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<1>
Accession Number
2013347744
Title
Apixaban versus PhenpRocoumon: Oral AntiCoagulation plus antiplatelet
tHerapy in patients with Acute Coronary Syndrome and Atrial Fibrillation
(APPROACH-ACS-AF): Rationale and design of the prospective randomized
parallel-group, open-label, blinded-endpoint, superiority,
multicenter-trial of a triple therapy versus a dual therapy in patients
with Atrial Fibrillation and Acute Coronary Syndrome undergoing coronary
stenting.
Source
IJC Heart and Vasculature. 35 (no pagination), 2021. Article Number:
100810. Date of Publication: August 2021.
Author
Riesinger L.; Strobl C.; Leistner D.M.; Gori T.; Akin I.; Mehr M.; Kellnar
A.; Mahabadi A.A.; Bogossian H.; Block M.; Edelmann F.; Sarafoff N.;
Sibbing D.; Ince H.; Rassaf T.; Mansmann U.; Mehilli J.; Kaab S.;
Hausleiter J.; Massberg S.; Wakili R.
Institution
(Riesinger, Strobl, Mehr, Kellnar, Sarafoff, Sibbing, Mehilli, Kaab,
Hausleiter, Massberg, Wakili) Department of Medicine I, University
Hospital Munich, Campus Grosshadern, Ludwig-Maximilians-University Munich
(LMU Munich), Munich, Germany
(Riesinger, Strobl, Mehr, Kellnar, Sibbing, Mehilli, Kaab, Hausleiter,
Massberg, Wakili) DZHK (German Centre for Cardiovascular Research),
Partner Site Munich Heart Alliance, Munich 80802, Germany
(Riesinger, Mahabadi, Rassaf, Wakili) Department of Cardiology and
Vascular Medicine, West-German Heart and Vascular Center Essen, University
Hospital Essen, University Duisburg-Essen, Essen, Germany
(Leistner) Department of Cardiology, Charite University of Medicine,
Berlin, Campus Benjamin Franklin, Germany and Berlin Institute of Health
(BIH), Berlin 10117, Germany
(Leistner, Edelmann) DZHK (German Center for Cardiovascular Research),
Partner Site Berlin, Germany
(Gori) Center for Cardiology, Cardiology 1, Universitatsmedizin Mainz,
Mainz, Germany
(Gori) DZHK (German Center for Cardiovascular Research), Partner Site
Rhine-Main, Germany
(Akin) First Department of Medicine, Faculty of Medicine Mannheim,
University Medical Centre Mannheim (UMM), University of Heidelberg,
Germany
(Akin) DZHK (German Center for Cardiovascular Research), Partner Site
Heidelberg/Mannheim, Germany
(Bogossian) Markische Kliniken GmbH, Klinikum Ludenscheid, Ludenscheid,
Germany
(Bogossian) Department of Cardiology, University Witten/Herdecke, Witten,
Germany
(Block) Department of Cardiology, Augustinum Hospital, Munich, Germany
(Edelmann) Department of Internal Medicine and Cardiology, Charite
University Hospital (Campus Virchow Klinikum), Berlin, Germany
(Ince) Department of Cardiology, Rostock University Medical Center,
Rostock, Germany
(Mansmann) Department of Medical Information Processing, Biometry and
Epidemiology (IBE), Ludwig-Maximilians-University Munich (LMU Munich),
Munich, Germany
(Mehilli) Department of Medicine I, Landshut-Achdorf Hospital, Landshut,
Germany
Publisher
Elsevier Ireland Ltd
Abstract
Background: A regimen of dual (DAT) vs. triple (TAT) antithrombotic
therapy reduces bleeding in patients with atrial fibrillation (AF)
undergoing percutaneous coronary intervention (PCI). However, recent
evidence suggests that DAT may be associated with an increased ischemic
risk. This raises the question whether DAT rather than TAT should be
recommended to AF patients that undergo PCI for acute coronary syndrome
(ACS), carrying a particularly high risk of both bleeding and ischemic
events, studied only as subgroups of previous trials. Methods and design:
The APPROACH-ACS-AF-(DZHK-7) trial is a multicenter prospective,
randomized, open-label, blinded endpoint (PROBE) trial which will include
patients presenting with an ACS managed by PCI and requiring oral
anticoagulation (OAC) due to AF. The trial will test, whether a
DAT-regimen comprising clopidogrel plus the non-Vitamin-K-antagonist oral
anticoagulant (NOAC) apixaban is superior to a TAT-regimen of
vitamin-K-antagonist (VKA) plus dual anti-platelet therapy (APT) with
respect to bleeding. A total of 400 patients will be randomized 1:1 to a
control-arm with guideline-recommended TAT with VKA plus clopidogrel and
acetylsalicylic-acid and a study arm receiving DAT comprising apixaban
plus clopidogrel. Patients will be followed-up for 6 months. The primary
endpoint of the study is the cumulative incidence of BARC type >=2
bleeding, secondary endpoints include a composite clinical ischemic
outcome and net clinical outcome. <br/>Conclusion(s): APPROACH-ACS-AF is
the first trial dedicated to ACS patients, testing whether in terms of
bleeding a DAT with NOAC is superior to a TAT regimen with VKA in
high-risk ACS patients with AF.<br/>Copyright &#xa9; 2021 The Authors

<2>
Accession Number
2007316070
Title
Impact of Aortic Annulus Enlargement on the Outcomes of Aortic Valve
Replacement: A Meta-analysis.
Source
Seminars in Thoracic and Cardiovascular Surgery. 33(2) (pp 316-325), 2021.
Date of Publication: Summer 2021.
Author
Sa M.P.B.O.; Zhigalov K.; Cavalcanti L.R.P.; Escorel Neto A.C.; Rayol
S.C.; Weymann A.; Ruhparwar A.; Lima R.C.
Institution
(Sa, Cavalcanti, Escorel Neto, Rayol, Lima) Division of Cardiovascular
Surgery of Pronto Socorro Cardiologico de Pernambuco - PROCAPE, Recife,
Brazil
(Sa, Cavalcanti, Escorel Neto, Rayol, Lima) University of Pernambuco -
UPE, Recife, Brazil
(Sa, Lima) Nucleus of Postgraduate and Research in Health Sciences of
Faculty of Medical Sciences and Biological Sciences Instituite - FCM/ICB,
Recife, Brazil
(Zhigalov, Weymann, Ruhparwar) Department of Thoracic and Cardiovascular
Surgery, West German Heart and Vascular Center Essen, University Hospital
of Essen, University Duisburg-Essen, Essen, Germany
Publisher
W.B. Saunders
Abstract
We sought to evaluate the impact of surgical aortic annulus enlargement
(ARE) on the perioperative outcomes of surgical aortic valve replacement.
Databases were searched for articles published by October 2019 in order to
carry out a systematic review followed by meta-analysis. Thirteen studies
with 40,447 patients (aortic valve replacement [AVR] with aortic annulus
enlargement [AAE]: 4686 patients; AVR without AAE: 35,761 patients) were
included. The total rate of AAE was 11.6%, ranging from 4.1%-28.1%. The
overall unadjusted odds ratio (OR) (95% confidence interval [CI]) for
operative mortality showed a statistically significant difference between
the groups, with higher risk in the "AVR with AAE" group (OR 1.388; 95% CI
1.049-1.836, P < 0.001), but not for isolated AVR+AAE (OR 1.341; 95% CI
0.920-1.956, P = 0.127) and also not in matched populations (OR 1.003; 95%
CI 0.773-1.300, P = 0.984). The "AVR with AAE" group showed an overall
lower risk of significant patient-prosthesis mismatch (PPM) (OR 0.567; 95%
CI 0.376-0.854, P = 0.007) and a higher overall difference in means of
indexed effective orifice area (iEOA) (random effect model: 0.058
cm²/m²; 95% CI 0.024-0.092, P < 0.001). The overall
ORs for myocardial infarction, stroke, complete heart block/permanent
pacemaker implantation and reoperation for bleeding showed no
statistically significant difference between the groups. AAE is a useful
adjunct to AVR, but the benefit of reduced PPM must be balanced against a
possibly higher risk of perioperative mortality.<br/>Copyright &#xa9; 2020
Elsevier Inc.

<3>
Accession Number
2015424106
Title
Commentary.
Source
Annals of Internal Medicine. 174(3) (pp JC30), 2021. Date of Publication:
01 Mar 2021.
Author
Bates E.R.
Institution
(Bates) University of Michigan, Ann Arbor, MI, United States
Publisher
American College of Physicians

<4>
Accession Number
2014151262
Title
Plasma biomarker profiling in heart failure patients with preserved
ejection fraction before and after spironolactone treatment: Results from
the Aldo-DHF trial.
Source
Cells. 10(10) (no pagination), 2021. Article Number: 2796. Date of
Publication: October 2021.
Author
Schnelle M.; Leha A.; Eidizadeh A.; Fuhlrott K.; Trippel T.D.; Hashemi D.;
Toischer K.; Wachter R.; Herrmann-Lingen C.; Hasenfuss G.; Pieske B.;
Binder L.; Edelmann F.
Institution
(Schnelle, Eidizadeh, Binder) Institute for Clinical Chemistry, University
Medical Center Goettingen, Goettingen 37075, Germany
(Schnelle, Leha, Toischer, Wachter, Herrmann-Lingen, Hasenfus, Binder)
DZHK (German Centre for Cardiovascular Research), Partner Site Goettingen,
Goettingen 37075, Germany
(Leha) Department of Medical Statistics, University Medical Center
Goettingen, Goettingen 37075, Germany
(Fuhlrott, Toischer, Wachter, Hasenfus) Clinic of Cardiology and
Pneumology, University Medical Center Goettingen, Goettingen 37075,
Germany
(Trippel, Hashemi, Pieske, Edelmann) Department of Internal Medicine and
Cardiology, Charite-Universitatsmedizin Berlin, Campus Virchow Klinikum,
Berlin 13353, Germany
(Trippel, Hashemi, Pieske, Edelmann) DZHK (German Centre for
Cardiovascular Research), Partner Site Berlin, Berlin 10785, Germany
(Wachter) Clinic and Policlinic for Cardiology, University Hospital
Leipzig, Leipzig 04103, Germany
(Herrmann-Lingen) Department of Psychosomatic Medicine and Psychotherapy,
University Medical Center Goettingen, Goettingen 37075, Germany
(Pieske, Edelmann) Berlin Institute of Health, Berlin 13353, Germany
(Pieske) Department of Cardiology, Germany Heart Center Berlin, Berlin
13353, Germany
Publisher
MDPI
Abstract
The pathophysiology of heart failure with preserved ejection fraction
(HFpEF) is poorly understood and therapeutic strategies are lacking. This
study aimed to identify plasma proteins with pathophysiological relevance
in HFpEF and with respect to spironolactone-induced effects. We assessed
92 biomarkers in plasma samples from 386 HFpEF patients-belonging to the
Aldo-DHF trial-before (baseline, BL) and after one-year treatment (follow
up, FU) with spironolactone (verum) or a placebo. At BL, various
biomarkers showed significant associations with the two Aldo-DHF primary
end point parameters: 33 with E/e' and 20 with peak VO2. Ten proteins
including adrenomedullin, FGF23 and inflammatory peptides (e.g.,
TNFRSF11A, TRAILR2) were significantly associated with both parameters,
suggesting a role in the clinical HFpEF presentation. For 13 proteins,
expression changes from BL to FU were significantly different between
verum and placebo. Among them were renin, growth hormone, adrenomedullin
and inflammatory proteins (e.g., TNFRSF11A, IL18 and IL4RA), indicating
distinct spironolactone-mediated effects. BL levels of five proteins,
e.g., inflammatory markers such as CCL17, IL4RA and IL1ra, showed
significantly different effects on the instantaneous risk for
hospitalization between verum and placebo. This study identified plasma
proteins with different implications in HFpEF and following spironolactone
treatment. Future studies need to define their precise mechanistic
involvement.<br/>Copyright &#xa9; 2021 by the authors. Licensee MDPI,
Basel, Switzerland.

<5>
Accession Number
2013622015
Title
Metabolic effects of gastrectomy and duodenal bypass in early gastric
cancer patients with T2DM: A prospective single-center cohort study.
Source
Journal of Clinical Medicine. 10(17) (no pagination), 2021. Article
Number: 4008. Date of Publication: September 2021.
Author
Lee Y.K.; Lee E.K.; Lee Y.J.; Eom B.W.; Yoon H.M.; Kim Y.-I.; Cho S.J.;
Lee J.Y.; Kim C.G.; Kong S.-Y.; Yoo M.K.; Hwangbo Y.; Kim Y.-W.; Choi
I.J.; Kim H.J.; Kwak M.H.; Ryu K.W.
Institution
(Lee, Lee, Lee, Hwangbo) Division of Endocrinology and Metabolism,
Department of Internal Medicine, National Cancer Center, Goyang 10408,
South Korea
(Lee, Yoon, Kim, Kong) Department of Cancer Biomedical Science, National
Cancer Center Graduate School of Cancer Science and Policy, National
Cancer Center, Goyang 10408, South Korea
(Eom, Yoon, Kim, Cho, Lee, Kim, Kim, Choi, Ryu) Center for Gastric Cancer,
National Cancer Center, Goyang 10408, South Korea
(Kong) Department of Laboratory Medicine, National Cancer Center, Goyang
10408, South Korea
(Yoo) Department of Clinical Nutrition, National Cancer Center, Goyang
10408, South Korea
(Hwangbo, Choi) Department of Cancer Control and Population Health,
National Cancer Center, Graduate School of Cancer Science and Policy,
National Cancer Center, Goyang 10408, South Korea
(Kim, Kwak) Division of Cardiology, Department of Internal Medicine,
National Cancer Center, Goyang 10408, South Korea
Publisher
MDPI
Abstract
We evaluated the metabolic effects of gastrectomies and endoscopic
submucosal dissections (ESDs) in early gastric cancer (EGC) patients with
type 2 diabetes mellitus (T2DM). Forty-one EGC patients with T2DM
undergoing gastrectomy or ESD were prospectively evaluated. Metabolic
parameters in the patients who underwent gastrectomy with and without a
duodenal bypass (groups 1 and 2, n = 24 and n = 5, respectively) were
compared with those in patients who underwent ESD (control, n = 12). After
1 year, the proportions of improved/equivocal/worsened glycemic control
were 62.5%/29.2%/8.3% in group 1, 40.0%/60.0%/0.0% in group 2, and
16.7%/50.0%/33.3% in the controls, respectively (p = 0.046). The
multivariable ordered logistic regression analysis results showed that
both groups had better 1-year glycemic control. Groups 1 and 2 showed a
significant re-duction in postprandial glucose (-97.9 and -67.8 mg/dL),
body mass index (-2.1 and -2.3 kg/m²), and glycosylated
hemoglobin (group 1 only, -0.5% point) (all p < 0.05). Furthermore,
improvements in group 1 were more prominent when preoperative leptin
levels were high (p for interaction < 0.05). Metabolic improvements in
both groups were also observed for insulin resistance, leptin,
plasmino-gen activator inhibitor-1, and resistin. Gastrectomy improved
glycemic control and various metabolic parameters in EGC patients with
T2DM. Patients with high leptin levels may experience greater metabolic
benefits from gastrectomy with duodenal bypass.<br/>Copyright &#xa9; 2021
by the authors. Licensee MDPI, Basel, Switzerland.

<6>
Accession Number
2013491396
Title
Postoperative Atrial Fibrillation or Flutter Following Transcatheter or
Surgical Aortic Valve Replacement: PARTNER 3 Trial.
Source
JACC: Cardiovascular Interventions. 14(14) (pp 1565-1574), 2021. Date of
Publication: 26 Jul 2021.
Author
Shahim B.; Malaisrie S.C.; George I.; Thourani V.H.; Biviano A.B.; Russo
M.; Brown D.L.; Babaliaros V.; Guyton R.A.; Kodali S.K.; Nazif T.M.;
Kapadia S.; Pibarot P.; McCabe J.M.; Williams M.; Genereux P.; Lu M.; Yu
X.; Alu M.; Webb J.G.; Mack M.J.; Leon M.B.; Kosmidou I.
Institution
(Shahim, Alu, Leon, Kosmidou) Cardiovascular Research Foundation, New
York, NY, United States
(Malaisrie) Division of Cardiac Surgery, Northwestern University, Chicago,
IL, United States
(George, Biviano, Kodali, Nazif, Alu, Leon, Kosmidou) NewYork-Presbyterian
Hospital/Columbia University Irving Medical Center, New York, NY, United
States
(Thourani) Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta,
GA, United States
(Russo) Division of Cardiac Surgery, Rutgers-Robert Wood Johnson Medical
School, New Brunswick, NJ, United States
(Brown, Mack) Baylor Scott & White Health, Plano, TX, United States
(Babaliaros, Guyton) Emory University Medical Center, Atlanta, GA, United
States
(Kapadia) Cleveland Clinic, Cleveland, OH, United States
(Pibarot) Quebec Heart and Lung Institute, Laval University, Quebec, QC,
Canada
(McCabe) University of Washington, Seattle, WA, United States
(Williams) NYU Langone Medical Center, New York, NY, United States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Lu, Yu) Edwards Lifesciences, Irvine, CA, United States
(Webb) St. Paul's Hospital, Vancouver, BC, Canada
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to assess the incidence and
prognostic impact of early and late postoperative atrial fibrillation or
flutter (POAF) in patients with severe aortic stenosis (AS) treated with
transcatheter aortic valve replacement (TAVR) or surgical aortic valve
replacement (SAVR). <br/>Background(s): There is an ongoing controversy
regarding the incidence, recurrence rate, and prognostic impact of early
(in-hospital) POAF and late (postdischarge) POAF in patients with AS
undergoing TAVR or SAVR. <br/>Method(s): In the PARTNER (Placement of
Aortic Transcatheter Valve) 3 trial, patients with severe AS at low
surgical risk were randomized to TAVR or SAVR. Analyses were performed in
the as-treated population excluding patients with preexistent atrial
fibrillation or flutter. <br/>Result(s): Among 781 patients included in
the analysis, early POAF occurred in 152 (19.5%) (18 of 415 [4.3%] and 134
of 366 [36.6%] following TAVR and SAVR, respectively). Following
discharge, 58 new or recurrent late POAF events occurred within 1 year
following the index procedure in 55 of 781 patients (7.0%). Early POAF was
not an independent predictor of late POAF following discharge (odds ratio:
1.04; 95% CI: 0.52-2.08; P = 0.90). Following adjustment, early POAF was
not an independent predictor of the composite outcome of death, stroke, or
rehospitalization (hazard ratio: 1.10; 95% CI: 0.64-1.92; P = 0.72),
whereas late POAF was associated with an increased adjusted risk for the
composite outcome (hazard ratio: 8.90; 95% CI: 5.02-15.74; P < 0.0001),
irrespective of treatment modality. <br/>Conclusion(s): In the PARTNER 3
trial, early POAF was more frequent following SAVR compared with TAVR.
Late POAF, but not early POAF, was significantly associated with worse
outcomes at 2 years, irrespective of treatment modality.<br/>Copyright
&#xa9; 2021 The Authors

<7>
Accession Number
633905971
Title
Bras for Breast Support After Sternotomy: Patient Satisfaction and Wear
Compliance.
Source
American journal of critical care : an official publication, American
Association of Critical-Care Nurses. 30(1) (pp 21-26), 2021. Date of
Publication: 01 Jan 2021.
Author
Bolling K.; Long T.; Jennings C.D.; Dane F.C.; Carter K.F.
Institution
(Bolling) Carilion Roanoke Memorial Hospital, Kimberly Bolling is a
registered nurse in the cardiac surgery intensive care unit, Roanoke, VA,
United States
(Long) Carilion Roanoke Memorial Hospital, Takako Long is a registered
nurse in the cardiovascular progressive care unit, Roanoke, VA, United
States
(Jennings) Carilion Roanoke Memorial Hospital, Cathy D. Jennings is a
clinical nurse specialist
(Dane) Francis C. Dane is a professor of psychology, Radford University,
Radford, Virginia, and a professor of interprofessionalism, Virginia Tech
Carilion School of Medicine, Roanoke, Virginia
(Carter) nursing research, Carilion Clinic, Kimberly Ferren Carter is
senior director, Roanoke, VA, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: For women undergoing median sternotomy, especially those with
a bra cup size C or larger, breast support can reduce pain, wound
breakdown, and infection. This study addressed a gap in research,
identifying the best bra after sternotomy in terms of patient satisfaction
and wear compliance. <br/>OBJECTIVE(S): To evaluate larger-breasted
women's satisfaction and compliance with wearing 3 commercially available
front-closure bras-with a hook-loop closure (the hospital's standard of
care), a zipper closure, or a hook-eye closure-after cardiac surgery.
<br/>METHOD(S): This study used a posttest-only, 3-group randomized
controlled design. A convenience sample of participants were sized and
randomly assigned a product that was placed immediately postoperatively.
Participants agreed to wear the bra at least 20 h/d until the provider
cleared them for less wear. At inpatient day 5 or discharge, and at the
follow-up outpatient visit, subjects completed investigator-developed
surveys. Data were analyzed from 60 participants by using the chi2 test
and Kruskal-Wallis analysis of variance; also, patterns were identified
within written comments. <br/>RESULT(S): Participants were most satisfied
with the hook-eye front-closure product before (P = .05) and after (P =
.02) discharge. Participants recommended the hook-eye and zipper products
over the hook-loop bra (H = 8.39, P = .02). Wear compliance was strongest
in the group wearing the hook-eye bra. <br/>CONCLUSION(S): The hook-eye
closure product had the most satisfaction and greatest wear compliance,
and it received the highest recommendation. A practice change was made to
fit and place the hook-eye bra in the operating room immediately after
surgery.<br/>Copyright &#xa9;2021 American Association of Critical-Care
Nurses.

<8>
Accession Number
2013691318
Title
The association of prothrombin complex concentrates with postoperative
outcomes in cardiac surgery: an observational substudy of the FIBRES
randomized controlled trial.
Source
Canadian Journal of Anesthesia. 68(12) (pp 1789-1801), 2021. Date of
Publication: December 2021.
Author
Bartoszko J.; Callum J.; Karkouti K.
Institution
(Bartoszko, Karkouti) Department of Anesthesia and Pain Management,
Toronto General Hospital - University Health Network, Sinai Health System,
Women's College Hospital, University of Toronto, 200 Elizabeth Street,
3EN-464, Toronto, ON M5G 2C4, Canada
(Bartoszko, Karkouti) Peter Munk Cardiac Centre and Toronto General
Hospital Research Institute, University Health Network, Toronto, ON,
Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre, Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Queen's
University, Kingston, ON, Canada
(Karkouti) Institute of Health Policy Management and Evaluation,
University of Toronto, Toronto, ON, Canada
Publisher
Springer
Abstract
Purpose: The mainstay of therapy for coagulation factor deficiency in
cardiac surgical patients is frozen plasma (FP); however, prothrombin
complex concentrates (PCCs) may offer logistical and safety advantages. As
there is limited comparative evidence, we conducted this study to explore
the association of comparable PCC or FP doses with transfusion and
outcomes. <br/>Method(s): This was a post hoc analysis of a multicentre
randomized trial comparing fibrinogen concentrate with cryoprecipitate
(FIBRES trial) in bleeding cardiac surgical patients. This analysis
included 415 patients who received only PCC (n = 72; 17%) or only FP (n =
343; 83%) for factor replacement. The main outcomes of interest were red
blood cell (RBC) and platelet transfusion within 24 hr of cardiopulmonary
bypass. Secondary outcomes included postoperative adverse events.
Associations were examined by hierarchical generalized estimating equation
models adjusted for demographic and surgical characteristics.
<br/>Result(s): The median [interquartile range (IQR)] PCC dose was 1,000
[1,000-2,000] units, while the median [IQR] FP dose was 4 [2-6] units.
Each unit of FP was independently associated with increased adjusted odds
of RBC (1.60; 95% confidence interval [CI], 1.36 to 1.87; P < 0.01) and
platelet transfusion (1.40; 95% CI, 1.15 to 1.69; P < 0.01) while each 500
units of PCC was independently associated with reduced adjusted odds of
RBC (0.67; 95% CI, 0.50 to 0.90; P < 0.01) and platelet transfusion (0.80;
95% CI, 0.70 to 0.92; P < 0.01). Adverse event rates were comparable.
<br/>Conclusion(s): In cardiac surgical patients with post-cardiopulmonary
bypass bleeding, PCC use was associated with lower RBC and platelet
transfusion than FP use was. Prospective, randomized clinical trials
comparing FP with PCC in this setting are warranted.<br/>Copyright &#xa9;
2021, The Author(s).

