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<1>
Accession Number
2016417219
Title
A multi-center, international, randomized, 2-year, parallel-group study to
assess the superiority of IVUS-guided PCI versus qualitative angio-guided
PCI in unprotected left main coronary artery (ULMCA) disease: Study
protocol for OPTIMAL trial.
Source
PLoS ONE. 17(1 January) (no pagination), 2022. Article Number: e0260770.
Date of Publication: January 2022.
Author
de Maria G.L.; Testa L.; de la Torre Hernandez J.M.; Terentes-Printzios
D.; Emfietzoglou M.; Scarsini R.; Bedogni F.; Spitzer E.; Banning A.
Institution
(de Maria, Terentes-Printzios, Emfietzoglou, Scarsini, Banning) Heart
Centre, John Radcliffe Hospital, Oxford University Hospitals, NHS
Foundation Trust, Oxford, United Kingdom
(Testa, Bedogni) Coronary Revascularisation Unit, IRCCS Policlinico S.
Donato, San Donato Milanese, Milan, Italy
(de la Torre Hernandez) Cardiology Department, Hospital Universitario
Marques de Valdecilla, IDIVAL, Santander, Spain
(Spitzer) European Cardiovascular Research Institute, Rotterdam,
Netherlands
(Spitzer) Department of Cardiology, Thoraxcenter, Erasmus Medical Centre,
Rotterdam, Netherlands
Publisher
Public Library of Science
Abstract
Background Percutaneous coronary intervention (PCI) is used increasingly
for revascularization of unprotected left main coronary artery (LMCA)
disease. Observational studies and subgroup analyses from clinical trials,
have suggested a possible benefit from the use of intravascular ultrasound
(IVUS) guidance when performing unprotected LMCA PCI. However, the value
of imaging with IVUS has never been proven in an appropriately powered
randomized clinical trial. The OPtimizaTIon of Left MAin PCI With
IntravascuLar Ultrasound (OPTIMAL) trial has been designed to establish
whether IVUS-guided PCI optimization on LMCA is associated with superior
clinical outcomes when compared with standard qualitative
angiography-guided PCI. Methods The OPTIMAL trial is a randomized,
multicenter, international study designed to enroll a total of 800
patients undergoing PCI for unprotected LMCA disease. Patients will be
randomized in a 1:1 fashion to IVUS-guided PCI versus angiogram-guided
PCI. In patients allocated to the angiogram-guided arm, use of IVUS is
discouraged, unless there are safety concerns. In patients allocated to
the IVUS guidance arm, pre-procedural IVUS assessment is highly
recommended, whilst post-procedural IVUS assessment is mandatory to
confirm appropriate stenting result and/or to guide stent result
optimization, according to predefined criteria. Patients will be followed
up to 2 years after the index procedure. The primary outcome measure is
the Academic Research Consortium (ARC) patient-oriented composite endpoint
(PoCE) which includes all-cause death, any stroke, any myocardial
infarction and any repeat revascularization at 2 years follow-up.
Discussion The OPTIMAL trial aims to provide definitive evidence about the
clinical impact of IVUS-guidance during PCI to an unprotected LMCA. It is
anticipated by the investigators, that an IVUS-guided strategy will be
associated with less clinical events compared to a strategy guided by
angiogram alone. Copyright © 2022 De Maria et al. This is an open
access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<2>
Accession Number
2015617597
Title
Antiplatelet therapy after transcatheter aortic valve implantation: A
systematic review and meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 60(5) (pp 1022-1029), 2021.
Date of Publication: 01 Nov 2021.
Author
Costa G.F.; Costa M.; Goncalves L.; Teixeira R.
Institution
(Costa, Costa, Goncalves, Teixeira) Servico de Cardiologia, Centro
Hospitalar e Universitario de Coimbra, Coimbra, Portugal
(Goncalves, Teixeira) Faculdade de Medicina da Universidade de Coimbra,
Coimbra, Portugal
(Goncalves, Teixeira) Coimbra Institute for Clinical and Biomedical
Research (ICBR), Coimbra, Portugal
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The aim of this study was to compare antithrombotic regimens
after transcatheter aortic valve implantation (TAVI) in patients without
an indication for long-term anticoagulation. TAVI is a safe and effective
approach for patients with symptomatic severe aortic stenosis and an
intermediate-to-high surgical risk. Nevertheless, the antithrombotic
regimen after procedure remains controversial. METHOD(S): We
systematically searched PubMed, Embase and Cochrane databases for
interventional studies comparing single antiplatelet therapy with double
antiplatelet therapy after TAVI. A meta-analysis was carried out to
compare thrombotic and bleeding events between both strategies.
 RESULT(S): Four randomized clinical trials were included comprising a
total of 1085 patients. Our meta-analysis revealed a higher odds ratio
(OR) of major bleeding events (pooled OR 2.45, 95% confidence interval
(CI) 1.29-4.67; P < 0.01; I2 = 0%) and minor bleeding (pooled OR 1.73, 95%
CI 1.12-2.66; P = 0.01; I2 = 0%) for the double antiplatelet therapy group
compared with the single antiplatelet therapy group. There was no
difference between groups in the risk of stroke (pooled OR 1.04, 95% CI
0.58-1.86; P = 0.91; I2 = 0%), myocardial infarction (pooled OR 2.10, 95%
CI 0.75-5.84; P = 0.16, I2 = 0%) and all-cause mortality (pooled OR 1.07,
95% CI 0.63-1.86; P = 0.08; I2 = 0%) after TAVI. CONCLUSION(S): Our
pooled analysis suggests that for patients who underwent TAVI, double
antiplatelet therapy compared with single antiplatelet therapy alone
increased the risk of bleeding without reducing mortality and ischaemic
events. Copyright © 2021 The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<3>
Accession Number
2015617550
Title
Reply to Anastasiadis et al.
Source
European Journal of Cardio-thoracic Surgery. 60(4) (pp 1007), 2021. Date
of Publication: 01 Oct 2021.
Author
Semrau J.S.; Boyd J.G.
Institution
(Semrau, Boyd) Centre for Neuroscience Studies, Queen's University,
Kingston, ON, Canada
(Boyd) Kingston Health Sciences Centre, Kingston, ON, Canada
(Boyd) Department of Critical Care, Faculty of Health Sciences, Queen's
University, Kingston, ON, Canada
Publisher
European Association for Cardio-Thoracic Surgery

<4>
Accession Number
2016458597
Title
Effects of Remifentanil and Sufentanil Anesthesia on Cardiac Function and
Serological Parameters in Congenital Heart Surgery.
Source
Journal of Healthcare Engineering. 2021 (no pagination), 2021. Article
Number: 4650291. Date of Publication: 2021.
Author
Qin Z.; Xu Y.
Institution
(Qin) Surgical Anesthesia Center, TaiKang Tongji (Wuhan) Hospital, Hubei,
Wuhan 430000, China
(Xu) Department of Anesthesiology, Wuhan Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Hubei, Wuhan
430030, China
Publisher
Hindawi Limited
Abstract
In this study, we have investigated feasibility of remifentanil and
sufentanil anesthesia in children with congenital heart disease surgery
and its effects on cardiac function and serological parameters. For this
purpose, a retrospective study was conducted on 120 children with
congenital heart disease who underwent repair of ventricular septum or
atrial septum in our hospital, specifically from January 2016 to January
2018, and 60 patients in each group were randomly divided into the control
and treatment groups, respectively. The control group was anesthetized
with sufentanil, and the treatment group was anesthetized with
remifentanil. The heart function, serological indexes, and adverse
reactions were observed and compared. We have observed that there was no
significant difference in HR levels between these groups (P>0.05), but SDP
and DBP values of the two groups were decreased after anesthetic induction
(P<0.05). ACH, cortisol, and lactic acid in the treatment group were
significantly lower than those in the control group, and the difference
was statistically significant (P<0.05). The incidence of bradycardia,
nausea and vomiting, hypotension, muscle rigidity, and respiratory
depression in the treatment group was 16.67% lower than that in the
control group (P<0.05). Remifentanil has less influence on hemodynamics
and a better analgesic effect than fentanyl in inhibiting stress response
in congenital heart surgery, which provides reference and basis for
children congenital heart surgery. Copyright © 2021 Zhigang Qin
and Younian Xu.

<5>
Accession Number
2016352586
Title
Postoperative prophylactic intermittent noninvasive ventilation versus
usual postoperative care for patients at high risk of pulmonary
complications: a multicentre randomised trial.
Source
British Journal of Anaesthesia. (no pagination), 2022. Date of
Publication: 2022.
Author
Abrard S.; Rineau E.; Seegers V.; Lebrec N.; Sargentini C.; Jeanneteau A.;
Longeau E.; Caron S.; Callahan J.-C.; Chudeau N.; Beloncle F.; Lasocki S.;
Dupoiron D.
Institution
(Abrard, Rineau, Sargentini, Jeanneteau, Longeau, Lasocki) Department of
Anesthesiology and Intensive Care, University Hospital of Angers, Angers,
France
(Abrard, Rineau) MITOVASC Institute, INSERM 1083, CNRS 6015, University of
Angers, Angers, France
(Abrard) Department of Anesthesiology and Critical Care Medicine, Edouard
Herriot Hospital, Hospices Civils de Lyon, Lyon, France
(Seegers) Department of Clinical Research, Integrated Center for Oncology
Paul Papin, Angers, France
(Lebrec, Dupoiron) Anesthesiology and Pain Medicine Department, Integrated
Center for Oncology Paul Papin, Angers, France
(Caron) Department of Anesthesiology, Le Mans Hospital, Le Mans, France
(Callahan, Chudeau) Department of Intensive Care, Le Mans Hospital, Le
Mans, France
(Beloncle) Medical Intensive Care Department, University Hospital of
Angers, Angers, France
Publisher
Elsevier Ltd
Abstract
Background: Pulmonary complications are an important cause of morbidity
and mortality after surgery. We evaluated the clinical effectiveness of
noninvasive ventilation (NIV) in preventing postoperative acute
respiratory failure. Method(s): This is an open, multicentre
randomised trial that included patients at high risk of postoperative
pulmonary complications after elective or semi-urgent surgery with an
Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score
>=45. Patients were randomly assigned to intermittent prophylactic
face-mask NIV for 6-8 h day-1 or usual postoperative care. The
primary outcome was in-hospital acute respiratory failure within 7 days
after surgery. Patients who underwent surgery and postoperative extubation
were included in the modified intended-to-treat analysis. Results are
presented as n (%) and odds ratios (ORs) with 95% confidence intervals.
 Result(s): Between November 2017 and October 2019, 266 patients were
randomised and 253 included in the main analysis. 203 patients (80.2%)
were male with a mean age of 68 (11) yr and an ARISCAT score of 53 (6);
237 patients (93.7%) underwent cardiac or thoracic surgery. 125 patients
were allocated to prophylactic NIV and 128 to usual care. Unplanned
treatment termination occurred in 58 patients in the NIV group, which was
linked to NIV discomfort for 36 patients. There was no difference in the
incidence of the primary outcome of postoperative acute respiratory
failure between treatment groups (NIV: 30 of 125 patients [24.0%] vs usual
care: 35 of 128 patients [27.3%]; OR 0.97 [0.90-1.04]; P=0.54).
 Conclusion(s): Prophylactic NIV was difficult to implement after
high-risk surgery because of low patient compliance. Prophylactic NIV did
not prevent acute respiratory failure. Clinical trial registration: NCT
03629431 and EudraCT 2017-001011-36. Copyright © 2021 British
Journal of Anaesthesia

<6>
Accession Number
2015854702
Title
Risk factors of invasive fungal infections in lung transplant recipients:
A systematic review and meta-analysis.
Source
Journal of Heart and Lung Transplantation. 41(2) (pp 255-262), 2022. Date
of Publication: February 2022.
Author
Phoompoung P.; Villalobos A.P.C.; Jain S.; Foroutan F.; Orchanian-Cheff
A.; Husain S.
Institution
(Phoompoung, Villalobos, Foroutan, Husain) Ajmera Transplant Center,
University Health Network, Toronto, Canada
(Phoompoung) Faculty of Medicine Siriraj Hospital, Mahidol University,
Bangkok, Thailand
(Jain) Trillium Health Partners, Canada
(Orchanian-Cheff) Library and Information Services, University Health
Network, Toronto, Canada
Publisher
Elsevier Inc.
Abstract
Background: : Invasive fungal infection (IFI) remains a common
complication after lung transplantation, causing significant morbidity and
mortality. We have attempted to quantify systematically risk factors of
IFI in lung transplant recipients. Method(s): : Studies were
retrieved from Ovid MEDLINE, Ovid Embase, Cochrane database of systematic
reviews and Cochrane central register of controlled trials. All
case-control and cohort studies evaluating the risk factors of IFI in
adult lung transplant recipients were screened. Two researchers reviewed
and assessed all studies independently. We pooled the estimated effect of
each factor associated with IFI by using a random effect model.
 Result(s): : Eight studies were included in the systematic review and
5 studies were eligible for the meta-analysis. Rates of IFI range from 8%
to 33% in lung transplant recipients. Independent risk factors for
invasive aspergillosis (IA) in lung transplantation include previous
fungal colonization (odds ratio [OR] 2.44; 95% confidence interval [CI]
0.08-0.47), cytomegalovirus infection (OR 1.96; 95% CI 1.08-3.56), and
single lung transplantation (OR 1.77; 95% CI 1.08-2.91). Pre-emptive
antifungal therapy is a protective factor for IA in lung transplant (OR
0.2; 95% CI 0.08-0.47). Conclusion(s): : Cytomegalovirus infection,
previous fungal colonization and single lung transplantation independently
increase the risk of IA in lung transplant recipients. Pre-emptive
antifungal therapy is a protective factor for IA in the lung transplant
population. Copyright © 2021

<7>
Accession Number
2015783952
Title
Surgical outcomes of diaphragmatic resection during cytoreductive surgery
for advanced gynecological ovarian neoplasia: A randomized single center
clinical trial - DRAGON.
Source
Gynecologic Oncology. 164(2) (pp 271-277), 2022. Date of Publication:
February 2022.
Author
Cianci S.; Fedele C.; Vizzielli G.; Pasciuto T.; Gueli Alletti S.;
Cosentino F.; Chiantera V.; Fagotti A.; Scambia G.
Institution
(Cianci) Department of Human Pathology of Adult and Childhood "G.
Barresi", University Hospital "G. Martino", Messina, Italy
(Cianci, Fedele, Vizzielli, Gueli Alletti, Fagotti, Scambia) Gynecologic
Oncology Unit, Women Wealth Area, Department of Woman and Child Health and
Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS,
Rome, Italy
(Pasciuto) Research Core Facilty Data Collection G-STeP, Fondazione
Policlinico Universitario Agostino Gemelli IRCCS, Italy
(Cosentino) Division of Gynecologic Oncology, Gemelli Molise Hospital,
Campobasso, Italy
(Chiantera) Department of Gynecologic Oncology, ARNAS Civico Di Cristina
Benfratelli, Palermo, Italy
(Chiantera) Gynecologic Oncology, University of Palermo, Palermo, Italy
(Fagotti, Scambia) Catholic University of Sacred Heart, Rome, Italy
Publisher
Academic Press Inc.
Abstract
Introduction: Ovarian cancer (OC) represent nearly 4% of gynecologic
malignancies and it is often diagnosed at advanced stage. Diaphragmatic
surgery, a fundamental step of advanced stage ovarian cancer (ASOC)
debulking surgery, is associated with a high post-operative complication
incidence, which is supposedly reduced with thoracostomy tube placement.
We assessed the role of intra-operative thoracostomy tube placement, as a
prevention measure for post-operative complications, after diaphragmatic
resection. Method(s): This was a single center prospective randomized
trial. Ovarian cancer patients, who underwent mono-lateral diaphragmatic
resection, were randomized 1:1 into two arms. Arm A included patients
receiving intra-operative thoracostomy tube placement (TP); Arm B patients
did not receive thoracostomy tube placement (NTP). After surgery, all
patients underwent seriate chest x-ray and ultrasound to record thoracic
complications. Statistical analysis included uni- and multivariable
logistic regression model (proportional odds model). Result(s): Three
hundred seventy-one patients were screened and 88 patients were enrolled:
44 in arm A and B, respectively. No statistically significant differences
for intra-operative (p = 0.291) and any grade of post-operative
complication (p = 0.072) were detected, while 6.8% of patients in arm A
and 22.7% in arm B experienced severe respiratory symptoms (p = 0.035);
18.2% of patients in arm A had a moderate/large pleural effusion versus
65.9% in arm B (p < 0.0001). At multivariable analysis, results confirmed
that the NTP-group had a higher risk to receive post-operative
thoracostomy tube placement due to pleural effusion than the TP-group
(odds ratio [95% Confidence Interval] = 14.5 [3.7-57.4]).
 Conclusion(s): Thoracostomy intra-operative tube placement after
diaphragmatic resection is effective to prevent post-operative thoracic
complications. The extension of resection does not influence outcomes and
the risk of post-operative thoracentesis or TP remain
elevated. Copyright © 2021 Elsevier Inc.

<8>
[Use Link to view the full text]
Accession Number
637002093
Title
Plasma and Platelet Transfusions Strategies in Neonates and Children
Undergoing Cardiac Surgery With Cardiopulmonary Bypass or Neonates and
Children Supported by Extracorporeal Membrane Oxygenation: From the
Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding.
Source
Pediatric critical care medicine : a journal of the Society of Critical
Care Medicine and the World Federation of Pediatric Intensive and Critical
Care Societies. (Supplement 1 1S) (pp e25-e36), 2022. Date of Publication:
01 Jan 2022.
Author
Cholette J.M.; Muszynski J.A.; Ibla J.C.; Emani S.; Steiner M.E.; Vogel
A.M.; Parker R.I.; Nellis M.E.; Bembea M.M.
Institution
(Cholette) Department of Pediatrics, University of Rochester Golisano
Children's Hospital, Rochester, NY
(Muszynski) Department of Pediatrics, Division of Critical Care Medicine,
Nationwide Children's Hospital, Columbus, OH
(Ibla) Division of Cardiac Anesthesia, Department of Anesthesiology,
Critical Care and Pain Medicine, Boston Children's Hospital and Harvard
Medical School, MA, Boston
(Emani) Department of Cardiac Surgery, Boston Children's Hospital, MA,
Boston
(Steiner) Divisions of Critical Care and Hematology, Department of
Pediatrics, University of Minnesota Masonic Children's Hospital, MN,
Minneapolis, United States
(Vogel) Division of Pediatric Surgery, Department of Surgery, Texas
Children's Hospital and Baylor College of Medicine, TX, Houston
(Parker) Professor Emeritus, Department of Pediatrics,
Hematology/Oncology, Renaissance School of Medicine, SUNY at Stony Brook,
Stony Brook, NY
(Nellis) Division of Pediatric Critical Care Medicine, Department of
Pediatrics, NY Presbyterian Hospital - Weill Cornell Medicine, NY, NY
(Bembea) Department of Anesthesiology and Critical Care Medicine, Johns
Hopkins University School of Medicine, MD, Baltimore, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To present the recommendations and consensus statements with
supporting literature for plasma and platelet transfusions in critically
ill neonates and children undergoing cardiac surgery with cardiopulmonary
bypass or supported by extracorporeal membrane oxygenation from the
Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding.
DESIGN: Systematic review and consensus conference of international,
multidisciplinary experts in platelet and plasma transfusion management of
critically ill children. SETTING: Not applicable. PATIENTS: Critically ill
neonates and children following cardiopulmonary bypass or supported by
extracorporeal membrane oxygenation.None. MEASUREMENTS AND MAIN RESULTS: A
panel of nine experts developed evidence-based and, when evidence was
insufficient, expert-based statements for plasma and platelet transfusions
in critically ill neonates and children following cardiopulmonary bypass
or supported by extracorporeal membrane oxygenation. These statements were
reviewed and ratified by the 29 Transfusion and Anemia EXpertise
Initiative-Control/Avoidance of Bleeding experts. A systematic review was
conducted using MEDLINE, EMBASE, and Cochrane Library databases, from
inception to December 2020. Consensus was obtained using the Research and
Development/University of California, Los Angeles Appropriateness Method.
Results were summarized using the Grading of Recommendations Assessment,
Development, and Evaluation method. We developed one good practice
statement, two recommendations, and three expert consensus statements.
 CONCLUSION(S): Whereas viscoelastic testing and transfusion
algorithms may be considered, in general, evidence informing indications
for plasma and platelet transfusions in neonatal and pediatric patients
undergoing cardiac surgery with cardiopulmonary bypass or those requiring
extracorporeal membrane oxygenation support is lacking. Copyright
© 2022 by the Society of Critical Care Medicine and the World
Federation of Pediatric Intensive and Critical Care Societies.

<9>
[Use Link to view the full text]
Accession Number
636640660
Title
Icosapent Ethyl Reduces Ischemic Events in Patients With a History of
Previous Coronary Artery Bypass Grafting: REDUCE-IT CABG.
Source
Circulation. 144(23) (pp 1845-1855), 2021. Date of Publication: 07 Dec
2021.
Author
Verma S.; Bhatt D.L.; Steg P.G.; Miller M.; Brinton E.A.; Jacobson T.A.;
Dhingra N.K.; Ketchum S.B.; Juliano R.A.; Jiao L.; Doyle R.T.; Granowitz
C.; Gibson C.M.; Pinto D.; Giugliano R.P.; Budoff M.J.; Mason R.P.; Tardif
J.-C.; Ballantyne C.M.
Institution
(Verma, Tardif) Montreal Heart Institute, Universite de Montreal, QC
(Bhatt, Giugliano) Brigham and Women's Hospital Heart and Vascular Center,
Harvard Medical School, Boston
(Steg) Universite de Paris, Hopital Bichat, French Alliance for
Cardiovascular Trials, Institut National de la Sante et de la Recherche
Medicale U-1148, Assistance Publique-Hopitaux de Paris, Paris, United
States
(Miller) Department of Medicine, University of Maryland School of Medicine
(Brinton) Utah Lipid Center
(Jacobson) Office of Health Promotion and Disease Prevention, Department
of Medicine, Emory University School of Medicine, Atlanta, United States
(Dhingra) Division of Cardiac Surgery, St Michael's Hospital, University
of Toronto, ON
(Ketchum, Juliano, Jiao, Doyle, Granowitz) Amarin Pharma Inc, R.A.J.,
L.J., R.T.D., Bridgewater, United States
(Gibson, Pinto) Baim Clinical Research Institute, Boston
(Budoff) David Geffen School of Medicine, Torrance
(Mason) Elucida Research, Beverly, United States
(Ballantyne) Department of Medicine, Baylor College of Medicine, Center
for Cardiovascular Disease Prevention, Methodist DeBakey Heart and
Vascular Center, Houston
Publisher
NLM (Medline)
Abstract
BACKGROUND: Despite advances in surgery and pharmacotherapy, there remains
significant residual ischemic risk after coronary artery bypass grafting
surgery. METHOD(S): In REDUCE-IT (Reduction of Cardiovascular Events
With Icosapent Ethyl-Intervention Trial), a multicenter,
placebo-controlled, double-blind trial, statin-treated patients with
controlled low-density lipoprotein cholesterol and mild to moderate
hypertriglyceridemia were randomized to 4 g daily of icosapent ethyl or
placebo. They experienced a 25% reduction in risk of a primary efficacy
end point (composite of cardiovascular death, myocardial infarction,
stroke, coronary revascularization, or hospitalization for unstable
angina) and a 26% reduction in risk of a key secondary efficacy end point
(composite of cardiovascular death, myocardial infarction, or stroke) when
compared with placebo. The current analysis reports on the subgroup of
patients from the trial with a history of coronary artery bypass grafting.
 RESULT(S): Of the 8179 patients randomized in REDUCE-IT, a total of
1837 (22.5%) had a history of coronary artery bypass grafting, with 897
patients randomized to icosapent ethyl and 940 to placebo. Baseline
characteristics were similar between treatment groups. Randomization to
icosapent ethyl was associated with a significant reduction in the primary
end point (hazard ratio [HR], 0.76 [95% CI, 0.63-0.92]; P=0.004), in the
key secondary end point (HR, 0.69 [95% CI, 0.56-0.87]; P=0.001), and in
total (first plus subsequent or recurrent) ischemic events (rate ratio,
0.64 [95% CI, 0.50-0.81]; P=0.0002) compared with placebo. This yielded an
absolute risk reduction of 6.2% (95% CI, 2.3%-10.2%) in first events, with
a number needed to treat of 16 (95% CI, 10-44) during a median follow-up
time of 4.8 years. Safety findings were similar to the overall study:
beyond an increased rate of atrial fibrillation/flutter requiring
hospitalization for at least 24 hours (5.0% vs 3.1%; P=0.03) and a
nonsignificant increase in bleeding, occurrences of adverse events were
comparable between groups. CONCLUSION(S): In REDUCE-IT patients with
a history of coronary artery bypass grafting, treatment with icosapent
ethyl was associated with significant reductions in first and recurrent
ischemic events. Registration: URL: https://www.clinicaltrials.gov; Unique
identifier: NCT01492361.

<10>
Accession Number
635516869
Title
Effect of White Noise and Lullabies on Pain and Vital Signs in Invasive
Interventions Applied to Premature Babies.
Source
Pain management nursing : official journal of the American Society of Pain
Management Nurses. 22(6) (pp 724-729), 2021. Date of Publication: 01 Dec
2021.
Author
Dora O.; Buyuk E.T.
Institution
(Dora) Faculty of Health Sciences, Ondokuz Mayis University, Samsun,
Turkey
(Buyuk) Department of Child Health Nursing, Ondokuz Mayis University,
Samsun, Turkey
Publisher
NLM (Medline)
Abstract
BACKGROUND: Preterm babies are exposed to many repetitive painful
interventions in NICU. AIMS: This study aimed to comparatively determine
the effect of white noise and lullabies on pain perception and vital signs
of premature babies during painful interventions. DESIGN: Randomised
controlled trialParticipants/Subjects; A sample group of 66 premature
babies with a gestational age of 3237 weeks and a weight more than 1000 g
were included in this study conducted between May and August 2019 in the
NICU of a university hospital. METHOD(S): The babies were randomly
divided into three groups: lullaby, white noise, and control. The
behavioral responses of the babies were recorded with a camera during the
whole procedure. Before, during, and after the procedure, the heart rate,
respiratory rate, and oxygen saturation level were measured and recorded,
and the pain was evaluated using the premature infant pain profile (PIPP)
after the procedure. The mean PIPP score, heart rate during and after the
procedure, mean respiratory rate, and oxygen saturation were significantly
lower in the white noise and lullaby groups compared with the control
group (P < 0.001). RESULT(S): The premature babies in the white noise
group were found to have the lowest mean PIPP score, mean heart rate, and
respiratory rate, and the highest mean oxygen saturation rate (p < 0.001).
 CONCLUSION(S): The white noise and lullabies played to premature
babies during the blood collection process were effective in pain
reduction, and the pain score was lower in the white noise group than in
the lullaby group. Copyright © 2021 Elsevier Ltd. All rights
reserved.

<11>
Accession Number
635784626
Title
Sex differences in outcomes after coronary artery bypass grafting: a
pooled analysis of individual patient data.
Source
European heart journal. 43(1) (pp 18-28), 2021. Date of Publication: 28
Dec 2021.
Author
Gaudino M.; Di Franco A.; Alexander J.H.; Bakaeen F.; Egorova N.;
Kurlansky P.; Boening A.; Chikwe J.; Demetres M.; Devereaux P.J.; Diegeler
A.; Dimagli A.; Flather M.; Hameed I.; Lamy A.; Lawton J.S.; Reents W.;
Robinson N.B.; Audisio K.; Rahouma M.; Serruys P.W.; Hara H.; Taggart
D.P.; Girardi L.N.; Fremes S.E.; Benedetto U.
Institution
(Gaudino, Di Franco, Hameed, Robinson, Audisio, Rahouma, Girardi)
Department of Cardiothoracic Surgery, Weill Cornell Medicine, 525 East
68th Street, NY, NY 10065, United States
(Alexander) Department of Medicine, Division of Cardiology, Duke Clinical
Research Institute, Duke University Medical Center, 40 Duke Medicine Cir,
Durham, United States
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Carnegie Ave, Cleveland, OH 44103, USA
(Egorova) Department of Population Health Science and Policy, Icahn School
of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, NY, NY 10029, United
States
(Kurlansky) Department of Surgery, Center for Innovation and Outcomes
Research, Columbia University Medical Center, 622 W 168th St, NY, NY
10032, United States
(Boening) Department of Cardiovascular Surgery, Justus-Liebig University
Giesen, Ludwigstrase 23, Germany
(Chikwe) Department of Cardiac Surgery, Smidt Heart Institute,
Cedars-Sinai Medical Center, 8700 Beverly Blvd #2900A, Los Angeles, CA
90048, USA
(Demetres) Weill Cornell Medicine, Samuel J. Wood Library and C.V. Starr
Biomedical Information Center525 East 68th Street, NY, NY 10065, United
States
(Devereaux, Lamy) Population Health Research Institute, McMaster
University, 1280 Main St W, Hamilton ON L8S 4L8, Canada
(Diegeler, Reents) Department Cardiac Surgery, Cardiovascular Center Bad
Neustadt/Saale, Germany
(Dimagli, Benedetto) Bristol Heart Institute, University of Bristol,
Terrell St, Bristol BS2 8ED, United Kingdom
(Flather) Research and Development Unit, Norfolk and Norwich University
Hospitals NHS Foundation Trust, Colney Ln, Norwich NR4 7UY, United Kingdom
(Lawton) Division of Cardiac Surgery, Department of Surgery, Johns Hopkins
University School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA
(Serruys, Hara) Department of Cardiology, National University of Ireland,
University Rd, Galway, Ireland
(Taggart) Nuffield Department of Surgical Sciences, John Radcliffe
Hospital, University of Oxford, Oxford OX1 2JD, United Kingdom
(Fremes) Schulich Heart Centre Sunnybrook Health Sciences Centre,
University of Toronto, Hospital Road, Toronto, Canada
Publisher
NLM (Medline)
Abstract
AIMS: Data suggest that women have worse outcomes than men after coronary
artery bypass grafting (CABG), but results have been inconsistent across
studies. Due to the large differences in baseline characteristics between
sexes, suboptimal risk adjustment due to low-quality data may be the
reason for the observed differences. To overcome this limitation, we
undertook a systematic review and pooled analysis of high-quality
individual patient data from large CABG trials to compare the adjusted
outcomes of women and men. METHODS AND RESULTS: The primary outcome was a
composite of all-cause mortality, myocardial infarction (MI), stroke, and
repeat revascularization (major adverse cardiac and cerebrovascular
events, MACCE). The secondary outcome was all-cause mortality.
Multivariable mixed-effect Cox regression was used. Four trials involving
13193 patients (10479 males; 2714 females) were included. Over 5years of
follow-up, women had a significantly higher risk of MACCE [adjusted hazard
ratio (HR) 1.12, 95% confidence interval (CI) 1.04-1.21; P=0.004] but
similar mortality (adjusted HR 1.03, 95% CI 0.94-1.14; P=0.51) compared to
men. Women had higher incidence of MI (adjusted HR 1.30, 95% CI 1.11-1.52)
and repeat revascularization (adjusted HR 1.22, 95% CI 1.04-1.43) but not
stroke (adjusted HR 1.17, 95% CI 0.90-1.52). The difference in MACCE
between sexes was not significant in patients 75years and older. The use
of off-pump surgery and multiple arterial grafting did not modify the
difference between sexes. CONCLUSION(S): Women have worse outcomes
than men in the first 5years after CABG. This difference is not
significant in patients aged over 75years and is not affected by the
surgical technique. Copyright Published on behalf of the European
Society of Cardiology. All rights reserved. © The Author(s) 2021. For
permissions, please email: journals.permissions@oup.com.

<12>
Accession Number
2016560130
Title
Direct Oral Anticoagulants in Patients with Atrial Fibrillation and
Bioprosthetic Valves A Systematic Review and Meta-Analysis.
Source
Journal of Innovations in Cardiac Rhythm Management. 12(12) (pp
4797-4805), 2021. Date of Publication: December 2021.
Author
Ruzieh M.; Wolbrette D.L.; Naccarelli G.V.
Institution
(Ruzieh) Division of Cardiovascular Medicine, University of Florida
College of Medicine, 4037 NW 86th Terrace, Gainesville, FL 32606, United
States
(Wolbrette, Naccarelli) Division of Cardiology, Penn State Heart and
Vascular Institute, Penn State College of Medicine, Hershey, PA, United
States
Publisher
MediaSphere Medical LLC
Abstract
Oral anticoagulation is recommended for patients with atrial fibrillation
and an elevated stroke risk. Direct oral anticoagulants (DOACs) are
generally preferred over vitamin K antagonists. Nonetheless, there
controversy persists regarding whether DOACs should be used in patients
with atrial fibrillation and bioprosthetic valves. Therefore, we conducted
this systematic review and meta-Analysis to assess the safety and efficacy
of DOACs compared to warfarin in this patient population. We performed a
systematic search of the MEDLINE and PubMed Central databases for relevant
articles. The incidence rate and risk ratio (RR) of all-cause mortality,
cardiovascular mortality, ischemic stroke/systemic thromboembolism,
hemorrhagic stroke/ intracranial bleeding, major bleeding, and minor
bleeding were calculated. A total of eight studies were included,
including 5,300 patients (stratified as 1,638 patients in the DOAC arm and
3,662 patients in the warfarin arm). There was no significant difference
in the rate of stroke/systemic thromboembolism [RR: 0.85; 95% confidence
interval (CI): 0.43 1.69], all-cause mortality (RR: 0.77; 95% CI: 0.53
1.11), or cardiovascular death (RR: 0.81; 95% CI: 0.40 1.63) between DOACs
and warfarin. Major bleeding and hemorrhagic stroke/intracranial bleeding
were similar between both treatment arms (RR: 0.61; 95% CI: 0.35 1.06 and
RR: 0.27; 95% CI: 0.06 1.13, respectively). In conclusion, DOACs are safe
and effective in patients with atrial fibrillation and bioprosthetic
valves. Future large-scale randomized studies are warranted to confirm
this observation. Copyright © 2021 MediaSphere Medical LLC. All
Rights Reserved.

<13>
Accession Number
2016505558
Title
Narrative review of Ebstein's anomaly beyond childhood: Imaging, surgery,
and future perspectives.
Source
Cardiovascular Diagnosis and Therapy. 11(6) (pp 1310-1323), 2021. Date of
Publication: December 2021.
Author
Neumann S.; Ruffer A.; Sachweh J.; Biermann D.; Herrmann J.;
Jerosch-Herold M.; Hazekamp M.; Sinning C.; Zengin E.; Blankenberg S.;
Girdauskas E.; Reichenspurner H.; Kehl T.; Muller G.; Kozlik-Feldmann R.;
Rickers C.
Institution
(Neumann, Kehl, Muller, Kozlik-Feldmann) Department of Pediatric
Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany
(Ruffer, Sachweh, Biermann) Surgery for Congenital Heart Disease,
University Heart & Vascular Center Hamburg, Hamburg, Germany
(Herrmann) Department of Pediatric Radiology, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
(Jerosch-Herold) Brigham and Women's Hospital, Harvard Medical School,
Boston, United States
(Hazekamp) Department of Cardiothoracic Surgery, Leiden University Medical
Center, Leiden, Netherlands
(Sinning, Zengin, Blankenberg) Department of Cardiology, University Heart
& Vascular Center Hamburg, Hamburg, Germany
(Girdauskas, Reichenspurner) Department of Cardiovascular Surgery,
University Heart & Vascular Center Hamburg, Hamburg, Germany
(Rickers) Adult Congenital Heart Disease Section, University Heart &
Vascular Center Hamburg, Hamburg, Germany
Publisher
AME Publishing Company
Abstract
Ebstein's anomaly is a rare congenital heart disease with malformation of
the tricuspid valve and myopathy of the right ventricle. The septal and
inferior leaflets adhere to the endocardium due to failure of
delamination. This leads to apical displacement of their hinge points with
a shift of the functional tricuspid valve annulus towards the right
ventricular outflow tract with a possibly restrictive orifice. Frequently,
a coaptation gap yields tricuspid valve regurgitation and over time the
"atrialized" portion of the right ventricle may dilate. The highly
variable anatomy determines the clinical presentation ranging from
asymptomatic to very severe with need for early operation.
Echocardiography and magnetic resonance imaging are the most important
diagnostic modalities to assess the tricuspid valve as well as ventricular
morphology and function. While medical management of asymptomatic patients
can be effective for many years, surgical intervention is indicated before
development of significant right ventricular dilatation or dysfunction.
Onset of symptoms and arrhythmias are further indications for surgery.
Modified cone reconstruction of the tricuspid valve is the
state-of-the-art approach yielding the best results for most patients.
Alternative procedures for select cases include tricuspid valve
replacement and bidirectional cavopulmonary shunt depending on patient age
and other individual characteristics. Long-term survival after surgery is
favorable but rehospitalization and reoperation remain significant issues.
Further studies are warranted to identify the optimal surgical strategy
and timing before adverse right ventricular remodeling occurs. It is this
article's objective to provide a comprehensive review of current
literature and an overview on the management of Ebstein's Anomaly. It
focuses on imaging, cardiac surgery, and outcome. Additionally, a brief
insight into arrhythmias and their management is given. The "future
perspectives" summarize open questions and fields of future
research. Copyright © Cardiovascular Diagnosis and Therapy. All
rights reserved.

<14>
Accession Number
637015901
Title
Transcatheter Aortic Valve Implantation With or Without Predilation: A
Meta-Analysis.
Source
The Journal of invasive cardiology. (no pagination), 2022. Date of
Publication: 06 Jan 2022.
Author
Conrotto F.; D'Ascenzo F.; Franchin L.; Bruno F.; Mamas M.A.; Toutouzas
K.; Cuisset T.; Leclercq F.; Dumonteil N.; Latib A.; Nombela-Franco L.;
Schaefer A.; Anderson R.D.; Marruncheddu L.; Gallone G.; De Filippo O.; La
Torre M.; Rinaldi M.; Omede P.; Salizzoni S.; De Ferrari G.M.
Institution
(D'Ascenzo) Division of Cardiology, Department of Medical Science,
University of Turin, Corso Bramante 88/90, Turin, Italy
Publisher
NLM (Medline)
Abstract
AIMS: To evaluate the impact of systematic predilation with balloon aortic
valvuloplasty (BAV) on transcatheter aortic valve implantation (TAVI).
METHODS AND RESULTS: We performed a systematic meta-analysis investigating
patients undergoing TAVI with systematic BAV vs no BAV in RCT or in
adjusted studies. Device success was the primary endpoint, while all-cause
mortality, 30-day moderate/severe aortic regurgitation (AR), stroke,
permanent pacemaker implantation (PPI) and acute kidney injury (AKI) were
the secondary endpoints. Subanalysis according to design of the study (RCT
and adjusted analysis) and to the type of valve (balloon-expandable [BE]
vs self-expanding [SE]) were conducted. We obtained data from 15 studies,
comprising 16,408 patients: 10,364 undergoing BAV prior to TAVI and 6,044
in which direct TAVI has been performed. At 30-day follow-up, BAV did not
improve the rate of device success in the overall population (OR, 1.09;
95% CI, 0.90-1.31), both in SE (OR, 0.93; 95% CI, 0.60-1.45) and in BE
(OR, 1.16; 95% CI, 0.88-1.52) valves. Between BAV and direct TAVI, no
differences in secondary outcomes were observed neither in overall
population nor according to valve type between BAV and direct TAVI
strategies. All endpoints results were consistent between RCTs and
adjusted studies except for postdilation rate that did not differ in
observational studies (OR, 0.70; 95% CI, 0.47-1.04), while it was lower in
BAV when only RCTs were included in the analysis (OR, 0.48; 95% CI,
0.24-0.97). CONCLUSION(S): Direct TAVI is feasible and safe compared
to predilation approach with similar device success rates and clinical
outcomes. Direct TAVI could represent a first-choice approach in
contemporary TAVI procedures.

