 15 centers across Germany (n = 795 with ST-elevation
myocardial infarction and 440 with non-ST-elevation MI). Right atrial (RA)
performance was evaluated using CMR myocardial feature tracking (CMR-FT)
for the assessment of RA reservoir (total strain epsilons), conduit
(passive strain epsilone), booster pump function (active strain epsilona),
and associated strain rates (SR) in a blinded core-laboratory. The primary
endpoint was the occurrence of major adverse cardiac events (MACE) 12
months post AMI. Result(s): RA reservoir (epsilons p = 0.061, SRs p =
0.049) and conduit functions (epsilone p = 0.006, SRe p = 0.030) were
impaired in patients with MACE as opposed to RA booster pump (epsilona p =
0.579, SRa p = 0.118) and RA volume index (p = 0.866). RA conduit function
was associated with the clinical onset of heart failure and MACE
independently of RV systolic function and atrial fibrillation (AF)
(multivariable analysis hazard ratio 0.95, 95% confidence interval 0.92 to
0.99, p = 0.009), while RV systolic function and AF were not independent
prognosticators. Furthermore, RA conduit strain identified low-and
high-risk groups within patients with reduced RV systolic function (p =
0.019 on log rank testing). Conclusion(s): RA impairment is a
distinct feature and independent risk factor in patients following AMI and
can be easily assessed using CMR-FT-derived quantification of RA
strain. Copyright © 2020 by the authors. Licensee MDPI, Basel,
Switzerland.

<58>
Accession Number
2003437325
Title
Invasive evaluation of the microvasculature in acute myocardial
infarction: Coronary flow reserve versus the index of microcirculatory
resistance.
Source
Journal of Clinical Medicine. 9 (1) (no pagination), 2020. Article Number:
86. Date of Publication: January 2020.
Author
Clarke J.-R.D.; Kennedy R.; Lau F.D.; Lancaster G.I.; Zarich S.W.
Institution
(Clarke, Lau) Department of Internal Medicine, Yale-New Haven
Health/Bridgeport Hospital, Bridgeport, CT 06610, United States
(Kennedy) Department of Internal Medicine, St. Vincent Charity Medical
Center, Cleveland, OH 44115, United States
(Lancaster, Zarich) The Heart and Vascular Institute, Yale-New Haven
Health/Bridgeport Hospital, Bridgeport, CT 06610, United States
Publisher
MDPI
Abstract
Acute myocardial infarction (AMI) is one of the most common causes of
death in both the developed and developing world. It has high associated
morbidity despite prompt institution of recommended therapy. The focus
over the last few decades in ST-segment elevation AMI has been on timely
reperfusion of the epicardial vessel. However, microvascular consequences
after reperfusion, such as microvascular obstruction (MVO), are equally
reliable predictors of outcome. The attention on the microcirculation has
meant that traditional angiographic/anatomic methods are insufficient. We
searched PubMed and the Cochrane database for English-language studies
published between January 2000 and November 2019 that investigated the use
of invasive physiologic tools in AMI. Based on these results, we provide a
comprehensive review regarding the role for the invasive evaluation of the
microcirculation in AMI, with specific emphasis on coronary flow reserve
(CFR) and the index of microcirculatory resistance (IMR). Copyright
© 2019 by the authors. Licensee MDPI, Basel, Switzerland.

<59>
Accession Number
2002496939
Title
Utilization of percutaneous mechanical circulatory support devices in
cardiogenic shock complicating acute myocardial infarction and high-risk
percutaneous coronary interventions.
Source
Journal of Clinical Medicine. 8 (8) (no pagination), 2019. Article Number:
1209. Date of Publication: August 2019.
Author
Asleh R.; Resar J.R.
Institution
(Asleh, Resar) Division of Cardiology, Department of Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD 21205, United States
Publisher
MDPI
Abstract
Given the tremendous progress in interventional cardiology over the last
decade, a growing number of older patients, who have more comorbidities
and more complex coronary artery disease, are being considered for
technically challenging and high-risk percutaneous coronary interventions
(PCI). The success of performing such complex PCI is increasingly
dependent on the availability and improvement of mechanical circulatory
support (MCS) devices, which aim to provide hemodynamic support and left
ventricular (LV) unloading to enable safe and successful coronary
revascularization. MCS as an adjunct to high-risk PCI may, therefore, be
an important component for improvement in clinical outcomes. MCS devices
in this setting can be used for two main clinical conditions: Patients who
present with cardiogenic shock complicating acute myocardial infarction
(AMI) and those undergoing technically complex and high-risk PCI without
having overt cardiogenic shock. The current article reviews the
advancement in the use of various devices in both AMI complicated by
cardiogenic shock and complex high-risk PCI, highlights the available
hemodynamic and clinical data associated with the use of MCS devices, and
presents suggestive management strategies focusing on appropriate patient
selection and optimal timing and support to potentially increase the
clinical benefit from utilizing these devices during PCI in this high-risk
group of patients. Copyright © 2019 by the authors. Licensee
MDPI, Basel, Switzerland.

<60>
Accession Number
2002288325
Title
Total intravenous anesthesia maintained the degree of pre-existing mitral
regurgitation better than isoflurane anesthesia in cardiac surgery: A
randomized controlled trial.
Source
Journal of Clinical Medicine. 8 (8) (no pagination), 2019. Article Number:
1104. Date of Publication: August 2019.
Author
Ahn J.H.; Ahn H.J.; Yi J.-W.
Institution
(Ahn) Department of Anesthesiology and Pain Medicine, Kangbuk Samsung
Hospital, Sungkyunkwan University, School of Medicine, Seoul 03181, South
Korea
(Ahn) Department of Anesthesiology and Pain Medicine, College of Medicine,
Graduate School, Kyung Hee University, Seoul 02447, South Korea
(Ahn) Department of Anesthesiology and Pain Medicine, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul 06351, South
Korea
(Yi) Department of Anesthesiology and Pain Medicine, College of Medicine,
Kyung Hee, University, Seoul 02447, South Korea
Publisher
MDPI
Abstract
Accurate assessment of mitral regurgitation (MR) is critical during mitral
valve repair surgery. However, anesthesia may influence the degree of
mitral regurgitation by changing pre-and after-load or cardiac
contractility. Therefore, we compared changes in mitral regurgitation by
total intravenous anesthesia (TIVA) and inhalation anesthesia in patients
with pre-existing mitral regurgitation. This was a double-blind randomized
controlled study conducted at a tertiary care center in 2018. Fifty-four
mitral regurgitation patents undergoing elective cardiac surgery were
randomly assigned to receive TIVA or isoflurane. Primary endpoint was
change of regurgitation volume by anesthesia. The reduction of
regurgitation volume by anesthesia was greater in the isoflurane group
than in the TIVA group (mean (95% confidence interval CI): -0.20 (-6.15,
5.75) vs. -9.66 (-15.77, -3.56), mL.beat-1, p = 0.0266) and
this phenomenon was more prominent with severe mitral regurgitation (grade
3 or 4) (mean (95% CI): -0.33 (-9.10, 8.44) vs. -16.20 (-24.22, -8.18),
mL.beat-1, p = 0.0079). Among patients with MR grade 3 or 4,
94% remained the same with TIVA during anesthesia compared to 56% with
isoflurane. In conclusion, TIVA maintained the pre-anesthetic state of
mitral regurgitation relatively well, while the severity of mitral
regurgitation tended to decrease with isoflurane anesthesia. Copyright
© 2019 by the authors. Licensee MDPI, Basel, Switzerland.

<61>
Accession Number
2002232708
Title
The effects of iloprost on oxygenation during one-lung ventilation for
lung surgery: A randomized controlled trial.
Source
Journal of Clinical Medicine. 8 (7) (no pagination), 2019. Article Number:
982. Date of Publication: July 2019.
Author
Choi H.; Jeon J.; Huh J.; Koo J.; Yang S.; Hwang W.
Institution
(Choi, Huh, Koo, Yang, Hwang) Department of Anesthesia and Pain Medicine,
Seoul St. Mary's Hospital, College of Medicine, The Catholic University of
Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, South Korea
(Jeon) Department of Anesthesia and Pain Medicine, Eunpyeong St. Mary's
Hospital, College of Medicine, The Catholic University of Korea, 93-6,
Jingwan-dong, Eunpyeong-gu, Seoul 122200, South Korea
Publisher
MDPI
Abstract
Hypoxemia can occur during one-lung ventilation (OLV) in thoracic surgery,
leading to perioperative complications. Inhaled iloprost is a selective
pulmonary vasodilator with efficacy in patients with pulmonary
hypertension. The purpose of this study was to evaluate the effects of
off-label inhaled iloprost on oxygenation during OLV in patients
undergoing lung surgery. Seventy-two patients who were scheduled for
elective video-assisted thoracoscopic lobectomy were assigned to receive
an inhaled nebulizer of distilled water (control group), 10 microg
iloprost (IL10 group), or 20 microg iloprost (IL20 group). Arterial and
venous blood gas and hemodynamic analyses were obtained. Changes in
partial pressure of oxygen in arterial blood (PaO<inf>2</inf>), after the
initiation of OLV and the resumption two-lung ventilation (TLV), were
similar in all three groups. However, PaO<inf>2</inf> in the IL10 group
was comparable to that in the control group, whereas PaO<inf>2</inf> in
the IL20 group was significantly higher than that in the control group at
10, 20, and 30 min after administration of iloprost (275.1 +/- 50.8 vs.
179.3 +/- 38.9, p < 0.0001; 233.9 +/- 39.7 vs. 155.1 +/- 26.5, p < 0.0001;
and 224.6 +/- 36.4 vs. 144.0 +/- 22.9, p < 0.0001, respectively). The
shunt fraction in the IL20 group was significantly higher than that in the
control group after administration of iloprost (26.8 +/- 3.1 vs. 32.2 +/-
3.4, p < 0.0001; 24.6 +/- 2.2 vs. 29.9 +/- 3.4, p < 0.0001; and 25.3 +/-
2.0 vs. 30.8 +/- 3.1, p < 0.0001, respectively). Administration of inhaled
iloprost during OLV improves oxygenation and decreases intrapulmonary
shunt. Copyright © 2019 by the authors. Licensee MDPI, Basel,
Switzerland.

<62>
Accession Number
2001567364
Title
A longitudinal examination of the social-ecological correlates of exercise
in men and women following cardiac rehabilitation.
Source
Journal of Clinical Medicine. 8 (2) (no pagination), 2019. Article Number:
250. Date of Publication: February 2019.
Author
Moghei M.; Reid R.D.; Wooding E.; Ghisi G.M.; Pipe A.; Chessex C.; Prince
S.A.; Blanchard C.; Oh P.; Grace S.L.
Institution
(Moghei, Grace) School of Kinesiology and Health Science, York
University-Bethune 368, 4700 Keele St., Toronto, ON M3J 1P3, Canada
(Reid, Wooding, Pipe, Prince) Heart Institute, University of Ottawa, 40
Ruskin Street, Ottawa, ON K1Y 4W7, Canada
(Reid, Oh) Faculty of Medicine, University of Ottawa, 451 Smyth Rd,
Ottawa, ON K1H 8M5, Canada
(Ghisi, Chessex, Grace) Toronto Rehabilitation Institute, University
Health Network, University of Toronto, 347 Rumsey Rd, Toronto, ON M4G 1R7,
Canada
(Blanchard) Department of Medicine, Dalhousie University, 5790 University
Avenue, Halifax, NS B3H 1V7, Canada
Publisher
MDPI
Abstract
Cardiac patients who engage in >=150 min of moderate- to
vigorous-intensity physical activity (MVPA)/week have lower mortality, yet
MVPA declines even following cardiac rehabilitation (CR), and is lower in
women. A randomized trial of nine socioecological theory-based exercise
facilitation contacts over 50weeks versus usual care (1:1 parallel
arms)was undertaken (NCT01658683). The tertiary objective, as presented in
this paper, was to test whether the intervention impacted socioecological
elements, and in turn their association with MVPA. The 449 participants
wore an accelerometer and completed questionnaires post-CR, and 26, 52 and
78 weeks later. At 52 weeks, exercise task self-efficacy was significantly
greater in the intervention arm (p = 0.01), but no other differences were
observed except more encouragement from other cardiac patients at 26 weeks
(favoring controls). Among women adherent to the intervention, the group
in whom the intervention was proven effective, physical activity (PA)
intentions at 26 weeks were significantly greater in the intervention arm
(p = 0.04), with no other differences. There were some differences in
socioecological elements associated with MVPA by arm. There were also some
differences by sex, with MVPA more often associated with exercise
benefits/barriers in men, versus with working and the physical environment
in women. Copyright © 2019 by the authors. Licensee MDPI, Basel,
Switzerland.

<63>
Accession Number
2001561031
Title
Interventions to promote patient utilization of cardiac rehabilitation:
Cochrane systematic review and meta-analysis.
Source
Journal of Clinical Medicine. 8 (2) (no pagination), 2019. Article Number:
189. Date of Publication: 2019.
Author
de Araujo Pio C.S.; Chaves G.; Davies P.; Taylor R.; Grace S.
Institution
(de Araujo Pio, Grace) School of Kinesiology and Health Science, York
University, 4700 Keele St, Toronto, ON M3J 1P3, Canada
(Chaves) Department of Physical Therapy, Federal University of Minas
Gerais, Av. Pres. Antonio Carlos, 6627-Pampulha, Belo Horizonte, MG
31270-901, Brazil
(Davies) School of Social and Community Medicine, University of Bristol,
Queens Road, Bristol BS8 1QU, United Kingdom
(Taylor) Institute of Health Research, University of Exeter Medical
School, St Luke's Campus, Heavitree Road, Exeter EX1 2LU, United Kingdom
(Grace) Toronto Rehabilitation Institute, University Health Network,
University of Toronto, 399 Bathurst St, Toronto, ON M5T 2S8, Canada
Publisher
MDPI
Abstract
Too few patients utilize cardiac rehabilitation (CR), despite its
benefits. The Cochrane review assessing the effectiveness of interventions
to increase CR utilization (enrolment, adherence, and completion) was
updated. A search was performed through July 2018 of the Cochrane and
MEDLINE (Medical Literature Analysis and Retrieval System Online)
databases, among other sources. Randomized controlled trials in adults
with myocardial infarction, angina, revascularization, or heart failure
were included. Interventions had to aim to increase utilization of
comprehensive phase II CR. Two authors independently performed all stages
of citation processing. Following the random-effects meta-analysis,
meta-regression was undertaken to explore the impact of pre-specified
factors. Twenty-six trials with 5299 participants were included (35.8%
women). Low-quality evidence showed an effect of interventions in
increasing enrolment (risk ratio (RR) = 1.27, 95% confidence interval (CI)
= 1.13-1.42). Meta-regression analyses suggested that the intervention
deliverer (nurse or allied healthcare provider, p = 0.02) and delivery
format (face-to-face, p = 0.01) were influential in increasing enrolment.
There was low-quality evidence that interventions to increase adherence
were effective (standardized mean difference (SMD) = 0.38, 95% CI =
0.20-0.55), particularly where remotely-offered (SMD = 0.56, 95% CI =
0.36-0.76). There was moderate-quality evidence that interventions to
increase program completion were effective (RR = 1.13, 95% CI =
1.02-1.25). There are effective interventions to increase CR utilization,
but more research is needed to establish specific, implementable materials
and protocols, particularly for completion. Copyright © 2019 by
the authors. Licensee MDPI, Basel, Switzerland.

<64>
Accession Number
2003353364
Title
Near-infrared spectroscopy monitoring in cardiac and noncardiac surgery:
Pairwise and network meta-analyses.
Source
Journal of Clinical Medicine. 8 (12) (no pagination), 2019. Article
Number: 2208. Date of Publication: December 2019.
Author
Ortega-Loubon C.; Herrera-Gomez F.; Bernuy-Guevara C.; Jorge-Monjas P.;
Ochoa-Sangrador C.; Bustamante-Munguira J.; Tamayo E.; Alvarez F.J.
Institution
(Ortega-Loubon, Bustamante-Munguira) Department of Cardiac Surgery,
University Clinical Hospital of Valladolid, Ramon y Cajal Ave. 3,
Valladolid 47003, Spain
(Ortega-Loubon, Herrera-Gomez, Jorge-Monjas, Tamayo, Alvarez) BioCritic.
Group for Biomedical Research in Critical Care Medicine, Ramon y Cajal
Ave. 7, Valladolid 47005, Spain
(Herrera-Gomez, Bernuy-Guevara, Alvarez) Pharmacological Big Data
Laboratory, Department of Pharmacology and Therapeutics, University of
Valladolid, Ramon y Cajal Ave. 7, Valladolid 47005, Spain
(Herrera-Gomez) Department of Anatomy and Radiology, Faculty of Medicine,
University of Valladolid, Ramon y Cajal Ave. 7, Valladolid 47005, Spain
(Jorge-Monjas, Tamayo) Department of Anaesthesiology, University Clinical
Hospital of Valladolid, Ramon y Cajal Ave. 3, Valladolid 47003, Spain
(Jorge-Monjas, Tamayo) Department of Surgery, Faculty of Medicine,
University of Valladolid, Ramon y Cajal Ave. 7, Valladolid 47005, Spain
(Ochoa-Sangrador) Clinical Epidemiology Support Office, Sanidad Castilla y
Leon, Requejo Ave. 35, Zamora 49022, Spain
(Alvarez) Ethics Committee of Drug Research-East Valladolid, University
Clinical Hospital of Valladolid, Ramon y Cajal Ave. 3, Valladolid 47003,
Spain
Publisher
MDPI
Abstract
Goal-directed therapy based on brain-oxygen saturation (bSo<inf>2</inf>)
is controversial and hotly debated. While meta-analyses of aggregated data
have shown no clinical benefit for brain near-infrared spectroscopy
(NIRS)-based interventions after cardiac surgery, no network meta-analyses
involving both major cardiac and noncardiac procedures have yet been
undertaken. Randomized controlled trials involving NIRS monitoring in both
major cardiac and noncardiac surgery were included. Aggregate-level data
summary estimates of critical outcomes (postoperative cognitive decline
(POCD)/postoperative delirium (POD), acute kidney injury, cardiovascular
events, bleeding/need for transfusion, and postoperative mortality) were
obtained. NIRS was only associated with protection against POCD/POD in
cardiac surgery patients (pooled odds ratio (OR)/95% confidence interval
(CI)/I2/number of studies (n): 0.34/0.14-0.85/75%/7), although
a favorable effect was observed in the analysis, including both cardiac
and noncardiac procedures. However, the benefit of the use of NIRS
monitoring was undetectable in Bayesian network meta-analysis, although
maintaining bSo<inf>2</inf> > 80% of the baseline appeared to have the
most pronounced impact. Evidence was imprecise regarding acute kidney
injury, cardiovascular events, bleeding/need for transfusion, and
postoperative mortality. There is evidence that brain NIRS-based
algorithms are effective in preventing POCD/POD in cardiac surgery, but
not in major noncardiac surgery. However, the specific target
bSo<inf>2</inf> threshold has yet to be determined. Copyright ©
2019 by the authors. Licensee MDPI, Basel, Switzerland.

<65>
Accession Number
2003250472
Title
Antithrombotic therapy for percutaneous cardiovascular interventions: From
coronary artery disease to structural heart interventions.
Source
Journal of Clinical Medicine. 8 (11) (no pagination), 2019. Article
Number: 2016. Date of Publication: November 2019.
Author
Caracciolo A.; Mazzone P.; Laterra G.; Garcia-Ruiz V.; Polimeni A.;
Galasso S.; Saporito F.; Carerj S.; D'ascenzo F.; Marquis-Gravel G.;
Giustino G.; Costa F.
Institution
(Caracciolo, Mazzone, Laterra, Galasso, Saporito, Carerj, Costa)
Department of Clinical and Experimental Medicine, Policlinic "G. Martino",
University of Messina, Messina 98100, Italy
(Garcia-Ruiz) UGC del Corazon, Servicio de Cardiologia, Hospital Clinico
Universitario Virgen de la Victoria, Malaga 29010, Spain
(Polimeni) Division of Cardiology, Department of Medical and Surgical
Sciences, Magna Graecia University, Catanzaro 88100, Italy
(D'ascenzo) Division of Cardiology, Department of Medical Sciences, Citta
della Salute e della Scienza, University of Turin, Turin 10124, Italy
(Marquis-Gravel) Duke Clinical Research Institute, Durham, NC 27708,
United States
(Marquis-Gravel) Montreal Heart Institute, Montreal, QC H1T 1C8, Canada
(Giustino) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY 10029-6574, United States
(Giustino) Department of Population Health Science and Policy, Icahn
School of Medicine at Mount Sinai, New York, NY 10029-6574, United States
Publisher
MDPI
Abstract
Percutaneous cardiovascular interventions have changed dramatically in
recent years, and the impetus given by the rapid implementation of novel
techniques and devices have been mirrored by a refinement of
antithrombotic strategies for secondary prevention, which have been
supported by a significant burden of evidence from clinical studies. In
the current manuscript, we aim to provide a comprehensive, yet pragmatic,
revision of the current available evidence regarding antithrombotic
strategies in the domain of percutaneous cardiovascular interventions. We
revise the evidence regarding antithrombotic therapy for secondary
prevention in coronary artery disease and stent implantation, the complex
interrelation between antiplatelet and anticoagulant therapy in patients
undergoing percutaneous coronary intervention with concomitant atrial
fibrillation, and finally focus on the novel developments in the secondary
prevention after structural heart disease intervention. A special focus on
treatment individualization is included to emphasize risk and benefits of
each therapeutic strategy. Copyright © 2019 by the authors.
Licensee MDPI, Basel, Switzerland.

<66>
Accession Number
2002865874
Title
Comparison of hemodynamic factors predicting prognosis in heart failure: A
systematic review.
Source
Journal of Clinical Medicine. 8 (10) (no pagination), 2019. Article
Number: 1757. Date of Publication: October 2019.
Author
Aalders M.; Kok W.
Institution
(Aalders, Kok) Department of Clinical and Experimental Cardiology,
Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105AZ,
Netherlands
Publisher
MDPI
Abstract
Objectives: We systematically reviewed the literature to address the
question of which of the three hemodynamic factors predicts prognosis best
in heart failure patients when directly compared to each other: cardiac
output, preload or afterload. Method(s): Prognostic studies in heart
failure (HF) were searched that included at least two of the three
hemodynamic variables: (1) cardiac output or cardiac index (CI), (2)
preload represented by pulmonary capillary wedge pressure (PCWP) and (3)
afterload simplified to systolic blood pressure (SBP). Critical appraisal
was done according to the QUIPS format for prognostic studies. The main
endpoint was all-cause mortality, which could be combined with other
endpoints. We report the number of studies in which CI, PCWP and SBP
remained significant prognostic predictors in multivariate analysis. We
also assessed whether hemodynamic predictors of prognosis varied in four
different HF-populations. Result(s): Included were 18 studies
containing a multivariate analysis. PCWP was an independent predictor of
prognosis in 10 of 18 studies, SBP in 3 of 14 studies and CI in none of 18
studies. Results were not specific for any of the HF-populations.
 Conclusion(s): A higher PCWP and lower SBP are independent predictors
of poor prognosis in HF. In spite of the frequently used concept behind
HF, this review demonstrates that CI is not an independent predictor of
prognosis in HF. Copyright © 2019 by the authors. Licensee MDPI,
Basel, Switzerland.

<67>
Accession Number
2002799396
Title
Acute kidney injury after lung transplantation: A systematic review and
meta-analysis.
Source
Journal of Clinical Medicine. 8 (10) (no pagination), 2019. Article
Number: 1713. Date of Publication: October 2019.
Author
Lertjitbanjong P.; Thongprayoon C.; Cheungpasitporn W.; O'corragain O.A.;
Srivali N.; Bathini T.; Watthanasuntorn K.; Aeddula N.R.; Salim S.A.;
Ungprasert P.; Gillaspie E.A.; Wijarnpreecha K.; Mao M.A.; Kaewput W.
Institution
(Lertjitbanjong, Watthanasuntorn) Department of Internal Medicine, Bassett
Medical Center, Cooperstown, NY 13326, United States
(Thongprayoon) Division of Nephrology and Hypertension, Mayo Clinic,
Rochester, MN 55905, United States
(Cheungpasitporn, Salim) Division of Nephrology, Department of Medicine,
University of Mississippi Medical Center, Jackson, MS 39216, United States
(O'corragain) Department of Thoracic Medicine and Surgery, Temple
University Hospital, Philadelphia, PA 19140, United States
(Srivali) Department of Internal Medicine, St. Agnes Hospital, Baltimore,
MD 21229, United States
(Bathini) Department of Internal Medicine, University of Arizona, Tucson,
AZ 85721, United States
(Aeddula) Department of Medicine, Deaconess Health System, Evansville, IN
47747, United States
(Ungprasert) Cleveland Clinic Lerner College of Medicine of Case Western
Reserve University, Cleveland Clinic, Cleveland, OH 44195, United States
(Gillaspie) Department of Thoracic Surgery, Vanderbilt University Medical
Center, Nashville, TN 37212, United States
(Wijarnpreecha, Mao) Department of Medicine, Mayo Clinic, Jacksonville, FL
32224, United States
(Kaewput) Department of Military and Community Medicine, Phramongkutklao
College of Medicine, Bangkok 10400, Thailand
Publisher
MDPI
Abstract
Background: Lung transplantation has been increasingly performed worldwide
and is considered an effective therapy for patients with various causes of
end-stage lung diseases. We performed a systematic review to assess the
incidence and impact of acute kidney injury (AKI) and severe AKI requiring
renal replacement therapy (RRT) in patients after lung transplantation.
 Method(s): A literature search was conducted utilizing Ovid MEDLINE,
EMBASE, and Cochrane Database from inception through June 2019. We
included studies that evaluated the incidence of AKI, severe AKI requiring
RRT, and mortality risk of AKI among patients after lung transplantation.
Pooled incidence and odds ratios (ORs) with 95% confidence interval (CI)
were obtained using random-effects meta-analysis. The protocol for this
meta-analysis is registered with PROSPERO (International Prospective
Register of Systematic Reviews; no. CRD42019134095). Result(s): A
total of 26 cohort studies with a total of 40,592 patients after lung
transplantation were enrolled. Overall, the pooled estimated incidence
rates of AKI (by standard AKI definitions) and severe AKI requiring RRT
following lung transplantation were 52.5% (95% CI: 45.8-59.1%) and 9.3%
(95% CI: 7.6-11.4%). Meta-regression analysis demonstrated that the year
of study did not significantly affect the incidence of AKI (p = 0.22) and
severe AKI requiring RRT (p = 0.68). The pooled ORs of in-hospital
mortality in patients after lung transplantation with AKI and severe AKI
requiring RRT were 2.75 (95% CI, 1.18-6.41) and 10.89 (95% CI,
5.03-23.58). At five years, the pooled ORs of mortality among patients
after lung transplantation with AKI and severe AKI requiring RRT were 1.47
(95% CI, 1.11-1.94) and 4.79 (95% CI, 3.58-6.40), respectively.
 Conclusion(s): The overall estimated incidence rates of AKI and
severe AKI requiring RRT in patients after lung transplantation are 52.5%
and 9.3%, respectively. Despite advances in therapy, the incidence of AKI
in patients after lung transplantation does not seem to have decreased. In
addition, AKI after lung transplantation is significantly associated with
reduced short-term and long-term survival. Copyright © 2019 by
the authors. Licensee MDPI, Basel, Switzerland.

<68>
Accession Number
2002659831
Title
Systemic oxygen delivery during one-lung ventilation: Comparison between
propofol and sevoflurane anaesthesia in a randomised controlled trial.
Source
Journal of Clinical Medicine. 8 (9) (no pagination), 2019. Article Number:
1438. Date of Publication: September 2019.
Author
Hahm T.S.; Jeong H.; Ahn H.J.
Institution
(Hahm, Jeong, Ahn) Department of Anaesthesiology and Pain Medicine,
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
06351, South Korea
Publisher
MDPI
Abstract
Systemic oxygen delivery (DO<inf>2</inf>) is a more comprehensive marker
of patient status than arterial oxygen saturation (SaO<inf>2</inf>), and
DO<inf>2</inf> in the range of 330-500 mL min-1 is reportedly
adequate during anaesthesia. We measured DO<inf>2</inf> during one-lung
ventilation (OLV) for thoracic surgery-where the risk of pulmonary shunt
is significant, and hypoxia occurs frequently-and compared sevoflurane and
propofol, the two most commonly used anaesthetics in terms of
DO<inf>2</inf>. Sevoflurane impairs hypoxic pulmonary vasoconstriction.
Thus, our hypothesis was that propofol-based anaesthesia would show a
higher DO<inf>2</inf> value than sevoflurane-based anaesthesia. This was a
double-blinded randomised controlled trial conducted at a university
hospital from 2017 to 2018. The study population consisted of patients
scheduled for lobectomy under OLV (N = 120). Sevoflurane or propofol was
titrated to a bispectral index of 40-50. Haemodynamic variables were
measured during two-lung ventilation (TLV) and OLV at 15 and 45 min (OLV15
and OLV45, respectively) using oesophageal Doppler monitoring. The mean
DO<inf>2</inf> (mL min-1) was not different between the
sevoflurane and propofol anaesthesia groups (TLV: 680 vs. 706; OLV15: 685
vs. 703; OLV45: 759 vs. 782, respectively). SaO<inf>2</inf> was not
correlated with DO<inf>2</inf> (r = 0.09, p = 0.100). Patients with
SaO<inf>2</inf> < 94% showed adequate DO<inf>2</inf> (641 +/- 203 mL
min-1), and patients with high SaO<inf>2</inf> (> 97%) showed
inadequate DO<inf>2</inf> (14% of measurements < 500 mL min-1).
In conclusion, DO<inf>2</inf> did not significantly differ between
sevoflurane and propofol. SaO<inf>2</inf> was not correlated with
DO<inf>2</inf> and was not informative regarding whether the patients were
receiving an adequate oxygen supply. DO<inf>2</inf> may provide additional
information on patient status, which may be especially important when
patients show a low SaO<inf>2</inf>. Copyright © 2019 by the
authors. Licensee MDPI, Basel, Switzerland.

<69>
Accession Number
2002629167
Title
Pterins as diagnostic markers of mechanical and impact-induced trauma: A
systematic review.
Source
Journal of Clinical Medicine. 8 (9) (no pagination), 2019. Article Number:
1383. Date of Publication: September 2019.
Author
Lindsay A.; Baxter-Parker G.; Gieseg S.P.
Institution
(Lindsay) Institution for Physical Activity and Nutrition (IPAN), School
of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
(Baxter-Parker, Gieseg) School of Biological Sciences, University of
Canterbury, Christchurch 8140, New Zealand
(Gieseg) Department of Radiology, University of Otago Christchurch, PO Box
4345, Christchurch 8011, New Zealand
Publisher
MDPI
Abstract
We performed a systematic review of the literature to evaluate pterins as
biomarkers of mechanical and impact-induced trauma. MEDLINE and Scopus
were searched in March 2019. We included in vivo human studies that
measured a pterin in response to mechanical or impact-induced trauma with
no underlying prior disease or complication. We included 40 studies with a
total of 3829 subjects. Seventy-seven percent of studies measured a
significant increase in a pterin, primarily neopterin or total neopterin
(neopterin + 7,8-dihydroneopterin). Fifty-one percent of studies measured
an increase within 24 h or trauma, while 46% measured increases beyond 48
h. Pterins also showed promise as predictors of post-trauma complications
such as sepsis, multi-organ failure and mortality. Exercise-induced trauma
and traumatic brain injury caused an immediate increase in neopterin or
total neopterin, while patients of multiple trauma had elevated pterin
levels that remained above baseline for several days. Pterin concentration
changes in response to surgery were variable with patients undergoing
cardiac surgery having immediate and sustained pterin increases, while
hysterectomy, liver resection or hysterectomy showed no change. This
review provides systematic evidence that pterins, in particular neopterin
and total neopterin, increase in response to multiple forms of mechanical
or impact-induced trauma. Copyright © 2019 by the authors.
Licensee MDPI, Basel, Switzerland.

<70>
Accession Number
2001499750
Title
Reevaluating the importance of modified ultrafiltration in contemporary
pediatric cardiac surgery.
Source
Journal of Clinical Medicine. 7 (12) (no pagination), 2018. Article
Number: 498. Date of Publication: 01 Dec 2018.
Author
Milovanovic V.; Bisenic D.; Mimic B.; Ali B.; Cantinotti M.; Soldatovic
I.; Vulicevic I.; Murzi B.; Ilic S.
Institution
(Milovanovic, Bisenic, Vulicevic) Department of Cardiac Surgery,
University Childrens Hospital, Belgrade 11 000, Serbia
(Mimic, Ali) East Midlands Congenital Heart Centre, University Hospitals
of Leicester, Leicester LE39QB, United Kingdom
(Cantinotti) Institute of Clinical Physiology, Fondazione G. Monasterio
CNR-Regione Toscana, Pisa 56100, Italy
(Soldatovic, Ilic) School of Medicine, University of Belgrade, Belgrade 11
000, Serbia
(Murzi) Fondazione G. Monasterio CNR-Regione Toscana, Massa 54100, Italy
Publisher
MDPI
Abstract
Objective(s): Modified ultrafiltration has gained wide acceptance as a
powerful tool against cardiopulmonary bypass morbidity in pediatric
cardiac surgery. The aim of our study was to assess the importance of
modified ultrafiltration within conditions of contemporary cardiopulmonary
bypass characteristics. Method(s): Ninety-eight patients (overall
cohort) weighing less than 12 kg undergoing surgical repair with
cardiopulmonary bypass were prospectively enrolled in a randomized
protocol to receive modified and conventional ultrafiltration (MUF group)
or just conventional ultrafiltration (non-MUF group). A special attention
was paid to forty-nine neonates and infants weighing less than 5 kg (lower
weight (LW) cohort). Result(s): Post-filtration hematocrit was
significantly higher in the MUF group for both cohorts (overall cohort p =
0.001; LW cohort p = 0.04), but not at other time points. During the
postoperative course, patients in the MUF group received fewer packed red
blood cells, (overall cohort p = 0.01; LW cohort p = 0.07), but required
more fresh frozen plasma (overall cohort p = 0.04; LW cohort p = 0.05).
There was no difference between groups in hemodynamic state, chest tube
output, duration of mechanical ventilation, respiratory parameters,
duration of intensive care unit, and hospitalization stay.
 Conclusion(s): If conventional ultrafiltration provides adequate
hemoconcentration modified ultrafiltration does not provide additional
positive benefits except for reduction in blood cell transfusion, This,
however, comes at the cost of needing more fresh frozen plasma. Of
particular importance is that this also applies to infants with weight
bellow 5 kg where modified ultrafiltration was supposed to have the
greatest positive impact. Copyright © 2018 by the authors.
Licensee MDPI, Basel, Switzerland.