<9>
Accession Number
2011079994
Title
Safety and Efficacy of Non-Vitamin K Oral Anticoagulant Use Early After
Cardiac Surgery: A Systematic Review.
Source
Annals of Pharmacotherapy. 55(12) (pp 1525-1535), 2021. Date of
Publication: December 2021.
Author
Wang E.H.Z.; Ye J.; Turgeon R.
Institution
(Wang, Ye, Turgeon) University of British Columbia, Vancouver, BC, Canada
Publisher
SAGE Publications Inc.
Abstract
Objective: To determine the safety and efficacy of non-vitamin K oral
anticoagulants (NOACs) initiated early after cardiac surgery. <br/>Data
Sources:: Cochrane Central Register of Controlled Trials, EMBASE, and
MEDLINE (database inception to January 20, 2021), www.clinicaltrials.gov,
www.who.int/ictrp/search/en/, NOAC trial registries, and bibliographies of
relevant guidelines and other reviews were used. Study Selection and Data
Extraction: Observational studies and randomized controlled trials (RCTs)
that initiated NOACs within the index hospitalization and that reported
bleeding for the primary outcome were included. <br/>Data Synthesis: A
total of 6 cohort studies, 1 RCT, and 3 ongoing RCTs were included. Most
studies were single-centered, limited to postoperative atrial fibrillation
after coronary artery bypass grafting, and with 30-day follow-up; few
studies included patients with isolated bioprosthetic valve replacement or
valve repair. Bleeding risk varied (0%-28.6%), and all but one study
showed no significantly higher risk with NOAC compared with warfarin.
Relevance to Patient Care and Clinical Practice: Overall, NOACs were used
in 26% to 37.5% of patients early after cardiac surgery. Starting a NOAC
on postoperative day 4 appeared to have similar bleeding rates compared
with warfarin, but clinical application is limited by heterogeneity of
outcome definitions, confounding, and bias. Compared with warfarin, NOACs
may have similar thromboembolism risk, reduced length of stay, and cost.
<br/>Conclusion(s): There is limited evidence to guide NOAC use early
after cardiac surgery. Three ongoing randomized trials will add to the
literature and provide guidance for clinicians on whether, in whom, when,
and how to use NOACs safely early after cardiac surgery.<br/>Copyright
&#xa9; The Author(s) 2021.

<10>
Accession Number
635983074
Title
Preoperative incentive spirometry for preventing postoperative pulmonary
complications in patients undergoing coronary artery bypass graft surgery:
a prospective, randomized controlled trial.
Source
Journal of cardiothoracic surgery. 16(1) (pp 241), 2021. Date of
Publication: 24 Aug 2021.
Author
Sweity E.M.; Alkaissi A.A.; Othman W.; Salahat A.
Institution
(Sweity, Salahat) Faculty of Graduate Studies, An-Najah National
University, Nablus 44839, Palestine
(Sweity) Cardiology Department, An-Najah National University Hospital,
Nablus 44839, Palestine
(Alkaissi) Department of Anaesthesiology and Intensive Care, Faculty of
Medicine and Health Sciences, Nursing and Midwifery Department, An-Najah
National University, Nablus 44839, Palestine
(Othman) An-Najah National University Hospital, Nablus 44839, Palestine
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative pulmonary complications (PPCs) often occur after
cardiac operations and are a leading cause of morbidity, inhibit
oxygenation, and increase hospital length of stay and mortality. Although
clinical evidence for PPCs prevention is often unclear and crucial,
measures occur to reduce PPCs. One device usually used for this reason is
incentive spirometry (IS). The aim of the study is to evaluate the effect
of preoperative incentive spirometry to prevent postoperative pulmonary
complications, improve postoperative oxygenation, and decrease hospital
stay following coronary artery bypass graft (CABG) surgery patients.
<br/>METHOD(S): This was a clinical randomized prospective study. A total
of 80 patients were selected as candidates for CABG at An-Najah National
University Hospital, Nablus-Palestine. Patients had been randomly assigned
into two groups: incentive spirometry group (IS), SI performed before
surgery (study group) and control group, preoperative spirometry was not
performed. The 40 patients in each group received the same protocol of
anesthesia and ventilation in the operating room. <br/>RESULT(S): The
study findings showed a significant difference between the IS and control
groups in the incidence of postoperative atelectasis. There were 8
patients (20.0%) in IS group and 17 patients (42.5%) in the control group
(p=0.03). Mechanical ventilation duration was significantly less in IS
group. The median was four hours versus six hours in the control group
(p<0.001). Hospital length of stay was significantly less in IS group, and
the median was six days versus seven days in the control group (p<0.001).
The median of the amount of arterial blood oxygen and oxygen saturation
was significantly improved in the IS group (p<0.005). <br/>CONCLUSION(S):
Preoperative incentive spirometry for two days along with the exercise of
deep breathing, encouraged coughing, and early ambulation following CABG
are in connection with prevention and decreased incidence of atelectasis,
hospital stay, mechanical ventilation duration and improved postoperative
oxygenation with better pain control. A difference that can be considered
both significant and clinically relevant. Trial registration Thai Clinical
Trials Registry: TCTR20201020005. Registered 17 October
2020-retrospectively registered.<br/>Copyright &#xa9; 2021. The Author(s).

<11>
Accession Number
635983070
Title
Balanced forced-diuresis compared to control as a reno-protective approach
in cardiac surgery: secondary outcome of a randomized controlled trial,
assessment of neutrophil gelatinase-associated lipocalin levels.
Source
Journal of cardiothoracic surgery. 16(1) (pp 240), 2021. Date of
Publication: 24 Aug 2021.
Author
Luckraz H.; Giri R.; Wrigley B.; Nagarajan K.; Senanayake E.; Sharman E.;
Beare L.; Nevill A.
Institution
(Luckraz) American Hospital, PO Box 5566, Dubai, United Arab Emirates
(Giri, Wrigley, Nagarajan, Senanayake, Sharman) Heart and Lung Centre,
Wolverhampton WV10 0QP, United Kingdom
(Beare) University Hospitals of North Midlands, Stoke-on-Trent ST4 6QG,
United Kingdom
(Nevill) Faculty of Education, Health and Wellbeing, University of
Wolverhampton, Wolverhampton WS1 3BD, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL) is a
recognised biomarker for acute kidney injury (AKI).This study investigated
the impact of balanced forced-diuresis using RenalGuard system (RG), in
reducing acute kidney injury (AKI) rates and the associated NGAL levels
(6-h post-CPB plasma level) post adult cardiac surgery with
cardiopulmonary bypass (CPB). <br/>METHOD(S): Patients included in the
study were at high-risk for AKI post cardiac surgery, namely history of
diabetes and/or anaemia, e-GFR 20-60 ml/min/1.73 m2, Logistic EuroScore>5,
anticipated CPB time>120 min. Patients were randomized to either RG
(n=110) or managed as per current practice (control=110). RIFLE-defined
AKI rate (based on serum creatinine level increase) within first 3 days of
surgery and 6-h post CPB NGAL levels were the primary and secondary
end-points. <br/>RESULT(S): Pre and intra-operative characteristics
between the two groups were similar (p>0.05) including the pre-op NGAL
levels, the oxygen delivery (ecDO2i) and the carbon dioxide production
(ecVCO2i) during CPB. Patients in the RG group had a significantly lower
post-operative RIFLE-defined AKI rate compared to control (10% (11/110)
v/s 20.9% (23/110), p=0.03). Overall, median 6-h post CPB NGAL levels in
patients with AKI were significantly higher than those who did not develop
AKI (211 vs 150 ng/ml, p<0.001). Patients managed by balanced
forced-diuresis had lower post-operative NGAL levels (146 vs 178 ng/ml,
p=0.09). Using previously reported NGAL cut-off level for AKI (142 ng/ml),
binary logistic regression analysis confirmed a beneficial effect of the
RG system, with an increased risk of AKI of 2.2 times in the control group
(OR 2.2, 95% CI 1.14-4.27, p=0.02). <br/>CONCLUSION(S): Overall, the 6-h
post-CPB plasma NGAL levels were significantly higher in patients who
developed AKI. Patients managed with the novel approach of balanced
forced-diuresis, provided by the RenalGuard system, had a lower AKI rate
and lower NGAL levels indicating a lesser degree of renal tissue injury.
Trial registration ClinicalTrials.gov website, NCT02974946,
https://clinicaltrials.gov/ct2/show/NCT02974946 .<br/>Copyright &#xa9;
2021. The Author(s).

<12>
Accession Number
635149007
Title
Systematic review of prospective studies focused on regionalization of
care in surgical oncology.
Source
Updates in surgery. 73(5) (pp 1699-1707), 2021. Date of Publication: 01
Oct 2021.
Author
Goel S.; Symer M.M.; Alzghari T.; Baltich Nelson B.; Yeo H.L.
Institution
(Goel) Department of Surgery, Weill Cornell Medical College, NY, NY,
United States
(Goel) Department of Surgical Oncology, Department of Healthcare Policy,
Weill Cornell Medicine, 525 E 68th St, NY, NY 10065, United States
(Symer, Alzghari, Yeo) Department of Surgery, Weill Cornell Medical
College, NY, NY, United States
(Baltich Nelson) Clinical and Systems Librarian, Weill Cornell Medical
College, NY, NY, United States
(Yeo) Department of Surgical Oncology, Department of Healthcare Policy,
Weill Cornell Medicine, 525 E 68th St, NY, NY 10065, United States
Publisher
NLM (Medline)
Abstract
To perform a systematic review of studies prospectively analyzing the
impact of regionalization of complex surgical oncology care on patient
outcomes. High volume care of complex surgical oncology patients has been
repeatedly associated with improved outcomes. Most studies, however, are
retrospective and have not prospectively accounted for confounders such as
financial ability and social support. Four electronic databases (Ovid
MEDLINE, Ovid EMBASE, Cochrane Library (Wiley), and EBSCHOHost) were
searched from inception until August 25, 2018. Two authors independently
reviewed 5887 references, with a third independent reviewer acting as
arbitrator when needed. Data extracted from 11 articles that met inclusion
criteria. Risk of bias assessments conducted using MINORS criteria for the
non-randomized, observational studies, and the Cochrane tool for the
randomized-controlled trial. Of the 11 studies selected, we found 7
historically-controlled trials, two retrospective cohort studies with
prospective data collection, one prospective study, and one
randomized-controlled trial. 73% of studies were from Northern Europe, 18%
from Ontario, Canada, and 9% from England. Pancreatic surgery accounted
for 36% of studies, followed by gynecologic oncology (27%), thoracic
surgery (18%), and dermatologic surgery (9%). The studies reported varying
outcome parameters, but all showed improvement post-regionalization.
Included studies featured poor-to-fair risk of bias. 11 studies indicated
improved outcomes following regionalization of surgical oncology, but most
exhibit poor methodological rigor. Prospective evidence for the
regionalization of surgical oncology is lacking. More research addressing
patient access to care and specialist availability is needed to understand
the shortcomings of centralization.<br/>Copyright &#xa9; 2021. Italian
Society of Surgery (SIC).

<13>
Accession Number
636408059
Title
Autoimmune platelet function disorders: Systematic review of acquired
glanzmann thrombasthenia and acquired delta storage pool disease cases.
Source
Research and Practice in Thrombosis and Haemostasis. Conference: 2021
Congress of the International Society of Thrombosis and Haemostasis, ISTH
2021. Virtual. 5(SUPPL 2) (no pagination), 2021. Date of Publication:
October 2021.
Author
Ferretti A.; Bacci M.; Marchetti M.; Alberelli M.A.; Falanga A.; Lodigiani
C.; De Candia E.
Institution
(Ferretti, Alberelli) IRCCS Policlinico Universitario A. Gemelli
Foundation, Rome, Italy
(Bacci) Humanitas Clinical and Research Center-IRCCS, Milan, Italy
(Marchetti) Department of Immunohematology and Transfusion Medicine,
Hospital Papa Giovanni XXIII, Bergamo, Italy
(Falanga) Universita di Milano Bicocca, School of Medicine and Surgery,
Monza, Italy
(Lodigiani) Humanitas University, Department of Biomedical Sciences,
Milan, Italy
(De Candia) Department of Translational Medicine and Surgery, Catholic
University of Rome, Rome, Italy
Publisher
Wiley-Blackwell Publishing Ltd
Abstract
Background : Acquired platelet function disorders (PFD) are rare bleeding
diseases that should be suspected in all patients (pts) with unexplained
recent mucocutaneous bleeding onset, no previous history of bleedings,
normal coagulation test and platelet count. Aims : We revised the
literature of the acquired PFD caused by autoimmune mechanisms (aPFDs).
Methods : We queried the electronic databases PubMed, Embase, Scopus and
Google Scholar for "acquired Glanzmann Thromboasthenia" (aGT), "acquired
delta storage pool disease" (adSPD) retrieving all articles reporting
aPFDs sustained by autoimmune mechanism until December 2020. Results : We
found 44 cases of aGT, 12 cases of adSPD and 47 cases of autoimmune PFDs
of uncertain/mixed diagnosis. APFDs can be primary or secondary to other
diseases. Among aGT, 10 cases were primary, 17 were associated to
lymphoproliferative diseases (5 HL, 7 NHL, 1 ALL, 1 HCL, 1 MM, 4
MGUS/paraprotein), 4 were described in renal and heart transplant
recipients receiving immunosuppressive therapy, 13 cases had autoimmune
disorders, including ITP. Among adSPD, 7 cases were associated with
autoimmune/connective tissue disorders (2 SLE, 1 RA, 2 unspecified
connective tissue diseases), 4 cases were associated with
lymphoproliferative disorders (1 HCL, 2 CLL, 1 Waldenstrom disease), only
one case was a primary adSPD. Autoimmune PFDs may develop in patients
splenectomized for ITP (13 cases). Fourteen out of 44 aGT cases and 3 out
of 11 adSPD cases had ITP before or after aPFD. Treatments included
hemostatic therapies for the control of bleedings, treatment of primary
disease, if present, and immunosuppressive treatment for the eradication
of antibodies. Response to treatments was variable and unpredictable.
Conclusions : Autoimmune PFDs are rare syndromes whose diagnosis is
challenging and might be underestimated. A rapid diagnosis and appropriate
therapy are crucial to stop bleedings. So far, therapies have been
personalized based on clinical phenotype (major/minor bleedings), clinical
needs (surgery, anemia) and underlying disease.

<14>
Accession Number
636404970
Title
Estimating the causal association between body mass index and platelet
properties: Evidence for a positive association with immature platelet
count.
Source
Research and Practice in Thrombosis and Haemostasis. Conference: 2021
Congress of the International Society of Thrombosis and Haemostasis, ISTH
2021. Virtual. 5(SUPPL 2) (no pagination), 2021. Date of Publication:
October 2021.
Author
Goudswaard L.; Corbin L.; Burley K.; Akbari P.; Butterworth A.; Soranzo
N.; Mumford A.; Timpson N.; Hers I.
Institution
(Goudswaard, Corbin, Burley, Mumford, Timpson, Hers) University of
Bristol, Bristol, United Kingdom
(Akbari, Butterworth) University of Cambridge, Cambridge, United Kingdom
(Soranzo) Wellcome Sanger Institute, Hinxton, United Kingdom
Publisher
Wiley-Blackwell Publishing Ltd
Abstract
Background: A higher body mass index (BMI) is a recognised risk factor for
thrombotic disorders. Platelets are essential for haemostasis but also
contribute to thrombosis when activated pathologically. <br/>Aim(s): We
aimed to identify whether higher BMI may lead to changes in platelet
characteristics, thereby contributing to an increased thrombotic risk.
<br/>Method(s): The effect of BMI on a range of platelet traits was
measured in 33,388 healthy adults from the INTERVAL study of UK blood
donors and used Mendelian randomization (MR) to estimate a causal effect.
Linear regression was used for observational analyses between BMI and
platelet characteristics. A genetic risk score for BMI was used to
estimate causal effects in the MR. <br/>Result(s): Observationally, higher
BMI was positively associated with plateletcrit (PCT, 0.12 SD higher per
SD BMI, 95% CI 0.11-0.13, P = 9.2 x 10^-88 ), platelet count
(PLT), immature platelet count (IPC, 0.06 SD higher per SD BMI, 95% CI
0.05 to 0.08, P = 4.8 x 10^-22) and side fluorescence (SFL, a
measure of mRNA content used to derive IPC). MR provided causal estimates
for the association between BMI and both SFL (0.08 SD higher per SD BMI,
95% CI 0.03-0.14, P = 0.003) and IPC (0.06 SD higher per SD BMI, 95% CI
0.006-0.12, P = 0.03), but there was no strong evidence for a causal
effect of BMI on PCT or PLT. Post-hoc analysis in The COagulation and
Platelet laboratory Testing in Cardiac Surgery (COPTIC) study provided
evidence for a positive association between IPC and whole blood
aggregation. <br/>Conclusion(s): Results indicate that higher BMI may lead
to a greater number of immature platelets, and that immature platelets are
hyperactive, which might contribute to obesity-related thrombosis.

<15>
Accession Number
2015477009
Title
Comment on "The direct comparison of inhaled versus intravenous
levosimendan in children with pulmonary hypertension undergoing
on-cardiopulmonary bypass cardiac surgery: A randomized, controlled,
non-inferiority study".
Source
Journal of Clinical Anesthesia. 76 (no pagination), 2022. Article Number:
110572. Date of Publication: February 2022.
Author
Zang H.; Yan W.; Xie W.
Institution
(Zang, Yan) Department of Anaesthesia, Gansu Provincial Hospital, Lanzhou,
Gansu 730000, China
(Xie) Department of Cardiology, Gansu Provincial Hospital, Lanzhou, Gansu
730000, China
Publisher
Elsevier Inc.

<16>
Accession Number
636379653
Title
Exercise-based cardiac rehabilitation for coronary heart disease.
Source
Cochrane Database of Systematic Reviews. 2021(11) (no pagination), 2021.
Article Number: CD001800. Date of Publication: 06 Nov 2021.
Author
Dibben G.; Faulkner J.; Oldridge N.; Rees K.; Thompson D.R.; Zwisler
A.-D.; Taylor R.S.
Institution
(Dibben) MRC/CSO Social and Public Health Sciences Unit, Institute of
Health and Well Being, University of Glasgow, Glasgow, United Kingdom
(Faulkner) Faculty Health and Wellbeing, School of Sport, Health and
Community, University of Winchester, Winchester, United Kingdom
(Oldridge) College of Health Sciences, University of Wisconsin-Milwaukee,
Milwaukee, WI, United States
(Rees) Division of Health Sciences, Warwick Medical School, University of
Warwick, Coventry, United Kingdom
(Thompson) School of Nursing and Midwifery, Queen's University Belfast,
Belfast, United Kingdom
(Zwisler) REHPA, The Danish Knowledge Centre for Rehabilitation and
Palliative Care, Odense University Hospital, Nyborg, Denmark
(Zwisler) Department of Clinical Research, University of Southern Denmark,
Odense, Denmark
(Taylor) MRC/CSO Social and Public Health Sciences Unit & Robertson Centre
for Biostatistics, Institute of Health and Well Being, University of
Glasgow, Glasgow, United Kingdom
(Taylor) National Institute of Public Health, University of Southern
Denmark, Copenhagen, Denmark
Publisher
John Wiley and Sons Ltd
Abstract
Background: Coronary heart disease (CHD) is the most common cause of death
globally. However, with falling CHD mortality rates, an increasing number
of people living with CHD may need support to manage their symptoms and
prognosis. Exercise-based cardiac rehabilitation (CR) aims to improve the
health and outcomes of people with CHD. This is an update of a Cochrane
Review previously published in 2016. <br/>Objective(s): To assess the
clinical effectiveness and cost-effectiveness of exercise-based CR
(exercise training alone or in combination with psychosocial or
educational interventions) compared with 'no exercise' control, on
mortality, morbidity and health-related quality of life (HRQoL) in people
with CHD. <br/>Search Method(s): We updated searches from the previous
Cochrane Review, by searching CENTRAL, MEDLINE, Embase, and two other
databases in September 2020. We also searched two clinical trials
registers in June 2021. <br/>Selection Criteria: We included randomised
controlled trials (RCTs) of exercise-based interventions with at least six
months' follow-up, compared with 'no exercise' control. The study
population comprised adult men and women who have had a myocardial
infarction (MI), coronary artery bypass graft (CABG) or percutaneous
coronary intervention (PCI), or have angina pectoris, or coronary artery
disease. <br/>Data Collection and Analysis: We screened all identified
references, extracted data and assessed risk of bias according to Cochrane
methods. We stratified meta-analysis by duration of follow-up: short-term
(6 to 12 months); medium-term (> 12 to 36 months); and long-term (> 3
years), and used meta-regression to explore potential treatment effect
modifiers. We used GRADE for primary outcomes at 6 to 12 months (the most
common follow-up time point). <br/>Main Result(s): This review included 85
trials which randomised 23,430 people with CHD. This latest update
identified 22 new trials (7795 participants). The population included
predominantly post-MI and post-revascularisation patients, with a mean age
ranging from 47 to 77 years. In the last decade, the median percentage of
women with CHD has increased from 11% to 17%, but females still account
for a similarly small percentage of participants recruited overall (<
15%). Twenty-one of the included trials were performed in low- and
middle-income countries (LMICs). Overall trial reporting was poor,
although there was evidence of an improvement in quality over the last
decade. The median longest follow-up time was 12 months (range 6 months to
19 years). At short-term follow-up (6 to 12 months), exercise-based CR
likely results in a slight reduction in all-cause mortality (risk ratio
(RR) 0.87, 95% confidence interval (CI) 0.73 to 1.04; 25 trials; moderate
certainty evidence), a large reduction in MI (RR 0.72, 95% CI 0.55 to
0.93; 22 trials; number needed to treat for an additional beneficial
outcome (NNTB) 75, 95% CI 47 to 298; high certainty evidence), and a large
reduction in all-cause hospitalisation (RR 0.58, 95% CI 0.43 to 0.77; 14
trials; NNTB 12, 95% CI 9 to 21; moderate certainty evidence).
Exercise-based CR likely results in little to no difference in risk of
cardiovascular mortality (RR 0.88, 95% CI 0.68 to 1.14; 15 trials;
moderate certainty evidence), CABG (RR 0.99, 95% CI 0.78 to 1.27; 20
trials; high certainty evidence), and PCI (RR 0.86, 95% CI 0.63 to 1.19;
13 trials; moderate certainty evidence) up to 12 months' follow-up. We are
uncertain about the effects of exercise-based CR on cardiovascular
hospitalisation, with a wide confidence interval including considerable
benefit as well as harm (RR 0.80, 95% CI 0.41 to 1.59; low certainty
evidence). There was evidence of substantial heterogeneity across trials
for cardiovascular hospitalisations (I² = 53%), and of small
study bias for all-cause hospitalisation, but not for all other outcomes.
At medium-term follow-up, although there may be little to no difference in
all-cause mortality (RR 0.90, 95% CI 0.80 to 1.02; 15 trials), MI (RR
1.07, 95% CI 0.91 to 1.27; 12 trials), PCI (RR 0.96, 95% CI 0.69 to 1.35;
6 trials), CABG (RR 0.97, 95% CI 0.77 to 1.23; 9 trials), and all-cause
hospitalisation (RR 0.92, 95% CI 0.82 to 1.03; 9 trials), a large
reduction in cardiovascular mortality was found (RR 0.77, 95% CI 0.63 to
0.93; 5 trials). Evidence is uncertain for difference in risk of
cardiovascular hospitalisation (RR 0.92, 95% CI 0.76 to 1.12; 3 trials).
At long-term follow-up, although there may be little to no difference in
all-cause mortality (RR 0.91, 95% CI 0.75 to 1.10), exercise-based CR may
result in a large reduction in cardiovascular mortality (RR 0.58, 95% CI
0.43 to 0.78; 8 trials) and MI (RR 0.67, 95% CI 0.50 to 0.90; 10 trials).
Evidence is uncertain for CABG (RR 0.66, 95% CI 0.34 to 1.27; 4 trials),
and PCI (RR 0.76, 95% CI 0.48 to 1.20; 3 trials). Meta-regression showed
benefits in outcomes were independent of CHD case mix, type of CR,
exercise dose, follow-up length, publication year, CR setting, study
location, sample size or risk of bias. There was evidence that
exercise-based CR may slightly increase HRQoL across several subscales
(SF-36 mental component, physical functioning, physical performance,
general health, vitality, social functioning and mental health scores) up
to 12 months' follow-up; however, these may not be clinically important
differences. The eight trial-based economic evaluation studies showed
exercise-based CR to be a potentially cost-effective use of resources in
terms of gain in quality-adjusted life years (QALYs). Authors'
conclusions: This updated Cochrane Review supports the conclusions of the
previous version, that exercise-based CR provides important benefits to
people with CHD, including reduced risk of MI, a likely small reduction in
all-cause mortality, and a large reduction in all-cause hospitalisation,
along with associated healthcare costs, and improved HRQoL up to 12
months' follow-up. Over longer-term follow-up, benefits may include
reductions in cardiovascular mortality and MI. In the last decade, trials
were more likely to include females, and be undertaken in LMICs,
increasing the generalisability of findings. Well-designed,
adequately-reported RCTs of CR in people with CHD more representative of
usual clinical practice are still needed. Trials should explicitly report
clinical outcomes, including mortality and hospital admissions, and
include validated HRQoL outcome measures, especially over longer-term
follow-up, and assess costs and cost-effectiveness.<br/>Copyright &#xa9;
2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