<15>
Accession Number
637008609
Title
Meta-Analysis of 5-Year Risk of All-Cause Death or Stroke After
Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve
Replacement.
Source
The American journal of cardiology. (no pagination), 2022. Date of
Publication: 03 Jan 2022.
Author
Yokoyama Y.; Kuno T.; Ando T.; Sugiura T.; Latib A.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network, PA
(Kuno, Latib) Division of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, NY
(Ando) Department of Cardiology, Kawasaki Saiwai Hospital, Kawasaki, Japan
(Sugiura) Division of Cardiothoracic Surgery, Montefiore Medical Center,
Albert Einstein College of Medicine, NY
Publisher
NLM (Medline)

<16>
Accession Number
637008060
Title
Uniportal Video-Assisted Thoracic Surgery in a Pediatric Hospital: Early
Results and Review of the Literature.
Source
Journal of laparoendoscopic & advanced surgical techniques. Part A. (no
pagination), 2022. Date of Publication: 06 Jan 2022.
Author
Ugolini S.; Coletta R.; Lo Piccolo R.; Dell'Otto F.; Voltolini L.;
Gonfiotti A.; Morabito A.
Institution
(Ugolini, Coletta, Lo Piccolo, Dell'Otto, Morabito) Department of
Pediatric Surgery, Meyer Children's Hospital Academic Centre, Florence,
Italy
(Coletta) School of Environment and Life Science, University of Salford,
Salford, United Kingdom
(Dell'Otto, Morabito) Department of Neurosciences, Psychology, Drug
Research and Child Health (NEUROFARBA), University of Florence, Florence,
Italy
(Voltolini, Gonfiotti) Department of Thoracic Surgery, University Hospital
Careggi, Florence, Italy
(Voltolini, Gonfiotti) Department of Experimental and Clinical Medicine
(DMSC), University of Florence, Florence, Italy
Publisher
NLM (Medline)
Abstract
Background: Uniportal video-assisted thoracic surgery (U-VATS) is an
implemented technique in adult surgery that may aid to extend offer the
benefits of thoracoscopy to a wide number of pediatric patients.
 Material(s) and Method(s): Consecutive cases treated between July
2019 and July 2021 were retrospectively analyzed. Simultaneously, a
MEDLINE systematic search was conducted. Result(s): Twelve patients
(median age 13 years, median weight 44.5kg) underwent 4 major procedures
(n=2 lobectomy, n=2 segmentectomy) and 11 minor procedures (n=1
bronchogenic cyst resection, n=4 apical wedge resections and pleurodesis
for pneumothorax, n=4 wedge resections for lung nodules, and n=2
debridement for empyema). The median observed operative time was 77
minutes. We recorded one conversion to biportal VATS. No intraoperative
complications or 30-day morbidity-mortality was reported. A rate of 40%
adverse postoperative events was observed (Clavien-Dindo grade I-IVa).
Visual analog scale for postoperative pain recorded a median value of 0 on
days 1, 2, and 3. The systematic review provided 15 full-text articles
reporting 76 pediatric interventions (4 major and 72 minor procedures);
among them, 1 biportal conversion, 3 mild postoperative complications, and
1 redo surgery are presented. Conclusion(s): As emerged from the
literature review, U-VATS remains scarcely adopted by pediatric surgeons.
Its feasibility is supported by the four reported major lung resections
plus the four cases added on by our series. Thanks to a more rapid
learning curve over conventional VATS, the uniportal technique could be
accessible to a wider number of centers.

<17>
Accession Number
2016569242
Title
Comparing Single- and Dual-Antiplatelet Therapies After Transcatheter
Aortic Valve Implantation.
Source
Annals of Thoracic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Chiu H.-T.; Jhou H.-J.; Chen P.-H.; Lee C.-H.; Lin C.-Y.
Institution
(Chiu) Department of Surgery, Tri-Service General Hospital, National
Defense Medical Center, Taipei, Taiwan, Taiwan (Republic of China)
(Jhou) Department of Neurology, Changhua Christian Hospital, Changhua,
Taiwan, Taiwan (Republic of China)
(Jhou) School of Medicine, Kaohsiung Medical University, Kaohsiung,
Taiwan, Taiwan (Republic of China)
(Chen) Department of Internal Medicine, Tri-Service General Hospital,
National Defense Medical Center, Taipei, Taiwan, Taiwan (Republic of
China)
(Lee) Division of Hematology and Oncology Medicine, Department of Internal
Medicine, Tri-Service General Hospital, National Defense Medical Center,
Taipei, Taiwan, Taiwan (Republic of China)
(Lin) Division of Cardiovascular Surgery, Department of Surgery,
Tri-Service General Hospital, National Defense Medical Center, Taipei,
Taiwan, Taiwan (Republic of China)
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve implantation has been an
established treatment in patients with symptomatic severe aortic stenosis.
However, the postoperative antiplatelet regimen after transcatheter aortic
valve implantation has not been established with certainty. This
meta-analysis compared the safety and efficacy of single- antiplatelet
therapies (SAPTs) and dual-antiplatelet therapies (DAPT) in patients
undergoing transcatheter aortic valve implantation. Method(s):
Eligible randomized controlled trials and cohort studies published before
February 2021 were retrieved from PubMed, Embase, and the Cochrane
Library. We calculated odds ratios (ORs) with 95% CIs. Result(s):
Nine articles, involving 19 277 patients, met the selection criteria. In
the short-term outcome, compared with SAPT, DAPT was associated with a
significantly higher rate of bleeding (OR, 3.00; 95% CI, 1.67-5.38) and
showed no significant differences in thrombotic events (OR, 1.25; 95% CI,
0.74-2.11) and all-cause mortality (OR, 0.84; 95% CI, 0.42-1.69). In the
long-term outcome, DAPT was associated with a significantly higher
bleeding rate (OR, 1.85; 95% CI, 1.24-.78) and showed no differences in
thrombotic events (OR, 1.13; 95% CI, 0.86-1.48) and all-cause mortality
(OR, 1.12; 95% CI, 0.95-1.32). Our trial sequential analysis confirmed
DAPT did not confer any benefit for reducing all-cause mortality and
thrombotic events and carried a higher risk of bleeding than SAPT.
 Conclusion(s): SAPT should be a sufficient antiplatelet strategy in
patients after transcatheter aortic valve implantation who do not have
indications for oral anticoagulation medication, especially in the
long-term follow-up period. Copyright © 2022 The Society of
Thoracic Surgeons

<18>
Accession Number
2014799221
Title
The Efficacy of Corticosteroids, NSAIDs, and Colchicine in the Treatment
of Pediatric Postoperative Pericardial Effusion.
Source
Pediatric Cardiology. (no pagination), 2022. Date of Publication: 2022.
Author
Somani N.; Breur H.
Institution
(Somani, Breur) Department of Pediatric Cardiology, University Medical
Center Utrecht, Lundlaan 6, Utrecht 3584 EA, Netherlands
Publisher
Springer
Abstract
The objective of this study is to investigate and compare the efficacy of
corticosteroids, NSAIDs, and colchicine in treating postoperative
pericardial effusion (PPE) following cardiac surgery in the pediatric
setting, on the basis of available literature. To investigate and compare
the efficacy of corticosteroids, NSAIDs, and colchicine in treating
postoperative pericardial effusion (PPE) following cardiac surgery in the
pediatric setting, on the basis of available literature. A systematic
review was conducted by carrying out a database search in PubMed on April
20th, 2021. An English language filter was added, but no time restrictions
were applied. Lack of pediatric literature prompted a broadening of the
search to include adult literature. One pediatric and four adult studies
were included, but the pediatric evidence was not found to be of
satisfactory quality, and the findings of adult literature could not be
readily generalized to the pediatric setting. No well-founded conclusions
could be drawn regarding the efficacy of corticosteroids, NSAIDs, or
colchicine in treating PPE, as a striking lack of evidence for their
efficacy in the pediatric setting were revealed. A knowledge gap was found
in the literature, indicating a need for good-quality randomized
controlled trials to bridge this gap. Copyright © 2022, The
Author(s).

<19>
Accession Number
600029584
Title
Effect of darapladib on major coronary events after an acute coronary
syndrome: The SOLID-TIMI 52 randomized clinical trial.
Source
JAMA - Journal of the American Medical Association. 312(10) (pp
1006-1015), 2014. Date of Publication: 10 Sep 2014.
Author
O'Donoghue M.L.; Braunwald E.; White H.D.; Lukas M.A.; Tarka E.; Steg
P.G.; Hochman J.S.; Bode C.; Maggioni A.P.; Im K.; Shannon J.B.; Davies
R.Y.; Murphy S.A.; Crugnale S.E.; Wiviott S.D.; Bonaca M.P.; Watson D.F.;
Weaver W.D.; Serruys P.W.; Cannon C.P.; Steen D.P.; Lamp J.M.; McCourt A.;
Barakat D.; Mezzetti J.; Morrison C.; Stevens M.; Ward C.; Ardissino D.;
Aylward P.E.; Babilonia N.; Britto F.; Budaj A.; Chen S.A.; Corbalan R.;
Dalby A.J.; Dellborg M.; deWinter R.J.; Dorobantu M.; Duris T.; Gao R.;
Goudev A.R.; Grande P.; Gratsiansky N.; Guneri S.; Hamm C.; Husted S.;
Isaza D.; Kimura T.; Kiss R.; Lewis B.; Lopez-Sendon J.; Mancini G.B.;
Mathur A.; Mittal S.; Montalescot G.; Nicolau J.C.; Ophuis T.O.; Paolasso
E.; Parkhomenko A.; Ray K.; Reddy K.; Seung K.B.; Somaraju B.; Spinar J.;
Sritara P.; Theroux P.; Wijns W.; Collins R.; DeMets D.; Ganz P.;
Sandercock P.; Weber M.; Fisher M.; Buhr K.; Diegel S.; Schultz M.; Lowe
C.; Mills K.; Ruvido J.; Alkhalil M.; Rehman M.Q.; Stebletsova I.; Shimmer
M.; Forni D.; Awtry E.; Berger C.J.; Croce K.; Desai A.; Gelfand E.; Ho
C.; Leeman D.E.; Link M.S.; Pande A.; Ruberg F.; Vita J.A.; Gignac G.;
Hochberg E.; Lane A.; Rosenberg C.; Wagner A.; Wolpin B.M.; Goessling W.;
Acquilano D.E.; Waltemyer R.; Kunder S.; Syed A.; Aigbogun J.; Taylor M.;
Daga S.; Cicconetti G.; Nandy I.; Deenadayalu N.; Koduru S.; Zhou J.;
Abraham L.; Beloscar J.; Bettinotti M.; Dumont C.; Fernandez R.;
Fuentealba V.J.; Covelli G.; Garcia Duran R.; Hominal M.A.; Jure H.;
Litvak M.; Luciardi H.; Macin S.; MacKinnon I.; Milesi R.; Montana O.;
Olavegogeascoechea P.; Prado A.; Sala J.; Gorosito V.; Sassone S.; Maffei
L.; Schmuck R.; Vico M.; Vita N.; Arstall M.; Ashby D.; Colquhoun D.;
Cross D.; Farshid A.; Freeman M.; New G.; Hammett C.; Kanna R.; Lehman R.;
Roberts-Thomson P.; William M.; Yamen E.; Beauloye C.; Beunk J.; Boland
J.; Charlier F.; Claeys M.; Dujardin K.; Friart A.; Legrand V.; Schoors
D.; Sinnaeve P.; Vandenbossche J.L.; Abrantes J.; Alves da Costa F.;
Ardito W.; Bodanese L.; Braga J.C.; Carvalho A.; Dutra O.; Feitosa G.;
Guimaraes A.E.; Hernandes M.; Leaes P.; Lima F.; Lotufo P.; Maia L.;
Manenti E.; Mattos M.A.; Michalaros Y.; Paiva M.S.; Piegas L.; Pimentel
Filho P.; Precoma D.; Rabelo Alves Junior A.; Rassi S.; Reis G.; Resende
E.; Rossi P.; Saraiva J.F.; Silva Junior D.; Silva F.A.; Souza J.;
Wainstein M.; Ribeiro J.; Benov H.; Chompalova B.; Goshev E.; Raev D.;
Goudev A.; Grigorov M.; Grigorova V.; Mihov A.; Nikolov F.; Petrov I.;
Postadzhiyan A.; Ramshev K.; Tisheva S.; Tzekova M.; Bhargava R.; Cha J.;
Constance C.; Della Siega A.; Klinke P.; Dong R.; Dupuis R.; Gyenes G.;
Huynh T.; Labonte R.; Lai C.; Leader R.; Leiter L.; Lonn E.; Nguyen M.;
Pandey A.; Polasek P.; Ramanathan K.; Rose B.; Rupka D.; Sabbah E.; Syan
G.; Tishler S.; Vizel S.; Zeman P.; Albornoz Alarcon F.J.; Castro Galvez
P.; Florenzano Urzua F.; Pedemonte Villablanca O.A.; Perez Pino L.;
Pincetti C.; Rodriguez Venegas M.; Romero Castro C.; Lamich R.; Sepulveda
Varela P.A.; Stockins B.; Chen Y.; Dong Y.; Fu G.; Hao Y.; Huang D.; Jiao
Y.; Ke Y.; Li C.; Li H.; Li T.; Li X.; Li Z.; Liao D.; Liu L.; Lu Q.; Qu
P.; Shen Z.; Shi H.; Wu S.; Xiang M.; Xu J.; Yang X.; Yu J.; Yuan Z.;
Zhang Y.; Zhou S.; Accini Mendoza J.L.; Bohorquez R.; Botero R.; Cano
Lopez N.; Hernandez H.; Jaramillo C.; Jaramillo M.; Jaramillo N.; Manzur
F.; Mendoza F.; Reynales H.; Sanchez Vallejo G.; Ternera A.; Urina M.;
Cermak O.; Coufal Z.; Dedek V.; Francek L.; Grunfeldova H.; Gregor P.;
Kellnerova I.; Klimsa Z.; Kuchar L.; Linhart A.; Mayer O.; Taborsky M.;
Vitovec J.; Andersen U.; Kristensen K.; Bang L.; Bronnum-Schou J.; Egstrup
K.; Frost L.; Galatius S.; Jeppesen J.; Rokkedal J.; Klarlund K.; Laursen
R.; Nielsen T.; Melchior T.; Mickley H.; Nielsen H.; Nielsen W.; Schmidt
E.; Sjol A.; Skagen K.; Sykulski R.; Zeuthen E.; Nyvad O.; Agraou B.;
Bayet G.; Caussin C.; Coisne D.; Cottin Y.; Decoulx E.; Delahaye F.;
Delarche N.; D'Houdain F.; Dourmap-Collas C.; Dubois-Rande J.L.; Elbaz M.;
Martelet M.; Nallet O.; Cattan S.; Ohlmann P.; Schiele F.; Traisnel G.;
Tricot O.; Berrouschot J.; Duengen H.D.; Elsaesser A.; Erbel R.;
Moehlenkamp S.; Franz N.; Frey N.; Hambrecht R.; Haude M.; Janssens U.;
Joost A.; Schunkert H.; Kadel C.; Katus H.; Koenig W.; Laufs U.; Loew A.;
Klauss V.; Koenig A.; Sohn H.Y.; Mudra H.; Neumann F.J.; Olbrich H.G.;
Plehn A.; Buerke M.; Ebelt H.; Schaefer A.; Fischer D.; Schaeufele T.;
Steiner S.; Kreuzer J.; Tsoy I.; Stellbrink C.; Sydow K.; Baldus S.;
Tiroch K.; Guelker H.; Haltern G.; Voehringer H.F.; Weber D.; Werner G.;
Zeiher A.M.; Zeymer U.; Zirlik A.; Csapo K.; Herczeg B.; Katona A.; Keltai
K.; Kiss R.G.; Laszlo Z.; Lupkovics G.; Medvegy M.; Merkely B.; Muller G.;
Nagy A.; Nagy L.; Palinkas A.; Sziliczei-Nemeth; Sereg M.; Valco J.;
Vertes A.; Zamolyi K.; Arora P.; Bali H.; Banker D.; Chaganti V.R.;
Chandra P.K.; Chopra A.; Christopher J.; Dani S.; Gupta S.; Shah S.;
Hiremath S.; Kaul U.; Koduganti S.; Kumar N.; Kumar S.; Mandala G.; Naik
S.; Oomman A.; Padmanabhan T.N.; Parikh K.; Reddy R.P.; Roy S.; Sankardas
M.; Sapra R.; Chopra V.; Sathe S.; Sawhney J.; Atar S.; Banai S.; Eldar
M.; Elis A.; Gavish D.; Goldhaber A.; Gottlieb S.; Hayek T.; Hussein O.;
Katz A.; Klutstein M.; Kracoff O.; Lishner M.; Lotan C.; Meisel S.;
Mosseri M.; Qarawani D.; Hasin Y.; Rozenman Y.; Schiff E.; Oliven A.;
Weiss A.; Baldin M.G.; Berni A.; Biasucci L.M.; Bongo A.; Campo G.;
Valgimigli M.; Colivicchi F.; De Servi S.; Esposito G.; Gavazzi A.;
Marzilli M.; Merlini P.; Moretti L.; Morocutti G.; Mos L.; Patrizi G.;
Rapezzi C.; Branzi A.; Terrosu P.; Domae H.; Fujii S.; Furukawa Y.; Goto
Y.; Hirokami M.; Ito H.; Kawajiri K.; Kimura K.; Kuramochi T.; Miyauchi
K.; Muroya T.; Hata S.; Yoshida T.; Oku K.; Okutsu M.; Ooie T.; Saito T.;
Shimomura H.; Shinozaki N.; Shishido K.; Sugitatsu K.; Tanaka S.; Suwa S.;
Takenaka T.; Tamada A.; Tanabe K.; Tanaka Y.; Takahashi S.; Yamazaki S.;
Chae S.C.; Hong T.J.; Jeong J.O.; Jeong M.; Kim H.S.; Kim Y.H.; Ko Y.G.;
Lee S.H.; Yoon J.; Bartels L.; Basart D.; De Nooijer C.; Dijkgraaf R.; de
Graaf J.J.; Groutars R.; Visser J.; Hamer B.J.; Hamraoui K.; Heijmeriks
J.; Huizenga A.; Herrman J.P.; Knufman N.M.; Frederiks J.; Kuijper A.F.;
Lenderink T.; van der Meer P.; Milhous G.J.; Nierop P.; Oude Ophuis A.J.;
Peerenboom P.; Peters R.; Plomp J.; Prins P.; Schaap A.; van der Sluis A.;
Smeele F.J.; van Hal J.M.; Swart H.P.; Tjeerdsma G.; Troquay R.; Van Eck
M.; Viergever E.; de Weerd G.J.; van Daele M.; de Winter R.J.;
Zoet-Nugteren S.K.; van der Zwaan C.; Zwart P.; Devlin G.; Elliott J.;
Harrison N.; Hart H.; O'Meeghan T.; Stewart R.; Ternouth I.; Tisch J.; van
Pelt N.; Wilkins G.; Chen V.; Alarco Leon W.; Rodriguez Chavez V.E.; Rojas
Canamero R.; Rotta Rotta A.; Toce L.; Anonuevo J.; Barcinas R.; Coching
R.M.; Matiga G.; Sulit D.J.; Uy N.; Bronisz M.; Buszman P.; Dalkowski M.;
Derlaga B.; Fijalkowski M.; Rynkiewicz A.; Firek B.; Gil R.; Jaworska K.;
Kasprzak J.; Krzeminska-Pakula M.; Kleinrok A.; Kopaczewski J.; Kuc K.;
Kusnierz B.; Lewczuk J.; Lysek R.; Miekus P.; Mirek-Bryniarska E.;
Mlodziankowski A.; Musial W.; Mysiak A.; Napora P.; Piepiorka M.; Pluta
W.; Prochaczek F.; Przewlocki T.; Rekosz J.; Rusicka T.; Galaj A.;
Sciborski R.; Szelemej R.; Szpajer M.; Wojewoda P.; Wrzosek B.; Zurakowski
A.; Arsenescu Georgescu C.M.; Benedek I.; Capalneanu R.; Cinteza M.; Craiu
E.; Cristea M.; Dimulescu D.; Fruntelata A.G.; Ginghina C.; Minescu B.;
Musetescu R.; Ionescu D.; Pop C.; Radoi M.; Sinescu C.; Vinereanu D.;
Arkhipov M.; Barbarash O.; Bessonova N.; Boldueva S.; Boyarkin M.; Demko
A.; Duplyakov D.; Ermoshkina L.; Glezer M.; Goloshchekin B.; Gordeev I.;
Grinshtein Y.; Karpov Y.; Kobalava Z.; Konstantinov V.; Kostenko V.;
Kuimov A.; Kuznetsov V.; Libis R.; Markov V.; Motylev I.; Novikova N.;
Orlikova O.; Panchenko E.; Panov A.; Ruda M.; Sementsov D.; Shalaev S.;
Shvarts Y.; Simanenkov V.; Skorichenko V.; Sukmanova I.; Smolenskaya O.;
Tsyba L.; Vishnevsky A.; Yakhontov D.; Yakusevich V.; Zadionchenko V.;
Zateyshchikov D.; Zateyshchikova A.; Zrazhevskiy K.; Fridrich V.; Gaspar
L.; Hasilla J.; Hranai M.; Kokles M.; Pella D.; Basson M.; Bayat J.;
Blignaut S.; Burgess L.; Corbett C.; Da Silva A.; De Jong D.; Mabin T.;
Manga P.; Oosthuysen W.; Ranjith N.; Roodt A.; Roux J.; Soma P.; Swanepoel
N.; Theron H.; van Zyl L.; Barrabes Riu J.A.; Figueras Bellot J.; Bayon
Fernandez J.; Simarro Martin-Ambrosio E.; Benedicto Buendia A.; Castro
Conde A.; Iniguez Romo A.; Jimenez Navarro M.; Lopez Garcia-Aranda V.;
Mainar Tello V.; Marco Garde P.; Mayordomo Lopez J.; Molla Jimenez C.;
Anton Pascual J.L.; Plaza Perez I.; Ridocci Soriano F.; Viles Beltran D.;
Bandh S.; Christensen K.; Herlitz J.; Karlsson J.E.; Mooe T.; Persson B.;
Timberg I.; Witt N.; Cheng C.C.; Hung H.H.; Lai W.T.; Tu C.M.; Li A.H.; Wu
C.F.; Wu C.J.; Yin W.H.; Buakhamsri A.; Kaewsuwanna P.; Kiatchoosakun S.;
Kuanprasert S.; Wongpraparut N.; Bayata S.; Yavuzgil O.; Amosova E.;
Batushkin V.; Dyadyk O.; Goloborodko B.; Karpenko O.; Kononenko L.;
Kopytsya M.; Koval O.; Kovalskyy I.; Legkonogov O.; Malynovsky Y.;
Shershnyova O.; Netiazhenko V.; Nikonov V.; Parkhomenko O.; Prokhorov O.;
Rebrov B.; Potapenko P.; Rudenko L.; Shcherbak V.; Stanislavchuk M.;
Tseluyko V.; Yagensky A.; Ahsan A.; Been M.; Bethell H.; Senior R.; Cox
D.; Findlay I.; Gandhi M.; Gorog D.; Jacques A.; Keeling P.; O'Rourke B.;
Pell A.; Spratt J.; Trouton T.; Wong Y.K.; Abadier R.; Abrahams L.; Afonso
L.; Aggarwal A.; Aggarwal K.; Ahmed A.; Ahmed S.; Albirini A.; Anderson
J.; Angiolillo D.; Ansari S.; Applegate R.; Arif I.; Leesar M.; Aronow H.;
Asbill B.; Ashraf R.; Atalay H.; Atassi K.; Atieh M.; Babayan Z.; Harjai
K.; Baker S.; Barr L.; Barringhaus K.; Bayron C.; Benjamin S.; Benton R.;
Berglund R.; Conn E.; Bertolet B.; Bhagwat R.; Biederman R.; Bisher E.;
Blanchard A.; Brown C.; Butman S.; Campbell C.; Canaday D.; Carlson T.;
Casale P.; Cashion W.; Chandler A.; Chandna H.; Chandrasekaran S.; Chang
G.; Chronos N.; Chang M.; Chhabra A.; Chin J.; Cochran D.; Cohen K.;
Cucher F.; Dauber I.; De Gregorio M.; Del Core M.; Dewhurst R.; Rodriguez
R.; Dionisopoulos P.; Donovan D.; Doty W.; Drossner M.; East C.; Eaton G.;
Ebrahimi R.; Effron B.; Elkhadra M.; Elsner G.; Erickson B.; Fehrenbacher
G.; Feldman R.; Fernandes V.; Fishberg R.; Flores A.; Foreman R.; Frankel
R.; French W.; Fuentes F.; Fujise K.; Fulmer J.; Gabry M.; Baig M.; Curran
P.; Garcia Pulido J.; Gatien L.; Gazmuri R.; Gencheff N.; Gilmore R.;
Giugliano G.; Goldberg R.; Goldman S.; Movahed M.R.; Goldstein M.;
Gonzalez D.; Gottlieb D.; Grabarczyk M.; Graham B.; Gruberg L.; Gumm D.;
Lee D.; Hage-Korban E.; Hakas J.; Hamroff G.; Harris B.; Hearne S.; Held
J.; Henderson D.A.; Hermany P.; Herzog W.; Hinchman D.; Fry S.; Hockstad
E.; Hodson R.; Hollenbaugh D.; Horwitz P.; Hurst P.; Ibrahim H.; Imburgia
M.; Izzo M.; Jaffrani N.; Jan M.; Janout M.; Ring M.; Jones S.; Kahn B.;
Kakavas P.; Kates A.; Bach R.; Katopodis J.; Kazimir M.; Kennett J.;
Kereiakes D.; Kersh R.; Kershner D.; Meilman H.; Kerwin P.; Khera A.;
Kieval J.; Kim E.; Kobayashi J.; Nelson R.; Kosinski E.; Kovacich D.;
Kraft P.; Kramer J.; Kruse K.; Kuvin J.; Labib A.; Labroo A.; Langer M.;
Lau T.; Lee K.; Lee T.; Levite H.; Lewis D.; Lieber I.; Loh I.; Lopez M.;
Lui H.; Malkowski M.; Mammen G.; Mascolo R.; Matsumura M.; Matthews G.;
Corbelli J.; Mayer T.; McAlhany C.; McCullum K.; Meholick A.; Mehta V.;
Melhado M.; Menees D.; Miller M.; Minisi A.; Minor S.; Moore C.; Nygaard
T.; Morcos N.; Morris P.; Morrow D.; Mostel E.; Murdock D.; Nadar V.;
Nahhas A.; Navas J.; Nukta E.; Oberoi M.; O'Donnell P.; Ostfeld R.;
Pacheco T.; Panchal V.; Parang P.; Paraschos A.; Pasquini J.; Williams J.;
Patlola R.; Peart B.; Penny W.; Pepine C.; Perlman R.; Pavlides A.; Popeil
L.; Prashad R.; Price D.; Price R.; Puleo P.; Puri S.; Raikhel M.;
Ramachandran A.; Ramos M.; Concha M.; Randhawa P.; Reichek N.; Riba A.;
Ricciardi M.; Rider J.; Fenton S.; Rizvi M.A.; Dahiya R.; Rogers W.; Roth
D.; Rowe W.; Saba F.; Sabri M.; Patel P.; Sandoval J.; Sangrigoli R.;
Schwartzbard A.; Seidner M.; Shah A.; Shanes J.; Sharma M.; Siegel C.;
Singal D.; Singh N.; Smith A.; Panetta C.; Smith S.; Whitaker J.; Snell
J.; Snyder H.; Soffer A.; Sonel A.; Spencer R.; Staniloae C.; Stephenson
C.; Sundaram S.; Sutton L.; Letts D.; Swint R.; Tallet J.; Tami L.; Taylor
R.; Hanovich G.; Tedder B.; Teufel E.; Brett C.; Thomas J.; Thompson P.;
Polk D.; Tilkian A.; Tinkel J.; Pandya U.; Tobiansky J.; Trippi J.; Tuohy
E.; Uretsky B.; Uusinarkaus K.; Varma S.; Velasquez E.; Vogel C.; Voyce
S.; Wainwright W.; Hancock H.; Walder J.; Wali A.; Watkins S.; Weiss R.;
Wickemeyer W.; Wilson D.; Wilson V.; Wiseman A.; Wright W.; Xenakis M.;
Zelenka J.; Zilz N.; Amidon T.
Institution
(O'Donoghue, Braunwald, Steen, Im, Murphy, Crugnale, Wiviott, Bonaca,
Cannon) TIMI Study Group, Cardiovascular Division, Brigham AndWomen's
Hospital, 350 Longwood Ave, Boston, MA 02115, United States
(White) Green Lane Cardiovascular Service, Auckland City Hospital,
Auckland University, Auckland, New Zealand
(Lukas) Metabolic Pathways and Cardiovascular Therapeutic Area,
GlaxoSmithKline, Philadelphia, PA, United States
(Tarka, Davies) Metabolic Pathways and Cardiovascular Therapeutic Area,
GlaxoSmithKline, King of Prussia, PA, United States
(Steg) Departement Hospitalo-Universitaire FIRE, Hopital Bichat,
Universite Paris-Diderot, Paris, France
(Steg) NHLI Imperial College, ICMS Royal Brompton Hospital, United Kingdom
(Hochman) Department of Medicine, NYU Langone Medical Center, New York,
NY, United States
(Bode) Heart Center, Department for Cardiology and Angiology I, University
of Freiburg, Freiburg, Germany
(Maggioni) ANMCO Research Center, Florence, Italy
(Shannon, Watson) Metabolic Pathways and Cardiovascular Therapeutic Area,
GlaxoSmithKline, Research Triangle Park, NC, United States
(Weaver) Henry Ford Heart and Vascular Institute, Detroit, MI, United
States
(Serruys) Erasmus University, Thoraxcentrum, Rotterdam, Netherlands
(Serruys) International Center for Circulatory Health, Imperial College,
London, United Kingdom
Publisher
American Medical Association
Abstract
IMPORTANCE: Lipoprotein-associated phospholipase
A<inf>2</inf>(Lp-PLA<inf>2</inf>) has been hypothesized to be involved in
atherogenesis through pathways related to inflammation. Darapladib is an
oral, selective inhibitor of the Lp-PLA<inf>2</inf>enzyme.
 OBJECTIVE(S): To evaluate the efficacy and safety of darapladib in
patients after an acute coronary syndrome (ACS) event. DESIGN, SETTING,
AND PARTICIPANTS: SOLID-TIMI 52was a multinational, double-blind,
placebo-controlled trial that randomized 13 026 participants within 30
days of hospitalization with an ACS (non-ST-elevation or
ST-elevationmyocardial infarction [MI]) at 868 sites in 36 countries.
INTERVENTIONS: Patients were randomized to either once-daily darapladib
(160mg) or placebo on a background of guideline-recommended therapy.
Patients were followed up for a median of 2.5 years between December 7,
2009, and December 6, 2013. MAIN OUTCOMES AND MEASURES: The primary end
point (major coronary events)was the composite of coronary heart disease
(CHD) death, MI, or urgent coronary revascularization formyocardial
ischemia. Kaplan-Meier event rates are reported at 3 years.
 RESULT(S): During a median duration of 2.5 years, the primary end
point occurred in 903 patients in the darapladib group and 910 in the
placebo group (16.3%vs 15.6%at 3 years; hazard ratio [HR], 1.00 [95%CI,
0.91-1.09]; P = .93). The composite of cardiovascular death, MI, or stroke
occurred in 824 in the darapladib group and 838 in the placebo group
(15.0%vs 15.0%at 3 years; HR, 0.99 [95%CI, 0.90-1.09]; P = .78). There
were no differences between the treatment groups for additional secondary
end points, for individual components of the primary end point, or in
all-cause mortality (371 events in the darapladib group and 395 in the
placebo group [7.3%vs 7.1%at 3 years; HR, 0.94 [95%CI, 0.82-1.08]; P =
.40). Patients were more likely to report an odor-related concern in the
darapladib group vs the placebo group (11.5%vs 2.5%) and also more likely
to report diarrhea (10.6%vs 5.6%). CONCLUSIONS AND RELEVANCE: In patients
who experienced an ACS event, direct inhibition of Lp-PLA<inf>2</inf>with
darapladib added to optimal medical therapy and initiated within 30 days
of hospitalization did not reduce the risk of major coronary events. TRIAL
REGISTRATION: clinicaltrials.gov Identifier: NCT01000727 Copyright 2014
American Medical Association. All rights reserved.

<20>
Accession Number
2015353824
Title
Effectiveness of the Self-report Pain Intensity Scale in Pain Control
After Coronary Artery Bypass Surgery.
Source
Iranian Heart Journal. 23(1) (pp 205-213), 2022. Date of Publication:
Winter 2022.
Author
Aghdaii N.; Azarfarin R.; Ziyaeifard M.; Navabi Z.S.; Faritous Z.
Institution
(Aghdaii, Faritous) Rajaie Cardiovascular Medical and Research Center,
Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Azarfarin, Ziyaeifard) Cardio-oncology Research Center, Rajaie
Cardiovascular, Medical, and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Navabi) Ayatollah Kashani Haspital, Isfahan University of Medical
Sciences, Isfahan, Iran, Islamic Republic of
Publisher
Iranian Heart Association
Abstract
Background: Pain following cardiac surgery is common, and pain assessment
is a precondition for adequate pain management. We designed this study to
evaluate the effectiveness of pain control using the self-report pain
intensity scale during the postoperative period after coronary artery
bypass surgery in the cardiac ICU. Method(s): Of 160 patients
scheduled for elective coronary revascularization, 154 patients were
included in this prospective, double-blind clinical trial. The pain
management program was performed on conscious patients for 48 hours. The
study population was randomly divided into 2 groups. One group received
analgesics as needed, based on conventional nurse-controlled analgesia
(the NCA group; n=77), and the other group received analgesics based on
the pain intensity score determined using the linear numerical rating
scale (NRS group; n=77). In both groups, opioid and non-opioid analgesic
consumption and satisfaction levels with pain relief were recorded.
 Result(s): The use of the self-report pain intensity scale led to an
increase in the number of recipients of analgesic drugs and a decrease in
their opioid/analgesic consumption during a 48-hour period in the NRS
group. Satisfaction levels with pain relief were higher in the NRS group
than in the NCA group (maximum satisfaction =43 [55.8%] vs 9 [11.8%],
respectively; P=0.0001). Conclusion(s): The findings of this study
showed the efficacy of the self-report pain intensity scale in controlling
patients' pain, using adequate and appropriate analgesics, prescribing
accurate amounts of medication based on patients' pain, and increasing
patients' satisfaction with pain relief. (Iranian Heart Journal 2022;
23(1): 205-213). Copyright © 2022, Iranian Heart Association. All
rights reserved.

<21>
Accession Number
2016500758
Title
Vascular complications and bleeding after balloon aortic valvuloplasty
performed with or without heparin: HEPAVALVE randomized study.
Source
IJC Heart and Vasculature. 39 (no pagination), 2022. Article Number:
100951. Date of Publication: April 2022.
Author
Akodad M.; Labour J.; Nogue E.; Delseny D.; Macia J.-C.; Gervasoni R.;
Lattuca B.; Nagot N.; Roubille F.; Cayla G.; Leclercq F.
Institution
(Akodad, Labour, Delseny, Macia, Gervasoni, Roubille, Leclercq) Department
of Cardiology, CHU Montpellier, Univ Montpellier, Montpellier, France
(Akodad, Roubille) PhyMedExp, Uni Montpellier, INSERM, CNRS, France
(Nogue, Nagot) Clinical Research and Epidemiology Unit, CHU Montpellier,
Univ Montpellier, Montpellier, France
(Lattuca, Cayla) Department of Cardiology, CHU Nimes, Univ Montpellier,
Nimes, France
Publisher
Elsevier Ireland Ltd
Abstract
Background: Vascular and bleeding events remain the main complications
after balloon aortic valvuloplasty (BAV). While BAV is usually performed
with per procedural heparin injection, BAV performed without heparin may
reduce hemorrhagic events. We aimed to determine whether vascular and
bleeding complications may be reduced with BAV performed without heparin.
 Method(s): This randomized, double-blind, placebo-controlled study
was conducted from January 2013 to September 2016. Patients were randomly
assigned to placebo or intravenous unfractionated heparin (UH) 50 IU/kg
bolus during the procedure. The primary endpoint included major vascular,
bleeding and ischemic complications (stroke, transient ischemic attack,
myocardial infarction) according to VARC-2 criteria. Result(s): Among
89 randomized patients, 82 completed the study (n = 39 in the UH group and
n = 43 in the placebo group). At baseline, diabetes, sex male and renal
failure were more frequent in the UH group and peripheral artery disease
was more frequent in the placebo group. The primary endpoint was achieved
in 7 patients (8.5%), 1 in the placebo group (2.3%) versus 6 in the UH
group (15.4%). After adjustment on diabetes, sex, renal failure,
peripheral artery disease, percutaneous closure device and chronic
obstructive pulmonary disease, UH utilization was associated with a
significant risk of major vascular, bleeding and ischemic complications
(primary endpoint) (<inf>adj</inf>OR: 11.9; 95%CI: 1.2-117.2; p = 0.03).
Hospitalization length was lower in the placebo group compared to the UH
group (p = 0.03). Conclusion(s): BAV without per procedural UH was
associated with a reduction of major VC and bleeding events without
increasing the ischemic risk and with a shorter hospitalization
length. Copyright © 2022 The Author(s)

<22>
Accession Number
2007661084
Title
Antithrombotic therapy with or without clopidogrel after transcatheter
aortic valve replacement. A meta-analysis of randomized controlled trials.
Source
Clinical Research in Cardiology. 111(1) (pp 14-22), 2022. Date of
Publication: January 2022.
Author
Pellegrini C.; Xhepa E.; Ndrepepa G.; Alvarez-Covarrubias H.; Kufner S.;
Lahmann A.L.; Rheude T.; Rai H.; Mayr N.P.; Schunkert H.; Kastrati A.;
Joner M.; Cassese S.
Institution
(Pellegrini, Xhepa, Ndrepepa, Alvarez-Covarrubias, Kufner, Lahmann,
Rheude, Rai, Schunkert, Kastrati, Joner, Cassese) Klinik Fur Herz- und
Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technische
Universitat Munchen, Lazarettstrasse, 36, Munich, Germany
(Schunkert, Kastrati, Joner) German Center for Cardiovascular Research
(DZHK), Partner Site Munich Heart Alliance, Munich, Germany
(Alvarez-Covarrubias) Hospital de Cardiologia, IMSS, Centro Medico
Nacional Siglo XXI, Cd. de Mexico, Mexico City, Mexico
(Lahmann) Facharztliche Praxis, Kardiologie Im Herzen Munchens, Tal 21,
Munich, Germany
(Mayr) Institut fur Anasthesiologie, Deutsches Herzzentrum Munchen,
Technische Universitat Munchen, Munich, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Aims: To investigate the clinical outcomes associated with an
antithrombotic therapy with or without clopidogrel after transcatheter
aortic valve replacement (TAVR). Methods and Results: This is a
study-level meta-analysis including all randomized trials investigating
antithrombotic regimens after TAVR. The protocol was registered with
PROSPERO (CRD42020191036). We searched electronic scientific databases for
eligible studies. The primary outcome was all-cause death. Main secondary
outcome was major bleeding. Other outcomes were life-threatening (or
disabling) bleeding, myocardial infarction (MI) and stroke. Six eligible
trials randomly allocated 3056 TAVR patients to aspirin or oral
anticoagulation (OAC) with clopidogrel (n = 1525) versus aspirin and/or
OAC without clopidogrel (n = 1531). In the overall estimates, an
antithrombotic therapy with clopidogrel versus without displayed a
comparable risk of all-cause death [Risk Ratio-RR = 0.83, 95% Confidence
intervals-CI (0.57-1.20); P = 0.25] and major bleeding [RR = 1.33, 95% CI
(0.61-2.92); P = 0.39]. However, the combination of aspirin or OAC with
clopidogrel doubled the risk of major bleeding as compared to aspirin or
OAC without clopidogrel [RR = 2.08, 95% CI (1.27-3.42); P = 0.015, P for
interaction = 0.021]. Treatment strategies did not differ with respect to
the risk of life-threatening bleeding, MI and stroke. Conclusion(s):
In patients receiving TAVR, a therapeutic strategy of aspirin or OAC with
clopidogrel significantly increases the risk of major bleeding without
impact on mortality and ischemic outcomes compared to aspirin or OAC
without clopidogrel. The performance of different antithrombotic regimens
in terms of long-term clinical outcomes and bioprosthesis valve function
requires further investigation. Graphic abstract: Forest plots from
pairwise and network meta-analyses associated with an antithrombotic
therapy with or without clopidogrel Risk ratio for all outcomes of
interest calculated with the pairwise meta-analysis (left side) and for
main outcomes calculated with the network meta-analysis (right side) in
patients allocated to an antithrombotic therapy with clopidogrel or
without. The diamonds indicate the point estimate and the left and the
right ends of the lines the [95% CI]. CI: Confidence intervals; OAC; oral
anticoagulation. [Figure not available: see fulltext.]. Copyright
© 2020, The Author(s).