<71>
Accession Number
625112699
Title
Lung protection strategies during cardiopulmonary bypass affect the
composition of blood electrolytes and metabolites-A randomized controlled
trial.
Source
Journal of Clinical Medicine. 7 (11) (no pagination), 2018. Article
Number: 462. Date of Publication: 21 Nov 2018.
Author
Buggeskov K.B.; Maltesen R.G.; Rasmussen B.S.; Hanifa M.A.; Lund M.A.V.;
Wimmer R.; Ravn H.B.
Institution
(Buggeskov, Ravn) Department of Cardiothoracic Anesthesiology,
Rigshospitalet, Copenhagen University Hospital, Copenhagen 2100, Denmark
(Maltesen, Rasmussen, Hanifa) Department of Anesthesia and Intensive Care,
Aalborg University Hospital, Aalborg 9000, Denmark
(Rasmussen, Hanifa) Department of Clinical Medicine, School of Medicine
and Health, Aalborg University, Aalborg 9000, Denmark
(Lund) Department of Biomedical Sciences, University of Copenhagen,
Copenhagen 2100, Denmark
(Wimmer) Department of Chemistry and Bioscience, Aalborg University,
Aalborg 9220, Denmark
Publisher
MDPI
Abstract
Cardiac surgery with cardiopulmonary bypass (CPB) causes an acute lung
ischemia-reperfusion injury, which can develop to pulmonary dysfunction
postoperatively. This sub-study of the Pulmonary Protection Trial aimed to
elucidate changes in arterial blood gas analyses, inflammatory protein
interleukin-6, and metabolites of 90 chronic obstructive pulmonary disease
patients following two lung protective regimens of pulmonary artery
perfusion with either hypothermic histidine-tryptophan-ketoglutarate (HTK)
solution or normothermic oxygenated blood during CPB, compared to the
standard CPB with no pulmonary perfusion. Blood was collected at six time
points before, during, and up to 20 hours post-CPB. Blood gas analysis,
enzyme-linked immunosorbent assay, and nuclear magnetic resonance
spectroscopy were used, and multivariate and univariate statistical
analyses were performed. All patients had decreased gas exchange,
augmented inflammation, and metabolite alteration during and after CPB.
While no difference was observed between patients receiving oxygenated
blood and standard CPB, patients receiving HTK solution had an excess of
metabolites involved in energy production and detoxification of reactive
oxygen species. Also, patients receiving HTK suffered a transient isotonic
hyponatremia that resolved within 20 hours post-CPB. Additional studies
are needed to further elucidate how to diminish lung ischemia-reperfusion
injury during CPB, and thereby, reduce the risk of developing severe
postoperative pulmonary dysfunction. Copyright © 2018 by the
authors. Licensee MDPI, Basel, Switzerland.

<72>
Accession Number
2010573225
Title
A Randomized Comparison of Positional Stability: The EZ-Blocker Versus
Left-Sided Double-Lumen Endobronchial Tubes in Adult Patients Undergoing
Thoracic Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (8) (pp 2319-2325),
2021. Date of Publication: August 2021.
Author
Morris B.N.; Fernando R.J.; Garner C.R.; Johnson S.D.; Gardner J.C.;
Marchant B.E.; Johnson K.N.; Harris H.M.; Russell G.B.; Wudel L.J.;
Templeton T.W.
Institution
(Morris, Fernando, Garner, Johnson, Gardner, Marchant, Johnson, Harris,
Russell, Templeton) Department of Anesthesiology, Wake Forest School of
Medicine, Winston-Salem, NC, United States
(Wudel) Department of Cardiothoracic Surgery, Wake Forest School of
Medicine, Winston-Salem, NC, United States
(Russell) Division of Public Health Sciences\Department of Biostatistics
and Data Science
Publisher
W.B. Saunders
Abstract
Objective: To assess if there is a difference in the repositioning rate of
the EZ-Blocker versus a left-sided double-lumen endobronchial tube (DLT)
in patients undergoing thoracic surgery and one-lung ventilation.
 Design(s): Prospective, randomized. Setting(s): Single center,
university hospital. Participant(s): One hundred sixty-three thoracic
surgery patients. Intervention(s): Patients were randomized to either
EZ-Blocker or a DLT. Measurements and Main Results: The primary
outcome was positional stability of either the EZ-Blocker or a left-sided
double-lumen endobronchial tube, defined as the number of repositionings
per hour of surgery and one-lung ventilation. Secondary outcomes included
an ordinal isolation score from 1 to 3, in which 1 was poor, up to 3,
which represented excellent isolation, and a visual analog postoperative
sore throat score (0-100) on postoperative days (POD) one and two. Rate of
repositionings per hour during one-lung ventilation and surgical
manipulation in left-sided cases was similar between the two devices: 0.08
+/- 0.15 v 0.11 +/- 0.3 (p = 0.72). In right-sided cases, the rate of
repositioning was higher in the EZ-Blocker group compared with DLT: 0.38
+/- 0.65 v 0.09 +/- 0.21 (p = 0.03). Overall, mean isolation scores for
the EZ-Blocker versus the DLT were 2.76 v 2.92 (p = 0.04) in left-sided
cases and 2.70 v 2.83 (p = 0.22) in right-sided cases. Median sore throat
scores for left sided cases were 0 v 5 (p = 0.13) POD one and 0 v 5 (p =
0.006) POD two for the EZ-Blocker and left-sided DLT, respectively.
 Conclusion(s): For right-sided procedures, the positional stability
of the EZ-Blocker is inferior to a DLT. In left-sided cases, the rate of
repositioning for the EZ-Blocker and DLT are not statistically
different. Copyright © 2020 Elsevier Inc.

<73>
Accession Number
2013514250
Title
Imaging in cardiac amyloidosis.
Source
Revista Argentina de Cardiologia. 89 (3) (pp 244-252), 2021. Date of
Publication: 2021.
Author
De Arenaza D.P.; Baratta S.; Campisi R.; Cerda M.; Aguirre A.; Villanueva
E.; Fernandez A.; Belziti C.
Institution
(De Arenaza) Hospital Italiano de Buenos Aires, Servicio de Cardiologia,
Argentina
Publisher
Sociedad Argentina de Cardiologia
Abstract
Cardiac amyloidosis is a systemic disorder caused by the extracellular
deposition of fibrils of insoluble proteins that misfold and deposit in
the myocardium. Patients with amyloidosis and cardiac involvement have
higher mortality rate than those without cardiac involvement. The two most
prevalent types are amyloidosis with cardiac involvement are light-chain
amyloidosis (AL) due to immunoglobulin light chain deposition and
transthyretin amyloidosis (ATTR) due to deposition of mutated or senile
forms of the transthyretin (TTR) protein. The aim of this paper is to
review the different modalities of cardiac imaging tests
(echocardiography, cardiac magnetic resonance imaging, nuclear medicine
images and computed tomography scan) that can determine the severity of
cardiac involvement in patients with amyloidosis, the type of amyloidosis
and its prognosis. Finally, a diagnostic algorithm is pro-posed to
determine cardiac involvement in amyloidosis, tailored to the diagnostic
tools locally available with a practical and clinical
approach. Copyright © 2021, Sociedad Argentina de Cardiologia.
All rights reserved.

<74>
Accession Number
2012051429
Title
Native and Prosthetic Valve Staphylococcus capitis Endocarditis: A Review
of the Literature.
Source
Cardiology Research. 12 (3) (pp 140-145), 2021. Date of Publication: June
2021.
Author
Thakker R.A.; Chatila K.; Reynoso D.; Karnath B.
Institution
(Thakker, Karnath) Department of Internal Medicine, University of Texas
Medical Branch, Galveston, TX, United States
(Chatila) Division of Cardiology, University of Texas Medical Branch,
Galveston, TX, United States
(Reynoso) Division of Infectious Disease, University of Texas Medical
Branch, Galveston, TX, United States
Publisher
Elmer Press
Abstract
Infective endocarditis (IE) is a rare but serious disease.
Coagulase-negative staphylococci (CoNS) are among the least prevalent
causes of IE. Staphylococcus capitis, a species of CoNS, although
described in the literature before has only been seen in a few cases. Even
with such few cases, complications and mortality have still been
demonstrated. In our review, we look at the epidemiology, diagnosis,
management, and literature prevalence of CoNS in native and prosthetic
valve IE. Copyright © 2021. The authors.

<75>
Accession Number
2007324281
Title
Influence of internal thoracic artery harvesting on sternal osteoblastic
activity and perfusion.
Source
Diagnostics. 10 (11) (no pagination), 2020. Article Number: 921. Date of
Publication: November 2020.
Author
Mamchur S.; Vecherskii Y.; Chichkova T.
Institution
(Mamchur, Chichkova) Department of Cardiovascular Surgery, Research
Institute for Complex Issues of Cardiovascular Diseases, Kemerovo 650002,
Russian Federation
(Vecherskii) Department of Cardiovascular Surgery, Research Institute of
Cardiology, Tomsk 634012, Russian Federation
Publisher
MDPI
Abstract
The purpose of this study was to assess the sternal osteoblastic activity
and perfusion in the early period after a coronary artery bypass graft
(CABG) using single-photon emission computed tomography (SPECT) and
three-phasic dynamic scintigraphy (3PDS) with 99mTc methylene
diphosphonate (MDP). Method(s): The study group consisted of 57 male
patients that were 57.3 +/- 6.6 years of age. Thirty-six of them were
randomized into two groups: in group I (n = 18), the internal thoracic
artery (ITA) was skeletonized, and in group II (n = 18), the ITA was
pedicled. All the patients in groups I and II underwent an off-pump CABG
using 1.7 +/- 0.3 grafts, including one anastomosis of the ITA to the left
anterior descending coronary artery. The control group III (n = 21)
consisted of patients that underwent mitral valve repair surgery, in whom
the sternotomy without the ITA harvesting was performed. The 3PDS and
SPECT of the thorax with 99mTc MDP were performed 2 weeks after surgery.
 Result(s): The sternal phosphates uptake in group I was approximately
twice as high as in group II and approximately 1.5 times higher than in
group III (p < 0.05). The MDP uptake asymmetry after the ITA
skeletonization was the same as in the group with both intact ITAs. In
contrast, after the pedicled ITA harvesting, the osteoblastic activity of
the ipsilateral side of the sternum was lower than in the contralateral
one. There was no statistically significant difference in scintillation
count in the xiphoid process between groups I and II (p > 0.05); however,
we observed a significant difference in the manubrium and body (p < 0.05).
 Conclusion(s): The main factor that improved the sternal perfusion
after a CABG was the preservation of branches supplying the sternum using
the skeletonization technique of ITA harvesting. Copyright © 2020
by the authors. Licensee MDPI, Basel, Switzerland.

<76>
Accession Number
2014156935
Title
Sex-Specific Outcomes of Transcatheter Mitral-Valve Repair and Medical
Therapy for Mitral Regurgitation in Heart Failure.
Source
JACC: Heart Failure. 9 (9) (pp 674-683), 2021. Date of Publication:
September 2021.
Author
Kosmidou I.; Lindenfeld J.; Abraham W.T.; Rinaldi M.J.; Kapadia S.R.;
Rajagopal V.; Sarembock I.J.; Brieke A.; Gaba P.; Rogers J.H.; Shahim B.;
Redfors B.; Zhang Z.; Mack M.J.; Stone G.W.
Institution
(Kosmidou, Gaba, Redfors) NewYork-Presbyterian Hospital/Columbia
University Irving Medical Center, New York, NY, United States
(Kosmidou, Shahim, Redfors, Zhang, Stone) Clinical Trials Center,
Cardiovascular Research Foundation, New York, NY, United States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University,
Columbus, OH, United States
(Rinaldi) Sanger Heart & Vascular Institute/Atrium Health, Charlotte, NC,
United States
(Kapadia) Cleveland Clinic, Cleveland, OH, United States
(Rajagopal) Piedmont Hospital, Atlanta, GA, United States
(Sarembock) The Christ Hospital and Lindner Clinical Research Center,
Cincinnati, OH, United States
(Brieke) University Of Colorado Hospital, Aurora, CO, United States
(Rogers) UC Davis Medical Center, Davis, CA, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Mack) Baylor Scott & White Health, Plano, TX, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Objectives: This study sought to assess the sex-specific outcomes in
patients with heart failure (HF) with 3+ and 4+ secondary mitral
regurgitation (SMR) treated with transcatheter mitral valve repair (TMVr)
plus guideline-directed medical therapy (GDMT) versus GDMT alone in the
COAPT trial. Background(s): The impact of sex in patients with HF and
severe SMR treated with TMVr with the MitraClip compared with GDMT alone
is unknown. Method(s): Patients were randomized 1:1 to TMVr versus
GDMT alone. Two-year outcomes were examined according to sex.
 Result(s): Among 614 patients, 221 (36.0%) were women. Women were
younger than men and had fewer comorbidities, but reduced quality of life
and functional capacity at baseline. In a joint frailty model accounting
for the competing risk of death, the 2-year cumulative incidence of the
primary endpoint of all HF hospitalizations (HFH) was higher in men
compared with women treated with GDMT alone. However, the relative
reduction in HFHs with TMVr was greater in men (HR: 0.43; 95% CI:
0.34-0.54) than women (HR: 0.78; 95% CI: 0.57-1.05)
(P<inf>interaction</inf> = 0.002). A significant interaction between TMVr
versus GDMT alone treatment and time was present for all HFHs in women
(HR: 0.57; 95% CI: 0.39-0.84, and HR: 1.39; 95% CI: 0.83-2.33 between 0-1
year and 1-2 years after randomization, respectively,
P<inf>interaction</inf> = 0.007) but not in men (HR: 0.48; 95% CI:
0.36-0.64, and HR: 0.33; 95% CI: 0.21-0.51; P<inf>interaction</inf> =
0.16). Female sex was independently associated with a lower adjusted risk
of death at 2 years (HR: 0.64; 95% CI: 0.46-0.90; P = 0.011). TMVr
consistently reduced 2-year mortality compared with GDMT alone,
irrespective of sex (P<inf>interaction</inf> = 0.99). Conclusion(s):
In the COAPT trial, TMVr with the MitraClip resulted in improved clinical
outcomes compared with GDMT alone, irrespective of sex. However, the
impact of TMVr in reducing HFH was less pronounced in women compared with
men beyond the first year after treatment. (Cardiovascular Outcomes
Assessment of the MitraClip Percutaneous Therapy for Heart Failure
Patients With Functional Mitral Regurgitation [The COAPT Tria] [COAPT];
NCT01626079) Copyright © 2021 American College of Cardiology
Foundation

<77>
Accession Number
2014071056
Title
New internet-based warfarin anticoagulation management approach after
mechanical heart valve replacement: Prospective, multicenter, randomized
controlled trial.
Source
Journal of Medical Internet Research. 23 (8) (no pagination), 2021.
Article Number: e29529. Date of Publication: August 2021.
Author
Zhu Z.; Li C.; Shen J.; Wu K.; Liu K.; Zhang F.; Zhang Z.; Li Y.; Han J.;
Qin Y.; Yang Y.; Fan G.; Ding Z.; Xu D.; Chen Y.; Zheng Y.; Zheng Z.; Meng
X.; Zhang H.
Institution
(Zhu, Shen, Wu, Li, Liu, Zhang, Zhang, Li, Han, Qin, Meng, Zhang)
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
(Zhu) Ludwig Maximilian University of Munich, Munich, Germany
(Li) Renal Division, Department of Medicine IV, Ludwig Maximilian
University of Munich, Munich, Germany
(Zhang) Department of Cardiovascular Surgery, Beijing Luhe Hospital,
Capital Medical University, Beijing, China
(Yang, Xu) Department of Cardiovascular Surgery, Beijing Xuanwu Hospital,
Beijing, China
(Fan, Chen) Department of Cardiovascular Surgery, Peking University
People's Hospital, Beijing, China
(Zhang) Department of Cardiovascular Surgery, PLA General Hospital,
Beijing, China
(Ding, Zheng) Department of Pharmacy, Fuwai Hospital, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing, China
(Zheng) Department of Cardiovascular Surgery, Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences,
Peking Union Medical College, Beijing, China
Publisher
JMIR Publications Inc.
Abstract
Background: Mechanical heart valve replacement (MHVR) is an effective
method for the treatment of severe heart valve disease; however, it
subjects patient to lifelong warfarin therapy after MHVR with the
attendant risk of bleeding and thrombosis. Whether internet-based warfarin
management reduces complications and improves patient quality of life
remains unknown. Objective(s): This study aimed to compare the
effects of internet-based warfarin management and the conventional
approach in patients who received MHVR in order to provide evidence
regarding alternative strategies for long-term anticoagulation.
 Method(s): This was a prospective, multicenter, randomized,
open-label, controlled clinical trial with a 1-year follow-up. Patients
who needed long-term warfarin anticoagulation after MHVR were enrolled and
then randomly divided into conventional and internet-based management
groups. The percentage of time in the therapeutic range (TTR) was used as
the primary outcome, while bleeding, thrombosis, and other events were the
secondary outcomes. Result(s): A total of 721 patients were enrolled.
The baseline characteristics did not reach statistical differences between
the 2 groups, suggesting the random assignment was successful. As a
result, the internet-based group showed a significantly higher TTR (mean
0.53, SD 0.24 vs mean 0.46, SD 0.21; P<.001) and fraction of time in the
therapeutic range (mean 0.48, SD 0.22 vs mean 0.42, SD 0.19; P<.001) than
did those in the conventional group. Furthermore, as expected, the
anticoagulation complications, including the bleeding and embolic events
had a lower frequency in the internet-based group than in the conventional
group (6.94% vs 12.74%; P=.01). Logistic regression showed that
internet-based management increased the TTR by 7% (odds ratio [OR] 1.07,
95% CI 1.05-1.09; P<.001) and reduced the bleeding and embolic risk by 6%
(OR 0.94, 95% CI 0.92-0.96; P=.01). Moreover, low TTR was found to be a
risk factor for bleeding and embolic events (OR 0.87, 95% CI 0.83-0.91;
P=.005). Conclusion(s): The internet-based warfarin management is
superior to the conventional method, as it can reduce the anticoagulation
complications in patients who receive long-term warfarin anticoagulation
after MHVR. Copyright ©Zhihui Zhu, Chenyu Li, Jinglun Shen,
Kaisheng Wu, Yuehuan Li, Kun Liu, Fan Zhang, Zhenhua Zhang, Yan Li, Jie
Han, Ying Qin, Yu Yang, Guangpu Fan, Huajun Zhang, Zheng Ding, Dong Xu, Yu
Chen, Yingli Zheng, Zhe Zheng, Xu Meng, Haibo Zhang.

<78>
Accession Number
635896436
Title
Effect of remimazolam induction on hemodynamics in patients undergoing
valve replacement surgery: A randomized, double-blind, controlled trial.
Source
Pharmacology research & perspectives. 9 (5) (pp e00851), 2021. Date of
Publication: 01 Oct 2021.
Author
Liu T.; Lai T.; Chen J.; Lu Y.; He F.; Chen Y.; Xie Y.
Institution
(Liu, Chen, Xie) Department of Anesthesiology, First Affiliated Hospital
of Guangxi Medical University, Nanning, China
(Lai, Lu, He, Chen) Department of Anesthesiology, Cardiovascular
Institute, First Affiliated Hospital of Guangxi Medical University,
Nanning, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The stability of hemodynamics during anesthesia induction in
patients undergoing valve replacement surgery is particularly important.
Remimazolam is a new type of benzodiazepine drug, with supposed advantages
of rapid induction, rapid recovery, stable hemodynamics, and mild
respiratory inhibition. AIM: To evaluate the effect of remimazolam
anesthesia induction on hemodynamics in patients undergoing valve
replacement surgery. METHOD(S): This randomized, double-blind,
controlled trial enrolled consecutive patients undergoing mitral valve
replacement (MVR)/aortic valve replacement (AVR)/double-valve replacement
(DVR) surgery on cardiopulmonary bypass (CPB). The study was conducted
according to the Consolidated Standards of Reporting Trials statement.
Participants were randomly assigned to receive either remimazolam or
propofol induction of 30 patients each. All patients, data collectors, and
data analyzers were blinded to the group allocation. The primary outcomes
were the fluctuations in hemodynamic parameters (the difference of maximum
or minimum heart rate to baseline, HR, the difference of maximum or
minimum mean arterial pressure to baseline, MAP), the occurrence of
cardiovascular events (hypotension, severe bradycardia), and the
cumulative norepinephrine doses used per patient, averaged per group
during induction. The secondary outcomes were hemodynamic parameters
(heart rate, HR, mean arterial pressure, MAP, bispectral index, BIS,
plasma lactic acid, Lac, and blood glucose, Glu values). RESULT(S): A
total of 60 patients with heart valve replacement were included in the
final analysis, with 30 patients in each group. The MAP was significantly
lower in the remimazolam group than in the propofol group during induction
(p < .05). The incidences of hypotension and the cumulative norepinephrine
doses used per patient, averaged per group during induction were
significantly lower in the remimazolam group than in the propofol group (p
< .05). CONCLUSION(S): Remimazolam may be safe and effective for
induction and may as an alternative to propofol during anesthesia
induction in patients undergoing valve replacement surgery. Copyright
© 2021 The Authors. Pharmacology Research & Perspectives published by
British Pharmacological Society and American Society for Pharmacology and
Experimental Therapeutics and John Wiley & Sons Ltd.

<79>
Accession Number
2013551352
Title
Left ventricular apex: A "minimally invasive motorway" for safe
cardiovascular procedures.
Source
Journal of Clinical Medicine. 10 (17) (no pagination), 2021. Article
Number: 3857. Date of Publication: 01 Sep 2021.
Author
Agostinelli A.; Gallingani A.; Maestri F.; Grossi S.; Gripshi F.; Donno
L.D.; Nicolini F.
Institution
(Agostinelli, Gallingani, Maestri, Gripshi, Donno, Nicolini) Cardiac
Surgery Division, Parma University Hospital, Via Gramsci 14, Parma 43126,
Italy
(Grossi) Cardiac Surgery Intensive Care Unit, Parma University Hospital,
Via Gramsci 14, Parma 43126, Italy
Publisher
MDPI
Abstract
Since the advent of TAVR (transcatheter aortic valve replacement), the
transapical surgical approach has been affirmed as a safe and effective
alternative access for patients with unsuitable peripheral arteries. With
the improvement of devices for transfemoral approach and the development
of other alternative accesses, the number of transapical procedures has
decreased significantly worldwide. The left ventricular apex, however, has
proved to be a safe and valid alternative access for various other
structural heart procedures such as mitral valve repair, mitral
valve-in-valve or valve-in-ring replacement, transcatheter mitral valve
replacement (TMVR), transcatheter mitral paravalvular leak repair, and
thoracic aorta endovascular repair (TEVAR). We review the literature and
our experience of various hybrid transcatheter structural heart procedures
using the transapical surgical approach and discuss pros and
cons. Copyright © 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<80>
Accession Number
2013462912
Title
Pseudomeningocele-a rare complication following thoracic spinal
decompression surgery: clinical features, treatment guidelines, technical
notes, and evaluation of results.
Source
International Orthopaedics. (no pagination), 2021. Date of Publication:
2021.
Author
Wang L.; Yang X.; Wang H.; Chen Z.; Sun C.; Li W.
Institution
(Wang, Yang, Wang, Chen, Sun, Li) Department of Orthopaedics, Peking
University Third Hospital, Haidian District, 49 North Garden Road, Beijing
100191, China
(Wang, Yang, Wang, Chen, Sun, Li) Engineering Research Center of Bone and
Joint Precision Medicine, Beijing, China
(Wang, Yang, Wang, Chen, Sun, Li) Beijing Key Laboratory of Spinal Disease
Research, Beijing, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Pseudomeningocele (PMC) is a rare complication following thoracic
spinal decompression surgery. The aim of this study is to assess the
clinical features and treatment of PMC and provide the technical notes
with revision surgery. Method(s): Between January 2010 and December
2019, patients who developed PMC after posterior thoracic surgery were
enrolled. An additional 25 patients who suffered cerebrospinal fluid
leakage (CSFL) but did not develop PMC in the same period were randomly
selected. General data, intra-operative factors, CSFL position, cost,
modified Japanese Orthopaedic Association (mJOA) scores, patient
satisfaction, and clinical features were recorded and compared between the
two groups. Result(s): Eighteen patients were diagnosed with PMC
after thoracic spinal surgery. The average length, width, and depth were
16.25 +/- 5.73 cm, 6.96 +/- 3.61 cm and 4.39 +/- 2.2 cm, respectively. The
most common symptom was neurological deficits following incision problems
and headache. Compared with the control group, the PMC group showed a
longer duration of initial surgery, greater estimated blood loss, an
increased rate of CSFL on the ventral side, reduced mJOA scores, and lower
patient satisfaction at the final follow-up. Conclusion(s): PMC is a
rare complication of thoracic surgery with an incidence of 1.12%. PMC
typically occurs at the upper and lower thoracic spine, resulting in
increased health care costs, poorer neurological recovery, and a lower
rate of patient satisfaction. The management of PMC should be
individualized depending on diagnosis time and symptoms. Copyright
© 2021, SICOT aisbl.

<81>
Accession Number
2013337975
Title
Patients with Atrial Fibrillation Undergoing Cardiac Surgery: No Left
Atrial Appendage Shall Remain Untouched.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 16 (4) (pp 301-302), 2021. Date of Publication: July 2021.
Author
Whitlock R.P.; Belley-Cote E.P.
Institution
(Whitlock, Belley-Cote) McMaster University, Hamilton, Canada
(Whitlock, Belley-Cote) Hamilton Health Sciences, Hamilton, Canada
(Whitlock, Belley-Cote) Population Health Research Institute, Hamilton,
Canada
Publisher
SAGE Publications Ltd
Abstract
The Left Atrial Appendage Occlusion Study III randomized 4,811 patients
with atrial fibrillation and a CHA<inf>2</inf>DS<inf>2</inf>VASc score >=2
undergoing cardiac surgery to surgical left atrial appendage occlusion or
no occlusion. At a mean follow-up of 3.8 years, stroke or systemic
embolism was reduced by 33% in the occlusion group with no evidence of
early or late adverse effects. This review discusses the implication of
these findings. Copyright © The Author(s) 2021.

<82>
Accession Number
2013331794
Title
Atrial fibrillation ablation in heart failure patients.
Source
Journal of Clinical Medicine. 10 (16) (no pagination), 2021. Article
Number: 3512. Date of Publication: 02 Aug 2021.
Author
Derndorfer M.; Chen S.; Purerfellner H.
Institution
(Derndorfer, Purerfellner) Ordensklinikum Linz Elisabethinen, Interne
II/Kardiologie und Interne Intensivmedizin, Fadingerstrase 1, Linz 4020,
Austria
(Chen) Cardioangiologisches Centrum Bethanien (CCB), Kardiologie,
Medizinische Klinik III, Agaplesion Markus Krankenhaus, Akademisches
Lehrkrankenhaus der Goethe-Universitat Frankfurt am Main, Frankfurt am
Main 60431, Germany
Publisher
MDPI
Abstract
Atrial Fibrillation (AF) and Heart Failure (HF) are closely linked to each
other, as each can be either the cause of or the result of the other.
Successfully treating one of the two entities means laying the basis for
treating the other one as well. Management of patients with AF and HF can
be challenging and should primarily adhere to available guidelines.
Concerning AF, medication is limited and causes many side effects, leading
to low medical adherence. Several smaller studies, summarized in a big
meta-analysis, provide evidence that ablation of AF in HF patients is
crucial for improving quality of life, reducing HF hospitalizations, and
reducing death, provided the LVEF is at least 25% or higher. In advanced
HF, alternative treatment options (including assist devices, heart
transplant) might still be the better option. Early rhythm control should
be taken into consideration, as there is evidence that it is associated
with better cardiovascular outcome. Copyright © 2021 by the
authors. Licensee MDPI, Basel, Switzerland.

<83>
Accession Number
2013091735
Title
Neurally-adjusted ventilatory assist (NAVA) versus pneumatically
synchronized ventilation modes in children admitted to PICU.
Source
Journal of Clinical Medicine. 10 (15) (no pagination), 2021. Article
Number: 3393. Date of Publication: 01 Aug 2021.
Author
Sugunan P.; Hosheh O.; Garcia Cusco M.; Mildner R.
Institution
(Sugunan, Hosheh, Mildner) Paediatric Intensive Care Unit, Birmingham
Children's Hospital, Birmingham B4 6NH, United Kingdom
(Garcia Cusco) Paediatric Intensive Care Unit, Royal Bristol Children's
Hospital, Bristol BS 2 8BJ, United Kingdom
Publisher
MDPI
Abstract
Traditionally, invasively ventilated children in the paediatric intensive
care unit (PICU) are weaned using pneumatically-triggered ventilation
modes with a fixed level of assist. The best weaning mode is currently not
known. Neurally adjusted ventilatory assist (NAVA), a newer weaning mode,
uses the electrical activity of the diaphragm (Edi) to synchronise
ventilator support proportionally to the patient's respiratory drive. We
aimed to perform a systematic literature review to assess the effect of
NAVA on clinical outcomes in invasively ventilated children with
nonneonatal lung disease. Three studies (n = 285) were included for
analysis. One randomised controlled trial (RCT) of all comers showed a
significant reduction in PICU length of stay and sedative use. A cohort
study of acute respiratory distress syndrome (ARDS) patients (n = 30)
showed a significantly shorter duration of ventilation and improved
sedation with the use of NAVA. A cohort study of children recovering from
cardiac surgery (n = 75) showed significantly higher extubation success,
shorter duration of ventilation and PICU length of stay, and a reduction
in sedative use. Our systematic review presents weak evidence that NAVA
may shorten the duration of ventilation and PICU length of stay, and
reduce the requirement of sedatives. However, further RCTs are required to
more fully assess the effect of NAVA on clinical outcomes and treatment
costs in ventilated children. Copyright © 2021 by the authors.
Licensee MDPI, Basel, Switzerland.

<84>
Accession Number
2013091729
Title
Should we monitor glucose and biomarkers in diabetics over heart surgery?.
Source
Journal of Clinical Medicine. 10 (15) (no pagination), 2021. Article
Number: 3399. Date of Publication: 01 Aug 2021.
Author
Golukhova E.Z.; Lifanova L.S.; Pugovkina Y.V.; Grigoryan M.V.; Bulaeva
N.I.
Institution
(Golukhova, Lifanova, Pugovkina, Grigoryan, Bulaeva) Cardiology
Department, Bakulev National Medical Research Center of Cardiovascular
Surgery, Roublyevskoe Shosse 135, Moscow 121552, Russian Federation
Publisher
MDPI
Abstract
Hyperglycemia is associated with adverse outcomes after coronary artery
bypass grafting (CABG). While there is a consensus that blood glucose
control may benefit patients undergoing CABG, the role of biomarkers,
optimal method, and duration of such monitoring are still unclear. The aim
of this study is to define the efficacy of a continuous glucose monitoring
system (CGMS) and link it to pro-inflammatory biomarkers while on insulin
pump therapy in diabetic patients undergoing CABG. We prospectively
assessed CGMS for 72 h in 105 patients including 52 diabetics undergoing
isolated CABG. In diabetics, CGMS was connected to an insulin pump for
precise glucose control. On top of conventional biomarkers (HbA1C, lipid
profile), high sensitive C-reactive protein (hs-CRP), Regulated upon
Activation Normal T cell Expressed and presumably Secreted (RANTES), and
leptin levels were collected before surgery, 1 h, 12 h, 7 days, and at 1
year after CABG. Overall, CGMS revealed high glucose independently from
underlying diabetes during first 48 h following CABG but was higher (p <
0.05) in diabetics. The insulin pump improved glycemic control over early
follow-up (72 h) post-CABG. There were no hypoglycemic episodes in
patients on insulin pump therapy and those receiving bolus insulin
therapy. We revealed a lower rate of postpericardiotomy syndrome (PCTS) in
patients on insulin pump therapy compared to patients prescribed bolus
insulin therapy in the early postoperative period (p = 0.03). Hs-CRP and
RANTES levels were lower in patients with T2DM on insulin pump therapy
compared to patients prescribed bolus insulin therapy in the early
postoperative period (p < 0.05). It is most likely due to the fact that
insulin pump therapy decreases systemic inflammatory response. Further
controlled trials should assess whether CGMS improves outcomes after
cardiac surgery. Copyright © 2021 by the authors. Licensee MDPI,
Basel, Switzerland.

<85>
Accession Number
2011023358
Title
Minimally Invasive Versus Sternotomy for Mitral Surgery in the Elderly: A
Systematic Review and Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 16 (4) (pp 310-316), 2021. Date of Publication: July 2021.
Author
Hage A.; Hage F.; Al-Amodi H.; Gupta S.; Papatheodorou S.I.; Hawkins R.;
Ailawadi G.; Mittleman M.A.; Chu M.W.A.
Institution
(Hage, Hage, Al-Amodi, Chu) Western University, London, ON, Canada
(Hage, Hage, Gupta, Papatheodorou, Mittleman) Department of Epidemiology,
Harvard T.H. Chan School of Public Health, Boston, MA, United States
(Hawkins, Ailawadi) University of Virginia, Charlottesville, VA, United
States
Publisher
SAGE Publications Ltd
Abstract
Objective: The safety of minimally invasive mitral valve surgery (MIMVS)
in elderly patients is still debated. Our objective was to perform a
systematic review and meta-analysis of studies comparing MIMVS with
conventional sternotomy (CS) in elderly patients (>=65 years old).
 Method(s): We searched PubMed, EMBASE, Web of Science,
clinicaltrials.gov, and Cochrane Central Register of Controlled Trials for
trials and observational studies comparing MIMVS with CS in patients >=65
years old presenting for mitral valve surgery. We performed a
random-effects meta-analysis of all outcomes. Result(s): The MIMVS
group had lower odds of acute renal failure (odds ratio [OR] 0.27; 95% CI
0.10 to 0.78), prolonged intubation (>48 h; OR 0.47; 95% CI 0.31 to 0.70),
less blood product transfusion (weighted mean difference [WMD] -0.82
units; 95% CI -1.29 to -0.34 units), shorter ICU length of stay (LOS; WMD
-2.57 days; 95% CI -3.24 to -1.90 days) and hospital LOS (WMD -4.06 days;
95% CI -5.19 to -2.94 days). There were no significant differences in the
odds of mortality, stroke, respiratory infection, reoperation for
bleeding, and postoperative atrial fibrillation. MIMVS was associated with
longer cross-clamp (WMD 11.8 min; 95% CI 3.5 to 20.1 min) and
cardiopulmonary bypass times (WMD 23.0 min; 95% CI 10.4 to 35.6 min).
 Conclusion(s): MIMVS in elderly patients is associated with lower
postoperative complications, blood transfusion, shorter ICU, and hospital
LOS, and longer cross-clamp and bypass times. Copyright © The
Author(s) 2021.