<17>
Accession Number
636368741
Title
Efficacy and Safety of Lipid-Lowering Drugs of Different Intensity on
Clinical Outcomes: A Systematic Review and Network Meta-Analysis.
Source
Frontiers in Pharmacology. 12 (no pagination), 2021. Article Number:
713007. Date of Publication: 21 Oct 2021.
Author
Ma W.; Pan Q.; Pan D.; Xu T.; Zhu H.; Li D.
Institution
(Ma, Pan, Li) Institute of Cardiovascular Disease Research, Xuzhou Medical
University, Xuzhou, China
(Pan, Xu, Zhu, Li) Xuzhou Medical University Affiliated Hospital, Xuzhou,
China
Publisher
Frontiers Media S.A.
Abstract
There have been many meta-analyses for statins, ezetimibe and proprotein
convertase subtilisin/kexin type 9 inhibitors (PCSK9i) to evaluate
clinical outcomes, but the efficacy and safety of different intensity of
these three drugs on clinical outcomes was absent. PCSK9i, ezetimibe, and
statins were divided into seven interventions as follows: including PCSK9i
+ high-intensity statins (P9i+HT), PCSK9i + moderate-intensity statins
(P9i+MT), ezetimibe + high-intensity statins (Eze+HT), ezetimibe +
moderate-intensity statins (Eze+MT), high-intensity statins (HT),
moderate-intensity statins (MT), and low-intensity statins (LT). The risk
ratios (RR) and 95% confidence intervals (CI) were calculated to evaluate
the clinical outcomes in all randomized controlled trials included. In
traditional meta-analysis, the more intensive treatment had a lower risk
of all-cause mortality (RR 0.91, 95% CI 0.88-0.95), cardiovascular
mortality (RR 0.89, 95% CI 0.86-0.92), myocardial infarction (RR 0.79, 95%
CI 0.77-0.81), coronary revascularization (RR 0.80, 95% CI 0.76-0.84), and
cerebrovascular events (RR 0.84, 95% CI 0.80-0.88) compared with the less
intensive treatment. However, the more intensive treatment had a higher
risk of new-onset diabetes (RR 1.08, 95% CI 1.04-1.12). The network
meta-analysis demonstrated that P9i+HT, P9i+MT, HT, and MT were
significantly associated with a risk reduction in coronary
revascularization and cerebrovascular events compared with PLBO. LT could
effectively reduce the risk of cardiovascular mortality (RR 0.71, 95% CI
0.54-0.92), MI (RR 0.67, 95% CI 0.54-0.82), and coronary revascularization
(RR 0.77, 95% CI 0.65-0.91) compared with PLBO. P9i+HT was superior to HT
in reducing the risk of MI (RR 0.78, 95% CI 0.68-0.90), coronary
revascularization (RR 0.84, 95% CI 0.73-0.96), and cerebrovascular events
(RR 0.78, 95% CI 0.64-0.95). However, compared with PLBO, P9i+HT, HT, and
MT could increase the risk of new-onset diabetes (RR 1.23, 95% CI
1.11-1.37; RR 1.23, 95% CI 1.14-1.33; RR 1.09, 95% CI 1.02-1.15,
respectively). In conclusion, PCSK9i added to background statins may be
recommended as preferred lipid-lowering therapy, and did not increase the
additional risk of new-onset diabetes. The safety and efficacy of
ezetimibe was not superior to that of statins. LT can be recommended as
the initial therapy.<br/>&#xa9; Copyright &#xa9; 2021 Ma, Pan, Pan, Xu,
Zhu and Li.

<18>
Accession Number
2015369354
Title
Early high-energy feeding in infants following cardiac surgery: A
randomized controlled trial.
Source
Translational Pediatrics. 10(10) (pp 2439-2448), 2021. Date of
Publication: October 2021.
Author
Chen X.; Zhang M.; Song Y.; Luo Y.; Wang L.; Xu Z.; Bao N.
Institution
(Chen, Zhang, Song, Luo, Wang, Xu) Cardiac Intensive Care Unit, Department
of Thoracic and Cardiovascular Surgery, Shanghai Children's Medical
Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang
Road, Shanghai 200127, China
(Bao) Department of Pediatric Surgery, Shanghai Children's Medical Center,
Shanghai JiaoTong University School of Medicine, 1678 Dongfang Road,
Shanghai 200127, China
Publisher
AME Publishing Company
Abstract
Background: Effective nutrition programs are beneficial for nutritional
recovery in infants. Few studies have focused on the effect of early
high-energy feeding after open heart surgery. This study sought to assess
the effects of early high-energy feeding in infants after congenital heart
surgery. <br/>Method(s): Patients at a tertiary pediatric cardiology
center who underwent open heart surgery between July 2016 and July 2018
were recruited and randomly allocated to 1 of the following 2 groups: (I)
the intervention group (postoperative early high-energy feeding; n=124);
and (II) the control group (no intervention; n=120). The primary endpoints
of average energy delivery and growth Z-scores [i.e., weight-for-height
Z-score (WHZ), weight-for-age Z-score (WAZ), and height-for-age Z-score
(HAZ)] were recorded preoperatively, during the intensive care unit (ICU)
stay, at discharge, and at 1 and 3 months postoperatively. The secondary
endpoints of malnutrition recovery, ventilator support time, infection
rate, and cardiac ICU (CICU) stay were also recorded. <br/>Result(s): A
total of 244 infants were included in the study. There were no significant
differences in the baseline features between the 2 groups. The
intervention group received higher calories on average than the control
group (44.5 vs. 34.7; P<0.001). At discharge from the ICU, the WHZ (-2.29
vs. -2.76; P<0.001) and WAZ (-3.08 vs. -3.43; P=0.005) of patients in the
intervention group were higher than those of patients in the control
group. Ventilator support time (P=0.004), CICU stay (P=0.045), and
infection rate (P=0.001) were significantly lower in the intervention
group than the control group. At 3 months post-surgery, the intervention
group exhibited a higher malnutrition recovery rate than the control group
(19.4% vs. 6.5%; P=0.002). <br/>Conclusion(s): The administration of early
high-energy feeding to infants after congenital heart surgery is
associated with improved growth, reduced CICU stay, decreased ventilator
support time, and reduced postoperative infection rates.<br/>Copyright
&#xa9; Translational Pediatrics. All rights reserved.

<19>
Accession Number
2014160428
Title
Dysphagia aortica.
Source
European Surgery - Acta Chirurgica Austriaca. (no pagination), 2021. Date
of Publication: 2021.
Author
Grimaldi S.; Milito P.; Lovece A.; Asti E.; Secchi F.; Bonavina L.
Institution
(Grimaldi, Milito, Lovece, Asti, Secchi, Bonavina) Department of
Biomedical Sciences for Health, Division of General and Foregut Surgery,
IRCCS Policlinico San Donato, University of Milan, Piazza Edmondo Malan,
San Donato Milanese, Milan 20097, Italy
(Secchi) Department of Radiology, IRCCS Policlinico San Donato, University
of Milan, Milan, Italy
Publisher
Springer
Abstract
Background: Dysphagia aortica is an umbrella term to describe swallowing
obstruction from external aortic compression secondary to a dilated,
tortuous, or aneurysmal aorta. We performed a systematic literature review
to clarify clinical features and outcomes of patients with dysphagia
aortica. <br/>Material(s) and Method(s): We searched PubMed, EMBASE, Web
of Science, and the Cochrane Library. The terms "aortic dysphagia,"
"dysphagia aortica," "dysphagia AND aortic aneurysm" were matched. We also
queried the prospectively updated database of our esophageal center to
identify patients with aortic dysphagia referred for diagnosis and
treatment over the past two decades. <br/>Result(s): A total of 57 studies
including 69 patients diagnosed with dysphagia aortica were identified,
and one patient from our center was added to the database. The mean age
was 72 years (range 22-98), and the male to female ratio 1.1:1. Of these
70 patients, the majority (n= 63, 90%) had an aortic aneurysm,
pseudoaneurysm, or dissection. Overall, 37 (53%) patients received an
operative treatment (81.1% a vascular procedure, 13.5% a digestive tract
procedure, 5.4% both procedures). Thoracic endovascular aortic repair
(TEVAR) accounted for 60% of all vascular procedures. The postoperative
mortality rate was 21.2% (n= 7/33). The mortality rate among patients
treated conservatively was 55% (n= 11/20). Twenty-six (45.6%) studies were
deemed at a high risk of bias. <br/>Conclusion(s): Dysphagia aortica is a
rare clinical entity with high morbidity and mortality rates and no
standardized management. Early recognition of dysphagia and a high
suspicion of aortoesophageal fistula may be lifesaving in this patient
population.<br/>Copyright &#xa9; 2021, The Author(s).

<20>
Accession Number
2014159169
Title
Isolated tricuspid valve surgery-Repair versus replacement: A
meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Sarris-Michopoulos P.; Macias A.E.; Sarris-Michopoulos C.; Woodhouse P.;
Buitrago D.; Salerno T.A.; Magarakis M.
Institution
(Sarris-Michopoulos) University of Miami Miller School of Medicine, Miami,
FL, United States
(Macias) Department of Surgery, Jackson Memorial Hospital, University of
Miami Miller School of Medicine, Miami, FL, United States
(Sarris-Michopoulos) Department of Economics, University of Georgia,
Athens, GA, United States
(Woodhouse) Department of Surgery, Vanderbilt University School of
Medicine, Vanderbilt University Medical Center, Nashville, Vanderbilt,
United States
(Buitrago) Department of Surgery, Division of Cardiothoracic Surgery,
University of Miami Miller School of Medicine, Jackson Memorial Hospital,
Miami, FL, United States
(Salerno, Magarakis) Department of Surgery, Division of Cardiothoracic
Surgery, Jackson Memorial Hospital, University of Miami Miller School of
Medicine, Miami, FL, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: There is a paucity of data on outcomes after isolated tricuspid
valve surgery. This meta-analysis aims to compile available data on
isolated tricuspid valve surgery and compare isolated tricuspid valve
repair (iTVr) with isolated tricuspid valve replacement (iTVR) to
elucidate outcomes after tricuspid valve surgery. <br/>Method(s): A
literature search of 6 databases was performed. The primary outcomes was
30-day mortality. Secondary outcomes were early stroke, post-op pacemaker
placement, and tricuspid reoperation within 5 years. Publication bias was
explored using the funnel plot. <br/>Result(s): Ten retrospective studies
involving 1407 patients (iTVr group = 779 patients and iTVR group = 628
patients) were included. A cumulative analysis demonstrated a significant
difference favoring iTVr for 30-day mortality (odds ratio [OR]: 10 studies
[95% confidence interval [CI]]: 0.34 [0.18-0.66]); 4.7% versus 12.6%, for
iTVr and iTVR, respectively. Post-op pacemaker placement favored iTVr (OR:
6 studies [95% CI]: 0.37 [0.18-0.77]). Although stroke rates and TV
reoperation favored iTVr, they did not reach statistical significance. No
publication bias was identified. <br/>Conclusion(s): This meta-analysis
demonstrates that iTVr has better 30-day mortality and fewer permanent
pacemaker placements. Etiology and severity of TR, as well as careful
patient selection remain the most important factors for optimal
outcomes.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC.

<21>
Accession Number
2003394770
Title
Fetal heart rate monitoring in nonobstetric surgery: a systematic review
of the evidence.
Source
American Journal of Obstetrics and Gynecology MFM. 1(4) (no pagination),
2019. Article Number: 100048. Date of Publication: November 2019.
Author
Higgins M.F.; Pollard L.; McGuinness S.K.; Kingdom J.C.
Institution
(Higgins, Kingdom) Maternal Fetal Medicine, Mount Sinai Hospital, Toronto,
ON, Canada
(Higgins) Perinatal Research Center, Obstetrics and Gynaecology, School of
Medicine and Medical Sciences, University College Dublin, National
Maternity Hospital, Dublin, Ireland
(Pollard) Department of Nursing, Mount Sinai Hospital, Toronto, ON, Canada
(McGuinness) Department of Anaesthesia, St. Vincent's University Hospital,
Dublin, Ireland
(Kingdom) Obstetrics and Gynaecology, University of Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Objective: Concern for fetal well-being during maternal nonobstetric
surgery may result in obstetricians and other maternity care providers
being asked to perform intraoperative fetal heart rate (FHR) monitoring.
We systematically reviewed the evidence regarding the use of FHR
monitoring during nonobstetric surgery after potential fetal viability
(>22 weeks gestational age), and examined the FHR patterns and outcomes
reported. Data sources: A systematic review of the evidence was performed.
Sources included databases (MEDLINE, EMBASE, Cochrane, and CENTRAL), hand
searching, guidelines, conference proceedings, and literature reviews.
Online searching was performed to include literature published from 1966
to May 2019. Study eligibility criteria: All studies reviewing care of
pregnant women undergoing nonobstetric surgery where FHR monitoring was
performed intraoperatively. Data were extracted from appropriate full-text
articles using a data abstraction form. Study appraisal and synthesis:
Case reports and case series only were identified. A total of 74 cases
were reviewed, encompassing maternal general surgery (n = 41,
cardiovascular surgery (n = 13) and neurosurgery/orthopedics (n = 20).
Median gestational age at time of maternal surgery was 30 weeks (range,
22-36 weeks). In 41 cases, findings of FHR monitoring were not reported.
Abnormal tracings were observed in 29 cases, as either reduced variability
(n = 13) or fetal bradycardia (n = 17). All but 3 bradycardias reported
occurred during maternal cardiac surgery involving aortic clamping and
cardiopulmonary bypass. In 1 case, FHR monitoring was not possible because
of a surgical pneumoperitoneum; there was 1 fetal tachycardia associated
with maternal pyrexia, and three cases in which FHR monitoring was deemed
stable or normal. Three preterm infants were delivered simultaneously at
the time of general surgery as a result of FHR abnormalities (at 30, 33,
and 34 weeks respectively), 2 as a result of fetal bradycardia and 1
because of protracted reduced variablity. <br/>Conclusion(s): The evidence
for intraoperative fetal monitoring is based on case reports and cases
series. Maternal cardiac surgery involving cardiopulmonary bypass commonly
results in fetal bradycardia, which may be challenging to interpret.
Obstetricians should be aware of FHR pattern changes in response to
anesthesia and surgery that do not justify iatrogenic preterm cesarean
delivery.<br/>Copyright &#xa9; 2019 Elsevier Inc.

<22>
[Use Link to view the full text]
Accession Number
635266647
Title
Review of Trials on Exercise-Based Rehabilitation Interventions following
Acute Decompensated Heart Failure: OBSERVATIONS from the WHO INTERNATIONAL
CLINICAL TRIALS REGISTRY PLATFORM.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. 41(4) (pp
214-223), 2021. Date of Publication: July 2021.
Author
Babu A.S.; Arena R.; Satyamurthy A.; Padmakumar R.; Myers J.; Lavie C.J.
Institution
(Babu, Satyamurthy) Department of Physiotherapy, Manipal College of Health
Professions, Manipal Academy of Higher Education, Karnataka, India
(Babu, Arena, Myers, Lavie) Healthy Living for Pandemic Event Protection
(HL-PIVOT) Network, Chicago, IL, United States
(Arena) Department of Physical Therapy, University of Illinois at Chicago,
United States
(Padmakumar) Department of Cardiology, Kasturba Medical College, Manipal
Academy of Higher Education, Karnataka, India
(Myers) Department of Cardiology, Veterans Affairs Palo Alto Health Care
System, Stanford University, Palo Alto, CA, United States
(Lavie) Department of Cardiovascular Diseases, John Ochsner Heart and
Vascular Institute, Ochsner Clinical School, The University of Queensland
School of Medicine, New Orleans, LA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose: Cardiac rehabilitation is an important intervention for patients
with heart failure. However, its clinical application in acute
decompensated heart failure (ADHF) remains underutilized with limited
research available. An assessment of current research in this area will
help guide future investigations. The aim of this review is to summarize
the current research focusing on rehabilitation interventions following
recovery from ADHF. Review Methods: A systematic search was carried out on
all trials registered in the clinical trial registry database of the World
Health Organization - International Clinical Trial Registry Platform
(WHO-ICTRP). Studies focusing on ADHF and utilizing any exercise and
rehabilitation-based intervention were included. <br/>Result(s): A
majority of 11 trial protocols, including 3827 participants with low
ejection fraction (<40%), were identified from the WHO-ICTRP database.
Majority of the protocols (64%) focused on exercise-based interventions
with approximately one-quarter (29%) focusing on neuromuscular electrical
stimulation and one on noninvasive ventilation during exercise.
Irrespective of the mode of exercise, all protocols employed low-moderate
intensity training with outcomes focusing on physical function and quality
of life. <br/>Conclusion(s): Studies on rehabilitative interventions for
ADHF are still in their early stages. More research is needed using
innovative methodologies and testing for feasibility and
fidelity.<br/>Copyright &#xa9; 2021 Lippincott Williams and Wilkins. All
rights reserved.

<23>
Accession Number
2013871808
Title
Particle flow rate from the airways as fingerprint diagnostics in
mechanical ventilation in the intensive care unit: A randomised controlled
study.
Source
ERJ Open Research. 7(3) (no pagination), 2021. Article Number: 00961-2020.
Date of Publication: 01 Jul 2021.
Author
Hallgren F.; Stenlo M.; Niroomand A.; Broberg E.; Hyllen S.; Malmsjo M.;
Lindstedt S.
Institution
(Hallgren, Lindstedt) Dept of Cardiothoracic Surgery and Transplantation,
Skane University Hospital, Lund University, Lund, Sweden
(Stenlo, Broberg, Hyllen) Cardiothoracic Anaesthesia and Intensive Care,
Skane University Hospital, Lund University, Lund, Sweden
(Stenlo, Niroomand, Broberg, Hyllen, Lindstedt) Wallenberg Center for
Molecular Medicine, Lund University, Lund, Sweden
(Stenlo, Niroomand, Broberg, Hyllen, Malmsjo, Lindstedt) Dept of Clinical
Sciences, Lund University, Lund, Sweden
(Stenlo, Niroomand, Broberg, Hyllen, Lindstedt) Lund Stem Cell Center,
Lund University, Lund, Sweden
(Niroomand) Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ,
United States
Publisher
European Respiratory Society
Abstract
Introduction Mechanical ventilation can be monitored by analysing
particles in exhaled air as measured by particle flow rate (PFR). This
could be a potential method of detecting ventilator-induced lung injury
(VILI) before changes in conventional parameters can be detected. The aim
of this study was to investigate PFR during different ventilation modes in
patients without lung pathology. Method A prospective study was conducted
on patients on mechanical ventilation in the cardiothoracic intensive care
unit (ICU). A PExA 2.0 device was connected to the expiratory limb on the
ventilator for continuous measurement of PFR in 30 patients randomised to
either volume-controlled ventilation (VCV) or pressure-controlled
ventilation (PCV) for 30 min including a recruitment manoeuvre. PFR
measurements were continued as the patients were transitioned to
pressure-regulated volume control (PRVC) and then pressure support
ventilation (PSV) until extubation. Results PRVC resulted in significantly
lower PFR, while those on PSV had the highest PFR. The distribution of
particles differed significantly between the different ventilation modes.
Conclusions Measuring PFR is safe after cardiac surgery in the ICU and may
constitute a novel method of continuously monitoring the small airways in
real time. A low PFR during mechanical ventilation may correlate to a
gentle ventilation strategy. PFR increases as the patient transitions from
controlled mechanical ventilation to autonomous breathing, which most
likely occurs as recruitment by the diaphragm opens up more distal
airways. Different ventilation modes resulted in unique particle patterns
and could be used as a fingerprint for the different ventilation
modes.<br/>Copyright &#xa9; The authors 2021.

<24>
Accession Number
2013646654
Title
The evolving role of omega 3 fatty acids in cardiovascular disease: Is
icosapent ethyl the answer?.
Source
Heart International. 15(1) (pp 7-13), 2021. Date of Publication: 2021.
Author
Lakshmanan S.; Budoff M.J.
Institution
(Lakshmanan, Budoff) The Lundquist Institute for Biomedical Innovation,
Harbor-UCLA Medical Center, Los Angeles, CA, United States
Publisher
Touch Medical Media
Abstract
Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause
of morbidity and mortality globally. Despite significant advances in
pharmacotherapies and the beneficial effects of statin therapy on ASCVD
outcomes and progression of atherosclerosis, residual cardiovascular (CV)
risk remains. Extensive evidence has identified the contribution of
atherogenic dyslipidaemia, which is particularly characterised by elevated
triglycerides (TGL) as a key driver of CV risk, even if low-density
lipoprotein cholesterol levels are well controlled. Epidemiologic and
genetic/Mendelian randomisation studies have demonstrated that elevated
TGL levels serve as an independent marker for an increased risk of
ischaemic events, highlighting TGLs as a suitable therapeutic target.
Clinical studies have shown that omega 3 fatty acids (OM3FA) are effective
in lowering TGLs; however, to date, trials and meta-analyses of combined
OM3FA products have not demonstrated any clinical CV outcome benefit in
patients receiving statins. However, icosapent ethyl (IPE) - a highly
purified, stable ethyl ester of eicosapentaenoic acid (EPA) - has been
rigorously demonstrated in multiple studies to be a useful adjunctive
therapy to address residual CV risk. EPA is an omega-3 polyunsaturated
fatty acid that is incorporated into membrane phospholipid bilayers and is
reported to exert multiple beneficial effects along the pathway of
coronary atherosclerosis. In this brief review, we will provide an
overview of the mode of action of IPE in coronary atherosclerosis, the
robust clinical evidence and trial data supporting its use, and expert
consensus/recommendations on its use in specific populations, as an
adjunct to existing anti-atherosclerotic therapies.<br/>Copyright &#xa9;
2021, Touch Medical Media. All rights reserved.

<25>
Accession Number
2013646653
Title
Comprehensive review of complete versus culprit-only revascularization for
multivessel disease in ST-segment elevation myocardial infarction.
Source
Heart International. 15(1) (pp 54-59), 2021. Date of Publication: 2021.
Author
Jacob R.; Sachedina A.K.; Kumar S.
Institution
(Jacob, Kumar) Division of Cardiology, University of Texas Health Science
Center, Houston, TX, United States
(Sachedina) Libin Cardiovascular Institute, University of Calgary,
Calgary, AB, Canada
Publisher
Touch Medical Media
Abstract
Several organizations have developed guidelines for the management of
ST-segment elevation myocardial infarction (STEMI). However, the optimal
strategy regarding revascularization in the setting of multivessel
disease, specifically with regards to culprit vessel versus complete
revascularization, continues to evolve. While previous observational
studies promoted culprit vessel-only intervention in patients with STEMI,
recent randomized controlled trials suggest potential benefits with
multivessel revascularization, either at the time of the index event or in
a staged fashion, in patients without cardiogenic shock. This may be due
to the known instability of non-culprit lesions in the setting of acute
coronary syndrome, and the diffuse coronary processes involved. As
additional literature examines culprit vessel versus multivessel
revascularization strategies, clinicians continue to be tasked with
determining optimal treatment plans for their patients and understanding
the factors that promote selected revascularization strategies. This
review summarizes and discusses observational studies, randomized control
trials and current guidelines in order to evaluate optimal reperfusion
strategies for patients presenting with STEMI in the setting of
multivessel disease.<br/>Copyright &#xa9; 2021, Touch Medical Media. All
rights reserved.

<26>
Accession Number
2010595017
Title
Is a fixed low-dose protamine better at reducing postoperative bleeding in
off pump coronary artery bypass grafting?.
Source
Asian Cardiovascular and Thoracic Annals. 29(9) (pp 922-927), 2021. Date
of Publication: November 2021.
Author
Murugesh W.R.; Prasad S.S.; Ramachandrappa Sujay K.; Dinesh Kumar U.S.
Institution
(Murugesh, Dinesh Kumar) Department of Cardiac Anaesthesia, JSS Medical
College and Hospital, Mysuru, India
(Prasad, Ramachandrappa Sujay) Department of CTVS, JSS Medical College and
Hospital, Mysuru, India
Publisher
SAGE Publications Inc.
Abstract
Context: Protamine is used ubiquitously in all cardiac surgeries for
reversal of heparin. Risk of postoperative bleeding is increased with
inadequate heparin reversal or due to anticoagulant side effects of
protamine; hence, it is important to dose protamine properly. This study
compares 80% protamine dose with full dose on postoperative bleeding and
transfusion needs in OPCAB. <br/>Aim(s): The aim of our study was to find
whether lower dose of protamine could reduce postoperative bleeding and
need for blood product transfusions in off pump coronary artery bypass
grafting as compared to the regular dose of protamine. Settings and
design: This was a double-blinded randomised controlled trial where
patients posted for off pump CABG meeting the inclusion criteria were
included in the study. Methods and material: Ninety patients were
randomised to two groups, group F receiving full dose of protamine of 1 mg
per mg heparin used, and group L received 0.8 mg per mg. Postoperative
activated clotting time, bleeding at 1 h, 4 h, 24 h and total drainage
till drains removal and blood product transfusion requirements were noted.
Statistical analysis used: SPSS software. <br/>Result(s): Both groups were
matched in demographics, preoperative cessation of heparin and aspirin and
platelet counts. Both groups received equal heparin dose, activated
clotting time before protamine, activated clotting time post protamine in
OT and ICU were equal as were the conduits used. There was no significant
difference between the groups in post-operative drainage over time or in
the need for blood product transfusions. <br/>Conclusion(s): Eighty per
cent of the dose of protamine can adequately reverse the heparin used
during off pump cardiac surgery without any increase in incidence of
postoperative bleeding or need for blood product
transfusions.<br/>Copyright &#xa9; The Author(s) 2021.