<23>
Accession Number
635152007
Title
Psychological interventions to reduce postoperative pain and opioid
consumption: A narrative review of literature.
Source
Regional Anesthesia and Pain Medicine. 46(10) (pp 893-903), 2021. Date of
Publication: 01 Oct 2021.
Author
Gorsky K.; Black N.D.; Niazi A.; Saripella A.; Englesakis M.; Leroux T.;
Chung F.; Niazi A.U.
Institution
(Gorsky, Saripella, Niazi) Department of Anesthesia and Pain Management,
University of Toronto, Toronto, ON, Canada
(Black) Department of Anaesthesia, Belfast Health and Social Care Trust,
Belfast, United Kingdom
(Niazi) Department of Biology, Trent University, Peterborough, ON, Canada
(Englesakis) Library and Information Services, University Health Network,
Toronto, ON, Canada
(Leroux) The Arthritis Program, University Health Network, Toronto, ON,
Canada
(Chung) Anesthesia Toronto Western Hospital, University Health Network,
University of Toronto, Toronto, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Background Evidence suggests that over half of patients undergoing
surgical procedures suffer from poorly controlled postoperative pain. In
the context of an opioid epidemic, novel strategies for ameliorating
postoperative pain and reducing opioid consumption are essential.
Psychological interventions defined as strategies targeted towards
reducing stress, anxiety, negative emotions and depression via education,
therapy, behavioral modification and relaxation techniques are an emerging
approach towards these endpoints. Objective This review explores the
efficacy of psychological interventions for reducing postoperative pain
and opioid use in the acute postoperative period. Evidence review An
extensive literature search was conducted in MEDLINE, Cochrane Central
Register of Controlled Trials, Cochrane Database of Systematic Reviews,
Medline In-Process/ePubs, Embase, Ovid Emcare Nursing, and PsycINFO, Web
of Science (Clarivate), PubMed-NOT-Medline (NLM), CINAHL and ERIC, and two
trials registries, ClinicalTrials.Gov (NIH) and WHO ICTRP. Included
studies were limited to those investigating adult human subjects, and
those published in English. Findings Three distinct forms of psychological
interventions were identified: relaxation, psychoeducation and behavioral
modification therapy. Study results showed a reduction in both
postoperative opioid use and pain scores (n=5), reduction in postoperative
opioid use (n=3), reduction in postoperative pain (n=5), no significant
reduction in pain or opioid use (n=7), increase in postoperative opioid
use (n=1) and an increase in postoperative pain (n=1). Conclusion Some
preoperative psychological interventions can reduce pain scores and opioid
consumption in the acute postoperative period; however, there is a clear
need to strengthen the evidence for these interventions. The optimal
technique, strategies, timing and interface requires further
investigation. Copyright © 2021 BMJ Publishing Group. All rights
reserved.

<24>
Accession Number
2015617554
Title
Mitral and tricuspid annuloplasty ring dehiscence: A systematic review
with pooled analysis.
Source
European Journal of Cardio-thoracic Surgery. 60(4) (pp 801-810), 2021.
Date of Publication: 01 Oct 2021.
Author
Arjomandi Rad A.; Naruka V.; Vardanyan R.; Viviano A.; Salmasi M.Y.;
Magouliotis D.; Kendall S.; Casula R.; Athanasiou T.
Institution
(Arjomandi Rad, Vardanyan) Department of Medicine, Faculty of Medicine,
Imperial College London, London, United Kingdom
(Naruka, Viviano, Casula) Department of Cardiothoracic Surgery, Imperial
College Nhs Trust, Hammersmith Hospital, London, United Kingdom
(Salmasi, Athanasiou) Department of Surgery and Cancer, Imperial College
London, London, United Kingdom
(Magouliotis) Department of Surgery, Faculty of Medicine, School of Health
Sciences, University of Thessaly, Larissa, Greece
(Kendall) Department of Cardiothoracic Surgery, James Cook University
Hospital, Middlesborough, United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Mitral and tricuspid ring annuloplasty dehiscence with
consequent recurrent valve regurgitation is a rare but challenging
procedural failure. The incidence and predisposing risk factors for
annuloplasty ring dehiscence include technical and pathological ones.
 METHOD(S): A systematic database search with pooled analysis was
conducted of original articles that only included dehiscence rate of
mitral and tricuspid ring in EMBASE, MEDLINE, Cochrane database and Google
Scholar, from inception to November 2020. The outcomes included were
dehiscence rate in mitral and tricuspid, type of ring implanted,
dehiscence rate by pathology and by ring size and shape. RESULT(S):
Our search yielded 821 relevant studies. Thirty-three studies met the
inclusion criteria with a total of 10 340 patients (6543 mitral, 1414
tricuspid) of which 87 (mitral) and 30 (tricuspid) had dehiscence.
Overall, dehiscence rate was 1.43%, diagnosed at a median of 4.5 +/- 1.0
months postoperatively. A significant difference in mitral dehiscence rate
was found by ring type (semi-rigid 1.86%, rigid 2.32%; flexible 0.43%; P <
0.001). There was no significant difference in rate of dehiscence by ring
size (P = 0.067) and shape in mitral (P = 0.281) but there was higher
dehiscence rate in ischaemic compared to non-ischaemic mitral
regurgitation (3.91% vs 1.63%; P = 0.022). Among tricuspid studies, 9 of
10 studies did not report any dehiscence. CONCLUSION(S): Although
rigid, semi-rigid and flexible annuloplasty rings provide acceptable valve
repair outcomes, mitral annuloplasty ring dehiscence is clinically more
common among rigid rings. Understanding the multifactorial nature of ring
dehiscence will help in identifying the patients at high risk and improve
their clinical outcomes. Copyright © 2021 The Author(s).
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery.

<25>
Accession Number
2010082656
Title
Percutaneous Coronary Intervention With Drug Eluting Stents Versus
Coronary Artery Bypass Graft Surgery in Patients With Advanced Chronic
Kidney Disease: A Systematic Review and Meta-Analysis.
Source
Seminars in Thoracic and Cardiovascular Surgery. 33(4) (pp 958-969), 2021.
Date of Publication: Winter 2021.
Author
Doulamis I.P.; Tzani A.; Tzoumas A.; Iliopoulos D.C.; Kampaktsis P.N.;
Briasoulis A.
Institution
(Doulamis) Department of Cardiac Surgery, Boston Children's Hospital,
Harvard Medical School, Boston, MA, United States
(Tzani) Brigham and Women's Hospital Heart and Vascular Center, Harvard
Medical School, Boston, MA, United States
(Tzoumas) Medical School, Aristotle University of Thessaloniki,
Thessaloniki, Greece
(Iliopoulos) Department of Cardiothoracic Surgery, Hygeia Medical Center,
Athens, Greece
(Kampaktsis) Division of Cardiology, New York University Langone Medical
Center, New York, NY, United States
(Briasoulis) University of Iowa Hospitals and Clinics, Iowa City, IA,
United States
Publisher
W.B. Saunders
Abstract
Tomicron perform a systematic review and meta-analysis of the available
literature comparing safety and efficacy outcomes between percutaneous
coronary intervention (PCI) with drug-eluting stents (DES) and coronary
artery bypass grafting (CABG) in patients with chronic kidney disease
(CKD). Eligible studies included patients with eGFR < 60 mL/min/1.73
m2 that underwent revascularization. Subgroup analyses
according to DES generation and dialysis status were performed. A total of
7157 and 8156 patients were included in the CABG and PCI arms respectively
across 16 studies eligible studies. Weighted mean age was 68.6 and 63.8
years for the CABG and PCI arms, respectively. Mean follow-up time was 3.2
and 2.9 years respectively. Compared to CABG, PCI was associated with
increased risk for all-cause mortality (hazard ratio [HR]: 1.28, 95%
confidence interval [CI]: 1.13, 1.46; P < 0.01), cardiac mortality (HR:
1.59, 95% CI: 1.13, 2.23; P = 0.01), myocardial infarction (MI) (HR: 1.89,
95% CI: 1.43, 2.49; P < 0.01), and repeat revascularization (HR: 2.97, 95%
CI: 2.20, 3.97; P < 0.01). Risk for stroke was lower (HR: 0.64, 95% CI:
0.50, 0,81; P < 0.01) in the PCI group. These results were unchanged when
1st or 2nd DES were used. A subgroup analysis showed no difference in
all-cause mortality for DES PCI vs CABG in dialysis patients (HR: 1.11,
95% CI: 0.71, 1.73; P = 0.65). In patients with CKD, PCI is associated
with higher risk of mortality, MI, and repeat revascularization compared
with CABG and regardless of DES generation. Risk of stroke is higher with
CABG. Type of revascularization had no impact on survival of dialysis
patients. Copyright © 2020 Elsevier Inc.

<26>
Accession Number
2013627977
Title
Efficacy and safety of dexmedetomidine in maintaining hemodynamic
stability in pediatric cardiac surgery: a systematic review and
meta-analysis.
Source
Jornal de Pediatria. 98(1) (pp 15-25), 2022. Date of Publication: 01 Jan
2022.
Author
Wang Q.; Chen C.; Wang L.
Institution
(Wang, Chen) Hainan Women and Children's Medical Center, Department of
Anesthesiology, Haikou, China
(Wang) The First Hospital of Hebei Medical University, Department of
Anesthesiology, Shijiazhuang, China
Publisher
Elsevier Editora Ltda
Abstract
Objectives: Dexmedetomidine (DEX) is a highly selective alpha-2 adrenergic
receptor agonist, which is the main sedative in the intensive care unit.
This study aims to investigate the effectiveness and adverse events of DEX
in maintaining hemodynamic stability in pediatric cardiac surgery.
Sources: Databases such as PubMed, Cochrane, Web of Science, WANFANG STATA
and China National Knowledge Infrastructure were searched for articles
about the application of DEX in maintaining hemodynamic stability during
and after pediatric cardiac surgery up to 18th Feb. 2021. Only randomized
controlled trials were included and random-effects model meta-analysis was
applied to calculate the standardized mean deviation (SMD), odds ratio
(OR) and 95% confidence interval (CI). Summary of the findings: Fifteen
articles were included for this meta-analysis, and 9 articles for
qualitative analysis. The results showed that preoperative prophylaxis and
postoperative recovery of DEX in pediatric patients undergoing cardiac
surgery were effective in maintaining systolic blood pressure (SBP), mean
arterial pressure (MAP), diastolic blood pressure (DBP) and reducing heart
rate (HR) (SBP: SMD = -0.35,95% CI: -0.72, 0.01; MAP: SMD = -0.83, 95% CI:
-1.87,0.21; DBP: SMD = -0.79,95% CI: -1.66,0.08; HR: SMD = -1.71,95% CI:
-2.29, -1.13). In addition, the frequency of Junctional Ectopic
Tachycardia in the DEX treatment group was lower than that in the placebo
group. Conclusion(s): The application of DEX for preoperative
prophylaxis and postoperative recovery in pediatric cardiac surgery
patients are effective in maintaining hemodynamic stability, and the
clinical dose of DEX is not significantly related to the occurrence of
pediatric adverse events which may be related to individual
differences. Copyright © 2021 Sociedade Brasileira de Pediatria

<27>
Accession Number
2015209915
Title
Rationale and design of the SMall Annuli Randomized To Evolut or SAPIEN
Trial (SMART Trial).
Source
American Heart Journal. 243 (pp 92-102), 2022. Date of Publication:
January 2022.
Author
Herrmann H.C.; Abdel-Wahab M.; Attizzani G.F.; Batchelor W.; Bleiziffer
S.; Verdoliva S.; Chang Y.; Gada H.; Gillam L.; Guerrero M.; Mahoney P.D.;
Petronio A.S.; Rogers T.; Rovin J.; Szerlip M.; Whisenant B.; Mehran R.;
Tchetche D.
Institution
(Herrmann) Perelman School of Medicine at the University of Pennsylvania,
Philadelphia, PA
(Abdel-Wahab) Heart Center Leipzig at the University of Leipzig, Leipzig,
Germany
(Attizzani) University Hospitals of Cleveland, Cleveland, OH
(Batchelor) Inova Heart and Vascular Institute, Falls Church, VA, United
States
(Bleiziffer) Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Germany
(Verdoliva, Chang) Medtronic, Mounds View, MN, United States
(Gada) UPMC Harrisburg, Harrisburg, PA
(Gillam) Morristown Medical Center/Atlantic Health System, Morristown, NJ,
United States
(Guerrero) Mayo Clinic, Rochester, MN
(Mahoney) Sentara Healthcare, Norfolk, VA
(Petronio) Universita di Pisa, Ospedale di Cisanello Pisa, Italy
(Rogers) MedStar Washington Hospital Center, DC, Washington
(Rogers) National Institutes of Health, Bethesda, MD
(Rovin) BayCare Health System/Morton Plant Hospital, Clearwater, FL
(Szerlip) Baylor Scott and White Heart Hospital, Plano, TX
(Whisenant) Intermountain Medical Center, Murray, UT
(Mehran) Mount Sinai School of Medicine, New York, NY
(Tchetche) Clinique Pasteur, Toulouse, France
Publisher
Elsevier Inc.
Abstract
Background: The SMall Annuli Randomized To Evolut or SAPIEN (SMART) Trial
was designed to compare the performance of the two most widely available
commercial transcatheter aortic valve replacement (TAVR) devices in
patients with symptomatic severe native aortic stenosis with a small
aortic valve annulus undergoing transfemoral TAVR. Patients with small
aortic valve annuli are typically female and are often underrepresented in
clinical trials. Method(s): The SMART Trial is an international,
prospective, multi-center, randomized controlled, post-market trial. The
trial will be conducted in approximately 700 subjects at approximately 90
sites globally. Inclusion criteria include severe aortic stenosis, aortic
valve annulus area of <=430 mm2 based on multi-detector
computed tomography, and appropriate anatomy for both the Medtronic Evolut
PRO/PRO+ self-expanding and Edwards SAPIEN 3/3 Ultra balloon-expandable
devices. The primary clinical outcome composite endpoint is defined as
mortality, disabling stroke or heart failure rehospitalization at 12
months. The co-primary valve function composite endpoint is defined as
bioprosthetic valve dysfunction at 12 months which includes hemodynamic
structural valve dysfunction, defined as a mean gradient >=20 mmHg,
non-structural valve dysfunction, defined as severe prothesis-patient
mismatch or >=moderate aortic regurgitation, thrombosis, endocarditis, and
aortic valve re-intervention. Powered secondary endpoints will be assessed
hierarchically. Conclusion(s): The SMART trial will be the largest
head-to-head comparative trial of transfemoral TAVR using the two most
widely available contemporary TAVR devices in the setting of small aortic
annuli and the largest trial to enroll primarily women. Clinical trial
registration: URL: www.clinicaltrials.gov, Unique identifier:
NCT04722250. Copyright © 2021 Elsevier Inc.

<28>
Accession Number
2016562522
Title
Rationale and design of a randomized trial evaluating an external support
device for saphenous vein coronary grafts.
Source
American Heart Journal. 246 (pp 12-20), 2022. Date of Publication: April
2022.
Author
Bagiella E.; Puskas J.D.; Moskowitz A.J.; Gelijns A.C.; Alexander J.H.;
Narula J.; Smith P.K.; Hutcheson K.; Chang H.L.; Gammie J.S.; Iribarne A.;
Marks M.E.; Vengrenyuk Y.; Yasumura K.; Raymond S.; Taylor B.S.; Yarden
O.; Orion E.; Dagenais F.; Ailawadi G.; Chu M.W.A.; Gupta L.; Levitan
R.G.; Williams J.B.; Crestanello J.A.; Jessup M.; Rose E.A.; Scavo V.;
Acker M.A.; Gillinov M.; O'Gara P.T.; Voisine P.; Mack M.J.; Goldstein
D.J.
Institution
(Bagiella, Moskowitz, Gelijns, Chang, Marks, Raymond, Gupta, Levitan,
Rose) Department of Population Health Science and Policy, Icahn School of
Medicine at Mount Sinai, New York, NY
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Morningside,
New York, NY
(Alexander, Smith) Department of Surgery, Division of Cardiovascular and
Thoracic Surgery, Duke University Medical Center, Durham, NC
(Narula) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New
York, NY
(Hutcheson, Mack) Cardiothoracic Surgery, Baylor Scott & White Health,
Plano, TX
(Gammie) Johns Hopkins Heart and Vascular Institute, Johns Hopkins Health
System, Baltimore, MD
(Iribarne) Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center,
Lebanon, NH
(Vengrenyuk, Yasumura) Division of Cardiology, Mount Sinai Hospital and
Icahn School of Medicine at Mount Sinai, New York, NY
(Taylor) Division of Cardiac Surgery, University of Maryland School of
Medicine, Baltimore, MD
(Yarden, Orion) Vascular Graft Solutions Ltd., Tel Aviv, Israel
(Dagenais, Voisine) Department of Surgery, Institut de Cardiologie et
Pneumologie de Quebec, Quebec City, Quebec, Canada
(Ailawadi) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
(Chu) Division of Cardiac Surgery, Western University, London Health
Sciences Centre, London, Ontario, Canada
(Williams) Cardiovascular Surgery, WakeMed Health and Hospitals, Raleigh,
NC
(Crestanello) Department of Cardiovascular Surgery, Mayo Clinic,
Rochester, MN
(Jessup) American Heart Association, Dallas, TX
(Scavo) Cardiovascular and Thoracic Surgery, Lutheran Medical Group, Fort
Wayne, IN, United States
(Acker) Division of Cardiovascular Surgery, University of Pennsylvania,
Hospital of the University of Pennsylvania, Philadelphia, PA
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH
(O'Gara) Cardiovascular Division, Brigham and Women's Hospital, Boston, MA
(Goldstein) Department of Cardiovascular and Thoracic Surgery, Montefiore
Medical Center, Bronx, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Coronary artery bypass grafting (CABG) is the most common
revascularization approach for the treatment of multi-vessel coronary
artery disease. While the internal mammary artery is nearly universally
used to bypass the left anterior descending coronary artery, autologous
saphenous vein grafts (SVGs) are still the most frequently used conduits
to grafts the remaining coronary artery targets. Long-term failure of
these grafts, however, continues to limit the benefits of surgery.
 Method(s): The Cardiothoracic Surgical Trials Network trial of the
safety and effectiveness of a Venous External Support (VEST) device is a
randomized, multicenter, within-patient trial comparing VEST-supported
versus unsupported saphenous vein grafts in patients undergoing CABG. Key
inclusion criteria are the need for CABG with a planned internal mammary
artery to the left anterior descending and two or more saphenous vein
grafts to other coronary arteries. The primary efficacy endpoint of the
trial is SVG intimal hyperplasia (plaque + media) area assessed by
intravascular ultrasound at 12 months post randomization. Occluded grafts
are accounted for in the analysis of the primary endpoint. Secondary
confirmatory endpoints are lumen diameter uniformity and graft failure
(>50% stenosis) assessed by coronary angiography at 12 months. The safety
endpoints are the occurrence of major adverse cardiac and cerebrovascular
events and hospitalization within 5 years from randomization.
 Conclusion(s): The results of the VEST trial will determine whether
the VEST device can safely limit SVG intimal hyperplasia in patients
undergoing CABG as treatment for coronary atherosclerotic
disease. Copyright © 2021 Elsevier Inc.

<29>
[Use Link to view the full text]
Accession Number
2016509269
Title
Effect of Perioperative Intravenous Iron Supplementation for Complex
Cardiac Surgery on Transfusion Requirements: A Randomized, Double-blinded
Placebo-controlled Trial.
Source
Annals of Surgery. 275(2) (pp 232-239), 2022. Date of Publication: 01 Feb
2022.
Author
Song J.W.; Soh S.; Shim J.-K.; Lee S.; Lee S.H.; Kim H.B.; Kim M.-Y.; Kwak
Y.L.
Institution
(Song, Soh, Shim, Kim, Kim, Kwak) Department of Anesthesiology and Pain
Medicine, Seoul, South Korea
(Song, Soh, Shim, Kim, Kwak) Anesthesia and Pain Research Institute,
Seoul, South Korea
(Lee, Lee) Department of Thoracic and Cardiovascular Surgery, Yonsei
University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, South
Korea
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives:We investigated whether routine perioperative intravenous iron
replenishment reduces the requirement for packed erythrocytes (pRBC)
transfusion.Summary of Background Data:Patients undergoing complex cardiac
surgery are at high risk of developing postoperative iron deficiency
anemia, thus requiring transfusion, which is associated with adverse
outcomes. Method(s):Patients were randomized to receive either ferric
derisomaltose 20 mg/kg (n = 103) or placebo (n = 101) twice during the
perioperative period: 3 days before and after the surgery. The primary
endpoint was the proportion of patients who received pRBC transfusion
until postoperative day (POD) 10. Hemoglobin, reticulocyte count, serum
iron profile, hepcidin, and erythropoietin were serially measured.
 Result(s):pRBC was transfused in 60.4% and 57.2% of patients in the
control and iron group, respectively (P = 0.651). Hemoglobin concentration
at 3 weeks postoperatively was higher in the iron group than in the
control group (11.6 +/- 1.5 g/dL vs 10.9 +/- 1.4 g/dL, P < 0.001). The
iron group showed higher reticulocyte count [205
(150-267)x103/muL vs 164 (122-207)x103/muL, P =
0.003] at POD 10. Transferrin saturation and serum ferritin were
significantly increased in the iron group than in the control group (P <
0.001). Serum hepcidin was higher in the iron group than in the control
group at POD 3 [106.3 (42.9-115.9) ng/mL vs 39.3 (33.3-43.6) ng/mL, P <
0.001]. Erythropoietin concentration increased postoperatively in both
groups (P = 0.003), with no between-group difference.
 Conclusion(s):Intravenous iron supplementation during index
hospitalization for complex cardiac surgery did not minimize pRBC
transfusion despite replenished iron store and augmented erythropoiesis,
which may be attributed to enhanced hepcidin expression. Copyright
© 2022 Lippincott Williams and Wilkins. All rights reserved.

<30>
Accession Number
2016559805
Title
Effect of Pentoxifylline on Claudication Distances And Lipid Profile In
Patients With Occlusive Peripheral Arterial Disease.
Source
JK Practitioner. 26(2) (pp 44-51), 2021. Date of Publication: April 2021.
Author
Singh S.; Singh G.
Institution
(Singh) Department of Clinical Pharmacology, SKIMS, Srinagar, India
(Singh) Department of Cardiothoracic and Vascular surgery, GMC Jammu,
India
Publisher
JK Practitioner
Abstract
Objective: To study the efficacy and tolerability of pentoxifylline in
patients with moderately severe peripheral arterial disease.
 Method(s): This is a prospective, randomized, open-label, parallel
study conducted at the Postgraduate Department of Pharmacology and
Therapeutics in collaboration with Cardiothoracic and Vascular Surgery
department Govt. Medical College Jammu for a period of one year. After
fulfilling the eligibility criteria, patients were divided into groups
after proper randomization; one group was administered tablet
pentoxifylline 400mg three times a day whereas another was assigned
matched tablet of placebo. Clinical evaluation was carried out by complete
history, general physical examination, systemic examination, baseline
investigations and lipid profile. Special investigations like color
Doppler study and angiography of lower limb vessels was also done.
Patients were followed up at every 2, 4, 6, 8, 10 and 12 weeks.
 Result(s): Out of 51 patients, 26 were administered pentoxifylline
400mg three times a day and 25 were administered placebo. Pentoxifyllne
significantly raised both initial as well as absolute claudication
distances, which remained well sustained throughout all the weeks of
follow up, whereas, placebo raised the claudication distances for initial
few weeks, but decreased it below the baseline subsequently. There was
almost no statistically significant difference between patient's
assessment and physician's assessment between two groups, and except for
pharyngitis, which was significantly more in pentoxifylline treated
patients, there was no significant difference in other side effects
between two groups. Conclusion(s): Pentoxifylline can be an effective
treatment for patients of peripheral arterial disease with claudication.
However, long term controlled randomized trials on large scale are
recommended to further substantiate our findings. Copyright ©
2021 JK Practitioner. All rights reserved.

<31>
Accession Number
2014763658
Title
Hematinic and Iron Optimization in Peri-operative Anemia and Iron
Deficiency.
Source
Current Anesthesiology Reports. (no pagination), 2022. Date of
Publication: 2022.
Author
Miles L.F.; Richards T.
Institution
(Miles) Department of Critical Care, Faculty of Medicine, Dentistry and
Health Sciences, The University of Melbourne, Melbourne, Australia
(Miles) Department of Anaesthesia, Austin Health, Melbourne, Australia
(Miles, Richards) Division of Surgery, Faculty of Health and Medical
Science, The University of Western Australia, Perth, Australia
Publisher
Springer
Abstract
Purpose of Review: Preoperative anemia is independently associated with
worse postoperative outcomes following cardiac and noncardiac surgery.
This article explores the current understanding of perioperative anemia
and iron deficiency with reference to definition, diagnosis, and
treatment. Recent Findings: Iron deficiency is the most common cause of
anemia. It can arise from reduced iron intake, poor absorption, or excess
iron loss. Inflammation throughout the preoperative period can drive iron
sequestration, leading to a functional deficiency of iron and the
development of what was referred to until recently as the "anemia of
chronic disease." Current best practice guidance supports the routine
administration of preoperative intravenous iron to treat anemia despite
limited evidence. This "one size fits all" approach has been called into
question following results from a recent large, randomized trial (the
PREVENTT trial) that assessed the use of a single dose of intravenous iron
compared to placebo 10-42 days before major abdominal surgery. Although
there were no improvements in patient-centered outcomes apparent during
the initial hospital stay, secondary endpoints of this trial suggested
there may be some late benefit after discharge from the hospital (8 weeks
postoperatively). This trial raises questions on (1) the mechanisms of
iron deficiency in the perioperative patient; (2) the need to reassess our
opinions on generic anemia management; and (3) the need to address patient
outcomes after discharge from hospital. Summary: Despite the known
associations between preoperative anemia (particularly iron deficiency
anemia) and poor postoperative outcome, recent evidence suggests that
administering intravenous iron relatively close to surgery does not yield
a tangible short-term benefit. This is made more complex by the interplay
between iron and innate immunity. Iron deficiency irrespective of
hemoglobin concentration may also impact postoperative outcomes.
Therefore, further research into associations between iron deficiency and
postoperative outcomes, and between postoperative anemia, delayed outcomes
(hospital readmission), and the efficacy of postoperative intravenous iron
is required. Copyright © 2022, The Author(s).

<32>
Accession Number
636993780
Title
Letter on Incidence and prognosis of COVID-19 amongst heart transplant
recipients: a systematic review and meta-analysis.
Source
European journal of preventive cardiology. (no pagination), 2022. Date of
Publication: 04 Jan 2022.
Author
Shoar S.
Institution
(Shoar) Department of Clinical Research, TX, 7900 Cambridge Street,
Houston
Publisher
NLM (Medline)

<33>
Accession Number
2016536933
Title
Heart transplantation in systemic lupus erythematosus: A case report and
meta-analysis.
Source
Heart and Lung. (no pagination), 2022. Date of Publication: 2022.
Author
Chapa J.J.; Ilonze O.J.; Guglin M.E.; Rao R.A.
Institution
(Chapa) Indiana University School of Medicine, Department of Medicine
(Ilonze, Guglin, Rao) Indiana University School of Medicine, Department of
Medicine, Division of Cardiology
Publisher
Elsevier Inc.
Abstract
Cardiac involvement in Systemic Lupus Erythematosus can present as end
stage heart failure necessitating orthotopic heart transplantation. Most
transplant centers regard Lupus as a contraindication to transplant due to
risk of disease recurrence in the transplanted organ. Limited reports of
heart transplant in Lupus exist in the literature. Herein, we aim to
report on the successful transplant and long-term survival of a
24-year-old woman with Lupus and biventricular heart failure. Given the
rarity of transplant in Lupus, we also conducted a meta-analysis of
reported cases in the literature to assess post-transplant outcomes and
evaluate immunosuppression strategies. Our case underlines the feasibility
of transplant in Lupus patients, outlines a detailed immunosuppression
strategy and favorable long-term outcome to guide centers contemplating
such transplants. The long-term survival of our patient, together with
review of the thirteen previously described cases, supports that
orthotopic heart transplantation can be considered in select patients with
Systemic Lupus Erythematosus. Copyright © 2022 Elsevier Inc.

<34>
Accession Number
2014782537
Title
Conventional Versus Minimally Invasive Aortic Valve Replacement Surgery: A
Systematic Review, Meta-Analysis, and Meta-Regression.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2022. Date of Publication: 2022.
Author
Almeida A.S.; Ceron R.O.; Anschau F.; de Oliveira J.B.; Leao Neto T.C.;
Rode J.; Rey R.A.W.; Lira K.B.; Delvaux R.S.; de Souza R.O.R.R.
Institution
(Almeida, de Oliveira, Leao Neto, de Souza) Postgraduate Studies Program
in Minimally Invasive Cardiovascular Surgery, Goiania, Brazil
(Almeida, Ceron, Anschau, Rode, Rey, Lira, Delvaux) Cardiothoracic Surgery
Division, Hospital Nossa Senhora da Conceicao, Grupo Hospitalar Conceicao,
Porto Alegre, Brazil
(Almeida, Anschau) Health Technology Assessment Center (NATS), Grupo
Hospitalar Conceicao, Porto Alegre, Brazil
(Anschau) Postgraduate Program in Technology Assessment for SUS
(PPGATSUS/GHC), Grupo Hospitalar Conceicao, Porto Alegre, Brazil
(de Oliveira, Leao Neto, de Souza) Cardiothoracic Surgery Division,
Hospital Ruy Azeredo, Goiania, Brazil
Publisher
SAGE Publications Ltd
Abstract
Objective: To assess the potential benefits of minimally invasive aortic
valve replacement (MIAVR) compared with conventional AVR (CAVR) by
examining short-term outcomes. Method(s): A systematic search
identified randomized trials comparing MIAVR with CAVR. To assess study
limitations and quality of evidence, we used the Cochrane Risk of Bias
tool and GRADE and performed random-effects meta-analysis. We used
meta-regression and sensitivity analysis to explore reasons for diversity.
 Result(s): Thirteen studies (1,303 patients) were included. For the
comparison of MIAVR and CAVR, the risk of bias was judged low or unclear
and the quality of evidence ranged from very low to moderate. No
significant difference was observed in mortality, stroke, acute kidney
failure, infectious outcomes, cardiac events, intubation time, intensive
care unit stay, reoperation for bleeding, and blood transfusions. Blood
loss (mean difference [MD] = -130.58 mL, 95% confidence interval [CI] =
-216.34 to -44.82, I2 = 89%) and hospital stay (MD = -0.93
days, 95% CI = -1.62 to -0.23, I2 = 81%) were lower with MIAVR.
There were shorter aortic cross-clamp (MD = 5.99 min, 95% CI = 0.99 to
10.98, I2 = 93%) and cardiopulmonary bypass (CPB) times (MD =
7.75 min, 95% CI = 0.27 to 15.24, I2 = 94%) in the CAVR group.
In meta-regression analysis, we found that age was the variable with the
greatest influence on heterogeneity. Conclusion(s): MIAVR seems to be
an excellent alternative to CAVR, reducing hospital stay and incidence of
hemorrhagic events. Despite significantly greater aortic cross-clamp and
CPB times with MIAVR, this did not translate into adverse effects, with no
changes in the results found with CAVR. Copyright © The Author(s)
2022.

<35>
Accession Number
2014782427
Title
Narrative review of the systemic inflammatory reaction to cardiac surgery
and cardiopulmonary bypass.
Source
Artificial Organs. (no pagination), 2022. Date of Publication: 2022.
Author
Squiccimarro E.; Stasi A.; Lorusso R.; Paparella D.
Institution
(Squiccimarro, Paparella) Division of Cardiac Surgery, Department of
Medical and Surgical Sciences, University of Foggia, Foggia, Italy
(Squiccimarro, Lorusso) Cardio-Thoracic Surgery Department, Heart &
Vascular Centre, Maastricht University Medical Centre, Maastricht,
Netherlands
(Stasi) Department of Emergency and Organ Transplantation, University of
Bari, Bari, Italy
(Lorusso) Cardiovascular Research Institute Maastricht, Maastricht,
Netherlands
(Paparella) Division of Cardiac Surgery, Santa Maria Hospital, GVM Care &
Research, Bari, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Data from large cardiac surgery registries have been depicting
a downward trend of mortality and morbidities in the last 20 years.
However, despite decades of medical evolution, cardiac surgery and
cardiopulmonary bypass still provoke a systemic inflammatory response,
which occasionally leads to worsened outcome. This article seeks to
outline the mechanism of the phenomenon. Method(s): A thorough review
of the literature has been performed. Criteria for considering studies for
this non-systematic review were as follows: observational and
interventional studies investigating the systemic inflammatory response to
cardiac surgery, experimental studies describing relevant molecular
mechanisms, and essential review studies pertinent to the topic.
 Result(s): The intrinsic variability of the inflammatory response to
cardiac surgery, together with its heterogenous perception among
clinicians, as well as the arduousness to early discriminate
high-responder patients from those who will not develop a clinically
relevant reaction, concurred to hitherto unconclusive randomized
controlled trials. Furthermore, peremptory knowledge about the
pathophysiology of maladaptive inflammation following heart surgery is
still lacking. Conclusion(s): Systemic inflammation following cardiac
surgery is a frequent entity that occasionally becomes clinically
relevant. Specific genomic differences, age, and other preoperative
factors influence the magnitude of the response, which elements display
extreme redundancy and pleiotropism that the target of a single pathway
cannot represent a silver bullet. Copyright © 2022 The Authors.
Artificial Organs published by International Center for Artificial Organ
and Transplantation (ICAOT) and Wiley Periodicals LLC

<36>
Accession Number
636992871
Title
Ivabradine and Atrial Fibrillation: A Meta-analysis of Randomized
Controlled Trials.
Source
Journal of cardiovascular pharmacology. (no pagination), 2021. Date of
Publication: 27 Dec 2021.
Author
Wang Z.; Wang W.; Li H.; Zhang A.; Han Y.; Wang J.; Hou Y.
Institution
(Wang) Department of Cardiology, PR China. Cheeloo College of Medicine,
Shandong University, PR China. Department of Pharmacy, First Affiliated
Hospital of Shandong First Medical &Shandong Provincial Qianfoshan
Hospital, Shandong Province, Jinan, China
Publisher
NLM (Medline)
Abstract
ABSTRACT: This was a meta-analysis of randomized control trials (RCTs) to
evaluate the effect of ivabradine on the risk of atrial fibrillation (AF)
as well as its effect on the ventricular rate in patients with AF. The
PubMed, EMBASE, Cochrane Controlled Trials Register, and other databases
were searched for RCTs of ivabradine. Thirteen trials with 37,533 patients
met the inclusion criteria. The incidence of AF was significantly higher
in the ivabradine treatment group than in the control group (odds ratio
(OR), 1.23; 95% confidence interval (CI), 1.08-1.41), although it was
reduced after cardiac surgery (OR, 0.70; 95% CI, 0.23-2.12). Regarding
left ventricular ejection fraction (LVEF), ivabradine increased the risk
of AF in both LVEF >40% (OR, 1.42; 95% CI, 1.24 to 1.63) and LVEF <=40%
subgroups (OR, 1.16; 95% CI, 0.98-1.37). The risk of AF was increased by
both small and large cumulative doses of ivabradine (small cumulative
dose: OR, 3.00; 95% CI, 0.48 to 18.93; large cumulative dose: OR, 1.05;
95% CI, 0.83-1.34). Furthermore, ivabradine may reduce the ventricular
rate in patients with AF. In conclusion, we found that both large and
small cumulative doses of ivabradine were associated with an increased
incidence of AF, and the effect was more marked in the LVEF >40% subgroup.
Nevertheless, ivabradine therapy is beneficial for the prevention of
post-operative AF. Furthermore, ivabradine may be effective in controlling
the ventricular rate in patients with AF, although more RCTs are needed to
support this conclusion. Copyright © 2022 Wolters Kluwer Health,
Inc. All rights reserved.

<37>
Accession Number
636995880
Title
Topical Vancomycin and Risk of Sternal Wound Infections: A Double-Blind
Randomized Controlled Trial.
Source
The Annals of thoracic surgery. (no pagination), 2021. Date of
Publication: 09 Dec 2021.
Author
Servito M.; Khani-Hanjani A.; Smith K.-M.; Tsuyuki R.T.; Mullen J.C.
Institution
(Servito) School of Medicine, Queen's University, ON, Kingston, Canada
(Khani-Hanjani) Division of Cardiac Surgery, Royal University Hospital,
University of Saskatchewan, Saskatoon, Canada
(Smith, Mullen) Division of Cardiac Surgery, Faculty of Medicine and
Dentistry, University of Alberta, AB, Edmonton, Canada
(Tsuyuki) Departments of Pharmacology and Medicine (Cardiology), Faculty
of Medicine and Dentistry, University of Alberta, AB, Edmonton, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: The use of topical vancomycin in the reduction of sternal
wound infection (SWI) risk has become a point of contention. Prior
literature consists of only observational studies and one unblinded trial.
Hence, our objective was to assess whether vancomycin reduces the
incidence of SWI in a double-blind randomized controlled trial.
 METHOD(S): Patients were randomized 1:1 to either vancomycin-soaked
(vancomycin) or saline-soaked (control) sponges. The sponges were applied
once the sternum was opened and were removed just prior to sternal
closure. Patients were followed at three months and one-year
post-operatively to determine the incidence of SWI in each group. Results
were analyzed according to the modified intention-to-treat principle.
 RESULT(S): We assessed 1038 patients for eligibility and enrolled
1037 patients. There were 517 patients randomized to the vancomycin group,
and 520 patients to the control group. Analysis was performed on 1021
patients. At three months post-operatively, there was no significant
difference in the incidence of SWI between the vancomycin and control
groups (2.7% vs 4.1%, p = 0.23). There was also no significant difference
between the vancomycin and control groups in the risk of superficial,
deep, and organ-space infections. Similar findings were observed one-year
post-operatively. The most common organism isolated was Coagulase-negative
Staphylococci. CONCLUSION(S): The use of vancomycin applied to the
sternum during cardiac surgery does not reduce the incidence of SWI.
[NCT02374853]. Copyright © 2021 The Society of Thoracic Surgeons.
Published by Elsevier Inc. All rights reserved.