<86>
Accession Number
2007872671
Title
Effect of deep versus moderate neuromuscular blockade on quantitatively
assessed postoperative atelectasis using computed tomography in thoracic
surgery; a randomized double-blind controlled trial.
Source
Journal of Clinical Medicine. 10 (15) (no pagination), 2021. Article
Number: 3228. Date of Publication: 01 Aug 2021.
Author
Lee B.-J.; Lee H.N.; Chung J.-Y.; Kim D.; Kim J.I.; Seo H.
Institution
(Lee, Chung, Seo) Department of Anesthesiology and Pain Medicine, Kyung
Hee University Hospital at Gangdong, College of Medicine, Kyung Hee
University, Seoul 05278, South Korea
(Lee, Kim) Department of Radiology, Kyung Hee University Hospital at
Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, South
Korea
(Kim) Department of Thoracic Surgery, Kyung Hee University Hospital at
Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, South
Korea
Publisher
MDPI
Abstract
Background: postoperative atelectasis is a significant clinical problem
during thoracic surgery with one-lung ventilation. Intraoperative deep
neuromuscular blockade can improve surgical conditions, but an increased
risk of residual paralysis may aggravate postoperative atelectasis. Every
patient was verified to have full reversal before extubation. We compared
the effect of deep versus moderate neuromuscular blockade on postoperative
atelectasis quantitatively using chest computed tomography.
 Method(s): patients undergoing thoracic surgery were randomly
allocated to two groups: moderate neuromuscular blockade during surgery
(group M) and deep neuromuscular blockade during surgery (group D). The
primary outcome was the proportion and the volume of postoperative
atelectasis measured by chest computed tomography on postoperative day 2.
The mean values of the repeatedly measured intraoperative dynamic lung
compliance during surgery were also compared. Result(s): the
proportion of postoperative atelectasis did not differ between the groups
(1.32 [0.47-3.20]% in group M and 1.41 [0.24-3.07]% in group D, p =
0.690). The actual atelectasis volume was 38.2 (12.8-61.4) mL in group M
and 31.9 (7.84-75.0) mL in group D (p = 0.954). Some factors described in
the lung protective ventilation were not taken into account and might
explain the atelectasis in both groups. The mean lung compliance during
one-lung ventilation was higher in group D (26.6% in group D vs. 24.1% in
group M, p = 0.026). Conclusion(s): intraoperative deep neuromuscular
blockade did not affect postoperative atelectasis when compared with
moderate neuromuscular blockade if full reversal was
verified. Copyright © 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<87>
Accession Number
2007618184
Title
Role of concomitant coronary artery bypass grafting in valve surgery for
infective endocarditis.
Source
Journal of Clinical Medicine. 10 (13) (no pagination), 2021. Article
Number: 2867. Date of Publication: 01 Jul 2021.
Author
Diab M.; Lehmann T.; Weber C.; Petrov G.; Luehr M.; Akhyari P.; Tugtekin
S.-M.; Schulze P.C.; Franz M.; Misfeld M.; Borger M.A.; Matschke K.;
Wahlers T.; Lichtenberg A.; Hagl C.; Doenst T.
Institution
(Diab, Doenst) Department of Cardiothoracic Surgery, Jena University
Hospital-Friedrich Schiller University of Jena, Jena 07747, Germany
(Lehmann) Center of Clinical Studies, Jena University Hospital-Friedrich
Schiller University of Jena, Jena 07747, Germany
(Weber, Luehr, Wahlers) Department of Cardiothoracic Surgery, Heart Center
of the University of Cologne, Colonge 50937, Germany
(Petrov, Akhyari, Lichtenberg) Department of Cardiothoracic Surgery,
Heinrich-Heine-University Duesseldorf, Duesseldof 40225, Germany
(Tugtekin, Matschke) Department of Cardiac Surgery, Heart Center Dresden,
Dresden 01307, Germany
(Schulze, Franz) Department of Internal Medicine I, Jena University
Hospital-Friedrich Schiller University of Jena, Jena 07747, Germany
(Misfeld) Department of Cardiothoracic Surgery, Royal Prince Alfred
Hospital, Sydney 2050, Australia
(Misfeld, Borger) Department of Cardiac Surgery, Heart Center Leipzig,
Leipzig 04289, Germany
(Hagl) Department of Cardiac Surgery, Ludwig Maximilian University Munich,
Munich 80539, Germany
Publisher
MDPI
Abstract
Background: It is current practice to perform concomitant coronary artery
bypass grafting (CABG) in patients with infective endocarditis (IE) who
have relevant coronary artery disease (CAD). However, CABG may add
complexity to the operation. We aimed to investigate the impact of
concomitant CABG on perioperative outcomes in patients undergoing surgery
for IE. Method(s): We retrospectively used data of surgically treated
IE patients between 1994 and 2018 in six German cardiac surgery centers.
We performed inverse probability weighting (IPW), multivariable
adjust-ment, chi-square analysis, and Kaplan-Meier survival estimates.
 Result(s): CAD was reported in 1242/4917 (25%) patients. Among them,
527 received concomitant CABG. After adjustment for basal characteristics
between CABG and no-CABG patients using IPW, concomitant CABG was
associated with higher postoperative stroke (26% vs. 21%, p = 0.003) and a
trend towards higher postoperative hemodialysis (29% vs. 25%, p = 0.052).
Thirty-day mortality was similar in both groups (24% vs. 23%, p = 0.370).
Multivariate Cox regression analysis after IPW showed that CABG was not
associated with better long-term survival (HR: 1.00, 95% CI: 0.82-1.23, p
= 0.998). Conclusion(s): In endocarditis patients with CAD, adding
CABG to valve surgery may be associated with a higher likelihood of
postoperative stroke without adding long-term survival benefits.
Therefore, in the absence of critical CAD, concomitant CABG may be omitted
without impacting outcome. The results are limited due to a lack of data
on the severity of CAD, and therefore there is a need for a randomized
trial. Copyright © 2021 by the authorsLicensee MDPI, Basel,
Switzerland.

<88>
Accession Number
2007532304
Title
Impact of bundle branch block on permanent pacemaker implantation after
transcatheter aortic valve implantation: A meta-analysis.
Source
Journal of Clinical Medicine. 10 (12) (no pagination), 2021. Article
Number: 2719. Date of Publication: 02 Jun 2021.
Author
Ravaux J.M.; Di Mauro M.; Vernooy K.; Mariani S.; Ronco D.; Simons J.;
Van'T Hof A.W.; Veenstra L.; Kats S.; Maessen J.G.; Lorusso R.
Institution
(Ravaux, Di Mauro, Mariani, Ronco, Simons, Kats, Maessen, Lorusso)
Department of Cardio-Thoracic Surgery, Heart and Vascular Centre,
Maastricht University Medical Centre (MUMC), Maastricht 6202 AZ,
Netherlands
(Vernooy, Van'T Hof, Veenstra) Department of Cardiology, Maastricht
University Medical Centre (MUMC), Maastricht 6202 AZ, Netherlands
(Vernooy, Van'T Hof, Maessen, Lorusso) Cardiovascular Research Institute
Maastricht (CARIM), Maastricht University Medical Center, Maastricht 6202
AZ, Netherlands
(Vernooy) Department of Cardiology, Radboud University Medical Center
(Radboudumc), Nijmegen 6525 GA, Netherlands
(Ronco) Department of Medicine and Surgery, Circolo Hospital, University
of Insubria, Varese 21100 VA, Italy
Publisher
MDPI
Abstract
Data regarding the impact of infra-Hisian conduction disturbances leading
to permanent pacemaker implantation (PPI) after transcatheter aortic valve
implantation (TAVI) remain limited. The aim of this study was to determine
the impact of right and/or left bundle branch block (RBBB/LBBB) on
post-TAVI PPI. We performed a systematic literature review to identify
studies reporting on RBBB and/or LBBB status and post-TAVI PPI. Study
design, patient characteristics, and the presence of branch block were
analyzed. Odds ratios (ORs) with 95% CI were extracted. The final analysis
included 36 studies, reporting about 55,851 patients. Data on LBBB were
extracted from 33 studies. Among 51,026 patients included, 5503 showed
pre-implant LBBB (11.9% (10.4%- 13.8%)). The influence of LBBB on
post-TAVI PPI was not significant OR 1.1474 (0.9025; 1.4588), p = 0.2618.
Data on RBBB were extracted from 28 studies. Among 46,663 patients
included, 31,603 showed pre-implant RBBB (9.2% (7.3%-11.6%)). The
influence of RBBB on post-TAVI PPI was significant OR 4.8581 (4.1571;
5.6775), p < 0.0001. From this meta-analysis, the presence of RBBB
increased the risk for post-TAVI PPI, independent of age or LVEF, while
this finding was not con-firmed for patients experimenting with LBBB. This
result emphasizes the need for pre-operative evaluation strategies in
patient selection for TAVI. Copyright © 2021 by the authors.
Licensee MDPI, Basel, Switzerland.

<89>
Accession Number
2007230937
Title
Cardiac rehabilitation in german speaking countries of
europe-evidence-based guidelines from germany, austria and switzerland
llkardreha-dach-part 1.
Source
Journal of Clinical Medicine. 10 (10) (no pagination), 2021. Article
Number: 2192. Date of Publication: 02 May 2021.
Author
Rauch B.; Salzwedel A.; Bjarnason-Wehrens B.; Albus C.; Meng K.; Schmid
J.-P.; Benzer W.; Hackbusch M.; Jensen K.; Schwaab B.; Altenberger J.;
Benjamin N.; Bestehorn K.; Bongarth C.; Dorr G.; Eichler S.; Einwang
H.-P.; Falk J.; Glatz J.; Gielen S.; Grilli M.; Grunig E.; Guha M.;
Hermann M.; Hoberg E.; Hofer S.; Kaemmerer H.; Ladwig K.-H.; Mayer-Berger
W.; Metzendorf M.-I.; Nebel R.; Neidenbach R.C.; Niebauer J.; Nixdorff U.;
Oberhoffer R.; Reibis R.; Reiss N.; Saure D.; Schlitt A.; Voller H.; von
Kanel R.; Weinbrenner S.; Westphal R.
Institution
(Rauch) Institut fur Herzinfarktforschung Ludwigshafen, Ludwigshafen
D-67063, Germany
(Rauch) Zentrum fur Ambulante Rehabilitation, ZAR Trier GmbH, Trier
D-54292, Germany
(Salzwedel, Eichler, Voller) Department of Rehabilitation Medicine,
Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam
D-14469, Germany
(Bjarnason-Wehrens) Institut fur Kreislaufforschung und Sportmedizin, Abt.
Praventive und rehabilitative Sport-und Leistungsmedizin, Deutsche
Sporthochschule Koln, Koln D-50937, Germany
(Albus) Department of Psychosomatics and Psychotherapy, Faculty of
Medicine, University Hospital, Koln D-50937, Germany
(Meng) Institut fur Klinische Epidemiologie und Biometrie (IKE-B),
Universitat Wurzburg, Wurzburg D-97078, Germany
(Schmid) Klinik Barmelweid AG, Barmelweid CH-5017, Switzerland
(Benzer) Reha-Klinik Montafon, Schruns A-6780, Austria
(Hackbusch, Jensen, Saure) Institute of Medical Biometry and Informatics
(IMBI), University of Heidelberg, Heidelberg D-69120, Germany
(Schwaab) Curschmann Klinik Dr. Guth GmbH & Co KG, Timmendorfer Strand
D-23669, Germany
(Altenberger) Rehabilitationszentrum Grosgmain, Grosgmain A-5084, Austria
(Benjamin, Grunig) Zentrum fur Pulmonale Hypertonie, Thorax-Klinik am
Universitatsklinikum Heidelberg, Heidelberg D-69126, Germany
(Bestehorn) Institut fur Klinische Pharmakologie, Technische Universitat
Dresden, Fiedlerstrase 42, Dresden D-01307, Germany
(Bongarth, Einwang) Klinik Hohenried gGmbH, Rehabilitationszentrum am
Starnberger See, Bernried D-82347, Germany
(Dorr) Alexianer St. Josefs-Krankenhaus Potsdam-Sanssouci, Potsdam
D-14471, Germany
(Falk, Weinbrenner) Deutsche Rentenversicherung Bund (DRV-Bund), Berlin
D-10709, Germany
(Glatz) Reha-Zentrum Seehof der Deutschen Rentenversicherung Bund, Teltow
D-14513, Germany
(Gielen) Klinikum Lippe, Standort Detmold, Detmold D-32756, Germany
(Grilli) Universitatsbibliothek, Universitatsmedizin Mannheim, Mannheim
D-68167, Germany
(Guha) Reha-Zentrum am Sendesaal, Bremen D-28329, Germany
(Hermann) Klinik fur Kardiologie, Universitatsspital Zurich, Ramistrasse
100, Zurich CH-8091, Switzerland
(Hoberg) Wismarstrase 13, Heikendorf D-24226, Germany
(Hofer) Universitatsklinik fur Medizinische Psychologie und
Psychotherapie, Medizinische Universitat Innsbruck, Innsbruck A-6020,
Austria
(Kaemmerer) Klinik fur Angeborene Herzfehler und Kinderkardiologie,
Deutsches Herzzentrum Munchen, Klinik der Technischen Universitat Munchen,
Munchen D-80636, Germany
(Ladwig) Department of Psychosomatic Medicine and Psychotherapy, Klinikum
rechts der Isar, Technische Universitat Munchen (TUM), Langerstrase 3,
Munich D-81675, Germany
(Mayer-Berger) Klinik Roderbirken der Deutschen Rentenversicherung
Rheinland, Leichlingen D-42799, Germany
(Metzendorf) Cochrane Metabolic and Endocrine Disorders Group, Institute
of General Practice (ifam), Medical Faculty of the Heinrich-Heine
University, Werdener Strase. 4, Dusseldorf D-40227, Germany
(Nebel) Hermann-Albrecht-Klinik METTNAU, Medizinische Reha-Einrichtungen
der Stadt Radolfzell, Radolfzell D-73851, Germany
(Neidenbach) Institut fur Sportwissenschaft, Universitat Wien, Auf der
Schmelz 6 (USZ I), Wien AU-1150, Austria
(Niebauer) Universitatsinstitut fur Praventive und Rehabilitative
Sportmedizin, Uniklinikum Salzburg Paracelsus Medizinische
Privatuniversitat, Salzburg A-5020, Austria
(Nixdorff) EPC GmbH, European Prevention Center, Medical Center
Dusseldorf, Dusseldorf D-40235, Germany
(Oberhoffer) Lehrstuhl fur Praventive Padiatrie, Fakultat fur Sport-und
Gesundheitswissenschaften, Technische Universitat Munchen, Munchen
D-80992, Germany
(Reibis) Kardiologische Gemeinschaftspraxis Am Park Sanssouci, Potsdam
D-14471, Germany
(Reiss) Schuchtermann-Schiller'sche Kliniken, Ulmenallee 5-12, Bad
Rothenfelde D-49214, Germany
(Schlitt) Paracelsus Harz-Klinik Bad Suderode GmbH, Quedlinburg D-06485,
Germany
(Voller) Klinik am See, Rudersdorf D-15562, Germany
(von Kanel) Klinik fur Konsiliarpsychiatrie und Psychosomatik,
Universitatsspital Zurich, Zurich CH-8091, Switzerland
(Westphal) Herzzentrum Segeberger Kliniken, Bad Segeberg D-23795, Germany
Publisher
MDPI
Abstract
Background: Although cardiovascular rehabilitation (CR) is well accepted
in general, CR-attendance and delivery still considerably vary between the
European countries. Moreover, clinical and prognostic effects of CR are
not well established for a variety of cardiovascular diseases.
 Method(s): The guidelines address all aspects of CR including
indications, contents and delivery. By processing the guidelines, every
step was externally supervised and moderated by independent members of the
"Association of the Scientific Medical Societies in Germany" (AWMF). Four
meta-analyses were performed to evaluate the prognostic effect of CR after
acute coronary syndrome (ACS), after coronary bypass grafting (CABG), in
patients with severe chronic systolic heart failure (HFrEF), and to define
the effect of psychological interventions during CR. All other indications
for CR-delivery were based on a predefined semi-structured literature
search and recommendations were established by a formal consenting process
including all medical societies involved in guideline generation.
 Result(s): Multidisciplinary CR is associated with a significant
reduction in all-cause mortality in patients after ACS and after CABG,
whereas HFrEF-patients (left ventricular ejection fraction <40%)
especially benefit in terms of exercise capacity and health-related
quality of life. Patients with other cardiovascular diseases also benefit
from CR-participation, but the scientific evidence is less clear. There is
increasing evidence that the beneficial effect of CR strongly depends on
"treatment intensity" including medical supervision, treatment of
cardiovascular risk factors, information and education, and a minimum of
individually adapted exercise volume. Additional psychologic interventions
should be performed on the basis of individual needs. Conclusion(s):
These guidelines reinforce the substantial benefit of CR in specific
clinical indications, but also describe remaining deficits in CR-delivery
in clinical practice as well as in CR-science with respect to methodology
and presentation. Copyright © 2021 by the authors. Licensee MDPI,
Basel, Switzerland.

<90>
Accession Number
2001499914
Title
Comparative effectiveness of the core components of cardiac rehabilitation
on mortality and morbidity: A systematic review and network meta-analysis.
Source
Journal of Clinical Medicine. 7 (12) (no pagination), 2018. Article
Number: 514. Date of Publication: 01 Dec 2018.
Author
Kabboul N.N.; Tomlinson G.; Francis T.A.; Grace S.L.; Chaves G.; Rac V.;
Daou-Kabboul T.; Bielecki J.M.; Alter D.A.; Krahn M.
Institution
(Kabboul, Tomlinson, Francis, Rac, Bielecki, Krahn) Toronto Health
Economics and Technology Assessment (THETA) Collaborative, 200 Elizabeth
Street, Toronto, ON M5G 2C4, Canada
(Kabboul, Francis, Rac, Bielecki, Krahn) Faculty of Pharmacy, University
of Toronto, 144 College St, Toronto, ON M5S 3M2, Canada
(Tomlinson, Alter, Krahn) Department of Medicine, University Health
Network, 27 King's College Circle, Toronto, ON M5S 1A1, Canada
(Tomlinson, Alter, Krahn) Institute of Health Policy, Management and
Evaluation (IHPME), University of Toronto, 4th Floor, 155 College St,
Toronto, ON M5T 3M6, Canada
(Tomlinson, Grace, Alter, Krahn) Faculty of Medicine, University of
Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, ON M5S
1A8, Canada
(Grace, Alter) Toronto Rehabilitation Institute, University Health
Network, University of Toronto, 550 University Ave, Toronto, ON M5G 2A2,
Canada
(Grace) School of Kinesiology and Health Science, York University, 4700
Keele St, Toronto, ON M3J 1P3, Canada
(Chaves) Department of Physical Therapy, Federal University of Minas
Gerais, Av. Pres. Antonio Carlos, 6627-Pampulha, Belo Horizonte, MG
31270-901, Brazil
(Daou-Kabboul) Human Nutrition, Bridgeport University, 126 Park Ave,
Bridgeport, CT 06604, United States
Publisher
MDPI
Abstract
A systematic review and network meta-analysis (NMA) of randomized
controlled trials (RCTs) evaluating the core components of cardiac
rehabilitation (CR), nutritional counseling (NC), risk factor modification
(RFM), psychosocial management (PM), patient education (PE), and exercise
training (ET)) was undertaken. Published RCTs were identified from
database inception dates to April 2017, and risk of bias assessed using
Cochrane's tool. Endpoints included mortality (all-cause and
cardiovascular (CV)) and morbidity (fatal and non-fatal myocardial
infarction (MI), coronary artery bypass surgery (CABG), percutaneous
coronary intervention (PCI), and hospitalization (all-cause and CV)).
Meta-regression models decomposed treatment effects into the main effects
of core components, and two-way or all-way interactions between them.
Ultimately, 148 RCTs (50,965 participants) were included. Main effects
models were best fitting for mortality (e.g., for all-cause, specifically
PM (hazard ratio HR = 0.68, 95% credible interval CrI = 0.54-0.85) and ET
(HR = 0.75, 95% CrI = 0.60-0.92) components effective), MI (e.g., for
all-cause, specifically PM (hazard ratio HR = 0.76, 95% credible interval
CrI = 0.57-0.99), ET (HR = 0.75, 95% CrI = 0.56-0.99) and PE (HR = 0.68,
95% CrI = 0.47-0.99) components effective) and hospitalization (e.g.,
all-cause, PM (HR = 0.76, 95% CrI = 0.58-0.96) effective). For
revascularization (including CABG and PCI individually), the full
interaction model was best-fitting. Given that each component, individual
or in combination, was associated with mortality and/or morbidity,
recommendations for comprehensive CR are warranted. Copyright ©
2018 by the authors. Licensee MDPI, Basel, Switzerland.

<91>
Accession Number
635906502
Title
Posterior pericardiotomy to prevent new-onset atrial fibrillation after
coronary artery bypass grafting: a systematic review and meta-analysis of
10 randomized controlled trials.
Source
Journal of cardiothoracic surgery. 16 (1) (pp 233), 2021. Date of
Publication: 14 Aug 2021.
Author
Xiong T.; Pu L.; Ma Y.-F.; Zhu Y.-L.; Li H.; Cui X.; Li Y.-X.
Institution
(Xiong, Pu, Ma, Zhu, Li, Cui, Li) Department of Cardiac Surgery, Kunming
Yan'an Hospital, Affiliated Hospital of Kunming Medical University,
Kunming, Yunnan 650000, China
(Pu, Li, Cui, Li) Cardiovascular Surgery, Kunming, Yunnan 650000, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Atrial fibrillation (AF) is associated with adverse events
after cardiac surgery. Multiple studies have reported that posterior
pericardiotomy (PP) may be effective for preventing AF after coronary
artery bypass grafting (CABG), but some conflicting results have been
reported and the quality of evidence from previous meta-analyses has been
limited. The present study aimed to systematically evaluate the safety and
efficacy of PP for preventing AF after CABG in adults. METHOD(S): We
conducted a quantitative meta-analysis of randomized controlled trials
(RCTs) published before May 31, 2021. The primary outcome was AF after
CABG under cardiopulmonary bypass. Secondary outcomes included early
pericardial effusion, late pericardial effusion, pericardial tamponade,
pleural effusion, length of hospital stay, length of intensive care unit
(ICU) stay, pulmonary complications, intra-aortic balloon pump use,
revision surgery for bleeding, and mortality. RESULT(S): Ten RCTs
with 1829 patients (910 in the PP group and 919 in the control group) were
included in the current meta-analysis. The incidence of AF was 10.3%
(94/910) in the PP group and 25.7% (236/919) in the control group. A
random-effects model indicated that incidence of AF after CABG
significantly lower in the PP group than in the control group (risk
ratio=0.45, 95% confidence interval 0.29-0.64, P<0.0001). PP also
effectively reduced the post-CABG occurrence of early pericardial effusion
(RR=0.28, 95% CI 0.15-0.50; P<0.05), late pericardial effusion (RR=0.06,
95% CI 0.02-0.16; P<0.05), and pericardial tamponade (RR=0.08, 95% CI
0.02-0.33; P<0.05) as well as the length of ICU stay (weighted mean
difference [WMD]=0.91,95% CI 0.57-1.24; P<0.05), while increasing the
occurrence pleural effusion (RR=1.51, 95% CI 1.19-1.92; P<0.05). No
significant differences length of hospital stay (WMD=-0.45, 95% CI-2.44 to
1.54, P=0.66), pulmonary complications (RR=0.99, 95% CI 0.71-1.39,
P=0.97), revision surgery for bleeding (RR=0.84, 95% CI 0.43-1.63,
P=0.60), use of IABP (RR=1, 95% CI 0.61-1.65, P=1.0), or death (RR=0.45,
95% CI 0.07-3.03, P=0.41) were observed between the PP and control groups.
 CONCLUSION(S): PP may be a safe, effective, and economical method for
preventing AF after CABG in adult patients. Copyright © 2021. The
Author(s).

<92>
Accession Number
2013615672
Title
Perioperative risk factors for new-onset postoperative atrial fibrillation
after coronary artery bypass grafting: a systematic review.
Source
BMC Cardiovascular Disorders. 21 (1) (no pagination), 2021. Article
Number: 418. Date of Publication: December 2021.
Author
Seo E.J.; Hong J.; Lee H.-J.; Son Y.-J.
Institution
(Seo) Ajou University College of Nursing and Research Institute of Nursing
Science, Suwon 16499, South Korea
(Hong) Department of Thoracic and Cardiovascular Surgery, Chung-Ang
University, Seoul 06974, South Korea
(Lee) Department of Nursing, Tongmyoung University, Busan 48520, South
Korea
(Son) Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro
Dongjak-Gu, Seoul 06974, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative atrial fibrillation (POAF) is the most common
cardiac dysrhythmia to occur after coronary artery bypass grafting (CABG).
However, the risk factors for new-onset POAF after CABG during the
perioperative period have yet to be clearly defined. Accordingly, the aim
of our systematic review was to evaluate the perioperative predictors of
new-onset POAF after isolated CABG. Method(s): Our review methods
adhered to the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guideline. We searched seven electronic databases (PubMed,
Embase, CINAHL, PsycArticles, Cochrane, Web of Science, and SCOPUS) to
identify all relevant English articles published up to January 2020.
Identified studies were screened independently by two researchers for
selection, according to predefined criteria. The Newcastle-Ottawa Scale
was used to evaluate the quality of studies retained. Result(s):
After screening, nine studies were retained for analysis, including 4798
patients, of whom 1555 (32.4%) experienced new-onset POAF after CABG. The
incidence rate of new-onset POAF ranged between 17.3% and 47.4%. The
following risk factors were identified: old age (p < 0.001), a high
preoperative serum creatinine level (p = 0.001), a low preoperative
hemoglobin level (p = 0.007), a low left ventricle ejection fraction in
Asian patients (p = 0.001), essential hypertension (p < 0.001), chronic
obstructive pulmonary disease (p = 0.010), renal failure (p = 0.009),
cardiopulmonary bypass use (p = 0.002), perfusion time (p = 0.017),
postoperative use of inotropes (p < 0.001), postoperative renal failure (p
= 0.001), and re-operation (p = 0.005). All studies included in the
analysis were of good quality. Conclusion(s): The risk factors
identified in our review could be used to improve monitoring of at-risk
patients for early detection and treatment of new-onset POAF after CABG,
reducing the risk of other complications and negative clinical
outcomes. Copyright © 2021, The Author(s).

<93>
Accession Number
2014436121
Title
Impact of major infections on 10-year mortality after revascularization in
patients with complex coronary artery disease.
Source
International Journal of Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Ono M.; Kawashima H.; Hara H.; Mancone M.; Mack M.J.; Holmes D.R.; Morice
M.-C.; Kappetein A.P.; Thuijs D.J.F.M.; Noack T.; Mohr F.W.; Davierwala
P.M.; Onuma Y.; Serruys P.W.
Institution
(Ono, Kawashima, Hara) Amsterdam UMC, University of Amsterdam, Heart
Center, Department of Clinical and Experimental Cardiology, Amsterdam
Cardiovascular Sciences, Meibergdreef 9, Amsterdam, Netherlands
(Ono, Kawashima, Hara, Onuma, Serruys) Department of Cardiology, National
University of Ireland, Galway (NUIG), Galway, Ireland
(Mancone) Department of Clinical, Internal, Anesthesiology and
Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
(Mack) Department of Cardiothoracic Surgery, Baylor University Medical
Center, Dallas, TX, United States
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Morice) Departement of Cardiologie, Hopital prive Jacques Cartier,
Generale de Sante Massy, France
(Kappetein, Thuijs) Department of Cardiothoracic Surgery, Erasmus
University Medical Centre, Rotterdam, Netherlands
(Noack, Mohr, Davierwala) University Department of Cardiac Surgery, Heart
Centre Leipzig, Leipzig, Germany
(Serruys) NHLI, Imperial College London, London, United Kingdom
(Onuma, Serruys) CURAM-SFI Centre for Research in Medical Devices, Galway,
Ireland
Publisher
Elsevier Ireland Ltd
Abstract
Background: The significant interaction between major infection and 5-year
mortality after percutaneous coronary intervention (PCI) or coronary
artery bypass graft (CABG) for complex coronary artery disease (CAD) was
observed previously. However, the very long-term outcomes beyond 5 years
remains unclear. Methods and Results: This is a subgroup analysis of
the SYNTAX Extended Survival (SYNTAXES) trial, which is the extended
follow-up of the randomized SYNTAX trial comparing PCI versus CABG in
patients with three-vessel disease (3VD) or left-main CAD (LMCAD). Out of
1517 patients enrolled in the SYNTAX trial with available survival status
from 5 to 10 years, 140 patients had experienced major infections and
survived at 5 years (major infection group). From 5 to 10 years, the
mortality of major infection group was 19.8% whereas the mortality of no
major infection group was 15.1% (p = 0.157). After the adjustment of other
clinical factors, the risk of mortality from 5 to 10 years did not
significantly differ between major infection and no major infection groups
(HR: 1.10; 95% CI: 0.62-1.96; p = 0.740). When stratified by the presence
or absence of periprocedural major infections, defined as a major
infection within 60 days after index procedure, there was also no
significant difference in 10-year mortality between two groups (30.8% vs.
24.5%; p = 0.057). Conclusion(s): Despite the initial association
between major infections and 5 years mortality, postprocedural major
infection was not evident in the 10 years follow-up, suggesting that the
impact of major infection on mortality subsided over time beyond 5 years.
Trial registration: SYNTAXES ClinicalTrials.gov reference: NCT03417050
SYNTAX ClinicalTrials.gov reference: NCT00114972 Copyright © 2021
The Author(s)

<94>
Accession Number
2014435285
Title
Coronary artery bypass with single versus multiple arterial grafts in
women: A meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2021.
Date of Publication: 2021.
Author
Robinson N.B.; Lia H.; Rahouma M.; Audisio K.; Soletti G.; Demetres M.;
Leonard J.R.; Fremes S.E.; Girardi L.N.; Gaudino M.
Institution
(Robinson, Rahouma, Audisio, Soletti, Leonard, Girardi, Gaudino)
Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York,
NY, United States
(Lia, Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Centre, Weill Cornell, Medicine, New York, NY, United States
Publisher
Mosby Inc.
Abstract
Objective: The study objective was to investigate the impact of multiple
arterial grafting on long-term all-cause mortality in women undergoing
isolated coronary artery bypass grafting. Method(s): A comprehensive
search was performed to identify observational studies reporting outcomes
after coronary artery bypass grafting reported by sex and stratified into
multiple arterial grafting versus single arterial grafting strategies.
Articles were considered for inclusion if they were written in English and
were propensity-matched observational studies. Included studies were then
pooled in a meta-analysis performed using the generic inverse variance
method. The primary outcome was long-term all-cause mortality. Secondary
outcomes were operative mortality and spontaneous myocardial infarction.
Meta-regression was used to explore the effects of preoperative and
intraoperative variables on the primary outcome. Result(s): A total
of 6 studies with 32,793 women (25,714 single arterial grafting and 7079
multiple arterial grafting) were included. Women who received multiple
arterial grafting had lower long-term mortality (incidence rate ratio,
0.86; 95% confidence interval, 0.76-0.96; P = .007) and spontaneous
myocardial infarction (incidence rate ratio, 0.80; 95% confidence
interval, 0.68-0.93; P = .003) compared with women who received single
arterial grafting, but the difference in mortality disappeared when
including only the 3 largest studies. There was no difference between
groups in operative mortality (odds ratio, 0.99; 95% confidence interval,
0.84-1.17; P = .91). Meta-regression did not identify any associations
with the incidence rate ratio for long-term mortality. Conclusion(s):
The use of multiple arterial grafting in women undergoing coronary artery
bypass grafting is associated with lower long-term mortality, although the
difference is mostly driven by small series. Further studies, including
randomized trials, are needed to evaluate the efficacy of multiple
arterial grafting in women undergoing coronary artery bypass
grafting. Copyright © 2021 The American Association for Thoracic
Surgery

<95>
Accession Number
2013622969
Title
Dextran-based priming solution during cardiopulmonary bypass attenuates
renal tubular injury-A secondary analysis of randomized controlled trial
in adult cardiac surgery patients.
Source
Acta Anaesthesiologica Scandinavica. (no pagination), 2021. Date of
Publication: 2021.
Author
Kolsrud O.; Barbu M.; Dellgren G.; Bjork K.; Corderfeldt A.; Thoren A.;
Jeppsson A.; Ricksten S.-E.
Institution
(Kolsrud, Dellgren, Bjork, Corderfeldt, Jeppsson) Cardiothoracic Surgery,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Kolsrud, Barbu, Dellgren, Jeppsson, Ricksten) Sahlgrenska Academy,
University of Gothenburg, Gothenburg, Sweden
(Barbu) Department of Cardiology, Karlskrona Hospital, Karlskrona, Sweden
(Dellgren) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Thoren, Ricksten) Departments of Cardiothoracic Anesthesiology and
Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: Acute kidney injury (AKI) is a well-known complication after
cardiac surgery and cardiopulmonary bypass (CPB). In the present secondary
analysis of a blinded randomized controlled trial, we evaluated the
effects of a colloid-based versus a conventional crystalloid-based prime
on tubular injury and postoperative renal function in patients undergoing
cardiac surgery with CPB. Method(s): Eighty-four adult patients
undergoing cardiac surgery with CPB were randomized to receive either a
crystalloid- or colloid- (dextran 40) based CPB priming solution. The
crystalloid solution was based on Ringer-Acetate plus mannitol. The
tubular injury biomarker, N-acetyl-b-D-glucosaminidase (NAG), serum
creatinine and diuresis were measured before, during and after CPB. The
incidence of AKI was assessed according to the KDIGO criteria.
 Result(s): The urinary-NAG/urinary-creatinine ratio rose in both
groups during and after CPB, with a more pronounced increase in the
crystalloid group (p =.038). One hour after CPB, the
urinary-NAG/urinary-creatinine ratio was 88% higher in the crystalloid
group (4.7 +/- 6.3 vs. 2.5 +/- 2.7, p =.045). Patients that received the
dextran 40-based priming solution had a significantly lower intraoperative
diuresis (p <.001) compared to the crystalloid group. The incidence of AKI
was 18% in the colloid and 22% in the crystalloid group (p =.66).
Postoperative serum creatinine did not differ between groups.
 Conclusion(s): In patients undergoing cardiac surgery with CPB,
colloid-based priming solution (dextran 40) induced less renal tubular
injury compared to a crystalloid-based priming solution. Whether a
colloid-based priming solution will improve renal outcome in high-risk
cardiac surgery, or not, needs to be evaluated in future studies on higher
risk cardiac surgery patients. Copyright © 2021 Acta
Anaesthesiologica Scandinavica Foundation

<96>
Accession Number
2013619355
Title
Intra-aortic balloon pump versus percutaneous Impella© in
emergency revascularisation for myocardial infarction and cardiogenic
shock: systematic review.
Source
Perfusion (United Kingdom). (no pagination), 2021. Date of Publication:
2021.
Author
Frain K.; Rees P.
Institution
(Frain) Faculty of Medicine, University of St Andrews, St Andrews, United
Kingdom
(Rees) Academic Department of Military Medicine, Barts Heart Centre,
London, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objectives: Mortality rates in patients with acute myocardial infarction
and cardiogenic shock (AMI-CS) remain persistently high despite advances
over the past decade in percutaneous mechanical circulatory support. This
systematic review aims to analyse the existing literature to compare
mortality outcomes in patients mechanically supported by intra-aortic
balloon pump or percutaneous Impella 2.5/CP© for AMI-CS
undergoing emergency revascularisation. Method(s): The following MeSH
terms were applied to the databases Ovid Medline, Ovid Embase, Cochrane
and Web of Science: 'Intra-aortic balloon pump', 'Impella', 'Cardiogenic
shock', 'Myocardial Infarction' and 'Mortality'. This yielded 2643
studies. Using predefined inclusion and exclusion criteria, the studies
were initially screened by title and abstract before full text analysis.
 Result(s): Fourteen studies met eligibility criteria: two randomised
controlled trials (RCTs) and 12 observational studies. Data from a total
of 21,006 patients were included across the studies. Notably, one study
claimed reduced mortality with IABP versus control, and one study
concluded that Impella© improved survival rates over the
IABP. The average 30-day all-cause mortality in patients supported by IABP
was 38.1%, 54.3% in Impella© groups and 39.4% in control
groups. Conclusion(s): AMI-CS presents an important cohort of
patients in whom conducting RCTs is difficult. As a result, the literature
is limited. Analysis of the available literature suggests that there is
insufficient evidence to support superior survival in those supported by
IABP or Impella© when compared to control despite
suggestions that the Impella© offers superior haemodynamic
support. Limitations of the studies have been discussed to outline
suggestions for future research. Copyright © The Author(s) 2021.