<27>
Accession Number
2010510251
Title
Double-lumen endotracheal tubes and bronchial blockers exhibit similar
lung collapse physiology during lung isolation.
Source
Canadian Journal of Anesthesia. 68(6) (pp 791-800), 2021. Date of
Publication: June 2021.
Author
Moreault O.; Couture E.J.; Provencher S.; Somma J.; Lohser J.; Ugalde
P.A.; Lemieux J.; Lellouche F.; Bussieres J.S.
Institution
(Moreault, Couture, Lemieux, Lellouche, Bussieres) Department of
Anesthesiology and Critical Care, Universite Laval, Quebec City, QC,
Canada
(Provencher, Ugalde) Department of Respirology and Thoracic Surgery,
Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec
City, QC, Canada
(Moreault, Couture, Somma, Lemieux, Lellouche, Bussieres) Department of
Anesthesiology, Institut Universitaire de Cardiologie et de Pneumologie de
Quebec - Universite Laval, 2725, Chemin Sainte-Foy, Quebec City, QC G1V
4G5, Canada
(Lohser) Department of Anesthesiology, Pharmacology and Therapeutics,
University of British Columbia, Vancouver, BC, Canada
(Lellouche) Research Center, Institut Universitaire de Cardiologie et de
Pneumologie de Quebec, Quebec City, QC, Canada
Publisher
Springer
Abstract
Purpose: Double-lumen endotracheal tubes (DL-ETT) and bronchial blockers
(BB) are frequently used to allow one-lung ventilation (OLV) during
video-assisted thoracic surgery (VATS). Recently, faster lung collapse has
been documented with a BB than with a DL-ETT. The physiologic mechanisms
behind this faster collapse remained unknown. We aimed to measure ambient
air absorption (V<inf>resorb</inf>) and intra-bronchial pressure
(P<inf>airway</inf>) into the non-ventilated lung during OLV using DL-ETT
and BB. <br/>Method(s): Patients undergoing VATS and OLV for lung
resection were randomly assigned to have measurements made of
V<inf>resorb</inf> or P<inf>airway</inf> within the non-ventilated lung
using either a DL-ETT or BB. <br/>Result(s): Thirty-nine patients were
included in the analyses. The mean (standard error of the mean [SEM])
V<inf>resorb</inf> was similar in the DL-ETT and BB groups [504 (85) vs
630 (86) mL, respectively; mean difference, 126; 95% confidence interval
[CI], -128 to 380; P = 0.31]. The mean (SEM) P<inf>airway</inf> became
progressively negative in the non-ventilated lung in both the DL-ETT and
the BB groups reaching [-20 (5) and -31 (10) cmH<inf>2</inf>O,
respectively; mean difference, -11; 95% CI, -34 to 12; P = 0.44] at the
time of the pleural opening. <br/>Conclusion(s): During OLV before pleural
opening, entrainment of ambient air into the non-ventilated lung occurs
when the lumen of the lung isolation device is kept open. This phenomenon
is prevented by occluding the lumen of the isolation device before pleural
opening, resulting in a progressive build-up of negative pressure in the
non-ventilated lung. Future clinical studies are needed to confirm these
physiologic results and their impact on lung collapse and operative
outcomes. Trial registration: www.clinicaltrials.gov (NCT02919267);
registered 28 September 2016.<br/>Copyright &#xa9; 2021, Canadian
Anesthesiologists' Society.

<28>
Accession Number
2010447866
Title
Postoperative hemodynamics after high spinal block with or without
intrathecal morphine in cardiac surgical patients: a randomized-controlled
trial.
Source
Canadian Journal of Anesthesia. 68(6) (pp 825-834), 2021. Date of
Publication: June 2021.
Author
Bhat I.; Arya V.K.; Mandal B.; Jayant A.; Dutta V.; Rana S.S.
Institution
(Bhat, Arya, Mandal) Department of Anaesthesiology and Intensive Care,
Post Graduate Institute of Medical Education and Research, Chandigarh,
India
(Arya, Dutta) Department of Anesthesiology, Perioperative and Pain
Medicine, Max Rady College of Medicine, University of Manitoba, St.
Boniface Hosptial, Winnipeg, MB, Canada
(Jayant) Department of Anaesthesiology and Critical Care Medicine, Amrita
Institute of Medical Sciences, Kochi, India
(Rana) Department of Cardiothoracic and Vascular Surgery, Post Graduate
Institute of Medical Education and Research, Chandigarh, India
Publisher
Springer
Abstract
Purpose: There is some evidence for the use of intrathecal morphine as a
means to provide prolonged analgesia in selective cardiac surgical
patients; however, the hemodynamic effects of intrathecal morphine are not
well defined. This study was designed to study the effect of intrathecal
morphine on hemodynamic parameters in cardiac surgery patients.
<br/>Method(s): In a prospective, double-blind study, 100 adult cardiac
surgical patients were randomized to receive either intrathecal 40 mg of
0.5% hyperbaric bupivacaine alone (intrathecal bupivacaine [ITB] group, n
= 50) or intrathecal 250 microg of morphine added to 40 mg of 0.5%
bupivacaine (intrathecal bupivacaine and morphine [ITBM] group, n = 50).
Hemodynamic data, pain scores, rescue analgesic use, spirometry, and
vasopressor use were recorded every four hours after surgery for 48 hr.
The primary outcome was the incidence of vasoplegia in each group, which
was defined as a cardiac index > 2.2 L.min^-1.m^-2
with the requirement of vasopressors to maintain the mean arterial
pressure > 60 mmHg with the hemodynamic episode lasting > four hours.
<br/>Result(s): Eighty-seven patients were analyzed (ITB group, n = 42,
and ITBM group, n =45). The incidence of vasoplegia was higher in the ITBM
group than in the ITB group [14 (31%) vs 5 (12%), respectively; relative
risk, 2.6; 95% confidence interval [CI], 1.0 to 6.6; P = 0.04]. The mean
(standard deviation [SD]) duration of vasoplegia was significantly longer
in the ITBM group than in the ITB group [8.9 (3.0) hr vs 4.3 (0.4) hr,
respectively; difference in means, 4.6; 95% CI, 3.7 to 5.5; P < 0.001].
<br/>Conclusion(s): Intrathecal morphine added to bupivacaine for high
spinal anesthesia increases the incidence and duration of vasoplegia in
cardiac surgery patients. Trial registration: www.clinicaltrials.gov
(NCT02825056); registered 19 June 2016.<br/>Copyright &#xa9; 2021,
Canadian Anesthesiologists' Society.

<29>
Accession Number
2012859511
Title
Effect of intrapartum oxygen on the rate of cesarean delivery: a
meta-analysis.
Source
American Journal of Obstetrics and Gynecology MFM. 3(4) (no pagination),
2021. Article Number: 100374. Date of Publication: July 2021.
Author
Burd J.; Quist-Nelson J.; Moors S.; Raghuraman N.; Aly H.; Berghella V.
Institution
(Burd) Department of Obstetrics and Gynecology, Thomas Jefferson
University Hospital, Philadelphia, PA, United States
(Quist-Nelson, Berghella) Division of Maternal-Fetal Medicine, Department
of Obstetrics and Gynecology, Thomas Jefferson University Hospital,
Philadelphia, PA, United States
(Moors) Department of Obstetrics and Gynecology, St. Antonius Hospital,
Utrecht, Netherlands
(Raghuraman) Department of Obstetrics and Gynecology, Washington
University School of Medicine in St. Louis, St. Louis, MO, United States
(Aly) Department of Neonatology, Cleveland Clinic Children's Hospital,
Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
OBJECTIVE: This study aimed to determine if maternal intrapartum
administration of oxygen altered the rate of cesarean delivery compared
with room air. DATA SOURCES: This study was a systematic review and
meta-analysis of randomized controlled trials. Searches were performed in
MEDLINE, OVID, Scopus, ClinicalTrials.gov, and the Cochrane Central
Register of Controlled Trials using a combination of key words related to
"pregnant patients," "labor," "oxygen," "fetus," "newborn," and pregnancy
outcomes from database inception until April 2020. The study was
registered in PROSPERO (registration number CRD42020162110). STUDY
ELIGIBILITY CRITERIA: The inclusion criteria were randomized controlled
trials of maternal administration of oxygen compared with room air in
labor. The exclusion criteria were quasi-randomized trials and oxygen
administered for planned cesarean deliveries. The primary outcome was the
rate of cesarean delivery. Secondary maternal and neonatal outcomes,
including cord gas values, were analyzed. <br/>METHOD(S): The Cochrane
Handbook guidelines were used to assess bias in trials. To calculate the
relative risk or mean differences with confidence intervals, a
random-effects model was employed. Subgroup analyses were performed for
women who received oxygen for nonreassuring fetal heart rate monitoring or
prophylactically. <br/>RESULT(S): Five randomized controlled trials,
including 768 women, were included in the meta-analysis, 3 using
prophylactic oxygen and 2 using oxygen for nonreassuring fetal heart rate
monitoring. The risk of bias was generally considered low. There was no
statistically significant difference in the rate of cesarean delivery
between patients administered oxygen and patients provided room air (16 of
365 [4.4%] vs 11 of 379 [2.9%]; risk ratio 1.5; 95% confidence interval,
0.7-3.3). In addition, there were no statistically significant differencs
in the rates of cesarean delivery for nonreassuring fetal heart rate
monitoring, operative vaginal deliveries, Apgar scores of <7, neonatal
intensive care unit admissions, or cord blood gas values. There were no
statistically significant difference when analyzing oxygen for
nonreassuring fetal heart rate monitoring alone or prophylactic oxygen
alone. Data regarding FHT is mixed, with one study suggesting an
improvement and three suggesting no change. <br/>CONCLUSION(S): Maternal
intrapartum oxygen administration was not associated with any differences
in the rate of cesarean delivery or any secondary outcomes compared with
room air overall and in the subgroups of therapeutic (for nonreassuring
fetal heart rate monitoring) or prophylactic administration in this
meta-analysis. Large randomized controlled trials are necessary to further
examine any possible benefits or harms of oxygen administration in labor,
particularly for nonreassuring fetal heart rate monitoring.<br/>Copyright
&#xa9; 2021 Elsevier Inc.

<30>
Accession Number
2006803151
Title
Pulmonary vein stenosis mimicking interstitial lung disease.
Source
Pulmonology. 27(6) (pp 584-589), 2021. Date of Publication: 01 Nov 2021.
Author
Carrico F.; Gurioli C.; Piciucchi S.; Dubini A.; Tomassetti S.; Poletti V.
Institution
(Carrico) Pulmonology Department, Sousa Martins Hospital, Guarda, Portugal
(Gurioli, Tomassetti, Poletti) Department of Diseases of the Thorax, G.B.
Morgagni - L. Pierantoni Hospital, Forli, Italy
(Piciucchi) Radiology Department, G.B. Morgagni - L. Pierantoni Hospital,
Forli, Italy
(Dubini) Pathology Department, G.B. Morgagni - L. Pierantoni Hospital,
Forli, Italy
(Poletti) Department of Respiratory Diseases & Allergy, Aarhus University
Hospital, Aarhus, Denmark
Publisher
Elsevier Espana S.L.U
Abstract
Pulmonary vein stenosis (PVS) is a rare condition, often difficult to
diagnose and associated with poor prognosis at advanced stages. Lung
parenchymal abnormalities are indirect evidence of PVS and can manifest as
multifocal opacities, nodular lesions, unilateral effusions, and
interstitial septal thickening. These can lead to erroneous diagnoses of
airway disease, pneumonia, malignancies or interstitial lung disease. This
review summarizes the current literature about the approach to, evaluation
and management of these patients. Our case report demonstrates that PVS is
an under-recognized complication of cardiovascular surgery and should be
considered in all patients presenting with respiratory symptoms after a
cardiac procedure.<br/>Copyright &#xa9; 2020 Sociedade Portuguesa de
Pneumologia

<31>
Accession Number
2004685462
Title
Derivation and Validation of a Risk Stratification System for Predicting
Postoperative Cognitive Impairment.
Source
Journal of Investigative Surgery. 34(10) (pp 1121-1127), 2021. Date of
Publication: 2021.
Author
Liao Y.; Su X.; Ouyang W.; Li L.; Chen S.; Chou J.; Le Y.
Institution
(Liao, Su, Ouyang, Li, Chen, Chou, Le) Department of Anesthesiology, The
Third Xiangya Hospital, Central South University, Changsha, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: To establish and validate a risk stratification scoring system
(we name it as PreOp-BFS, which represents Pre-Operative Brain Fragility
Score) for postoperative cognitive impairment containing postoperative
cognitive dysfunction (POCD) and postoperative delirium (POD) in elderly
patients undergoing non-cardiac surgery. <br/>Method(s): We searched for
relevant literatures and reviews reported in PubMed and ScienceDirect
databases from January 1994 to December 2017. We performed a preoperative
risk factor for cognitive impairment in elderly patients (age >= 60 years)
who underwent non-cardiac surgery, and finally constructed a risk scoring
system to predict postoperative cognitive impairment. <br/>Result(s): The
test data included 49 patients with postoperative cognitive impairment and
31 patients without postoperative cognitive impairment. The postoperative
risk scale score ranged from 0 to 8 points. The incidence of postoperative
cognitive impairment was 16.2%, 62.9% and 96.2% in the low (0-2 scores),
medium (3-4 scores) and high (5-8 scores) risk groups, respectively. In
addition, the risk of postoperative cognitive impairment was significantly
higher in high and medium risk groups than in low risk group. Receiver
operating characteristic (ROC) analysis showed that the area under the
curve (AUC) of the risk scoring system was 0.862 [95% CI 0.784-0.941].
<br/>Conclusion(s): The preoperative risk stratification scoring system
(PreOp-BFS) established in this study had a good prediction effect, which
was helpful for rapid identification and screening of high-risk
susceptible patients with early postoperative cognitive impairment, and
for performing targeted perioperative prevention.<br/>Copyright &#xa9;
2020 Taylor & Francis Group, LLC.

<32>
Accession Number
2015391763
Title
Factors Associated with Return to Work After Heart Transplantation: A
Systematic Review of the Literature.
Source
American Journal of the Medical Sciences. 362(6) (pp 592-597), 2021. Date
of Publication: December 2021.
Author
Rivera E.L.; Aponte J.; Montes M.C.; Adams C.D.; Gomez-Mesa J.E.
Institution
(Rivera, Aponte) Master of Occupational Health Program, Health Sciences
Department, Universidad Libre, Cali, Columbia, United States
(Rivera, Montes, Adams, Gomez-Mesa) Cardiology Service, Department of
Internal Medicine, Fundacion Valle del Lili, Cali, Columbia, United States
Publisher
Elsevier B.V.
Abstract
Background: Heart transplantation represents one of the last treatment
options for advanced heart failure. Little is known about the factors
associated with return to work in patients after heart transplantation.
The aim of this study was to identify those factors. <br/>Method(s): A
systematic literature review was conducted in the PubMed, LILACS, SCIELO
and ScienceDirect databases using the keywords "trasplante cardiaco",
"calidad de vida", "reingreso laboral", "return to work", "heart
transplantation" and "occupation related". Quantitative studies with
patients over 18 years of age that were published between January 2007 and
June 2017 were included. <br/>Result(s): A total of 6 articles were
included, none from Latin America. Heart transplantation patients had a
mean age of 51 years; approximately 17% were over 65 years of age; 73-84%
were males; 7-16.4% were professionals; 70-86.6% were previously employed;
and 30-60% returned to work. The following factors were related to return
to work: higher education (p = 0.0017), young age (p = 0.003), better
scores on the physical and mental domains of the SF-36 questionnaire (p =
0.035), higher six-minute walk test results (median of 560 m), and
previous employment with less than 24 months interrupted by the inability
to work (p = 0.017). Return to work occurred, on average, 6 to 7.5 months
after heart transplantation. <br/>Conclusion(s): Return to work after
heart transplantation is variable, with a tendency to be low, and is lower
in patients near to retirement age. Protective factors were related to the
social, physical and mental environment.<br/>Copyright &#xa9; 2021

<33>
Accession Number
2015435213
Title
Prevalence of preoperative cognitive impairment in older surgical
patients.: A systematic review and meta-analysis.
Source
Journal of Clinical Anesthesia. 76 (no pagination), 2022. Article Number:
110574. Date of Publication: February 2022.
Author
Kapoor P.; Chen L.; Saripella A.; Waseem R.; Nagappa M.; Wong J.; Riazi
S.; Gold D.; Tang-Wai D.F.; Suen C.; Englesakis M.; Norman R.; Sinha S.K.;
Chung F.
Institution
(Kapoor, Chen, Saripella, Waseem, Wong, Riazi, Suen, Chung) Department of
Anesthesiology and Pain Medicine, Toronto Western Hospital, University
Health Network, University of Toronto, Toronto, ON, Canada
(Nagappa) Department of Anesthesia & Perioperative Medicine, Western
University, London, ON, Canada
(Wong) Department of Anesthesiology and Pain Medicine, Women's College
Hospital, Toronto, ON, Canada
(Gold) Department of Psychiatry, University of Toronto, Toronto, ON,
Canada
(Tang-Wai) Division of Neurology, Department of Medicine, University of
Toronto, Toronto, ON, Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
(Norman, Sinha) Division of Geriatric Medicine, Department of Medicine,
University of Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Study objective: Older surgical patients with cognitive impairment are at
an increased risk for adverse perioperative outcomes, however the
prevalence of preoperative cognitive impairment is not well-established
within this population. The purpose of this review is to determine the
pooled prevalence of preoperative cognitive impairment in older surgical
patients. <br/>Design(s): Systematic review and meta-analysis.
<br/>Setting(s): MEDLINE (Ovid), PubMed (non-MEDLINE records only),
Embase, Cochrane Central, Cochrane Database of Systematic Reviews,
PsycINFO, and EMCare Nursing for relevant articles from 1946 to April
2021. <br/>Patient(s): Patients aged >=60 years old undergoing surgery,
and preoperative cognitive impairment assessed by validated cognitive
assessment tools. <br/>Intervention(s): Preoperative assessment.
Measurements: Primary outcomes were the pooled prevalence of preoperative
cognitive impairment in older patients undergoing either elective (cardiac
or non-cardiac) or emergency surgery. <br/>Main Result(s): Forty-eight
studies (n = 42,498) were included. In elective non-cardiac surgeries, the
pooled prevalence of unrecognized cognitive impairment was 37.0% (95%
confidence interval [CI]: 30.0%, 45.0%) among 27,845 patients and
diagnosed cognitive impairment was 18.0% (95% CI: 9.0%, 33.0%) among
11,676 patients. Within the elective non-cardiac surgery category,
elective orthopedic surgery was analyzed. In this subcategory, the pooled
prevalence of unrecognized cognitive impairment was 37.0% (95% CI: 26.0%,
49.0%) among 1117 patients, and diagnosed cognitive impairment was 17.0%
(95% CI: 3.0%, 60.0%) among 6871 patients. In cardiac surgeries, the
unrecognized cognitive impairment prevalence across 588 patients was 26.0%
(95% CI: 15.0%, 42.0%). In emergency surgeries, the unrecognized cognitive
impairment prevalence was 50.0% (95% CI: 35.0%, 65.0%) among 2389
patients. <br/>Conclusion(s): A substantial number of surgical patients
had unrecognized cognitive impairment. In elective non-cardiac and
emergency surgeries, the pooled prevalence of unrecognized cognitive
impairment was 37.0% and 50.0%. Preoperative cognitive screening warrants
more attention for risk assessment and stratification.<br/>Copyright
&#xa9; 2021 Elsevier Inc.

<34>
Accession Number
2015437870
Title
Transcatheter Versus Surgical Aortic Valve Replacement in Patients With
Complex Coronary Artery Disease.
Source
JACC: Cardiovascular Interventions. 14(22) (pp 2490-2499), 2021. Date of
Publication: 22 Nov 2021.
Author
Alperi A.; Mohammadi S.; Campelo-Parada F.; Munoz-Garcia E.;
Nombela-Franco L.; Faroux L.; Veiga G.; Serra V.; Fischer Q.; Pascual I.;
Asmarats L.; Gutierrez E.; Regueiro A.; Vilalta V.; Ribeiro H.B.; Matta
A.; Munoz-Garcia A.; Armijo G.; Metz D.; De la Torre Hernandez J.M.;
Rodenas-Alesina E.; Urena M.; Moris C.; Arzamendi D.; Perez-Fuentes P.;
Fernandez-Nofrerias E.; Campanha-Borges D.C.; Mesnier J.; Voisine P.;
Dumont E.; Kalavrouziotis D.; Rodes-Cabau J.
Institution
(Alperi, Mohammadi, Mesnier, Voisine, Dumont, Kalavrouziotis, Rodes-Cabau)
Quebec Heart and Lung Institute, Laval University, Quebec City, QC, Canada
(Campelo-Parada, Matta) Rangueil University Hospital, Toulouse, France
(Munoz-Garcia, Munoz-Garcia) Hospital Universitario Virgen de la Victoria,
Malaga, Spain
(Nombela-Franco, Armijo) Cardiovascular Institute, Hospital Clinico San
Carlos, IdISSC, Madrid, Spain
(Faroux, Metz) Reims University Hospital, Reims, France
(Veiga, De la Torre Hernandez) Hospital Marques de Valdecilla, Santander,
Spain
(Serra, Rodenas-Alesina) Hospital Universitari Vall d'Hebron, Barcelona,
Spain
(Fischer, Urena) Assistance Publique-Hopitaux de Paris, Bichat Hospital,
Paris, France
(Pascual, Moris) Hospital Universitario Central de Asturias, Oviedo, Spain
(Asmarats, Arzamendi) Hospital Santa Creu i Sant Pau, Barcelona, Spain
(Gutierrez) Hospital Gregorio Maranon, Madrid, Spain
(Regueiro, Perez-Fuentes, Rodes-Cabau) Hospital Clinic de Barcelona,
Barcelona, Spain
(Vilalta, Fernandez-Nofrerias) Hospital Germans Trias i Pujol, Badalona,
Spain
(Ribeiro, Campanha-Borges) Instituto do Coracao (InCor), Heart Institute,
University of Sao Paulo, Sao Paulo, Brazil
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to compare, in a cohort of patients
with complex coronary artery disease (CAD) and severe aortic stenosis
(AS), the clinical outcomes associated with transfemoral transcatheter
aortic valve replacement (TAVR) (plus percutaneous coronary intervention
[PCI]) versus surgical aortic valve replacement (SAVR) (plus coronary
artery bypass grafting [CABG]). <br/>Background(s): Patients with complex
CAD were excluded from the main randomized trials comparing TAVR with
SAVR, and no data exist comparing TAVR + PCI vs SAVR + CABG in such
patients. <br/>Method(s): A multicenter study was conducted including
consecutive patients with severe AS and complex CAD (SYNTAX [Synergy
Between PCI with Taxus and Cardiac Surgery] score >22 or unprotected left
main disease). A 1:1 propensity-matched analysis was performed to account
for unbalanced covariates. The rates of major adverse cardiac and
cerebrovascular events (MACCE), including all-cause mortality,
nonprocedural myocardial infarction, need for new coronary
revascularization, and stroke, were evaluated. <br/>Result(s): A total of
800 patients (598 undergoing SAVR + CABG and 202 undergoing transfemoral
TAVR + PCI) were included, and after propensity matching, a total of 156
pairs of patients were generated. After a median follow-up period of 3
years (interquartile range: 1-6 years), there were no significant
differences between groups for MACCE (HR for transfemoral TAVR vs SAVR:
1.33; 95% CI: 0.89-1.98), all-cause mortality (HR: 1.25; 95% CI:
0.81-1.94), myocardial infarction (HR: 1.16; 95% CI: 0.41-3.27), and
stroke (HR: 0.42; 95% CI: 0.13-1.32), but there was a higher rate of new
coronary revascularization in the TAVR + PCI group (HR: 5.38; 95% CI:
1.73-16.7). <br/>Conclusion(s): In patients with severe AS and complex
CAD, TAVR + PCI and SAVR + CABG were associated with similar rates of
MACCE after a median follow-up period of 3 years, but TAVR + PCI
recipients exhibited a higher risk for repeat coronary revascularization.
Future trials are warranted.<br/>Copyright &#xa9; 2021 American College of
Cardiology Foundation