<38>
Accession Number
2016352076
Title
Impact of procedural variability and study design quality on the efficacy
of cell-based therapies for heart failure - a meta-analysis.
Source
PLoS ONE. 17(1 January) (no pagination), 2022. Article Number: e0261462.
Date of Publication: January 2022.
Author
Xu Z.; Neuber S.; Nazari-Shafti T.; Liu Z.; Dong F.; Stamm C.
Institution
(Xu, Neuber, Nazari-Shafti, Liu, Stamm) Berlin Institute of Health Center
for Regenerative Therapies, Charite-Universitatsmedizin Berlin, Berlin,
Germany
(Neuber, Nazari-Shafti, Stamm) Department of Cardiothoracic and Vascular
Surgery, German Heart Center Berlin, Berlin, Germany
(Neuber, Nazari-Shafti, Stamm) German Centre for Cardiovascular Research,
Partner Site Berlin, Berlin, Germany
(Nazari-Shafti) Berlin Institute of Health at Charite, Universitatsmedizin
Berlin, Berlin, Germany
(Dong) Department of Cardiology, Shenzhen University General Hospital,
Guangdong, Shenzhen, China
(Stamm) Helmholtz Zentrum Geesthacht, Institut fur Aktive Polymere,
Teltow, Germany
Publisher
Public Library of Science
Abstract
Background Cell-based therapy has long been considered a promising
strategy for the treatment of heart failure (HF). However, its
effectiveness in the clinical setting is now doubted. Because previous
meta-analyses provided conflicting results, we sought to review all
available data focusing on cell type and trial design. Methods and
findings The electronic databases PubMed, Cochrane library,
ClinicalTrials.gov, and EudraCT were searched for randomized controlled
trials (RCTs) utilizing cell therapy for HF patients from January 1, 2000
to December 31, 2020. Forty-three RCTs with 2855 participants were
identified. The quality of the reported study design was assessed by
evaluating the risk-of-bias (ROB). Primary outcomes were defined as
mortality rate and left ventricular ejection fraction (LVEF) change from
baseline. Secondary outcomes included both heart function data and
clinical symptoms/events. Between-study heterogeneity was assessed using
the I2 index. Subgroup analysis was performed based on HF type, cell
source, cell origin, cell type, cell processing, type of surgical
intervention, cell delivery routes, cell dose, and follow-up duration.
Only 10 of the 43 studies had a low ROB for all method- and outcome
parameters. A higher ROB was associated with a greater increase in LVEF.
Overall, there was no impact on mortality for up to 12 months follow-up,
and a clinically irrelevant average LVEF increase by LVEF (2.4%, 95% CI =
0.75-4.05, p = 0.004). Freshly isolated, primary cells tended to produce
better outcomes than cultured cell products, but there was no clear impact
of the cell source tissue, bone marrow cell phenotype or cell chricdose
(raw or normalized for CD34+ cells). A meaningful increase in LVEF was
only observed when cell therapy was combined with myocardial
revascularization. Conclusions The published results suggest a small
increase in LVEF following cell therapy for heart failure, but publication
bias and methodologic shortcomings need to be taken into account. Given
that cardiac cell therapy has now been pursued for 20 years without real
progress, further efforts should not be made. Study registry number This
meta-analysis is registered at the international prospective register of
systematic reviews, number CRD42019118872. Copyright: © 2022 Xu
et al. This is an open access article distributed under the terms of the
Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author
and source are credited.

<39>
Accession Number
2015294470
Title
The Effect of Open Lung Ventilation on Respiratory Mechanics,
Postoperative Organ Function, and Inflammatory Mediators in Coronary
Artery Bypass Surgery.
Source
Journal of Advances in Medical and Biomedical Research. 30(138) (pp
12-16), 2022. Date of Publication: January-February 2022.
Author
Kashani S.S.; Rokhtabnak F.; Ghodraty M.R.; Zamani M.M.; Kiaee M.M.;
Ghorbanlo M.; Movassaghi S.; Derakhshan P.
Institution
(Kashani, Kiaee, Movassaghi, Derakhshan) Dept. of Anesthesiology, Rasoul
Akram Hospital, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Rokhtabnak, Ghodraty) Dept. of Anesthesiology, Firoozgar Hospital, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Zamani) Exceptional Talent Development Center (EDTC), Tehran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Zamani, Ghorbanlo) Dept. of Anesthesiology, School of Medicine, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Zamani, Ghorbanlo) Hasheminejad Kidney Center (HKC), Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Zanjan University of Medical Sciences and Health Services
Abstract
Background & Objective: The present study aimed to assess the supportive
role of open lung ventilation on respiratory mechanics, the rate of
oxygenation, inflammatory biomarkers, and probable liver or renal injuries
following coronary artery bypass grafting surgery. Material(s) and
Method(s): This randomized double-blinded clinical trial study was
conducted on 64 candidates for coronary artery bypass surgery using a
cardiopulmonary pump. The patients were randomly categorized into the
Positive end-expiratory pressure (PEEP) group (n = 32) or Zero End
Expiratory Pressure (ZEEP) group (n = 32). Result(s): Interleukin-6
levels were similar between the PEEP and ZEEP groups before surgery (p =
0.18) and were significantly higher in the ZEEP group after pump insertion
(p = 0.005). On the contrary, the levels of Interleukin-6 were
significantly higher in the PEEP group after extubation (p = 0.001). The
Between-group analysis also showed a significant difference between the
levels of interleukin-6 in the ZEEP and PEEP groups, representing a
greater increase in the PEEP group (p < 0.001). There was no difference in
certain hemodynamic parameters, including heart rate, mean blood pressure,
mean CO2 pressure (PCO2), mean concentration of HCO3, and base excess. The
mean arterial O2 saturation was higher overall in the PEEP group compared
to the ZEEP group. The mean PaO2/FiO2 was significantly higher in the PEEP
than in the ZEEP group (p < 0.001). Conclusion(s): Supportive
ventilation technique leads to better oxygenation and better lung
expansion, as well as lowering inflammatory biomarkers, after coronary
artery bypass surgery. Copyright © 2022, Saloomeh Sehat Kashani
Et al.

<40>
Accession Number
2014716654
Title
Risk and benefits of temporary pacemaker electrodes in adult open-heart
surgery-a systematic review.
Source
Cardiothoracic Surgeon. 30(1) (no pagination), 2022. Article Number: 5.
Date of Publication: December 2022.
Author
Enevoldsen M.S.; Nielsen P.H.; Hasenkam J.M.
Institution
(Enevoldsen, Nielsen, Hasenkam) Department of Cardiothoracic and Vascular
Surgery, Aarhus University Hospital, Aarhus, Denmark
(Enevoldsen) Aarhus University, Palle Juul-Jensens Boulevard 99, Aarhus
8200, Denmark
(Hasenkam) Department of Clinical Medicine, Aarhus University, Aarhus,
Denmark
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: To assess the achieved risk and benefits of inserting
temporary epicardial pacemaker electrodes after open-heart surgery for
potential treatment of postoperative cardiac arrhythmias, and to
investigate the extent of its use in clinical practice. Main text: A
systematic search was conducted in PubMed and repeated in Embase and
Scopus using the PRISMA guidelines. The search identified 905 studies and
resulted in 12 included studies, where the type of surgery, study design,
total number of included patients, number of patients having temporary
pacemaker electrodes inserted, number of patients requiring temporary
pacing, primary reason for pacing, significant factors predicting
temporary pacing, registered complications and study conclusion were
assessed. Eight papers concluded that routine insertion of temporary
pacemaker electrodes in all postoperative patients is unnecessary. One
paper concluded that they should always be inserted, while three papers
concluded that pacing is useful in the postoperative period, but did not
recommend a frequency of which they should be inserted.
 Conclusion(s): The literature suggests that the subgroup of younger
otherwise healthy patients without preoperative arrhythmia having isolated
coronary artery bypass grafting surgery or single valve surgery should not
routinely have temporary pacemaker electrodes inserted. Copyright
© 2022, The Author(s).

<41>
Accession Number
2013365395
Title
Prognostic models for mortality after cardiac surgery in patients with
infective endocarditis: a systematic review and aggregation of prediction
models.
Source
Clinical Microbiology and Infection. 27(10) (pp 1422-1430), 2021. Date of
Publication: October 2021.
Author
Fernandez-Felix B.M.; Barca L.V.; Garcia-Esquinas E.; Correa-Perez A.;
Fernandez-Hidalgo N.; Muriel A.; Lopez-Alcalde J.; Alvarez-Diaz N.; Pijoan
J.I.; Ribera A.; Elorza E.N.; Munoz P.; Farinas M.D.C.; Goenaga M.A.;
Zamora J.
Institution
(Fernandez-Felix, Correa-Perez, Muriel, Lopez-Alcalde, Zamora) Clinical
Biostatistics Unit, Hospital Universitario Ramon y Cajal (IRYCIS), Madrid,
Spain
(Fernandez-Felix, Garcia-Esquinas, Muriel, Lopez-Alcalde, Pijoan, Ribera,
Zamora) CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
(Barca) Department of Cardiovascular Surgery, Fundacion Jimenez Diaz
University Hospital, Madrid, Spain
(Garcia-Esquinas) Department of Preventive Medicine and Public Health,
School of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
(Garcia-Esquinas) IdiPaz (Hospital Universitario La Paz-Universidad
Autonoma de Madrid), Madrid, Spain
(Correa-Perez, Lopez-Alcalde) Faculty of Medicine, Universidad Francisco
de Vitoria, Madrid, Spain
(Fernandez-Hidalgo) Servei de Malalties Infeccioses, Hospital Universitari
Vall d'Hebron, Barcelona, Spain
(Fernandez-Hidalgo) Red Espanola de Investigacion en Patologia Infecciosa
(REIPI), Instituto de Salud Carlos III, Madrid, Spain
(Lopez-Alcalde) Institute for Complementary and Integrative Medicine,
University Hospital Zurich and University of Zurich, Zurich, Switzerland
(Alvarez-Diaz) Medical Library, Hospital Universitario Ramon y Cajal
(IRYCIS), Madrid, Madrid, Spain
(Pijoan) Hospital Universitario Cruces/OSI EEC, Barakaldo, Spain
(Pijoan) Biocruces-Bizkaia Health Research Institute, Barakaldo, Spain
(Ribera) Cardiovascular Epidemiology and Research Unit, Hospital
Universitari Vall d'Hebron, Barcelona, Spain
(Elorza) Department of Infectology, Hospital Universitario Ramon y Cajal
(IRYCIS), Madrid, Spain
(Munoz) Clinical Microbiology and Infectious Diseases Service, Hospital
General Universitario Gregorio Maranon, Instituto de Investigacion
Sanitaria Gregorio Maranon, CIBER Enfermedades Respiratorias-CIBERES,
Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
(Farinas) Infectious Diseases Service, Hospital Universitario Marques de
Valdecilla-IDIVAL, Universidad de Cantabria, Santander, Spain
(Goenaga) Infectious Diseases Service, Hospital Universitario Donostia,
IIS Biodonostia, OSI Donostialdea, San Sebastian, Spain
(Zamora) WHO Collaborating Centre for Global Women's Health, Institute of
Metabolism and Systems Research, University of Birmingham, Birmingham,
United Kingdom
Publisher
Elsevier B.V.
Abstract
Background: There are several prognostic models to estimate the risk of
mortality after surgery for active infective endocarditis (IE). However,
these models incorporate different predictors and their performance is
uncertain. Objective(s): We systematically reviewed and critically
appraised all available prediction models of postoperative mortality in
patients undergoing surgery for IE, and aggregated them into a meta-model.
Data sources: We searched Medline and EMBASE databases from inception to
June 2020. Study eligibility criteria: We included studies that developed
or updated a prognostic model of postoperative mortality in patient with
IE. Method(s): We assessed the risk of bias of the models using
PROBAST (Prediction model Risk Of Bias ASsessment Tool) and we aggregated
them into an aggregate meta-model based on stacked regressions and
optimized it for a nationwide registry of IE patients. The meta-model
performance was assessed using bootstrap validation methods and adjusted
for optimism. Result(s): We identified 11 prognostic models for
postoperative mortality. Eight models had a high risk of bias. The
meta-model included weighted predictors from the remaining three models
(EndoSCORE, specific ES-I and specific ES-II), which were not rated as
high risk of bias and provided full model equations. Additionally, two
variables (age and infectious agent) that had been modelled differently
across studies, were estimated based on the nationwide registry. The
performance of the meta-model was better than the original three models,
with the corresponding performance measures: C-statistics 0.79 (95% CI
0.76-0.82), calibration slope 0.98 (95% CI 0.86-1.13) and
calibration-in-the-large -0.05 (95% CI -0.20 to 0.11). Conclusion(s):
The meta-model outperformed published models and showed a robust
predictive capacity for predicting the individualized risk of
postoperative mortality in patients with IE. Protocol Registration:
PROSPERO (registration number CRD42020192602). Copyright © 2021
European Society of Clinical Microbiology and Infectious Diseases

<42>
Accession Number
2014886518
Title
Robotic and video-assisted lobectomy/segmentectomy for non-small cell lung
cancer have similar perioperative outcomes: A systematic review and
meta-analysis.
Source
Translational Cancer Research. 10(9) (pp 3883-3893), 2021. Date of
Publication: September 2021.
Author
Mao J.; Tang Z.; Mi Y.; Xu H.; Li K.; Liang Y.; Wang N.; Wang L.
Institution
(Mao, Tang, Mi, Xu, Li, Liang, Wang) Department of Thoracic Surgery, the
Fourth Hospital, Hebei Medical University, Shijiazhuang, China
(Wang) Department of Cancer Institute, the Fourth Hospital, Hebei Medical
University, Shijiazhuang, China
Publisher
AME Publishing Company
Abstract
Background: At present, the clinical conclusion that robotic-assisted
thoracic surgery (RATS) and video-assisted thoracic surgery (VATS), which
is better for patients with non-small cell lung cancer (NSCLC) is not
clear. Therefore, this meta-analysis aimed to compare the perioperative
outcomes between RATS and VATS for NSCLC. Method(s): The Population,
Interventions, Comparators, Outcomes, and Study design (PICOS) framework
was employed to develop the search strategy, and the findings was reported
in accordance with the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA) statement. We searched EMbase, The Cochrane
Library, PubMed, Web of Science, CNKI, and Wan Fang Data to collect
clinical studies about RATS vs. VATS for patients with NSCLC from
inception to October 2019. The following outcomes were measured: Rate of
conversion to thoracotomy, postoperative complications, postoperative
hospital mortality, lymph node dissection, hospitalization time, operating
time, and postoperative drainage days. Estimation of potential publication
bias was conducted by Begg's test and Egger's test. The Standardized Mean
Difference (SMD) and Odds Ratio (OR) with 95% confidence intervals (CI)
were pooled using Stata 15.0 software. Result(s): A total of 18
studies involving 60,349 patients were included. Among them, 8,726 cases
were in the RATS group, and 51,623 were in the VATS group. The results of
meta-analysis showed that the operation time of RATS group was longer than
that of VATS group (SMD=0.532, 95% CI: 0.391-0.674, P=0.000). And the
further meta-analysis suggested that the incidence of postoperative
complications was lower in patients who underwent RATS after 2015
(OR=0.848, 95% CI: 0.748-0.962, P=0.010). Meanwhile, there was no
significant difference between both groups in postoperative
hospitalization time (SMD=0.003, 95% CI: -0.104-0.110, P=0.957). In
addition, more lymph nodes were retrieved in RATS group than VATS
(SMD=0.308, 95% CI: 0.131-0.486, P=0.001). However, the conversion rate,
retrieved lymph node station, days to tube removal and in-hospital
mortality rate have no significant differences between both groups.
 Discussion(s): The current meta-analysis indicates that the
perioperative outcomes of RATS and VATS for NSCLC are equivalence. Due to
the limited quantity and quality of included studies, the above
conclusions still need to be verified by more high-quality
studies. Copyright © 2021 AME Publishing Company. All rights
reserved.

<43>
Accession Number
2006135383
Title
Effects of anesthetics on microvascular reactivity measured by vascular
occlusion tests during off-pump coronary artery bypass surgery: a
randomized controlled trial.
Source
Journal of Clinical Monitoring and Computing. 35(5) (pp 1219-1228), 2021.
Date of Publication: October 2021.
Author
Cho Y.J.; Yoo S.J.; Nam K.; Bae J.Y.; Lee S.H.; Jeon Y.
Institution
(Cho, Yoo, Nam, Bae, Lee, Jeon) Department of Anesthesiology and Pain
Medicine, Seoul National University Hospital, Seoul National University
College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea
Publisher
Springer Science and Business Media B.V.
Abstract
Abstract: Microvascular function may be modulated by various anesthetics.
Desflurane and propofol anesthesia have different effects on microvascular
function. However, there are few reports on the effects of sevoflurane and
desflurane on microvascular function during cardiac surgery. We compared
the effects of sevoflurane and desflurane on microvascular reactivity, as
measured by the vascular occlusion tests (VOTs) during off-pump coronary
artery bypass (OPCAB) surgery. Patients undergoing OPCAB were eligible for
study inclusion. Patients were excluded if they were unsuitable for
treatment with volatile agents or the VOT, had renal failure or
uncontrolled diabetes, or were pregnant. The enrolled patients were
randomized to receive sevoflurane or desflurane during surgery. Tissue
oxygen saturation (StO<inf>2</inf>) dynamics during the VOT were measured
at baseline (pre-anesthesia), pre-anastomosis, post-anastomosis of vessel
grafts, and at the end of surgery. Macrohemodynamic variables, arterial
blood gas parameters, and in-hospital adverse events were also evaluated.
A total of 64 patients (32 in each group) were analyzed. StO<inf>2</inf>
dynamics did not differ between the groups. Compared to baseline,
StO<inf>2</inf> and the rate of recovery following vascular occlusion
decreased at the end of surgery in both groups (adjusted p-value, <
0.001), and no group difference was observed. Macrohemodynamic variables,
blood gas analysis results, and the rate of postoperative in-hospital
adverse events were similar between the groups. Microvascular reactivity,
as measured by the VOT during OPCAB, showed no difference between the
sevoflurane and desflurane groups. Also, there were no group differences
in macrohemodynamics or the rate of postoperative adverse events. Trial
registration: Clinicaltrials.gov, identifier NCT03209193; registered on
July 3, 2017. Copyright © 2020, Springer Nature B.V.

<44>
Accession Number
2016352198
Title
Comparison between Bilateral Internal Mammary Artery Graft and Left
Internal Mammary Artery Graft in Patients Undergoing Coronary Artery
Bypass Grafting.
Source
Pakistan Journal of Medical and Health Sciences. 15(12) (pp 3375-3377),
2021. Date of Publication: December 2021.
Author
Khan A.K.; Rahim S.S.; Salman M.; Pannu F.Y.; Ahmed B.; Iqbal S.; Shafqat
A.; Afshan S.
Institution
(Khan, Rahim, Salman, Iqbal) SR Cardiac Surgery, Punjab Institute of
Cardiology, Lahore, Pakistan
(Pannu, Ahmed) SR, Cardiology Department, Mayo hospital Lahore, Pakistan
(Shafqat, Afshan) Punjab Institute of Cardiology, Lahore, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Background: Increasing evidence continues to demonstrate a survival
advantage for bilateral internal mammary artery (BIMA) over Left internal
mammary artery for coronary artery bypass grafting (CABG). However, there
are still uncertainties about which surgical approach is the best one to
use with BIMA grafting. Objective(s): To compare Bilateral Internal
Mammary Artery (BIMA) Grafting with Left Internal Mammary Artery (LIMA)
Grafting during Coronary Artery Bypass Grafting (CABG) in terms of early
mortality and sternal wound infections. Materials & Methods Randomized:
control trialtechnique enrolled. The study was conducted at the Cardiac
Surgery Department, King Edward Medical University (KEMU), Mayo Hospital
Lahore Results: Total 96patients undergoing CABG were included in this
study. Patients were randomly divided into 2 groups; each group contains
48 patients. Group A included patients having Left IMA to LAD; second and
third graft by Great Saphenous Vein and Group B included patients having
Bilateral Internal Mammary Arteries with Left IMA to LAD or OM and Right
IMA to RCA, LAD or Ramus Intermedius. The superficial and deep sternal
wound infections was recorded along with the different risk factors
including diabetes, obesity, hypertension, smoking and use of inotropes
intra-operatively and post operatively. The incision site over the sternum
was being evaluated on daily basis throughout the stay of the patients
(from 5-8 days). Diagnosis of Sternal infections was based on the presence
of positive cultures, dehiscence of the sternum incision, fever, redness
pain, and infected (purulent) secretions. Sternal instability and
discharge, ventilation time, length of ICU stay, chest drainage,
re-exploration and length of hospital stay was also recorded.
 Result(s):Not any of the patients included in these two treatment
groups suffered from mortality (LIMA: 0%, BIMA: 0%). Deep sternal wound
infection [LIMA: 4.17% & BIMA: 6.25%, p-value=0.646] and superficial wound
infection [LIMA: 4.17% & BIMA: 6.25%, p-value=0.646] did not show any
statistically significant association towards both grafts type. Patients
who underwent BIMA grafting suffered from higher in hospital stay as
compared to patients who underwent LIMAgrafting. i.e. [LIMA: 7.02 & BIMA:
8.02, P value = 0.000] Conclusion(s): Results of the study showed no
significant difference for deep sternal wound infection and superficial
wound infection between the two grafts BIMA and LIMA. However, patients
who underwent BIMA grafting had significantly higher hospital stay as
compared to patients who underwent LIMA grafting. Copyright ©
2021 Lahore Medical And Dental College. All rights reserved.

<45>
Accession Number
2016427814
Title
A systematic review of the evidence supporting post-operative
antithrombotic use following cardiopulmonary bypass in children with CHD.
Source
Cardiology in the Young. (no pagination), 2022. Date of Publication:
2022.
Author
Thompson E.J.; Foote H.P.; Li J.S.; Rotta A.T.; Goldenberg N.A.; Hornik
C.P.
Institution
(Thompson, Foote, Li, Rotta, Hornik) Department of Pediatrics, Duke
University, School of Medicine, Durham, NC, United States
(Li, Hornik) Duke Clinical Research Institute, Duke University, School of
Medicine, Durham, NC, United States
(Goldenberg) Department of Pediatrics and Medicine, Division of
Hematology, Johns Hopkins University, School of Medicine, Baltimore, MD,
United States
(Goldenberg) Institute for Clinical and Translational Research, Cancer and
Blood Disorders Institute, Heart Institute, Johns Hopkins All Children's
Hospital, St. Petersburg, FL, United States
Publisher
Cambridge University Press
Abstract
Objectives: To determine the optimal antithrombotic agent choice, timing
of initiation, dosing and duration of therapy for paediatric patients
undergoing cardiac surgery with cardiopulmonary bypass. Method(s): We
used PubMed and EMBASE to systematically review the existing literature of
clinical trials involving antithrombotics following cardiac surgery from
2000 to 2020 in children 0-18 years. Studies were assessed by two
reviewers to ensure they met eligibility criteria. Result(s): We
identified 10 studies in 1929 children across three medications classes:
vitamin K antagonists, cyclooxygenase inhibitors and indirect thrombin
inhibitors. Four studies were retrospective, five were prospective
observational cohorts (one of which used historical controls) and one was
a prospective, randomised, placebo-controlled, double-blind trial. All
included were single-centre studies. Eight studies used surrogate
biomarkers and two used clinical endpoints as the primary endpoint. There
was substantive variability in response to antithrombotics in the
immediate post-operative period. Studies of warfarin and aspirin showed
that laboratory monitoring levels were frequently out of therapeutic range
(variably defined), and findings were mixed on the association of these
derangements with bleeding or thrombotic events. Heparin was found to be
safe at low doses, but breakthrough thromboembolic events were common.
 Conclusion(s): There are few paediatric prospective randomised
clinical trials evaluating antithrombotic therapeutics post-cardiac
surgery; most studies have been observational and seldom employed clinical
endpoints. Standardised, validated endpoints and pragmatic trial designs
may allow investigators to determine the optimal drug, timing of
initiation, dosing and duration to improve outcomes by limiting
post-operative morbidity and mortality related to bleeding or thrombotic
events. Copyright © The Author(s), 2022. Published by Cambridge
University Press

<46>
Accession Number
2016416422
Title
Aortic Valve Replacement for Patients with Heyde Syndrome: A Literature
Review.
Source
Chinese Medical Sciences Journal. 36(4) (pp 307-315), 2021. Date of
Publication: December 2021.
Author
Li H.; Lin P.; Yao Y.
Institution
(Li) Department of Anesthesiology, The First Hospital of Hebei Medical
University, Shijiazhuang 050000, China
(Lin) Department of Anesthesiology, Fujian Medical University Affiliated
First Quanzhou Hospital, Quanzhou 362000, China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking
Union Medical College, Beijing 100037, China
Publisher
Elsevier Ltd
Abstract
Objective: To explore the characteristics and clinical outcomes of
patients with Heyde syndrome (HS) who undergo aortic valve replacement
(AVR). Method(s): Electronic databases including PubMed, Embase,
Ovid, WANFANG, VIP and CNKI were searched to identify all case reports of
HS patients undergoing AVR surgery, using different combinations of search
terms "Heyde syndrome", "gastrointestinal bleeding", "aortic stenosis",
and "surgery". Three authors independently extracted the clinical data
including the patients' characteristics, aortic stenosis severity,
gastrointestinal bleeding sites, surgical treatments and prognosis.
 Result(s): Finally, 46 case reports with SS patients aging from 46 to
87 years, were determined eligible and included. Of them, 1 patient had
mild aortic stenosis, 1 had moderate aortic stenosis, 42 had severe aortic
stenosis, and 11 were not mentioned. Gastrointestinal bleeding was
detected in colon (n=8), jejunum (n=6), ileum (n=4), cecum
(n=3), duodenal (n=3) and multiple sites (n=8). No
specific bleeding site was identified in 23 patients. Preoperative
hemoglobin level ranged from 43 to 117 g/L. All but one of 16 patients
showed decreased level of high molecule weight von Willebrand factor. Of
the 55 patients, 43 underwent AVR, and 12 received transcatheter AVR.
Aortic valves of 14 cases were replaced by mechanical valves, and 33 cases
by biological valves. All patients recovered well during the follow-up,
except 5 patients. One patient who had perivalvular leakage and
gastrointestinal bleeding after AVR underwent the second AVR. Two patients
had recurrent gastrointestinal bleeding. Two patients died of
hfe-threatening acute subdural hematoma and multiple organ failure,
respectively. Conclusion(s): HS is a rare syndrome characterized by
aortic stenosis and gastrointestinal bleeding. AVR is an effective
treatment for HS. Copyright © 2021 Chinese Academy Medical
Sciences

<47>
Accession Number
635195304
Title
Institutional case volume-incorporated mortality risk prediction model for
cardiac surgery.
Source
Asian journal of surgery. 45(1) (pp 189-196), 2022. Date of Publication:
01 Jan 2022.
Author
Lee S.; Jang E.J.; Jo J.; Park D.; Ryu H.G.
Institution
(Lee, Park) Department of Anesthesiology and Pain Medicine, Seoul National
University College of Medicine, Seoul National University Hospital, 101
Daehak-Ro Jongno-Gu, Seoul 03080, South Korea
(Jang) Department of Information Statistics, ong National University,
Gyeongsangbuk-do 36729, South Korea
(Jo) Department of Statistics, Kyungpook National University, 80
Daehak-Ro, Daegu 41566, South Korea
(Ryu) Department of Anesthesiology and Pain Medicine, Seoul National
University College of Medicine, Seoul National University Hospital, 101
Daehak-Ro Jongno-Gu, Seoul 03080, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: Most risk prediction models predicting short-term mortality
after cardiac surgery incorporate patient characteristics, laboratory
data, and type of surgery, but do not account for surgical experience.
Considering the impact of case volume on patient outcome after high-risk
procedures, we attempted to develop a risk prediction model for mortality
after cardiac surgery that incorporates institutional case volume.
 METHOD(S): Adult patients who underwent cardiac surgery from 2009 to
2016 were identified. Patients who underwent cardiac surgery (n = 57,804)
were randomly divided into the derivation cohort (n = 28,902) or the
validation cohorts (n = 28,902). A risk prediction model for in-hospital
mortality and 1-year mortality was developed from the derivation cohort
and the performance of the model was evaluated in the validation cohort.
 RESULT(S): The model demonstrated fair discrimination (c-statistics,
0.76 for in-hospital mortality in both cohorts; 0.74 for 1-year mortality
in both cohorts) and acceptable calibration. Hospitals were classified
based on case volume into 50 or less, 50-100, 100-200, or more than 200
average cardiac surgery cases per year and case volume was a significant
variable in the prediction model. CONCLUSION(S): A new risk
prediction model that incorporates institutional case volume and
accurately predicts in-hospital and 1-year mortality after cardiac surgery
was developed and validated. Copyright © 2021. Published by
Elsevier Taiwan LLC.

<48>
Accession Number
2014644893
Title
Changes in eicosapentaenoic acid and docosahexaenoic acid and risk of
cardiovascular events and atrial fibrillation: A secondary analysis of the
OMEMI trial.
Source
Journal of Internal Medicine. (no pagination), 2022. Date of Publication:
2022.
Author
Myhre P.L.; Kalstad A.A.; Tveit S.H.; Laake K.; Schmidt E.B.; Smith P.;
Nilsen D.W.T.; Tveit A.; Solheim S.; Arnesen H.; Seljeflot I.
Institution
(Myhre, Tveit, Smith) Department of Cardiology, Division of Medicine,
Akershus University Hospital, Lorenskog, Norway
(Myhre, Kalstad, Tveit, Smith, Tveit, Arnesen, Seljeflot) Institute of
Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
(Kalstad, Laake, Solheim, Arnesen, Seljeflot) Center for Clinical Heart
Research, Department of Cardiology, Oslo University Hospital Ulleval,
Oslo, Norway
(Schmidt) Department of Cardiology, Aalborg University Hospital and
Aalborg University, Aalborg, Denmark
(Nilsen) Department of Cardiology, Stavanger University Hospital,
Stavanger, Norway
(Nilsen) Department of Clinical Science, Faculty of Medicine, University
of Bergen, Bergen, Norway
(Tveit) Department of Medical Research, Vestre Viken Hospital Trust,
Baerum Hospital, Gjettum, Norway
Publisher
John Wiley and Sons Inc
Abstract
Background: The cardiovascular benefit from n-3 polyunsaturated fatty
acids (PUFAs) after acute myocardial infarction (AMI) is controversial,
and the importance of serum eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA) concentrations for clinical events is unclear.
 Objective(s): To assess changes in EPA and DHA serum concentrations
during n-3 PUFA supplementation and their association with incident
cardiovascular events. Method(s): In the OMEMI trial, elderly
patients with a recent AMI were randomized to 1.8 g/day of EPA/DHA or
control (corn oil) for 2 years. The primary outcome was a composite of
AMI, coronary revascularization, stroke, heart failure hospitalization, or
all-cause death (major adverse cardiovascular event [MACE]) and the
secondary outcome was new-onset atrial fibrillation (AF). Result(s):
EPA and DHA measurements were available in 881 (92% of survivors)
participants at randomization and study completion. EPA and DHA increased
in the active treatment arm (n = 438) by a median of 87% and 16%,
respectively. Greater on-treatment increases in EPA and DHA were
associated with decreasing triglycerides, increasing high-density
lipoprotein cholesterol, and lower baseline EPA and DHA concentrations.
Greater on-treatment increases in EPA were associated with lower risk of
MACE (adjusted hazard ratio 0.86 [95% confidence interval, CI, 0.75-0.99],
p = 0.034), and higher risk of AF (adjusted hazard ratio (HR) 1.36 [95% CI
1.07-1.72], p = 0.011). Although there were similar tendencies for DHA
changes and outcomes, these associations were not statistically
significant (HR 0.84 [0.66-1.06] for MACE and 1.39 [0.90-2.13] for AF).
 Conclusion(s): Greater on-treatment increases in EPA were associated
with lower risk of MACE and higher risk of new-onset AF. These data
suggest that the cardiovascular effects of increasing n-3 PUFA levels
through supplements are complex, involving both potential benefits and
harm. Copyright © 2021 The Authors. Journal of Internal Medicine
published by John Wiley & Sons Ltd on behalf of Association for
Publication of The Journal of Internal Medicine.

<49>
Accession Number
2014636633
Title
Commentary: Prevention of saphenous vein graft disease remains elusive.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Hays N.M.; Balsam L.B.
Institution
(Hays) Department of Surgery, University of Massachusetts Chan Medical
School, Worcester, MA, United States
(Balsam) Division of Cardiac Surgery, UMass Memorial Medical Center,
Worcester, MA, United States
Publisher
John Wiley and Sons Inc
Abstract
One-year outcomes of Ticagrelor Antiplatelet Therapy to Reduce Graft
Events and Thrombosis (TARGET), a randomized double-blinded clinical trial
comparing post-coronary artery bypass surgery antiplatelet therapy with
ticagrelor versus aspirin are published in this issue of the Journal.
Although the authors did not detect statistically significant differences
in their primary outcome (saphenous vein graft patency at 1 year) and
major adverse cardiovascular events, their findings must be interpreted
with caution given important limitations in the design and execution of
the trial. Copyright © 2022 Wiley Periodicals LLC

<50>
Accession Number
2014651857
Title
Cardiac allograft vasculopathy: A review.
Source
Pediatric Transplantation. (no pagination), 2022. Date of Publication:
2022.
Author
Laks J.A.; Dipchand A.I.
Institution
(Laks) Heart Institute, Johns Hopkins All Children's Hospital, St
Petersburg, FL, United States
(Dipchand) Labatt Family Heart Centre, The Hospital for Sick Children,
Toronto, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Heart transplantation has become the standard of care for
pediatric patients with end-stage heart disease, and outcomes have
consistently improved over the last few decades. CAV, however, remains a
leading cause of morbidity and mortality in heart transplantation and is
the leading cause of death beyond 3 years post-transplantation. We sought
out to provide an in-depth overview of CAV in the pediatric heart
transplant population. Method(s): Database searches were conducted in
both Medline and Embase on the topic of cardiac vasculopathy in pediatric
heart transplant recipients. The search used five broad concept terms:
heart transplant; pediatric; CAV; diagnosis, prognosis, and risk factors;
and guidelines and reviews. References were captured if there was at least
one term in each of the concepts. The search was limited to articles in
the English language. Result(s): A total of 148 articles were
identified via the literature search with further articles identified via
review of references. Pediatric data regarding the etiology and
development of CAV remain limited although knowledge about the immune and
non-immune factors playing a role are increasing. CAV continues to be
difficult to detect with many invasive and non-invasive methods available,
yet their effectiveness in the detection of CAV remains suboptimal. There
remains no proven medical intervention to treat or reverse established CAV
disease, and CAV is associated with high rates of graft loss once
detected. However, several medications are used in hopes of preventing,
slowing progression, or modifying the outcomes. Conclusion(s): This
review provides a comprehensive overview of CAV, discusses its clinical
presentation, risk factors, diagnostic tools used to identify CAV in the
pediatric population, and highlights the current therapeutic options and
the need for ongoing research. Copyright © 2022 Wiley Periodicals
LLC

<51>
Accession Number
2014647315
Title
The use of a vascular occlusion test combined with near-infrared
spectroscopy in perioperative care: a systematic review.
Source
Journal of Clinical Monitoring and Computing. (no pagination), 2022. Date
of Publication: 2022.
Author
Niezen C.K.; Massari D.; Vos J.J.; Scheeren T.W.L.
Institution
(Niezen, Massari, Vos, Scheeren) Department of Anesthesiology, University
Medical Center Groningen, University of Groningen, PO Box 30 001,
Groningen 9700 RB, Netherlands
Publisher
Springer Science and Business Media B.V.
Abstract
In the perioperative phase oxygen delivery and consumption can be
influenced by different factors, i.e. type of surgery, anesthetic and
cardiovascular drugs, or fluids. By combining near-infrared spectroscopy
(NIRS) monitoring of regional tissue oxygen saturation (StO<inf>2</inf>)
with an ischemic provocation test, the vascular occlusion test (VOT),
local tissue oxygen consumption and vascular reactivity at the
microcirculatory level can be assessed. This systematic review aims to
give an overview of the clinical information that VOT-derived NIRS values
can provide in the perioperative period. After performing a systematic
literature search, we included 29 articles. It was not possible to perform
a meta-analysis because of the lack of comparable data and the
observational nature of the majority of the included articles. We have
clustered the found articles in two groups: non-cardiac surgery and
cardiac surgery. We found that VOT-derived NIRS values show a wide
variability and are influenced by the effects of anesthetics,
cardiovascular drugs, fluids, and by the type of surgery. Additionally,
deviations in VOT-derived NIRS values are also associated with adverse
patients' outcomes, such as postoperative complications, prolonged
mechanical ventilation and prolonged hospital length of stay. However,
given the variability in VOT-derived NIRS values, clinical applicability
remains elusive. Future clinical interventional trials might provide
additional insight into the potential of VOT associated with NIRS to
optimize perioperative care by targeting specific interventions to
optimize the function of the microvasculature. Copyright © 2022,
The Author(s), under exclusive licence to Springer Nature B.V.