<97>
Accession Number
2013619342
Title
Impact of minimal invasive extracorporeal circulation on perioperative
intravenous fluid management in coronary artery bypass surgery.
Source
Perfusion (United Kingdom). (no pagination), 2021. Date of Publication:
2021.
Author
Ellam S.; Rasanen J.; Hartikainen J.; Selander T.; Juutilainen A.; Halonen
J.
Institution
(Ellam) Department of Anesthesiology and Operative Services, Kuopio
University Hospital, Kuopio, Finland
(Rasanen, Hartikainen, Juutilainen, Halonen) School of Medicine,
University of Eastern Finland, Kuopio, Finland
(Hartikainen, Halonen) Heart Center, Kuopio University Hospital, Kuopio,
Finland
(Selander) Research Support Services, Kuopio University Hospital, Kuopio,
Finland
Publisher
SAGE Publications Ltd
Abstract
Objective: Compare the use of blood products and intravenous fluid
management in patients scheduled for coronary artery bypass surgery and
randomized to minimal invasive extracorporeal circulation (MiECC) and
conventional extracorporeal circulation (CECC). Method(s): A total of
240 patients who were scheduled for their first on-pump CABG, were
randomized to MiECC or CECC groups. The study period was the first 84
hours after surgery. Hemoglobin <80 g/l was used as transfusion trigger.
 Result(s): Red blood cell transfusions intraoperatively were given
less often in the MiECC group (23.3% vs 9.2%, p = 0.005) and the total
intravenous fluid intake was significantly lower in the MiECC group (3300
ml [2950-4000] vs 4800 ml [4000-5500], p < 0.001). Hemoglobin drop also
was lower in the MiECC group (35.5 +/- 8.9 g/l vs 50.7 +/- 9 g/l, p <
0.001) as was hemoglobin drop percent (25.3 +/- 6% vs 35.3 +/- 5.9%, p <
0.001). Chest tube drainage output was higher in the MiECC group (645 ml
[500-917.5] vs 550 ml [412.5-750], p = 0.001). Particularly, chest tube
drainage in up to 600 ml category, was in benefit of CECC group (59.1% vs
40.8%, p = 0.003). ROC curve analysis showed that patients with hemoglobin
level below 95 g/l upon arrival to intensive care unit was associated with
increased risk of developing postoperative atrial fibrillation (POAF) (p =
0.002, auc = 0.61, cutoff <95, sensitivity = 0.47, positive predictive
value = 0.64). Conclusion(s): MiECC reduced the intraoperative need
for RBC transfusion and intravenous fluids compared to the CECC group,
also reducing hemoglobin drop compared to the CECC group in CABG surgery
patients. Postoperative hemoglobin drop was a predictor of
POAF. Copyright © The Author(s) 2021.

<98>
Accession Number
2013619241
Title
Current Perspectives on Contemporary Rheumatic Mitral Valve Repair.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2021. Date of Publication: 2021.
Author
Dejsupa C.; Chotivatanapong T.; Caputo M.; Vohra H.A.
Institution
(Dejsupa, Caputo, Vohra) Department of Cardiac Surgery/Cardiovascular
Sciences, University of Bristol, United Kingdom
(Chotivatanapong) Department of Cardiothoracic Surgery, Central Chest
Institute of Thailand, Nonthabhuri, Thailand
Publisher
SAGE Publications Ltd
Abstract
The surgical management of rheumatic mitral valve disease remains a
challenge for cardiac surgeons. Durability of mitral valve repair (MVr) is
likely compromised not simply due to high technical demand, but surgeon
reluctance, despite boasting copious advantages over MV replacement. This
comprehensive review aims to evoke a deeper understanding of MVr concepts
necessary to abate these limitations and shift mindset towards a more
holistic approach to repair. Details of commonly utilized techniques in
contemporary MVr for rheumatic heart disease will be discussed. Of
importance, the reparative procedures will be mapped to an in-depth
physiological exploration of the mitral complex-dynamism and rheumatic
interplay. This is further emphasized by outlining the current
"aggressive" resection strategy in contemporary rheumatic
MVr. Copyright © The Author(s) 2021.

<99>
[Use Link to view the full text]
Accession Number
635909578
Title
Effects of perioperative interventions for preventing postoperative
delirium: A protocol for systematic review and meta-analysis of randomized
controlled trials.
Source
Medicine. 100 (29) (pp e26662), 2021. Date of Publication: 23 Jul 2021.
Author
Li X.; Wang Y.; Liu J.; Xiong Y.; Chen S.; Han J.; Xie W.; Wu Q.
Institution
(Li) Department of Anaesthesiology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative delirium (POD) not only increases the medical
burden but also adversely affects patient prognosis. Although some cases
of delirium can be avoided by early intervention, there is no clear
evidence indicating whether any of these measures can effectively prevent
POD in specific patient groups. OBJECTIVE(S): The aim of this
meta-analysis was to compare the efficacy and safety of the existing
preventive measures for managing POD. METHOD(S): The PubMed, OVID
(Embase and MEDLINE), Web of Science, and the Cochrane Library databases
were searched for articles published before January 2020. The relevant
randomized controlled trials (RCTs) were selected based on the inclusion
and exclusion criteria. Data extraction and methodological quality
assessment were performed according to a predesigned data extraction form
and scoring system, respectively. The interventions were compared on the
basis of the primary outcome like incidence of POD, and secondary outcomes
like duration of delirium and the length of intensive care unit and
hospital stay. RESULT(S): Sixty-three RCTs were included in the
study, covering interventions like surgery, anesthesia, analgesics,
intraoperative blood glucose control, cholinesterase inhibitors,
anticonvulsant drugs, antipsychotic drugs, sleep rhythmic regulation, and
multi-modal nursing. The occurrence of POD was low in 4 trials that
monitored the depth of anesthesia with bispectral index during the
operation (P < .0001). Two studies showed that supplementary analgesia was
useful for delirium prevention (P = .002). Seventeen studies showed that
perioperative sedation with alpha2-adrenergic receptor agonists prevented
POD (P = .0006). Six studies showed that both typical and atypical
antipsychotic drugs can reduce the incidence of POD (P = .002). Multimodal
nursing during the perioperative period effectively reduced POD in 6
studies (P < .00001). Furthermore, these preventive measures can reduce
the duration of delirium, as well as the total and postoperative length of
hospitalized stay for non-cardiac surgery patients. For patients
undergoing cardiac surgery, effective prevention can only reduce the
length of intensive care unit stay. CONCLUSION(S): Measures including
intraoperative monitoring of bispectral index, supplemental analgesia,
alpha2-adrenergic receptor agonists, antipsychotic drugs, and multimodal
care are helpful to prevent POD effectively. However, larger, high-quality
RCTs are needed to verify these findings and develop more interventions
and drugs for preventing postoperative delirium. Copyright © 2021
the Author(s). Published by Wolters Kluwer Health, Inc.

<100>
[Use Link to view the full text]
Accession Number
635909215
Title
Impact of chronic kidney disease on the prognosis of transcatheter aortic
valve replacement in patients with aortic stenosis: A protocol for
systematic review and meta-analysis.
Source
Medicine. 100 (29) (pp e26696), 2021. Date of Publication: 23 Jul 2021.
Author
Wang J.; Liu S.; Han X.; Wan Z.; Chen Y.; Chen H.; Song B.
Institution
(Wang, Han, Chen, Chen) First Clinical Medical College of Lanzhou
University, Lanzhou University, Lanzhou, China
(Liu, Wan, Song) Department of Cardiovascular Surgery, First Hospital of
Lanzhou University, Lanzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The prognosis of patients with aortic stenosis, in conjunction
with chronic kidney disease (CKD), after transcatheter aortic valve
replacement (TAVR) remains unclear. This study assessed the impact of CKD,
and different stages of CKD, on prognosis of patients undergoing TAVR.
 METHOD(S): The protocol was written following the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses Protocols statement
guidelines. As of June 2021, we performed a comprehensive literature
search on studies related to CKD and TAVR, using databases such as PubMed,
Embase, Cochrane Library, and Web of Science. Two researchers
independently screened the literature, extracted the data, and evaluated
the risk of bias in the included studies. Then, Stata 15.0 software was
used for meta-analysis. RESULTS AND CONCLUSION(S): The purpose of
this study was to evaluate the effect of CKD and different stages of CKD
on the prognosis of patients with TAVR. It is hoped to provide a
comprehensive reference for clinical practice and related clinical trials
in the future. Copyright © 2021 the Author(s). Published by
Wolters Kluwer Health, Inc.

<101>
Accession Number
2011486117
Title
European Resuscitation Council Guidelines 2021: Executive summary.
Source
Resuscitation. 161 (pp 1-60), 2021. Date of Publication: April 2021.
Author
Perkins G.D.; Graesner J.-T.; Semeraro F.; Olasveengen T.; Soar J.; Lott
C.; Van de Voorde P.; Madar J.; Zideman D.; Mentzelopoulos S.; Bossaert
L.; Greif R.; Monsieurs K.; Svavarsdottir H.; Nolan J.P.
Institution
(Perkins, Nolan) Warwick Clinical Trials Unit, Warwick Medical School,
University of Warwick, Coventry CV4 7AL, United Kingdom
(Perkins) University Hospitals Birmingham, Birmingham B9 5SS, United
Kingdom
(Graesner) University Hospital Schleswig-Holstein, Institute for Emergency
Medicine, Kiel, Germany
(Semeraro) Department of Anaesthesia, Intensive Care and Emergency Medical
Services, Maggiore Hospital, Bologna, Italy
(Olasveengen) Department of Anesthesiology, Oslo University Hospital and
Institute of Clinical Medicine, University of Oslo, Norway
(Soar) Southmead Hospital, North Bristol NHS Trust, Bristol BS10 5NB,
United Kingdom
(Lott) Department of Anesthesiology, University Medical Center, Johannes
Gutenberg-University Mainz, Germany
(Van de Voorde) Department of Emergency Medicine, Faculty of Medicine
Ghent University, Ghent, Belgium
(Van de Voorde) EMS Dispatch Center, East-West Flanders, Federal
Department of Health, Belgium
(Madar) Department of Neonatology, University Hospitals Plymouth,
Plymouth, United Kingdom
(Zideman) Thames Valley Air Ambulance, Stokenchurch, United Kingdom
(Mentzelopoulos) National and Kapodistrian University of Athens Medical
School, Athens, Greece
(Bossaert) University of Antwerp, Antwerp, Belgium
(Greif) Department of Anaesthesiology and Pain Medicine, Bern University
Hospital, University of Bern, Bern, Switzerland
(Greif) School of Medicine, Sigmund Freud University Vienna, Vienna,
Austria
(Monsieurs) Department of Emergency Medicine, Antwerp University Hospital
and University of Antwerp, Belgium
(Svavarsdottir) Akureyri Hospital, Akureyri, Iceland
(Svavarsdottir) University of Akureyri, Akureyri, Iceland
(Nolan) Royal United Hospital, Bath BA1 3NG, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Informed by a series of systematic reviews, scoping reviews and evidence
updates from the International Liaison Committee on Resuscitation, the
2021 European Resuscitation Council Guidelines present the most up to date
evidence-based guidelines for the practice of resuscitation across Europe.
The guidelines cover the epidemiology of cardiac arrest; the role that
systems play in saving lives, adult basic life support, adult advanced
life support, resuscitation in special circumstances, post resuscitation
care, first aid, neonatal life support, paediatric life support, ethics
and education. Copyright © 2021

<102>
Accession Number
2007627575
Title
Veno-Arterial Extracorporeal Life Support in Heart Transplant and
Ventricle Assist Device Centres. Meta-analysis.
Source
ESC Heart Failure. 8 (2) (pp 1064-1075), 2021. Date of Publication: April
2021.
Author
Kowalewski M.; Zielinski K.; Gozdek M.; Raffa G.M.; Pilato M.; Alanazi M.;
Gilbers M.; Heuts S.; Natour E.; Bidar E.; Schreurs R.; Delnoij T.;
Driessen R.; Sels J.W.; van de Poll M.; Roekaerts P.; Pasierski M.; Meani
P.; Maessen J.; Suwalski P.; Lorusso R.
Institution
(Kowalewski, Pasierski, Suwalski) Department of Cardiac Surgery, Central
Clinical Hospital of the Ministry of Interior, Centre of Postgraduate
Medical Education, Woloska 137 Str, Warsaw 02-507, Poland
(Kowalewski, Alanazi, Gilbers, Heuts, Natour, Bidar, Schreurs, Maessen,
Lorusso) Cardio-Thoracic Surgery Department, Maastricht University Medical
Centre, Maastricht, Netherlands
(Kowalewski, Gozdek) Thoracic Research Centre, Collegium Medicum, Nicolaus
Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
(Zielinski) Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
(Gozdek) Department of Cardiology and Internal Medicine, Collegium
Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
(Raffa, Pilato) Department for the Treatment and Study of Cardiothoracic
Diseases and Cardiothoracic Transplantation, ISMETT-IRCCS, Palermo, Italy
(Delnoij, Driessen, Sels, Meani) Cardiology Department, Maastricht
University Medical Centre, Maastricht, Netherlands
(Delnoij, Driessen, Sels, van de Poll, Roekaerts, Meani) Department of
Intensive Care, Maastricht University Medical Centre, Maastricht,
Netherlands
(Lorusso) Cardiovascular Research Institute Maastricht (CARIM), University
of Maastricht, Maastricht, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Aims: Because reported mortality on veno-arterial (V-A) extracorporeal
life support (ECLS) substantially varies between centres, the aim of the
current analysis was to assess the outcomes between units performing heart
transplantation and/or implanting ventricular assist device (HTx/VAD) vs.
non-HTx/VAD units in patients undergoing V-A ECLS for cardiogenic shock.
 Methods and Results: Systematic search according to the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses was performed
using PubMed/MEDLINE databases until 30 November 2019. Articles reporting
in-hospital/30-day mortality and centre's HTx/VAD status were included.
In-hospital outcomes and long-term survival were analysed in subgroup
meta-analysis. A total of 174 studies enrolling n = 13 308 patients were
included with 20 series performed in non-HTx/VAD centres (1016 patients,
7.8%). Majority of patients underwent V-A ECLS for post-cardiotomy shock
(44.2%) and acute myocardial infarction (20.7%). Estimated overall
in-hospital mortality was 57.2% (54.9-59.4%). Mortality rates were higher
in non-HTx/VAD [65.5% (59.8-70.8%)] as compared with HTx/VAD centres
[55.8% (53.3-58.2%)], P < 0.001. Estimated late survival was 61.8%
(55.7-67.9%) without differences between non-HTx/VAD and HTx/VAD centres:
66.5% (30.3-1.02%) vs. 61.7% (55.5-67.8%), respectively (P = 0.797). No
differences were seen with respect to ECLS duration, limb complications,
and reoperations for bleeding, kidney injury, and sepsis. Yet, weaning
rates were higher in HTx/VAD vs. non-HTx/VAD centres: 58.7% (56.2-61.1%)
vs. 48.9% (42.0-55.9%), P = 0.010. Estimated rate of bridge to heart
transplant was 6.6% (5.2-8.3%) with numerical, yet not statistically
significant, difference between non-HTx/VAD [2.7% (0.8-8.3%)] as compared
with HTx/VAD [6.7% (5.3-8.6%)] (P = 0.131). Conclusion(s): Survival
after V-A ECLS differed according to centre's HTx/VAD status. Potentially
different risk profiles of patients must be taken account for before
definite conclusions are drawn. Copyright © 2020 The Authors. ESC
Heart Failure published by John Wiley & Sons Ltd on behalf of the European
Society of Cardiology

<103>
Accession Number
2013141369
Title
Acute coronary syndrome treatment delay in low to middle-income countries:
A systematic review.
Source
IJC Heart and Vasculature. 35 (no pagination), 2021. Article Number:
100823. Date of Publication: August 2021.
Author
Beza L.; Leslie S.L.; Alemayehu B.; Gary R.
Institution
(Beza, Alemayehu) College of Health Sciences, Addis Ababa University,
Addis Ababa, Ethiopia
(Leslie) Woodruff Health Sciences Center Library, Emory University,
Atlanta, Georgia
(Gary) Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta,
Georgia
Publisher
Elsevier Ireland Ltd
Abstract
Although morbidity and mortality rates are declining for acute coronary
syndrome (ACS) in most high-income countries, it is rising at an alarming
pace for low to middle income countries (LMICs). A major factor that is
contributing to the poor clinical outcomes among LMICs is largely due to
prehospital treatment delays. This systematic review was conducted to
determine the mean length of time from symptom onset to treatment in LMICs
and the sociodemographic, clinical and health system characteristics that
contribute to treatment delays. We conducted a comprehensive review of the
relevant literature published in English between January 1990 through May
2020 using predefined inclusion and exclusion criteria. Twenty-nine
studies were included and time to treatment was defined from ACS symptom
onset to first medical contact and dichotomized further as less than or
>12-hours. The mean time from symptom onset to first medical contact was
12.7 h which ranged from 10-minutes to 96 h. There was consensus among
studies that being older, female, illiterate, living in a rural area, and
financially limited was associated with longer treatment delays. Lack of a
developed emergency transportation system, poor communication and
organization between community facilities and interventional facilities
were also cited as major contributors for ACS treatment delays. Findings
from this systematic review provide future directions to potentially
reduce prehospital delays in LMICs and improve ACS outcomes. Copyright
© 2021 The Author(s)

<104>
Accession Number
2012198011
Title
The relationship between preoperative serum vitamin D deficiency and
postoperative atrial fibrillation: A systematic review and metaanalysis.
Source
Journal of Cardiovascular and Thoracic Research. 13 (2) (pp 102-108),
2021. Date of Publication: May 2021.
Author
Rahimi M.; Taban-Sadeghi M.; Nikniaz L.; Pashazadeh F.
Institution
(Rahimi) Student Research Committee, Cardiovascular Research Center,
Tabriz University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Rahimi, Taban-Sadeghi) Cardiovascular Research Center, Tabriz University
of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Nikniaz) Tabriz Health Services Management Research Center, Health
Management and Safety Promotion Research Institute, Tabriz University of
Medical Sciences, Tabriz, Iran, Islamic Republic of
(Pashazadeh) Research Center for Evidence-based Medicine, Iranian EBM
Centre: A Joanna Briggs Institute (JBI) Centre of Excellence, Faculty of
Medicine, Tabriz University of Medical Sciences, Tabriz, Iran, Islamic
Republic of
Publisher
Tabriz University of Medical Sciences
Abstract
Postoperative atrial fibrillation (POAF) is the most common arrhythmia
seen in the first days following cardiac surgeries. Recently, there is a
growing discussion regarding the link between vitamin D deficiency and
POAF development. This systematic review and meta-analysis of the
observational studies aimed at evaluating the association between
preoperative vitamin D deficiency and Postoperative atrial fibrillation.
In this study, using PubMed, Scopus, Google Scholar, EMBASE, Web of
Science, and Cochrane Libraries, we searched for records published before
July 2020. Two reviewers screened for studies that examined the
relationship between preoperative vitamin D levels and the generation of
POAF. Data regarding study design, patient characteristics, definition of
atrial fibrillation (AF), type of surgery, vitamin D levels, and
measurement methods were extracted. Five studies were included in the
meta-analysis. Our primary analysis showed a significant relationship
between preoperative levels of vitamin D and POAF development (mean
differences (MD) = -2.851, 95% confidence interval (CI) =-5.506 to -0.195;
P value = 0.035). Our meta-analysis suggested serum vitamin D deficiency
is associated with an increased risk of POAF development. Further large
scale interventional studies are needed to explore whether vitamin D
supplementation will prevent POAF. Copyright © 2021 The
Author(s).

<105>
Accession Number
2011445027
Title
The effect of peri-operative dexmedetomidine on the incidence of
postoperative delirium in cardiac and non-cardiac surgical patients: a
randomised, double-blind placebo-controlled trial.
Source
Anaesthesia. 76 (10) (pp 1342-1351), 2021. Date of Publication: October
2021.
Author
van Norden J.; Spies C.D.; Borchers F.; Mertens M.; Kurth J.; Heidgen J.;
Pohrt A.; Mueller A.
Institution
(van Norden, Spies, Borchers, Mertens, Kurth, Heidgen, Mueller) Department
of Anaesthesia and Intensive Care Medicine, Institute of Biometry and
Clinical Epidemiology, Charite - Universitatsmedizin Berlin, Freie
Universitat Berlin, Humboldt-Universitat zu Berlin, Berlin Institute of
Health, Berlin, Germany
(Pohrt) Institute of Biometry and Clinical Epidemiology, Charite -
Universitatsmedizin Berlin, Freie Universitat Berlin, Humboldt-Universitat
zu Berlin, Berlin Institute of Health, Berlin, Germany
Publisher
John Wiley and Sons Inc
Abstract
Delirium occurs commonly following major non-cardiac and cardiac surgery
and is associated with: postoperative mortality; postoperative
neurocognitive dysfunction; increased length of hospital stay; and major
postoperative complications and morbidity. The aim of this study was to
investigate the effect of peri-operative administration of dexmedetomidine
on the incidence of postoperative delirium in non-cardiac and cardiac
surgical patients. In this randomised, double-blind placebo-controlled
trial we included 63 patients aged >= 60 years undergoing major open
abdominal surgery or coronary artery bypass graft surgery with
cardiopulmonary bypass. The primary outcome was the incidence of
postoperative delirium, as screened for with the Confusion Assessment
Method. Delirium assessment was performed twice daily until postoperative
day 5, at the time of discharge from hospital or until postoperative day
14. We found that dexmedetomidine was associated with a reduced incidence
of postoperative delirium within the first 5 postoperative days, 43.8% vs.
17.9%, p = 0.038. Severity of delirium, screened with the Intensive Care
Delirium Screening Checklist, was comparable in both groups, with a mean
maximum score of 1.54 vs. 1.68, p = 0.767. No patients in the
dexmedetomidine group died while five (15.6%) patients in the placebo
group died, p = 0.029. For patients aged >= 60 years undergoing major
cardiac or non-cardiac surgery, we conclude that the peri-operative
administration of dexmedetomidine is associated with a lower incidence of
postoperative delirium. Copyright © 2021 The Authors. Anaesthesia
published by John Wiley & Sons Ltd on behalf of Association of
Anaesthetists.

<106>
Accession Number
2013618728
Title
Coronary artery bypass grafting (Cabg) versus percutaneous coronary
intervention (pci) in the treatment of multivessel coronary disease: A
review.
Source
Australasian Medical Journal. 14 (1) (pp 29-33), 2021. Date of
Publication: 2021.
Author
Al Ansari A.E.; Alzahrani H.A.; Alqulayti W.M.; Rawah M.A.; Alnajjar L.L.;
Subedar A.T.M.; Aloufi B.M.M.; Ajwah I.M.H.; Albalawi A.A.M.; Aljohani
K.M.A.; Albalawi A.M.K.; Aljoaid S.S.A.; Alatawi R.A.S.; Alsaiari A.S.M.;
Alrefai L.M.S.; Hameed A.M.H.; Al Masoud D.K.H.; Alsada A.M.S.
Institution
(Al Ansari, Alzahrani, Alqulayti, Rawah, Alnajjar, Subedar, Aloufi, Ajwah)
Saudi Commission for Health Specialties, Saudi Arabia
(Albalawi, Aljohani, Albalawi, Aljoaid, Alatawi, Alsaiari, Alrefai)
University of Tabuk, Saudi Arabia
(Hameed) Ibn-Sina college, Jeddah, Saudi Arabia
(Al Masoud) Taibah University, Saudi Arabia
(Alsada) Salmaniya Medical Complex, Bahrain
Publisher
Australasian Medical Journal Pty Ltd
Abstract
Background Revascularization for patients who suffer multivessel coronary
artery disease is a common procedure around the world. Taking United about
700,000 patients have multivessel coronary revascularization per year 1/4
of these patients are diagnosed with diabetes. Aims To summarize the
current evidence that compare CABG to PCI in multivessel coronary
diseasein form of cardiac death, stroke, MI and unplanned
devascularization. Methods This is a systematic review was carried out,
including PubMed, Google Scholar, and EBSCO that examining randomized
trials of treatment of multivessel coronary disease to summarize the major
RCT concerning this topic. Results The review included five randomized
studies that compare coronary artery bypass grafting and percutaneous
coronary intervention. The findings showed that CABG show better result
with less mortality rate. Conclusion This review concluded that there
revascularization in treating coronary artery disease could be conducted
either by CABG or PCI, CABG show better result as it cause less death, MI
and revascularization rates, but the usage of new additions such as second
generation DES, can also improve the safety and efficacy of PCI when added
to it. Copyright © 2021, Australasian Medical Journal Pty Ltd.
All rights reserved.

<107>
Accession Number
2013618727
Title
Coronary artery bypass grafting (Cabg) versus percutaneous coronary
intervention (pci) in treatment of left main coronary artery disease: A
review.
Source
Australasian Medical Journal. 14 (1) (pp 34-38), 2021. Date of
Publication: 2021.
Author
Alkaabneh W.A.M.; Kaby B.M.M.; Albalawi Y.A.Z.; Albalawi A.O.A.; Alharfy
A.A.N.; Albalawi M.B.G.; Alwabisi Y.H.O.; Alerrwi G.A.S.; Albalawi A.A.S.;
Alhawiti N.S.S.; Albalawi N.S.A.; Alghazzawi R.A.M.; Alatwi G.J.E.; Twair
A.A.A.; Hakami A.H.O.; Alshahrani A.A.A.; Ajwah I.M.H.
Institution
(Alkaabneh, Kaby, Albalawi, Albalawi, Alharfy, Albalawi, Alwabisi,
Alerrwi, Albalawi, Alhawiti, Albalawi, Alghazzawi, Alatwi) University of
Tabuk, Saudi Arabia
(Twair) Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
(Hakami) King Fahad Central Hospital, Jazan, Saudi Arabia
(Alshahrani) King Abdullah Hospital, Bisha, Saudi Arabia
(Ajwah) King Salman Armed Forced Hospital, Tabuk, Saudi Arabia
Publisher
Australasian Medical Journal Pty Ltd
Abstract
Background Coronary artery bypass graft surgery (CABG) has been widely
used for left main coronary artery disease (LMCAD). Percutaneous coronary
intervention (PCI) has become an option for this condition. Aims To
summarize the current evidence that compare between CABG vs. PCI in
regards to cardiac death, stroke, and myocardial infarction. Methods We
searched randomized trials of treatment of LMCAD with PubMed, Google
Scholar, and EBSCO. Results Five randomized studies were retrieved, which
compared the efficacy between CABG vs. PCI in treatment of LMCAD.
Conclusion PCI may be reasonable management of patients with LM stenosis
involving distal bifurcation or with coexisting multivessel
disease. Copyright © 2021, Australasian Medical Journal Pty Ltd.
All rights reserved.

<108>
Accession Number
2014431643
Title
Derivation and validation of a clinical model to predict death or cardiac
hospitalizations while on the cardiac surgery waitlist.
Source
CMAJ. 193 (34) (pp E1333-E1340), 2021. Date of Publication: 30 Aug 2021.
Author
Sun L.Y.; Eddeen A.B.; Wijeysundera H.C.; Mamas M.A.; Tam D.Y.; Mesana
T.G.
Institution
(Sun) Division of Cardiac Anesthesiology, University of Ottawa Heart
Institute, School of Epidemiology and Public Health, University of Ottawa,
Canada
(Sun, Eddeen) ICES uOttawa, Ottawa, ON, Canada
(Wijeysundera, Tam) ICES Central, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Wijeysundera) Schulich Heart Program (Wijeysundera), Sunnybrook Health
Sciences Centre, Toronto, ON, Canada
(Wijeysundera) Division of Cardiology, Department of Medicine and
Institute for Health Policy, Management and Evaluation, University of
Toronto, Toronto, ON, Canada
(Mamas) Keele Cardiovascular Research Group, Centre for Prognosis
Research, Institutes of Applied Clinical Science and Primary Care and
Health Sciences, Keele University, Staffordshire, United Kingdom
(Mamas) Department of Cardiology, Royal Stoke University Hospital,
Stoke-on-Trent, United Kingdom
(Tam) Division of Cardiac Surgery, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Mesana) Division of Cardiac Surgery, University of OttawaHeartInstitute,
Ottawa, ON, Canada
Publisher
Canadian Medical Association
Abstract
Background: Waitlist management is a global challenge. For patients with
severe cardiovascular diseases awaiting cardiac surgery, prolonged wait
times are associated with unplanned hospitalizations. To facilitate
evidence-based resource allocation, we derived and validated a clinical
risk model to predict the composite outcome of death and cardiac
hospitalization of patients on the waitlist for cardiac surgery.
 Method(s): We used the CorHealth Ontario Registry and linked ICES
health care administrative databases, which have information on all
Ontario residents. We included patients 18 years or older who waited at
home for coronary artery bypass grafting, valvular or thoracic aorta
surgeries between 2008 and 2019. The primary outcome was death or an
unplanned cardiac hospitalizaton, defined as nonelective admission for
heart failure, myocardial infarction, unstable angina or endocarditis. We
randomly divided two-thirds of these patients into derivation and
one-third into validation data sets. We derived the model using a
multivariable Cox proportional hazard model with backward stepwise
variable selection. Result(s): Among 62 375 patients, 41 729 patients
were part of the derivation data set and 20 583 were part of the
validation data set. Of the total, 3033 (4.9%) died or had an unplanned
cardiac hospitalization while waiting for surgery. The area under the
curve of our model at 15, 30, 60 and 89 days was 0.85, 0.82, 0.81 and
0.80, respectively, in the derivation cohort and 0.83, 0.80, 0.78 and
0.78, respctively, in the validation cohort. The model calibrated well at
all time points. Interpretation(s): We derived and validated a
clinical risk model that provides accurate prediction of the risk of death
and unplanned cardiac hospitalization for patients on the cardiac surgery
waitlist. Our model could be used for quality benchmarking and data-driven
decision support for managing access to cardiac surgery. Copyright
© 2021 Canadian Medical Association. All rights reserved.