<35>
Accession Number
2015427957
Title
Progress of research in postoperative cognitive dysfunction in cardiac
surgery patients: A review article.
Source
International Journal of Surgery. 95 (no pagination), 2021. Article
Number: 106163. Date of Publication: November 2021.
Author
Bhushan S.; Li Y.; Huang X.; Cheng H.; Gao K.; Xiao Z.
Institution
(Bhushan, Li, Cheng, Gao, Xiao) Department of Cardiothoracic Surgery,
Chengdu Second People's Hospital, Chengdu, Sichuan 610017, China
(Huang) Department of Anesthesiology, West China Hospital of Medicine,
Sichuan University, Sichuan 610017, China
Publisher
Elsevier Ltd
Abstract
Background: Postoperative cognitive dysfunction (POCD) is a common
complication of central nervous system in middle-aged and elderly patients
after cardiac surgery. The purpose of this study was to review the
progress in diagnosis, pathogenesis and risk factors and control strategy
of POCD. <br/>Method(s): A systematic literature search was conducted
using Pubmed and EMBASE, using the Mesh terms and key words "POCD",
"diagnostic criteria", "pathogenesis", "influencing factors" and
"prevention strategies". Studies were retained for review after meeting
strict inclusion criteria that included only prospective studies
evaluating risk factors for POCD in patients who had elective cardiac
surgery. Diagnosis of POCD needed to be confirmed using the Diagnostic and
Statistical Manual of Montreal Cognitive Assessment (MoCA) Scale and other
criteria. <br/>Result(s): "Twenty two articles were selected for
inclusion. The incidence of POCD across the studies ranged from 9% to 54%.
Multiple factors have been associated with the pathogenesis and increased
risk of POCD, including neuroinflammation, dysfunction of cholinergic
system, abnormal protein function (beta-amyloid), old age, anesthetic,
surgical and other factors." <br/>Conclusion(s): POCD is a common
complication after cardiac surgery in elderly. The highest POCD incidence
was observed after open aortic, TAVI and CABG surgery. Age, cognitive
function, depression, CPB and anesthetic use are leading risk factors.
Further research is needed in determining interventions that will be
effective in preventing and treating POCD in cardiac surgical
setting.<br/>Copyright &#xa9; 2021 IJS Publishing Group Ltd

<36>
Accession Number
2015398670
Title
Mirogabalin treatment of postoperative neuropathic pain after thoracic
surgery: Study protocol for a multicenter, randomized, open-label,
parallel-group, interventional trial.
Source
Journal of Thoracic Disease. 13(10) (pp 6062-6070), 2021. Date of
Publication: October 2021.
Author
Doi R.; Miyazaki T.; Tsuchiya T.; Matsumoto K.; Tomoshige K.; Machino R.;
Mizoguchi S.; Matsumoto T.; Yamaguchi K.; Takatsuna H.; Shiosakai K.;
Nagayasu T.
Institution
(Doi, Miyazaki, Tsuchiya, Matsumoto, Tomoshige, Machino, Mizoguchi,
Matsumoto, Nagayasu) Department of Surgical Oncology, Nagasaki University
Graduate School of Biomedical Sciences, Nagasaki, Japan
(Yamaguchi) Oncology Medical Science Department, Daiichi Sankyo Co., Ltd.,
Tokyo, Japan
(Takatsuna) Primary Medical Science Department, Daiichi Sankyo Co., Ltd.,
Tokyo, Japan
(Shiosakai) Data Intelligence Department, Daiichi Sankyo Co., Ltd., Tokyo,
Japan
Publisher
AME Publishing Company
Abstract
Background: Intercostal nerve damage due to thoracotomy or thoracoscopic
manipulation is a major contributor to chronic postsurgical pain after
pulmonary resection. Chronic postsurgical pain may last for months or
years and can negatively impair physical functioning and daily activities.
Global consensus on severe postoperative pain management is lacking, and
chronic pain incidence after thoracic surgery remains high. Many patients
report neuropathic pain, which can be difficult to treat with currently
available therapies. The efficacy and safety of mirogabalin have been
demonstrated for other types of neuropathic pain; thus, this study was
planned to investigate the efficacy and safety of mirogabalin to treat
neuropathic pain after thoracic surgery. <br/>Method(s): In this
multicenter, randomized, open-label, parallel-group, interventional study,
patients who are diagnosed with neuropathic pain following removal of a
chest drain after lung resection will receive conventional therapy
(non-steroidal anti-inflammatory drugs and/or acetaminophen) with or
without the addition of a clinical dose of mirogabalin for 8 weeks. For
patient stratification, a visual analog scale pain intensity score at
baseline of <60 vs. >=60 mm will be used. Treatment efficacy and safety
with and without the addition of mirogabalin will be assessed using a
questionnaire evaluating postoperative changes in pain severity and
activity. The primary study endpoint is the change in pain intensity from
baseline to Week 8, measured by the visual analog scale. Additionally, the
presence of chronic pain at 12 weeks after enrollment in each treatment
group will be recorded. <br/>Discussion(s): This protocol has been
reviewed and approved by the Clinical Research Review Board of Nagasaki
University. Study data will be published in the Japan Registry of Clinical
Trials database and peer-reviewed journals. Mirogabalin is already
approved for the treatment of other types of neuropathic pain. It is
anticipated that this study will provide data to elucidate the impact of
mirogabalin treatment, in combination with conventional therapy, to
benefit patients with neuropathic pain following thoracic surgery. Trial
Registration: Japan Registry of Clinical Trials Identifier:
jRCTs071200053.<br/>Copyright &#xa9; Journal of Thoracic Disease. All
rights reserved.

<37>
Accession Number
2015398656
Title
Evaluation of local aggressive lung therapy versus systemic therapy in
oligometastatic non-small cell lung cancer: A systematic review and
meta-analysis.
Source
Journal of Thoracic Disease. 13(10) (pp 5899-5910), 2021. Date of
Publication: October 2021.
Author
Zhang C.; Ma N.; Zhang Q.; Zheng K.; Sun C.; Tang X.; Li X.; Zhao J.
Institution
(Zhang, Zheng, Tang, Li, Zhao) Department of Thoracic Surgery, Tangdu
Hospital, Air Force Medical University, Xi'an, China
(Ma) Department of Ophthalmology, Tangdu Hospital, Air Force Medical
University, Xi'an, China
(Zhang) School of Stomatology, Xi'an Medical University, Xi'an, China
(Sun) Department of Cardiology, Xi'an International Medical Center
Hospital, Xi'an, China
(Li, Zhao) Department of Thoracic Surgery, Tangdu Hospital, Air Force
Medical University, No. 569, Xinsi Road, Shaanxi, Xi'an 710038, China
Publisher
AME Publishing Company
Abstract
Background: Previous studies have shown the feasibility and effectiveness
of local aggressive thoracic therapy (surgery and radiotherapy) for
oligometastatic non-small cell lung cancer compared with systemic therapy,
but with small sample. This study aims to perform a pooled analysis to
explore whether LT could improve outcomes of oligometastatic patients with
non-small cell lung cancer. <br/>Method(s): Protocol of present study was
registered on PROSPERO as number: CRD42021233095. PubMed, Embase and Web
of knowledge were searched, and eligible studies investigating local
therapy for non-small cell lung cancer with 1-5 metastases regardless of
organs were included. Linear regression between survival and clinical
characteristics were conducted. Hazard ratios of survival and adverse
effects were merged. Pooled survival curves were carried out.
<br/>Result(s): Three randomized controlled trials and 5 cohort studies
enrolling 499 patients were included. There was a trend that median
overall survival declined with the increasing proportion of N2-3 positive
patients in local therapy group, but with no statistical difference
(P=0.09, R²=0.98). Undergoing local therapy for oligometastatic
non-small cell lung cancer achieved reduction of 47% and 60% in the risk
of death and cancer progression (P<0.001), respectively. In subgroup
analysis, patients receiving local therapy including surgery showed hazard
ratio of 0.33 on progression-free survival and 0.55 of these excluding
surgery. Patients receiving consolidative local therapy (local therapy
after systemic therapy) obtained hazard ratios 0.33 and 0.45 on
progression-free and overall survival vs. systemic therapy, respectively.
Hazard ratios of those receiving upfront local therapy (local therapy
first) were 0.62 and 0.68 on progression-free and overall survival vs.
systemic therapy. Pooled survival analysis showed median overall and
progression-free survival of local therapy (21.6 and 14 months) group were
both longer than systemic one (14.3 and 6.5 months). Odds ratio of adverse
effects were no difference between 2 groups (P=0.16). <br/>Conclusion(s):
Local aggressive thoracic therapy could prolong 7 months overall and
progression-free survival compared with systemic therapy in patients with
oligometastatic non-small cell lung cancer. Consolidative local therapy
might be a more favorable choice of local therapy. Benefits of local
therapy for N2-3 positive patients should explored further.<br/>Copyright
&#xa9; Journal of Thoracic Disease. All rights reserved.

<38>
Accession Number
2015398655
Title
Is sleeve lobectomy safe after induction therapy?-a systematic review and
meta-analysis.
Source
Journal of Thoracic Disease. 13(10) (pp 5887-5898), 2021. Date of
Publication: October 2021.
Author
Chriqui L.-E.; Forster C.; Lovis A.; Bouchaab H.; Krueger T.; Perentes
J.Y.; Gonzalez M.
Institution
(Chriqui, Forster, Krueger, Perentes, Gonzalez) Service of Thoracic
Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
(Lovis) Service of Pneumology, University Hospital of Lausanne (CHUV),
Lausanne, Switzerland
(Lovis, Krueger, Perentes, Gonzalez) University of Lausanne, Lausanne,
Switzerland
(Bouchaab) Service of Oncology University Hospital of Lausanne (CHUV),
Lausanne, Switzerland
Publisher
AME Publishing Company
Abstract
Background: Sleeve lobectomy (SL) is a lung-sparing procedure, which is
accepted as a valid operation for centrally-located advanced tumors. These
tumors often require induction treatment by chemotherapy and/ or
radiotherapy to downstage the disease and thus facilitate subsequent
surgery. However, induction therapy may potentially increase the risk of
bronchial anastomotic complications and related morbidity. This
meta-analysis aims to determine the impact of induction therapy on the
outcomes of pulmonary SL. <br/>Method(s): We compared studies of patients
undergoing SL or bilobectomy for non-small cell lung cancer (NSCLC) with
and without induction therapy. Outcomes of interest were in-hospital
mortality, morbidity, anastomosis complication and 5-year survival. Odds
ratio (OR) were computed following the Mantel-Haenszel method.
<br/>Result(s): Ten studies were included for a total of 1,204 patients.
There was no statistical difference for between patients who underwent
induction therapy followed by surgery and patients who underwent surgery
alone in term of post-operative mortality (OR: 1.80, 95% confidence
interval (CI): 0.76-4.25, P value =0.19) and morbidity (OR: 1.17, 95% CI:
0.90-1.52, P value =0.237). Anastomosis related complications rate were
5.2% and appears increased after induction therapy with a statistical
difference close to the significance (OR: 1.65, 95% CI: 0.97-2.83, P value
=0.06). Patients undergoing surgery alone showed better survival at 5
years (OR: 1.52, 95% CI: 1.15-2.00, P value =0.003). <br/>Conclusion(s):
SL following induction therapy can be safely performed with no increase of
mortality and morbidity. However, the need for induction therapy before
surgery is associated with increased anastomotic complications and poorer
survival prognosis at 5 years.<br/>Copyright &#xa9; Journal of Thoracic
Disease. All rights reserved.

<39>
Accession Number
635996429
Title
In-Hospital Outcomes of Acute Kidney Injury After Pediatric Cardiac
Surgery: A Meta-Analysis.
Source
Frontiers in Pediatrics. 9 (no pagination), 2021. Article Number: 733744.
Date of Publication: 03 Sep 2021.
Author
Van den Eynde J.; Rotbi H.; Gewillig M.; Kutty S.; Allegaert K.; Mekahli
D.
Institution
(Van den Eynde, Kutty) Helen B. Taussig Heart Center, The Johns Hopkins
Hospital and School of Medicine, Baltimore, MD, United States
(Van den Eynde, Gewillig) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Rotbi) Faculty of Medicine, Radboud University, Nijmegen, Netherlands
(Rotbi) Department of Physiology, Radboud Institute for Health Sciences,
Radboud University Medical Center, Nijmegen, Netherlands
(Gewillig) Pediatric Cardiology, University Hospitals Leuven, Leuven,
Belgium
(Allegaert) Department of Development and Regeneration, KU Leuven, Leuven,
Belgium
(Allegaert) Department of Pharmacy and Pharmaceutical Sciences, KU Leuven,
Leuven, Belgium
(Allegaert) Department of Hospital Pharmacy, Erasmus Medical Center,
Rotterdam, Netherlands
(Mekahli) Department of Pediatric Nephrology, University Hospitals of
Leuven, Leuven, Belgium
(Mekahli) PKD Research Group, GPURE, Department of Development and
Regeneration, KU Leuven, Leuven, Belgium
Publisher
Frontiers Media S.A.
Abstract
Background: Cardiac surgery-associated acute kidney injury (CS-AKI) is
associated with increased morbidity and mortality in both adults and
children. This study aimed to investigate the in-hospital outcomes of
CS-AKI in the pediatric population. <br/>Method(s): PubMed/MEDLINE,
Embase, Scopus, and reference lists of relevant articles were searched for
studies published by August 2020. Random-effects meta-analysis was
performed, comparing in-hospital outcomes between patients who developed
CS-AKI and those who did not. <br/>Result(s): Fifty-eight publications
between 2008 and 2020 consisting of 18,334 participants (AKI: 5,780; no
AKI: 12,554) were included. Higher rates of in-hospital mortality (odds
ratio [OR] 7.22, 95% confidence interval [CI] 5.27-9.88), need for renal
replacement therapy (RRT) (OR 18.8, 95% CI 11.7-30.5), and cardiac
arrhythmias (OR 2.67, 95% 1.86-4.80) were observed in patients with
CS-AKI. Furthermore, patients with AKI had longer ventilation times (mean
difference [MD] 1.76 days, 95% CI 1.05-2.47), pediatric intensive care
unit (PICU) length of stay (MD 3.31, 95% CI 2.52-4.10), and hospital
length of stay (MD 5.00, 95% CI 3.34-6.67). <br/>Conclusion(s): CS-AKI in
the pediatric population is associated with a higher risk of mortality,
cardiac arrhythmias and need for RRT, as well as greater mechanical
ventilation time, PICU and hospital length of stay. These results might
help improve the clinical care protocols prior to cardiac surgery to
minimize the disease burden of CS-AKI in children. Furthermore,
etiology-specific approaches to AKI are warranted, as outcomes are likely
impacted by the underlying cause.<br/>&#xa9; Copyright &#xa9; 2021 Van den
Eynde, Rotbi, Gewillig, Kutty, Allegaert and Mekahli.

<40>
Accession Number
2013787642
Title
A Prospective Study on Type-2 Diabetic Complications and Efficacy of
Integrated Yoga: A Pan India 2017.
Source
Annals of Neurosciences. 28(1-2) (pp 21-28), 2021. Date of Publication:
January 2021.
Author
Patil S.S.; Raghuram N.; Singh A.; Rajesh S.K.; Ahmed S.; Hongasandra N.
Institution
(Patil, Raghuram, Singh, Ahmed, Hongasandra) Department of Yoga and Life
Science, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru,
Karnataka, India
(Rajesh) Department of Yoga and Physical Science, Swami Vivekananda Yoga
Anusandhana Samsthana, Bengaluru, Karnataka, India
Publisher
SAGE Publications Inc.
Abstract
Background: Type 2 diabetes (T2DM) contributes to high mortality and
morbidity because of its major complications related to kidney, heart,
brain, and eyes. It also poses a high risk for mortality because of
COVID-19. Studies suggest the possible implications of Yoga in delaying or
attenuating such complications. Methodology: This was a pan-India multi
centered cluster-randomized (4 level) two-armed trial in the rural and
urban population of all populous states of India. Data were obtained using
mobile app in all adults in the household of the selected clusters.
<br/>Result(s): We report the diabetes related complications in 16623
adults (48% males, 52% females) from 65 districts (1 in 10 districts, 2011
census) of 29 (out of 35) states and Union Territories of India; mean age
was 48.2 +/- 12.46 years. Out of this 40% lived in rural and 62% in urban
locations. In high risk diabetes individuals (scored >= 60 points on
Indian diabetes risk score key), 18.0% had self-reported history of
(peripheral neuropathy, 6.1% had h/o major strokes, 5.5% had minor strokes
(transient ischemic episodes), 18.1% had lower limb claudication, 20.5%
leg ulcers, 4.4% had h/o cardiac surgery, 4.8% angioplasty, and 15.1% had
diabetes retinopathy. Complications were higher in rural than in urban
areas, higher in people with extended duration of diabetes. Integrated
yoga module for three months (one hour daily) showed significantly better
reduction in symptoms related to complications as compared to control
group (P <.001) <br/>Conclusion(s): The alarming high prevalence of
complications in diabetes population calls for urgent action, where yoga
may show the benefits in reduction of symptoms of
complications.<br/>Copyright &#xa9; 2021 Indian Academy of Neurosciences
(IAN).

<41>
Accession Number
2007629343
Title
A rare case of late-onset ticagrelor-induced sinus arrest.
Source
Asian Cardiovascular and Thoracic Annals. 29(9) (pp 946-949), 2021. Date
of Publication: November 2021.
Author
Aranganathan P.; Wilson B.; Rangan A.; Boopathi A.; Balasundaram R.
Institution
(Aranganathan, Wilson, Rangan, Boopathi, Balasundaram) Department of
Cardiology, G. Kuppuswamy Naidu Memorial Hospital, Coimbatore, India
Publisher
SAGE Publications Inc.
Abstract
Ticagrelor is a potent reversible P2Y12 inhibitor with proven superiority
over clopidogrel. Ticagrelor increases the tissue concentration of
adenosine, thereby leading to bradyarrhythmia. This complication is
reported to occur very early after initiating the drug. A randomized
controlled trial reported that ticagrelor-induced pauses have an early
onset without much clinical impact. However, our patient developed
ticagrelor-induced hemodynamically significant sinus arrest 10 months
after coronary artery stenting, which improved after stopping the drug.
Ticagrelor should be considered as one of the uncommon reasons for
late-onset sinus pause or bradyarrhythmia.<br/>Copyright &#xa9; The
Author(s) 2020.

<42>
Accession Number
2013939989
Title
Late health outcomes after dexrazoxane treatment: A report from the
Children's Oncology Group.
Source
Cancer. (no pagination), 2021. Date of Publication: 2021.
Author
Chow E.J.; Aplenc R.; Vrooman L.M.; Doody D.R.; Huang Y.-S.V.; Aggarwal
S.; Armenian S.H.; Baker K.S.; Bhatia S.; Constine L.S.; Freyer D.R.; Kopp
L.M.; Leisenring W.M.; Asselin B.L.; Schwartz C.L.; Lipshultz S.E.
Institution
(Chow, Doody, Baker, Leisenring) Fred Hutchinson Cancer Research Center,
Seattle Children's Hospital, Seattle, WA, United States
(Aplenc, Huang) Children's Hospital of Philadelphia, Philadelphia, PA,
United States
(Vrooman) Dana-Farber Cancer Institute, Boston Children's Hospital,
Boston, MA, United States
(Aggarwal) Wayne State University, Detroit, MI, United States
(Armenian) City of Hope, Duarte, CA, United States
(Bhatia) University of Alabama at Birmingham, Birmingham, AL, United
States
(Constine, Asselin) Golisano Children's Hospital, University of Rochester
Medical Center, Rochester, NY, United States
(Freyer) Children's Hospital Los Angeles, University of Southern
California, Los Angeles, CA, United States
(Kopp) University of Arizona, Tucson, AZ, United States
(Schwartz) Children's Wisconsin, Medical College of Wisconsin, Milwaukee,
WI, United States
(Lipshultz) Oishei Children's Hospital, Roswell Park Comprehensive Center,
University at Buffalo Jacobs School of Medicine and Biomedical Sciences,
Buffalo, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The objective of this study was to examine long-term outcomes
among children newly diagnosed with cancer who were treated in
dexrazoxane-containing clinical trials. <br/>Method(s): P9404 (acute
lymphoblastic leukemia/lymphoma [ALL]), P9425 and P9426 (Hodgkin
lymphoma), P9754 (osteosarcoma), and Dana-Farber Cancer Institute 95-01
(ALL) enrolled 1308 patients between 1996 and 2001: 1066 were randomized
(1:1) to doxorubicin with or without dexrazoxane, and 242 (from P9754)
were nonrandomly assigned to receive dexrazoxane. Trial data were linked
with the National Death Index, the Organ Procurement and Transplantation
Network, the Pediatric Health Information System (PHIS), and Medicaid.
Osteosarcoma survivors from the Childhood Cancer Survivor Study (CCSS; n =
495; no dexrazoxane) served as comparators in subanalyses. Follow-up
events were assessed with cumulative incidence, Cox regression, and
Fine-Gray methods. <br/>Result(s): In randomized trials (cumulative
prescribed doxorubicin dose, 100-360 mg/m²; median follow-up,
18.6 years), dexrazoxane was not associated with relapse (hazard ratio
[HR], 0.84; 95% confidence interval [CI], 0.63-1.13), second cancers (HR,
1.19; 95% CI, 0.62-2.30), all-cause mortality (HR, 1.07; 95% CI,
0.78-1.47), or cardiovascular mortality (HR, 1.45; 95% CI, 0.41-5.16).
Among P9754 patients (all exposed to dexrazoxane; cumulative doxorubicin,
450-600 mg/m²; median follow-up, 16.6-18.4 years), no
cardiovascular deaths or heart transplantation occurred. The 20-year heart
transplantation rate among CCSS osteosarcoma survivors (mean doxorubicin,
377 +/- 145 mg/m²) was 1.6% (vs 0% in P9754; P =.13). Among
randomized patients, serious cardiovascular outcomes (cardiomyopathy,
ischemic heart disease, and stroke) ascertained by PHIS/Medicaid occurred
less commonly with dexrazoxane (5.6%) than without it (17.6%; P =.02),
although cardiomyopathy rates alone did not differ (4.4% vs 8.1%; P =.35).
<br/>Conclusion(s): Dexrazoxane did not appear to adversely affect
long-term mortality, event-free survival, or second cancer
risk.<br/>Copyright &#xa9; 2021 American Cancer Society

<43>
Accession Number
2012058387
Title
Surgical Risk Scoring in TAVR: Still Needed? A Metaregression Analysis.
Source
Current Problems in Cardiology. 46(12) (no pagination), 2021. Article
Number: 100875. Date of Publication: December 2021.
Author
Baro R.; Cura F.; Belardi J.; Brugaletta S.; Lamelas P.
Institution
(Baro, Cura, Belardi, Lamelas) Instituto Cardiovascular de Buenos Aires,
Buenos Aires, Argentina
(Brugaletta) Clinic Cardiovascular Institute, Hospital Clinic, IDIBAPS,
Barcelona, Spain
(Lamelas) Health Research Methods, Evidence, and Impact, McMaster
University, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Several randomized controlled trials evaluating the effectiveness of
transcatheter aortic valve replacement (TAVR) against surgical aortic
valve replacement have been published to date. The fact that higher risk
populations were implemented first does not necessarily mean that they
benefit more from a TAVR procedure. We performed meta-analysis of the 8
randomized clinical trials performing TAVR for both mortality and stroke
outcomes. Meta-regression was used to evaluate the association between
mean surgical risk using the Society of Thoracic Surgeons (STS) score and
hazard ratio observed in each of the trials. Overall, TAVR was associated
with a significant reduction of both mortality and stroke across the whole
spectrum of patients enrolled, with no evidence of significant
heterogeneity. Metaregression analysis does not suggest a statistically
significant association between STS score and hazard ratio for both
mortality and stroke. This observation suggests reconsidering the use of
risk scores to prioritize TAVR utilization in higher risk patients, while
more focus should be done on patient's life expectancy related to TAVR
durability.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<44>
Accession Number
2010543371
Title
Minimally invasive (mini-thoracotomy) versus median sternotomy in redo
mitral valve surgery: A meta-analysis of observational studies.
Source
Asian Cardiovascular and Thoracic Annals. 29(9) (pp 893-902), 2021. Date
of Publication: November 2021.
Author
Hussain A.; Chacko J.; Uzzaman M.; Hamid O.; Butt S.; Zakai S.B.; Khan H.
Institution
(Hussain, Chacko, Hamid, Butt, Khan) Department of Cardiothoracic Surgery,
King's College Hospital, London, United Kingdom
(Uzzaman) Department of Cardiac Surgery, Queen Elizabeth Hospital,
Birmingham, United Kingdom
(Zakai) National Institute of Cardiovascular Diseases, Karachi, Pakistan
Publisher
SAGE Publications Inc.
Abstract
Objective: Redo mitral valve surgery has traditionally been performed via
a median sternotomy. It is often challenging and is associated with
increased perioperative mortality. Advances in cardiac surgical techniques
over the last two decades have led to an increase in the use of a
minimally invasive approach via a right anterolateral mini-thoracotomy as
opposed to a repeat median sternotomy. However, despite these advances,
there is no general consensus on the best form of entry, and as of yet,
there are no randomized controlled trials. We performed a meta-analysis of
observational studies to aid in determining the best approach for redo
mitral valve surgery. <br/>Method(s): The MEDLINE and EMBASE databases
were conducted up until 1 June 2020. Data regarding mortality, stroke,
reoperation for bleeding and length of hospital stay, wound infection and
cardiopulmonary bypass time were extracted and submitted to a
meta-analysis using random effects modelling and the I²-test
for heterogeneity. Seven retrospective observational studies were
included, enrolling a total of 1070 patients. <br/>Result(s): There were a
total of 1070 patients. Of these 364 had non-sternotomy approach compared
with 707 patients who had median sternotomy. Further subgroup analysis
revealed that 327 of the 364 patients had a mini-thoracotomy approach
while the remaining 37 patients had a full thoracotomy approach.
In-hospital mortality and length of stay were less in non-sternotomy group
compared to median sternotomy group. There were no differences in stroke,
CPB time and wound infections between the two groups. <br/>Conclusion(s):
Redo mitral valve surgery can be performed safely with satisfactory
outcomes via a mini-thoracotomy approach. This meta-analysis shows
comparable results with reduced in-hospital mortality and hospital length
of stay with a mini-thoracotomy approach.<br/>Copyright &#xa9; The
Author(s) 2021.