<52>
Accession Number
636699122
Title
Fractional Flow Reserve to Guide Treatment of Patients With Multivessel
Coronary Artery Disease.
Source
Journal of the American College of Cardiology. 78(19) (pp 1875-1885),
2021. Date of Publication: 09 Nov 2021.
Author
Rioufol G.; Derimay F.; Roubille F.; Perret T.; Motreff P.; Angoulvant D.;
Cottin Y.; Meunier L.; Cetran L.; Cayla G.; Harbaoui B.; Wiedemann J.-Y.;
Van Belle E.; Pouillot C.; Noirclerc N.; Morelle J.-F.; Soto F.-X.;
Caussin C.; Bertrand B.; Lefevre T.; Dupouy P.; Lesault P.-F.; Albert F.;
Barthelemy O.; Koning R.; Leborgne L.; Barnay P.; Chapon P.; Armero S.;
Lafont A.; Piot C.; Amaz C.; Vaz B.; Benyahya L.; Varillon Y.; Ovize M.;
Mewton N.; Finet G.
Institution
(Rioufol, Derimay, Finet) Hopital Cardiologique et Pneumologique Louis
Pradel, Hospices Civils de Lyon, Bron, France
(Roubille) Hopital Arnaud de Villeneuve, Montpellier, France
(Perret) Centre Hospitalier Saint Joseph-Saint Luc, Lyon, France
(Motreff) Hopital Gabriel Montpied, Clermont-Ferrand, France
(Angoulvant) Hopital Trousseau, CHRU de Tours, Universite de Tours, Tours,
France
(Cottin) Hopital du Bocage Central, Dijon, France
(Meunier) Centre Hospitalier de La Rochelle, La Rochelle, France
(Cetran) Hopital Cardiologique, Centre Hospitalo-Universitaire de
Bordeaux, Universite de Bordeaux, Bordeaux, France
(Cayla) Service de cardiologie, Hopital Caremeau, Universite de
Montpellier, Nimes, France
(Harbaoui) Hopital de la Croix-Rousse, Hospices Civils de Lyon, Lyon,
France
(Wiedemann) Centre Hospitalier de Mulhouse, Mulhouse, France
(Van Belle) Hopital Cardiologique Calmette, Lille, France
(Pouillot) Clinique Sainte Clotilde, La Reunion, France
(Noirclerc) Centre Hospitalier Annecy-Genevois, Annecy, France
(Morelle) Clinique Saint Martin, Caen, France
(Soto) Centre Hospitalier d'Auxerre, Auxerre, France
(Caussin) Institut Mutualiste de Montsouris, Paris, France
(Bertrand) Hopital Michallon, Grenoble, France
(Lefevre) Institut Hospitalier Jacques Cartier, Massy, France
(Dupouy) Clinique Les Fontaines, Melun, France
(Lesault) Hopital Prive de l'Estuaire, Le Havre, France
(Albert) Centre Hospitalier General, Chartres, France
(Barthelemy) Hopital de La Pitie-Salpetriere, Assistance Publique-Hopitaux
de Paris, Paris, France
(Koning) Clinique Saint Hilaire, Rouen, France
(Leborgne) Centre Hospitalier Amiens-Picardie, Hopital Sud, Amiens, France
(Barnay) Hopital Henri Duffaut, Avignon, France
(Chapon) Centre Hospitalier de Valence, Valence, France
(Armero) Hopital Europeen, Marseille, France
(Lafont) Hopital Europeen George Pompidou, Assistance Publique-Hopitaux de
Paris, Paris, France
(Piot) Clinique Le Millenaire, Montpellier, France
(Amaz, Vaz, Benyahya, Varillon, Ovize, Mewton) Centre d'investigation
clinique de Lyon, INSERM 1407, Hopital Cardiologique et Pneumologique
Louis Pradel, Hospices Civils de Lyon, Bron, France
Publisher
NLM (Medline)
Abstract
BACKGROUND: There is limited evidence that fractional flow reserve (FFR)
is effective in guiding therapeutic strategy in multivessel coronary
artery disease (CAD) beyond prespecified percutaneous coronary
intervention or coronary graft surgery candidates. OBJECTIVE(S): The
FUTURE (FUnctional Testing Underlying coronary REvascularization) trial
aimed to evaluate whether a treatment strategy based on FFR was superior
to a traditional strategy without FFR in the treatment of multivessel CAD.
 METHOD(S): The FUTURE trial is a prospective, randomized, open-label
superiority trial. Multivessel CAD candidates were randomly assigned (1:1)
to treatment strategy based on FFR in all stenotic (>=50%) coronary
arteries or to a traditional strategy without FFR. In the FFR group,
revascularization (percutaneous coronary intervention or surgery) was
indicated for FFR <=0.80 lesions. The primary endpoint was a composite of
major adverse cardiac or cerebrovascular events at 1 year. RESULT(S):
The trial was stopped prematurely by the data safety and monitoring board
after a safety analysis and 927 patients were enrolled. At 1-year
follow-up, by intention to treat, there were no significant differences in
major adverse cardiac or cerebrovascular events rates between groups
(14.6% in the FFR group vs 14.4% in the control group; hazard ratio: 0.97;
95% confidence interval: 0.69-1.36; P = 0.85). The difference in all-cause
mortality was nonsignificant, 3.7% in the FFR group versus 1.5% in the
control group (hazard ratio: 2.34; 95% confidence interval: 0.97-5.18; P =
0.06), and this was confirmed with a 24 months' extended follow-up. FFR
significantly reduced the proportion of revascularized patients, with more
patients referred to exclusively medical treatment (P = 0.02).
 CONCLUSION(S): In patients with multivessel CAD, we did not find
evidence that an FFR-guided treatment strategy reduced the risk of
ischemic cardiovascular events or death at 1-year follow-up. (Functional
Testing Underlying Coronary Revascularisation; NCT01881555). Copyright
© 2021 American College of Cardiology Foundation. Published by
Elsevier Inc. All rights reserved.

<53>
Accession Number
2016482663
Title
Impact of new-onset versus pre-existing atrial fibrillation on outcomes
after transcatheter aortic valve replacement/implantation.
Source
IJC Heart and Vasculature. 38 (no pagination), 2022. Article Number:
100910. Date of Publication: February 2022.
Author
Nso N.; Emmanuel K.; Nassar M.; Bhangal R.; Enoru S.; Iluyomade A.; Marmur
J.D.; Ilonze O.J.; Thambidorai S.; Ayinde H.
Institution
(Nso, Nassar, Bhangal) Department of Medicine, Icahn School of Medicine at
Mount Sinai/NYC H+H/Queens, NY, United States
(Emmanuel) Department of Medicine, University of Pittsburgh, Medical
Center Pinnacle, PA, United States
(Enoru, Marmur) Department of Cardiovascular Disease, SUNY Downstate
Health Science University, NY, United States
(Iluyomade) Division of Cardiovascular Disease, University of Miami Miller
School of Medicine, Miami, FL, United States
(Ilonze) Department of Cardiovascular Disease, Indiana University School
of Medicine, IN, United States
(Thambidorai) Division of Cardiac Electrophysiology, HCA Medical City
Program, Fort Wort, TX, United States
(Ayinde) Division of Clinical Cardiac Electrophysiology, Novant Health
Heart & Vascular Institute, Charlotte, NC, United States
Publisher
Elsevier Ireland Ltd
Abstract
Patients with aortic stenosis who undergo transcatheter aortic valve
replacement/transcatheter aortic valve implantation (TAVR/TAVI) experience
a high incidence of pre-existing atrial fibrillation (pre-AF) and
new-onset atrial fibrillation (NOAF) post-operatively. This systematic
review and meta-analysis aimed to update current evidence concerning the
incidence of 30-day mortality, stroke, acute kidney injury (AKI), length
of stay (LOS), and early/late bleeding in patients with NOAF or pre-AF who
undergo TAVR/TAVI. PubMed, Google Scholar, JSTOR, Cochrane Library, and
Web of Science were searched for studies published between January 2012
and December 2020 reporting the association between NOAF/pre-AF and
clinical complications after TAVR/TAVI. A total of 15 studies including
158,220 adult patients with TAVI/TAVR and NOAF or pre-AF were identified.
Compared to patients in sinus rhythm, patients who developed NOAF had a
higher risk of 30-day mortality, AKI, early bleeding events, extended LOS,
and stroke after TAVR/TAVI (odds ratio [OR]: 3.18 [95% confidence interval
[CI] 1.58, 6.40]) (OR: 3.83 [95% CI 1.18, 12.42]) (OR: 1.70 [95% CI 1.05,
2.74]) (OR: 13.96 [95% CI, 6.41, 30.40]) (OR: 2.51 [95% CI 1.59, 3.97],
respectively). Compared to patients in sinus rhythm, patients with pre-AF
had a higher risk of AKI and early bleeding episodes after TAVR/TAVI (OR:
2.43 [95% CI 1.10, 5.35]) (OR: 17.41 [95% CI 6.49, 46.68], respectively).
Atrial fibrillation is associated with a higher risk of all primary and
secondary outcomes. Specifically, NOAF but not pre-AF is associated with a
higher risk of 30-day mortality, stroke, and extended LOS after
TAVR/TAVI. Copyright © 2021

<54>
Accession Number
2015288403
Title
Change in Physical Activity and Function in Patients with Baseline
Advanced Nondialysis CKD.
Source
Clinical Journal of the American Society of Nephrology. 16(12) (pp
1805-1812), 2021. Date of Publication: December 2021.
Author
Rampersad C.; Darcel J.; Harasemiw O.; Brar R.S.; Komenda P.; Rigatto C.;
Prasad B.; Bohm C.; Tangri N.
Institution
(Rampersad, Darcel, Harasemiw, Brar, Komenda, Rigatto, Bohm, Tangri) Rady
Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
(Harasemiw, Brar, Komenda, Rigatto, Bohm, Tangri) Chronic Disease
Innovation Centre, Seven Oaks General Hospital, Winnipeg, MB, Canada
(Prasad) Regina Qu'Appelle Health Region, Regina General Hospital, Regina,
SK, Canada
Publisher
American Society of Nephrology
Abstract
Background and objectives Although progressive decline in physical
activity and function are common in individuals with worsening CKD, little
is known about the effect of dialysis initiation on physical activity. We
assessed for any association of progression to dialysis in people with
advanced CKD with temporal rates of change in physical activity and
function. Design, setting, participants, & measurements Canadian Frailty
Observation and Interventions Trial (CanFIT) participants with an eGFR of
<30 ml/min per 1.73 m2 were included. Outcomes included change
in physical activity level, measured using the Physical Activity Scale for
the Elderly, and physical function, measured using the chair stand, 4-m
gait speed, and grip strength tests. Generalized linear regression models
were conducted to determine whether dialysis initiation was associated
with greater decline in physical activity or function. Results Of 386
individuals, 162 progressed to dialysis. Both assessments were completed
by 98% of individuals for the Physical Activity Scale for the Elderly, 86%
for the chair stand test, 84% for the gait speed test, and 91% for the
grip strength test. Median (interquartile range) interassessment follow-up
was 427 (357-578) days for the "stable advanced CKD" group and 606
(428-1000) days for the "progressed to dialysis" group. Self-reported
physical activity and gait speed significantly declined in both groups.
Mean (SD) chair stand time increased from 20.8 (17.1) to 24.0 (21.0)
seconds among patients with stable advanced CKD, and from 18.5 (15.4) to
27.4 (22.2) seconds among those who progressed to dialysis (adjusted
difference in change, 5.2 seconds; 95% confidence interval, 0.8 to 9.7
seconds; P=0.02). Conclusions Patients with advanced CKD experience
progressive declines in physical activity and function. Transition to
dialysis is associated with accelerated decline in physical function, as
measured by the chair stand test. Copyright © 2021 by the
American Society of Nephrology.

<55>
Accession Number
2013603154
Title
Assessment of patients with a suspected cardioembolic ischemic stroke. A
national consensus statement.
Source
Scandinavian Cardiovascular Journal. 55(5) (pp 315-325), 2021. Date of
Publication: 2021.
Author
Aplin M.; Andersen A.; Brandes A.; Dominguez H.; Dahl J.S.; Damgaard D.;
Iversen H.K.; Iversen K.K.; Nielsen E.; Risum N.; Schmidt M.R.; Andersen
N.H.
Institution
(Aplin, Dominguez) Department of Cardiology, Bispebjerg University
Hospital, Copenhagen, Denmark
(Andersen) Department of Cardiology, Aarhus University Hospital, Aarhus N,
Denmark
(Brandes, Dahl, Andersen) Department of Cardiology, Odense University
Hospital, Odense, Denmark
(Brandes) Department of Internal Medicine-Cardiology, University Hospital
of Southern Denmark-Esbjerg, Esbjerg, Denmark
(Damgaard) Department of Neurology, Aarhus University Hospital, Aarhus N,
Denmark
(Iversen) Department of Neurology, Rigshospitalet, University of
Copenhagen, Copenhagen, Denmark
(Iversen) Department of Cardiology, Herlev-Gentofte Hospital, Herlev,
Denmark
(Nielsen) Department of Neuroradiology, Aarhus University Hospital, Aarhus
N, Denmark
(Risum, Schmidt) Department of Cardiology, Rigshospitalet, University of
Copenhagen, Copenhagen, Denmark
(Andersen) Department of Cardiology, Aalborg University Hospital, Aalborg,
Denmark
Publisher
Taylor and Francis Ltd.
Abstract
Objectives: Several cardiovascular, structural, and functional
abnormalities have been considered as potential causes of cardioembolic
ischemic strokes. Beyond atrial fibrillation, other sources of embolism
clearly exist and may warrant urgent action, but they are only a minor
part of the many stroke mechanisms and strokes that seem to be of embolic
origin remain without a determined source. The associations between stroke
and findings like atrial fibrillation, valve calcification, or heart
failure are confounded by co-existing risk factors for atherosclerosis and
vascular disease. In addition, a patent foramen ovale which is a common
abnormality in the general population is mostly an innocent bystander in
patients with ischemic stroke. For these reasons, experts from the
national Danish societies of cardiology, neurology, stroke, and
neuroradiology sought to develop a consensus document to provide national
recommendations on how to manage patients with a suspected cardioembolic
stroke. Design(s): Comprehensive literature search and analyses were
done by a panel of experts and presented at a consensus meeting. Evidence
supporting each subject was vetted by open discussion and statements were
adjusted thereafter. Result(s): The most common sources of embolic
stroke were identified, and the statement provides advise on how
neurologist can identify cases that need referral, and what is expected by
the cardiologist. Conclusion(s): A primary neurological and
neuroradiological assessment is mandatory and neurovascular specialists
should manage the initiation of secondary prophylactic treatment. If a
cardioembolic stroke is suspected, a dedicated cardiologist experienced in
the management of cardioembolism should provide a tailored clinical and
echocardiographic assessment. Copyright © 2021 Informa UK
Limited, trading as Taylor & Francis Group.

<56>
Accession Number
635317125
Title
Anti-Xa Monitoring of Low-Molecular-Weight Heparin during Pregnancy: A
Systematic Review.
Source
Seminars in Thrombosis and Hemostasis. 47(7) (pp 824-842), 2021. Date of
Publication: 01 Oct 2021.
Author
Kjaergaard A.B.; Fuglsang J.; Hvas A.-M.
Institution
(Kjaergaard, Hvas) Department of Clinical Biochemistry, Palle Juul-Jensens
Boulevard 99, Aarhus N 8200, Denmark
(Fuglsang) Department of Obstetrics and Gynecology, Aarhus University
Hospital, Aarhus, Denmark
(Fuglsang, Hvas) Department of Clinical Medicine, Aarhus University,
Aarhus, Denmark
Publisher
Thieme Medical Publishers, Inc.
Abstract
Low-molecular-weight heparin (LMWH) is commonly used for preventing or
treating venous thromboembolic disease (VTE) during pregnancy. The
physiological changes in maternal metabolism have led to discussions on
optimal LMWH dosing strategy and possible need for monitoring. The aim of
this systematic review is to summarize and discuss whether LMWH dose
adjustment according to anti-Xa provides superior effectiveness and safety
compared with weight adjusted or fixed dosed LMWH in pregnant women. A
systematic literature search was performed in PubMed, Embase, and Scopus
on September 26, 2020. The study is reported according to Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
guidelines. Effectiveness was defined as episodes of thrombosis and safety
as bleeding episodes. In total, 33 studies were included: 4 randomized
controlled studies and 29 cohort studies. Prophylactic dosing strategies
employing weight dosed, fixed dosed, or anti-Xa adjusted LMWH dosing
performed equal in effectiveness and safety. In pregnant women with VTE or
high thromboembolic risk, therapeutic weight-adjusted LMWH and weight plus
anti-Xa-adjusted LMWH provided equal results in terms of effectiveness and
safety. Pregnant women with mechanical heart valves (MHVs) received
therapeutic anti-Xa-adjusted LMWH with four out of seven studies
presenting mean peak anti-Xa within target ranges. Still, pregnant women
with MHV experienced both thrombosis and bleeding with anti-Xa in target.
Based on the results of this systematic review, current evidence does not
support the need for anti-Xa monitoring when using LMWH as
thromboprophylaxis or treatment during pregnancy. Nonetheless, the need
for anti-Xa monitoring in pregnant women with MHV may need further
scrutiny. Copyright © 2021 Georg Thieme Verlag. All rights
reserved.

<57>
Accession Number
2007404360
Title
Efficacy of Transcutaneous Electrical Nerve Stimulation for Postoperative
Pain, Pulmonary Function, and Opioid Consumption Following Cardiothoracic
Procedures: A Systematic Review.
Source
Neuromodulation. 24(8) (pp 1439-1450), 2021. Date of Publication: December
2021.
Author
Cardinali A.; Celini D.; Chaplik M.; Grasso E.; Nemec E.C.
Institution
(Cardinali, Celini, Chaplik, Grasso, Nemec) Sacred Heart University,
Fairfield, CT, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: Transcutaneous electrical nerve stimulation (TENS) is a
minimally invasive method for treating pain. In the most recent review
published in 2012, TENS was associated with increased pain relief
following cardiothoracic surgery when compared to standard multimodal
analgesia. The purpose of this systematic review and meta-analysis is to
determine if adding TENS to current pain management practices decreases
pain and analgesic use and improves pulmonary function for
postcardiothoracic surgery patients. Material(s) and Method(s):
CINAHL, MEDLINE, Cochrane Database of Systematic Reviews, PubMed, and
ClinicalTrials.gov were searched using specific keywords. Covidence was
used to screen, select studies, and extract data by two independent
reviewers. The Cochrane Risk of Bias tool assessed risk of bias. Visual
analog scale (VAS) and pulmonary function data were exported for
meta-analysis using a random effects model. Result(s): The search
yielded 38 articles. Eight randomized controlled trials met inclusion
criteria for the literature review. Five studies were included in the
meta-analysis of pain at 24, 48, and 72 hours postoperatively. Data were
analyzed using the standard mean difference (SMD). TENS had a significant
impact on VAS at rest (-0.76 SMD [95% confidence interval, CI = -1.06 to
-0.49], p < 0.00001) and with coughing (-1.11 SMD [95% CI = -1.64 to
-0.56], p < 0.0001). FEV1 improved after 72 hours (1.00 SMD [95% CI =
0.66-1.35], p < 0.00001), as did forced vital capacity (1.16 SMD [95% CI =
0.23-2.10], p = 0.01). Conclusion(s): The addition of TENS therapy to
multimodal analgesia significantly decreases pain following cardiothoracic
surgery, increases the recovery of pulmonary function, and decreases the
use of analgesics. Copyright © 2020 International Neuromodulation
Society

<58>
Accession Number
2011261059
Title
Prospective ARNI vs. ACE inhibitor trial to DetermIne Superiority in
reducing heart failure Events after Myocardial Infarction (PARADISE-MI):
design and baseline characteristics.
Source
European Journal of Heart Failure. 23(6) (pp 1040-1048), 2021. Date of
Publication: June 2021.
Author
Jering K.S.; Claggett B.; Pfeffer M.A.; Granger C.; Kober L.; Lewis E.F.;
Maggioni A.P.; Mann D.; McMurray J.J.V.; Rouleau J.-L.; Solomon S.D.; Steg
P.G.; van der Meer P.; Wernsing M.; Carter K.; Guo W.; Zhou Y.; Lefkowitz
M.; Gong J.; Wang Y.; Merkely B.; Macin S.M.; Shah U.; Nicolau J.C.;
Braunwald E.
Institution
(Jering, Claggett, Pfeffer, Solomon) Cardiovascular Division, Brigham and
Women's Hospital, and Harvard Medical School, Boston, MA, United States
(Granger) Duke University Medical Center, Durham, NC, United States
(Kober) Rigshospitalet, Copenhagen, Denmark
(Lewis) Division of Cardiovascular Medicine, Stanford University School of
Medicine, Stanford University, Palo Alto, CA, United States
(Maggioni) ANMCO Research Center, Florence, Italy
(Mann) Washington University Medical Center, St Louis, MO, United States
(McMurray) British Heart Foundation Cardiovascular Research Centre,
University of Glasgow, Glasgow, United Kingdom
(Rouleau) Montreal Heart Institute, University of Montreal, Montreal,
Canada
(Steg) Universite de Paris, AP-HP (Assistance Publique-Hopitaux de Paris),
FACT (French Alliance for Cardiovascular Trials) and INSERM U-1148, Paris,
France
(van der Meer) Department of Cardiology, University Medical Center
Groningen, University of Groningen, Groningen, Netherlands
(Wernsing, Carter, Guo, Zhou, Lefkowitz, Gong, Wang) Novartis
Pharmaceutical Corporation, East Hanover, NJ, United States
(Merkely) Semmelweis University, Heart and Vascular Center, Budapest,
Hungary
(Macin) Instituto de Cardiologia JF Cabral Corrientes, Corrientes,
Argentina
(Shah) Care Institute of Medical Sciences, Ahmedabad, India
(Nicolau) Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade
de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
(Braunwald) TIMI Study Group, Cardiovascular Division, Brigham and Women's
Hospital, and Harvard Medical School, Boston, MA, United States
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Patients surviving an acute myocardial infarction (AMI) are at risk
of developing symptomatic heart failure (HF) or premature death. We
hypothesized that sacubitril/valsartan, effective in the treatment of
chronic HF, prevents development of HF and reduces cardiovascular death
following high-risk AMI compared to a proven angiotensin-converting enzyme
(ACE) inhibitor. This paper describes the study design and baseline
characteristics of patients enrolled in the Prospective ARNI vs. ACE
inhibitor trial to DetermIne Superiority in reducing heart failure Events
after Myocardial Infarction (PARADISE-MI) trial. Methods and Results:
PARADISE-MI, a multinational (41 countries), double-blind,
active-controlled trial, randomized patients within 0.5-7 days of
presentation with index AMI to sacubitril/valsartan or ramipril. Transient
pulmonary congestion and/or left ventricular ejection fraction (LVEF)
<=40% and at least one additional factor augmenting risk of HF or death
(age >=70 years, estimated glomerular filtration rate <60 mL/min/1.73
m2, diabetes, prior myocardial infarction, atrial fibrillation,
LVEF <30%, Killip class >=III, ST-elevation myocardial infarction without
reperfusion) were required for inclusion. PARADISE-MI was event-driven
targeting 708 primary endpoints (cardiovascular death, HF hospitalization
or outpatient development of HF). Randomization of 5669 patients occurred
4.3 +/- 1.8 days from presentation with index AMI. The mean age was 64 +/-
12 years, 24% were women. The majority (76%) qualified with ST-segment
elevation myocardial infarction; acute percutaneous coronary intervention
was performed in 88% and thrombolysis in 6%. LVEF was 37 +/- 9% and 58%
were in Killip class >=II. Conclusion(s): Baseline therapies in
PARADISE-MI reflect advances in contemporary evidence-based care. With
enrollment complete PARADISE-MI is poised to determine whether
sacubitril/valsartan is more effective than a proven ACE inhibitor in
preventing development of HF and cardiovascular death following
AMI. Copyright © 2021 European Society of Cardiology

<59>
Accession Number
2013554784
Title
Renal protection of transaxillary/subclavian accesses for transcatheter
aortic valve implantation in patients with impossible femoral access.
Source
Scandinavian Cardiovascular Journal. 55(5) (pp 297-299), 2021. Date of
Publication: 2021.
Author
Shi R.; Wu Q.; Tie H.
Institution
(Shi) Service de medecine intensive-reanimation, Hopitaux universitaires
Paris-Saclay, Hopital de Bicetre, APHP, Le Kremlin-Bicetre, France
(Shi) Inserm UMR S_999, Univ Paris-Saclay, Le Kremlin-Bicetre, France
(Wu, Tie) Department of Cardiothoracic Surgery, The First Affiliated
Hospital of Chongqing Medical University, Chongqing, China
Publisher
Taylor and Francis Ltd.
Abstract
Acute kidney injury (AKI) is a common postoperative complication after
transcatheter aortic valve replacement (TAVR). In patients with ineligible
femoral access, transaxillary/subclavian (TAx/TSc) might be competitive
alternative access. With nine cohort studies and 4995 patients, we found
that TAx/TSc access was associated with decreased incidences of AKI
(Relative risk [RR]: 0.573, 95% confidence interval [CI]:0.456-0.718, p
<.001) and stage 3 AKI (RR 0.460, 95%CI 0.318-0.665, p <.001) by
comparison with intrathoracic approaches. Our findings suggest that
TAx/TSc is associated with a reduced AKI risk after TAVR in patients with
impossible femoral access. Copyright © 2021 Informa UK Limited,
trading as Taylor & Francis Group.

<60>
Accession Number
2016115655
Title
Misdiagnosis of aortic dissection: A systematic review of the literature.
Source
American Journal of Emergency Medicine. 53 (pp 16-22), 2022. Date of
Publication: March 2022.
Author
Lovatt S.; Wong C.W.; Schwarz K.; Borovac J.A.; Lo T.; Gunning M.; Phan
T.; Patwala A.; Barker D.; Mallen C.D.; Kwok C.S.
Institution
(Lovatt, Wong, Lo, Gunning, Phan, Patwala, Barker, Kwok) Department of
Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, United
Kingdom
(Schwarz) Karl Landsteiner University of Health Sciences, Department of
Internal Medicine 3, University Hospital St. Polten, Krems, Austria
(Borovac) Clinic for Heart and Cardiovascular Diseases, University
Hospital of Split, Split, Croatia
(Mallen, Kwok) School of Medicine, Keele University, Stoke-on-Trent,
United Kingdom
Publisher
W.B. Saunders
Abstract
Background: Aortic dissection is a rare but potentially catastrophic
condition. Misdiagnosis of aortic dissection is not uncommon as symptoms
can overlap with other diagnoses. Objective(s): We conducted a
systematic review to better understand the factors contributing to
incorrect diagnosis of this condition. Method(s): We searched MEDLINE
and EMBASE for studies that evaluated the misdiagnosis of aortic
dissection. The rate of misdiagnosis was pooled and results were
narratively synthesized. Result(s): A total of 12 studies with were
included with 1663 patients. The overall rate of misdiagnosis of aortic
dissection was 33.8%. The proportion of patients presenting with chest
pain, back pain and syncope were 67.5%, 24.8% and 6.8% respectively. The
proportion of patients with pre-existing hypertension was 55.4%, 30.5%
were smokers while the proportion of patients with coronary artery
disease, previous cardiovascular surgery or surgical trauma and Marfan
syndrome was 14.7%, 5.8%, and 3.7%, respectively. Factors related to
misdiagnosis included the presence of symptoms and features associated
with other diseases (such as acute coronary syndrome, stroke and pulmonary
embolism), the absence of typical features (such as widened mediastinum on
chest X-ray) or concurrent conditions such congestive heart failure.
Factors associated with more accurate diagnosis included more
comprehensive history taking and increased use of imaging.
 Conclusion(s): Misdiagnosis in patients with an eventual diagnosis of
aortic dissection affects 1 in 3 patients. Clinicians should consider
aortic dissection as differential diagnosis in patients with chest pain,
back pain and syncope. Imaging should be used early to make the diagnosis
when aortic dissection is suspected. Copyright © 2021

<61>
Accession Number
2016374784
Title
10-Year All-Cause Mortality Following Percutaneous or Surgical
Revascularization in Patients With Heavy Calcification.
Source
JACC: Cardiovascular Interventions. 15(2) (pp 193-204), 2022. Date of
Publication: 24 Jan 2022.
Author
Kawashima H.; Serruys P.W.; Hara H.; Ono M.; Gao C.; Wang R.; Garg S.;
Sharif F.; de Winter R.J.; Mack M.J.; Holmes D.R.; Morice M.-C.; Kappetein
A.P.; Thuijs D.J.F.M.; Milojevic M.; Noack T.; Mohr F.-W.; Davierwala
P.M.; Onuma Y.
Institution
(Kawashima, Serruys, Hara, Ono, Gao, Wang, Sharif, Onuma) Department of
Cardiology, National University of Ireland, Galway, Galway, Ireland
(Kawashima, Hara, Ono, de Winter) Department of Cardiology, Academic
Medical Center, University of Amsterdam, Amsterdam, Netherlands
(Serruys) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Gao, Wang) Department of Cardiology, Radboud University, Nijmegen,
Netherlands
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Mack) Baylor Scott & White Health, Dallas, Texas, United States
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, Minnesota, United States
(Morice) Departement of Cardiologie, Hopital prive Jacques Cartier,
Generale de Sante Massy, Massy, France
(Kappetein, Thuijs, Milojevic) Department of Cardiothoracic Surgery,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
(Noack, Mohr) University Department of Cardiac Surgery, Heart Centre
Leipzig, Leipzig, Germany
(Davierwala) Division of Cardiovascular Surgery, Peter Munk Cardiac
Centre, Toronto General Hospital, University Health Network, Toronto,
Ontario, Canada
(Davierwala) Department of Surgery, University of Toronto, Toronto, Canada
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to assess 10-year all-cause
mortality in patients with heavily calcified lesions (HCLs) undergoing
percutaneous coronary intervention (PCI) or coronary artery bypass
grafting (CABG). Background(s): Limited data are available on very
long term outcomes in patients with HCLs according to the mode of
revascularization. Method(s): This substudy of the SYNTAXES (Synergy
Between PCI With Taxus and Cardiac Surgery Extended Survival) study
assessed 10-year all-cause mortality according to the presence of HCLs
within lesions with >50% diameter stenosis and identified during the
calculation of the anatomical SYNTAX (Synergy Between PCI With Taxus and
Cardiac Surgery) score among 1,800 patients with the 3-vessel disease
and/or left main disease randomized to PCI or CABG in the SYNTAX trial.
Patients with HCLs were further stratified according to disease type
(3-vessel disease or left main disease) and assigned treatment (PCI or
CABG). Result(s): The 532 patients with >=1 HCL had a higher crude
mortality rate at 10 years than those without (36.4% vs 22.3%; HR: 1.79;
95% CI: 1.49-2.16; P < 0.001). After adjustment, an HCL remained an
independent predictor of 10-year mortality (HR: 1.36; 95% CI: 1.09-1.69; P
= 0.006). There was a significant interaction in mortality between
treatment effect (PCI and CABG) and the presence or absence of HCLs
(P<inf>interaction</inf> = 0.005). In patients without HCLs, mortality was
significantly higher after PCI than after CABG (26.0% vs 18.8%; HR: 1.44;
95% CI: 0.97-1.41; P = 0.003), whereas in those with HCLs, there was no
significant difference (34.0% vs 39.0%; HR: 0.85; 95% CI: 0.64-1.13; P =
0.264). Conclusion(s): At 10 years, the presence of an HCL was an
independent predictor of mortality, with a similar prognosis following PCI
or CABG. Whether HCLs require special consideration when deciding the mode
of revascularization beyond their current contribution to the anatomical
SYNTAX score deserves further evaluation. (Synergy Between PCI With TAXUS
and Cardiac Surgery: SYNTAX Extended Survival [SYNTAXES], NCT03417050;
SYNTAX Study: TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass
Surgery for the Treatment of Narrowed Arteries [SYNTAX],
NCT00114972) Copyright © 2022 American College of Cardiology
Foundation

<62>
Accession Number
2016140820
Title
Effect of Cyclosporine on Cytokine Production in Elective Coronary Artery
Bypass Grafting: A Sub-Analysis of the CiPRICS (Cyclosporine to Protect
Renal Function in Cardiac Surgery) Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2021.
Date of Publication: 2021.
Author
Grins E.; Ederoth P.; Bjursten H.; Dardashti A.; Bronden B.; Metzsch C.;
Erdling A.; Nozohoor S.; Mokhtari A.; Hansson M.J.; Elmer E.; Algotsson
L.; Shrestha N.M.; Jovinge S.
Institution
(Grins, Ederoth, Dardashti, Bronden, Metzsch, Erdling, Algotsson)
Department of Cardiothoracic Anesthesia and Intensive Care, Department of
Clinical Sciences, Lund University, Skane University Hospital, Lund,
Sweden
(Bjursten, Nozohoor, Mokhtari) Department of Cardiothoracic Surgery,
Department of Clinical Sciences Lund University, Skane University
Hospital, Lund, Sweden
(Hansson, Elmer) Mitochondrial Medicine, Department of Clinical Sciences
Lund, Lund University, Lund, Sweden
(Shrestha, Jovinge) DeVos Cardiovascular Research Program, Fredrik Meijer
Heart and Vascular Institute Spectrum Health/Van Andel Institute, Grand
Rapids, MI, United States
(Jovinge) Cardiovascular Institute, Stanford University, Palo Alto, CA,
United States
Publisher
W.B. Saunders
Abstract
Objectives: The augmented inflammatory response to cardiac surgery is a
recognized cause of postoperative acute kidney injury. The present study
aimed to investigate the effects of preoperative cyclosporine treatment on
cytokine production and delineate factors associated with postoperative
kidney impairment. Design(s): A randomized, double-blind,
placebo-controlled, single-center study. Setting(s): At a tertiary
care, university hospital. Participant(s): Patients eligible for
elective coronary artery bypass grafting surgery; 67 patients were
enrolled. Intervention(s): Patients were randomized to receive 2.5
mg/kg cyclosporine or placebo before surgery. Cytokine levels were
measured after the induction of anesthesia and 4 hours after the end of
cardiopulmonary bypass. Measurements and Main Results:
Tissue-aggressive (interleukin [IL]-1beta, macrophage inflammatory protein
[MIP]-1beta, granulocyte colony-stimulating factor [G-CSF], IL-6, IL-8,
IL-17, MCP-1), as well tissue-lenient (IL-4) cytokines, were significantly
elevated in response to surgery. Changes in cytokine levels were not
affected by cyclosporine pretreatment. Conclusion(s): Elective
coronary artery bypass grafting surgery with cardiopulmonary bypass
triggers cytokine activation. This activation was not impacted by
preoperative cyclosporine treatment. Copyright © 2021 Elsevier
Inc.

<63>
Accession Number
2016140587
Title
Network meta-analysis comparing the short and long-term outcomes of
alternative access for transcatheter aortic valve replacement.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2021. Date of
Publication: 2021.
Author
Ranka S.; Lahan S.; Chhatriwalla A.K.; Allen K.B.; Chiang M.; O'Neill B.;
Verma S.; Wang D.D.; Lee J.; Frisoli T.; Eng M.; Bagur R.; O'Neill W.;
Villablanca P.
Institution
(Ranka) Department of Cardiovascular Medicine, University of Kansas
Medical Center, Kansas City, KS, United States
(Lahan) Division of Cardiovascular Prevention & Wellness, Department of
Cardiology, Houston Methodist, Houston, TX, United States
(Chhatriwalla, Allen) Department of Cardiothoracic Surgery, Saint Luke's
Mid America Heart Institute and University of Missouri-Kansas City, Kansas
City, MO, United States
(Chiang, O'Neill, Wang, Lee, Frisoli, O'Neill, Villablanca) Department of
Medicine, Division of Cardiology, Henry Ford Health System, Detroit, MI,
United States
(Verma) Department of Family Medicine, Henry Ford Allegiance Health,
Jackson, MI, United States
(Eng) Department of Cardiology, Banner University Medical Center, Phoenix,
AZ, United States
(Bagur) Division of Cardiology, Department of Medicine, London Health
Sciences Centre, Western University, London, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Several studies have pair-wise compared access sites for
transcatheter aortic valve replacement (TAVR) but pooled estimate of
overall comparative efficacy and safety outcomes are not well known. We
sought to compare short- and long-term outcomes following various
alternative access routes for TAVR. Method(s): Thirty-four studies
with a pooled sample size of 32,756 patients were selected by searching
PubMed and Cochrane library databases from inception through 11th June
2021 for patients undergoing TAVR via 1 of 6 different access sites:
Transfemoral (TF), Transaortic (TAO), Transapical (TA), Transcarotid (TC),
Transaxillary/Subclavian (TSA), and Transcaval (TCV). Data were extracted
to conduct a frequentist network meta-analysis with a random-effects model
using TF access as a reference group. Result(s): Compared with TF,
both TAO [RR 1.91, 95% CI (1.46-2.50)] and TA access [RR 2.12, 95% CI
(1.84-2.46)] were associated with an increased risk of 30-day mortality.
No significant difference was observed for stroke, myocardial infarction,
major bleeding, conversion to open surgery, and major adverse
cardiovascular or cerebrovascular events at 30 days between different
accesses. Major vascular complications were lower in TA [RR 0.43, (95% CI,
0.28-0.67)] and TC [RR 0.51, 95% CI (0.35-0.73)] access compared to TF.
The 1-year mortality was higher in TAO [RR of 1.35, (95% CI, 1.01-1.81)]
and TA [RR 1.44, (95% CI, 1.14-1.81)] groups. Conclusion(s):
Non-thoracic alternative access site utilization for TAVR implantation
(TC, TSA and TCV) is associated with outcomes similar to conventional TF
access. Thoracic TAVR access (TAO and TA) translates into increased short
and long-term mortality. Copyright © 2021 Elsevier Inc.

<64>
Accession Number
2016165010
Title
Comparison of invasive blood pressure monitoring versus normal
non-invasive blood pressure monitoring in ST-elevation myocardial
infarction patients with percutaneous coronary intervention.
Source
Injury. (no pagination), 2021. Date of Publication: 2021.
Author
Jiang Y.; Liu J.; Peng W.; Wang A.; Guo L.; Xu Z.
Institution
(Jiang, Liu, Peng, Wang, Guo, Xu) Department 2 of Cardiology, Cangzhou
Central Hospital, No. 16 Xinhua Road, Cangzhou, Hebei 061000, China
Publisher
Elsevier Ltd
Abstract
Background: Hypotension post percutaneous coronary intervention (PCI)
causes stent thrombosis and reduced coronary perfusion, which aggravate
myocardial ischemia and lead to patient death. Therefore, the accuracy and
timeliness of blood pressure monitoring (BPM) are crucial for the nursing
of patients post PCI. However, it is still controversial whether invasive
blood pressure monitoring (IBPM) or non-invasive blood pressure monitoring
(NIBPM) should be used for patients post PCI, and the magnitude of their
assistance for patients' recovery remains unclear. Method(s): A
randomized controlled trial was performed in this study. 126 ST-segment
elevation myocardial infarction (STEMI) patients post PCI were recruited
and randomly divided into two groups (NIBPM group n = 63; IBPM group n =
63). Result(s): Clinical characteristics and physiological outcomes
of participants received different BPM methods were collected and analyzed
to compare the effects of these two methods on the nursing of PCI
patients. Compared to NIBPM group, IBPM assisted to shorten the time of
myocardial ischemia, promote coronary reperfusion, reduce the occurrence
of cardiovascular disease and other complications, and ultimately reduce
the mortality of patients post PCI. Conclusion(s): The application of
IBPM contributed to reduce the occurrence of complications, shorten the
time of vascular reperfusion, and guide treatment of clinicians in
time. Copyright © 2021 Elsevier Ltd

<65>
Accession Number
2016104951
Title
Geographic barriers to children's surgical care: A systematic review of
existing evidence.
Source
Journal of Pediatric Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Buss R.; SenthilKumar G.; Bouchard M.; Bowder A.; Marquart J.;
Cooke-Barber J.; Vore E.; Beals D.; Raval M.; Rich B.S.; Goldstein S.; Van
Arendonk K.
Institution
(Buss, SenthilKumar, Bowder, Marquart, Van Arendonk) Division of Pediatric
Surgery, Department of Surgery, Medical College of Wisconsin, 999 North
92nd StreetSuite CCC 320, Milwaukee, WI 53226, United States
(Bouchard, Raval, Goldstein) Division of Pediatric Surgery, Ann and Robert
H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave. Chicago, IL
60611, United States
(Cooke-Barber) Division of Pediatric General and Thoracic Surgery,
Cincinnati Children's Hospital, 3333 Burnet Ave. ML 2023, Cincinnati, OH
45229, United States
(Vore, Beals) Department of Surgery, Marshall University Medical Center,
1600 Medical Center DriveSuite 2500, Huntington, WV 25701, United States
(Rich) Division of Pediatric Surgery, Cohen Children's Medical Center, 450
Lakeville Rd, North New Hyde Park, NY 11042, United States
Publisher
W.B. Saunders
Abstract
Background: Ensuring that children have access to timely and appropriate
surgical care is a vital component of comprehensive pediatric care. This
study systematically reviews the existing evidence related to geographic
barriers in children's surgery. Method(s): Medline and Scopus
databases were searched for any English language studies that examined
associations between geographic burden (rural residence or distance to
care) and a quantifiable outcome within pediatric surgical subspecialties.
Two independent reviewers extracted data from each study. Result(s):
From 6331 studies screened, 22 studies met inclusion criteria. Most
studies were retrospective analyses and conducted in the U.S. or Canada
(14 and three studies, respectively); five were conducted outside North
America. In transplant surgery (seven studies), greater distance from a
transplant center was associated with higher waitlist mortality prior to
kidney and liver transplantation, although graft outcomes were generally
similar. In congenital cardiac surgery (five studies), greater travel was
associated with higher neonatal mortality and older age at surgery but not
with post-operative outcomes. In general surgery (eight studies), rural
residence was associated with increased rates of perforated appendicitis,
higher frequency of negative appendectomy, and increased length of stay
after appendectomy. In orthopedic surgery (one study), rurality was
associated with decreased post-operative satisfaction. No evidence for
disparate outcomes based upon distance or rurality was identified in
neurosurgery (one study). Conclusion(s): Substantial evidence
suggests that geographic barriers impact the receipt of surgical care
among children, particularly with regard to transplantation, congenital
cardiac surgery, and appendicitis. Copyright © 2021

<66>
Accession Number
2010487834
Title
Intensive blood pressure treatment in coronary artery disease:
implications from the Systolic Blood Pressure Intervention Trial (SPRINT).
Source
Journal of Human Hypertension. 36(1) (pp 86-94), 2022. Date of
Publication: January 2022.
Author
Zang J.; Liang J.; Zhuang X.; Zhang S.; Liao X.; Wu G.
Institution
(Zang) Department of Cardiology, The Third Affiliated Hospital of Sun
Yat-sen University, Guangdong, Guangzhou, China
(Zang, Liang, Wu) Department of Cardiology, The Eighth Affiliated Hospital
of Sun Yat-sen University, Guangdong, Shenzhen, China
(Zang, Liang, Wu) Guangdong Innovative Engineering and Technology Research
Center for Assisted Circulation, Guangdong, Shenzhen, China
(Zhuang, Zhang, Liao) Department of Cardiology, The First Affiliated
Hospital of Sun Yat-sen University, Guangdong, Guangzhou, China
(Zhuang, Zhang, Liao, Wu) NHC Key Laboratory on Assisted Circulation, Sun
Yat-sen University, Guangdong, Guangzhou, China
Publisher
Springer Nature
Abstract
To investigate the optimal blood pressure (BP) in patients with coronary
artery disease (CAD), we conducted subgroup analysis using SPRINT data.
The study sample included 1206 participants with CAD (of whom 692
underwent coronary revascularization) and 8127 participants without CAD.
Participants were randomized into two groups (systolic BP target of 140 mm
Hg vs. 120 mm Hg). The primary outcome was a composite of cardiovascular
events. After a median follow-up of 3.9 years, the hazard ratios (HRs) for
the primary outcome were 0.65 (95% confidence interval (CI) 0.53-0.79) and
1.05 (95% CI 0.76-1.46) among those in the non-CAD and CAD subgroups,
respectively (P value for interaction 0.02). Intensive BP treatment was a
protective factor for all-cause death (HR 0.60, 95% CI 0.37-0.96) in the
CAD subgroup, compared with standard BP treatment. The HRs (95% CI) for
stroke were 3.57 (1.17-10.85) and 1.03 (0.29-3.62) among those in the
coronary revascularization and non-revascularization subgroups,
respectively (P value for interaction 0.13). For safety events, intensive
BP treatment increased the risk of hypotension (HR 2.00, 95% CI 1.06-3.79)
and electrolyte abnormalities (HR 2.38, 95% CI 1.25-4.56) in the CAD
subgroup, while the risk of serious adverse events did not increase (HR
1.03, 95% CI 0.88-1.20). These results suggest that positive benefits from
intensive BP treatment might be attenuated in patients with CAD who are
under better secondary prevention. The risk of stroke might increase at
the systolic BP target of 120 mm Hg in case of coronary revascularization,
although the confidence interval was wide. Copyright © 2021, The
Author(s).