<109>
Accession Number
613120360
Title
Percutaneous Intervention for Concurrent Chronic Total Occlusions in
Patients With STEMI: The EXPLORE Trial.
Source
Journal of the American College of Cardiology. 68 (15) (pp 1622-1632),
2016. Date of Publication: 11 Oct 2016.
Author
Henriques J.P.S.; Hoebers L.P.; Strauss B.H.; Barbato E.; Nijveldt R.; van
Rossum A.C.; Elias J.; van Dongen I.M.; Claessen B.E.P.M.; Tijssen J.G.;
van der Schaaf R.; Tijssen J.G.P.; Zijlstra F.; de Boer M.-J.; Michels R.;
Agostoni P.; van Houwelingen K.G.; Verberne H.J.; Hirsch A.; Piek J.J.; de
Winter R.J.; Koch K.T.; Vis M.M.; Baan J.; Wykrzykowska J.; Ramunddal T.;
Ioanes D.; Laanmets P.; van der Schaaf R.J.; Slagboom T.; Amoroso G.;
Eriksen E.; Tuseth V.; Bax M.; Schotborgh C.E.; Suttorp M.J.; Marques
K.M.; Bertrand O.; Meuwissen M.; van der Ent M.; Koolen J.
Institution
(Henriques, Hoebers, Elias, van Dongen, Claessen, Tijssen) Academic
Medical Center, University of Amsterdam, Amsterdam, Netherlands
(Ramunddal, Ioanes) Sahlgrenska University Hospital, Gothenburg, Sweden
(Laanmets) North Estonia Medical Center, Tallinn, Estonia
(Eriksen) Haukeland University Hospital, Bergen, Norway
(Bax) Haga Teaching Hospital, The Hague, Netherlands
(Suttorp) Sint Antonius Ziekenhuis, Nieuwegein, Netherlands
(Strauss) Sunnybrook Health Sciences Centre, Toronto, Canada
(Barbato) Onze Lieve Vrouwe Ziekenhuis, Aalst, Belgium
(Nijveldt, van Rossum, Marques) VU University Medical Center, Amsterdam,
Netherlands
(van der Schaaf) Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background In 10% to 15% of patients with ST-segment elevation myocardial
infarction (STEMI), concurrent coronary chronic total occlusion (CTO) in a
non-infarct-related artery is present and is associated with increased
morbidity and mortality. Objectives The EXPLORE (Evaluating Xience and
Left Ventricular Function in Percutaneous Coronary Intervention on
Occlusions After ST-Elevation Myocardial Infarction) trial evaluated
whether patients with STEMI and concurrent CTO in a non-infarct-related
artery benefit from additional percutaneous coronary intervention (PCI) of
CTO shortly after primary PCI. Methods From November 2007 through April
2015, we enrolled 304 patients with acute STEMI who underwent primary PCI
and had concurrent CTO in 14 centers in Europe and Canada. A total of 150
patients were randomly assigned to early PCI of the CTO (CTO PCI), and 154
patients were assigned to conservative treatment without PCI of the CTO
(no CTO PCI). Primary outcomes were left ventricular ejection fraction
(LVEF) and left ventricular end diastolic volume (LVEDV) on cardiac
magnetic resonance imaging after 4 months. Results The
investigator-reported procedural success rate in the CTO PCI arm of the
trial was 77%, and the adjudicated success rate was 73%. At 4 months, mean
LVEF did not differ between the 2 groups (44.1 +/- 12.2% vs. 44.8 +/-
11.9%, respectively; p = 0.60). Mean LVEDV at 4 months was 215.6 +/- 62.5
ml in the CTO PCI arm versus 212.8 +/- 60.3 ml in the no-CTO PCI arm (p =
0.70). Subgroup analysis revealed that patients with CTO located in the
left anterior descending coronary artery who were randomized to the CTO
PCI strategy had significantly higher LVEF compared with patients
randomized to the no-CTO PCI strategy (47.2 +/- 12.3% vs. 40.4 +/- 11.9%;
p = 0.02). There were no differences in terms of 4-month major adverse
coronary events (5.4% vs. 2.6%; p = 0.25). Conclusions Additional CTO PCI
within 1 week after primary PCI for STEMI was feasible and safe. In
patients with STEMI and concurrent CTO, we did not find an overall benefit
for CTO PCI in terms of LVEF or LVEDV. The finding that early CTO PCI in
the left anterior descending coronary artery subgroup was beneficial
warrants further investigation. (Evaluating Xience and Left Ventricular
Function in Percutaneous Coronary Intervention on Occlusions After
ST-Segment Elevation Myocardial Infarction; NTR1108) Copyright ©
2016 American College of Cardiology Foundation

<110>
Accession Number
2011549271
Title
Clopidogrel vs. prasugrel vs. ticagrelor in patients with acute myocardial
infarction complicated by cardiogenic shock: a pooled IABP-SHOCK II and
CULPRIT-SHOCK trial sub-analysis.
Source
Clinical Research in Cardiology. 110 (9) (pp 1493-1503), 2021. Date of
Publication: September 2021.
Author
Orban M.; Kleeberger J.; Ouarrak T.; Freund A.; Feistritzer H.-J.; Fuernau
G.; Geisler T.; Huber K.; Dudek D.; Noc M.; Montalescot G.; Neumer A.;
Haller P.; Clemmensen P.; Zeymer U.; Desch S.; Massberg S.; Schneider S.;
Thiele H.; Hausleiter J.
Institution
(Orban, Kleeberger, Massberg, Hausleiter) Department of Medicine I,
University Hospital, Ludwig-Maximilians-University, Munich, Germany
(Orban, Kleeberger, Massberg, Hausleiter) German Center for Cardiovascular
Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich,
Germany
(Ouarrak, Neumer, Zeymer, Schneider) Stiftung Institut fur
Herzinfarktforschung, Ludwigshafen, Germany
(Freund, Feistritzer, Desch, Thiele) Heart Center Leipzig at University of
Leipzig, Leipzig, Germany
(Fuernau) University Heart Center Lubeck, Lubeck, Germany
(Geisler) University Hospital of Tubingen, Tubingen, Germany
(Huber) Medical Faculty, 3rd Department of Medicine, Cardiology and
Intensive Care Medicine, Wilhelminenhospital, and Sigmund Freud
University, Vienna, Austria
(Dudek) Jagiellonian University, Krakow, Poland
(Noc) University Medical Center Ljubljana, Ljubljana, Slovenia
(Montalescot) Sorbonne Universite, ACTION Group, Hopital Pitie-Salpetriere
(AP-HP), Paris, France
(Haller, Clemmensen) Universitares Herz- Und Gefaszentrum UKE Hamburg,
Klinik Und Poliklinik Fur Kardiologie, Hamburg, Germany
(Orban) Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Campus
Groshadern, Ludwig-Maximilians-Universitat Munchen, Marchioninistr. 15,
Munchen 81377, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Aims: The aim of this pooled sub-analysis of the Intraaortic Balloon Pump
in Cardiogenic Shock II (IABP-SHOCK II) and Culprit Lesion Only PCI versus
Multivessel PCI in Cardiogenic Shock (CULPRIT-SHOCK) trial was to compare
the clinical outcome of patients with acute myocardial infarction
complicated by cardiogenic shock treated either with clopidogrel or the
newer, more potent ADP-receptor antagonists prasugrel or ticagrelor.
 Methods and Results: For the current analysis the primary endpoint
was 1-year mortality and the secondary safety endpoint was moderate or
severe bleedings until hospital discharge with respect to three different
ADP-receptor antagonists. 856 patients were eligible for analysis. Of
these, 507 patients (59.2%) received clopidogrel, 178 patients (20.8%)
prasugrel and 171 patients (20.0%) ticagrelor as acute antiplatelet
therapy. The adjusted rate of mortality after 1-year did not differ
significantly between prasugrel and clopidogrel (hazard ratio [HR]: 0.81,
95% confidence interval [CI] 0.60-1.09, p<inf>adj</inf> = 0.17) or between
ticagrelor and clopidogrel treated patients (HR: 0.86, 95% CI 0.65-1.15,
p<inf>adj</inf> = 0.31). In-hospital bleeding events were significantly
less frequent in patients treated with ticagrelor vs. clopidogrel (HR:
0.37, 95% CI 0.20 -0.69, p<inf>adj</inf> = 0.002) and not significantly
different in patients treated with prasugrel vs. clopidogrel (HR: 0.73,
95% CI 0.43 -1.24, p<inf>adj</inf> = 0.24). Conclusion(s): This
pooled sub-analysis is the largest analysis on safety and efficacy of
three oral ADP-receptor antagonists and shows that acute therapy with
either clopidogrel, prasugrel or ticagrelor is no independent predictor of
1-year mortality. Treatment with ticagrelor seems independently associated
with less in-hospital moderate and severe bleeding events compared to
clopidogrel. This finding might be due to selection bias and should be
interpreted with caution. Graphic abstract: [Figure not available: see
fulltext.] Copyright © 2021, The Author(s).

<111>
Accession Number
2011221270
Title
Cardiovascular mortality and morbidity in patients undergoing percutaneous
coronary intervention after out-of-hospital cardiac arrest: A systematic
review and meta-analysis.
Source
EuroIntervention. 16 (15) (pp E1245-E1253), 2021. Date of Publication:
2021.
Author
Spirito A.; Gargiulo G.; Siontis G.C.M.; Mitsis A.; Billinger M.;
Windecker S.; Valgimigli M.
Institution
(Spirito, Gargiulo, Siontis, Mitsis, Billinger, Windecker, Valgimigli)
Department of Cardiology, Inselspital, Bern University Hospital, Bern,
Switzerland
(Gargiulo) Department of Advanced Biomedical Sciences, Federico II
University of Naples, Naples, Italy
(Valgimigli) Cardiocentro Ticino, Lugano, Switzerland
Publisher
Europa Group
Abstract
Aims: The aim of this meta-analysis was to appraise the burden of
cardiovascular mortality and morbidity among patients undergoing
percutaneous coronary intervention (PCI) after out-of-hospital cardiac
arrest (OHCA). Methods and Results: This was a meta-analysis of
studies assessing the cardiovascular mortality or at least one other
pre-defined outcome in OHCA patients undergoing PCI. Forty-nine studies
with a total of 301,902 patients (73,634 OHCA and 228,268 non-OHCA
patients) were included. Compared to non-OHCA patients, all-cause
mortality was higher in OHCA patients (29% vs 4%). The cause of 39% of
deaths among OHCA patients was cardiovascular: PCI was more frequently
unsuccessful (9.2% vs 7.6%) and there were higher rates of stent
thrombosis (2.9% vs 0.8%), myocardial infarction (1.7% vs 1.4%), relevant
bleeding (10.2% vs 2.1%) and stroke (1.7% vs 0.5%). OHCA patients compared
to non-OHCA patients had a higher risk of all-cause mortality (risk ratio
[RR] 6.4, 95% CI: 5.5-7.4), cardiovascular death (4.6, 1.1-19),
unsuccessful coronary revascularisation (1.4, 1.1-1.7), stent thrombosis
(3.8, 0.6-22.7), myocardial infarction (1.4, 1.1-1.7), relevant bleeding
(3.2, 2.5-4.1) and stroke (3.1, 2.3-4.3). Conclusion(s): Almost one
third of OHCA patients undergoing PCI die and more than one third of the
fatalities are attributable to cardiovascular causes. The burden of
ischaemic and bleeding complications was consistently higher and the
success rates of PCI lower among OHCA as compared to non-OHCA
patients. Copyright © Europa Digital & Publishing 2021. All
rights reserved.

<112>
Accession Number
2010776905
Title
Determination of the optimal dose of ephedrine in the treatment of
arterial hypotension due to general anesthesia in neonates and infants
below 6 months old: the ephedrine study protocol for a randomized,
open-label, controlled, dose escalation trial.
Source
Trials. 22 (1) (no pagination), 2021. Article Number: 208. Date of
Publication: December 2021.
Author
Szostek A.S.; Boucher P.; Subtil F.; Zerzaihi O.; Saunier C.; de Queiroz
Siqueira M.; Merquiol F.; Martin P.; Granier M.; Gerst A.; Lambert A.;
Storme T.; Chassard D.; Nony P.; Kassai B.; Gaillard S.
Institution
(Szostek, Boucher, de Queiroz Siqueira, Lambert, Storme, Chassard)
Hospices Civils de Lyon, Service d'anesthesie pediatrique-HFME, Bron
69677, France
(Subtil) Hospices Civils de Lyon, Service de Biostatistiques, Lyon, France
(Zerzaihi, Saunier, Kassai, Gaillard) Hospices Civils de Lyon, EPICIME-CIC
1407 de Lyon, Inserm, Departement d'epidemiologie clinique, Bron, CHU-Lyon
F-69677, France
(Merquiol, Martin) Department of Anesthesiology and Intensive Care,
University Hospital of Saint-Etienne, Saint-Etienne Cedex, France
(Granier, Gerst) Departement de Medecine Perioperatoire, Anesthesie et
Reanimation, Centre Hospitalier Universitaire Clermont-Ferrand,
Clermont-Ferrand 63000, France
(Nony, Kassai, Gaillard) Universite de Lyon; CNRS, UMR 5558, Laboratoire
de Biometrie et Biologie Evolutive, Villeurbanne F-69622, France
Publisher
BioMed Central Ltd
Abstract
Background: Arterial hypotension induced by general anesthesia is commonly
identified as a risk factor of morbidity, especially neurological, after
cardiac or noncardiac surgery in adults and children. Intraoperative
hypotension is observed with sevoflurane anesthesia in children, in
particular in neonates, infants younger than 6 months, and preterm babies.
Ephedrine is commonly used to treat intraoperative hypotension. It is an
attractive therapeutic, due to its dual action on receptors alpha and beta
and its possible peripheral intravenous infusion. There are few data in
the literature on the use of ephedrine in the context of pediatric
anesthesia. The actual recommended dose of ephedrine (0.1 to 0.2 mg/Kg)
frequently leads to a therapeutic failure in neonates and infants up to 6
months of age. The use of higher doses would probably lead to a better
correction of hypotension in this population. The objective of our project
is to determine the optimal dose of ephedrine for the treatment of
hypotension after induction of general anesthesia with sevoflurane, in
neonates and infants up to 6 months of age. Method(s): The ephedrine
study is a prospective, randomized, open-label, controlled,
dose-escalation trial. The dose escalation consists of 6 successive
cohorts of 20 subjects. The doses studied are 0.6, 0.8, 1, 1.2, and 1.4
mg/kg. The dose chosen as the reference is 0.1 mg/kg, the actual
recommended dose. Neonates and infants younger than 6 months, males and
females, including preterm babies who undergo a surgery with general
anesthesia inducted with sevoflurane were eligible. Parents of the subject
were informed. Then, the subjects were randomized if presenting a decrease
in mean blood pressure superior to 20% of their initial mean blood
pressure (before induction of anesthesia), despite a vascular filling with
sodium chloride 0.9%. The primary outcome is the success of the therapy
defined as an mBP superior to 80% of the baseline mBP (prior to
anesthesia) within 10 min post ephedrine administration. The subjects were
followed-up for 3 days postanesthesia. Discussion(s): This study is
the first randomized, controlled trial intending to determine the optimal
dose of ephedrine to treat hypotension in neonates and infants below 6
months old. Trial registration: ClinicalTrials.gov NCT02384876. Registered
on March 2015. Copyright © 2021, The Author(s).

<113>
Accession Number
2007294874
Title
Comparison of mechanical circulatory support with venoarterial
extracorporeal membrane oxygenation or Impella for patients with
cardiogenic shock: a propensity-matched analysis.
Source
Clinical Research in Cardiology. 110 (9) (pp 1404-1411), 2021. Date of
Publication: September 2021.
Author
Karatolios K.; Chatzis G.; Markus B.; Luesebrink U.; Ahrens H.; Divchev
D.; Syntila S.; Jerrentrup A.; Schieffer B.
Institution
(Karatolios, Markus, Luesebrink, Ahrens, Divchev, Syntila, Schieffer)
Department of Cardiology, Angiology and Intensive Care, Philipps
University Marburg, BaldingerStr., Marburg 35043, Germany
(Chatzis, Jerrentrup) Department of Emergency Medicine, Philipps
University Marburg, Marburg, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Percutaneous mechanical circulatory devices are increasingly
used in patients with cardiogenic shock (CS). As evidence from randomized
studies comparing these devices are lacking, optimal choice of the device
type is unclear. Here we aim to compare outcomes of patients with CS
supported with either Impella or vaECMO. Method(s): Retrospective
single-center analysis of patients with CS, from September 2014 to
September 2019. Patients were assisted with either Impella 2.5/CP or
vaECMO. Patients supported ultimately with both devices were analyzed
according to the first device implanted. Primary outcomes were hospital
and 6-month survival. Secondary endpoints were complications. Survival
outcomes were compared using propensity-matched analysis to account for
differences in baseline characteristics between both groups.
 Result(s): A total of 423 patients were included (Impella, n = 300
and vaECMO, n = 123). Survival rates were similar in both groups (hospital
survival: Impella 47.7% and vaECMO 37.3%, p = 0.07; 6-month survival
Impella 45.7% and vaECMO 35.8%, p = 0.07). There was no significant
difference in survival rates, even after adjustment for baseline
differences (hospital survival: Impella 50.6% and vaECMO 38.6%, p = 0.16;
6-month survival Impella 45.8% and vaECMO 38.6%, p = 0.43). Access-site
bleeding and leg ischemia occurred more frequently in patients with vaECMO
(17% versus 7.3%, p = 0.004; 17% versus 7.7%, p = 0.008).
 Conclusion(s): In this retrospective analysis of patients with CS,
treatment with Impella 2.5/CP or vaECMO was associated with similar
hospital and 6-month survival rates. Device-related access-site vascular
complications occurred more frequently in the vaECMO group. A randomized
trial is warranted to examine the effects of these devices on outcomes and
to determine the optimal device choice in patients with CS. Copyright
© 2020, The Author(s).

<114>
Accession Number
2007251152
Title
Outcome of patients treated with extracorporeal life support in
cardiogenic shock complicating acute myocardial infarction: 1-year result
from the ECLS-Shock study.
Source
Clinical Research in Cardiology. 110 (9) (pp 1412-1420), 2021. Date of
Publication: September 2021.
Author
Lackermair K.; Brunner S.; Peterss S.; Orban M.; Theiss H.D.; Huber B.C.;
Juchem G.; Born F.; Boulesteix A.-L.; Bauer A.; Pichlmaier M.; Hausleiter
J.; Massberg S.; Hagl C.; Guenther S.P.W.
Institution
(Lackermair, Brunner, Orban, Orban, Theiss, Huber, Bauer, Hausleiter,
Massberg) Department of Medicine I, Munich University Hospital,
Ludwig-Maximilian-University, Marchioninistr. 15, Munich 81377, Germany
(Peterss, Juchem, Born, Pichlmaier, Hagl, Guenther) Department of Cardiac
Surgery, Munich University Hospital, Ludwig-Maximilian-University,
Marchioninistr. 15, Munich 81377, Germany
(Boulesteix) Institute for Medical Information Processing, Biometry and
Epidemiology (IBE), Ludwig-Maximilian-University, Munich, Germany
(Bauer, Hausleiter, Massberg, Hagl) Munich Heart Alliance, German Centre
for Cardiovascular Research, Munich, Germany
(Bauer) Department of Cardiology, University Hospital Innsbruck,
Innsbruck, Austria
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Treatment with extracorporeal life support (ECLS) in acute
myocardial infarction (AMI) complicated by cardiogenic shock (CS) fell
short of improving myocardial recovery measured by 30 day ejection
fraction in the ECLS-SHOCK trial. However, to date, no data regarding
impact of ECLS on long-term outcomes exist. Method(s): In this
randomized, controlled, prospective, open-label trial, 42 patients with CS
complicating AMI were randomly assigned to ECLS (ECLS group, n = 21) or no
ECLS (control group, n = 21). The primary endpoint was left ventricular
ejection fraction (LVEF) after 30 days. Secondary endpoints included
mortality and neurological outcome after 12 months. Evaluation of
neurological outcome used the modified Rankin Scale. Result(s): The
12-month all-cause mortality was 19% in the ECLS group versus 38% in the
control group (p = 0.31). Only one patient (control group) died after the
initial 30 days. Three patients underwent elective percutaneous coronary
intervention (PCI) during follow-up (one in the control and two in the
ECLS group). Favorable neurological outcome (modified Rankin Score <= 2)
was seen in 61.9% of patients in the ECLS group versus 57.1% in the
control group (p = 1). Conclusion(s): This pilot study showed that
randomized studies with ECLS in CS patients are feasible and safe. Small
numbers of included patients impede meaningful conclusions about mortality
and neurological outcome. Our findings of numerical differences in
mortality and survival with severe neurological impairment give an urgent
call for larger multi-centric randomized trials assessing the endpoint of
all-cause mortality but also considering the effects on neurological
outcome measures. Graphic abstract: [Figure not available: see
fulltext.] Copyright © 2020, Springer-Verlag GmbH Germany, part
of Springer Nature.

<115>
Accession Number
634884020
Title
The Effect of Coronary Angiography Timing on Cardiac Surgery Associated
Acute Kidney Injury Incidence and Prognosis.
Source
Frontiers in Medicine. 8 (no pagination), 2021. Article Number: 619210.
Date of Publication: 15 Apr 2021.
Author
Liu K.; Li M.; Li L.; Wu B.; Xu X.; Ge Y.; Mao H.; Xing C.
Institution
(Liu, Li, Li, Wu, Xu, Ge, Mao, Xing) Department of Nephrology, The First
Affiliated Hospital of Nanjing Medical University (Jiangsu Province
Hospital), Nanjing, China
Publisher
Frontiers Media S.A.
Abstract
Introduction: Acute kidney injury has been identified as a common
complication of cardiac surgery. To date, the effect of the time interval
from coronary angiography to cardiac surgery on postoperative acute kidney
injury is still controversial. The aim of this study was to investigate
the relationship between the timing of coronary angiography and cardiac
surgery associated acute kidney injury. Method(s): Eight hundred
thirteen patients who underwent coronary angiography and cardiac surgery
successively from January 2017 to December 2018 were included in this
retrospective cohort study. We applied multivariate logistic regression,
propensity score analysis, and subgroup analysis to evaluate the
association between the time interval and postoperative acute kidney
injury incidence and prognosis. Meta-analysis was conducted to verify the
results. Result(s): The overall incidence of the cardiac surgery
associated acute kidney injury was 28.8%. Age (OR = 1.046, 95%CI:
1.017-1.075), cardiopulmonary bypass (OR = 3.439, 95%CI: 1.316-8.986) and
diabetes (OR = 2.522, 95%CI: 1.439-4.417) were found to be independent
risk factors of postoperative acute kidney injury in multivariate logistic
regression and propensity score analysis. Undergoing cardiac surgery
within 7 days after coronary angiography was not associated with increased
incidence of postoperative acute kidney injury or worse prognosis.
Meta-analysis obtained consistent results. Conclusion(s): The time
interval shorter than 7 days had no influence on cardiac surgery
associated acute kidney injury incidence and prognosis. The decision of
delaying the surgery should be made after comprehensive evaluation of the
patient. © Copyright © 2021 Liu, Li, Li, Wu, Xu, Ge, Mao and
Xing.

<116>
Accession Number
2011867433
Title
Effects of dexmedetomidine on clinical outcomes and renal function after
CABG.
Source
Journal of Cellular and Molecular Anesthesia. 6 (1) (pp 31-38), 2021. Date
of Publication: December 2021.
Author
Rahab M.; Heydarpour E.; Totonchi Z.; Kachoueian N.; Davani S.Z.; Kiaei
M.M.; Mehrabanian M.J.; Panahi M.; Ahmadvand P.; Kharazani S.; Mortazian
M.
Institution
(Rahab, Ahmadvand) Hazrat-E-Rasoul Akram Hospital, Iran University of
Medical Science, Tehran, Iran, Islamic Republic of
(Heydarpour, Totonchi) Rajaie Cardiovascular, Medical and Research Center,
Tehran, Iran, Islamic Republic of
(Kachoueian) Department of Cardiovascular Surgery, School of Medicine,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Davani) Department of General Surgery, School of Medicine, Hazrat-e
Rasool General Hospital, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Kiaei) Department of Anesthesiology, School of Medicine, Hasheminejad
Kidney Center, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Mehrabanian) Department of Anesthesiology, School of Medicine, Tehran
Heart Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Panahi, Kharazani) Rajaie Cardiovascular, Medical and Research Center,
Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Mortazian) AJA University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Shahid Beheshti University of Medical Sciences, Anesthesiology Research
Center
Abstract
Background: This study was carried out to determine the effects of
dexmedetomidine on clinical outcomes and renal function after coronary
artery bypass grafting (CABG) to address the increased rate of CABG? and
the importance of modification in stress responses and control of adverse
effects on renal function and with the aim of cost reduction.
 Material(s) and Method(s): This double-blind randomized clinical
trial was carried out with the participation of 129 subjects under
elective CABG in Rajaei Heart Center, Tehran, Iran in 2017. Patients were
randomly assigned to four groups with simple randomization including one
placebo (normal saline infusion) group and three dexmedetomidine groups;
0.5 microg/kg/h on CPB, 0.5 microg/kg/h in 24 hours, and 0.75 microg/kg/h
in 24 hours. The blood pressure, blood urea nitrogen (BUN), serum
creatinine, transfused blood volume, urine volume, and hemofiltration on
pump and lactate were assessed at different time intervals.
 Result(s): Results showed more stability especially in central venous
pressure (CVP) (p=0.001) and systolic blood pressure (p=0.006) in the
groups receiving dexmedetomidine 0.75 microg/kg/h per 24 hours. But
diastolic blood pressure and heart rate were the same across the groups
(p>0.05). All other variables including hepatic and renal function tests
were the same across the groups (P>0.05). Conclusion(s): Overall,
according to the obtained results in the current study, it may be
concluded that dexmedetomidine would have some promising effects on
hemodynamic stability but there are no obvious renoprotective effects for
this medication. Copyright © 2021 Journal of Cellular and
Molecular Anesthesia. All rights reserved.

<117>
Accession Number
2011867432
Title
The effect of dexmedetomidine infusion vs. morphine on duration of
mechanical ventilation in CABG: A clinical trial.
Source
Journal of Cellular and Molecular Anesthesia. 6 (1) (pp 24-30), 2021. Date
of Publication: December 2021.
Author
Masoumi G.; Hemasian A.R.; Mansouri M.
Institution
(Masoumi, Hemasian, Mansouri) Department of Anesthesiology, Faculty of
Medicine, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
Publisher
Shahid Beheshti University of Medical Sciences, Anesthesiology Research
Center
Abstract
Background: No single and ideal method has been proposed so far to
decrease the time of mechanical ventilation while maintaining patients'
hemodynamic stability after coronary bypass surgery. This study aimed to
compare the effect of Dexmedetomidine and Morphine infusion on the latter
parameters in patients after coronary artery bypass graft surgery in the
intensive care unit. Material(s) and Method(s): In this clinical
trial study, 60 patients undergoing coronary artery bypass graft surgery
were divided into two groups (N=30): the first group receiving Morphine
and the second group receiving Dexmedetomidine. At admission to the ICU in
the first group, Morphine was injected at a dose of 0.25 mg/kg, and in the
second group, Dexmedetomidine was injected at a dose of 1 mug/kg for 10
minutes. Hemodynamic parameters and blood gas levels at preoperative
cardiac care were compared between the two groups at the time of
endotracheal tube withdrawal. Result(s): The trend of hemodynamic
changes and blood gas levels during the intensive care unit stay did not
differ between the two groups. The mean duration of mechanical ventilation
in the Morphine group was 10.63/2 2.31 hours and in the Dexmedetomidine
group was 9.77/1 1.92 hours, and there was no significant difference
between the two groups (p=0.12). Conclusion(s): both Morphine and
Dexmedetomidine had similar effects on hemodynamic stability and blood gas
levels; however, Dexmedetomidine was associated with fewer drug-related
side effects; so, it seems wise to consider Dexmedetomidine superior to
Morphine in the postoperative period of CABG patients. Copyright
© 2021 Journal of Cellular and Molecular Anesthesia. All rights
reserved.

<118>
Accession Number
2007099096
Title
Effects of switching from clopidogrel to prasugrel at the chronic phase
after coronary stenting on antiplatelet action and vascular endothelial
function: Switch-Pras study.
Source
Heart and Vessels. 36 (4) (pp 442-451), 2021. Date of Publication: April
2021.
Author
Masuyama T.; Sakuma M.; Waku R.; Hirose S.; Kitahara K.; Naganuma J.;
Yazawa H.; Toyoda S.; Abe S.; Nakajima T.; Inoue T.
Institution
(Masuyama, Sakuma, Waku, Hirose, Kitahara, Naganuma, Yazawa, Toyoda, Abe,
Nakajima, Inoue) Department of Cardiovascular Medicine, School of
Medicine, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi
321-0293, Japan
Publisher
Springer Japan
Abstract
Compared to clopidogrel, prasugrel has a lower incidence of ischemic
events following percutaneous coronary intervention (PCI) because of an
early reduction during the acute phase in P2Y12 reaction units (PRU). The
objective of this study was to compare the antiplatelet effect and
vascular endothelial function of both drugs during the chronic phase after
PCI. Patients who had undergone PCI and were confirmed to have no
restenosis by follow-up coronary angiography under dual anti-platelet
therapy with clopidogrel (75 mg/day) and aspirin (100 mg/day) were
randomized to either continue clopidogrel or switch to prasugrel (3.75
mg/day). At baseline, prior to randomization we determined the CYP2C19
genotype. At the baseline and 24 weeks after randomization, the P2Y12
reactivity unit (PRU) was measured using the VerifyNowTM P2Y12 assay.
Endothelial function was evaluated by flow-mediated vasodilation (FMD) and
reactive hyperemia peripheral arterial tonometry (RH-PAT), while and
circulating CD34+/CD133+/CD45low progenitor cells were measured
by flow cytometric analysis. Serum high-sensitivity C-reactive protein
(hsCRP) level was also measured. The PRU was reduced significantly in the
prasugrel group (P = 0.0008), especially in patients who were intermediate
or poor metabolizers based on the CYP2C19 genotype (P < 0.0001). This
reduction was not observed in the clopidogrel group. The number of
CD34+/CD133+/CD45low cells increased in the clopidogrel group
(P = 0.008), but not in the prasugrel group. The hsCRP, FMD and reactive
hyperemia index measured by RH-PAT did not change in either group.
Prasugrel is potentially better than clopidogrel for preventing thrombotic
events, although clopidogrel may have an advantage over prasugrel in terms
of preventing atherosclerotic events. Proper use of thienopyridine drugs
based on the CYP2C19 genotype has promising clinical
potential. Copyright © 2020, The Author(s).

<119>
Accession Number
2013051933
Title
Comparison of transradial versus transfemoral diagnostic coronary
angiography in terms of oxidative stress: Which option is more
physiological?.
Source
European Journal of Inflammation. 19 (no pagination), 2021. Date of
Publication: 2021.
Author
Oktay V.; Keskin B.; Serin E.; Oksen D.; Kaya A.; Ozkan A.A.
Institution
(Oktay, Keskin, Serin, Oksen, Ozkan) Department of Cardiology, Istanbul
University Cerrahpasa, Institute of Cardiology, Istanbul, Turkey
(Kaya) Deparment of Biochemistry, Istanbul University Cerrahpasa,
Institute of Cardiology, Istanbul, Turkey
Publisher
SAGE Publications Inc.
Abstract
In this randomized, single-center, clinical study we aimed to compare the
oxidative stress response in patients undergoing diagnostic transradial or
transfemoral elective coronary angiography. Sixty patients with stable
angina pectoris undergoing elective coronary angiography to either
transradial (n = 30) or transfemoral (n = 30) approach were included. The
levels of plasma total oxidative status (TOS) were measured and compared
just before and immediately after the procedure in both groups. The
clinical and laboratory findings were compatible between the two groups.
Although the levels of plasma total oxidative status after coronary
angiography were increased in both groups (TF pTOS 20. +/- :3; 34 +/- 3 vs
TR pTOS 18 +/- 2; 23 +/- 4), this was more pronounced in the transfemoral
group as compared with the transradial group (DELTApTOS: 11 +/- 4 vs 4 +/-
3, p < 0.001) In correlation analysis, TOS levels and white blood cell
counts (r = 0.25, p = 0.042), total cholesterol levels (r = 0.267, p =
0.041), triglyceride levels (r = 0.253, p = 0.049), serum creatinine
levels (r = 0.260, p = 0.043) were found to be moderately positively
correlated. This study showed that oxidative stress response associated
with heart catheterization is more evident in patients undergoing
transfemoral coronary angiography versus transradial coronary
angiography. Copyright © The Author(s) 2021.

<120>
Accession Number
2012317614
Title
Left ventricular function recovery after ST-elevation myocardial
infarction: correlates and outcomes.
Source
Clinical Research in Cardiology. 110 (9) (pp 1504-1515), 2021. Date of
Publication: September 2021.
Author
Dauw J.; Martens P.; Deferm S.; Bertrand P.; Nijst P.; Hermans L.; Van den
Bergh M.; Housen I.; Hijjit A.; Warnants M.; Cottens D.; Ferdinande B.;
Vrolix M.; Dens J.; Ameloot K.; Dupont M.; Mullens W.
Institution
(Dauw, Martens, Deferm, Bertrand, Nijst, Hermans, Van den Bergh, Housen,
Hijjit, Warnants, Cottens, Ferdinande, Vrolix, Dens, Ameloot, Dupont,
Mullens) Department of Cardiology, Ziekenhuis Oost-Limburg, Schiepse Bos
6, Genk 3600, Belgium
(Dauw, Deferm) Doctoral School for Medicine and Life Sciences, LCRC,
UHasselt, Diepenbeek, Belgium
(Mullens) Faculty of Medicine and Life Sciences, Biomedical Research
Institute, LCRC, UHasselt, Diepenbeek, Belgium
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Contemporary data on left ventricular function (LVF) recovery
in patients with left ventricular dysfunction after ST-elevation
myocardial infarction (STEMI) are scarce and to date, no comparison has
been made with patients with a baseline normal LVF. This study examined
predictors of LVF recovery and its relation to outcomes in STEMI.
 Method(s): Patients presenting with STEMI between January 2010 and
December 2016 were categorized in three groups after 3 months according to
left ventricular ejection fraction (EF): (i) baseline normal LVF (EF >=
50% at baseline); (ii) recovered LVF (EF < 50% at baseline and >= 50%
after 3 months); and (iii) reduced LVF (EF < 50% at baseline and after 3
months). Heart failure hospitalization, all-cause mortality and
cardiovascular mortality were compared between the three groups.
 Result(s): Of 577 patients, 341 (59%) patients had a baseline normal
LVF, 112 (19%) had a recovered LVF and 124 (22%) had a reduced LVF.
Independent correlates of LVF recovery were higher baseline EF, lower peak
troponin and cardiac arrest. After median 5.8 years, there was no
difference in outcomes between patients with LVF recovery and baseline
normal LVF. In contrast, even after multivariate adjustment, patients with
persistently reduced LVF had a higher risk for heart failure
hospitalization (HR 5.00; 95% CI 2.17-11.46) and all-cause mortality (HR
1.87; 95% CI 1.11-3.16). Conclusion(s): In contemporary treated STEMI
patients, prognosis is significantly worse in those with a persistently
reduced LVF after 3 months, compared with patients with a baseline normal
LVF and those with LVF recovery. Graphic abstract: [Figure not available:
see fulltext.]. Copyright © 2021, Springer-Verlag GmbH Germany,
part of Springer Nature.