<45>
Accession Number
2010179069
Title
Aspergillus flavus costochondritis following coronary artery bypass
grafting: a case report and a brief review of literature.
Source
Asian Cardiovascular and Thoracic Annals. 29(9) (pp 960-963), 2021. Date
of Publication: November 2021.
Author
Mohammad A.; Benjamin S.R.; Mallampati S.; Gnanamuthu B.R.; Prabhu A.J.;
Ninan M.M.
Institution
(Mohammad, Benjamin, Mallampati, Gnanamuthu) Department of Cardiothoracic
Surgery, The Christian Medical College, Vellore, India
(Prabhu) Department of Pathology, The Christian Medical College, Vellore,
India
(Ninan) Department of Microbiology, The Christian Medical College,
Vellore, India
Publisher
SAGE Publications Inc.
Abstract
Bacterial sternal wound infections following cardiac surgery are not
uncommon. However, sternal wound infection by a fungus is a rarity, and it
warrants a correct diagnosis followed by specific treatment. We report a
case of Aspergillus sternal wound infection with costochondritis following
cardiac surgery, and briefly review the relevant literature.<br/>Copyright
&#xa9; The Author(s) 2021.

<46>
Accession Number
2014101907
Title
Should asymptomatic cervical stenosis be treated in the setting of
progressive thoracic myelopathy? A systematic review of the literature.
Source
European Spine Journal. (no pagination), 2021. Date of Publication: 2021.
Author
Dowlati E.; Mualem W.; Black J.; Nunez J.; Girish A.; Fayed I.; McGrail
K.M.; Voyadzis J.-M.
Institution
(Dowlati, Fayed, McGrail, Voyadzis) Department of Neurosurgery, MedStar
Georgetown University Hospital, 3800 Reservoir Rd. NW, PHC 7, Washington,
DC 20007, United States
(Mualem, Black, Nunez, Girish) Georgetown University School of Medicine,
3900 Reservoir Rd. NW, Washington, DC, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Unlike tandem stenosis of the cervical and lumbar spine, tandem
cervical and thoracic stenosis (TCTS) of the spine is less common, and the
approach and order of intervention are controversial. We aim to review the
literature to evaluate the incidence and interventions for patients with
cervical and thoracic stenosis. We provide illustrative cases to
demonstrate that thoracic myelopathy in the setting of asymptomatic
cervical stenosis can be treated safely. <br/>Method(s): A systematic
review of the literature through electronic databases of PubMed, EMBASE,
Web of Science, and Cochrane Library was performed to present the current
literature that evaluates TCTS as it relates to incidence and surgical
interventions. We also present two cases of patients undergoing operative
intervention for thoracic myelopathy in the setting of concurrent cervical
stenosis. <br/>Result(s): A total of 26 English original studies and case
reports were identified. Nine studies evaluated the incidence of TCTS. 20
studies with a total of 168 patients with TCTS presented information on
surgical intervention options. There is an overall aggregate incidence of
11.6% (530/4751) based on incidence studies. 165 patients underwent
thoracic intervention. Of these patients, 63 patients underwent cervical
intervention first, 29 underwent thoracic intervention first, and 73
underwent simultaneous, single-stage intervention. <br/>Conclusion(s): In
patients presenting with myelopathy, both cervical and thoracic spine
should be evaluated for TCTS. Order of operative intervention is tailored
to clinical and radiographic information. In cases of thoracic myelopathy
with asymptomatic cervical stenosis, thoracic intervention can be pursued
with precautions to prevent further cervical cord injury.<br/>Copyright
&#xa9; 2021, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<47>
Accession Number
2015283750
Title
A first-in-man clinical evaluation of sirolimus and ascorbic acid-eluting
stent systems: A multicenter, subject-blinded, randomized study.
Source
Korean Circulation Journal. 51 (no pagination), 2021. Article Number:
e116. Date of Publication: September 2020.
Author
Lim Y.-H.; Youn J.H.; Hong S.-J.; Ahn T.-H.; Yoon J.; Park J.-K.; Kim
H.-S.
Institution
(Lim) Division of Cardiology, Department of Internal Medicine, Hanyang
University Colloge of Medicine, Seoul, South Korea
(Youn, Park) CG Bio Co. Ltd, 211, Itaewon-ro, Yongsan-gu, Seoul 04349,
South Korea
(Hong, Ahn) Division of Cardiology, Cardiovascular Center, Korea
University Anam Hospital, Seoul, South Korea
(Yoon) Department of Cardiology, Yonsei University Wonju Severance
Christian Hospital, Wonju, South Korea
(Kim) Department of Internal Medicine, Cardiovascular Center, Seoul
National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul
03080, South Korea
Publisher
Korean Society of Circulation
Abstract
Background and Objectives: This clinical trial was conducted to evaluate
the safety and efficacy of D+StormTM drug-eluting stent (DES) and
BioMatrix FlexTM DES. <br/>Method(s): This study was a multicenter,
subject-single-blind, randomized, and confirmed comparative clinical
trial. According to the inclusion criteria, those diagnosed with stable
angina, unstable angina, silent ischemia, or non-ST-segment myocardial
infarction were selected among patients with coronary artery stenosis as
subjects. Among the subjects with 50% stenosis on coronary angiography,
the experiment was performed on those who had a lesion with reference
vessel 2.5-4.0 mm in diameter and <=40 mm in length. The primary endpoint
was an in-segment late loss and the secondary endpoints were in-stent late
lumen loss, stent malapposition, the incidence of mortality, myocardial
infarction, reoperation, and stent thrombosis at 36 weeks. <br/>Result(s):
57 patients in the D+StormTM DES group and 55 patients in the BioMatrix
FlexTM DES group were enrolled in the study. Fifty-seven patients in the
D+StormTM DES group and Fifty-five patients in the BioMatrix FlexTM DES
group were enrolled in the study. An average of in-segment late lumen loss
was 0.08+/-0.13 mm in the D+StormTM DES group and 0.14+/-0.32 mm in the
BioMatrix FlexTM DES group with no significant difference between the 2
groups (p=0.879). In addition, there was no significant difference in
adverse events between D+StormTM DES and BioMatrix FlexTM DES.
<br/>Conclusion(s): This study demonstrated the clinical effectiveness and
safety of D+StormTM DES implantation in patients with coronary artery
disease over a 36-week follow-up period.<br/>Copyright &#xa9; 2021. The
Korean Society of Cardiology

<48>
Accession Number
2015306034
Title
Physician-reported barriers and challenges to antibiotic prescribing in
surgical prophylaxis: A structured systematic review.
Source
Journal of Pharmaceutical Health Services Research. 12(3) (pp 444-451),
2021. Date of Publication: 01 Sep 2021.
Author
Gillani S.W.; Vippadapu P.; Gulam S.M.
Institution
(Gillani, Vippadapu) Department of Pharmacy Practice, College of Pharmacy,
Gulf Medical University, Ajman, United Arab Emirates
(Gulam) Thumbay Hospital, College of Pharmacy, Gulf Medical University,
Ajman, United Arab Emirates
Publisher
Oxford University Press
Abstract
Objectives: The purpose of the study is to identify and analyse the
barriers in surgical procedures where antibiotic dissipation is habitual.
<br/>Method(s): Extensive literature search is carried out using different
electronic databases (PubMed, Europe PMC, PLoS and Google Scholar) between
January 2000 and December 2020. The articles were selected purely based on
the inclusion criteria. Only qualitative and cross-sectional studies were
selected to reduce the risk of bias. The JBI and AXIS checklists were used
to assessed the quality of the enrolled articles. Data extractions were
done by using a predesigned standardized data collection form. <br/>Key
Findings: A total of 2067 articles were electronically retrieved but only
14 articles met the eligibility criteria. About 15 902 healthcare
professionals (HCPs) with an average response rate of 64.7% were pooled
for evidence synthesis. The majority of respondents (50%) discussed
different barriers in their practice site for surgical antibiotic
prophylaxis (SAP) administration. Barriers were categorized into four
themes: lack of guideline availability and knowledge, lack of adherence to
guidelines, lack of guideline knowledge and adherence and physician
perceptions or off-label practices. A total of 723 (56.3%) out of 1282
HCPs from nine different studies reported a lack of adherence to
guidelines during the perioperative process. The majority of respondents
in three studies, 318 (82%) out of 386 HCPs, reported that physicians'
perceptions play a crucial role in prescribing SAP during surgeries.
<br/>Conclusion(s): This study concluded that the barriers within the
practice site play a decisive role in SAP optimization and therefore all
HCPs are recommended to maintain local/standard guidelines and adhere to
them while prescribing SAP.<br/>Copyright &#xa9; 2021 The Author(s) 2021.
Published by Oxford University Press on behalf of the Royal Pharmaceutical
Society. All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<49>
Accession Number
2014413492
Title
Transradial versus transfemoral coronary intervention for acute st-
elevation myocardial infarction patients undergoing primary pci.
Source
Journal of Cardiovascular Disease Research. 12(5) (pp 730-737), 2021. Date
of Publication: 2021.
Author
Ragab T.M.; El Khashab K.A.; Aziz P.K.; Hussein M.Z.
Institution
(Ragab, El Khashab, Aziz, Hussein) Department of Cardiology, Faculty of
Medicine, Fayoum University, Egypt
Publisher
EManuscript Technologies
Abstract
Background:Patients with ST-segment elevation myocardial infarction
(STEMI) require an urgent revascularization strategy as well as aggressive
antiplatelet and antithrombotic pharmacotherapy and thus are particularly
susceptible to bleeding complications.This study aimed toassess and
compare the feasibility, success and safety of transradial approach (TRA)
versus transfemoral approach (TFA) in STEMI patients undergoing 1ry PCI
regarding clinical outcomes and vascular complications. <br/>Patients and
Methods:This randomized controlled study included 80 patients who were
admitted to the National Heart Institute in the period between May 2015 to
September 2017, because of ST-elevation myocardial infarction (STEMI)
andwere planned for 1ry PCI. Patients were divided into two groups, each
group included 40 patients. Group I; underwent tarnsradial PCI and Group
II; underwent tarnsfemoral PCI. We compared between both groups as regards
in hospital major bleeding & vascular complications and followed up for 3
months for (MACE). <br/>Result(s): The primary end points were
statistically insignificant in both groups however large access site
hematoma occurred in 3 patients in TFA group compared to none of patients
in TRA group. Additionally, one case had gastrointestinal hemorrhage in
TFA group compared to none of patients in TRA group. The secondary end
points: Major adverse cardiac events (MACE) during the in-hospital stay &
3 months follow up were statistically not significant in both groups.
However, one case of mortality occurred in TFA group while no cases
occurred in TRA group. The range of patients hospital stay was from 1 to 3
days with mean 2.1+/-0.38, while inTRAgroup.While itwas from 2 to 6 days
with mean 3.9+/-1.0 in TFA group, and that was statistically highly
significant (P 0.001). <br/>Conclusion(s):1ryPCI for STEMI can be
performed via RA with DTBs clinically equivalent to those performed from
FA after adequate experience and training.<br/>Copyright &#xa9; 2021
EManuscript Technologies. All rights reserved.

<50>
Accession Number
2013676387
Title
Necrotizing Enterocolitis in Children with Congenital Heart Disease: A
Literature Review.
Source
Pediatric Cardiology. 42(8) (pp 1688-1699), 2021. Date of Publication:
December 2021.
Author
Kelleher S.T.; McMahon C.J.; James A.
Institution
(Kelleher, McMahon, James) Department of Paediatric Cardiology, Children's
Health Ireland at Crumlin, Dublin 12, Ireland
Publisher
Springer
Abstract
Infants with congenital heart disease (CHD) are at an increased risk of
developing necrotising enterocolitis (NEC), a serious inflammatory
intestinal condition classically associated with prematurity. CHD not only
increases the risk of NEC in preterm infants but is one of the most
commonly implicated risk factors in term infants. Existing knowledge on
the topic is limited largely to retrospective studies. This review acts to
consolidate existing knowledge on the topic in terms of disease incidence,
pathophysiology, risk factors, outcomes and the complex relationship
between NEC and enteral feeds. Potential preventative strategies, novel
biomarkers for NEC in this population, and the role of the intestinal
microbiome are all explored. Numerous challenges exist in the study of
this complex multifactorial disease which arise from the heterogeneity of
the affected population and its relative scarcity. Nevertheless, its high
related morbidity and mortality warrant renewed interest in identifying
those infants most at risk and implementing strategies to reduce the
incidence of NEC in infants with CHD.<br/>Copyright &#xa9; 2021, The
Author(s).

<51>
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.<br/>Copyright &#xa9; 2021
by the authors. Licensee MDPI, Basel, Switzerland.

<52>
Accession Number
2012271396
Title
QT interval prolongation and the risk of malignant ventricular dysrhythmia
and/or cardiac arrest: Systematic search and narrative review of risk
related to the magnitude of QT interval length.
Source
American Journal of Emergency Medicine. 49 (pp 40-47), 2021. Date of
Publication: November 2021.
Author
Robison L.B.; Brady W.J.; Robison R.A.; Charlton N.
Institution
(Robison) University of Virginia School of Medicine, Charlottesville, VA
22903, United States
(Brady) Department of Emergency Medicine, University of Virginia School of
Medicine, Charlottesville, VA 22903, United States
(Robison) Elder Research Inc., Charlottesville, VA 22903, United States
(Charlton) Division of Medical Toxicology, Department of Emergency
Medicine, University of Virginia School of Medicine, Charlottesville, VA
22903, United States
Publisher
W.B. Saunders
Abstract
Prolongation of the QTc interval is associated with an increased risk of
malignant ventricular dysrhythmias, such as ventricular tachycardia (VT),
and sudden cardiac death. The quantifiable risk rates of adverse
dysrhythmic outcome in relation to specific QTc interval length are not
known. We conducted a literature review on the topic of QT interval
prolongation in adult patients and the associated risk of malignant
dysrhythmic event. We specifically formulated our literature search and
subsequent literature review to address the following question: Can the
clinician identify specific QTc intervals at which a specific quantifiable
risk of malignant dysrhythmic event (malignant ventricular dysrhythmia
and/or cardiac arrest) occurs in an undifferentiated adult patient
population? In the literature search, we identified 701 studies; upon
review using specific, pre-determined inclusion criteria, we identified 16
articles for inclusion in the review. From this literature, we were unable
to answer the question in a quantifiable manner and only noted that the
risk of malignant dysrhythmic event increases with progressively longer
QTc interval. The current literature on this topic is inadequate to answer
this important question due to heterogenous study methodology, patient
populations, endpoints, and periods of observation. Additional prospective
research is required on this topic, aimed at addressing the important
issue of specific, quantifiable risk and its relation to degree of
prolongation of the QTc interval.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<53>
Accession Number
2012222159
Title
Long-term and short-term outcomes of robot-versus video-assisted anatomic
lung resection in lung cancer: A systematic review and meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 59(4) (pp 732-740), 2021.
Date of Publication: 01 Apr 2021.
Author
Wu H.; Jin R.; Yang S.; Park B.J.; Li H.
Institution
(Wu, Jin, Yang, Li) Department of Thoracic Surgery, Ruijin Hospital,
Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
(Park) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, NY, United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Minimally invasive thoracic surgery has evolved with the
introduction of robotic platforms. This study aimed to compare the
long-term and short-term outcomes of the robot-assisted thoracic surgery
(RATS) and video-assisted thoracic surgery (VATS) for anatomic lung
resection. <br/>METHOD(S): We searched published studies that investigated
RATS and VATS in anatomic lung resection. Long-term outcomes (disease-free
survival and overall survival) and short-term outcomes (30-day mortality,
postoperative complications, conversion rate to open surgery and lymph
node upstaging) were extracted. The features were compared and tested as
hazard ratios (HRs) and odds ratios (ORs) at a 95% confidence interval
(CI). <br/>RESULT(S): Twenty-five studies with 50 404 patients (7135 for
RATS and 43 269 for VATS) were included. The RATS group had a longer
disease-free survival than the VATS group (HR: 0.76; 95% CI: 0.59-0.97; P
= 0.03), and the overall survival showed a similar trend but was not
statistically significant (HR: 0.77; 95% CI: 0.57-1.05; P = 0.10). The
RATS group showed a significantly lower 30-day mortality (OR: 0.55; 95%
CI: 0.38-0.81; P = 0.002). No significant difference was found in
postoperative complications (OR: 1.01; 95% CI: 0.87-1.16; P = 0.94), the
conversion rate to open surgery (OR: 0.92; 95% CI: 0.56-1.52; P = 0.75)
and lymph node upstaging (OR: 0.89; 95% CI: 0.52-1.54; P = 0.68).
<br/>CONCLUSION(S): RATS has comparable short-term outcomes and potential
long-term survival benefits for anatomic lung resection compared with
VATS. &copy; 2020 The Author(s). Published by Oxford University Press on
behalf of the European Association for Cardio-Thoracic Surgery. All rights
reserved.<br/>Copyright &#xa9; 2021 European Association for
Cardio-Thoracic Surgery. All rights reserved.

<54>
Accession Number
2010719472
Title
Intranasal Fentanyl for Intervention-Associated Breakthrough Pain After
Cardiac Surgery.
Source
Clinical Pharmacokinetics. 60(7) (pp 907-919), 2021. Date of Publication:
July 2021.
Author
Valtola A.; Laakso M.; Hakomaki H.; Anderson B.J.; Kokki H.; Ranta V.-P.;
Rinne V.; Kokki M.
Institution
(Valtola, Laakso) Heart Centre, Kuopio University Hospital, Kuopio,
Finland
(Laakso, Kokki) School of Medicine, University of Eastern Finland, Kuopio,
Finland
(Hakomaki, Ranta) School of Pharmacy, University of Eastern Finland,
Kuopio, Finland
(Rinne) Admescope Ltd, Oulu, Finland
(Anderson) Department of Anaesthesiology, University of Auckland,
Auckland, New Zealand
(Kokki) Department of Anaesthesia and Intensive Care, Kuopio University
Hospital, KYS, PO Box 100, Kuopio 70029, Finland
Publisher
Adis
Abstract
Background: Cardiac bypass surgery patients have early postoperative
interventions that elicit breakthrough pain. We evaluated the use of
intranasal fentanyl for breakthrough pain management in these patients.
<br/>Method(s): Multimodal analgesia (paracetamol 1 g three times a day,
oxycodone 2-3 mg boluses with a patient-controlled intravenous pump) was
used in 16 patients (age 49-70 years, weight 59-129 kg) after cardiac
bypass surgery. Intranasal fentanyl 100 microg or 200 microg was used to
manage breakthrough pain on the first and third postoperative mornings in
a randomised order. Blood samples were collected for up to 3 h after
fentanyl administration, pain was assessed with a numeric rating scale of
0-10. Plasma fentanyl concentration was assayed using liquid
chromatography-mass spectrometry. Body composition was measured with a
bioelectrical impedance device. <br/>Result(s): Bioavailability of
intranasal fentanyl was high (77%), absorption half-time short (< 2 min)
and an analgesic plasma concentration >= 0.5 ng/mL was achieved in 31 of
32 administrations. Fentanyl exposure correlated inversely with skeletal
muscle mass and total body water. Fentanyl analgesia was effective both on
the first postoperative morning with chest pleural tube removal and during
physiotherapy on the third postoperative morning. The median time of
subsequent oxycodone administration was 1.1 h after intranasal fentanyl
100 microg and 2.1 h after intranasal fentanyl 200 microg, despite similar
oxycodone concentrations (median 13.8, range 5.2-35 ng/mL) in both
fentanyl dose groups. <br/>Conclusion(s): Intranasal fentanyl 100 microg
provided rapid-onset analgesia within 10 min and is an appropriate
starting dose for incidental breakthrough pain in the first 3
postoperative days after cardiac bypass surgery. Clinical Trial
Registration: EudraCT Number: 2018-001280-22.<br/>Copyright &#xa9; 2021,
The Author(s).

<55>
Accession Number
2007872297
Title
Recent developments in rodent models of high-fructose diet-induced
metabolic syndrome: A systematic review.
Source
Nutrients. 13(8) (no pagination), 2021. Article Number: 2497. Date of
Publication: August 2021.
Author
Chan A.M.L.; Ng A.M.H.; Mohd Yunus M.H.; Idrus R.B.H.; Law J.X.; Yazid
M.D.; Chin K.-Y.; Shamsuddin S.A.; Lokanathan Y.
Institution
(Chan, Ng, Idrus, Law, Yazid, Shamsuddin, Lokanathan) Centre for Tissue
Engineering and Regenerative Medicine, Faculty of Medicine, Universiti
Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras, Kuala
Lumpur 56000, Malaysia
(Chan) Ming Medical Sdn. Bhd, D3-3 (2nd Floor), Block D3 Dana 1 Commercial
Centre, Jalan PJU 1A/22, Petaling Jaya 47101, Malaysia
(Mohd Yunus) Department of Physiology, Faculty of Medicine, Universiti
Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras, Kuala
Lumpur 56000, Malaysia
(Chin) Department of Pharmacology, Faculty of Medicine, Universiti
Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras, Kuala
Lumpur 56000, Malaysia
Publisher
MDPI
Abstract
Metabolic syndrome (MetS) is the physiological clustering of hypertension,
hyperglycemia, hyperinsulinemia, dyslipidemia, and insulin resistance. The
MetS-related chronic illnesses encompass obesity, the cardiovascular
system, renal operation, hepatic function, oncology, and mortality. To
perform pre-clinical research, it is imperative that these symptoms be
successfully induced and optimized in lower taxonomy. Therefore, novel and
future applications for a disease model, if proven valid, can be
extrapolated to humans. MetS model establishment is evaluated based on the
significance of selected test parameters, paradigm shifts from new
discoveries, and the accessibility of the latest technology or advanced
methodologies. Ultimately, the outcome of animal studies should be
advantageous for human clinical trials and solidify their position in
advanced medicine for clinicians to treat and adapt to serious or specific
medical situations. Rodents (Rattus norvegicus and Mus musculus) have been
ideal models for mammalian studies since the 18th century and have been
mapped extensively. This review compiles and compares studies published in
the past five years between the multitude of rodent comparative models.
The response factors, niche parameters, and replicability of diet
protocols are also compiled and analyzed to offer insight into
MetS-related disease-specific modelling.<br/>Copyright &#xa9; 2021 by the
authors. Licensee MDPI, Basel, Switzerland.