<67>
Accession Number
2013570825
Title
Correlation of Near-Infrared Spectroscopy Oximetry and Corresponding
Venous Oxygen Saturations in Children with Congenital Heart Disease.
Source
Pediatric Cardiology. 43(1) (pp 197-206), 2022. Date of Publication:
January 2022.
Author
Loomba R.S.; Rausa J.; Sheikholeslami D.; Dyson A.E.; Farias J.S.;
Villarreal E.G.; Flores S.; Bronicki R.A.
Institution
(Loomba, Rausa) Cardiology, Pediatrics, Advocate Children's Hospital, Oak
Lawn, IL, United States
(Loomba, Sheikholeslami, Dyson) Medicine, Chicago Medical School/Rosalind
Franklin University of Medicine and Science, North Chicago, IL, United
States
(Farias, Villarreal) Tecnologico de Monterrey, Escuela de Medicina y
Ciencias de la Salud, Nuevo Leon, Monterrey, Mexico
(Flores, Bronicki) Division of Critical Care, Texas Children's
Hospital/Baylor College of Medicine, Houston, TX, United States
Publisher
Springer
Abstract
Invasive and non-invasive monitoring allow for early detection of
hemodynamic compromise, facilitating timely intervention and avoidance of
further decline. While venous oximetry is useful for assessing the
adequacy of systemic oxygen delivery (DO<inf>2</inf>), it is most often
intermittent, invasive, and costly. Near-infrared spectroscopy (NIRS)
oximetry allows for the non-invasive estimation of the adequacy of
DO<inf>2</inf>. We assessed the correlation between cerebral NIRS oximetry
and superior vena cava (SVC) and jugular venous (JV) oxygen saturations
and between renal NIRS oximetry and inferior vena cava (IVC) oxygen
saturations. Systematic review of the literature was conducted to identify
studies with data regarding near-infrared spectroscopy and venous
saturation. The PubMed, EMBASE, Medline, and Cochrane databases were
queried using the following terms in isolation and various combinations:
"congenital heart disease," "near infrared spectroscopy," "venous
saturation," and "pediatric." Pediatric studies in which simultaneous NIRS
oximetry and corresponding venous oxygen saturations were simultaneously
collected after cardiac surgery or catheterization were identified. Data
were pooled from these studies to analyze the correlation between NIRS
oximetry and the corresponding venous oxygen saturations. A total of 16
studies with 613 patients were included in the final analyses. Data were
present to compare cerebral and renal NIRS oximetry with corresponding
venous oxygen saturation. Cerebral NIRS and SVC and JV oxygen saturations
and renal NIRS and IVC oxygen saturations demonstrated strong degrees of
correlation (r-value 0.70 for each). However, cerebral NIRS and IVC oxygen
saturation had a week degree of correlation (r-value of 0.38). Pooled
analyses demonstrate that cerebral NIRS oximetry correlates strongly with
SVC or JV oxygen saturation while renal NIRS oximetry correlates strongly
with IVC oxygen saturations. A weak correlation was noted between cerebral
NIRS oximetry and IVC oxygen saturations. Copyright © 2021, The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<68>
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Accession Number
633374165
Title
Bariatric Surgery as a Bridge to Heart Transplantation in Morbidly Obese
Patients: A Systematic Review and Meta-Analysis.
Source
Cardiology in review. 30(1) (pp 1-7), 2022. Date of Publication: 01 Jan
2022.
Author
Lee Y.; Anvari S.; Sam Soon M.; Tian C.; Wong J.A.; Hong D.; Anvari M.;
Doumouras A.G.
Institution
(Lee, Sam Soon, Tian, Hong, Anvari, Doumouras) From the Division of
General Surgery, McMaster University, Hamilton, Ontario, Canada
(Anvari) Department of Medicine, McMaster University, Hamilton, Ontario,
Canada
(Wong) Population Health Research Institute, McMaster University,
Hamilton, Ontario, Canada
Publisher
NLM (Medline)
Abstract
Class 2 obesity or greater [body mass index (BMI) >35kg/m2] is a relative
contraindication for heart transplant due to its associated perioperative
risks and mortality. Whether bariatric surgery can act as a potential
bridging procedure to heart transplantation is unknown. The aim of this
systematic review and meta-analysis is to investigate the role of
bariatric surgery on improving transplant candidacy in patients with
end-stage heart failure (ESHF). MEDLINE, EMBASE, CENTRAL, and PubMed
databases were searched up to September 2019 for studies that performed
bariatric surgery on patients with severe obesity and ESHF. Outcomes of
interest included incidence of patients listed for heart transplantation
after bariatric surgery, proportion of patients that successfully received
transplant, the change in BMI after bariatric surgery, and 30-day
complications. Pooled estimates were calculated using a random-effects
meta-analysis of proportions. Eleven studies with 98 patients were
included. Mean preoperative BMI was 44.9 (2.1) kg/m2 and BMI after surgery
was 33.2 (2.3) kg/m2 with an absolute BMI reduction of 26.1%. After
bariatric surgery, 71% [95% confidence interval (CI), 55-86%] of patients
with ESHF were listed for transplantation. The mean time from bariatric
surgery to receiving a heart transplant was 14.9 (4.0) months. Of the
listed patients, 57% (95% CI, 39-74%) successfully received heart
transplant. The rate of 30-day mortality after bariatric surgery was 0%,
and the 30-day major and minor complications after bariatric surgery was
28% (95% CI, 10-49%). Bariatric surgery can facilitate sustained weight
loss in obese patients with ESHF, improving heart transplant candidacy and
the incidence of transplantation. Copyright © 2020 Wolters Kluwer
Health, Inc. All rights reserved.

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Accession Number
636125766
Title
No-Touch Versus Conventional Vein Harvesting Techniques at 12 Months After
Coronary Artery Bypass Grafting Surgery: Multicenter Randomized,
Controlled Trial.
Source
Circulation. 144(14) (pp 1120-1129), 2021. Date of Publication: 05 Oct
2021.
Author
Tian M.; Wang X.; Sun H.; Feng W.; Song Y.; Lu F.; Wang L.; Wang Y.; Xu
B.; Wang H.; Liu S.; Liu Z.; Chen Y.; Miao Q.; Su P.; Yang Y.; Guo S.; Lu
B.; Sun Z.; Liu K.; Zhang C.; Wu Y.; Xu H.; Zhao W.; Han C.; Zhou X.; Wang
E.; Huo X.; Hu S.
Institution
(Tian, Wang, Sun, Feng, Song, Lu, Wang, Yang, Guo, Sun, Liu, Zhang, Wu,
Xu, Zhao, Han, Zhou, Wang, Huo, Hu) Department of Surgery (M.T., H.S.,
F.L., S.G., K.L., C.H., Chinese Academy of Medical Sciences & Peking Union
Medical College, Beijing, China
(Wang) Medical Research & Biometrics Center (Yang Wang), Chinese Academy
of Medical Sciences & Peking Union Medical College, Beijing, China
(Xu) Department of Cardiology (B.X.), Chinese Academy of Medical Sciences
& Peking Union Medical College, Beijing, China
(Wang) Beijing Hospital, China (H.W.)
(Liu) Second Hospital of Hebei Medical University, China (S.L.)
(Liu) TEDA International Cardiovascular Hospital, Chinese Academy of
Medical Sciences & Peking Union Medical College, China (Z.L.), Tianjin,
China
(Chen) Peking University People's Hospital, China (Y.C.), Beijing, China
(Miao) National Center for Cardiovascular Disease, China & Fuwai Hospital,
Peking Union Medical College Hospital (Q.M.), Chinese Academy of Medical
Sciences & Peking Union Medical College, Beijing, China
(Su) Beijing Chaoyang Hospital, Capital Medical University, China (P.S.)
(Lu) Department of Radiology (B.L.), Chinese Academy of Medical Sciences &
Peking Union Medical College, Beijing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Vein graft occlusion is deemed a major challenge in coronary
artery bypass grafting. Previous studies implied that the no-touch
technique for vein graft harvesting could reduce occlusion rate compared
with the conventional approach; however, evidence on the clinical benefit
and generalizability of the no-touch technique is scare. METHOD(S):
From April 2017 to June 2019, we randomly assigned 2655 patients
undergoing coronary artery bypass grafting at 7 hospitals in a 1:1 ratio
to receive no-touch technique or conventional approach for vein
harvesting. The primary outcome was vein graft occlusion on computed
tomography angiography at 3 months and the secondary outcomes included
12-month vein graft occlusion, recurrence of angina, and major adverse
cardiac and cerebrovascular events. The generalized estimate equation
model was used to account for the cluster effect of grafts from the same
patient. RESULT(S): During the follow-up, 2533 (96.0%) participants
received computed tomography angiography at 3 months after coronary artery
bypass grafting and 2434 (92.2%) received it at 12 months. The no-touch
group had significantly lower rates of vein graft occlusion than the
conventional group both at 3 months (2.8% versus 4.8%; odds ratio, 0.57
[95% CI, 0.41-0.80]; P<0.001) and 12 months (3.7% versus 6.5%; odds ratio,
0.56 [95% CI, 0.41-0.76]; P<0.001). Recurrence of angina was also less
common in the no-touch group at 12 months (2.3% versus 4.1%; odds ratio,
0.55 [95% CI, 0.35-0.85]; P<0.01). Rates of major adverse cardiac and
cerebrovascular events were of no significant difference between the 2
groups. The no-touch technique was associated with higher rates of leg
wound surgical interventions at 3-month follow-up (10.3% versus 4.3%; odds
ratio, 2.55 [95% CI, 1.85-3.52]; P<0.001). CONCLUSION(S): Compared
with the conventional vein harvesting approach in coronary artery bypass
grafting, the no-touch technique significantly reduced the risk of vein
graft occlusion and improved patient prognosis. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier: NCT03126409.

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Accession Number
636055503
Title
Teprasiran, a Small Interfering RNA, for the Prevention of Acute Kidney
Injury in High-Risk Patients Undergoing Cardiac Surgery: A Randomized
Clinical Study.
Source
Circulation. 144(14) (pp 1133-1144), 2021. Date of Publication: 05 Oct
2021.
Author
Thielmann M.; Corteville D.; Szabo G.; Swaminathan M.; Lamy A.; Lehner
L.J.; Brown C.D.; Noiseux N.; Atta M.G.; Squiers E.C.; Erlich S.;
Rothenstein D.; Molitoris B.; Mazer C.D.
Institution
(Thielmann) Department of Thoracic and Cardiovascular Surgery, West-German
Heart and Vascular Center Essen, University Duisburg-Essen, Germany (M.T.)
(Corteville) Sands Constellation Heart Institute, Rochester Regional
Health, Rochester
(Szabo) Central German Heart Center University Hospital Halle (Saale),
University Clinic and Polyclinic for Cardiac Surgery, Germany (G.S.),
Halle, Belgium
(Swaminathan) Division of Cardiothoracic Anesthesiology and Critical Care
Medicine, Duke University Medical Center, Durham
(Lamy) David Braley Cardiac, Vascular and Stroke Research Institute,
McMaster University, ON, Hamilton, Bermuda
(Lehner) Department of Nephrology and Medical Intensive Care, Charite
Universitatsmedizin, Germany (L.J.L.), Berlin, Germany
(Brown) New Brunswick Heart Centre, Saint John Regional Hospital
(Noiseux) Division of Cardiac Surgery, University of Montreal Hospital
Center, CHUM Research Center, QC, Montreal, France
(Atta) Division of Nephrology, Johns Hopkins School of Medicine,
Baltimore, United States
(Squiers) Coastal Vista Consulting LLC, Half Moon Bay
(Erlich, Molitoris) Nephrology Division, Department of Medicine, Indiana
University School of Medicine; Indiana Center for Biological Microscopy,
Indianapolis (B.M.)
(Rothenstein) Quark Pharmaceuticals, Inc, Newark, United States
(Mazer) Li Ka Shing Knowledge Institute of St. Michael's Hospital,
Institute of Medical Sciences and Departments of Anesthesia and
Physiology, University of Toronto, ON
Publisher
NLM (Medline)
Abstract
BACKGROUND: Acute kidney injury (AKI) affects up to 30% of patients
undergoing cardiac surgery, leading to increased in-hospital and long-term
morbidity and mortality. Teprasiran is a novel small interfering RNA that
temporarily inhibits p53-mediated cell death that underlies AKI.
 METHOD(S): This prospective, multicenter, double-blind, randomized,
controlled phase 2 trial evaluated the efficacy and safety of a single 10
mg/kg dose of teprasiran versus placebo (1:1), in reducing the incidence,
severity, and duration of AKI after cardiac surgery in high-risk patients.
The primary end point was the proportion of patients who developed AKI
determined by serum creatinine by postoperative day 5. Other end points
included AKI severity and duration using various prespecified criteria. To
inform future clinical development, a composite end point of major adverse
kidney events at day 90, including death, renal replacement therapy, and
>=25% reduction of estimated glomerular filtration rate was assessed. Both
serum creatinine and serum cystatin-C were used for estimated glomerular
filtration rate assessments. RESULT(S): A total of 360 patients were
randomly assigned in 41 centers; 341 dosed patients were 73+/-7.5 years of
age (mean+/-SD), 72% were men, and median European System for Cardiac
Operative Risk Evaluation score was 2.6%. Demographics and surgical
parameters were similar between groups. AKI incidence was 37% for
teprasiran- versus 50% for placebo-treated patients, a 12.8% absolute risk
reduction, P=0.02; odds ratio, 0.58 (95% CI, 0.37-0.92). AKI severity and
duration were also improved with teprasiran: 2.5% of teprasiran- versus
6.7% of placebo-treated patients had grade 3 AKI; 7% teprasiran- versus
13% placebo-treated patients had AKI lasting for 5 days. No significant
difference was observed for the major adverse kidney events at day 90
composite in the overall population. No safety issues were identified with
teprasiran treatment. CONCLUSION(S): The incidence, severity, and
duration of early AKI in high-risk patients undergoing cardiac surgery
were significantly reduced after teprasiran administration. A phase 3
study with a major adverse kidney event at day 90 primary outcome that has
recently completed enrollment was designed on the basis of these findings
(NCT03510897). Registration: URL: https://www.clinicaltrials.gov; Unique
identifier: NCT02610283.

<71>
Accession Number
635783682
Title
Recommendations for the use of coronary and valve simulators in cardiac
surgical training: a systematic review.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 61(1) (pp 1-10), 2021.
Date of Publication: 27 Dec 2021.
Author
Whittaker G.; Salmasi M.Y.; Aydin A.; Magouliotis D.; Raja S.G.;
Asimakopoulos G.; Moorjani N.; Athanasiou T.
Institution
(Whittaker, Salmasi, Athanasiou) Department of Surgery and Cancer,
Imperial College London, London, United Kingdom
(Whittaker) Department of Cardiothoracic Surgery, Manchester University
NHS Foundation Trust, Manchester, United Kingdom
(Aydin) MRC Centre for Transplantation, King's College London, London,
United Kingdom
(Magouliotis) Department of Cardiothoracic Surgery, University of
Thessaly, Greece
(Raja, Asimakopoulos) Department of Cardiothoracic Surgery, Royal Brompton
& Harefield NHS Foundation Trust, London, United Kingdom
(Moorjani) Department of Cardiothoracic Surgery, Royal Papworth Hospital
NHS Foundation Trust, Cambridge, United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The aim of this study was to systematically review the
simulators that are currently available for coronary artery bypass graft
and valve surgery and, in addition, to review the validation evidence
supporting them and to recommend several simulators for training based on
the analysis of results. METHOD(S): A systematic literature search of
the MEDLINE (1946 to May 2021) and EMBASE (1947 to May 2021) databases was
performed to identify simulators for coronary artery and valvular
procedures in cardiothoracic surgery. A selection of keywords and MeSH
terms was used to execute the literature search. After identification of
relevant articles, data were extracted and analysed. RESULT(S):
Thirty-seven simulators were found in 31 articles. Simulators were found
for coronary artery bypass graft (n=24) and valve surgery (n=13). The
majority of models were either benchtop (n=28) or hybrid (n=8) modalities.
Evidence of validity was demonstrated in 15 (40.5%) simulators. Twenty-two
(59.5%) simulators had no validation evidence, and 1 (2.7%) simulator had
3 or more elements of validity established. CONCLUSION(S): Two
simulators were recommended for supplemental training in cardiothoracic
surgery. Low-fidelity models can provide a broad foundation for surgical
skills' development whereas high-fidelity simulators can be used for
immersive training scenarios and appraisals. These should be utilized in
early training, at which point the learning curve of trainees is
steepest. Copyright © The Author(s) 2021. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<72>
Accession Number
634331358
Title
Continuous Paravertebral Analgesia versus Continuous Epidural Analgesia
after Video-Assisted Thoracoscopic Lobectomy for Lung Cancer: A Randomized
Controlled Trial.
Source
Annals of thoracic and cardiovascular surgery : official journal of the
Association of Thoracic and Cardiovascular Surgeons of Asia. 27(5) (pp
297-303), 2021. Date of Publication: 20 Oct 2021.
Author
Lai J.; Situ D.; Xie M.; Yu P.; Wang J.; Long H.; Lai R.
Institution
(Lai, Situ, Xie, Yu, Wang, Long, Lai) Collaborative Innovation Center for
Cancer Medicine, State Key Laboratory of Oncology in South China, Sun
Yat-Sen University Cancer Center, Guangzhou, China
(Lai, Xie, Yu, Wang, Lai) Department of Anesthesiology, Sun Yat-Sen
University Cancer Center, Guangzhou, China
(Situ, Long) Lung Cancer Research Institute, Sun Yat-sen University,
Guangzhou, China
(Situ, Long) Department of Thoracic Surgery, Sun Yat-Sen University Cancer
Center, Guangzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Whether continuous thoracic epidural analgesia (TEA) and
continuous paravertebral block (PVB) have similar analgesic effects in
patients undergoing video-assisted thoracic surgery (VATS) lobectomy was
compared in this study. METHOD(S): In all, 86 patients undergoing
VATS lobectomy were enrolled in the prospective, randomized clinical
trial. Group E received TEA. Group P received PVB. The primary endpoint
was postoperative 24-hour visual rating scale (VAS) on coughing. Side
effects and postoperative complications were also analyzed.
 RESULT(S): Pain scores at rest or on coughing at 24 and 48 h
postoperatively were significantly lower in group E than in group P (P
<0.05). At 24 h postoperatively, more patients in group E suffered from
vomiting (32.6% vs 11.6%, P = 0.019), dizziness (55.8% vs 12.9%, P =
0.009), pruritus (27.9% vs 2.3%, P = 0.002), and hypotension (32.6% vs
4.7%, P = 0.002) than those in group P. Patients in group E were more
satisfied (P = 0.047). Four patients in group P and two patients in group
E suffered from pulmonary complications (P >0.05). The length of hospital
and intensive care unit (ICU) stays were not significantly different.
 CONCLUSION(S): Though TEA has more adverse events than PVB, it may be
superior to PVB in patients undergoing VATS lobectomy.

<73>
Accession Number
2014601407
Title
Ultrasound-guided erector spinae plane catheter versus video-assisted
paravertebral catheter placement in minimally invasive thoracic surgery:
comparing continuous infusion analgesic techniques on early quality of
recovery, respiratory function and chronic persistent surgical pain: study
protocol for a double-blinded randomised controlled trial.
Source
Trials. 22(1) (no pagination), 2021. Article Number: 965. Date of
Publication: December 2021.
Author
Moorthy A.; Eochagain A.N.; Dempsey E.; Buggy D.
Institution
(Moorthy, Buggy) Division of Anaesthesiology & Perioperative Medicine,
Mater University Hospital, Dublin, Ireland
(Eochagain, Dempsey) Department of Anaesthesia and Critical Care, St
James's University Hospital, Dublin, Ireland
Publisher
BioMed Central Ltd
Abstract
Background: Compared to conventional thoracotomy, minimally invasive
thoracic surgery (MITS) can reduce postoperative pain, reduce tissue
trauma and contribute to better recovery. However, it still causes
significant acute postoperative pain. Truncal regional anaesthesia
techniques such as paravertebral and erector spinae blocks have shown to
contribute to postoperative analgesia after MITS. Satisfactory placement
of an ultrasound-guided thoracic paravertebral catheter can be technically
challenging compared to an ultrasound-guided erector spinae catheter.
However, in MITS, an opportunity arises for directly visualised placement
of a paravertebral catheter by the surgeon under thoracoscopic guidance.
Alongside with thoracic epidural, a paravertebral block is considered the
"gold standard" of thoracic regional analgesic techniques. To the best of
our knowledge, there are no randomised controlled trials comparing
surgeon-administered paravertebral catheter and anaesthesiologist-assisted
erector spinae catheter for MITS in terms of patient-centred outcomes such
as quality of recovery. Method(s): This trial will be a prospective,
double-blinded randomised controlled trial. A total of 80 eligible
patients will be randomly assigned to receive either an
anaesthesiologist-assisted ultrasound-guided erector spinae catheter or a
surgeon-assisted video-assisted paravertebral catheter, in a 1:1 ratio
following induction of general anaesthesia for minimally assisted thoracic
surgery. Both groups will receive the same standardised analgesia protocol
for both intra- and postoperative periods. The primary outcome is defined
as Quality of Recovery (QoR-15) score between the two groups at 24 h
postoperative. Secondary outcomes include assessment of chronic persistent
surgical pain (CPSP) at 3 months postoperative using the Brief Pain
Inventory (BPI) Short Form and Short Form McGill (SF-15) questionnaires,
assessment of postoperative pulmonary function, area under the curve for
Verbal Rating Score for pain at rest and on deep inspiration versus time
over 48 h, total opioid consumption over 48 h, QoR-15 at 48 h, and
postoperative complications and morbidity as measured by the Comprehensive
Complication Index. Discussion(s): Despite surgical advancements in
thoracic surgery, severe acute postoperative pain following MITS is still
prevailing. This study will provide recommendations about the efficacy of
an anaesthesia-administered ultrasound-guided erector spinae catheter or
surgeon-administered, video-assisted paravertebral catheter techniques for
early quality of recovery following MITS. Trial registration:
ClinicalTrials.govNCT04729712. Registered on 28 January 2021. All items
from the World Health Organization Trial Registration Data Set have been
included. Copyright © 2021, The Author(s).

<74>
Accession Number
636955515
Title
The Outcomes of Patients Incidentally Confirmed with Covid-19 After
Cardiac Surgery.
Source
The heart surgery forum. 24(6) (pp E940-E946), 2021. Date of Publication:
12 Nov 2021.
Author
Uysal A.; Erturk E.; Abacilar A.F.; Duman U.; Dogan O.F.
Institution
(Uysal) Firat University Medical Faculty Cardiovascular Surgery Clinic,
Turkey
(Erturk) Health Science University, Mersin City Hospital, Department of
Cardiovascular Surgery, Mersin, Turkey
(Abacilar) Department of Cardiovascular Surgery, The Private Izmir Su
Hospital, Izmir, Turkey
(Duman) Department of Cardiovascular Surgery, Private Tekirdag Hospital,
Tekirdag, Turkey
(Dogan) diyaman University School of Medicine, Department of
Cardiovascular Surgery
Publisher
NLM (Medline)
Abstract
BACKGROUND: The aim of this study was to investigate the clinical outcomes
of cardiac surgery in patients who were incidentally diagnosed with
Covid-19 in the postoperative period. PATIENTS AND METHODS: We
performed 826 open cardiac surgeries in five tertiary centers. Most of the
surgeries were elective coronary artery bypass grafting (CABG) (93.8%). A
preoperative RT-PCR test and transcutaneous oxygen saturation were
routinely investigated prior to surgery. We also investigated whether the
patients already received Covid-19 treatment or had any contact with a
Covid-19 patient in the last two weeks. We analyzed high sensitive
C-reactive protein (hs-CRP), d-dimer, and fibrinogen, which plays a main
role in the activation of procoagulant state after surgeries.
 RESULT(S): Acute lung injury related to Covid-19 activation was
observed in 48 out of 826 patients (5.8%). The median age of 48 patients
was 63.9+/-12.4 years. Euro-Score and body mass index (BMI) were 6.1+/-1.1
and 29.2+/-4.1kg/m2, respectively. RT-PCR test results were positive in 29
patients (60.4%). We performed thoracic computed tomography (CT) in all
patients with or without positive RT-PCR test results. Thoracic CT images
showed that there was a different degree of ARDS (mild, moderate, and
serious). The median time of extracorporeal circulation (ECC) was
93.2+/-14.6 min. in on-pump surgery (IQR, 68-155 min.). Common symptoms
included dyspnea (N = 22; 45.8%) and fever (N = 12; 25%). Eleven patients
needed readmission to ICU. Compared with non-admitted to ICU patients, ICU
patients were higher comorbidities and severe laboratory abnormalities
(eg, high blood d-dimer and fibrinogen). We also detected significantly
low oxygen saturation, hypercapnia, and severe acidosis in readmitted
patients. Radiologic investigations showed that there were severe ARDS
with bilateral pneumonic infiltration resistant to medical treatment in 6
out of 11 patients who died (54.5%). CONCLUSION(S): Diffuse pneumonic
infiltration related to Covid-19 may develop in asymptomatic cardiac
surgery patients with negative RT-PCR test results. Immunologic disorders
resulting from ECC, physiologic distress, and anesthesia may activate
Covid-19 during the incubation period. We need randomized clinical trials
to explain Covid-19 activation in the latent period of the virus, and
clinical outcomes in cardiac surgery.

<75>
Accession Number
2016159052
Title
2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization:
Executive Summary: A Report of the American College of Cardiology/American
Heart Association Joint Committee on Clinical Practice Guidelines.
Source
Journal of the American College of Cardiology. 79(2) (pp 197-215), 2022.
Date of Publication: 18 Jan 2022.
Author
Lawton J.S.; Tamis-Holland J.E.; Bangalore S.; Bates E.R.; Beckie T.M.;
Bischoff J.M.; Bittl J.A.; Cohen M.G.; DiMaio J.M.; Don C.W.; Fremes S.E.;
Gaudino M.F.; Goldberger Z.D.; Grant M.C.; Jaswal J.B.; Kurlansky P.A.;
Mehran R.; Metkus T.S.; Nnacheta L.C.; Rao S.V.; Sellke F.W.; Sharma G.;
Yong C.M.; Zwischenberger B.A.
Publisher
Elsevier Inc.
Abstract
Aim: The executive summary of the American College of Cardiology/American
Heart Association/Society for Cardiovascular Angiography and Interventions
coronary artery revascularization guideline provides the top 10 items
readers should know about the guideline. In the full guideline, the
recommendations replace the 2011 coronary artery bypass graft surgery
guideline and the 2011 and 2015 percutaneous coronary intervention
guidelines. This summary offers a patient-centric approach to guide
clinicians in the treatment of patients with significant coronary artery
disease undergoing coronary revascularization, as well as the supporting
documentation to encourage their use. Method(s): A comprehensive
literature search was conducted from May 2019 to September 2019,
encompassing studies, reviews, and other evidence conducted on human
subjects that were published in English from PubMed, EMBASE, the Cochrane
Collaboration, CINHL Complete, and other relevant databases. Additional
relevant studies, published through May 2021, were also considered.
Structure: Recommendations from the earlier percutaneous coronary
intervention and coronary artery bypass graft surgery guidelines have been
updated with new evidence to guide clinicians in caring for patients
undergoing coronary revascularization. This summary includes
recommendations, tables, and figures from the full guideline that relate
to the top 10 take-home messages. The reader is referred to the full
guideline for graphical flow charts, supportive text, and tables with
additional details about the rationale for and implementation of each
recommendation, and the evidence tables detailing the data considered in
the development of this guideline. Copyright © 2022 The American
College of Cardiology Foundation and the American Heart Association, Inc.

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Accession Number
2016472849
Title
The design of an adaptive clinical trial to evaluate the efficacy of
platelets stored at low temperature in surgical patients.
Source
Journal of Trauma and Acute Care Surgery. 84(6S) (pp S41-S46), 2018. Date
of Publication: 01 Jun 2018.
Author
Krachey E.; Viele K.; Spinella P.C.; Steiner M.E.; Zantek N.D.; Lewis R.J.
Institution
(Krachey, Viele, Lewis) Berry Consultants, LLC, Austin, TX, United States
(Spinella) Division Critical Care, Department of Pediatrics, Washington
University in St Louis, St Louis, MO, United States
(Steiner) Divisions of Hematology/Oncology and Critical Care Medicine,
Department of Pediatrics, University of Minnesota, Minneapolis, MN, United
States
(Zantek) Department of Laboratory Medicine and Pathology, University of
Minnesota, Minneapolis, MN, United States
(Lewis) Department of Emergency Medicine, Harbor-UCLA Medical Center, Los
Angeles Biomedical Research Institute, Torrance, United States
(Lewis) Department of Emergency Medicine, David Geffen School of Medicine
at UCLA, Los Angeles, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Storage of platelets at 4degreeC compared with 22degreeC may
increase both hemostatic activity and storage duration; however, the
maximum duration of cold storage is unknown. We report the design of an
innovative, prospective, randomized, Bayesian adaptive, "duration finding"
clinical trial to evaluate the efficacy and maximum duration of storage of
platelets at 4degreeC. METHOD(S): Patients undergoing cardiac surgery
and requiring platelet transfusions will be enrolled. Patients will be
randomized to receive platelets stored at 22degreeC up to 5 days or
platelets stored at 4degreeC up to 5 days, 10 days, or 15 days. Longer
durations of cold storage will only be used if shorter durations at
4degreeC appear noninferior to standard storage, based on a four-level
clinical hemostatic efficacy score with a NIM of a half level. A Bayesian
linear model is used to estimate the hemostatic efficacy of platelet
transfusions based on the actual duration of storage at 4degreeC.
 RESULT(S): The type I error rate, if platelets stored at 4degreeC are
inferior, is 0.0247 with an 82% probability of early stopping for
futility. With a maximum sample size of 1,500, the adaptive trial design
has a power of over 90% to detect noninferiority and a high probability of
correctly identifying the maximum duration of storage at 4degreeC that is
noninferior to 22degreeC. CONCLUSION(S): An adaptive,
duration-finding trial design will generate Level I evidence and allow the
determination of the maximum duration platelet storage at 4degreeC that is
noninferior to standard storage at 22degreeC, with respect to hemostatic
efficacy. The adaptive trial design helps to ensure that longer cold
storage durations are only explored once substantial supportive data are
available for the shorter duration(s) and that the trial stops early if
continuation is likely to be futile. Copyright © 2018 Wolters
Kluwer Health, Inc. All rights reserved.

<77>
Accession Number
2016536944
Title
Outcomes of cardiac surgical procedures performed by trainees versus
consultants: A systematic review with meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2022.
Date of Publication: 2022.
Author
Escorel Neto A.C.; Sa M.P.; Van den Eynde J.; Rotbi H.; Do-Nguyen C.C.;
Olive J.K.; Cavalcanti L.R.P.; Torregrossa G.; Sicouri S.; Ramlawi B.;
Hussein N.
Institution
(Escorel Neto, Cavalcanti) Division of Cardiovascular Surgery of Pronto
Socorro Cardiologico de Pernambuco - PROCAPE, Recife, Brazil
(Escorel Neto, Cavalcanti) University of Pernambuco - UPE, Recife, Brazil
(Sa, Torregrossa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Main Line Health, Wynnewood, Pa, United States
(Sa, Sicouri, Ramlawi) Department of Cardiac Surgery Research, Lankenau
Institute for Medical Research, Wynnewood, Pa, United States
(Van den Eynde) Department of Cardiovascular Diseases, Unit of Cardiac
Surgery, University Hospitals Leuven, Leuven, Belgium
(Rotbi) Faculty of Medicine, Radboud University, Nijmegen, Netherlands
(Rotbi) Radboud Institute for Health Sciences, Department of Physiology,
Radboud University Medical Center, Nijmegen, Netherlands
(Do-Nguyen) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, Mich, United States
(Olive) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University Medical Center, Durham, NC
(Hussein) Department of Congenital Cardiac Surgery, Yorkshire Heart
Centre, Leeds General Infirmary, England, United Kingdom
Publisher
Elsevier Inc.
Abstract
Objectives: Cardiac surgery is highly demanding and the ideal teaching
method to reach competency is widely debated. Some studies have shown that
surgical trainees can safely perform full operations with equivocal
outcomes compared with their consultant colleagues while under
supervision. We aimed to compare outcomes after cardiac surgery with
supervised trainee involvement versus consultant-led procedures.
 Method(s): We systematically reviewed databases (PubMed/MEDLINE,
Embase, the Cochrane Central Register of Controlled Trials,
ClinicalTrials.gov, Google Scholar) and reference lists of relevant
articles for studies that compared outcomes of cardiac surgery performed
by trainees versus consultants. Primary end points included: operative
mortality, coronary events, neurological/renal complications, reoperation,
permanent pacemaker implantation, and sternal complications. Secondary
outcomes included cardiopulmonary bypass and aortic cross-clamp times and
intensive care/in-hospital length of stay. Random effects meta-analysis
was performed. Result(s): Thirty-three observational studies that
reported on a total of 81,616 patients (trainee: 20,154; consultant:
61,462) were included. There was a difference favoring trainees in terms
of operative mortality in the main analysis and in an analysis restricted
to propensity score-matched samples, whereas other outcomes were not
consistently different in both analyses. Overall cardiopulmonary bypass
and aortic cross-clamp times were longer in the trainee group but did not
translate in longer intensive care unit or hospital stay.
 Conclusion(s): In the right conditions, good outcomes are possible in
cardiac surgery with trainee involvement. Carefully designed training
programs ensuring graduated hands-on operative exposure as primary
operator with appropriate supervision is fundamental to maintain
high-quality training in the development of excellent cardiac
surgeons. Copyright © 2021

<78>
Accession Number
2016536941
Title
The detection, treatment of parvovirus B19 infection induced anemia in
solid organ transplants: A case series and literature review of 194
patients.
Source
Transfusion Clinique et Biologique. (no pagination), 2022. Date of
Publication: 2022.
Author
Zhong Q.; Zeng J.; Lin T.; Song T.
Institution
(Zhong, Lin, Song) Urology Department, Urology research institute, West
China Hospital, Sichuan University, Chengdu, Sichuan, China
(Zhong, Lin, Song) Organ transplantation center, West China Hospital,
Sichuan University, Chengdu, Sichuan, China
(Zeng) Department of Transplantation Surgery, The Affiliated Hospital of
Guizhou Medical University, Guiyang, Guizhou, China
Publisher
Elsevier Masson s.r.l.
Abstract
Background: There are no optimal diagnostic, treatment and post-infection
surveillance strategies for parvovirus B19 infection in solid organ
transplantation (SOT) recipients. Method(s): We conducted a
retrospective review of all PVB19 infected cases confirmed by qPCR among
SOT recipients at our institution over a 3-year period and reviewed the
literature from 1990 to 2021. Result(s): Eight kidney and two heart
transplant patients with refractory anemia had PVB19 infection. The viral
DNA load in peripheral blood ranged from 2.62 x 102 to 8.31 x
106 copies/mL. Two patients with the lowest PVB19 DNA load only
reduced the use of immunosuppressants and anemia was relieved. Eight
received intravenous immunoglobulin (IVIG) (ranging from 0.25 to 0.5
g/kg/day). The median time to anemia improvement (hemoglobulin > 100 g/L)
was 16 days (8-70 days) after treatment. One patient had a PVB19 relapse
and viral DNA load > 1.00 x 108 copies/mL at diagnosis. A total
of 86 studies involving 194 SOTs were screened from the literature, and
the most common symptom was anemia and low reticulocyte count. PVB19 DNA
was detected in all cases. Of that, 91.4% of cases received IVIG, 53.8%
received IVIG and immunosuppression reduction, 6.5% of cases showed
reduced immunosuppression without IVIG, and 2.1% did not receive any
special treatment. The recurrence rate was 17.5%. Conclusion(s):
PVB19 infection is a cause of anemia after SOT, and treatment mainly
relies on IVIG and/or immunosuppression reduction. Copyright ©
2022 Societe francaise de transfusion sanguine (SFTS)

<79>
Accession Number
2016506550
Title
Sex-Specific Outcomes Following Percutaneous Coronary Intervention Versus
Coronary Artery Bypass Grafting for Left Main Disease: A Systematic Review
and Meta-Analysis.
Source
Heart Lung and Circulation. (no pagination), 2022. Date of Publication:
2022.
Author
Zhou J.Y.; Tie E.N.; Liew D.; Duffy S.J.; Shaw J.; Walton A.; Chan W.;
Stub D.
Institution
(Zhou, Tie, Liew, Duffy, Shaw, Walton, Chan, Stub) Department of
Cardiology, The Alfred Hospital, Melbourne, Vic, Australia
(Liew, Duffy, Stub) School of Public Health and Preventive Medicine,
Monash University, Melbourne, Vic, Australia
(Chan, Stub) Western Health, Melbourne, Vic, Australia
Publisher
Elsevier Ltd
Abstract
Objective: To assess whether outcomes following percutaneous coronary
intervention (PCI) versus coronary artery bypass grafting (CABG) for left
main coronary artery (LMCA) disease differ between men and women.
 Background(s): Current guidelines recommend either PCI or CABG for
patients with unprotected LMCA disease and low-to-intermediate anatomical
complexity. However, it is unclear whether these guidelines apply to
women, who are underrepresented in clinical trials. Method(s): An
electronic search was performed to identify studies reporting sex-specific
outcomes after PCI versus CABG in patients with LMCA disease. Trial level
hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled by
random-effects modelling. Result(s): Eight (8) studies met inclusion
criteria, comprising 13,066 patients (24.3% women). In both sexes, there
was no difference between PCI and CABG with respect to the primary
composite endpoint of death, myocardial infarction or stroke (HR in women:
1.03, 95% CI 0.76-1.40; HR in men: 1.04, 95% CI 0.92-1.17). However, both
sexes were more likely to require repeat revascularisation after PCI.
There was no interaction between sex and treatment effect for the primary
composite endpoint nor for the individual outcomes of death, stroke and
repeat revascularisation. However, in women the risk of myocardial
infarction was higher after PCI compared with CABG (HR 1.84, 95% CI
1.06-3.18), with a trend toward the opposite in men (HR 0.78, 95% CI
0.54-1.13; p-interaction=0.01). Conclusion(s): Percutaneous coronary
intervention and CABG have a comparable risk of the composite outcome of
death, stroke or myocardial infarction in patients undergoing
revascularisation for LMCA disease, with no significant interaction
between sex and treatment effect. Copyright © 2021 Australian and
New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the
Cardiac Society of Australia and New Zealand (CSANZ)

<80>
Accession Number
2014753202
Title
Randomized controlled trial of an alternative drainage strategy vs routine
chest tube insertion for postoperative pain after thoracoscopic wedge
resection.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 27. Date
of Publication: December 2022.
Author
Wei S.; Zhang G.; Ma J.; Nong L.; Zhang J.; Zhong W.; Cui J.
Institution
(Wei) Department of Anaesthesiology, The First Affiliated Hospital of
Jinan University, Guangzhou 510632, China
(Zhang, Ma, Nong, Cui) Department of Anaesthesiology, Guangdong Provincial
People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou
510080, China
(Zhang, Zhong) Guangdong Lung Cancer Institute, Guangdong Provincial
People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou
510080, China
Publisher
BioMed Central Ltd
Abstract
Background: Thoracoscopic surgery has greatly alleviated the postoperative
pain of patients, but postsurgical acute and chronic pain still exists and
needs to be addressed. Indwelling drainage tubes are one of the leading
causes of postoperative pain after thoracic surgery. Therefore, the aim of
this study was to explore the effects of alternative drainage on acute and
chronic pain after video-assisted thoracoscopic surgery (VATS).
 Method(s): Ninety-two patients undergoing lung wedge resection were
selected and randomly assigned to the conventional chest tube (CT) group
and the 7-Fr central venous catheter (VC) group. Next, the numeric rating
scale (NRS) and pain DETECT questionnaire were applied to evaluate the
level and characteristics of postoperative pain. Result(s): NRS
scores of the VC group during hospitalization were significantly lower
than those of the CT group 6 h after surgery, at postoperative day 1, at
postoperative day 2, and at the moment of drainage tube removal. Moreover,
the number of postoperative salvage analgesics (such as nonsteroidal
anti-inflammatory drugs [(NSAIDs]) and postoperative hospitalization days
were notably reduced in the VC group compared with the CT group. However,
no significant difference was observed in terms of NRS pain scores between
the two groups of patients during the follow-up for chronic pain at 3
months and 6 months. Conclusion(s): In conclusion, a drainage
strategy using a 7-Fr central VC can effectively relieve perioperative
pain in selected patients undergoing VATS wedge resection, and this may
promote the rapid recovery of such patients after surgery. Trial
registration: ClinicalTrials.gov, NCT03230019. Registered July 23,
2017. Copyright © 2022, The Author(s).