<121>
[Use Link to view the full text]
Accession Number
634905135
Title
Transverse vs. parasagittal in-plane approaches in ultrasound-guided
paravertebral block using a microconvex probe: A randomised controlled
trial.
Source
European Journal of Anaesthesiology. 37 (9) (pp 752-757), 2020. Date of
Publication: September 2020.
Author
Fujii T.; Shibata Y.; Shinya S.; Nishiwaki K.
Institution
(Fujii, Nishiwaki) Department of Anaesthesiology, Nagoya University
Graduate School of Medicine, Nagoya, Japan
(Shibata) Department of Surgical Center, Nagoya University Hospital,
Nagoya, Japan
(Shinya) Department of Anaesthesiology, Nagoya University Hospital,
Nagoya, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND Several approaches have been proposed for ultrasound-guided
thoracic paravertebral block, but the best approach remains unclear.
OBJECTIVE We compared two ultrasound-guided in-plane approaches using a
microconvex probe, transverse and parasagittal. We assessed whether either
approach would facilitate successful catheter placement in the
paravertebral space. DESIGN Randomised controlled trial. SETTING
University hospital, July 2015 to March 2016. PATIENTS Sixty patients
scheduled to undergo thoracotomy were randomly allocated into two groups.
INTERVENTIONS A microconvex probe was placed transversely between adjacent
ribs (transverse) or sagittally between adjacent transverse processes
(parasagittal). When the Tuohy needle reached the paravertebral space, a
catheter was inserted to a depth of 4 cm. Then, 0.5-ml radiocontrast was
injected through the catheter under fluoroscopy. MAIN OUTCOME MEASURES The
primary outcome was successful catheter placement in the paravertebral
space; secondary outcomes were 0 to 100 mm visual analogue scale pain
score and morphine consumption in the first 24 h. RESULTS All patients
received the allocated paravertebral block. Correct catheter placement
occurred in 23 (77%) and 24 patients (80%) using the transverse (n=30) and
parasagittal approaches (n=30), respectively (P = 1.00). Five patients
were excluded due to changes in surgical procedure. Postoperative pain,
represented by median [IQR] visual analogue scale score, was 19.5 [12 to
25] at rest and 55 [44 to 77] on movement with the transverse approach
(n=28) vs. 22 [12 to 33.5] at rest and 59 [41.5 to 75] on movement with
the parasagittal approach (n=27) (P = 0.57 at rest, P = 0.76 on movement).
Median morphine consumption was 11.5 [5 to 21] and 11 [5 to 18] mg in the
transverse and parasagittal approaches, respectively (P = 0.99).
CONCLUSION There were no clinically significant differences between
approaches for continuous ultrasound-guided thoracic paravertebral block
using a microconvex probe, and both approaches achieved a high rate of
correct catheter placement. Copyright © 2020 European Society of
Anaesthesiology. All rights reserved.

<122>
Accession Number
2006148585
Title
Cardiac troponin levels after percutaneous atrial septal defect closure: A
qualitative systematic review and meta-analysis.
Source
Congenital Heart Disease. 15 (1) (pp 13-20), 2020. Date of Publication:
2020.
Author
Contreras A.E.; Peirone A.R.; Cuestas E.
Institution
(Contreras) Servicio de Cardiologia, Hospital Privado Universitario de
Cordoba, Cordoba X5016KEH, Argentina
(Peirone) Servicio de Hemodinamia y Cardiologia Intervencionista, Hospital
Privado Universitario de Cordoba, Cordoba X5016KEH, Argentina
(Cuestas) Servicio de Pediatria y Neonatologia, Hospital Privado
Universitario de Cordoba, Cordoba X5016KEH, Argentina
Publisher
Tech Science Press
Abstract
Introduction: We conducted a systematic review and meta-analysis of
published studies to determine the prevalence of troponin elevation after
percutaneous atrial septal defect closure (pASDc) as well as to describe
the association between troponin elevation and different anatomical risk
factors for erosion. Method(s): A qualitative systematic review and
meta-analysis was undertaken. The selected studies included patients of
any age receiving a pASDc; performed under transesophageal
echocardiography monitoring; reporting troponin level measurement after
the intervention; and indicating prevalence of troponin elevation and/or
the association with risk factors for erosion. Result(s): Six studies
were found which included 391 patients in total. The age of the patients
ranged from 1 to 80 years and were mainly female (between 59 and 81%). The
success rate of pASDc varied from 92-100%. The prevalence of myocardial
injury varied between 16% and 100%. In the meta-analysis cohort including
347 patients with available data, the fixed effect model showed a
prevalence of 41.8% CI (95%) 36.6% to 47.2%. Five studies found a
relationship between the size of the implanted device and the presence of
myocardial injury. The size of the defect, multiple defects within the
interatrial septum, deficient posterior rim, lack of use of sizing balloon
and longest duration of the procedure were also related to myocardial
injury. Conclusion(s): The usefulness of troponin levels measurements
after pASDc has been insufficiently studied. The routinely use in a
standardized protocol would be useful to determine which patients need a
closer follow-up. Copyright © 2020, Tech Science Press. All
rights reserved.

<123>
Accession Number
2013589163
Title
Endovascular treatment of the tricuspid valve: current status.
Source
Cirugia Cardiovascular. 28 (5) (pp 268-277), 2021. Date of Publication: 01
Sep 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. Copyright
© 2021 Sociedad Espanola de Cirugia Cardiovascular y Endovascular

<124>
Accession Number
2013443694
Title
Impact of COVID-19 pandemic in a pediatric and congenital cardiovascular
surgery program in Brazil.
Source
Brazilian Journal of Cardiovascular Surgery. 36 (3) (pp 289-294), 2021.
Date of Publication: 2021.
Author
Miana L.A.; Manuel V.; Caneo L.F.; Strabelli T.M.V.; Arita E.T.; Monteiro
R.; Jatene M.B.; Jatene F.B.
Institution
(Miana, Manuel, Caneo, Arita, Monteiro, Jatene, Jatene) Division of
Cardiovascular Surgery, Instituto do Coracao (InCor), Hospital das
Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Sao
Paulo, Brazil
(Strabelli) Infection Control Unit, Instituto do Coracao (InCor), Hospital
das Clinicas, Facul-dade de Medicina, Universidade de Sao Paulo, Sao
Paulo, Sao Paulo, Brazil
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: The coronavirus disease 2019 (COVID-19) has negatively
impacted healthcare services worldwide. We hypothesized that the pandemic
would affect our case mix and mortality. Our objective was to study this
impact. Method(s): We retrospectively studied all patients who
underwent congenital heart surgeries from March 21st to August
21st in 2019 and 2020 using the institutional electronic
database. We compared demographic data, preoperative and postoperative
length of stay (LOS), risk stratification using Risk Adjustment for
Congenital Heart Surgery (RACHS) classification and outcomes in both
periods. Result(s): We observed a 66.7% decrease in our surgical
volume (285 x 95 patients). Patients operated in the pre-pandemic period
were older (911.3 [174.8-5953.8] days-old) compared to the pandemic period
(275 days-old; P<0.05). When the case mix was compared between periods,
the percentage of neonatal surgery was increased in the pandemic era (8% x
21.1%; P<0.05), and the number of RACHS 1-2 surgeries decreased
significantly (60.7 x 27.4%; P<0.05). Preoperative LOS was increased in
the pandemic period (1.2 x 7 days; P=0.001). There was no significant
increment in mortality (P=0.1). Two patients tested positive for COVID-19
in the postoperative period and both died. Conclusion(s): Our program
observed a sudden decrease in surgical volume and a consequent increase in
surgical complexity. There was a non-significant increment in
mortality. Copyright © 2021, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<125>
Accession Number
2013142659
Title
Association of Pain With Atrial Fibrillation and Delirium After Cardiac
Surgery: A DECADE Sub-Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (10) (pp 3021-3026),
2021. Date of Publication: October 2021.
Author
Ince I.; Chiu A.; Sagir A.; Chahar P.; Lin J.; Douglas A.; Adi A.; Fang
J.; Mao G.; Turan A.
Institution
(Ince, Chiu, Chahar, Fang, Turan) Department of Outcomes Research,
Cleveland Clinic, Cleveland, OH, United States
(Ince) Anesthesiology Clinical Research Office, Ataturk University,
Erzurum, Turkey
(Sagir, Chahar, Turan) Department of General Anesthesia, Cleveland Clinic,
Cleveland, OH, United States
(Lin, Douglas, Adi) Department of Cardiovascular Anesthesiology, Cleveland
Clinic, Cleveland, OH, United States
(Mao) Department Quantitative Health Sciences, Cleveland Clinic,
Cleveland, OH, United States
Publisher
W.B. Saunders
Abstract
Objective: The authors aimed to evaluate the effects of postoperative pain
on the incidence of atrial fibrillation and delirium in patients having
surgery with cardiopulmonary bypass (CPB). Design(s): Post hoc
analysis of the (An investigator-initiated, multicentre, double-blind
trial (ClinicalTrials NCT02004613) (DECADE)), a randomized,
placebo-controlled trial. Setting(s): Tertiary, academic hospital.
 Participant(s): Six hundred five adults from the DECADE enrolled at
Cleveland Clinic Main Campus, who had had surgery with CPB.
 Intervention(s): Dexmedetomidine versus placebo started before
surgical incision and postoperatively was maintained until 24 hours.
Measurements: Primary outcomes were atrial fibrillation, diagnosed by
clinicians in the intensive care unit (ICU), presence of delirium assessed
with the Confusion Assessment Method for the ICU, data on pain scores, and
opioid consumption, occurring between ICU admission and the earlier of
postoperative day five or hospital discharge. Result(s):
Postoperative pain levels were similar among patients with or without
atrial fibrillation. Two hundred six (34%) patients had atrial
fibrillation and ninety-two (15%) had delirium before hospital discharge
within the first five postoperative days. The risk of atrial fibrillation
was not significantly different between groups (hazard ratio: 1.09; 97.5%
confidence interval [CI]: 0.99, 1.20, p = 0.039); there were no
associations between postoperative pain and the risk of postoperative
delirium (hazard ratio: 0.96; 97.5% CI: 0.84-1.11; p = 0.57).
Postoperative opioid consumption was neither significantly associated with
postoperative atrial fibrillation nor delirium. Conclusion(s): Atrial
fibrillation and delirium was not associated with pain after cardiac
surgery. Opioid use was not associated with atrial fibrillation and
delirium. Because both atrial fibrillation and delirium have a
multifactorial nature, further studies should be focused on other
plausible mechanisms. Copyright © 2021

<126>
Accession Number
2011890104
Title
Selected 2020 Highlights in Congenital Cardiac Anesthesia.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (10) (pp 2848-2854),
2021. Date of Publication: October 2021.
Author
Welch T.P.; Trivedi P.M.; Fang Z.A.; Ing R.J.; Mittnacht A.J.C.; Mossad
E.B.
Institution
(Welch, Trivedi, Mossad) Division of Pediatric Cardiovascular Anesthesia,
Baylor College of Medicine, Texas Children's Hospital, Houston, TX, United
States
(Fang) Department of Anesthesia and Pain Medicine, Hospital for Sick
Children Toronto, ON, Canada
(Ing) Department of Anesthesiology, Children's Hospital Colorado,
University of Colorado School of Medicine, Aurora, CO, United States
(Mittnacht) Department of Anesthesiology, Westchester Medical Center, New
York Medical College, Valhalla, NY, United States
Publisher
W.B. Saunders
Abstract
This article is a review of the highlights of pertinent literature
published during the 12 months of 2020 that are of interest to the
congenital cardiac anesthesiologist. After a search of the US National
Library of Medicine's PubMed database, several topics emerged for which
significant contributions were made in 2020. The authors of the present
article considered the following topics noteworthy to be included in this
review: pediatric cardiac care in the coronavirus disease 2019 era, the
use of mechanical circulatory support in coronavirus disease 2019-related
multisystem inflammatory syndrome in children, transfusion and coagulation
management in children undergoing congenital heart surgery, and pulmonary
vein stenosis. Copyright © 2021 Elsevier Inc.

<127>
Accession Number
2011577522
Title
High Versus Normal Blood Pressure Targets in Relation to Right Ventricular
Dysfunction After Cardiac Surgery: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (10) (pp 2980-2990),
2021. Date of Publication: October 2021.
Author
Bootsma I.T.; de Lange F.; Scheeren T.W.L.; Jainandunsing J.S.; Boerma
E.C.
Institution
(Bootsma, de Lange, Boerma) Department of Intensive Care, Medical Center
Leeuwarden, Leeuwarden, Netherlands
(Scheeren, Jainandunsing) Department of Anesthesiology, University of
Groningen, University Medical Center Groningen, Groningen, Netherlands
Publisher
W.B. Saunders
Abstract
Objective: Management of right ventricular (RV) dysfunction is
challenging. Current practice predominantly is based on data from
experimental and small uncontrolled studies and includes augmentation of
blood pressure. However, whether such intervention is effective in the
clinical setting of cardiac surgery is unknown. Design(s): Randomized
controlled trial. Setting(s): Single-center study in a tertiary
teaching hospital. Participant(s): The study comprised 78 patients
equipped with a pulmonary artery catheter (PAC), classified according to
PAC-derived RV ejection fraction (RVEF); 44 patients had an RVEF of <20%,
and 34 patients had an RVEF between >=20% and <30%. Intervention(s):
Patients randomly were assigned to either a normal target group (mean
arterial pressure 65 mmHg) or a high target group [mean arterial pressure
85 mmHg]). The primary end- point was the change in RVEF over a one-hour
study period. Measurements and Main Results: There was no significant
between-group difference in change of RVEF <20% (-1% [-3.3 to 1.8] in the
normal-target group v 0.5% [-1 to 4] in the high-target group; p = 0.159).
There was no significant between-group difference in change in RVEF
20%-to-30% (-1% [-3 to 0] in the normal-target group v 1% [-1 to 3] in the
high-target group; p = 0.074). These results were in line with the
simultaneous observation that echocardiographic variables of RV and left
ventricular function also remained unaltered over time, irrespective of
either baseline RVEF or treatment protocol. Conclusion(s): In a mixed
cardiac surgery population with RV dysfunction, norepinephrine-mediated
high blood pressure targets did not result in an increase in PAC-derived
RVEF compared with normal blood pressure targets. Copyright ©
2021 The Authors

<128>
Accession Number
2011132227
Title
Deep Hypothermic Circulatory Arrest in the Pediatric Population Undergoing
Cardiac Surgery With Electroencephalography Monitoring: A Systematic
Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (10) (pp 2875-2888),
2021. Date of Publication: October 2021.
Author
Alkhatip A.A.A.M.M.; Kamel M.G.; Farag E.M.; Elayashy M.; Farag A.; Yassin
H.M.; Bahr M.H.; Abdelhaq M.; Sallam A.; Kamal A.M.; Emady M.F.E.; Wagih
M.; Naguib A.A.; Helmy M.; Algameel H.Z.; Abdelkader M.; Mohamed H.;
Younis M.; Purcell A.; Elramely M.; Hamza M.K.
Institution
(Alkhatip) Department of Anaesthesia, Birmingham Children's Hospital,
Birmingham, United Kingdom
(Alkhatip, Farag, Bahr, Abdelkader) Department of Anaesthesia, Beni-Suef
University Hospital and Faculty of Medicine, Beni-Suef University,
Beni-Suef, Egypt
(Kamel) Faculty of Medicine, Minia University, Minia, Egypt
(Elayashy, Abdelhaq, Kamal, Emady, Wagih, Naguib, Helmy, Mohamed, Hamza)
Department of Anaesthesia, Faculty of Medicine, Cairo University, Cairo,
Egypt
(Farag) Department of Anesthesia, King Abdullah Medical City - Holy
Capital, Makkah, Saudi Arabia
(Yassin) Department of Anesthesia, Faculty of Medicine, Fayoum University,
Fayoum, Egypt
(Sallam, Purcell) Department of Anaesthesia, Beaumont Hospital, Dublin,
Ireland
(Sallam) Department of Anaesthesia, Faculty of Medicine, Ain-Shams
University, Cairo, Egypt
(Algameel) Department of Anaesthesia, Aberdeen Royal Infirmary Hospital,
Aberdeen, UK, United Kingdom
(Mohamed) Department of Anaesthesia, Royal Papworth Hospital, Cambridge,
UK, United Kingdom
(Younis) Department of Anaesthesia, Cambridge University Hospital,
Cambridge, UK, United Kingdom
(Elramely) Department of Anaesthesia, National Cancer Institute, Cairo
University, Cairo, Egypt
Publisher
W.B. Saunders
Abstract
Objective: Cardiac surgery for repair of congenital heart defects poses
unique hazards to the developing brain. Deep hypothermic circulatory
arrest (DHCA) is a simple and effective method for facilitating a
bloodless surgical field during congenital heart defect repair. There are,
however, some concerns that prolonged DHCA increases the risk of nervous
system injury. The electroencephalogram (EEG) is used in adult and, to a
lesser extent, pediatric cardiac procedures as a neuromonitoring method.
The present study was performed to assess outcomes following DHCA with EEG
monitoring in the pediatric population. Design(s): In this systematic
review and meta-analysis, the PubMed, Cochrane Central Register of
Controlled Trials, Scopus, Institute of Science Index, and Embase
databases were searched from inception for relevant articles. A fixed- or
random-effects model, as appropriate, was used. Setting(s): Surgical
setting. Participant(s): Pediatric population (<=18 y old).
 Intervention(s): DHCA (18degreeC) with EEG monitoring.
 Measurements and Main Results: Nineteen articles with 1,267 pediatric
patients <=18 years were included. The event rate of clinical and EEG
seizures among patients who underwent DHCA was 12.9% and 14.9%,
respectively. Mortality was found to have a 6.3% prevalence. A longer
duration of DHCA was associated with a higher risk of EEG seizure and
neurologic abnormalities. In addition, seizures were associated with
increased neurologic abnormalities and neurodevelopmental delay.
 Conclusion(s): EEG and neurologic abnormalities were common after
DHCA. A longer duration of DHCA was found to lead to more EEG seizure and
neurologic abnormalities. Moreover, EEG seizures were more common than
clinical seizures. Seizures were found to be associated with increased
neurologic abnormalities and neurodevelopmental delay. Copyright
© 2021 Elsevier Inc.

<129>
Accession Number
2010459950
Title
Comparison of CryoMaze With Cut-and-Sew Maze Concomitant With Mitral Valve
Surgery: A Randomized Noninferiority Trial.
Source
Seminars in Thoracic and Cardiovascular Surgery. 33 (3) (pp 680-688),
2021. Date of Publication: Autumn 2021.
Author
Han J.; Wang H.; Wang Z.; Yin Z.; Zhang J.; Jin Y.; Han H.
Institution
(Han, Wang, Wang, Yin, Zhang, Jin, Han) Department of Cardiovascular
Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning
Province, China
Publisher
W.B. Saunders
Abstract
In this trial, we sought to evaluate the efficacy and safety of the
addition of the Maze performed by cryoablation (CryoMaze) to the mitral
valve surgeries. The trial is a randomized, single-center trial to
determine whether CryoMaze was noninferior to cut-and-sew maze procedure
(CSM) in patients with persistent or long-standing persistent atrial
fibrillation (AF), with a 15% margin to establish noninferiority. The
primary endpoint was freedom from AF off antiarrhythmic drugs (AADs) at 12
months. Secondary endpoints included freedom from AF off AADs at 3 and 6
months, and a composite of serious adverse events. Two hundred patients
were randomized to either CryoMaze (n = 100) or CSM (n = 100). Freedom
from AF was achieved in 85 % (95% confidence interval, 0.76-0.91) in the
CryoMaze group and 88% (95% confidence interval, 0.80-0.94) in the CSM
group, showing that CryoMaze was noninferior to CSM at 12 months (P value
for noninferiority = 0.0065). There was no significant difference in
serious adverse effects (n = 12 in CryoMaze; n = 17 in CSM; P = 0.315).
Perioperative bleeding and the length of surgery, ICU stay, postoperative
hospital stay; and the need for temporary pacing decreased significantly
in the CryoMaze group. CryoMaze was noninferior to CSM for efficacy and
safety for patients with persistent or long-standing persistent AF
undergoing mitral valve surgeries. CryoMaze significantly decreased
bleeding, the length of surgery, ICU and hospital stay, as well the need
for temporary pacing. (Chinese Clinical Trial Register number,
ChiCTR-IOR-16008112.) Copyright © 2020 Elsevier Inc.

<130>
Accession Number
2013597952
Title
The coronary arteries in adults after the arterial switch operation: A
systematic review.
Source
Journal of Cardiovascular Development and Disease. 8 (9) (no pagination),
2021. Article Number: 102. Date of Publication: September 2021.
Author
Engele L.J.; Mulder B.J.M.; Schoones J.W.; Kies P.; Egorova A.D.; Vliegen
H.W.; Hazekamp M.G.; Bouma B.J.; Jongbloed M.R.M.
Institution
(Engele, Mulder, Bouma) Center for Congenital Heart Disease
Amsterdam-Leiden (CAHAL), Department of Clinical and Experimental
Cardiology, Amsterdam Cardiovascular Sciences, Heart Centre, Amsterdam
UMC, University of Amsterdam, Amsterdam 1105 AZ, Netherlands
(Engele, Mulder, Bouma) Netherlands Heart Institute, Utrecht 3511 EP,
Netherlands
(Schoones) Directorate of Research Policy, Leiden University Medical
Center, Leiden 2333 ZA, Netherlands
(Kies, Egorova, Vliegen, Jongbloed) Center for Congenital Heart Disease
Amsterdam-Leiden (CAHAL), Department of Cardiology, Leiden University
Medical Center, Leiden 2333 ZA, Netherlands
(Hazekamp) Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL),
Department of Cardiothoracic Surgery, Leiden University Medical Center,
Leiden 2333 ZA, Netherlands
(Jongbloed) Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL),
Department of Anatomy and Embryology, Leiden University Medical Center,
Leiden 2333 ZA, Netherlands
Publisher
MDPI
Abstract
Coronary artery status in adults long after the arterial switch operation
(ASO) is unclear. We conducted a systematic review to provide an overview
of coronary complications during adulthood and to evaluate the value of
routine coronary imaging in adults after ASO, in light of current
guidelines. Articles were screened for the inclusion of adult ASO patients
and data on coronary complications and findings of coronary imaging were
collected. A total of 993 adults were followed with a median available
follow-up of only 2.0 years after reaching adulthood. Myocardial ischemia
was suspected in 17/192 patients (8.9%). The number of coronary
interventions was four (0.4%), and coronary death was reported in four
(0.4%) patients. A lack of ischemia-related symptoms cannot be excluded
because innervation studies indicated deficient cardiac innervation after
ASO, although data is limited. Anatomical high-risk features found by
routine coronary computed tomography (cCT) included stenosis (4%), acute
angle (40%), kinking (24%) and inter-arterial course (11%). No coronary
complications were reported during pregnancy (n = 45), although,
remarkably, four (9%) patients developed heart failure. The 2020 European
Society of Cardiology (ESC) guidelines state that routine screening for
coronary pathologies is questionable. Based on current findings and in
line with the 2018 American ACC/AHA guidelines a baseline assessment of
the coronary arteries in all ASO adults seems justifiable. Thereafter, an
individualized coronary follow-up strategy is advisable at least until
significant duration of follow-up is available. Copyright © 2021
by the authors. Licensee MDPI, Basel, Switzerland.

<131>
Accession Number
2014376295
Title
Synchronous or staged carotid endarterectomy and coronary artery bypass
grafting? Propensity score matched study.
Source
Heart Surgery Forum. 21 (5) (pp E359-E364), 2018. Date of Publication: 06
Nov 2018.
Author
Hempe S.; Moza A.; Goetzenich A.; Tewarie L.; Bleilevens C.; Autschbach
R.; Schnoering H.; Zayat R.
Institution
(Hempe, Moza, Goetzenich, Tewarie, Autschbach, Schnoering, Zayat)
Department of Thoracic and Cardiovascular Surgery, University Hospital
RWTH Aachen, Pauwelsstrasse 30, Aachen 52074, Germany
(Bleilevens) Department of Anesthesiology, University Hospital RWTH
Aachen, Pauwelsstrasse 30, Aachen 52074, Germany
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: The optimal treatment strategy in patients presenting with
hemodynamically significant carotid artery disease who are to undergo
cardiac surgery, remains controversial. In this study, we retrospectively
analyzed the outcome data of patients receiving synchronous or staged
coronary artery bypass graft (CABG) surgery and carotid endarterectomy
(CEA). Method(s): Between 2011 and 2016, 3173 patients underwent CABG
surgery in our institution, of whom 323 received CABG and CEA either as
synchronous (N = 307) or as staged (N = 16) procedures. Patients'
characteristics, peri- and postoperative data were collected from our
digital medical database. Propensity score matching was used to match each
patient from the staged group to two appropriate patients (1:2 matching)
from the synchronous group (synchronousmatched). Result(s): The
overall incidence of ischemic stroke (IS) and transitory ischemic attack
(TIA) was 4.9% and 5.6%, respectively. No hemorrhagic stroke was noted in
both groups. Incidence of IS did not differ significantly between matched
groups (P = 1.000). Significantly higher rates of postoperative
neurological complications, such as TIA and delirium, were found in the
synchronousmatched group (P = .041 and P = .043, respectively) compared
with the staged group. Additionally, there were more postoperative
respiratory insufficiencies in the synchronousmatched group (P = .043).
Thirty days mortality did not differ significantly between the matched
groups. Conclusion(s): In this experience combined with the data
given in literature, our findings suggest a possible superiority of the
staged CABG/CEA approach. Large, randomized studies are required to verify
our findings and to establish applicable guidelines. Copyright ©
2018 Forum Multimedia Publishing, LLC.

<132>
Accession Number
2014376280
Title
A novel risk score to predict new onset atrial fibrillation in patients
undergoing isolated coronary artery bypass grafting.
Source
Heart Surgery Forum. 21 (6) (pp E489-E496), 2018. Date of Publication: 06
Nov 2018.
Author
Lin S.Z.; Crawford T.C.; Suarez-Pierre A.; Magruder J.T.; Carter M.V.;
Cameron D.E.; Whitman G.J.; Lawton J.; Baumgartner W.A.; Mandal K.
Institution
(Lin, Crawford, Suarez-Pierre, Magruder, Carter, Cameron, Whitman, Lawton,
Baumgartner, Mandal) Division of Cardiac Surgery, Johns Hopkins
University, School of Medicine, Baltimore, MD, United States
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Atrial fibrillation (AF) is common after cardiac surgery and
contributes to increased morbidity and mortality. Our objective was to
derive and validate a predictive model for AF after CABG in patients,
incorporating novel echocardiographic and laboratory values.
 Method(s): We retrospectively reviewed patients at our institution
without preexisting dysrhythmia who underwent on-pump, isolated CABG from
2011-2015. The primary outcome was new onset AF lasting >1 hour on
continuous telemetry or requiring medical treatment. Patients with a
preoperative echocardiographic measurement of left atrial diameter were
included in a risk model, and were randomly divided into derivation (80%)
and validation (20%) cohorts. The predictors of AF after CABG (PAFAC)
score was derived from a multivariable logistic regression model by
multiplying the adjusted odds ratios of significant risk factors (P < .05)
by a factor of 4 to derive an integer point system. Result(s): 1307
patients underwent isolated CABG, including 762/1307 patients with a
preoperative left atrial diameter measurement. 209/762 patients (27%)
developed new onset AF including 165/611 (27%) in the derivation cohort.
We identified four risk factors independently associated with
postoperative AF which comprised the PAFAC score: age > 60 years (5
points), White race (5 points), baseline GFR < 90 mL/min (4 points) and
left atrial diameter > 4.5 cm (4 points). Scores ranged from 0-18. The
PAFAC score was then applied to the validation cohort and predicted
incidence of AF strongly correlated with observed incidence (r = 0.92).
 Conclusion(s): The PAFAC score is easy to calculate and can be used
upon ICU admission to reliably identify patients at high risk of
developing AF after isolated CABG. Copyright © 2018 Forum
Multimedia Publishing, LLC.

<133>
Accession Number
2013613076
Title
A Systematic Review of Multiple Linear Regression-Based Limited Sampling
Strategies for Mycophenolic Acid Area Under the Concentration-Time Curve
Estimation.
Source
European Journal of Drug Metabolism and Pharmacokinetics. (no pagination),
2021. Date of Publication: 2021.
Author
Sobiak J.; Resztak M.
Institution
(Sobiak, Resztak) Department of Physical Pharmacy and Pharmacokinetics,
Poznan University of Medical Sciences, 6 Swiecickiego Street, Poznan
60-781, Poland
Publisher
Adis
Abstract
Background and Objective: One approach of therapeutic drug monitoring in
the case of mycophenolic acid (MPA) is a limited sampling strategy (LSS),
which allows the evaluation of the area under the concentration-time curve
(AUC) based on few concentrations. The aim of this systematic review was
to review the MPA LSSs and define the most frequent time points for MPA
determination in patients with different indications for mycophenolate
mofetil (MMF) administration. Method(s): The literature was
comprehensively searched in July 2021 using PubMed, Scopus, and Medline
databases. Original articles determining multiple linear regression
(MLR)-based LSSs for MPA and its free form (fMPA) were included. Studies
on enteric-coated mycophenolic sodium, previously established LSS,
Bayesian estimator, and different than twice a day dosing were excluded.
Data were analyzed separately for (1) adult renal transplant recipients,
(2) adults with other than renal transplantation indication, and (3) for
pediatric patients. Result(s): A total of 27, 17, and 11 studies were
found for groups 1, 2, and 3, respectively, and 126 MLR-based LSS formulae
(n = 120 for MPA, n = 6 for fMPA) were included in the review. Three
time-point equations were the most frequent. Four MPA LSSs: 2.8401 +
5.7435 x C0 + 0.2655 x C0.5 + 1.1546 x C1 + 2.8971 x C4 for adult renal
transplant recipients, 1.783 + 1.248 x C1 + 0.888 x C2 + 8.027 x C4 for
adults after islet transplantation, 0.10 + 11.15 x C0 + 0.42 x C1 + 2.80 x
C2 for adults after heart transplantation, and 8.217 + 3.163 x C0 + 0.994
x C1 + 1.334 x C2 + 4.183 x C4 for pediatric renal transplant recipients,
plus one fMPA LSS, 34.2 + 1.12 x C1 + 1.29 x C2 + 2.28 x C4 + 3.95 x C6
for adult liver transplant recipients, seemed to be the most promising and
should be validated in independent patient groups before introduction into
clinical practice. The LSSs for pediatric patients were few and not fully
characterized. There were only a few fMPA LSSs although fMPA is a
pharmacologically active form of the drug. Conclusion(s): The review
includes updated MPA LSSs, e.g., for different MPA formulations
(suspension, dispersible tablets), generic form, and intravenous
administration for adult and pediatric patients, and emphasizes the need
of individual therapeutic approaches according to MMF indication. Five
MLR-based MPA LSSs might be implemented into clinical practice after
evaluation in independent groups of patients. Further studies are
required, e.g., to establish fMPA LSS in pediatric patients. Copyright
© 2021, The Author(s).

<134>
Accession Number
2013604510
Title
Effect of music therapy on infants who underwent mechanical ventilation
after cardiac surgery.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Huang Y.-L.; Lei Y.-Q.; Xie W.-P.; Cao H.; Yu X.-R.; Chen Q.
Institution
(Huang, Lei, Xie, Cao, Yu, Chen) Department of Cardiac Surgery, Fujian
Branch of Shanghai Children's Medical Center, Fuzhou, China
(Huang, Lei, Xie, Cao, Yu, Chen) Fujian Children's Hospital, Fuzhou, China
(Huang, Lei, Xie, Cao, Yu, Chen) Fujian Maternity and Child Health
Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
(Huang, Lei, Xie, Cao, Yu, Chen) Fujian Key Laboratory of Women and
Children's Critical Diseases Research, Fujian Maternity and Child Health
Hospital, Fuzhou, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: To investigate the effect of music therapy on infants who
underwent mechanical ventilation after cardiac surgery. Method(s): A
prospective randomized controlled study was conducted in a provincial
hospital in southeast China. The subjects were randomly divided into the
music therapy (MT) group and the control group. Both groups were given
standardized sedation treatment and routine nursing. Infants in the MT
group received 60 min of MT three times a day. The sedation medication,
Richmond sedation agitation scale (RASS) score, incidence of delirium,
mechanical ventilation duration, length of cardiac intensive care unit
(CICU) stay, restraint belt use time, and successful ventilation
withdrawal rate were collected. Result(s): Infants in the control
group had a higher total amount of on-demand midazolam (p =.039). Infants
in the MT group had a significantly lower incidence of delirium, shorter
mechanical ventilation duration, and restraint band use time (p =.047, p
=.046, and p =.038, respectively). Although infants in the MT group had a
higher success rate of ventilation withdrawal, lower RASS scores, and
shorter ICU stay, the difference was not statistically significant (p
=.427, p =.585, and p =.068, respectively). Conclusion(s): MT in the
ICU can reduce the use of on-demand sedative drugs, shorten mechanical
ventilation, and reduce the occurrence of delirium in infants who
underwent mechanical ventilation after cardiac surgery. MT is a safe and
reliable treatment and worthy of clinical application. Copyright
© 2021 Wiley Periodicals LLC

<135>
Accession Number
635885650
Title
A Systematic Review and Pooled Prevalence of Delirium in Critically Ill
Children.
Source
Critical care medicine. (no pagination), 2021. Date of Publication: 14 Aug
2021.
Author
Semple D.; Howlett M.M.; Strawbridge J.D.; Breatnach C.V.; Hayden J.C.
Institution
(Semple) Pharmacy Department, Children's Health Ireland, Crumlin, Dublin,
Ireland. School of Pharmacy and Biomolecular Sciences, Royal College of
Surgeons in Ireland, Dublin, Ireland. Department of Intensive Care, School
of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in
Ireland, Dublin, Ireland
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Pediatric delirium is a neuropsychiatric disorder with
disrupted cerebral functioning due to underlying disease and/or critical
care treatment. Pediatric delirium can be classified as hypoactive,
hyperactive, and mixed. This systematic review was conducted to estimate
the pooled prevalence of pediatric delirium using validated assessment
tools in children (Cornell Assessment of Pediatric Delirium, Pediatric
Confusion Assessment Method for the ICU, PreSchool Confusion Assessment
Method for the ICU, Pediatric Confusion Assessment Method for the ICU
Severity Scale, and Sophia Observation Withdrawal Symptoms Pediatric
Delirium scale), identify modifiable and nonmodifiable risk factors, and
explore the association of pediatric delirium with clinical outcomes. DATA
SOURCES: A systematic search of PubMed, EMBASE, and CINAHL databases was
undertaken for full articles pertaining to pediatric delirium prevalence.
STUDY SELECTION: No language or date barriers were set. Studies were
included where the following eligibility criteria were met: study design
aimed to estimate pediatric delirium prevalence arising from treatment in
the intensive care setting, using a validated tool. Only randomized
controlled trials, cross-sectional studies, or cohort studies allowing an
estimate of the prevalence of pediatric delirium were included. DATA
EXTRACTION: Data were extracted by the primary researcher (D.S.) and
accuracy checked by coauthors. DATA SYNTHESIS: A narrative synthesis and
pooled prevalence meta-analysis were undertaken. CONCLUSION(S):
Pediatric delirium, as determined by the Cornell Assessment of Pediatric
Delirium score, is estimated to occur in 34% of critical care admissions.
Eight of 11 studies reporting on subtype identified hypoactive delirium as
most prevalent (46-81%) with each of the three remaining reporting either
hyperactive (44%), mixed (57%), or equal percentages of hypoactive and
mixed delirium (43%) as most prevalent. The development of pediatric
delirium is associated with cumulative doses of benzodiazepines, opioids,
the number of sedative classes used, deep sedation, and cardiothoracic
surgery. Increased time mechanically ventilated, length of stay,
mortality, healthcare costs, and associations with decreased quality of
life after discharge were also found. Multi-institutional and longitudinal
studies are required to better determine the natural history, true
prevalence, long-term outcomes, management strategies, and financial
implications of pediatric delirium. Copyright © by 2021 by the
Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All
Rights Reserved.