<56>
Accession Number
636336338
Title
Comparison of Safety and Efficacy Between Clopidogrel and Ticagrelor in
Elderly Patients With Acute Coronary Syndrome: A Systematic Review and
Meta-Analysis.
Source
Frontiers in Pharmacology. 12 (no pagination), 2021. Article Number:
743259. Date of Publication: 18 Oct 2021.
Author
Zhang J.; Guo J.; Wang J.; Pan Y.; Zhao X.; Sang W.; Yang K.; Xu F.; Chen
Y.
Institution
(Zhao, Zhang, Guo, Wang, Pan, Zhao, Sang, Yang, Xu, Xu, Chen) Department
of Emergency Medicine, Qilu Hospital, Shandong University, Jinan, China
(Zhao, Zhang, Guo, Wang, Pan, Zhao, Sang, Yang, Xu, Xu, Chen) Chest Pain
Center, Qilu Hospital, Shandong University, Jinan, China
(Zhao, Zhang, Guo, Wang, Pan, Zhao, Sang, Yang, Xu, Xu, Chen) Shandong
Provincial Clinical Research Center for Emergency and Critical Care
Medicine, Institute of Emergency and Critical Care Medicine, Shandong
University, Qilu Hospital, Shandong University, Jinan, China
(Zhao, Zhang, Guo, Wang, Pan, Zhao, Sang, Yang, Xu, Xu, Chen) Key
Laboratory of Emergency and Critical Care Medicine of Shandong Province,
Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of
Shandong Province, Shandong Provincial Engineering Laboratory for
Emergency and Critical Care Medicine, Qilu Hospital, Shandong University,
Jinan, China
(Zhao, Zhang, Guo, Wang, Pan, Zhao, Sang, Yang, Xu, Xu, Chen) The Key
Laboratory of Cardiovascular Remodeling and Function Research, Chinese
Ministry of Education, Chinese Ministry of Health and Chinese Academy of
Medical Sciences, The State and Shandong Province Joint Key Laboratory of
Translational Cardiovascular Medicine, Qilu Hospital, Shandong University,
Jinan, China
Publisher
Frontiers Media S.A.
Abstract
Background: Dual antiplatelet therapy combining aspirin with a P2Y12
adenosine diphosphate receptor inhibitor is a therapeutic mainstay for
acute coronary syndrome (ACS). However, the optimal choice of P2Y12
adenosine diphosphate receptor inhibitor in elderly (aged >=65 years)
patients remains controversial. We conducted a meta-analysis to compare
the efficacy and safety of ticagrelor and clopidogrel in elderly patients
with ACS. <br/>Method(s): We comprehensively searched in Web of Science,
EMBASE, PubMed, and Cochrane databases through 29^th March, 2021
for eligible randomized controlled trials (RCTs) comparing the efficacy
and safety of ticagrelor or clopidogrel plus aspirin in elderly patients
with ACS. Four studies were included in the final analysis. A fixed
effects model or random effects model was applied to analyze risk ratios
(RRs) and hazard ratios (HRs) across studies, and I² to assess
heterogeneity. <br/>Result(s): A total number of 4429 elderly patients
with ACS were included in this analysis, of whom 2170 (49.0%) patients
received aspirin plus ticagrelor and 2259 (51.0%) received aspirin plus
clopidogrel. The ticagrelor group showed a significant advantage over the
clopidogrel group concerning all-cause mortality (HR 0.78, 95% CI
0.63-0.96, I² = 0%; RR 0.79, 95% CI 0.66-0.95, I² =
0%) and cardiovascular death (HR 0.71, 95% CI 0.56-0.91, I² =
0%; RR 0.76, 95% CI 0.62-0.94, I² = 5%) but owned a higher risk
of PLATO major or minor bleeding (HR 1.46, 95% CI 1.13-1.89, I²
= 0%; RR 1.40, 95% CI 1.11-1.76, I² = 0%). Both the groups
showed no significant difference regarding major adverse cardiovascular
events (MACEs) (HR 1.06, 95% CI 0.68-1.65, I² = 77%; RR 1.04,
95% CI 0.69-1.58, I² = 77%). <br/>Conclusion(s): For elderly
ACS patients, aspirin plus ticagrelor reduces cardiovascular death and
all-cause mortality but increases the risk of bleeding. Herein, aspirin
plus ticagrelor may extend lifetime for elderly ACS patients compared with
aspirin plus clopidogrel. The optimal DAPT for elderly ACS patients may be
a valuable direction for future research studies.<br/>&#xa9; Copyright
&#xa9; 2021 Zhao, Zhang, Guo, Wang, Pan, Zhao, Sang, Yang, Xu, Xu and
Chen.

<57>
Accession Number
636210524
Title
Prospective randomised trial examining the impact of an educational
intervention versus usual care on anticoagulation therapy control based on
an SAMe-TT 2 R 2 score-guided strategy in anticoagulant-naive Thai
patients with atrial fibrillation (TREATS-AF): A study protocol.
Source
BMJ Open. 11(10) (no pagination), 2021. Article Number: e051987. Date of
Publication: 11 Oct 2021.
Author
Phrommintikul A.; Nathisuwan S.; Gunaparn S.; Krittayaphong R.;
Wongcharoen W.; Sehmi S.; Mehta S.; Winkles N.; Brocklehurst P.; Mathers
J.; Jowett S.; Jolly K.; Lane D.; Thomas G.N.; Lip G.Y.H.
Institution
(Phrommintikul, Gunaparn, Wongcharoen) Division of Cardiology, Department
of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang
Mai, Thailand
(Phrommintikul) Center for Medical Excellence, Faculty of Medicine, Chiang
Mai, Thailand
(Nathisuwan) Department of Pharmacy, Faculty of Pharmacy, Mahidol
University, Bangkok, Thailand
(Krittayaphong) Faculty of Medicine Siriraj Hospital, Mahidol University,
Bangkok, Thailand
(Sehmi, Mehta, Winkles, Brocklehurst) Clinical Trials Unit, University of
Birmingham, Birmingham, United Kingdom
(Mathers, Jolly) Institute of Applied Health Research, University of
Birmingham, Birmingham, United Kingdom
(Jowett) Health Economics Unit, Institute of Applied Health Research,
University of Birmingham, Birmingham, United Kingdom
(Lane) Department of Cardiovascular Health, Faculty of Health and Life
Sciences, University of Liverpool, Liverpool, United Kingdom
(Thomas) Department of Public Health and Epidemiology, Institute of
Applied Health Research, University of Birmingham, Birmingham, United
Kingdom
(Lip) Liverpool Centre for Cardiovascular Science, University of Liverpool
and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
(Lip) Department of Clinical Medicine, Aalborg Universitet, Aalborg,
Denmark
Publisher
BMJ Publishing Group
Abstract
Introduction The burden of atrial fibrillation (AF) in Thailand is high
and associated with increased morbidity, mortality and healthcare costs.
Vitamin K antagonists (eg, warfarin), commonly used for stroke prevention
in patients with AF in Thailand, are effective but are often suboptimally
controlled. We aim to evaluate the impact of an SAMe-TT 2 R 2 score-guided
strategy and educational intervention compared to usual care on
anticoagulation control expressed by the time in therapeutic range (TTR)
at 12 months, in anticoagulant-naive Thai patients with AF. Methods and
analysis Multicentre, open-label, parallel-group, randomised controlled
trial conducted in Thailand among adult patients (age: 18 years) with AF
who are anticoagulant naive. Patients will be randomised to one of two
groups; an SAMe-TT 2 R 2 score-guided strategy with educational
intervention and usual care versus usual care alone. The planned follow-up
period is 12 months. The primary outcome is TTR at 12 months. Secondary
outcomes include: (1) TTR at 6 months; (2) thromboembolic and bleeding
events at 12 months; (3) composite major adverse cardiovascular events at
12 months; (4) change in patients' knowledge of AF between baseline and 6
months and 12 months; (5) cost effectiveness; (6) quality of life at
baseline, 6 months and 12 months using EQ-5D-5L (Thai version) and (7)
patient satisfaction/perceptions of the TREAT intervention. An embedded
qualitative study will assess patient perceptions of the TREAT
intervention. Ethics and dissemination The study has been approved by the
Ethical Review Committee, Ministry of Public Health of Thailand, and
registered in the Thai Clinical Trials Registry. The results of this trial
will be submitted for publication in a peer-reviewed journal. Participants
will be informed via a link to a preview of the publication. A lay summary
will also be provided to all participants prior to publication. Trial
registration number TCTR20180711003.<br/>Copyright &#xa9; Author(s) (or
their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.

<58>
[Use Link to view the full text]
Accession Number
633925739
Title
The efficacy and safety of tirofiban for patients with acute ischemic
stroke; A protocol for systematic review and a meta-analysis.
Source
Medicine (United States). 98(9) (no pagination), 2019. Article Number:
e14673. Date of Publication: 2019.
Author
Niu J.; Ding Y.; Zhai T.; Ju F.; Lu T.; Xue T.; Yin D.; Fang D.; Chen H.;
Zhao G.
Institution
(Niu, Ju, Lu, Xue, Yin, Fang, Zhao) Department of Clinical Pharmacy,
United States
(Ding, Zhai) Department of Neurology, United States
(Chen) Department of Pharmacy, The Seventh Affiliated Hospital of Yangzhou
University, Jingjiang People's Hospital, Jiangsu, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The clinical use of tirofiban remains controversial for
patients with acute ischemic stroke (AIS), we aimed to conduct a meta- A
nalysis of cohort studies to assess the efficacy and safety of tirofiban
for AIS patients. <br/>Method(s):All apparently unconfounded randomized
controlled trials (RCTs) and case-controlled studies, with or without
blinding, of tirofiban in individuals with AIS will be included in this
review. We will conduct a literature search in 2 databases Pubmed and
Embase, using indexing terms related to cerebral infarctions and tirofiban
to include articles indexed as of Jan 31, 2019 in the English language
only. Two reviewers will independently select trials for inclusion and
assess trial quality. Two pairs of review authors will independently
extract information for each included trials. Primary outcomes are any
intracerebral hemorrhage (aICH), symptomatic intracranial hemorrhage
(sICH), fatal ICH, recanalization rate and long-term outcome. The risk of
bias of the included studies will be evaluated based on Cochrane
assessment tool. Revman 5.3 will be used for heterogeneity assessment,
generating funnel-plots, data synthesis, subgroup analysis, and
sensitivity analysis. <br/>Result(s): We will provide practical and
targeted results assessing the efficacy and safety of tirofiban for AIS
patients, to provide reference for clinical use of tirofiban.
<br/>Conclusion(s): The stronger evidence about the efficacy and safety of
tirofiban for AIS patients will be provided for clinicians. Abbreviations:
AICH = any intracerebral hemorrhage, AIS = acute ischemic stroke, CI =
confidence interval, eCAS = emergent carotid artery stenting, GPIIb/IIIa =
glycoprotein IIb/IIIa, MD = mean difference, MRS = modified Rankin scale,
NIHSS = National Institutes of Health Stroke Scale, OR = risk ratio, RCT =
randomized controlled trial, sICH = symptomatic intracranial hemorrhage,
TICI = thrombolysis in cerebral infarction.<br/>Copyright &#xa9; 2019 the
Author(s).

<59>
Accession Number
2013887783
Title
Outcomes of sutureless aortic valve replacement versus conventional aortic
valve replacement and transcatheter aortic valve replacement, updated
systematic review, and meta-analysis.
Source
Journal of Cardiac Surgery. 36(12) (pp 4734-4742), 2021. Date of
Publication: December 2021.
Author
Kim K.S.; Makhdoum A.; Koziarz A.; Gupta S.; Alsagheir A.; Pandey A.; Reza
S.; Um K.; Teoh K.; Alhazzani W.; Lamy A.; Yanagawa B.; Belley-Cote E.P.;
Whitlock R.P.
Institution
(Kim, Pandey, Reza, Um, Lamy, Belley-Cote, Whitlock) Population Health
Research Institute, McMaster University, Hamilton, Canada
(Kim, Alhazzani) Department of Health Research Methodology, Evidence and
Impact, McMaster University, Hamilton, Canada
(Makhdoum, Yanagawa) Division of Cardiac Surgery, Department of Surgery,
University of Toronto, Toronto, Canada
(Koziarz) Temerty Faculty of Medicine, University of Toronto, Toronto,
Canada
(Gupta, Alsagheir, Lamy, Whitlock) Division of Cardiac Surgery, Department
of Surgery, McMaster University, Hamilton, ON, Canada
(Um, Alhazzani, Belley-Cote) Department of Medicine, McMaster University,
Hamilton, ON, Canada
(Teoh) Southlake Regional Health Sciences Centre, Newmarket, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Sutureless aortic valve replacement (SuAVR) is an alternative
to surgical aortic valve replacement (SAVR) and transcatheter aortic valve
replacement (TAVR). This study compares the effectiveness of SuAVR to SAVR
and TAVR. <br/>Method(s): We searched MEDLINE and EMBASE from inception to
July 2021 for studies evaluating SuAVR, SAVR, and TAVR in adults with
aortic stenosis. We performed screening, full-text assessment, data
collection, and risk of bias evaluation independently and in duplicate. We
evaluated risk of bias using by Cochrane and CLARITY's tools, and
certainty in evidence using the GRADE framework. Data were pooled using a
random-effects model. <br/>Result(s): We identified one randomized and 78
observational studies (n = 60,689; SuAVR vs. SAVR = 39,171, vs. TAVR =
21,518). All studies were at high or unclear risk of bias, with very-low
certainty in effect estimates. Compared to TAVR, SuAVR demonstrates no
significant difference in mortality at 30-days (odds ratio [OR]: 0.52, 95%
confidence interval [CI: 0.85, 1.16], I² = 0%), but decreased
odds at 2-years (OR: 0.39, 95% CI [0.17, 0.88], I² = 0%). SuAVR
also reduced odds of mild paravalvular regurgitation (OR: 0.11, 95% CI
[0.06, 0.21], I² = 50%). Compared to SAVR, SuAVR was associated
with a similar mortality at 30-days (OR: 0.99, 95% CI [0.85, 1.16],
I² = 0%) and 2-years (OR: 0.99, 95% CI [0.43-2.30],
I² = 7%). SuAVR significantly increased odds of permanent
pacemaker implantation (OR: 2.5, 95% CI [2.25, 2.77], I² = 0%).
Pooled effect estimates were consistent with results from the randomized
trial comparing SuAVR and SAVR. <br/>Conclusion(s): Based on very-low
quality evidence, SuAVR is associated with similar short- and midterm
outcomes compared to TAVR and SAVR. Comparative randomized data with
long-term follow-up are required to clarify the role of
SuAVR.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<60>
Accession Number
2013842897
Title
To understand a meta-analysis, best read the fine print.
Source
Journal of Cardiac Surgery. 36(12) (pp 4743-4745), 2021. Date of
Publication: December 2021.
Author
Greason K.L.
Institution
(Greason) Department of Cardiovascular Surgery, Mayo Clinic, Rochester,
MN, United States
Publisher
John Wiley and Sons Inc
Abstract
The results of a meta-analysis are more than just the reported odds ratio,
95% confidence interval (CI), and p value. Of equal importance is the fine
print of the study which should include assessment of the risk of bias,
certainty in evidence, and heterogeneity in the individual point estimates
and CIs. These areas all have an influence on the quality of the data in
the analysis. Reading and understanding the fine print is
important.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<61>
Accession Number
2013802934
Title
Bioprosthetic valve fracture for valve-in-valve transcatheter aortic valve
implantation in patients with structural valve degeneration: Systematic
review with meta-analysis.
Source
Journal of Cardiac Surgery. 36(12) (pp 4722-4731), 2021. Date of
Publication: December 2021.
Author
Michel Pompeu S.A.; Rayol S.C.; Van den Eynde J.; Cavalcanti L.R.P.;
Escorel Neto A.C.; Perazzo A.M.; Weymann A.; Ruhparwar A.; Torregrossa G.;
Sicouri S.; Ramlawi B.
Institution
(Michel Pompeu, Torregrossa, Ramlawi) Department of Cardiothoracic
Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line
Health, Wynnewood, PA, United States
(Michel Pompeu, Torregrossa, Sicouri, Ramlawi) Department of
Cardiothoracic Surgery Research, Lankenau Institute for Medical Research,
Wynnewood, PA, United States
(Rayol, Cavalcanti, Escorel Neto, Perazzo) Division of Cardiovascular
Surgery, Pronto Socorro Cardiologico de Pernambuco (PROCAPE), Recife,
Brazil
(Rayol, Cavalcanti, Escorel Neto, Perazzo) University of Pernambuco (UPE),
Recife, Brazil
(Rayol) Nucleus of Postgraduate and Research in Health Sciences of Faculty
of Medical Sciences and Biological Sciences Institute (FCM/ICB), Recife,
Brazil
(Van den Eynde) Department of Cardiovascular Diseases, Unit of Cardiac
Surgery, University Hospitals Leuven, Leuven, Belgium
(Weymann, Ruhparwar) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University Duisburg-Essen, Essen, Germany
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To determine the outcomes of bioprosthetic valve fracture
(BVF) in valve-in-valve transcatheter aortic valve implantation (ViV-TAVI)
for patients with structural valve degeneration (SVD) of bioprosthetic
surgical valves (BSV) implanted during surgical aortic valve replacement
(SAVR). <br/>Method(s): A systematic review was conducted including
studies published by May 2021. The primary endpoints of the study were
30-day mortality, annular rupture, stroke, paravalvular leak, pacemaker
implantation, and coronary obstruction. The secondary endpoints were mean
valve gradients (mmHg) and aortic valve area (AVA-cm²). A
meta-analysis was conducted using the software R, version 3.6.3 (R
Foundation for Statistical Computing). <br/>Result(s): Four studies
including 242 patients met our eligibility criteria. The overall
proportions for 30-day mortality, annular rupture, stroke, paravalvular
leak, pacemaker implantation and coronary obstruction were 2.1%, <1.0%,
<1.5%, <1.0%, <1.0%, and <1.5%, respectively. After ViV-TAVI with BVF, the
difference in means for mean valve gradients showed a significant
reduction (random-effects model: -26.7; -28.8 to -24.7; p <.001), whereas
the difference in means for AVA showed a significant increase
(random-effects model: 0.55 cm²; 0.13-0.97; p =.029). Despite
the improvement in AVA means, these remain too low after the procedure
highly likely due to the small size of the bioprosthetic valves implanted
during the index SAVR. <br/>Conclusion(s): ViV-TAVI with BVF has proven to
be a promising option but data are still too scarce to enable us to draw
definitive conclusions. Despite the decrease in gradients, postprocedural
AVA remains worrisome. Studies with better designs and larger sample sizes
are needed to advance this treatment option.<br/>Copyright &#xa9; 2021
Wiley Periodicals LLC

<62>
Accession Number
2013800704
Title
The use of point-of-care testing in detecting platelet function recovery
in a patient treated with prasugrel undergoing urgent surgical
revascularization.
Source
Journal of Cardiac Surgery. 36(12) (pp 4801-4804), 2021. Date of
Publication: December 2021.
Author
Verzelloni Sef A.; Caliandro F.; Sef D.; Raja S.G.
Institution
(Verzelloni Sef, Caliandro) Department of Anesthesia and Critical Care,
Royal Brompton & Harefield Hospitals, Harefield Hospital, London, United
Kingdom
(Sef, Raja) Department of Cardiac Surgery, Royal Brompton & Harefield
Hospitals, Harefield Hospital, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
A recent administration of potent P2Y<inf>12</inf> receptor inhibitor such
as prasugrel in patients undergoing cardiac surgery remains a dilemma and
little is known about its impact on platelet function recovery. Guidelines
recommend discontinuation of prasugrel 7 days before surgery to reduce the
risk of surgery-related bleeding. Patients at risk may benefit from
preoperative platelet function testing to guide individualized
preoperative waiting time. We present a rare case of complete function
recovery in a patient treated with prasugrel revealed by preoperative
platelet function monitoring before urgent coronary artery bypass surgery
(CABG). A complete platelet function recovery was revealed by platelet
function testing after discontinuation of prasugrel for four days and
patient underwent urgent CABG without increased risk of postoperative
bleeding. Our case with a review of literature emphasized that the
decision to proceed with urgent CABG in a patient recently treated with
prasugrel should be based on a personalized risk assessment and might be
supported by preoperative platelet function monitoring to shorten the
waiting time.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<63>
Accession Number
2013787537
Title
Intrinsic left ventricular impairment in Marfan syndrome: A systematic
review and meta-analysis.
Source
Journal of Cardiac Surgery. 36(12) (pp 4715-4721), 2021. Date of
Publication: December 2021.
Author
Xu H.; Ma N.; Guo R.; Luo H.; Zhang L.; Liu D.; Zang S.; Zhao L.; Zhang
X.; Qiao C.
Institution
(Xu, Ma, Guo, Luo, Zhang, Liu, Zang, Zhao, Zhang, Qiao) Department of
Cardiac Surgery, The First Affiliated Hospital of Zhengzhou University,
Zhengzhou University, Zhengzhou, Henan, China
(Xu, Ma, Guo, Luo, Zhang, Liu, Zang, Zhao, Zhang, Qiao) Heart
Transplantation Center, The First Affiliated Hospital of Zhengzhou
University, Zhengzhou University, Zhengzhou, Henan, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Intrinsic cardiac impairment in Marfan syndrome (MFS) has been
explored in many clinical studies; however, their results have been
inconsistent. This meta-analysis aimed to assess the difference in cardiac
structure and function between Marfan patients and healthy individuals,
and to verify the hypothesis of intrinsic cardiac impairment in MFS.
<br/>Method(s): Electronic searches for studies were performed in the
PubMed, Embase, and Cochrane Library databases. Nine studies with 490
patients with MFS and 478 controls were included in the analysis. Age and
sex were strictly matched between Marfan patients and healthy controls in
every study. <br/>Result(s): There was no difference in the left
ventricular end systolic diameter index (mean difference [MD]: 0.33; 95%
confidence interval [CI]: (-0.24, 0.89); p = 0.26) and left ventricular
end diastolic diameter index (MD: 0.18; 95% CI: [-0.47, 0.83]; p = 0.58)
between Marfan patients and controls. Marfan patients showed larger left
ventricular end systolic volume index (MD: 2.62; 95% CI: [0.27, 4.97]; p =
0.03) and left ventricular end diastolic volume index (MD: 4.16; 95% CI:
[2.70, 5.63]; p < 0.01) than the control group. Furthermore, Marfan
patients showed a lower left ventricular ejection fraction than healthy
people (MD: -2.59%; 95% CI: [-4.64%, -0.54%]; p = 0.01).
<br/>Conclusion(s): Intrinsic cardiac impairment was observed in MFS. MFS
patients showed the larger left ventricular volume and poorer left
ventricular function than matched controls. Considering the potentially
adverse impact on cardiac function, intrinsic cardiac impairment in MFS
should be considered during the cardiac surgery.<br/>Copyright &#xa9; 2021
Wiley Periodicals LLC

<64>
Accession Number
2013680532
Title
Blood cysts of the cardiac valves in adults: Review and analysis of
published cases.
Source
Journal of Cardiac Surgery. 36(12) (pp 4690-4698), 2021. Date of
Publication: December 2021.
Author
Bortolotti U.; Vendramin I.; Lechiancole A.; Sponga S.; Pucci A.; Milano
A.D.; Livi U.
Institution
(Bortolotti, Vendramin, Lechiancole, Sponga, Livi) Cardiothoracic
Department, University Hospital of Udine, Udine, Italy
(Pucci) Division of Pathology, Pisa University Hospital, Pisa, Italy
(Milano) Division of Cardiac Surgery, University of Bari Aldo Moro, Bari,
Italy
Publisher
John Wiley and Sons Inc
Abstract
Background and aim: Blood cysts of cardiac valves are generally seen in
newborns and infants and very rarely in adults. Although in most cases
they are incidental findings they may be associated to severe cardiac or
systemic complications. This study analyzes incidence, presentation, and
treatment of valvular blood cysts in adults. <br/>Method(s): A review of
the pertinent literature through a search mainly on PubMed and Medline was
performed. <br/>Result(s): In patients >=18 years of age, our search
disclosed 54 patients with mitral blood cysts (mean age, 48 +/- 18 years),
9 with a tricuspid valve cyst (mean age, 67 +/- 15 years), 3 with a blood
cyst on the pulmonary valve (age 31, 43, and 44 years), and 1 aortic valve
cyst in a 22-year-old man. Most patients were asymptomatic while stroke,
syncope, or myocardial infarction occurred in six patients with a mitral
valve cyst. Blood cysts were removed surgically in 70% of patients with a
mitral cyst, in 55% with a tricuspid cyst, and in all those with a
pulmonary or aortic cyst. At histology, the cyst wall was composed mainly
by fibrous tissue and with the inner surface lined with typical
endothelium. <br/>Conclusion(s): Blood cysts of cardiac valves are rare in
adults but may cause life-threatening complications, particularly when
located on the mitral valve. For such reason, surgical removal appears
advisable, with low-risk procedures. Widespread use of multimodality
imaging techniques will most likely increase the number of valvular blood
cysts diagnosed also in adults.<br/>Copyright &#xa9; 2021 The Authors.
Journal of Cardiac Surgery published by Wiley Periodicals LLC.