<81>
Accession Number
2014759838
Title
The impact of intraoperative blood pressure variability on the risk of
postoperative adverse outcomes in non-cardiac surgery: a systematic
review.
Source
Journal of Anesthesia. (no pagination), 2022. Date of Publication: 2022.
Author
Putowski Z.; Czok M.; Krzych L.J.
Institution
(Putowski, Czok) Students' Scientific Society, Department of
Anaesthesiology and Intensive Care, Faculty of Medical Sciences in
Katowice, Medical University of Silesia, Medykow 14 Street, Katowice
40752, Poland
(Krzych) Department of Anaesthesiology and Intensive Care, Faculty of
Medical Sciences in Katowice, Medical University of Silesia, Katowice,
Poland
Publisher
Springer Japan
Abstract
Hemodynamic stability during surgery seems to account for positive
postoperative outcomes in patients. However, little is known about the
impact of intraoperative blood pressure variability (IBPV) on the
postoperative complications. The aim was to investigate whether IBPV is
associated with the development of postoperative complications and what is
the nature of this association. We conducted a systematic search in
PubMed, Medical Subject Headings, Embase, Web of Science, SCOPUS,
clinicaltrials.gov, and Cochrane Library on the 8th of April, 2021. We
included studies that only focused on adults who underwent primarily
elective, non-cardiac surgery in which intraoperative blood pressure
variation was measured and analyzed in regard to postoperative,
non-surgical complications. We identified 11 papers. The studies varied in
terms of applied definitions of blood pressure variation, of which
standard deviation and average real variability were the most commonly
applied definitions. Among the studies, the most consistent analyzed
outcome was a 30-day mortality. The studies presented highly heterogeneous
results, even after taking into account only the studies of best quality.
Both higher and lower IBPV were reported to be associated for
postoperative complications. Based on a limited number of studies, IBPV
does not seem to be a reliable indicator in predicting postoperative
complications. Existing premises suggest that either higher or lower IBPV
could contribute to postoperative complications. Taking into account the
heterogeneity and quality of the studies, the conclusions may not be
definitive. Copyright © 2022, The Author(s).

<82>
Accession Number
2014759317
Title
Biomarkers of acute kidney injury after pediatric cardiac surgery: a
meta-analysis of diagnostic test accuracy.
Source
European Journal of Pediatrics. (no pagination), 2022. Date of
Publication: 2022.
Author
Van den Eynde J.; Schuermans A.; Verbakel J.Y.; 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, United States
(Van den Eynde, Schuermans, Gewillig) Department of Cardiovascular
Sciences, KU Leuven, Leuven, Belgium
(Verbakel) Department of Public Health and Primary Care, KU Leuven,
Leuven, Belgium
(Verbakel) Nuffield Department of Primary Care Health Sciences, University
of Oxford, Oxford, United Kingdom
(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
Springer Science and Business Media Deutschland GmbH
Abstract
Acute kidney injury (AKI) occurs frequently after cardiac surgery in
children. Although current diagnostic criteria rely on serum creatinine
and urine output, changes occur only after considerable loss of kidney
function. This meta-analysis aimed to synthesize the knowledge on novel
biomarkers and compare their ability to predict AKI. PubMed/MEDLINE,
Embase, Scopus, and reference lists were searched for relevant studies
published by March 2021. Diagnostic accuracy parameters were extracted and
analyzed using hierarchical summary receiver operating characteristic
(HSROC) method. Pooled estimates of the area under the curve (AUC) were
calculated using conventional random-effects meta-analysis. Fifty-six
articles investigating 49 biomarkers in 8617 participants fulfilled our
eligibility criteria. Data from 37 studies were available for
meta-analysis. Of the 10 biomarkers suitable for HSROC analysis, urinary
neutrophil gelatinase-associated lipocalin (uNGAL) to creatinine (Cr)
ratio yielded the highest diagnostic odds ratio (91.0, 95% CI 90.1-91.9),
with a sensitivity of 91.3% (95% CI 91.2-91.3%) and a specificity of 89.7%
(95% CI 89.6-89.7%). These results were confirmed in pooled AUC analysis,
as uNGAL-to-Cr ratio and uNGAL were the only elaborately studied
biomarkers (> 5 observations) with pooled AUCs >= 0.800. Liver fatty
acid-binding protein (L-FABP), serum cystatin C (sCysC), serum NGAL
(sNGAL), and interleukin-18 (IL-18) all had AUCs >= 0.700.
 Conclusion(s): A variety of biomarkers have been proposed as
predictors of cardiac surgery-associated AKI in children, of which uNGAL
was the most prominent with excellent diagnostic qualities. However, more
consolidatory evidence will be required before these novel biomarkers may
eventually help realize precision medicine in AKI management.What is
Known:* Acute kidney injury (AKI) occurs in about 30-60% of children
undergoing cardiac surgery and is associated with increased in-hospital
mortality and adverse short-term outcomes. However, in current clinical
practice, AKI definitions and detection often rely on changes in serum
creatinine and urine output, which are late and insensitive markers of
kidney injury.* Although various novel biomarkers have been studied for
the diagnosis of AKI in children after cardiac surgery, it remains unclear
how these compare to one another in terms of diagnostic accuracy.What is
New:* Pooled analyses suggest that for the diagnosis of AKI in children
who underwent cardiac surgery, NGAL is the most accurate among the most
frequently studied biomarkers.* A number of other promising biomarkers
have been reported, although they will require further research into their
diagnostic accuracy and clinical applicability. Copyright © 2022,
The Author(s), under exclusive licence to Springer-Verlag GmbH Germany,
part of Springer Nature.

<83>
Accession Number
2014755582
Title
Association of Metformin with the Mortality and Incidence of
Cardiovascular Events in Patients with Pre-existing Cardiovascular
Diseases.
Source
Drugs. (no pagination), 2022. Date of Publication: 2022.
Author
Li T.; Providencia R.; Jiang W.; Liu M.; Yu L.; Gu C.; Chang A.C.Y.; Ma H.
Institution
(Li, Jiang, Liu, Ma) Department of Physiology and Pathophysiology, Fourth
Military Medical University, No. 169 Changle West Rd, Xi'an 710032, China
(Providencia) Barts Heart Centre, St. Bartholomew's Hospital, London,
United Kingdom
(Yu) Department of Pathology, Xijing Hospital, Fourth Military Medical
University, Xi'an 710032, China
(Gu) Department of Cardiovascular Surgery, Xijing Hospital, Fourth
Military Medical University, Xi'an 710032, China
(Chang) Department of Cardiology and Shanghai Institute of Precision
Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of
Medicine, Shanghai 211125, China
Publisher
Adis
Abstract
Introduction: Whether metformin reduces all-cause cardiovascular mortality
and the incidence of cardiovascular events in patients with pre-existing
cardiovascular diseases (CVD) remains inconclusive. Some randomised
controlled trials (RCTs) and cohort studies have shown that metformin is
associated with an increased risk of mortality and cardiovascular events.
 Method(s): We conducted a pooling synthesis to assess the effects of
metformin in all-cause cardiovascular mortality and incidence of
cardiovascular events in patients with CVD. Studies published up to
October 2021 in PubMed or Embase with a registration in PROSPERO
(CRD42020189905) were collected. Both RCT and cohort studies were
included. Hazard ratios (HR) with 95% CI were pooled across various trials
using the random-effects model. Result(s): This study enrolled 35
published studies (in 14 publications) for qualitative synthesis and
identified 33 studies (published in 26 publications) for quantitative
analysis. We analysed a total of 61,704 patients, among them 58,271
patients were used to calculate all-cause mortality while 12,814 patients
were used to calculate cardiovascular mortality. Compared with
non-metformin control, metformin usage is associated with a reduction in
all-cause mortality (HR: 0.90; 95% CI 0.83, 0.98; p = 0.01),
cardiovascular mortality (HR: 0.89; 95% CI 0.85, 0.94; p < 0.0001),
incidence of coronary revascularisation (HR: 0.79; 95% CI 0.64, 0.98; p =
0.03), and heart failure (HR: 0.90; 95% CI 0.87, 0.94; p < 0.0001) in
patients with pre-existing cardiovascular diseases. Conclusion(s):
Metformin use is associated with a reduction in all-cause mortality,
cardiovascular mortality, incidence of coronary revascularisation, and
heart failure in patients with CVD; however, metformin usage was not
associated with reduction in the incidence of myocardial infarction,
angina, or stroke. Copyright © 2022, The Author(s), under
exclusive licence to Springer Nature Switzerland AG.

<84>
Accession Number
636973179
Title
Effect of neuromuscular electrical stimulation on functional exercise
capacity in patients undergoing cardiac surgery: A randomized clinical
trial.
Source
Clinical rehabilitation. (pp 2692155211070945), 2021. Date of
Publication: 31 Dec 2021.
Author
Cerqueira T.C.F.; de Cerqueira Neto M.L.; Cacau L.A.P.; de Araujo Filho
A.A.; Oliveira G.U.; da Silva Junior W.M.; Carvalho V.O.; de Mendonca
J.T.; de Santana Filho V.J.
Institution
(Cerqueira) Department of Physical Therapy, Federal University of Sergipe,
Lagarto, SE, Brazil
(de Cerqueira Neto, da Silva Junior, Carvalho, de Santana Filho)
Department of Physical Therapy, Federal University of Sergipe, Sao
Cristovao, SE, Brazil
(Cacau) AracajuSEBrazil
(de Araujo Filho) Department of Physical Therapy, Tiradentes University,
Aracaju SE, Brazil
(Oliveira) University Hospital of the Federal University of Sergipe,
Aracaju, SE, Brazil
(de Mendonca) Department of Medicine, Federal University of Sergipe, Sao
Cristovao, SE, Brazil
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To evaluate the effects of neuromuscular electrical stimulation
on functional capacity of patients in the immediate postoperative period
of cardiac surgery. DESIGN: A prospective, randomized controlled trial.
SETTING: A cardiac surgery specialist hospital in Aracaju, Sergipe,
Brazil. Subjects: Patients in the postoperative period of cardiac surgery.
INTERVENTION: The control group received the conventional physiotherapy
and the intervention group received neuromuscular electrical stimulation
of the rectus femoris and gastrocnemius muscles bilaterally, applied for
60 min, twice a day for up to 10 sessions per patient, in the immediate
postoperative period until postoperative day 5. MAIN MEASURES: The primary
outcome was the distance walked, which was evaluated using the 6-min walk
test on postoperative day 5. Secondary outcomes were gait speed, lactate
levels, muscle strength, electromyographic activity of the rectus femoris
and Functional Independence Measure, some of them evaluated on
preoperative and postoperative period. RESULT(S): Of 132 eligible
patients, 88 patients were included and randomly allocated in two groups,
and 45 patients were included in the analysis. No significant difference
was found on the distance walked (p=0.650) between patients allocated in
intervention group (239.06+/-88.55) and control group (254.43+/-116.67) as
well as gait speed (p=0.363), lactate levels (p=0.302), knee extensor
strength (p=0.117), handgrip strength (p=0.882), global muscle strength
(p=0.104), electromyographic activity (p=0.179) and Functional
Independence Measure (p=0.059). CONCLUSION(S): Although the effects
are still uncertain, the use of neuromuscular electrical stimulation
carried out in five days didn't present any benefit on functional capacity
of patients in the immediate postoperative period of cardiac surgery.

<85>
Accession Number
636969282
Title
Expanding restrictive transfusion evidence in surgical practice: a
multicentre, prospective cohort study.
Source
Blood transfusion = Trasfusione del sangue. (no pagination), 2021. Date
of Publication: 29 Dec 2021.
Author
Wang L.; Wang Z.; Huang Y.; Wang Y.; Liu Z.; Xin S.; Lei G.; Han W.; Xue
F.; Chen Y.; Wu P.; Jiang J.; Yu X.
Institution
(Wang, Wang, Han, Xue, Chen, Wu, Jiang) Department of Epidemiology and
Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of
Medical Sciences/School of Basic Medicine, Peking Union Medical College,
Beijing, China
(Huang, Yu) Anaesthesiology Department, Peking Union Medical College
Hospital, Chinese Academy of Medical Sciences, Beijing, China
(Wang) Orthopaedics Department, Peking Union Medical College Hospital,
Chinese Academy of Medical Sciences, Beijing, China
(Liu) Clinical Transfusion Research Centre, Institute of Blood
Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
(Xin) Vascular and Thyroid Surgery Department, First Hospital of China
Medical University, Shenyang, China
(Lei) Orthopaedics Department, Xiangya Hospital, Central South University,
Changsha, China
(Yu) Nephrology Department, Peking Union Medical College Hospital, Chinese
Academy of Medical Sciences, Beijing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Findings of observational studies investigating the impact of
transfusions are at odds with those of randomised controlled trials,
raising concern that observational studies may be inappropriate to inform
transfusion decisions. We examined whether observational data could
replicate evidence from randomised controlled trials on restrictive
transfusion in cardiac and orthopaedic surgery, and be generalised to
broader specialties as well as to a lower haemoglobin transfusion
threshold (7 g/dL). MATERIAL AND METHODS: A multicentre, prospective
cohort study was performed at three representative regional hospitals in
China between 2015 and 2016. Participants were surgical inpatients (>=18
years; hospital stay >=24 h) in six specialties: cardiac, cerebral,
vascular (CCV), and orthopaedic, general, thoracic (non-CCV). Patients
with a stable haemoglobin (7-10 g/dL) constituted the primary analytic
sample, while patients with >=500 mL intra-operative bleeding were
analysed separately to avoid haemoglobin instability. The association of
transfusion with surgical outcomes (death, in-hospital complications) was
evaluated. RESULT(S): The transfusion rate was 10.7% in 36,607
patients (mean age, 52.5+/-14.3 years; 52.3% female). After restriction,
stratification, and propensity score matching to reduce patients'
heterogeneity, transfusion was unrelated to death (CCV: odds ratio
[OR]=0.74, 95% confidence interval [CI]: 0.16-3.39; non-CCV: OR 0.83, 95%
CI: 0.36-1.94) and the composite complication (CCV: OR 1.31, 95% CI:
0.63-2.72; non-CCV: OR=1.24, 95% CI: 0.81-1.90). The results were
consistent in subgroups (elderly, coronary heart disease, malignant
tumour, severe illness) and applicable to patients with significant
bleeding after restoration of a stable haemoglobin. DISCUSSION:
Transfusion at a stable haemoglobin concentration of 7-10 g/dL did not
alter surgical outcomes. Our results show the feasibility of observational
data to expand restrictive transfusion to broader specialties and a lower
transfusion threshold in surgical practice.

<86>
Accession Number
636964801
Title
Revascularization strategies in patients with multivessel coronary artery
disease: a Bayesian network meta-analysis.
Source
Interactive cardiovascular and thoracic surgery. (no pagination), 2021.
Date of Publication: 29 Dec 2021.
Author
Van den Eynde J.; Bomhals K.; Noe D.; Jacquemyn X.; McCutcheon K.; Bennett
J.; Puskas J.D.; Oosterlinck W.
Institution
(Van den Eynde) Helen B. Taussig Heart Center, Johns Hopkins Hospital and
School of Medicine, MD, Baltimore, United States
(Van den Eynde, Bomhals, Noe, Jacquemyn, McCutcheon, Bennett, Oosterlinck)
Department of Cardiovascular Diseases, University Hospitals Leuven,
Leuven, Belgium
(Van den Eynde, Bomhals, Noe, Jacquemyn, McCutcheon, Bennett, Oosterlinck)
Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Morningside
Hospital, NY, NY, United States
Publisher
NLM (Medline)
Abstract
Treatment modalities for multivessel disease have rapidly evolved, yet the
preferred strategy remains controversial. This meta-analysis compared
outcomes after on-pump (ONCAB), off-pump coronary artery bypass grafting
(OPCAB), percutaneous coronary intervention (PCI) or hybrid coronary
revascularization. A comprehensive search for observational studies and
randomized controlled trials published by August 2020 was performed. A
Bayesian network meta-analysis was conducted for early (<30 days) and late
(>12 months) outcomes. A total of 119 studies were included (n = 700 458
patients). The main analysis was confined to 31 randomized controlled
trials (n = 24 932 patients). PCI was associated with lower early
mortality [odds ratio (OR) 0.50, 95% confidence interval (CI) 0.31-0.79]
and stroke (OR 0.22, 95% CI 0.06-0.60) rates compared with ONCAB, whereas
a reduced risk of early myocardial infarction was observed with OPCAB
compared with ONCAB (OR 0.53, 95% CI 0.32-0.83). Late target vessel
revascularization and major adverse cardiac and cerebrovascular events
were both increased with PCI compared with ONCAB, OPCAB and hybrid
coronary revascularization (by 127-203% and 59-64%, respectively), and
late major adverse cardiac events were increased in PCI compared with
ONCAB and OPCAB (by 64% and 59%). However, PCI was associated with a
significantly lower risk of late stroke compared with ONCAB (OR 0.70, 95%
CI 0.52-0.89). Sensitivity analyses (i) including observational studies
and (ii) limiting to studies with recent cohorts confirmed the findings of
the main analysis. Surgical approaches for revascularization remain
superior to PCI in patients with multivessel disease. Hybrid coronary
revascularization might be viable for some patients, although more
evidence from randomized controlled trials is warranted. Copyright
© The Author(s) 2021. Published by Oxford University Press on behalf
of the European Association for Cardio-Thoracic Surgery.

<87>
Accession Number
636964319
Title
The effectiveness of preoperative education interventions on improving
perioperative outcomes of adult patients undergoing cardiac surgery: a
systematic review and meta-analysis.
Source
European journal of cardiovascular nursing : journal of the Working Group
on Cardiovascular Nursing of the European Society of Cardiology. (no
pagination), 2021. Date of Publication: 29 Dec 2021.
Author
Ng S.X.; Wang W.; Shen Q.; Toh Z.A.; He H.-G.
Institution
(Ng, Wang, Toh, He) Alice Lee Centre for Nursing Studies, Yong Loo Lin
School of Medicine, National University of Singapore, Clinical Research
Centre, Level 2Block MD11 ,10 Medical Drive 117597, Singapore
(Ng, Wang, Toh, He) National University Health System, NUHS Tower Block,
1E Kent Ridge Rd 119228, Singapore
(Shen) Department of Nursing, School of Medicine, Xiamen University, Room
220, Xiang An District, Fujian Province, Alice Lee Building ,Xiang An
South Road, Xiamen 361102, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cardiac surgeries pose as an emotional experience for
patients. Preoperative education is known to positively alter people's
perceptions, emotions, and mitigate surgical distress. However, this
intervention's effectiveness in improving perioperative outcomes among
patients undergoing cardiac surgery lacked rigorous statistical synthesis
and remains inconclusive. AIMS: The aim was to synthesize the
effectiveness of preoperative education on improving perioperative
outcomes [anxiety, depression, knowledge, pain intensity, pain
interference with daily activities, postoperative complications, length of
hospitalization, length of intensive care unit (ICU) stay, satisfaction
with the intervention and care, and health-related quality of life] among
patients undergoing cardiac surgery. METHOD(S): This systematic
review and meta-analysis conducted a comprehensive search of nine
electronic databases (PubMed, EMBASE, Scopus, MEDLINE, CINAHL, Cochrane
CENTRAL, Web of Science, PsycINFO, and ERIC) and grey literature for
randomized controlled trials examining the preoperative educational
interventional effects on patients undergoing cardiac surgery from
inception to 31 December 2020. The studies' quality was evaluated using
Cochrane Risk-of-Bias Tool 1 (RoB1). Meta-analyses via RevMan 5.4 software
synthesized interventional effects. RESULT(S): Twenty-two trials
involving 3167 participants were included. Preoperative education had
large significant effects on reducing post-intervention preoperative
anxiety (P = 0.02), length of ICU stay (P = 0.02), and improving knowledge
(P < 0.00001), but small significant effect sizes on lowering
postoperative anxiety (P < 0.0001), depression (P = 0.03), and enhancing
satisfaction (P = 0.04). CONCLUSION(S): This review indicates the
feasibility of preoperative education in clinical use to enhance health
outcomes of patients undergoing cardiac surgery. Future studies need to
explore knowledge outcomes in-depth and more innovative technologies in
preoperative education delivery. Copyright Published on behalf of the
European Society of Cardiology. All rights reserved. © The Author(s)
2021. For permissions, please email: journals.permissions@oup.com.

<88>
Accession Number
2014448866
Title
With or without you: Co-chaperones mediate health and disease by modifying
chaperone function and protein triage.
Source
Cells. 10(11) (no pagination), 2021. Article Number: 3121. Date of
Publication: November 2021.
Author
Altinok S.; Sanchez-Hodge R.; Stewart M.; Smith K.; Schisler J.C.
Institution
(Altinok, Sanchez-Hodge, Stewart, Smith, Schisler) Computational Medicine
Program, Department of Pharmacology, Department of Pathology and Lab
Medicine, McAllister Heart Institute, The University of North Carolina at
Chapel Hill, Chapel Hill, NC 27599, United States
Publisher
MDPI
Abstract
Heat shock proteins (HSPs) are a family of molecular chaperones that
regulate essential protein refolding and triage decisions to maintain
protein homeostasis. Numerous co-chaperone proteins directly interact and
modify the function of HSPs, and these interactions impact the outcome of
protein triage, impacting everything from structural proteins to cell
signaling mediators. The chaperone/co-chaperone machinery protects against
various stressors to ensure cellular function in the face of stress.
However, coding mutations, expression changes, and post-translational
modifications of the chaperone/co-chaperone machinery can alter the
cellular stress response. Im-portantly, these dysfunctions appear to
contribute to numerous human diseases. Therapeutic targeting of chaperones
is an attractive but challenging approach due to the vast functions of
HSPs, likely contributing to the off-target effects of these therapies.
Current efforts focus on targeting co-chaperones to develop precise
treatments for numerous diseases caused by defects in protein quality
control. This review focuses on the recent developments regarding selected
HSP70/HSP90 co-chaperones, with a concentration on cardioprotection,
neuroprotection, cancer, and autoimmune diseases. We also discuss
therapeutic approaches that highlight both the utility and challenges of
targeting co-chaperones. Copyright © 2021 by the authors.
Licensee MDPI, Basel, Switzerland.

<89>
Accession Number
2007815166
Title
Recent advances in liposomal-based anti-inflammatory therapy.
Source
Pharmaceutics. 13(7) (no pagination), 2021. Article Number: 1004. Date of
Publication: July 2021.
Author
Van Alem C.M.A.; Metselaar J.M.; Van Kooten C.; Rotmans J.I.
Institution
(Van Alem, Van Kooten, Rotmans) Department of Internal Medicine, Leiden
University Medical Center, Leiden 2333, Netherlands
(Metselaar) Institute for Experimental Molecular Imaging, Faculty of
Medicine, RWTH Aachen University, Aachen 52074, Germany
Publisher
MDPI
Abstract
Liposomes can be seen as ideal carriers for anti-inflammatory drugs as
their ability to (passively) target sites of inflammation and release
their content to inflammatory target cells enables them to increase local
efficacy with only limited systemic exposure and adverse effects.
Nonetheless, few liposomal formulations seem to reach the clinic. The
current review provides an overview of the more recent innovations in
liposomal treatment of rheumatoid arthritis, psoriasis, vascular
inflammation, and transplantation. Cutting edge developments include the
liposomal delivery of gene and RNA therapeutics and the use of hybrid
systems where several liposomal bilayer features, or several drugs, are
combined in a single formulation. The majority of the articles reviewed
here focus on preclinical animal studies where proof-of-principle of an
improved efficacy-safety ratio is observed when using liposomal
formulations. A few clinical studies are included as well, which brings us
to a discussion about the challenges of clinical translation of liposomal
nanomedicines in the field of inflammatory diseases. Copyright ©
2021 by the authors. Licensee MDPI, Basel, Switzerland.

<90>
Accession Number
2013478268
Title
Cognitive complaints in age-related chronic conditions: A systematic
review.
Source
PLoS ONE. 16(7 July) (no pagination), 2021. Article Number: e0253795. Date
of Publication: July 2021.
Author
Hill N.L.; Bhargava S.; Brown M.J.; Kim6 H.; Bhang I.; Mullin K.; Phillips
K.; Mogle J.
Institution
(Hill, Bhargava, Bhang) College of Nursing, Pennsylvania State University,
University Park, PA, United States
(Brown) Department of Epidemiology and Biostatistics, Arnold School of
Public Health, University of South Carolina, Columbia, SC, United States
(Brown) South Carolina SmartState Center for Healthcare Quality, Arnold
School of Public Health, University of South Carolina, Columbia, SC,
United States
(Brown) Rural and Minority Health Research Center, Arnold School of Public
Health, University of South Carolina, Columbia, SC, United States
(Brown) Arnold School of Public Health, University of South Carolina,
Office of the Study on Aging, Columbia, SC, United States
(Kim6) Department of Biobehavioral Nursing and Health Informatics, School
of Nursing, University of Washington, Seattle, WA, United States
(Mullin) Eberly College of Science, Pennsylvania State University,
University Park, PA, United States
(Phillips) Penn State University Libraries, University Park, PA, United
States
(Mogle) Edna Bennett Pierce Prevention Research Center, Pennsylvania State
University, University Park, PA, United States
Publisher
Public Library of Science
Abstract
Introduction Cognitive complaints in older adults may be indicative of
progressive cognitive decline including Alzheimer's disease (AD), but also
occur in other age-related chronic conditions, complicating identification
of early AD symptoms. To better understand cognitive complaints in aging,
we systematically reviewed the evidence to determine their prevalence and
characterization among older adults with the most common age-related
chronic conditions. Methods This systematic review was conducted in
accordance with the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses statement and the review protocol was prospectively
registered with PROSPERO (ID: CRD42020153147). Searches were conducted in
PubMed, CINAHL, PsycINFO, Web of Science, and ProQuest Dissertations &
Theses A&I in June 2020. Two members of the review team independently
determined article eligibility for inclusion and conducted quality
appraisal. A narrative synthesis of results was used to integrate findings
across studies and draw conclusions regarding the strength of the evidence
in each chronic condition category. Results Thirty-seven articles met
eligibility criteria and were included in the review. Conditions
represented were diabetes (n = 20), heart disease (n = 13), hypertension
(n = 10), chronic lung disease (n = 5), arthritis (n = 4), heart failure
(n = 2), and hyperlipidemia (n = 2). In addition, 16 studies included a
measure of multimorbidity. Overall, there was a higher prevalence of
cognitive complaints in individuals with higher multimorbidity, including
a potential dosedependent relationship. Findings for specific conditions
were inconsistent, but there is evidence to suggest that
cross-sectionally, older adults with diabetes, heart disease, chronic lung
disease, and arthritis have more cognitive complaints than those without
these conditions. Conclusion There is strong evidence demonstrating that
cognitive complaints are more common in older adults with higher
multimorbidity, but little research examining these associations over
time. Improving our understanding of the longitudinal trajectory of
cognitive complaints, multimorbidity, and objective cognition in older age
is an important area for future research. Copyright © 2021 Hill
et al.

<91>
Accession Number
2015895721
Title
Iatrogenic Atrial Septal Defects Following Transcatheter Mitral Valve
Repair and Implications of Interventional Closure.
Source
JACC: Cardiovascular Interventions. 14(24) (pp 2685-2694), 2021. Date of
Publication: 27 Dec 2021.
Author
Lurz P.; Unterhuber M.; Rommel K.-P.; Kresoja K.-P.; Kister T.; Besler C.;
Fengler K.; Sandri M.; Daehnert I.; Thiele H.; Blazek S.; von Roeder M.
Institution
(Lurz, Unterhuber, Rommel, Kresoja, Kister, Besler, Fengler, Sandri,
Thiele, Blazek, von Roeder) Department of Internal Medicine/Cardiology,
Heart Center Leipzig at Leipzig University, Leipzig, Germany
(Lurz, Kresoja, Thiele) Leipzig Heart Institute, Leipzig, Germany
(Daehnert) Department of Pediatric Cardiology, Heart Center Leipzig at
Leipzig University, Leipzig, Germany
Publisher
Elsevier Inc.
Abstract
Objectives: The authors investigated whether iatrogenic atrial septal
defect (iASD) closure post-transcatheter mitral valve edge-to-edge repair
(TMVR) is superior to conservative therapy (CT) and whether outcomes
(death/heart failure [HF] hospitalization) differ between patients with
and without an iASD post-TMVR. Background(s): Transseptal access for
TMVR can create an iASD, which is associated with impaired outcomes.
Controversially, the creation of an iASD in HF has been linked to improved
hemodynamics. Method(s): 80 patients with an iASD and relevant
left-to-right shunting (Qp:Qs >=1.3) 30 days following TMVR were
randomized to CT or interventional closure of the iASD (MITHRAS [Closure
of Iatrogenic Atrial Septal Defect Following Transcatheter Mitral Valve
Repair] cohort), and 235 patients without an iASD served as a comparative
cohort. Result(s): All patients of the MITHRAS cohort (mean age 77
+/- 9 years, 39% women) received their allocated treatment, and follow-up
was completed for all MITHRAS and comparative cohort (mean age 77 +/- 8
years, 47% women) patients. Twelve months post-TMVR, there was no
significant difference in the combined endpoint of death or HF
hospitalization within the MITHRAS cohort (iASD closure: 35% vs CT 50%; P
= 0.26). The combined endpoint was more frequent among patients within the
MITHRAS cohort as opposed to the comparative cohort (43% vs 17%; P <
0.0001), primarily driven by a higher rate of HF hospitalization (34% vs
8%; P = 0.004). Conclusion(s): In this randomized controlled trial,
interventional closure of a relevant iASD 1 month after TMVR did not
result in improved clinical outcomes at 12 months post-TMVR. Patients with
an iASD are at higher risk for HF hospitalization independent of iASD
management and warrant close follow-up. (Closure of Iatrogenic Atrial
Septal Defect Following Transcatheter Mitral Valve Repair [MITHRAS];
NCT03024268) Copyright © 2021 American College of Cardiology
Foundation

<92>
Accession Number
2015895710
Title
Subclinical Leaflet Thrombosis After Transcatheter Aortic Valve
Replacement: A Meta-Analysis.
Source
JACC: Cardiovascular Interventions. 14(24) (pp 2643-2656), 2021. Date of
Publication: 27 Dec 2021.
Author
Bogyi M.; Schernthaner R.E.; Loewe C.; Gager G.M.; Dizdarevic A.M.;
Kronberger C.; Postula M.; Legutko J.; Velagapudi P.; Hengstenberg C.;
Siller-Matula J.M.
Institution
(Bogyi, Gager, Dizdarevic, Kronberger, Hengstenberg, Siller-Matula)
Department of Internal Medicine II, Division of Cardiology, Medical
University of Vienna, Vienna, Austria
(Schernthaner, Loewe) Division of Cardiovascular and Interventional
Radiology, Department of Biomedical Imaging and Image-Guided Therapy,
Medical University of Vienna, Vienna, Austria
(Gager) Department of Clinical Pharmacology, Medical University of Vienna,
Vienna, Austria
(Postula, Siller-Matula) Department of Experimental and Clinical
Pharmacology, Medical University of Warsaw, Center for Preclinical
Research and Technology CEPT, Warsaw, Poland
(Legutko) Jagiellonian University Medical College, Faculty of Medicine,
Institute of Cardiology, Department of Interventional Cardiology, John
Paul II Hospital, Krakow, Poland
(Velagapudi) Division of Cardiovascular Medicine, University of Nebraska
Medical Center, Omaha, NE, United States
Publisher
Elsevier Inc.
Abstract
This meta-analysis and systematic review was performed to evaluate the
clinical relevance of subclinical leaflet thrombosis (SLT) following
transcatheter aortic valve replacement. PubMed, Web of Science, and
CENTRAL were searched for eligible randomized and nonrandomized studies
until November 2020. Risk ratios (RRs) or odds ratios and 95% CIs were
calculated, using a random-effects model. Overall, 25 studies were
eligible for the analysis and comprised a total of 11,098 patients. The
median incidence of SLT was 6% at a median follow-up of 30 days. Use of
intra-annular valves was associated with 2-fold greater risk for the
development of SLT compared with use of supra-annular valves. There was no
difference in the risk for SLT (RR: 0.97; 95% CI: 0.72-1.29; P = 0.83)
between single-antiplatelet therapy (SAPT) and dual-antiplatelet therapy
(DAPT), whereas oral anticoagulation (OAC) was associated with a 58%
relative risk reduction for SLT (RR: 0.42; 95% CI: 0.29-0.61; P < 0.00001)
compared with SAPT and DAPT. In patients with diagnosed leaflet thrombosis
at follow-up, the risk for stroke or transient ischemic attack was
increased by 2.6-fold (RR: 2.56; 95% CI: 1.60-4.09; P < 0.00001) compared
with patients without leaflet thrombosis. In patients diagnosed with SLT,
the odds of SLT resolution increased by 99% after switch from antiplatelet
agents to OAC (odds ratio: 0.01; 95% CI: 0.00-0.06; P < 0.00001). To
summarize, indication-based use of OAC after transcatheter aortic valve
replacement is associated with a lower risk for SLT compared with SAPT and
DAPT. Switching to OAC seems to be effective for SLT resolution. As SLT
increased the odds of stroke or transient ischemic attack in the included
population, further studies are needed to investigate whether screening
tests for SLT and appropriate antithrombotic therapy improve long-term
valve functionality and clinical prognosis. Copyright © 2021
American College of Cardiology Foundation

<93>
Accession Number
2014600509
Title
Heart valve surgery and the obesity paradox: A systematic review.
Source
Clinical Obesity. (no pagination), 2021. Date of Publication: 2021.
Author
EL-Andari R.; Bozso S.J.; Kang J.J.H.; Bedard A.M.A.; Adams C.; Wang W.;
Nagendran J.
Institution
(EL-Andari) Faculty of Medicine and Dentistry, University of Alberta,
Edmonton, AB, Canada
(Bozso, Kang, Wang, Nagendran) Division of Cardiac Surgery, Department of
Surgery, University of Alberta, Edmonton, AB, Canada
(Bedard) Department of Biological Sciences, Faculty of Science, University
of Alberta, Edmonton, AB, Canada
(Adams) Section of Cardiac Surgery, Department of Cardiac Sciences, Libin
Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB,
Canada
Publisher
John Wiley and Sons Inc
Abstract
Obesity has been associated with increased incidence of comorbidities and
shorter life expectancy, and it has generally been assumed that patients
with obesity should have inferior outcomes after surgery. Previous
literature has often demonstrated equivalent or even improved rates of
mortality after cardiac surgery when compared to their lower-weight
counterparts, coined the obesity paradox. Herein, we aim to review the
literature investigating the impact of obesity on surgical valve
interventions. PubMed and Embase were systematically searched for articles
published from 1 January 2000 to 15 October 2021. A total of 1315 articles
comparing differences in outcomes between patients of varying body mass
index (BMI) undergoing valve interventions were reviewed and 25 were
included in this study. Patients with higher BMI demonstrated equivalent
or reduced rates of postoperative myocardial infarction, stroke,
reoperation rates, acute kidney injury, dialysis and bleeding. Two studies
identified increased rates of deep sternal wound infection in patients
with higher BMI, although the majority of studies found no significant
difference in deep sternal wound infection rates. The obesity paradox has
described counterintuitive outcomes predominantly in coronary artery
bypass grafting and transcatheter aortic valve replacement. Recent
literature has identified similar trends in other heart valve
interventions. While the obesity paradox has been well characterized, its
causes are yet to be identified. Further study is essential in order to
identify the causes of the obesity paradox so patients of all body sizes
can receive optimal care. Copyright © 2021 World Obesity
Federation.