<136>
Accession Number
635884043
Title
Comparison of haemodynamic response to tracheal intubation with two
different videolaryngoscopes: A randomized clinical trial.
Source
Brazilian journal of anesthesiology (Elsevier). (no pagination), 2021.
Date of Publication: 09 Aug 2021.
Author
Cardakozu T.; Arslan Z.I.; Cesur S.; Aksu B.
Institution
(Cardakozu) Kocaeli University of Medical Faculty, Department of
Anesthesiology and Reanimation, Izmit, Turkey
(Arslan, Cesur) Kocaeli University of Medical Faculty, Department of
Anesthesiology and Reanimation, Izmit, Turkey
(Aksu) Kocaeli University of Kandira Vocational School, Izmit, Turkey
Publisher
NLM (Medline)
Abstract
BACKGROUND: Endotracheal intubation (ETI), which is the gold standard in
coronary artery bypass grafting (CABG), may cause myocardial ischaemia by
disturbing the balance between haemodynamic changes and oxygen supply and
consumption of the myocardium as a result of sympathetic stimulation. In
this study, we aimed to compare two different videolaryngoscopes (C-MAC
and Airtraq) in the hemodynamic response to ETI. METHOD(S): Fifty ASA
II-III CABG surgery patients were randomly assigned to C-MAC or Airtraq.
The hemodynamic data included arterial blood pressure [systolic (SAP),
diastolic (DAP) and mean (MAP)] and heart rate (HR) and were recorded at
six different points in time: before laryngoscopy-T1, during
laryngoscopy-T2, immediately after intubation-T3, and 3 (T4), 5 (T5) and
10 (T6) minutes after intubation. Intraoperative complications were
recorded. Patients were questioned about postoperative complications 2 and
24hours following extubation. RESULT(S): The hemodynamic response to
ETI was significantly greater with C-MAC. The increase in HR started with
the laryngoscopy procedure, whereas increases in SAP, DAP, and MAP started
immediately after ETI (p=0.024; p=0.012; p=0.030; p=0.009, respectively).
In group analyses, T1-T2, T2-T3 and T1-T3 comparisons did not show any
significant differences in HR with Airtraq. However, with C-MAC, HR after
intubation increased significantly compared to the pre-laryngoscopy values
(T1-T3) (p=0.004). The duration of laryngoscopy was significantly reduced
with C-MAC (p<0.001), but the duration of intubation and total intubation
were similar (p=0.36; p=0.79). CONCLUSION(S): Compared to C-MAC, the
hemodynamic response to ETI was less with Airtraq. Thus, Airtraq may be
preferred in CABG patients for ETI. Copyright © 2021. Published
by Elsevier Editora Ltda.

<137>
Accession Number
635877485
Title
Does Age Affect the Short- And Long-Term Outcomes of Coronary Bypass
Grafting?.
Source
International Journal of Angiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Anand P.A.; Keshavamurthy S.; Shelley E.M.; Saha S.
Institution
(Anand, Keshavamurthy, Shelley, Saha) Division of Cardiothoracic Surgery,
Department of Surgery, University of Kentucky, College of Medicine, 740 S.
Limestone, Ste.A301, Lexington, KY 40536, United States
Publisher
Thieme Medical Publishers, Inc.
Abstract
The etiology of coronary artery disease (CAD) is multifactorial, stemming
from both modifiable and nonmodifiable risk factors such as age. Several
studies have reported the effects of age on various outcomes of coronary
artery bypass grafting (CABG). This article reviews age-related outcomes
of CABG and offers direction for further studies in the field to create
comprehensive, evidence-based guidelines for the treatment of CAD.
Ninety-two primary sources were analyzed for relevance to the subject
matter, of which 17 were selected for further analysis: 14 retrospective
cohort studies, 2 randomized clinical trials, and 1 meta-analysis. Our
review revealed four broad age ranges into which patients can be grouped:
those with CAD (1) below the age of 40 years, (2) between the ages of 40
and 60 years, (3) between the ages of 60 and 80 years, and (4) at or above
80 years. Patients below the age of 40 years fare best overall with total
arterial revascularization (TAR). Patients between the ages of 40 and 60
years also fare well with the use of multiarterial grafts (MAGs) whereas
either MAGs or single-arterial grafts may be of significant benefit to
patients at or above the age of 60 years, with younger and diabetic
patients benefitting the most. Arterial grafting is superior to vein
grafting until the age of 80 years, at which point there is promising
evidence supporting the continued use of the saphenous vein as the favored
graft substrate. Age is a factor affecting the outcomes of CABG but should
not serve as a barrier to offering patients CABG at any age from either a
cost or a health perspective. Operative intervention starts to show
significant mortality consequences at the age of 80 years, but the
increased risk is countered by maintenance or improvement to patients'
quality of life. Copyright © 2021. International College of
Angiology. All rights reserved.

<138>
Accession Number
635874245
Title
The association between mean arterial pressure and outcomes in patients
with cardiogenic shock: insights from the DOREMI trial.
Source
European heart journal. Acute cardiovascular care. (no pagination), 2021.
Date of Publication: 12 Aug 2021.
Author
Parlow S.; Di Santo P.; Mathew R.; Jung R.G.; Simard T.; Gillmore T.; Mao
B.; Abdel-Razek O.; Ramirez F.D.; Marbach J.A.; Dick A.; Glover C.; Russo
J.J.; Froeschl M.; Labinaz M.; Fernando S.M.; Hibbert B.
Institution
(Parlow, Di Santo, Mathew, Jung, Simard, Abdel-Razek, Ramirez, Marbach,
Dick, Glover, Russo, Froeschl, Labinaz, Fernando, Hibbert) CAPITAL
Research Group, University of Ottawa Heart Institute, 40 Ruskin Street,
Ottawa, ON K1Y 4W7, Canada
(Parlow, Di Santo, Mathew, Abdel-Razek, Ramirez, Dick, Glover, Russo,
Froeschl, Labinaz, Hibbert) Division of Cardiology, University of Ottawa
Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada
(Di Santo) School of Epidemiology and Public Health, Faculty of Medicine,
University of Ottawa, 600 Peter Morand Crescent ,Room 101, Ottawa, ON K1G
5Z3, Canada
(Jung, Gillmore, Mao) Faculty of Medicine, University of Ottawa, Roger
Guindon Hall, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada
(Jung, Simard, Hibbert) Department of Cellular and Molecular Medicine,
Faculty of Medicine, University of Ottawa, Room #3206, 451 Smyth Road,
Ottawa, ON K1H 8M5, Canada
(Simard) Department of Cardiovascular Diseases, Mayo Clinic School of
Medicine, 200 First St. SW, Rochester, MN 55905, United States
(Marbach) Division of Pulmonary, Critical Care, Sleep Medicine, Tufts
Medical Center ,800 Washington Street, Boston, MA 02111, United States
(Fernando) Division of Critical Care, Department of Medicine, University
of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada
Publisher
NLM (Medline)
Abstract
AIMS: Cardiogenic shock (CS) is a state of low cardiac output resulting in
end-organ hypoperfusion. Despite high in-hospital mortality rates, little
evidence exists regarding the optimal mean arterial pressure (MAP) target
in CS. We therefore evaluated the relationship between achieved MAP and
clinical outcomes in patients with CS. METHODS AND RESULTS: We performed a
post hoc analysis of the CAPITAL DOREMI trial: a randomized, double-blind
trial comparing dobutamine to milrinone in patients with CS. We divided
patients into a high MAP group (average MAP >= 70mmHg over the 36h
following randomization), and a low MAP group (average MAP < 70mmHg). Our
primary outcome included in-hospital all-cause mortality, resuscitated
cardiac arrest, need for cardiac transplantation or mechanical circulatory
support, non-fatal myocardial infarction, transient ischaemic attack or
stroke, or initiation of renal replacement therapy. In total, 71 (37.0%)
patients achieved an average MAP < 70mmHg, and 121 (63.0%) achieved an
average MAP >= 70mmHg. The primary outcome occurred in 48 (67.6%) patients
in the low MAP group and 51 (42.2%) patients in the high MAP group
[adjusted relative risk (aRR) 0.70; 95% confidence interval (CI)
0.53-0.92; P=0.01]. All-cause mortality occurred in 41 (57.8%) and 35
(28.9%) patients in the low and high MAP groups, respectively (aRR 0.56;
95% CI 0.40-0.79; P<0.01). There were no significant differences in any
secondary outcomes between each group. CONCLUSION(S): In patients
with CS treated with inotrope therapy, low MAP is associated with worse
clinical outcomes. Randomized data evaluating optimal MAP targets in CS is
needed to guide medical therapy. Copyright Published on behalf of the
European Society of Cardiology. All rights reserved. © The Author(s)
2021. For permissions, please email: journals.permissions@oup.com.

<139>
Accession Number
635872606
Title
Permanent pacemaker implantation following transcatheter aortic valve
implantation using self-expandable, balloon-expandable, or mechanically
expandable devices: a network meta-analysis.
Source
Europace : European pacing, arrhythmias, and cardiac electrophysiology :
journal of the working groups on cardiac pacing, arrhythmias, and cardiac
cellular electrophysiology of the European Society of Cardiology. (no
pagination), 2021. Date of Publication: 11 Aug 2021.
Author
Ravaux J.M.; Di Mauro M.; Vernooy K.; Kats S.; Mariani S.; Ronco D.; Actis
Dato G.; Simons J.; Hof A.W.V.; Maessen J.G.; Lorusso R.
Institution
(Ravaux, Di Mauro, Kats, Mariani, Ronco, Actis Dato, Simons, Maessen,
Lorusso) Departement of Cardio-Thoracic Surgery, Heart and Vascular
Centre, Maastricht University Medical Centre (MUMC), P. Debyelaan ,25, AZ
Maastricht 6202, Netherlands
(Vernooy, Hof) Department of Cardiology, Maastricht University Medical
Centre (MUMC), Maastricht, Netherlands
(Vernooy, Hof, Maessen, Lorusso) Cardiovascular Research Institute
Maastricht (CARIM), Maastricht University Medical Center, Maastricht,
Netherlands
(Vernooy) Department of Cardiology, Radboud University Medical Center
(Radboudumc), Nijmegen, Netherlands
(Ronco) Department of Medicine and Surgery, Circolo Hospital, University
of Insubria, Varese, Italy
Publisher
NLM (Medline)
Abstract
AIMS: Permanent pacemaker implantation (PPI) still limits the expansion of
indications for transcatheter aortic valve implantation (TAVI). Comparison
between different systems remains scarce. We aimed to determine the impact
of the device type used on post-TAVI PPI. METHODS AND RESULTS: A
systematic literature review was performed to identify studies reporting
the use of balloon-expandable valve (BEV), self-expandable valve (SEV),
and mechanically expandable valve (MEV) and post-TAVI PPI. A network
meta-analysis was used to compare TAVI mechanisms (Analysis A) and
transcatheter heart valves (Analysis B) with respect to post-TAVI PPI.
Analysis A included 40 181 patients with a pooled PPI rate of 19.2% in
BEV, 24.7% in SEV, and 34.8% in MEV. Balloon-expandable valve showed lower
risk compared to either SEV or MEV and SEV demonstrated lower risk for PPI
than MEV. Implantation of BEV was associated with 39% and 62% lower PPI
rate with respect to SEV and MEV. Implantation of SEV was associated with
38% lower PPI rate with respect to MEV. Analysis B included 36.143
patients with the lowest pooled PPI rate of 9.6% for Acurate Neo or
others, and the highest pooled PPI rate of 34.3% for Lotus. CoreValve,
Evolut Portico, and Lotus influenced significantly PPI rate, while Sapien
group did not. CONCLUSION(S): Implantation of BEV and also SEV were
associated with lower post-TAVI PPI rate, while MEV were associated with
higher post-TAVI PPI. Patient tailored-approach including devices
characteristics may help to reduce post-TAVI PPI and to allow TAVI to take
the leap towards extension of use in younger patients. PROSPERO NUMBER:
CRD42021238671. Copyright Published on behalf of the European Society
of Cardiology. All rights reserved. © The Author(s) 2021. For
permissions, please email: journals.permissions@oup.com.

<140>
Accession Number
2013331580
Title
Effect of intravenous lidocaine on serum interleukin-17 after
video-assisted thoracic surgery for non-small-cell lung cancer: A
randomized, double-blind, placebo-controlled trial.
Source
Drug Design, Development and Therapy. 15 (pp 3379-3390), 2021. Date of
Publication: 2021.
Author
Hou Y.-H.; Shi W.-C.; Cai S.; Liu H.; Zheng Z.; Qi F.-W.; Li C.; Feng
X.-M.; Peng K.; Ji F.-H.
Institution
(Hou, Cai, Peng, Ji) Department of Anesthesiology, First Affiliated
Hospital of Soochow University, Jiangsu, Suzhou, China
(Shi, Zheng, Qi) Department of Anesthesiology, Taicang First People's
Hospital, Taicang Affiliated Hospital of Soochow University, Jiangsu,
Taicang, China
(Liu) Department of Anesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA, United States
(Li) Department of Thoracic Surgery, First Affiliated Hospital of Soochow
University, Jiangsu, Suzhou, China
(Feng) Department of Anesthesiology, University of Utah health, Salt Lake
City, UT, United States
(Feng) Intermountain Medical Center, Salt Lake City, UT, United States
Publisher
Dove Medical Press Ltd
Abstract
Purpose: Surgical stress promotes tumor metastasis. Interleukin (IL)-17
plays a pivotal role in cancer progression, and high IL-17 expression
predicts poor prognosis of non-small-cell lung cancer (NSCLC). Lidocaine
may exert tumor-inhibiting effects. We hypothesize that intravenous
lidocaine attenuates surgical stress and reduces serum IL-17 levels during
video-assisted thoracic surgery (VATS) for NSCLC. Method(s): This
randomized, double-blind, placebo-controlled trial included 60 early-stage
NSCLC patients undergoing VATS, into a lidocaine group (n = 30;
intravenous lidocaine bolus 1.0 mg/kg, and 1.0 mg/kg/h until the end of
surgery) or a normal saline control group (n = 30). The primary outcome
was serum IL-17 level at 24 hours postoperatively. The secondary outcomes
included serum IL-17 level at the time of post-anesthesia care unit (PACU)
discharge, serum cortisol level at PACU discharge and postoperative 24
hours, pain scores (0-10) from PACU discharge to 48 hours postoperatively,
incidences of postoperative nausea and vomiting, dizziness, and arrhythmia
during 0-48 hours postoperatively, and 30-day mortality. Long-term
outcomes included chemotherapy, cancer recurrence, and mortality.
 Result(s): The lidocaine group had lower serum IL-17 at 24 hours
postoperatively compared with the control group (23.0 +/- 5.8 pg/mL vs
27.3 +/- 8.2 pg/mL, difference [95% CI] = -4.3 [-8.4 to -0.2] pg/mL; P =
0.038). The lidocaine group also had reduced serum IL-17 (difference [95%
CI] = -4.6 [-8.7 to -0.5] pg/mL), serum cortisol (difference [95% CI] =
-37 [-73 to -2] ng/mL), and pain scores (difference [95% CI] = -0.7 [-1.3
to -0.1] points) at PACU discharge. During a median follow-up of 10 (IQR,
9-13) months, 2 patients in the lidocaine group and 6 patients in the
control group received chemotherapy, one patient in the control group had
cancer recurrence, and no death event occurred. Conclusion(s):
Intravenous lidocaine was associated with reduced serum IL-17 and cortisol
following VATS procedures in early-stage NSCLC patients. Trial
Registration: ChiCTR2000030629. Copyright © 2021 Hou et al.

<141>
Accession Number
635779529
Title
Prediction models for hospital readmissions in patients with heart
disease: A systematic review and meta-analysis.
Source
BMJ Open. 11 (8) (no pagination), 2021. Article Number: e047576. Date of
Publication: 17 Aug 2021.
Author
Van Grootven B.; Jepma P.; Rijpkema C.; Verweij L.; Leeflang M.; Daams J.;
Deschodt M.; Milisen K.; Flamaing J.; Buurman B.
Institution
(Van Grootven) Department of Public Health and Primary Care, Katholieke
Universiteit Leuven, Leuven, Belgium
(Van Grootven) Research Foundation Flanders, Brussel, Belgium
(Jepma, Verweij, Buurman) Center of Expertise Urban Vitality, Faculty of
Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
(Rijpkema) Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam,
Netherlands
(Leeflang, Buurman) Faculty of Science, Amsterdam UMC Locatie AMC,
Amsterdam, Netherlands
(Daams) Medical Library, Amsterdam UMC Location AMC, Amsterdam,
Netherlands
(Deschodt, Milisen) Department of Public Health and Primary Care, KU
Leuven - University of Leuven, Leuven, Belgium
(Deschodt) Department of Public Health, University of Basel, Basel,
Switzerland
(Milisen) Department of Geriatric Medicine, University Hospitals Leuven,
Leuven, Belgium
(Flamaing) Department of Public Health and Primary Care, University
Hospitals Leuven, Leuven, Belgium
(Flamaing) Department of Geriatric Medicine, KU Leuven - University of
Leuven, Leuven, Belgium
Publisher
BMJ Publishing Group
Abstract
Objective To describe the discrimination and calibration of clinical
prediction models, identify characteristics that contribute to better
predictions and investigate predictors that are associated with unplanned
hospital readmissions. Design Systematic review and meta-analysis. Data
source Medline, EMBASE, ICTPR (for study protocols) and Web of Science
(for conference proceedings) were searched up to 25 August 2020.
Eligibility criteria for selecting studies Studies were eligible if they
reported on (1) hospitalised adult patients with acute heart disease; (2)
a clinical presentation of prediction models with c-statistic; (3)
unplanned hospital readmission within 6 months. Primary and secondary
outcome measures Model discrimination for unplanned hospital readmission
within 6 months measured using concordance (c) statistics and model
calibration. Meta-regression and subgroup analyses were performed to
investigate predefined sources of heterogeneity. Outcome measures from
models reported in multiple independent cohorts and similarly defined risk
predictors were pooled. Results Sixty studies describing 81 models were
included: 43 models were newly developed, and 38 were externally
validated. Included populations were mainly patients with heart failure
(HF) (n=29). The average age ranged between 56.5 and 84 years. The
incidence of readmission ranged from 3% to 43%. Risk of bias (RoB) was
high in almost all studies. The c-statistic was <0.7 in 72 models, between
0.7 and 0.8 in 16 models and >0.8 in 5 models. The study population, data
source and number of predictors were significant moderators for the
discrimination. Calibration was reported for 27 models. Only the GRACE
(Global Registration of Acute Coronary Events) score had adequate
discrimination in independent cohorts (0.78, 95% CI 0.63 to 0.86).
Eighteen predictors were pooled. Conclusion Some promising models require
updating and validation before use in clinical practice. The lack of
independent validation studies, high RoB and low consistency in measured
predictors limit their applicability. PROSPERO registration number
CRD42020159839. Copyright © 2021 Institute of Electrical and
Electronics Engineers Inc.. All rights reserved.

<142>
Accession Number
2007668844
Title
Effect of Preoperative Infusion of Levosimendan on Biomarkers of
Myocardial Injury and Haemodynamics After Paediatric Cardiac Surgery: A
Randomised Controlled Trial.
Source
Drugs in R and D. 21 (1) (pp 79-89), 2021. Date of Publication: March
2021.
Author
Abril-Molina A.; Gomez-Luque J.M.; Perin F.; Esteban-Molina M.;
Ferreiro-Marzal A.; Fernandez-Guerrero C.; Ocete-Hita E.
Institution
(Abril-Molina, Gomez-Luque, Ocete-Hita) Pediatric Intensive Care Unit,
Hospital Universitario Virgen de las Nieves, University of Granada,
Granada, Spain
(Perin) Paediatric Cardiology Unit, Hospital Universitario Virgen de las
Nieves, Granada, Spain
(Esteban-Molina, Ferreiro-Marzal) Paediatric Cardiac Surgery Unit,
Hospital Universitario Virgen de las Nieves, Granada, Spain
(Fernandez-Guerrero) Pediatric Anesthesia Unit, Hospital Universitario
Virgen de las Nieves, Granada, Spain
Publisher
Adis
Abstract
Objective: The aim was to test the hypothesis that preoperative infusion
of levosimendan would decrease patients' cardiac biomarker profiles during
the immediate postoperative stage (troponin I and B-type natriuretic
peptide levels) more efficiently than placebo after cardiopulmonary
bypass. Method(s): In a randomised, placebo-controlled,
double-blinded study, 30 paediatric patients were scheduled for congenital
heart disease surgery. 15 patients (50%) received prophylactic
levosimendan and 15 patients (50%) received placebo from 12 h before
cardiopulmonary bypass to 24 h after surgery. Result(s): Troponin I
levels were higher in the placebo group at 0, 12, and 24 h after
cardiopulmonary bypass, although the mean differences between the study
groups and the 95% confidence intervals (CIs) for troponin I levels did
not present statistically significant differences at any of the three time
points considered (mean differences [95% CIs] - 3.32 pg/ml [- 19.34 to
12.70], - 2.42 pg/ml [- 19.78 to 13.95], and - 79.94 pg/ml [- 266.99 to
16.39] at 0, 12, and 24 h, respectively). A similar lack of statistically
significant difference was observed for B-type natriuretic peptide (mean
differences [95% CIs] 36.86 pg/dl [- 134.16 to 225.64], - 350.79 pg/dl [-
1459.67 to 557.45], and - 310.35 pg/dl [- 1505.76 to 509.82]). Lactic acid
levels were significantly lower with levosimendan; the mean differences
between the study groups and the 95% CIs for lactate levels present
statistically significant differences at 0 h (- 1.52 mmol/l [- 3.19 to -
0.25]) and 12 h (- 1.20 mmol/l [- 2.53 to - 0.10]) after cardiopulmonary
bypass. Oxygen delivery (DO<inf>2</inf>) was significantly higher at 12 h
and 24 h after surgery (mean difference [95% CI] 627.70
ml/min/m2 [122.34-1162.67] and 832.35 ml/min/m2
[58.15 to 1651.38], respectively). Conclusion(s): Levosimendan does
not significantly improve patients' postoperative troponin I and B-type
natriuretic peptide profiles during the immediate postoperative stage in
comparison with placebo, although both were numerically higher with
placebo. Levosimendan, however, significantly reduced lactic acid levels
and improved patients' DO<inf>2</inf> profiles. These results highlight
the importance of this new drug and its possible benefit with regard to
myocardial injury; however, evaluation in larger, adequately powered
trials is needed to determine the efficacy of levosimendan. Trial registry
number: EudraCT 2012-005310-19. Copyright © 2020, The Author(s).

<143>
Accession Number
2007627040
Title
Review of safety reports of cardiac MR-imaging in patients with recently
implanted coronary artery stents at various field strengths.
Source
Expert Review of Medical Devices. 18 (1) (pp 83-90), 2021. Date of
Publication: 2021.
Author
Schenk C.D.; Gebker R.; Berger A.; Pieske B.; Stehning C.; Kelle S.
Institution
(Schenk, Gebker, Berger, Pieske, Kelle) German Heart Center Berlin,
Department of Internal Medicine/Cardiology, Berlin, Germany
(Schenk, Pieske, Kelle) Charite Campus Virchow Klinikum, Department of
Internal Medicine/Cardiology, Berlin, Germany
(Pieske, Kelle) DZHK (German Center for Cardiovascular Research), Partner
Site, Berlin, Germany
(Stehning) Philips Healthcare, Hamburg, Germany
Publisher
Taylor and Francis Ltd.
Abstract
Background: Aim of this study was to review current literature and data
regarding the effects of MRI-examination post stent implantation on
re-occlusion rates. Method(s): We focused on representative studies
in the database MEDLINE. Inclusion criteria were: clinical studies with
the main focus on the safety of coronary artery stents after
MRI-examination in the time interval of 8 weeks post stent implantation.
During a follow up period the incidence of cardiac events was recorded. In
addition, the time interval between stent implantation and MRI-examination
should be defined. Result(s): Our search resulted in a total of
relevant 17 studies. There were in-vivo as well as in-vitro studies and in
addition three further publications f.e. guidelines. Concerning the
patients, we differentiated between MRI performed shortly after acute
cardiac event and in stable CAD. MRI-examinations were performed at
different field strengths and reported different stent types. Considered
were the incidences of cardiac events. Conclusion(s): Independent of
MRI field strength (1.5 Tesla or 3.0 Tesla) or used stent type (BMS or
DES), there was no increased rate for cardiac events in patients, who
underwent MRI < 8 weeks after stent placement. MRI < 8 weeks after stent
placement seems to be safe. Copyright © 2020 Informa UK Limited,
trading as Taylor & Francis Group.

<144>
Accession Number
2014212360
Title
Quantitative angiographic assessment of aortic regurgitation after
transcatheter implantation of the venus A-valve: Comparison with other
self-expanding valves and impact of a learning curve in a single Chinese
center.
Source
Global Heart. 16 (1) (no pagination), 2021. Article Number: 54. Date of
Publication: 2021.
Author
Wang R.; Kawashima H.; Mylotte D.; Rosseel L.; Gao C.; Aben J.-P.;
Abdelshafy M.; Onuma Y.; Yang J.; Soliman O.; Tao L.; Serruys P.W.
Institution
(Wang, Gao, Tao) Department of Cardiology, Xijing Hospital, Xi'an, China
(Wang, Kawashima, Mylotte, Rosseel, Gao, Abdelshafy, Onuma, Soliman,
Serruys) Department of Cardiology, National University of Ireland, Galway
(NUIG), Galway and CORRIB Research Center for Advanced Imaging and Core
Laboratory, Ireland
(Wang, Gao) Department of Cardiology, Radboud University Medical Center,
Nijmegen, Netherlands
(Kawashima) Amsterdam UMC, University of Amsterdam, Heart Center,
Department of Clinical and Experimental Cardiology, Amsterdam
Cardiovascular Sciences, Amsterdam, Netherlands
(Aben) Pie Medical Imaging, Maastricht, Netherlands
(Yang) Department of Cardiovascular Surgery, Xijing Hospital, Xi'an, China
(Serruys) NHLI, Imperial College London, London, United Kingdom
Publisher
Ubiquity Press
Abstract
Objectives: We aimed to compare the quantitative angiographic aortic
regurgitation (AR) into the left ventricular out flow tract (LVOT-AR) of
five different types of transcatheter self-expanding valves and to
investigate the impact of the learning curve on post-TAVR AR.
 Background(s): Quantitative video densitometric aortography is an
objective, accurate, and reproducible tool for assessment of AR following
TAVR. Methods and Results: This retrospective academic core-lab
analysis, analyzed 1150 consecutive cine aortograms performed immediately
post-TAVR. Quantitative angiographic AR of post-procedural aortography in
181 consecutive patients, who underwent TAVR with the Venus A-valve in a
single Chinese center, were compared to the results of Evolut Pro, Evolut
R, CoreValve, (Medtronic, Dublin, Ireland) and Acurate Neo (Boston
Scientific, Massachusetts, US) transcatheter heart valves (THVs), from a
previously published pooled database. Among the 181 aortograms of patients
treated with the Venus A-Valve, 113 (62.4%) were analyzable for
quantitative assessment of AR. The mean LVOT-AR was 8.9% +/- 10.0% with
14.2% of patients having moderate or severe AR in the Venus A-valve group.
No significant difference in mean LVOT-AR was observed between Evolut Pro,
Evolut R, Acurate Neo, and Venus A-valve. The incidence of LVOT-AR >17%,
which correlates with echocardiographic derived >= moderate AR, with the
Evolut Pro was lower than with the Venus A-valve (5.3% vs. 14.2%, p =
0.034), but was not different from the Evolut R (5.3% vs. 8.8%, p =
0.612), or the Acurate Neo (5.3% vs. 11.3% p = 0.16) systems. A landmark
analysis after recruitment of the first half of patients treated with the
Venus A valve (N = 56), showed a significantly lower mean LVOT-AR in the
second half of the series (11.3% +/- 11.9% vs. 6.5% +/- 7.1%, p = 0.011).
The incidence of LVOT-AR >17% in the latest 57 cases was also numerically
lower (7.0% vs. 21.4%, p = 0.857) and compared favorably with the best in
class of the self-expanding valves. Conclusion(s): The Venus A-valve
has comparable mean LVOT-AR to other self-expanding valves but has a
higher rate of moderate or severe AR than the Evolut Pro THV. However,
after completion of a learning phase, results improved and compared
favorably with the best in class of the commercially available
self-expanding valves. These findings should be confirmed in prospective
randomized comparisons of AR between different THVs. Copyright ©
2021 The Author(s). This is an open-access article distributed under the
terms of the Creative Commons Attribution 4.0 International License (CC-BY
4.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original author and source are credited. See
http://creativecommons.org/licenses/by/4.0/.

<145>
Accession Number
2014012598
Title
Effect of electroencephalography-guided anesthesia on neurocognitive
disorders in elderly patients undergoing major non-cardiac surgery: A
trial protocol the POEGEA trial (POncd Elderly GEneral Anesthesia).
Source
PLoS ONE. 16 (8 August) (no pagination), 2021. Article Number: e0255852.
Date of Publication: August 2021.
Author
Morisson L.; Laferriere-Langlois P.; Carrier F.M.; Page G.; Godbout C.;
Fortier L.-P.; Ogez D.; Letourneau G.; Jarry S.; Denault A.; Fortier A.;
Guertin M.-C.; Verdonck O.; Richebe P.
Institution
(Morisson, Laferriere-Langlois, Godbout, Fortier, Ogez, Verdonck, Richebe)
Department of Anesthesiology and Pain Medicine, Maisonneuve-Rosemont
Hospital - CIUSSS de L'Est de l'Ile de Montreal, Universite de Montreal,
Montreal, QC, Canada
(Laferriere-Langlois, Carrier, Page, Godbout, Fortier, Ogez, Denault,
Verdonck, Richebe) Department of Anesthesiology and Pain Medicine,
Universite de Montreal, Quebec, Canada
(Carrier) Department of Anesthesiology, Department of Medicine, Critical
Care Division, Centre Hospitalier de l'Universite de Montreal (CHUM),
Universite de Montreal, Montreal, QC, Canada
(Carrier, Page) Research Center of the CHUM (Centre Hospitalier de
l'Universite de Montreal), Universite de Montreal, Montreal, QC, Canada
(Page) Department of Psychology, Universite de Montreal, Montreal, QC,
Canada
(Godbout, Fortier, Ogez, Letourneau, Verdonck, Richebe) Research Center,
CIUSSS de L'Est de l'Ile de Montreal, Universite de Montreal, Montreal,
QC, Canada
(Jarry, Denault) Department of Anesthesiology, Montreal Heart Institute,
Montreal, QC, Canada
(Fortier, Guertin) Department of Statistics, Montreal Health Innovations
Coordinating Center (MHICC), Montreal, QC, Canada
Publisher
Public Library of Science
Abstract
Introduction The number of elderly patients undergoing major surgery is
rapidly increasing. They are particularly at risk of developing
postoperative neurocognitive disorders (NCD). Earlier studies suggested
that processed electroencephalographic (EEG) monitors may reduce the
incidence of postoperative NCD. However, none of these studies controlled
for intraoperative nociception levels or personalized blood pressure
targets. Their results remain unclear if the reduction in the incidence of
postoperative NCD relates to avoidance of any electroencephalographic
pattern suggesting excessive anesthesia depth. Objective The objective of
this trial is to investigate-in patients > 70 years old undergoing major
non-cardiac surgery-the effect of EEG-guided anesthesia on postoperative
NCD while controlling for intraoperative nociception, personalized blood
pressure targets, and using detailed information provided by the EEG
monitor (including burst suppression ratio, density spectral array, and
raw EEG waveform). Material and methods This prospective, randomized,
controlled trial will be conducted in a single Canadian university
hospital. Patients > 70 years old undergoing elective major non-cardiac
surgery will be included in the trial. The administration of sevoflurane
will be adjusted to maintain a BIS index value between 40 and 60, to keep
a Suppression Ratio (SR) at 0%, to keep a direct EEG display without any
suppression time and a spectrogram with most of the EEG wave frequency
within the alpha, theta, and delta frequencies in the EEG-guided group. In
the control group, sevoflurane will be administered to achieve an
age-adjusted minimum alveolar concentration of [0.8-1.2]. In both groups,
a nociception monitor will guide intraoperative opioid administration,
individual blood pressure targets will be used, and cerebral oximetry used
to tailor intraoperative hemodynamic management. The primary endpoint will
be the incidence of NCD at postoperative day 1, as evaluated by the
Montreal Cognitive Assessment (MoCA). Secondary endpoints will include the
incidence of postoperative NCD at different time points and the evaluation
of cognitive trajectories up to 90 days after surgery among EEG-guided and
control groups. Copyright © 2021 Morisson 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.