<65>
Accession Number
2013604510
Title
Effect of music therapy on infants who underwent mechanical ventilation
after cardiac surgery.
Source
Journal of Cardiac Surgery. 36(12) (pp 4460-4464), 2021. Date of
Publication: December 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. <br/>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. <br/>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). <br/>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.<br/>Copyright
&#xa9; 2021 Wiley Periodicals LLC

<66>
Accession Number
636355029
Title
A systematic review and meta-analysis on the curative effects of
cardiothoracic surgery for critical patients in the intensive care unit.
Source
Annals of palliative medicine. 10(9) (pp 9879-9888), 2021. Date of
Publication: 01 Sep 2021.
Author
Geng M.; Li Z.; Cui W.; Cheng J.; Li L.; Li J.; Li F.
Institution
(Geng, Li, Cui, Cheng, Li, Li, Li) Department of Critical Care, Jincheng
People's Hospital (Jincheng Hospital Affiliated to Changzhi Medical
College), Jincheng, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The aim of this study was to explore the curative effects of
cardiothoracic surgery (CTS) for critical patients in the intensive care
unit (ICU) using meta-analysis. <br/>METHOD(S): Literature was searched
using the following search terms: "cardiothoracic surgery", "intensive
care unit", "critical patients", "post-operation", and "curative effects".
Rev Man 5.3 was used for meta-analysis. <br/>RESULT(S): A total of 15
randomized controlled trials (RCTs) were included, all of which had a low
risk of bias, indicating medium and high quality. At 30 days after CTS,
the number of patients with grade III and IV cardiac function was reduced
by 76.84%, and the overall heterogeneity test results revealed that
Tau2=0.09, Chi2=17.08, df=5, I2=71%, P=0.004<0.01, Z=7.62, RR =0.33, and
95% CI: 0.24 to 0.43. The incidence of adverse reactions was analyzed in 6
RCTs, and mainly manifested as improper anticoagulation thrombosis and
bleeding. The overall heterogeneity test results revealed that Chi2=1.07,
df=5, I2=0%, P=0.96, Z=4.93, OR =0.46, 95% CI: 0.34 to 0.63, and P<0.01.
The 30-day mortality rate was analyzed in 8 RCTs. The overall analysis
using the fixed effects model revealed that there was a notable difference
between the experimental group and the baseline, with Z=10.11, OR =0.12,
95% CI: 0.08 to 0.18, and P<0.01. DISCUSSION: CTS can reduce the incidence
of adverse events and the mortality rate of critical patients in the ICU,
demonstrating high safety.

<67>
Accession Number
2015004479
Title
Letter on "RenalGuard system and conventional hydration for preventing
contrast-associated acute kidney injury in patients undergoing cardiac
interventional procedures: A systematic review and meta-analysis".
Source
International Journal of Cardiology. 344 (pp 86), 2021. Date of
Publication: 01 Dec 2021.
Author
Gu Z.
Institution
(Gu) Heart Center, The First Hospital of Lanzhou University, Lanzhou City,
Gansu 730000, China
Publisher
Elsevier Ireland Ltd

<68>
Accession Number
2014088720
Title
The effect of the family presence on anxiety and agitation of patients
under mechanical ventilation after open heart surgery: a randomized
clinical trial.
Source
Perioperative Medicine. 10(1) (no pagination), 2021. Article Number: 40.
Date of Publication: December 2021.
Author
Nouri J.M.; Safaeipour L.; Vafadar Z.; Moradian S.T.
Institution
(Nouri) Quran and Hadith Research Center, Nursing Faculty, Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Safaeipour) Baqiyatallah University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Vafadar) Health Management Research Center, Baqiyatallah University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Moradian) Atherosclerosis Research Center, Baqiyatallah University of
Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: Family-centered care has been considered as a philosophy of
care. Family presence in intensive care units (ICUs), especially in the
acute phase of the disease is controversial. This study has been carried
out in order to determine the effect of the family presence on anxiety and
agitation in patients undergoing coronary artery bypass grafting (CABG).
<br/>Material(s) and Method(s): In a clinical trial, 70 patients were
randomly allocated into groups of experimental and control. In the
experimental group, during the weaning process from the mechanical
ventilation, a family member was present at the bedside. The degree of
anxiety and Richmond's Agitation and Sedation Scale (RASS) were compared
in seven consecutive time stages, including the time of entry into the
ICU, the first respiratory drive, the family entrance, 20 min and 1 h
after the presence of the family member, the time of extubation, and 1 h
after extubation. <br/>Result(s): There was a significant difference
between the two groups in the mean scores of the anxiety scale in the
first (P =0.008), second (P=0.002), and third stages (P =0.005). This
difference was not significant in the fourth to seventh stages (P>0.05).
As the baseline anxiety levels were different, a covariate adjustment was
used for comparisons between treatments, adjusting the main analyses for
baseline anxiety levels. Analysis showed that groups were not different.
Also, there was no significant difference in the mean scores of RASS
between the two experimental and control groups at any of the seven stages
(P> 0.05). <br/>Conclusion(s): According to the findings of the present
study, the presence of a family member does not reduce the level of
anxiety and agitation of patients undergoing cardiac surgery. However, it
can be concluded that this intervention is feasible in acute and complex
situations after open heart surgeries. Trial registration: This study has
been registered in the Iranian Registry of Clinical Trials with the code
IRCT201609014299N4.<br/>Copyright &#xa9; 2021, The Author(s).

<69>
Accession Number
636379010
Title
Effect of coronary artery bypass grafting on quality of life: a
meta-analysis of randomized trials.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2021. Date of Publication: 13 Oct 2021.
Author
Creber R.M.; Dimagli A.; Spadaccio C.; Myers A.; Moscarelli M.; Demetres
M.; Little M.; Fremes S.; Gaudino M.
Institution
(Creber, Myers, Demetres, Gaudino) Weill Cornell Medicine, NY, United
States
(Dimagli) Bristol Heart Institute, University of Bristol, Bristol, United
Kingdom
(Spadaccio) Institute of Cardiovascular and Medical Sciences, University
of Glasgow, United Kingdom
(Spadaccio) Lancashire Cardiac Center, Blackpool Victoria Teaching
Hospital, Blackpool, United Kingdom
(Moscarelli) Imperial College London, London, United Kingdom
(Little) Health Economics Research Centre, Nuffield Department of
Population Health, University of Oxford, United Kingdom
(Fremes) Sunnybrook Health Sciences Center, University of Toronto,
Toronto, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: We conducted a systematic review and meta-analysis to evaluate
temporal trends in quality of life (QoL) after coronary artery bypass
grafting (CABG) surgery in randomized clinical trials, and a quantitative
comparison from before surgery to up to five years after surgery.
<br/>METHOD(S): We searched MEDLINE, CINAHL EMBASE, Cochrane Library,
PsycINFO from 2010-2020 to identify studies that included the measurement
of QoL in patients undergoing CABG. The primary outcome was Seattle Angina
Questionnaire (SAQ), and secondary outcomes were the 36-item Short Form
Health Survey (SF-36) and EuroQol Questionnaire (EQ-5D). We pooled the
means and the weighted mean differences over the follow-up period.
<br/>RESULT(S): 2,586 studies were screened and 18 full-text studies were
included in the meta-analysis. There was a significant trend towards
higher QoL scores from before surgery to 1 year post-operatively for the
SAQ Angina Frequency (AF), SAQ Quality of Life (QoL), SF-36 Physical
Component (PC) and EQ-5D; whereas the SF-36 Mental Component (MC) did not
improve significantly. The weighted mean differences from before surgery
to the one-year after for the SAQ AF was 24 (95% CI: 21.6-26.4), 31 (95%
CI: 27.5-34.6) for the SAQ QoL, 9.8 (95% CI: 7.1-12.8) for the SF-36 PC,
7.1 (95% CI: 4.2-10.0) for the SF-36 MC, and 0.1 (95% CI: 0.06-0.14) for
the EQ-5D. There was no evidence of publication bias or small study
effect. <br/>CONCLUSION(S): CABG had both short and long-term improvements
on disease-specific QoL and generic QoL, with the largest improvement in
angina frequency.<br/>Copyright &#xa9; The Author(s) 2021. Published by
Oxford University Press on behalf of the European Society of Cardiology.

<70>
Accession Number
636373746
Title
Regional analgesia techniques for video assisted thoracic surgery: a
frequentist network meta-analysis.
Source
Korean journal of anesthesiology. (no pagination), 2021. Date of
Publication: 13 Oct 2021.
Author
Jo Y.; Park S.; Oh C.; Pak Y.; Jeong K.; Yun S.; Noh C.; Chung W.; Kim
Y.-H.; Ko Y.K.; Hong B.
Institution
(Jo, Oh, Pak, Jeong, Yun, Noh, Chung, Kim, Ko, Hong) Department of
Anesthesiology and Pain Medicine, Chungnam National University Hospital,
Daejeon, South Korea
(Jo, Oh, Pak, Yun, Noh, Chung, Kim, Ko, Hong) Department of Anesthesiology
and Pain Medicine, College of Medicine, Chungnam National University,
Daejeon, South Korea
(Park) Department of Nursing, College of Nursing, Chungnam National
University, Daejeon, South Korea
(Ko, Hong) Biomedical Research Institute, Chungnam National University
Hospital, Daejeon, South Korea
Publisher
NLM (Medline)
Abstract
Background: Various regional analgesia techniques are used to reduce
postoperative pain in patients who received the video-assisted thoracic
surgery (VATS). This study aims to determine the relative efficacy of the
regional analgesic interventions for VATS using the network meta-analysis
(NMA). <br/>Method(s): We searched Medline, EMBASE, the Cochrane
Controlled Trial Register, Web of Science and Google Scholar databases to
identify all randomized controlled trials (RCT) which compare the
analgesic effects of the following interventions: control, thoracic
paravertebral block (TPVB), erector spinae plane block (ESPB), serratus
plane block (SPB), and intercostal nerve block (INB). The primary
endpoints were opioid consumption during the postoperative 24 hours. Also
collected were the pain scores at three different postoperative periods:
early (0-6 h), middle (6-18 h), and late (18-24 h) period. <br/>Result(s):
Twenty-one RCT with a total of 1391 patients were included. TPVB showed a
greatest effect on opioid consumption compared with control (mean
difference (MD) = - 13.2 mg, 95% CI -16.2 to -10.1). In respect of the
pain score in the early period, ESPB had the greatest effect compared with
control (MD = -1.6, 95% CI -2.3 to -0.9). In the middle and late period,
TPVB, ESPB and INB showed superior analgesic effect than control on pain
score, but SPB did not. <br/>Conclusion(s): TPVB showed most superior
analgesic efficacy following VATS. ESPB provides a comparable analgesic
efficacy with TPVB. However, further studies are needed to determine the
optimal regional analgesia technique to improve postoperative pain control
for VATS.

<71>
Accession Number
2015375916
Title
Efficacy of an Autologous Blood Patch for Prolonged Air Leak: A Systematic
Review.
Source
Annals of Thoracic Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Hugen N.; Hekma E.J.; Claessens N.J.M.; Smit H.J.M.; Reijnen M.M.P.J.
Institution
(Hugen, Hekma, Reijnen) Department of Thoracic Surgery, Rijnstate
Hospital, Arnhem, Netherlands
(Hugen) Department of Surgery, Radboud University Medical Center,
Netherlands
(Claessens, Smit) Department of Respiratory Medicine, Rijnstate Hospital,
Arnhem, Netherlands
(Reijnen) Multi-Modality Medical Imaging Group, TechMed Center, University
of Twente, Enschede, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Prolonged air leak after pulmonary surgery remains a clinical
challenge and sometimes needs surgical reintervention. An autologous blood
patch (ABP) may provide a noninvasive method to stop air leak. Its value,
however, is debatable. The aim of this systematic review is to synthesize
evidence regarding the efficacy of ABP in patients with prolonged air
leak. <br/>Method(s): A comprehensive search for published studies was
performed in the Medline database, Embase, and the Cochrane library.
Randomized controlled trials, case-control studies, and case series in
which a postoperative ABP was performed were included. Findings from these
studies were tabulated and data were synthesized graphically (PROSPERO
registration number CRD42020157591). <br/>Result(s): A total of eight
studies was included in the analysis, comprising 151 patients. Studies
demonstrated heterogeneity in ABP timing and practice, and an intermediate
to high risk of bias was scored. The majority of studies demonstrated a
beneficial effect of the ABP, with a high rate of success of more than
89%. One randomized trial did not find a difference in time to cessation
of air leak after ABP compared with conservative tube thoracostomy. The
overall complication rate was 10%. <br/>Conclusion(s): Quality of included
studies is limited owing to lack of comparison groups. Synthesized data in
this review demonstrate a high rate of successful procedures and
acceptable complication rates, and seems encouraging enough to justify a
large randomized clinical trial on the use of ABP for patients who have
prolonged air leak after thoracic surgery.<br/>Copyright &#xa9; 2021 The
Society of Thoracic Surgeons

<72>
Accession Number
2015290505
Title
Efficacy and safety of long-term evolocumab use among Asian subjects - A
subgroup analysis of the further cardiovascular outcomes research with
PCSK9 inhibition in subjects with elevated risk (fourier) trial - A s.
Source
Circulation Journal. 85(11) (pp 2063-2070), 2021. Date of Publication:
2021.
Author
Keech A.C.; Oyama K.; Sever P.S.; Tang M.; Murphy S.A.; Hirayama A.; Lu
C.; Tay L.; Deedwania P.C.; Siu C.-W.; Pineda A.L.; Choi D.; Charng M.-J.;
Amerena J.; Ahmad W.A.W.; Chopra V.K.; Pedersen T.R.; Giugliano R.P.;
Sabatine M.S.
Institution
(Keech) National Health and Medical Research Council, Clinical Trials
Centre, Sydney Medical School, University of Sydney, Sydney, NSW,
Australia
(Oyama, Tang, Murphy, Giugliano, Sabatine) TIMI Study Group, Division of
Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical
School, Boston, MA, United States
(Oyama) Department of Cardiovascular Medicine, Tohoku University Graduate
School of Medicine, Sendai, Japan
(Sever) International Centre for Circulatory Health, National Heart and
Lung Institute, Imperial College London, London, United Kingdom
(Hirayama) Division of Cardiology, Department of Medicine, Nihon
University School of Medicine, Tokyo, Japan
(Lu, Pineda) Amgen, Thousand Oaks, CA, United States
(Tay) Cardiology Department, Changi General Hospital, Singapore, Singapore
(Deedwania) University of California San Francisco, School of Medicine,
San Francisco, CA, United States
(Siu) Cardiology Division, Department of Medicine, Li Ka Shing Faculty of
Medicine, The University of Hong Kong, Hong Kong
(Choi) Division of Cardiology, Severance Cardiovascular Hospital, Yonsei
University College of Medicine, Seoul, South Korea
(Charng) Division of Cardiology, Taipei Veterans General Hospital, Taipei,
Taiwan (Republic of China)
(Charng) Faculty of Medicine, School of Medicine, National Yang Ming
University, Taipei, Taiwan (Republic of China)
(Amerena) Geelong Cardiology Research Unit, Barwon Health, Geelong, VIC,
Australia
(Ahmad) Cardiology Department, University Malaya Medical Center, Kuala
Lumpur, Malaysia
(Chopra) Department of Cardiology, Max Super Speciality Hospital, New
Delhi, Saket, India
(Pedersen) Medical Faculty, Oslo University Hospital Aker, Oslo, Norway
Publisher
Japanese Circulation Society
Abstract
Background: There are concerns that Asian patients respond differently to
some medications. This study evaluated the efficacy and safety of
evolocumab among Asian vs. other subjects in the FOURIER trial, which
randomized stable atherosclerosis patients to receive either evolocumab or
placebo. <br/>Methods and Results: Effects of adding evolocumab vs.
placebo to background statin therapy on low-density lipoprotein
cholesterol (LDL-C) reductions, cardiovascular outcomes, and adverse
events were compared among 27, 564 participants with atherosclerotic
disease, according to self-reported Asian (n=2, 723) vs. other (n=24, 841)
races followed for a median of 2.2 years in the FOURIER trial. The primary
endpoint was a composite of cardiovascular death, myocardial infarction,
stroke, hospitalization for unstable angina, or coronary
revascularization. At randomization, Asians had slightly lower LDL-C
(median 89 [IQR 78-104] mg/dL vs. 92 [80-109] mg/dL; P<0.001) and were
much less likely to be on a high-intensity statin (33.3% vs. 73.3%;
P<0.001). Evolocumab lowered LDL-C more in Asians than in others (66% vs.
58%; P<0.001). The effect of evolocumab on the primary endpoint was
similar in Asians (HR, 0.79; 95% CI, 0.61-1.03) and others (HR, 0.86; 95%
CI, 0.79-0.93; P interaction=0.55). There was no excess of serious adverse
events with evolocumab among Asians over others. <br/>Conclusion(s): Use
of evolocumab robustly lowers LDL-C and is equally efficacious in lowering
the risk of cardiovascular events and safe in Asians as it is in
others.<br/>Copyright &#xa9; 2021 Japanese Circulation Society. All rights
reserved.

<73>
Accession Number
2015249113
Title
Volatile anesthetics versus intravenous anesthetics for noncardiac
thoracic surgery: A systematic review and meta-Analysis.
Source
Minerva Anestesiologica. 87(8) (pp 927-939), 2021. Date of Publication:
August 2021.
Author
Fan Y.; Yu D.; Liang X.
Institution
(Fan) School of Medicine, Department of Anesthesiology, University of
Electronic Science and Technology of China, Chengdu, China
(Yu) Department of Anesthesiology, Second People s Hospital of Yibin,
Yibin, China
(Liang) Department of Anesthesiology, West China Hospital, Sichuan
University, Chengdu, China
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: We performed this meta-Analysis of randomized controlled
trials (RCTs) to investigate two types of anesthetics for noncardiac
thoracic surgery regarding their effects on clinical outcomes and the
inflammatory response. EVIDENCE ACQUISITION: We searched Cochrane Library,
PubMed and Embase for RCTs comparing volatile anesthetics to intravenous
anesthetics for noncardiac thoracic surgery. EVIDENCE SYNTHESIS: This
study reviewed 16 RCTs with 1467 patients. Volatile anesthetics reduced
postoperative complications and the length of intensive care unit stay for
lung surgery. They also lowered the concentrations of interleukin
(IL)-1beta, IL-6, IL-8 and tumour necrosis factor-alpha (TNF-alpha) in the
airways of patients undergoing noncardiac thoracic surgery. However, there
was no difference in short-Term mortality, postoperative complications
after esophagectomy, IL-1beta, IL-6, IL-8 or TNF-alpha concentrations in
the blood, IL-10 level in either the airway or the blood, overall monocyte
chemoattractant protein-1. <br/>CONCLUSION(S): In lung surgery, but not
esophagectomy, volatile anesthetics may be a better choice than
intravenous anesthetics, possibly because volatile anesthetics reduce
airway inflammation. (Cite this article as: Fan Y, Yu D, Liang X. Volatile
anesthetics versus intravenous anesthetics for noncardiac thoracic
surgery: A systematic review and meta-Analysis.<br/>Copyright &#xa9; 2021
Edizioni Minerva Medica. All rights reserved.

<74>
Accession Number
2015249111
Title
The opioid sparing effect of erector spinae plane block for various
surgeries: A meta-Analysis of randomized-controlled trials.
Source
Minerva Anestesiologica. 87(8) (pp 903-914), 2021. Date of Publication:
August 2021.
Author
Fanelli A.; No V.T.; Cozowicz C.; Mariano E.R.; Balzani E.
Institution
(Fanelli) Anesthesia and Pain Medicine Unit, Department of Emergency and
Urgency, S. Orsola-Malpighi Polyclinic Hospital, Bologna, Italy
(No) Anesthesia and Intensive Care Unit 1, Department of Emergency and
Urgency, ASST Grande Ospedale Metropolitano Niguarda Hospital, Milan,
Italy
(Cozowicz) Department of Anesthesiology, Perioperative Medicine and
Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria
(Mariano) Department of Anesthesiology, Perioperative and Pain Medicine,
Stanford University School of Medicine, Stanford, CA, United States
(Mariano) Anesthesiology and Perioperative Care Service, Veterans Affairs
Palo Alto Health Care System, Palo Alto, CA, United States
(Balzani) Department of Medicine and Surgery, University of Turin, Turin,
Italy
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: The erector spinae plane block (ESPB) is a newer fascial
plane block which has been broadly applied for postoperative analgesia
after various surgeries, but the effectiveness in these populations is not
well established. EVIDENCE ACQUISITION: A systematic database search was
conducted in PubMed, PMC, Embase, and Scopus for randomized controlled
trials (RCTs) comparing ESPB with control, placebo, or other blocks. The
primary outcome was intravenous opioid consumption in milligram morphine
equivalents 24 h after surgery. Standardized mean differences (SMDs) with
95% confidence intervals (CI) were calculated using a random-effects
model. EVIDENCE SYNTHESIS: A total of 29 RCTs were included. An analysis
was conducted by subgroups differentiated by surgery type, no block vs.
ESPB, and other blocks vs. ESPB. ESPB was effective in reducing opioid
consumption against no block for breast surgery (SMD-1.13; 95% CI),
thoracic surgery (SMD-3.00; 95% CI), and vertebral surgery (SMD-1.78; 95%
CI). ESPB was effective against alternative blocks for breast surgery (vs.
paravertebral, SMD-1.07; 95% CI) and abdominal surgery (SMD-1.77; 95% CI).
ESPB showed moderate effect in thoracic surgery against paravertebral (SMD
0.58; 95% CI) and against no block in abdominal surgery (SMD 0.80; 95%
CI). In only one case did ESPB perform worse than another block: vs. PECS
block for breast surgery (SMD 1.66; 95% CI). <br/>CONCLUSION(S): ESPB may
be a useful addition to the multimodal analgesic regimen for a variety of
surgeries especially when the alternative is no block. Unanswered
questions include determining of the mechanism of action, refining of the
EPSB technique, and establishing recommended local anesthetic dose and
volume.<br/>Copyright &#xa9; 2021 Edizioni Minerva Medica. All rights
reserved.

<75>
Accession Number
2011547428
Title
Effects of Colchicine on Cardiovascular Outcomes in Patients with Coronary
Artery Disease: A Systematic Review and One-Stage and Two-Stage
Meta-Analysis of Randomized-Controlled Trials.
Source
High Blood Pressure and Cardiovascular Prevention. 28(4) (pp 343-354),
2021. Date of Publication: July 2021.
Author
Teo Y.N.; Teo Y.H.; Syn N.L.; Goh M.W.; Yoong C.S.Y.; Lee C.-H.; Chan
M.Y.-Y.; Chai P.; Yeo T.-C.; Sia C.-H.
Institution
(Teo, Teo, Syn, Goh, Yoong, Lee, Chan, Chai, Yeo, Sia) Department of
Medicine, Yong Loo Lin School of Medicine, National University of
Singapore, Singapore, Singapore
(Lee, Chan, Chai, Yeo, Sia) Department of Cardiology, National University
Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9,
Singapore 119228, Singapore
Publisher
Adis
Abstract
Aim: Colchicine has received emerging interest due to its cardiovascular
benefits in patients with coronary artery disease (CAD). We conducted a
one-stage meta-analysis of reconstructed individual patient data (IPD)
from randomized-controlled trials to summarize the effects of colchicine
on cardiovascular outcomes in patients with CAD. <br/>Method(s): Four
databases (PubMed, Embase, Cochrane, SCOPUS) were searched for articles
published from inception to 30th September 2020, examining the effect of
colchicine on cardiovascular outcomes in patients with CAD, yielding 10
randomized-controlled trials with a combined cohort of 12,781 patients.
IPD was reconstructed from Kaplan-Meier curves published in 3 studies and
analysed using the shared-frailty Cox model. Aggregate data meta-analysis
of all 10 studies was performed for outcomes unsuitable for IPD
reconstruction. <br/>Result(s): In patients receiving colchicine compared
to placebo, one-stage meta-analysis demonstrated a hazard ratio of 0.70
(95% CI 0.61-0.80) for the composite outcome of cardiovascular death,
non-fatal myocardial infarction, non-fatal stroke, and urgent
hospitalization for angina requiring coronary revascularization. Aggregate
data meta-analysis demonstrated a significant reduction in hazard rate for
stroke (HR 0.45; 95% CI 0.27-0.75) and urgent revascularization (HR 0.59;
95% CI 0.38-0.91); and a relative risk reduction for myocardial infarction
(RR 0.72; 95% CI of 0.52-1.00) and post-operative atrial fibrillation (RR
0.64; 95% CI 0.48-0.86). <br/>Conclusion(s): Given the significant
benefits of colchicine demonstrated on IPD, and its consistent benefits
when analyzed using aggregate data meta-analysis, we propose that
colchicine may be considered as an additional pharmacological adjunct to
the first line therapy for patients with coronary artery
disease.<br/>Copyright &#xa9; 2021, Italian Society of Hypertension.