<146>
Accession Number
2013811485
Title
Trends, Predictors and In-Hospital Outcomes of the Next Day Discharge
Approach After Transcatheter Mitral Valve Repair.
Source
American Journal of Cardiology. 156 (pp 93-100), 2021. Date of
Publication: 01 Oct 2021.
Author
Grant J.K.; Vincent L.; Ebner B.; Singh H.; Maning J.; Rubin P.;
Olorunfemi O.; Colombo R.; Braghiroli J.; De Marchena E.
Institution
(Grant, Vincent, Ebner, Singh, Maning, Rubin) Department of Internal
Medicine, University of Miami Miller School of Medicine/Jackson Memorial
Hospital, Florida 33136
(Olorunfemi, Colombo, Braghiroli) Department of Medicine, Cardiovascular
Division, Jackson Memorial Hospital
(De Marchena) Department of Medicine, Cardiovascular Division, University
of Miami Miller School of Medicine
Publisher
Elsevier Inc.
Abstract
Early discharge strategies are associated with lower cost and resource
utilization during hospitalization, as such we sought to evaluate trends,
predictors and outcomes of the next day discharge (NDD) approach after
transcatheter mitral valve repair (TMVR) procedures with the MitraClip
device. The National Inpatient Sample (NIS) was queried between 2013 and
2018 for patients undergoing TMVR using the International Classification
of Diseases (ICD) 9 procedure code '3597' and ICD-10 procedure code
'02UG3JZ'. Patients undergoing TMVR were stratified into two groups,
determined by hospital length of stay (LOS) [<=1 day, NDD versus >1-day,
non-NDD]. Overall, 22,035 patients underwent TMVR with 35.7% (n = 7,870)
belonging to the NDD group (mean age 78.1 +/- 9.7 years, women 45%). From
2013 to 2018, the proportion of patients being discharged using the NDD
approach trended upward from 18.3% to 46.0%. Amongst demographic and
social factors, female sex, black race, and low median household income
were predictive of non-NDD (p <0.05 for all). Amongst clinical factors,
anemia, iron deficiency anemia, major depressive disorder,
thrombocytopenia, obesity and end stage renal disease were some predictors
of non-NDD (p <0.05 for all). In the non-NDD group there was a downward
trend of pooled post-procedure complications, post procedure cardiogenic
shock, vascular complications, acute kidney injury, mechanical circulatory
support use, acute respiratory distress and postoperative ischemic stroke
and (p for trend <0.001 for all). Despite the overall downward trend,
complications began increasing in 2017-18. In conclusion, these trends may
reflect improving operator experience, advancement in vascular access
device closures and techniques, and prioritization of decreasing length of
stay. Ideally, the feasibility and safety of this approach should be
confirmed in larger-sized multicenter, randomized trials. Copyright
© 2021 Elsevier Inc.

<147>
Accession Number
2013682337
Title
Prognostic relevance of exercise testing in hypertrophic cardiomyopathy. A
systematic review.
Source
International Journal of Cardiology. 339 (pp 83-92), 2021. Date of
Publication: 15 Sep 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, Lisboa 1649-028, Portugal
(Rodrigues, Brito, Lopes) CAML, CCUL, Lisbon School of Medicine,
Universidade de Lisboa, Av. Prof. Egas Moniz, Lisboa 1649-028, 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
(Raposo) Lisbon School of Medicine, Universidade de Lisboa, Lisboa,
Portugal
(Lopes) Barts Heart Centre, St. Bartholomew's Hospital, London, UK, United
Kingdom
(Lopes) Centre for Heart Muscle Disease, Institute of Cardiovascular
Science, University College London, London, UK, United Kingdom
Publisher
Elsevier Ireland Ltd
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. Aim(s): To systematically review the evidence on the
role of exercise testing for prognostic stratification in hypertrophic
cardiomyopathy. 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. Result(s): Eighteen
publications were included, corresponding to a total of 7525 patients. The
mean follow-up period varied between 1 and 8 years. 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. 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. Copyright © 2021 The Author(s)

<148>
Accession Number
2013410248
Title
Direct oral anticoagulants in patients with atrial fibrillation and
bioprosthetic valve replacement: A meta-analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2021.
Date of Publication: 2021.
Author
Lacy S.C.; Saint Croix G.R.; Porter K.; Latib A.; Beohar N.
Institution
(Lacy) Loyola University Medical Center, Maywood, IL, United States
(Saint Croix, Beohar) Columbia University Division of Cardiology at Mount
Sinai Medical Center, Miami Beach, FL, United States
(Porter) Jackson Memorial Hospital/University of Miami Hospital, Miami,
FL, United States
(Latib) Montefiore Medical Center, Albert Einstein College of Medicine,
New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Objectives: This systematic review and meta-analysis compares direct oral
anticoagulants (DOACs) versus vitamin K antagonists (VKAs) in patients
with atrial fibrillation and bioprosthetic valve replacement or repair
(BVR). Background(s): The optimal anticoagulation therapy for
patients with atrial fibrillation and a history of bioprosthetic valve
replacement or repair (BVR) is not well understood. Method(s): We
performed a systematic literature review to identify clinical studies that
compared anticoagulation therapies for patients with atrial fibrillation
and BVR. The primary outcomes of stroke, major bleeding, and mortality
were reported as random effects risk ratio (RR) with 95% confidence
interval. No prior ethical approval was required since all data is public.
 Result(s): Our search yielded 101 potential studies. We included six
studies reporting on 1911 patients. There was a lower risk of stroke and
major bleeding in patients with atrial fibrillation after BVR treated with
DOACs when compared to VKAs with risk ratios of 0.44 (95% CI 0.24-0.82, p
< 0.01) and 0.53 (95% CI 0.34-0.83, p < 0.01), respectively. There was no
statistically significant difference in mortality between patients with
atrial fibrillation after BVR treated with DOACs compared to patients
treated with VKAs with a risk ratio of 1.12 (95% CI 0.73-1.74, p = 0.60).
 Conclusion(s): This systematic review and meta-analysis suggests that
DOACs are superior to VKAs with respect to stroke and major bleeding in
patients with atrial fibrillation and BVR. Copyright © 2021 Wiley
Periodicals LLC.

<149>
Accession Number
2013401953
Title
Effects of remote ischemic postconditioning on HIF-1alpha and other
markers in on-pump cardiac surgery.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2021. Date
of Publication: 2021.
Author
Garcia-de-la-Asuncion J.; Moreno T.; Duca A.; Garcia-del-Olmo N.;
Perez-Griera J.; Belda J.; Soro M.; Garcia-del-Olmo E.
Institution
(Garcia-de-la-Asuncion, Moreno, Duca, Belda, Soro) Department of
Anaesthesiology and Critical Care, Hospital Clinico Universitario,
Instituto de Investigacion Sanitaria-INCLIVA, Valencia, Spain
(Garcia-del-Olmo) Department of General Surgery, Hospital Lluis Alcanyis,
Xativa, Spain
(Perez-Griera) Laboratory of Biochemistry, Hospital Clinico Universitario,
Instituto de Investigacion Sanitaria-INCLIVA, Valencia, Spain
(Garcia-del-Olmo) Department of Thoracic Surgery, Consorcio Hospital
General Universitario, Valencia, Spain
Publisher
Springer Japan
Abstract
Background: There is a lack of data about the effects of remote ischemic
postconditioning (RIPostC) on hypoxia-inducible factor-1alpha (HIF-1alpha)
plasma levels after on-pump cardiac surgery (OPCS). This study aimed to
measure the effects of RIPostC on postoperative HIF-1alpha plasma levels,
cardiac markers and arterial oxygenation in patients undergoing OPCS.
 Method(s): This single-centre randomized, double blind, controlled
trial, enrolled 70 patients (35 control and 35 RIPostC). RIPostC was
performed by 3 cycles (5 min of ischemia followed by 5 min of reperfusion)
administered in upper arm immediately after the pump period. The primary
outcome was to measure HIF-1alpha plasma levels: before surgery (T0), and
2 h (T1), 8 h (T2), 24 h (T3), 36 h (T4) and 48 h (T5) after RIPostC. As
secondary endpoint, Troponin T, CK-MB, CPK plasma levels and
PaO<inf>2</inf>/FiO<inf>2</inf> ratio were measured. Result(s):
HIF-1alpha plasma levels were increased at T1-T3 compared to T0 in both
groups (P < 0.001). In the RIPostC group HIF-1alpha increased compared to
the control group: differences between means (95% CI) were 0.034
(0.006-0.06) P = 0.019 at T1; 0.041 (0.013-0.069) P = 0.005 at T2; and
0.021 (0.001-0.042) P = 0.045 at T3. PaO<inf>2</inf>/FiO<inf>2</inf> was
higher in the RIPostC group than in the control group: at T3, T4 and T5.
Moreover, Troponin T, CK-MB and CPK values decreased in the RIPostC group
compared to the control group. Conclusion(s): HIF-1alpha plasma
levels increased in control patients during for at least 36 h after OPCS.
RIPostC resulted in even higher HIF-1alpha levels during at least the
first 24 h and improved arterial oxygenation and cardiac
markers. Copyright © 2021, The Japanese Association for Thoracic
Surgery.

<150>
Accession Number
2010936436
Title
Effects of preoperative nutrition and multimodal prehabilitation on
functional capacity and postoperative complications in surgical lung
cancer patients: a systematic review.
Source
Supportive Care in Cancer. 29 (10) (pp 5597-5610), 2021. Date of
Publication: October 2021.
Author
Ferreira V.; Lawson C.; Ekmekjian T.; Carli F.; Scheede-Bergdahl C.;
Chevalier S.
Institution
(Ferreira, Scheede-Bergdahl) Department of Kinesiology and Physical
Education, McGill University, Montreal, QC, Canada
(Lawson, Chevalier) School of Human Nutrition, McGill University,
Macdonald-Stewart Building, MS2-043, Macdonald Campus, 21111 Lakeshore
Road, Ste-Anne-de-Bellevue, Montreal, QC H9X 3V9, Canada
(Ekmekjian) Medical Libraries, McGill University Health Center, Montreal,
QC, Canada
(Carli) Department of Anesthesia, McGill University Health Centre,
Montreal, QC, Canada
(Chevalier) Research Institute of the McGill University Health Centre,
Montreal, QC, Canada
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: To determine the effect of preoperative nutrition and
multimodal prehabilitation on clinical and functional outcomes in surgical
lung cancer patients. Method(s): We searched MEDLINE, Cochrane
Library and CENTRAL, EMBASE, Scopus, and clinical trial registries
(clinicaltrials.gov, International Clinical Trials Registry Platform and
Google Scholar) to identify studies involving a preoperative
nutrition-based intervention or multimodal prehabilitation (nutrition with
exercise) of at least 7 days, in lung cancer patients awaiting surgery.
Studies must have reported results on at least one of the following
outcomes: functional capacity, pulmonary function, postoperative
complications, and length of hospital stay. The quality of included
studies was assessed using the Cochrane risk of bias assessment tool for
randomized trials and the modified Newcastle-Ottawa scale for
non-controlled trials. Result(s): Five studies were included (1
nutrition-only and 4 multimodal prehabilitation studies). Due to
substantial heterogeneity in the interventions across studies, a
meta-analysis was not conducted. Findings suggest that multimodal
prehabilitation, compared with standard hospital care, is associated with
improvements in both functional walking capacity and pulmonary function
during the preoperative period; however it does not appear to have an
effect on postoperative outcomes. Rather, the finding of significantly
lower rates of postoperative complications in the intervention group was
unique to the nutrition-only study. Conclusion(s): Multimodal
prehabilitation programs that combine nutrition and exercise may have
beneficial effects on various physical function outcomes in patients with
lung cancer awaiting surgery. Optimizing preoperative nutrition may have
postoperative benefits which remain to be confirmed. Copyright ©
2021, The Author(s), under exclusive licence to Springer-Verlag GmbH
Germany, part of Springer Nature.

<151>
Accession Number
634550726
Title
Colchicine efficacy and safety for the treatment of cardiovascular
diseases.
Source
Internal and emergency medicine. 16 (6) (pp 1691-1700), 2021. Date of
Publication: 01 Sep 2021.
Author
Andreis A.; Imazio M.; Casula M.; Avondo S.; De Ferrari G.M.
Institution
(Andreis, Imazio, Casula, Avondo, De Ferrari) Departement of Medical
Sciences, University Cardiology, A.O.U. Citta della Salute e della Scienza
di TorinoCorso Bramante 88, Turin 10126, Italy
Publisher
NLM (Medline)
Abstract
The emerging role of colchicine in the treatment of cardiovascular
diseases is a strong demand for a comprehensive understanding of its
efficacy and safety. This meta-analysis and systematic review aimed to
study the efficacy in the reduction of adverse cardiovascular outcomes
(CO), and the risk of colchicine-related adverse events (CRAEs). Fourteen
thousand and nine eighty three patients from 22 randomized controlled
trials (RCTs) were included, 9 in patients with coronary artery
disease-CAD, 9 in patients with pericarditis, 4 in patients with atrial
fibrillation-AF or heart failure. Colchicine was efficacious in the
reduction of adverse CO across different settings: pericardial diseases
(reduced risk of recurrent pericarditis, 17.6% vs. 35%, RR 0.50, 95% CI
0.41-0.61), CAD (reduced risk of cardiac death, myocardial infarction,
stroke,coronary revascularization or hospitalization, 6.1% vs. 8.5%, RR
0.73, 95% CI 0.64-0.83), AF (reduced risk of arrhythmia recurrence, 14.2%
vs. 22.7%, RR 0.62, 95% CI 0.44-0.88). Colchicine was associated with
increased risk of gastrointestinal CRAEs (11.2% vs. 8.8%, RR 1.87, 95% CI
1.41-2.47) and drug discontinuation (5.4% vs. 3.7%, RR 1.58, 95% CI
1.25-1.99). In both cases, the risk was proportional to the daily dose or
duration of treatment, possibly due to early drug discontinuation or
tolerance. Other CRAEs (muscle-related, liver,hematologic,cutaneous,
infections) were not increased by colchicine, as long as all-cause death
(2.2% vs. 1.9%, RR 1.11, 95% CI 0.79-1.54) or non-cardiovascular death
(1.5% vs. 1%, RR 1.43, 95% CI 0.93-2.19). Colchicine is efficacious and
safe for the treatment of cardiovascular diseases. The risk of
gastrointestinal CRAEs and drug discontinuation is not significant if
colchicine is used at lower doses (0.5 mg daily) or for longer periods of
time (>6 months). Copyright © 2021. Societa Italiana di Medicina
Interna (SIMI).

<152>
Accession Number
2013407522
Title
Impact of bilateral versus single internal thoracic artery grafting on the
long-term survival in adults: A systematic review.
Source
Vascular Health and Risk Management. 17 (pp 509-518), 2021. Date of
Publication: 2021.
Author
Smady M.N.A.; Zaki M.N.; Alataywi E.; Jegaden O.
Institution
(Smady, Zaki, Alataywi) College of Medicine, Mohammed Bin Rashid
University of Medicine and Health Sciences, Dubai, United Arab Emirates
(Jegaden) Cardiothoracic Surgery Department, Mediclinic Airport Road
Hospital, Abu Dhabi, United Arab Emirates
Publisher
Dove Medical Press Ltd
Abstract
Objective: To analyse the survival of patients who had undergone bilateral
internal thoracic artery grafting versus those with single internal
thoracic artery grafting from the available literature. Moreover, this
study will review the available literature regarding which of the two
techniques seems to be the safest with long-term survival and reduced
mortality rates. Method(s): A literature search of the databases was
conducted to retrieve studies that fall under the study design of cohort
and randomized controlled clinical trials in English from January 2015 to
July 2021. Finally, seven studies were selected: four cohort studies and
three other from a randomized trial. Result(s): The cohort studies
revealed that bilateral internal thoracic artery grafting is associated
with lower mortality rates and better long-term survival outcomes than
single internal thoracic artery grafting, while the ART randomized
controlled clinical trials showed that there is no significant difference
in mortality rates between both the coronary artery bypass grafting
techniques. However, all studies concluded that bilateral internal
thoracic artery grafting is associated with a higher frequency of deep
sternal wound infections. Conclusion(s): The discrepancy in results
between the cohort studies and randomized controlled clinical trial
remains persistent. However, the stated advantages of bilateral internal
thoracic artery grafting are not strong enough to convince surgeons to
alter their practice and the wide magnitude of expectations from the ART
study was reckoned as inadequate. This may well be due to the presence of
limited criteria for bilateral internal thoracic artery grafting in
identifying the impact on survival of extended arterial revascularization,
and there is a new colossal expectation from the ongoing randomized trial
based on multiple arterial grafting versus single arterial
grafting. Copyright © 2021 Al Smady et al.

<153>
Accession Number
635867223
Title
Comparative effectiveness of metoprolol, ivabradine, and its combination
in the management of inappropriate sinus tachycardia in coronary artery
bypass graft patients.
Source
Indian Journal of Pharmacology. 53 (4) (pp 264-269), 2021. Date of
Publication: July-August 2021.
Author
Bhatt P.; Bhavsar N.; Naik D.; Shah D.
Institution
(Bhatt, Bhavsar, Naik, Shah) Cardiovascular and Thoracic Surgery,
Department Care Institute of Medical Sciences, 12B, Riddhi Siddhi
Bungalows, Gujarat, Ahmedabad 380 015, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
BACKGROUND: Inappropriate sinus tachycardia (IST) is an arrhythmic
complication observed after coronary artery bypass graft (CABG) surgery
which left untreated, commonly increases chances of postoperative stroke.
The primary study objective was comparing effectiveness of beta
blocker-metoprolol; a specific I<inf>f</inf>blocker-ivabradine and its
combination in patients who develop IST as a complication following CABG.
MATERIALS AND METHODS: An open-labeled, investigator initiated, clinical
study was conducted on 150 patients who developed IST (heart rate [HR]
>100 beats/min) following elective CABG surgery. The patients were
randomized into three treatment groups. Group I-received ivabradine (5
mg), Group II-metoprolol (25 mg), and Group III-ivabradine (5 mg) and
metoprolol (25 mg). Treatment was given orally, twice a day for 7 days in
all the three groups postoperatively. Primary endpoints were comparative
effectiveness in HR and blood pressure reduction following treatment.
 RESULT(S): IST was diagnosed by an electrocardiogram (12-lead)
considering morphological features of P-wave and with 32% increase from
baseline HR in all the three groups. Compared to IST arrthymic rate, HR
was reduced in all groups following respective treatment (P = 0.05).
Reduction in HR was significant (P < 0.05) in combination group followed
by ivabradine which was significantly greater than metoprolol treated
group. None of the treatments clinically changed the systolic, diastolic
and mean blood pressure till discharge. No surgery/treatment-related
complications were observed in any groups. CONCLUSION(S): Ivabradine
stands as a pharmacological option for controlling HR and rhythm without
associated side effects in postoperative CABG patients with
IST. Copyright © 2021 Wolters Kluwer Medknow Publications. All
rights reserved.

<154>
Accession Number
2013578994
Title
The relationship between circulating bone morphogenetic protein-4 and
inflammation cytokines in patients undergoing thoracic surgery: A
prospective randomized study.
Source
Journal of Inflammation Research. 14 (pp 4069-4077), 2021. Date of
Publication: 2021.
Author
Zhao X.; Zhang J.; Zhang W.; Dai R.; Xu J.; Li Z.; Yang L.
Institution
(Zhao, Zhang, Dai, Xu, Li, Yang) Department of Anesthesiology, The Second
Xiangya Hospital, Central South University, Hunan, Changsha 410011, China
(Zhang) Department of Laboratory Medicine, The Second Xiangya Hospital,
Central South University, Hunan, Changsha 410011, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Bone morphogenetic protein-4 (BMP4) has been identified as an
inflammation regulator in the diseases of arteries and other organs.
However, the relationship between circulating BMP4 and perioperative
inflammation remains unclear. Patients and Methods: Forty patients
undergoing lobectomy were randomly allocated into the Control group (not
receiving flurbiprofen) and the Flurb group (received 100mg flurbi-profen
during surgery). Arterial blood was obtained before surgery (T1), at the
end of surgery (T2), and 24 hours after surgery (T3) to test the plasma
concentrations of BMP4, its antagonist Noggin, interleukin (IL)-1beta,
tumor necrosis factor-alpha (TNF-alpha), and IL-10. The relationship
between BMP4 and other variables and the effects of flurbiprofen on BMP4
changes were investigated. Result(s): A total of 35 patients were
included. Circulating BMP4 was positively correlated with IL-1beta
(P<0.01, r=0.575) and TNF-alpha (P<0.01, r=0.491), negatively correlated
with IL-10 (P<0.01, r=-0.675), but not correlated with Noggin. The plasma
concentrations of BMP4, IL-1beta, and TNF-alpha increased at T2 (P<0.01,
compared with T1) and decreased at T3 (P<0.05, compared with T2). BMP4
concentrations at T3 were significantly higher than at T1 in the Control
group (P<0.05), while showing no significant difference in the Flurb
group. However, in the Flurb group, the relative changes of BMP4 and
IL-1beta at T2 and T3 were significantly lower than those in the Control
group. Conclusion(s): Circulating BMP4 was elevated during surgery
and highly correlated with inflammation cytokines. The elevation of BMP4
and inflammatory cytokines could be alleviated by flurbiprofen, indicating
that BMP4 may exert pro-inflammatory properties via cyclooxygenase-II
signaling pathways. Copyright © 2021 Zhao et al.

<155>
Accession Number
2014191705
Title
The MITRA-HR study: design and rationale of a randomised study of
MitraClip transcatheter mitral valve repair in patients with severe
primary mitral regurgitation eligible for high-risk surgery.
Source
EuroIntervention. 15 (4) (pp E329-E335), 2019. Date of Publication: July
2019.
Author
Piriou N.; Al Habash O.; Donal E.; Senage T.; Tourneau T.L.; Pattier S.;
Guyomarch B.; Roussel J.C.; Trochu J.N.; Vahanian A.; Obadia J.F.; Iung
B.; Guerin P.
Institution
(Piriou, Al Habash, Senage, Tourneau, Pattier, Guyomarch, Roussel, Trochu,
Guerin) Institut du Thorax, Centre Hospitalier Universitaire de Nantes,
Nantes, France
(Donal) Centre Hospitalier Universitaire de Rennes, Service de
Cardiologie, Rennes, France
(Vahanian, Iung) Assistance Publique-Hopitaux de Paris, Hopital Bichat,
DHU Fire, Universite Paris Diderot, Paris, France
(Obadia) Service de Chirurgie Cardiothoracique et Transplantation, Hopital
Cardiothoracique Louis Pradel, Lyon-Bron, France
Publisher
Europa Group
Abstract
Aims: Percutaneous mitral valve repair has become an alternative to
conventional surgery in patients suffering primary mitral regurgitation
(MR) with a contraindication to surgery and could benefit patients at high
surgical risk. The aim of the MITRA-HR study is to raise the level of
evidence supporting the use of the MitraClip device in primary MR patients
with a predefined high risk for surgery. Methods and Results:
MITRA-HR is a prospective, multicentre, randomised study designed to
compare mitral valve repair using the MitraClip with conventional surgery
in patients with severe primary mitral regurgitation at high risk for
surgery. The surgical risk is defined by age, Society of Thoracic Surgeons
(STS) risk estimate score, frailty, major organ system dysfunction, and
procedure-specific impediments. The study will enrol 330 patients
randomised between conventional surgery and MitraClip with a 1:1 ratio.
The composite primary endpoint includes all-cause mortality, unplanned
rehospitalisation for cardiovascular reasons, and mitral valve
reintervention at 12 months. The main secondary safety endpoint is a major
adverse event composite assessment evaluated 30 days after the procedure.
 Conclusion(s): The randomised MITRA-HR study is designed to provide
additional supportive evidence of non-inferiority in efficacy and
superiority in safety for percutaneous mitral valve repair using the
MitraClip compared to conventional surgery in high surgical risk
patients. Copyright © Europa Digital & Publishing 2019.

<156>
Accession Number
2014353967
Title
Thiamine increases resident endoglin positive cardiac progenitor cells and
atrial contractile force in humans: A randomised controlled trial.
Source
International Journal of Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Coffey S.; Dixit P.; Saw E.L.; Babakr A.A.; van Hout I.; Galvin I.F.;
Saxena P.; Bunton R.W.; Davis P.J.; Lamberts R.R.; Katare R.; Williams
M.J.A.
Institution
(Coffey, Williams) Department of Medicine - HeartOtago, Dunedin School of
Medicine, University of Otago, New Zealand
(Coffey, Williams) Department of Cardiology, Southern District Health
Board, New Zealand
(Dixit, Saw, Babakr, van Hout, Lamberts, Katare) Department of Physiology
- HeartOtago, School of Biomedical Sciences, University of Otago, New
Zealand
(Galvin, Saxena, Bunton, Davis) Department of Cardiothoracic Surgery,
Southern District Health Board, New Zealand
Publisher
Elsevier Ireland Ltd
Abstract
Background: The heart has an intrinsic ability to regenerate, orchestrated
by progenitor or stem cells. However, the relative complexity of
non-resident cardiac progenitor cell (CPC) therapy makes modulation of
resident CPCs a more attractive treatment target. Thiamine analogues
improve resident CPC function in pre-clinical models. In this double
blinded randomised controlled trial (identifier: ACTRN12614000755639), we
examined whether thiamine would improve CPC function in humans.
 Methods and Results: High dose oral thiamine (one gram twice daily)
or matching placebo was administered 3-5 days prior to coronary artery
bypass surgery (CABG). Right atrial appendages were collected at the time
of CABG, and CPCs isolated. There was no difference in the primary outcome
(proliferation ability of CPCs) between treatment groups. Older age was
not associated with decreased proliferation ability. In exploratory
analyses, isolated CPCs in the thiamine group showed an increase in the
proportion of CD34-/CD105+ (endoglin) cells, but no
difference in CD34-/CD90+ or CD34+ cells.
Thiamine increased maximum force developed by isolated trabeculae, with no
difference in relaxation time or beta-adrenergic responsiveness.
 Conclusion(s): Thiamine does not improve proliferation ability of CPC
in patients undergoing CABG, but increases the proportion of
CD34-/CD105+ cells. Having not met its primary
endpoint, this study provides the impetus to re-examine CPC biology prior
to any clinical outcome-based trial examining potential beneficial
cardiovascular effects of thiamine. Copyright © 2021 Elsevier
B.V.

<157>
Accession Number
2013600436
Title
Harvesting techniques of the saphenous vein graft for coronary artery
bypass: Insights from a network meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Yokoyama Y.; Shimamura J.; Takagi H.; Kuno T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
PA, United States
(Shimamura) Division of Cardiac Surgery, Department of Surgery, Western
University, London Health Sciences Centre, ON, Canada
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, NY, United States
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: The optimal harvesting technique of saphenous vein (SVG) in
coronary artery bypass grafting (CABG) is still to be elucidated. The
present study aimed to compare the methods of SVG harvesting technique,
which were open vein harvesting (OVH), endoscopic vein harvesting (EVH),
and no-touch vein harvesting (NT), using a network meta-analysis of
randomized controlled trials (RCTs), and propensity-score matched (PSM)
studies. Method(s): MEDLINE and EMBASE were searched through April
2021 to identify RCTs and PSM studies that investigated the outcomes in
patients who underwent CABG with the SVG using one of three methods; OVH,
EVH, and NT. The outcomes of interest were all-cause mortality, the rates
of revascularization, and graft failure. Risk ratios (RRs) were extracted
for the rates of graft failure, and hazard ratios (HRs) were extracted for
all-cause mortality and the rates of revascularization. Result(s):
Eligible seven RCT and five PSM studies were identified which enrolled a
total of 8111 patients. All-cause mortality was significantly lower in
patients with EVH compared with OVH (HR [95% confidence interval (CI)]
=0.77 [0.65-0.92], p =.0032). The rates of revascularization were similar
among the groups. The rate of graft failures was significantly lower in
patients with NT compared with OVH (HR [95% CI] =0.54 [0.32-0.90], p
=.019) and with EVH (HR [95% CI] =0.39 [0.17-0.86], p =.023).
 Conclusion(s): NT vein harvesting is favorable for graft patency, and
OVH showed higher all-cause mortality than EVH. Further well-powered RCTs
are needed to confirm our findings. Copyright © 2021 Wiley
Periodicals LLC

<158>
Accession Number
635869105
Title
Coronary Stenting: Reflections on a 35-Year Journey.
Source
The Canadian journal of cardiology. (no pagination), 2021. Date of
Publication: 07 Aug 2021.
Author
Strauss B.H.; Tanguay J.-F.; Picard F.; Doucet S.; Morice M.-C.;
Elbaz-Greener G.
Institution
(Strauss) Schulich Heart Program, Sunnybrook Health Sciences Centre;
University of Toronto, Toronto, Ontario, Canada
(Tanguay, Doucet) Montreal Heart Institute, University of Montreal,
Montreal, Canada
(Picard) Cardiology Department, Hopital Cochin, Assistance
Publique-Hopitaux de Paris, Paris, France
(Morice) Department of Cardiology, Institut Hospitalier Jacques Cartier,
Ramsay Generale de Sante, Massy, France
(Elbaz-Greener) Schulich Heart Program, Sunnybrook Health Sciences Centre;
Department of Cardiology Hadassah Medical Center. The Faculty of Medicine,
Hebrew University of Jerusalem, Jerusalem, Israel
Publisher
NLM (Medline)
Abstract
Stenting was introduced as a therapy for coronary artery disease 35 years
ago, and is currently the most commonly performed minimally invasive
procedure globally. Percutaneous coronary revascularization (PCI),
initially by plain old balloon angioplasty (POBA) and later by stenting,
has dramatically impacted the outcomes of acute myocardial infarction
(AMI) and acute coronary syndromes (ACS). Coronary stenting is probably
the most intensively studied therapy in medicine based on the number of
randomized clinical trials for a broad range of indications. Continuous
improvements in stent materials, design and coatings concurrent with
procedural innovations have truly been awe-inspiring. The story of
stenting is replete with high points and some low points, such as the
initial experience with stent thrombosis (ST) and restenosis, and the more
recent disappointment with bioabsorbable scaffolds. History has shown both
rapid growth of stent use with expansion of indications followed by
contraction of some uses in response to clinical trial evidence in support
of bypass surgery or medical therapy. This review traces the constantly
evolving story of the coronary stent from its earliest experience until
the present time. Undoubtedly, future iterations of stent design and
materials will continue to move the stent story forward. BRIEF SUMMARY
Coronary stenting was introduced 35 years ago, and is currently the most
commonly performed minimally invasive procedure globally. The history of
stenting is replete with high points and some low points, such as the
initial experience with stent thrombosis and restenosis. This review
traces the constantly evolving story of the coronary stent from its
earliest experience until the present time, and looking ahead to future
innovations. Copyright © 2021. Published by Elsevier Inc.

<159>
Accession Number
635866431
Title
Effect of Remote Ischemic Conditioning on Bleeding Complications in
Surgery: A Systematic Review and Meta-Analysis.
Source
Seminars in Thrombosis and Hemostasis. (no pagination), 2021. Date of
Publication: 2021.
Author
Krag A.E.; Hvas C.L.; Kiil B.J.; Hvas A.-M.
Institution
(Krag, Hvas) Thrombosis and Hemostasis Research Unit, Department of
Clinical Biochemistry, Aarhus University Hospital, Palle Juul-Jensens
Boulevard 99, Aarhus N DK-8200, Denmark
(Krag, Hvas) Department of Clinical Medicine, Aarhus University, Aarhus,
Denmark
(Krag, Kiil) Department of Plastic and Breast Surgery, Aarhus University
Hospital, Denmark
(Hvas) Department of Anesthesiology and Intensive Care, Aarhus University
Hospital, Denmark
Publisher
Thieme Medical Publishers, Inc.
Abstract
Remote ischemic conditioning (RIC) is administered with an inflatable
tourniquet by inducing brief, alternating cycles of limb ischemia and
reperfusion. RIC possibly impacts the hemostatic system, and the
intervention has been tested as protective therapy against
ischemia-reperfusion injury and thrombotic complications in cardiac
surgery and other surgical procedures. In the present systematic review,
we aimed to investigate the effect of RIC on intraoperative and
postoperative bleeding complications in meta-analyses of randomized
controlled trials including adult patients undergoing surgery. A
systematic search was performed on November 7, 2020 in PubMed, Embase, and
the Cochrane Central Register of Controlled Trials. Randomized controlled
trials comparing RIC versus no RIC in adult patients undergoing surgery
that reported bleeding outcomes in English publications were included.
Effect estimates with 95% confidence intervals were calculated using the
random-effects model for intraoperative and postoperative bleeding
outcomes. Thirty-two randomized controlled trials with 3,804 patients were
eligible for inclusion. RIC did not affect intraoperative bleeding volume
(nine trials; 392 RIC patients, 399 controls) with the effect estimate
-0.95 [-9.90; 7.99] mL (p = 0.83). RIC significantly reduced postoperative
drainage volume (seven trials; 367 RIC patients, 365 controls) with mean
difference -83.6 [-134.9; -32.4] mL (p = 0.001). The risk of re-operation
for bleeding was reduced in the RIC group (16 trials; 838 RIC patients,
839 controls), albeit not significantly, with the relative risk 0.65
[0.39; 1.09] (p = 0.10). In conclusion, RIC reduced postoperative bleeding
measured by postoperative drainage volume in this meta-analysis of adult
patients undergoing surgery. Copyright © 2021 American Medical
Association. All rights reserved.

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