<94>
Accession Number
2015330419
Title
Proactive Management of Intraoperative Hypotension Reduces Biomarkers of
Organ Injury and Oxidative Stress during Elective Non-Cardiac Surgery: A
Pilot Randomized Controlled Trial.
Source
Journal of Clinical Medicine. 11(2) (no pagination), 2022. Article Number:
392. Date of Publication: January-2 2022.
Author
Murabito P.; Astuto M.; Sanfilippo F.; La Via L.; Vasile F.; Basile F.;
Cappellani A.; Longhitano L.; Distefano A.; Li Volti G.
Institution
(Murabito, Astuto, Sanfilippo, La Via, Vasile, Basile, Cappellani)
Department of General Surgery and Surgical-Medical Specialties, Section of
Anesthesia, University of Catania, Via S. Sofia 72, Catania 95125, Italy
(Longhitano, Distefano, Li Volti) Department of Biomedical and
Biotechnological Sciences, University of Catania, Via S. Sofia 97, Catania
95125, Italy
(Li Volti) Center of Excellence for the Acceleration of Harm
Reduction-CoEHAR, University of Catania, Via S. Sofia 97, Catania 95131,
Italy
Publisher
MDPI
Abstract
Background: Intraoperative hypotension is associated with increased
postoperative morbidity and mortality. Method(s): We randomly
assigned patients undergoing major general surgery to early warning system
(EWS) and hemodynamic algorithm (intervention group, n = 20) or standard
care (n = 20). The primary outcome was the difference in hypotension
(defined as mean arterial pressure < 65 mmHg) and as secondary outcome
surrogate markers of organ injury and oxidative stress. Result(s):
The median number of hypotensive episodes was lower in the intervention
group (-5.0 (95% CI: -9.0, -0.5); p < 0.001), with lower time spent in
hypotension (-12.8 min (95% CI: -38.0, -2.3 min); p = 0.048),
correspondent to -4.8% of total surgery time (95% CI: -12.7, 0.01%; p =
0.048).The median time-weighted average of hypotension was 0.12 mmHg
(0.35) in the intervention group and 0.37 mmHg (1.11) in the control
group, with a median difference of -0.25 mmHg (95% CI: -0.85, -0.01; p =
0.025). Neutrophil Gelatinase-Associated Lipocalin (NGAL) correlated with
time-weighted average of hypotension (R = 0.32; p = 0.038) and S100B with
number of hypotensive episodes, absolute time of hypotension, relative
time of hypotension and time-weighted average of hypotension (p < 0.001
for all). The intervention group showed lower Neuronal Specific Enolase
(NSE) and higher reduced glutathione when compared to the control group.
 Conclusion(s): The use of an EWS coupled with a hemodynamic algorithm
resulted in reduced intraoperative hypotension, reduced NSE and oxidative
stress. Copyright © 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<95>
Accession Number
2016490472
Title
A systematic review and pooled analysis of septal myectomy and
edge-to-edge mitral valve repair in obstructive hypertrophic
cardiomyopathy.
Source
Reviews in Cardiovascular Medicine. 22(4) (pp 1471-1477), 2021. Date of
Publication: 22 Dec 2021.
Author
Mihos C.G.; Escolar E.; Fernandez R.; Nappi F.
Institution
(Mihos, Fernandez) Echocardiography Laboratory, Columbia University
Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, FL
33140, United States
(Escolar) Coronary Care Unit, Columbia University Division of Cardiology,
Mount Sinai Heart Institute, Miami Beach, FL 33140, United States
(Nappi) Department of Cardiac Surgery, Centre Cardiologique du Nord de
Saint-Denis, Paris 93200, France
Publisher
IMR Press Limited
Abstract
Left ventricular outflow tract (LVOT) obstruction and systolic anterior
motion (SAM) of the mitral valve (MV) occurs in 70% of hypertrophic
cardiomyopathy (HCM) patients. In individuals undergoing septal myectomy,
concomitant MV surgery is considered for SAM with residual LVOT
obstruction or mitral regurgitation (MR); however, the optimal approach
remains debated. A literature search was performed in Pubmed, EMBASE,
Ovid, and the Cochrane library of published articles through June 2021
reporting on combined septal myectomy and edge-to-edge MV repair for
obstructive HCM. Continuous variables were weighted and compared using a
student's t-test, and categorical variables using a chi-square test with
Yates correction. Six studies with 158 total patients were included. The
mean follow-up was 2.8 +/- 2.7 years. Compared with pre-operative values,
there were significant reductions in the LV ejection fraction (69 +/- 10
vs 59 +/- 8%), peak LVOT gradient (82 +/- 34 vs 16 +/- 13 mmHg),
prevalence of moderate or greater MR (84 vs 5 %), and presence of SAM (96%
vs 0) (p < 0.001 for all). There was no change in LV internal diastolic
diameter (4.2 +/- 1.3 vs 4.4 +/- 1.5 cm, p = 0.32). There were 2 (1%)
operative mortalities. At follow-up, the survival rate was 97%, there were
3 (2%) re-operative MV replacements, 4 (3%) patients remained in New York
Heart Association functional class III/IV, and 8 (6%) required permanent
pacemaker implantation. In conclusion, combined septal myectomy and
edge-to-edge MV repair is a safe and effective treatment strategy in
carefully selected patients requiring surgical HCM
management. Copyright ©2021 The Author(s). Published by IMR
Press.

<96>
[Use Link to view the full text]
Accession Number
2016473480
Title
Aspirin Resistance: Cardiovascular Risk Game Changer.
Source
American Journal of Therapeutics. 26(5) (pp E593-E599), 2019. Date of
Publication: 01 Sep 2019.
Author
Yassin A.S.; Abubakar H.; Mishra T.; Subahi A.; Hartman M.; Ahmed A.;
Ibrahim W.; Singh M.; Pahuja M.
Institution
(Yassin, Abubakar, Mishra, Subahi, Ahmed, Ibrahim, Singh) Department of
Internal Medicine, Wayne State University, Detroit, MI, United States
(Hartman) Radboud University, School of Medicine, Nijmegen, Netherlands
(Pahuja) Department of Cardiovascular Medicine, Wayne State University,
Detroit, MI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Aspirin (ASA) is the most used medication on the globe. ASA is
a primary pillar of the secondary prevention of cardiovascular
atherothromboembolic events. However, a fraction of the population does
not respond to ASA as expected in a unique phenomenon called ASA
resistance. Multiple mechanisms were described and studied in the
literature to explain this phenomenon. Area of Uncertainty: ASA resistance
is an interesting phenomenon that is worth studying and reviewing.
Mechanisms behind this resistance are various and although the rarity of
some, it is crucial for the modern health provider to be aware of such
phenomenon and its possible explanations to provide more efficient
preventive cardiology practice. Our study aimed to review and conclude the
evidence behind ASA resistance and its implication on the cardiovascular
health. Data Sources: We searched databases like PubMed, EMBASE, Ovid
by midline, and Google Scholar for published articles and abstracts.
 Result(s): Our systemic search revealed more than 100 articles in
relation to ASA resistance. We selected 40 articles, which were relevant
for this review. Various mechanisms were described in the literature, with
few of them very well documented and understood. Main mechanisms include
medication nonadherence, interaction with proton pump inhibitors,
esterase-mediated ASA inactivation, post-coronary artery bypass grafting
(CABG) MRP-4-mediated ASA consumption, cyclooxygenase-1 (COX-1)
polymorphisms, high platelet turnover-associated regeneration of platelet
COX-1, and the documented platelet ability of de novo COX-1 synthesis in
response to thrombin and fibrinogen. Conclusion(s): Multiple
mechanisms of ASA resistance were described in the literature. Awareness
of such interaction is important for medical practitioners. Bottom line,
further studies and reviews are needed to further study this phenomenon
and its implication on the cardiovascular health and hence reaching a
valid evidence-based conclusion that might change the practice and improve
the patient preventive health care. Copyright © 2018 Wolters
Kluwer Health, Inc. All rights reserved.

<97>
Accession Number
2016514159
Title
Prognostic Value of Pulmonary Hypertension, Right Ventricular Function and
Tricuspid Regurgitation on Mortality After Transcatheter Mitral Valve
Repair: A Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. (no pagination), 2022. Date of Publication:
2022.
Author
Meijerink F.; de Witte S.M.; Limpens J.; de Winter R.J.; Bouma B.J.; Baan
J.
Institution
(Meijerink, de Witte, de Winter, Bouma, Baan) Department of Cardiology,
Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
(Limpens) Medical Library, Amsterdam UMC, University of Amsterdam,
Amsterdam, Netherlands
Publisher
Elsevier Ltd
Abstract
Background: Pulmonary hypertension (PH), right ventricular (RV)
dysfunction, and tricuspid regurgitation (TR) are commonly present in
patients with mitral regurgitation (MR) and known to impair prognosis.
This systematic review and meta-analysis aimed to determine the prognostic
value of PH, RV function, and TR on mortality after transcatheter mitral
valve repair (TMVR). Method(s): A systematic search was performed to
identify studies investigating PH, RV function, or TR in patients who
underwent TMVR. Studies were included for pooled analysis if hazard ratios
(HR) for all-cause mortality were given. Result(s): A total of 8,672
patients from 21 selected studies were included (PH, 11 studies; RV
function, nine studies; TR, 10 studies). Mean follow-up was 2.7+/-1.6
years. The HRs and 95% CIs for all-cause mortality of PH (dichotomised: HR
1.70 95% CI 1.00-2.87; per 10 mmHg increase in systolic PAP: HR 1.17 95%
CI 1.07-1.29), RV function (dichotomised: HR 1.86 95% CI 1.45-2.38; per 5
mm decrease in TAPSE: HR 1.18 95% CI 0.97-1.43) and TR (HR 1.51 95% CI
1.28-1.79) indicated a significant association. Conclusion(s):
Prognosis after TMVR is worse in patients with significant MR when
concomitant PH, RV dysfunction, or TR are present. Careful assessment of
these parameters should therefore precede clinical decision-making for
TMVR. The current results encourage investigation into whether (1)
intervention at an earlier stage of MR reduces incidence of PH, RV
dysfunction, and TR; and (2) transcatheter treatment of concomitant TR can
improve clinical outcome and prognosis for these patients. Copyright
© 2021 The Author(s)

<98>
Accession Number
2016506473
Title
Colchicine for Secondary Prevention of Coronary Artery Disease: A
Meta-Analysis of Randomised Controlled Trials.
Source
Heart Lung and Circulation. (no pagination), 2022. Date of Publication:
2022.
Author
Xu H.; Mao L.; Liu H.; Lin Z.; Zhang Y.; Yang J.
Institution
(Xu, Liu, Lin, Yang) Department of Cardiology, The Affiliated Huaian No. 1
People's Hospital of Nanjing Medical University, Jiangsu, Huai'an, China
(Mao) Department of Thyroid and Breast Surgery, The Affiliated Huai'an
Hospital of Xuzhou Medical University and The Second People's Hospital of
Huai'an, Jiangsu, Huai'an, China
(Zhang) Department of Medical Laboratory, The Affiliated Huaian No. 1
People's Hospital of Nanjing Medical University, Jiangsu, Huai'an, China
Publisher
Elsevier Ltd
Abstract
Background: Colchicine has become prominent as an anti-inflammatory
therapy for secondary cardiovascular prevention in patients with coronary
artery disease (CAD). This meta-analysis was performed to evaluate the
efficacy and safety of colchicine in patients with CAD. Method(s):
Randomised controlled trials (RCTs) that compare major adverse
cardiovascular events (MACEs) between patients with CAD randomised to
colchicine versus placebo (or no colchicine) were included. Random effect
risk ratios (RRs) were calculated for clinical outcomes. Result(s): A
total of 12,071 patients in seven RCTs were included in the meta-analysis.
Compared with placebo or no colchicine, colchicine was associated with a
significantly lower incidence of MACEs (RR 0.64 95% CI 0.51-0.80 p<0.01).
The reduction in MACEs in the colchicine group was driven by statistically
significant reductions in the incidence of myocardial ischaemia (RR 0.74
95% CI 0.58-0.95 p=0.02), coronary revascularisation (RR 0.61 95% CI
0.42-0.89 p=0.01), and stroke (RR 0.48 95% CI 0.28-0.83 p=0.01). However,
there was no statistically significant difference for cardiovascular death
(RR 0.82 95% CI 0.55-1.22 p=0.33). All-cause and non-cardiovascular
mortality, gastrointestinal events, infection, and cancer were not
significantly different between the colchicine and control groups.
 Conclusion(s): Colchicine is a reasonably efficacious and safe drug
that could be successfully utilised for the secondary prevention of
CAD. Copyright © 2021 Australian and New Zealand Society of
Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<99>
Accession Number
2016503839
Title
Multiple arterial coronary bypass grafting is associated with better
survival compared with second-generation drug-eluting stents in patients
with stable multivessel coronary artery disease.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2022.
Date of Publication: 2022.
Author
Rocha R.V.; Fang J.; Tam D.Y.; Elbatarny M.; Austin P.C.; Gaudino M.F.L.;
Lee D.S.; Fremes S.E.
Institution
(Rocha, Tam, Elbatarny, Fremes) Division of Cardiac Surgery, Schulich
Heart Centre, Department of Surgery, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, Ontario, Canada
(Fang, Austin, Lee) Cardiovascular Program, ICES, Toronto, Ontario, Canada
(Austin, Fremes) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, Ontario, Canada
(Gaudino) Department of Cardio-Thoracic Surgery, Weill Cornell Medicine,
New York, NY
(Lee) Division of Cardiology, Peter Munk Cardiac Centre, University Health
Network, University of Toronto, Toronto, Ontario, Canada
Publisher
Elsevier Inc.
Abstract
Objective: We sought to compare the long-term outcomes of multiarterial
graft (MAG) coronary artery bypass grafting (CABG) versus percutaneous
coronary intervention (PCI) with second-generation drug-eluting stents
(DES) to treat stable multivessel coronary artery disease. Method(s):
This study was a multicenter population-based retrospective analysis of
all residents of Ontario, Canada, from January 1, 2011, to December 31,
2019. We identified 3600 cases of elective primary isolated CABG with MAG
and 2187 cases of PCI with second-generation DES. Result(s): After
the application of propensity score-weighting using overlap weights, MAG
was associated with better survival over 5 years compared with DES (96.8%
vs 94.5%; hazard ratio [HR], 0.56; 95% CI, 0.37-0.85). MAG was also
associated with better secondary outcomes including a composite of death,
myocardial infarction, and stroke (94.3% vs 88.5%; HR, 0.49; 95% CI,
0.36-0.65). The rate of death, stroke, myocardial infarction, and repeat
revascularization (91.2% vs 70.7%; HR, 0.24; 95% CI, 0.20-0.30), and the
individual end points of myocardial infarction (1.4% vs 6.9%; HR, 0.22;
95% CI, 0.13-0.35), and repeat revascularization (4.1% vs 24.2%; HR, 0.14;
95% CI, 0.10-0.18) were lower with MAG. PCI with second-generation DES was
associated with a lower rate of stroke up to 5 years (0.6% vs 1.8%; HR,
3.97; 95% CI, 1.45-10.88). Conclusion(s): CABG with MAG was
associated with better survival and fewer major cardiac adverse events
compared with second-generation DES and might be considered the treatment
of choice for patients with stable multivessel coronary artery disease.
Further randomized controlled trials are needed to confirm this
hypothesis. Copyright © 2021 The American Association for
Thoracic Surgery

<100>
Accession Number
636930805
Title
Prophylactic use of donut-shaped cushion to reduce sacral pressure
injuries during open heart surgery.
Source
Saudi Journal of Anaesthesia. 16(1) (pp 17-23), 2022. Date of Publication:
January-March 2022.
Author
Heo M.H.; Kim J.Y.; Park B.I.; Lee S.I.; Kim K.-T.; Park J.S.; Choe W.J.;
Kim J.H.
Institution
(Heo, Kim, Park, Lee, Kim, Park, Choe, Kim) Department of Anesthesiology
and Pain Medicine, Inje University Ilsan Paik Hospital, Gyeonggi-do,
Goyang, South Korea
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Pressure injuries are likely to develop in the operating room
due to the high temperature and humidity underneath the patients. This
study was designed to reduce sacral pressure injuries using donut-shaped
cushions on patients undergoing open heart surgery in a supine position
for more than three hours. Material(s) and Method(s): Patients
undergoing open heart surgery for more than three hours were randomly
allocated. Depending on the allocation, either the donut-shaped cushion
(donut group) or hydrophilic foam dressing (control group) was applied
before draping. Patients were evaluated for the development of pressure
injuries, National Pressure Ulcer Advisory Panel (NPUAP) stage, and injury
size immediately after surgery, 48 hours, and seven days after surgery.
 Result(s): Forty-five patients were enrolled in this study.
Twenty-two were assigned to the donut group and 23 were assigned to the
control group. Three patients developed pressure injuries of NPUAP stage I
or higher. All injuries occurred in the control group, but there was no
statistically significant difference (P = 0.083). Conclusion(s):
Patients who underwent cardiac surgery for more than three hours and used
a donut-shaped cushion did not develop pressure injuries, although no
statistical difference was noted. Specific preventative measures in the
operating room may play a crucial role in preventing pressure injuries,
and further research should be pursued. Copyright © 2022 Saudi
Journal of Anesthesia.

<101>
Accession Number
2014716774
Title
Multidetector CT findings of primary pleural angiosarcoma : a systematic
review, an additional cases report.
Source
Cancer Imaging. 22(1) (no pagination), 2022. Article Number: 6. Date of
Publication: December 2022.
Author
Gil B.M.; Chung M.H.; Lee K.-N.; Jung J.I.; Yoo W.J.; Kwon S.S.; Lee H.
Institution
(Gil, Chung, Yoo) Department of Radiology, Bucheon St. Mary's Hospital,
College of Medicine, The Catholic University of Korea, 327, Sosa-ro,
Gyeonggi-do, Bucheon-si 14647, South Korea
(Lee) Department of Radiology, Dong-A University Hospital, Busan, South
Korea
(Lee) Kosin University Gospel Hospital, Busan, South Korea
(Jung) Department of Radiology, Seoul St. Mary's Hospital, College of
Medicine, The Catholic University of Korea, Seoul, South Korea
(Kwon) Division of Allergy and Pulmonary, Department of Internal Medicine,
BUCHEON St. Mary's Hospital, College of Medicine, The Catholic University
of Korea, Seoul, South Korea
(Lee) Department of Pathology, Bucheon St. Mary's Hospital, Colloge of
Medicine, The Catholic University of Korea, Seoul, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: To demonstrate and analyze the relatively common imaging
findings in this rare primary pleural angiosarcoma (PPA). Case
presentation: Three cases of PPA, proven by video-assisted thoracic
surgery biopsies are retrospectively reviewed. Patients were all male. Age
ranges from 65 to 75 years old age (mean; 69). Major chief complaints were
dyspnea and chest pain. One has a history of colon cancer, the other has a
tuberculosis history and the other has no known history. Multidetector
chest CT and PET CT were all done. Immunohistochemical studies were
performed including CD31, CD34, or factor VIII-related antigen, vimentin,
and cytokeratin. We also review the literatures on recently published PPA.
All masses were from 1 to 10 cm. All three patients had multiple pleural
based masses, which were ovoid in shape with relatively sharp margin in
unilateral hemithorax. Multiple small circumscribed pleural masses are
limited in the pleural space in two patients, whereas two, huge lobulated
masses about up to 10 cm were present with pleural and extrapleural
involvement in one patient. In two patients with pleural mass only,
multiple pleural masses were only seen in parietal pleura in one patient
and were in both visceral and parietal pleura in one patient. Pleural
effusion were found in one side in one patient and in both sides in one
patient. One angiosarcoma was arised from chronic tuberculotic pleurisy
sequelae. All pleural masses are heterogenous with irregular internal low
densities in all patients. Hematogenous metastases were found in liver,
vertebra, rib in one patient, and were in lungs with mediastinal lymph
node metastases in the other patient. Three patients survived for longer
than 3months after diagnosis, but continued to deteriorate rapidly. Two
patients underwent chemotherapy after surgical excision, and the other one
with multiple metastases treated chemotherapy after CT-guided biopsy, but
eventually all died. As a result of comparative analysis of a total of 13
patients' images including 10 cases previously published, there was
pleural effusion in all except 2 cases. Conclusion(s): PPA were all
necrotic without any vascularized enhancing nature, and manifested as
unilateral circumscribed or localized pleural-based masses. Copyright
© 2022, The Author(s).

<102>
Accession Number
2014727343
Title
Valve replacement or repair in native mitral valve infective
endocarditis-Which is better? A meta-analysis and systematic review.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
He K.; Song J.; Luo H.; Su H.; Liang W.; Bian L.; Yue H.; Wu Z.
Institution
(He, Song, Luo, Liang, Bian, Yue, Wu) Department of Cardiovascular
Surgery, West China Hospital of Sichuan University, Sichuan, Chengdu,
China
(Su) Department of Cardiovascular Surgery, West China (Sanya) Hospital,
Sichuan University, Hainan, Sanya, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Native mitral valve infective endocarditis (IE) plagues
patients and surgeons alike because of its high mortality and recurrence
rates as well as poor prognosis. Mitral valve repair (MVP) and mitral
valve replacement (MVR) are two main surgical methods. However, the
question of which benefits patients more remains controversial. Thus, we
conducted a meta-analysis to systematically review the two approaches,
focusing on the early survival rate and long-term outcomes.
 Method(s): A meta-analysis and systematic review were conducted using
studies sourced from the PubMed, Embase, and Cochrane literature databases
to compare MVP and MVR, with data extracted for baseline characteristics,
mortality, survival, recurrent endocarditis, and valve reoperation. Risk
ratio (RR) or hazard ratio (HR) values were calculated, and publication
bias was tested. Result(s): A total of 17 relevant publications with
a total population of 3759 patients, with 1180 patients having undergone
MVP and 2579 patients having undergone MVR, respectively, were analyzed.
Patients who underwent MVP may benefit from a lower risk of early
mortality (RR, 0.51; 95% confidence interval [CI], 0.39-0.66; p <.00001),
a higher long-term survival rate (HR, 0.69; 95% CI, 0.58-0.81; p <.001;
I2 = 0%), and a lower risk of recurrence (RR, 0.66; 95% CI,
0.40-1.09; p =.10; I2 = 0%). However, a similar risk of
reoperation was observed for both groups (RR, 1.02; 95% CI, 0.36-2.91; p
=.96; I2 = 43%). Conclusion(s): This meta-analysis
suggests that MVP may lead to better outcomes compared to MVR. Among
patients with mitral valve IE, MVP can reduce in-hospital mortality,
improve long-term survival, and has a lower risk of recurrent
endocarditis. As a result, MVP may be suitable as a primary treatment
choice and should be considered whenever possible in most IE
patients. Copyright © 2022 Wiley Periodicals LLC.

<103>
Accession Number
2014741083
Title
Morbidity and mortality in patients managed with high compared with low
blood pressure targets during on-pump cardiac surgery: a systematic review
and meta-analysis of randomized controlled trials.
Source
Canadian Journal of Anesthesia. (no pagination), 2022. Date of
Publication: 2022.
Author
McEwen C.C.; Amir T.; Qiu Y.; Young J.; Kennedy K.; Grocott H.P.; Kessani
H.; Mazer D.; Brudney S.; Kavosh M.; Jacobsohn E.; Vedel A.; Wang E.;
Whitlock R.P.; Belley-Cote E.P.; Spence J.
Institution
(McEwen) Department of Surgery (Cardiac Surgery), McMaster University,
Hamilton, ON, Canada
(Amir, Qiu, Wang) Faculty of Health Sciences, McMaster University,
Hamilton, ON, Canada
(Young) Health Sciences Library, McMaster University, Hamilton, ON, Canada
(Kennedy) Department of Health Research Methods, Evaluation, and Impact,
McMaster University, Hamilton, ON, Canada
(Grocott, Kessani, Kavosh) Department of Anesthesia and Perioperative
Medicine, University of Manitoba, Winnipeg, MB, Canada
(Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute, St.
Michael's Hospital, Toronto, ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Brudney, Jacobsohn) Departments of Medicine (Critical Care) and
Anesthesia and Perioperative Medicine, University of Manitoba, Winnipeg,
MB, Canada
(Vedel) Department of Cardiothoracic Anesthesiology, Copenhagen University
Hospital, Copenhagen, Denmark
(Whitlock) Departments of Surgery (Cardiac Surgery) and Health Research
Methods, Evaluation, and Impact, McMaster University, Hamilton, ON, Canada
(Whitlock, Belley-Cote, Spence) Perioperative Research Division,
Population Health Research Institute, Hamilton, ON, Canada
(Belley-Cote) Departments of Medicine (Cardiology and Critical Care) and
Health Research Methods, Evaluation, and Impact, McMaster University,
Hamilton, ON, Canada
(Spence) Departments of Anesthesia and Critical Care and Health Research
Methods, Evaluation, and Impact, McMaster University, Hamilton, ON, Canada
Publisher
Springer
Abstract
Purpose: Many believe that blood pressure management during cardiac
surgery is associated with postoperative outcomes. We conducted a
systematic review and meta-analysis of randomized controlled trials (RCTs)
to determine the impact of high compared with low intraoperative blood
pressure targets on postoperative morbidity and mortality in adults
undergoing cardiac surgery on cardiopulmonary bypass (CPB). Our primary
objective was to inform the design of a future large RCT. Source: We
searched MEDLINE, EMBASE, Web of Science, CINAHL, and CENTRAL for RCTs
comparing high with low intraoperative blood pressure targets in adult
patients undergoing any cardiac surgical procedure on CPB. We screened
reference lists, grey literature, and conference proceedings. Principal
findings: We included eight RCTs (N =1,116 participants); all examined the
effect of blood pressure management only during the CPB. Trial definitions
of high compared with low blood pressure varied and, in some, there was a
discrepancy between the target and achieved mean arterial pressure. We
observed no difference in delirium, cognitive decline, stroke, acute
kidney injury, or mortality between high and low blood pressure targets
(very-low to low quality evidence). Higher blood pressure targets may have
increased the risk of requiring a blood transfusion (three trials; n = 456
participants; relative risk, 1.4; 95% confidence interval, 1.1 to 1.9; P =
0.01; moderate quality evidence) but this finding was based on a small
number of trials. Conclusion(s): Individual trial definitions of high
and low blood pressure targets varied, limiting inferences. The effect of
high (compared with low) blood pressure targets on other morbidity and
mortality after cardiac surgery remains unclear because of limitations
with the body of existing evidence. Research to determine the optimal
management of blood pressure during cardiac surgery is required. Study
registration: PROSPERO (CRD42020177376); registered: 5 July
2020. Copyright © 2022, Canadian Anesthesiologists' Society.

<104>
Accession Number
636935207
Title
Management of Stage III Non-Small-Cell Lung Cancer: ASCO Guideline.
Source
Journal of clinical oncology : official journal of the American Society of
Clinical Oncology. (pp JCO2102528), 2021. Date of Publication: 22 Dec
2021.
Author
Daly M.E.; Singh N.; Ismaila N.; Antonoff M.B.; Arenberg D.A.; Bradley J.;
David E.; Detterbeck F.; Fruh M.; Gubens M.A.; Moore A.C.; Padda S.K.;
Patel J.D.; Phillips T.; Qin A.; Robinson C.; Simone C.B.
Institution
(Daly) University of California, Davis, CA
(Singh) Postgraduate Institute of Medical Education & Research,
Chandigarh, India
(Ismaila) American Society of Clinical Oncology (ASCO), VA, Alexandria,
Egypt
(Antonoff) MD Anderson Cancer Center, TX, Houston
(Arenberg, Qin) University of Michigan, MI, Ann Arbor, United States
(Bradley) Emory University, Atlanta, United States
(David) University of Southern California, Los Angeles, CA
(Detterbeck) Yale Cancer Center, CT, New Haven, United States
(Fruh) Department of Medical Oncology Cantonal Hospital of St Gallen, St
Gallen, Switzerland
(Fruh) University of Bern, Bern, Switzerland
(Gubens) University of California, San Francisco, CA
(Moore) LUNGevity Foundation, Chicago, Mexico
(Padda) Department of Medicine, Division of Oncology, Cedars-Sinai Medical
Center, Los Angeles, CA
(Patel) Northwestern University-Feinberg School of Medicine, Chicago,
Mexico
(Phillips) City of Hope, Lancaster, CA
(Robinson) Washington University, St Louis, MO
(Simone) New York Proton Center and Memorial Sloan Kettering Cancer
Center, NY, NY
Publisher
NLM (Medline)
Abstract
PURPOSE: To provide evidence-based recommendations to practicing
clinicians on management of patients with stage III non-small-cell lung
cancer (NSCLC). METHOD(S): An Expert Panel of medical oncology,
thoracic surgery, radiation oncology, pulmonary oncology, community
oncology, research methodology, and advocacy experts was convened to
conduct a literature search, which included systematic reviews,
meta-analyses, and randomized controlled trials published from 1990
through 2021. Outcomes of interest included survival, disease-free or
recurrence-free survival, and quality of life. Expert Panel members used
available evidence and informal consensus to develop evidence-based
guideline recommendations. RESULT(S): The literature search
identified 127 relevant studies to inform the evidence base for this
guideline. RECOMMENDATIONS: Evidence-based recommendations were developed
to address evaluation and staging workup of patients with suspected stage
III NSCLC, surgical management, neoadjuvant and adjuvant approaches, and
management of patients with unresectable stage III NSCLC.Additional
information is available at www.asco.org/thoracic-cancer-guidelines.

<105>
Accession Number
636935149
Title
A Blinded Randomized Trial Comparing Standard Activated Clotting Time
Heparin Management to High Target Active Clotting Time and Individualized
Hepcon HMS Heparin Management in Cardiopulmonary Bypass Cardiac Surgical
Patients.
Source
Annals of thoracic and cardiovascular surgery : official journal of the
Association of Thoracic and Cardiovascular Surgeons of Asia. (no
pagination), 2021. Date of Publication: 22 Dec 2021.
Author
Nuttall G.A.; Smith M.M.; Smith B.B.; Christensen J.M.; Santrach P.J.;
Schaff H.V.
Institution
(Nuttall, Smith, Smith, Christensen) Department of Anesthesiology and
Perioperative Medicine, Mayo Clinic, MN, Rochester, United States
(Santrach) Department of Laboratory Medicine and Pathology, Mayo Clinic,
MN, Rochester, United States
(Schaff) Department of Cardiovascular Surgery, Mayo Clinic, MN, Rochester,
United States
Publisher
NLM (Medline)
Abstract
PURPOSE: High-dose heparin has been suggested to reduce consumption
coagulopathy. MATERIALS AND METHODS: In a randomized, blinded, prospective
trial of patients undergoing elective, complex cardiac surgery with
cardiopulmonary bypass, patients were randomized to one of three groups:
1) high-dose heparin (HH) receiving an initial heparin dose of 450 u/kg,
2) heparin concentration monitoring (HC) with Hepcon Hemostasis Management
System (HMS; Medtronic, Minneapolis, MN, USA) monitoring, or 3) a control
group (C) receiving a standard heparin dose of 300 u/kg. Primary outcome
measures were blood loss and transfusion requirements. RESULT(S):
There were 269 patients block randomized based on primary versus redo
sternotomy to one of the three groups from August 2001 to August 2003.
There was no difference in operative bleeding between the groups. Chest
tube drainage did not differ between treatment groups at 8 hours (median
[25th percentile, 75th percentile] for control group was 321 [211, 490]
compared to 340 [210, 443] and 327 [250, 545], p = 0.998 and p = 0.540,
for HH and HC treatment groups, respectively). The percentage of patients
receiving transfusion was not different among the groups.
 CONCLUSION(S): Higher heparin dosing accomplished by either activated
clot time or HC monitoring did not reduce 24-hour intensive care unit
blood loss or transfusion requirements.

<106>
Accession Number
636934373
Title
Colchicine for patients with coronary artery disease: A Systematic Review
and Meta-Analysis.
Source
Journal of cardiovascular pharmacology. (no pagination), 2021. Date of
Publication: 13 Dec 2021.
Author
Shrestha D.B.; Budhathoki P.; Sedhai Y.R.; Khadka M.; Pokharel S.; Yadav
S.; Patel T.; Elgendy I.; Yadullahi Mir W.A.; Patel N.K.
Institution
(Shrestha) Department of Internal Medicine, Mount Sinai Hospital, Chicago,
IL, USA Department of Internal Medicine, Bronxcare Health System, Bronx,
NY, USA Department of Internal Medicine, Division of Hospital Medicine,
Virginia Commonwealth University, School of Medicine, Richmond, VA, USA
Nepalese Army Institute of Health Sciences (NAIHS), Kathmandu, Nepal
Department of Internal Medicine, Division of Cardiology, AdventHealth -
AdventHealth Medical Group at East Orlando, 258 South Chickasaw Trail
Suite 203, Orlando, FL, USA Department of Internal Medicine, Weill Cornell
Medicine-Qatar, Doha, Qatar Department of Internal Medicine, Division of
Cardiology, VCU Pauley Heart Center, Virginia Commonwealth University,
School of Medicine, Richmond, VA, USA
Publisher
NLM (Medline)
Abstract
ABSTRACT: Several randomized controlled trials (RCTs) have studied the
role of colchicine, a potent anti-inflammatory drug, to prevent adverse
cardiovascular events in patients with coronary artery disease (CAD). In
this meta-analysis, we aimed to determine the role of colchicine in CAD
patients in terms of clinical outcome and mortality. We searched PubMed,
PubMed Central (PMC), Scopus, and Embase for randomized controlled trials
evaluating the role of colchicine in CAD patients. After assessing the
eligibility for inclusion, risk of bias assessment, and data extraction
from the included studies, a narrative synthesis was conducted. Out of 17
studies included for the qualitative analysis, 11 studies reported that
inflammatory markers like C-reactive protein and cytokines were reduced in
the colchicine group, suggesting an anti-inflammatory role of colchicine
in coronary artery disease. Quantitative analysis with pooling of data
from 9 studies using fixed effect model showed 28% lower odds of acute
myocardial infarction (AMI) (OR 0.72, 95% CI 0.59 to 0.86; n = 11712), 52%
lower occurrence of stroke (OR 0.48, 95% CI 0.30 to 0.76) and 37%
reduction in odds of coronary revascularization procedure in colchicine
group (OR 0.63, 95% CI 0.52 to 0.76; n= 11258). However, the odds of
gastrointestinal adverse events were 50% higher in the colchicine group
(OR 1.50, 95% CI 1.01 to 2.23; n = 12214). In conclusion, colchicine is
associated with a lower risk of AMI, stroke, and coronary
revascularization. Although, there is some increased risk of GI adverse
events with the use of colchicine. Copyright © 2021 Wolters
Kluwer Health, Inc. All rights reserved.

<107>
Accession Number
636933552
Title
Effect of Dexmedetomidine on Tachyarrhythmias after Cardiac Surgery: A
Systematic Review and Meta-analysis.
Source
Journal of cardiovascular pharmacology. (no pagination), 2021. Date of
Publication: 13 Dec 2021.
Author
Wang W.; Liu J.; Ye H.; Wang M.; Wang T.
Institution
(Wang) Department of Anesthesiology, Jining No. 1 People's Hospital,
Jining, Shandong 272000, P.R. China Department of Emergency, Jining No. 1
People's Hospital, Jining, Shandong 272000, P.R. China Department of
Anesthesiology, Sishui County Hospital, Jining, Shandong 272000, P.R.
China Department of Anesthesiology, Qingdao Municipal Hospital Group,
Qingdao, Shandong 266000, P.R. China Department of Anesthesiology, The
Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan
570311, P.R. China
Publisher
NLM (Medline)
Abstract
ABSTRACT: Tachyarrhythmias after cardiac surgery is a common occurrence in
clinical practice, which can be life-threatening. We searched six
databases, including Embase, PubMed, Cochrane, CNKI, Wanfang, and Sinomed
to evaluate the effect of dexmedetomidine on tachyarrhythmias after adult
cardiac surgery. The primary endpoint was the number of patients with
atrial fibrillation after cardiac surgery. The secondary endpoints
included: the number of patients with supraventricular tachycardia or with
ventricular tachycardia or with ventricular fibrillation or with
myocardial infarction or deceased patients, the duration of mechanical
ventilation, the ICU stay, hospital stay, and the number of patients with
bradycardia and those with hypotension. Among the 1388 retrieved studies,
18 studies (N=3171 participants) met our inclusion criteria.
Dexmedetomidine reduced the incidence of atrial fibrillation by 17%
(RR=0.83, 95% CI 0.73-0.93, P=0.002). Through subgroup analysis, we found
that when the maintenance dose of dexmedetomidine was >0.7ug/kg/h, the
effect of preventing atrial fibrillation was obvious (RR=0.58, 95%CI
0.43-0.78, P=0.0003). Dexmedetomidine also reduced the incidence of
supraventricular tachycardia by about 70% (RR=0.29, 95% CI 0.11-0.77,
P=0.01), the incidence of ventricular tachycardia by about 80% (RR=0.23,
95% CI 0.08-0.63, P=0.004), but had no effect on ventricular fibrillation
(RR=1.02, 95% CI 0.14-7.31, P=0.99). The major side effect of
dexmedetomidine was bradycardia. Dexmedetomidine can reduce the incidence
of atrial fibrillation (especially high dosages), supraventricular
tachycardia, and ventricular tachycardia after cardiac surgery in adults,
but does not affect the occurrence of ventricular
fibrillation. Copyright © 2021 Wolters Kluwer Health, Inc. All
rights reserved.

<108>
Accession Number
636933028
Title
Frailty, depression and prognosis after transcatheter aortic valve
replacement: a literature review.
Source
Geriatrie et psychologie neuropsychiatrie du vieillissement. (no
pagination), 2021. Date of Publication: 19 Dec 2021.
Author
Dalberto M.; Miot S.; Leclercq F.; Blain H.
Institution
(Dalberto, Miot, Blain) Pole de gerontologie, CHU de Montpellier,
Universite de Montpellier, France
(Leclercq) Departement de cardiologie, CHU de Montpellier, Universite de
Montpellier, France
Publisher
NLM (Medline)
Abstract
A systematic review of the literature was conducted to analyse the results
of studies evaluating the link between frailty and depression before
transcatheter aortic valve replacement (TAVR) and vital prognosis and
quality of life after TAVR. The literature indicates that TAVR is a
procedure which improves quality of life at one year in older subjects.
The longer-term effects are debatable, possibly depending on underlying
comorbidities and their own course. The presence of depression before and
after TAVR is associated with a lower quality of life at follow-up,
suggesting the importance of systematic screening before and after TAVR.
The underlying frailty of older patients who are eligible for TAVR is
associated with excess mortality, justifying a pre-TAVR assessment of
functional and cognitive reserves, and particularly their nutritional
status. The link between depression before TAVR and excess mortality after
TAVR has not been clearly demonstrated and may, in part, be linked to
apathy or impaired executive functions, which can mimic depression, and
which should also be investigated before TAVR.

<109>
Accession Number
636940405
Title
Transcatheter aortic valve replacement in obese patients: procedural
vascular complications with the trans-femoral and trans-carotid access
routes.
Source
Interactive cardiovascular and thoracic surgery. (no pagination), 2021.
Date of Publication: 23 Dec 2021.
Author
Alperi A.; McInerney A.; Modine T.; Chamandi C.; Tafur-Soto J.D.; Barbanti
M.; Lopez D.; Campelo-Parada F.; Cheema A.N.; Toggweiler S.; Saia F.;
Amat-Santos I.; Oteo J.F.; Serra V.; Dabrowski M.; Abi-Akar R.; Echavarria
N.G.; Valvo R.; Lopez-Pais J.; Matta A.; Arif M.; Moccetti F.; Compagnone
M.; Mohammadi S.; Nombela-Franco L.; Rodes-Cabau J.
Institution
(Alperi, Mohammadi, Rodes-Cabau) Quebec Heart & Lung Institute, Laval
University, Quebec City, Canada
(McInerney, Nombela-Franco) Cardiovascular Institute, Hospital Clinico San
Carlos, Madrid, Spain
(Modine) Centre Hospitalier Universitaire de Lille, Lille, France
(Chamandi, Abi-Akar) Hopital europeen Georges-Pompidou, Paris, France
(Tafur-Soto, Echavarria) Ochsner Clinical School, Ochsner Medical Center,
LA, New Orleans, United States
(Barbanti, Valvo) Ferrarotto Hospital, University of Catania, Catania,
Italy
(Lopez, Lopez-Pais) Instituto de investigacion de Santiago (IDIS),
Hospital Clinico Universitario de Santiago de Compostela, Santiago de
Compostela, Spain
(Campelo-Parada, Matta) Cardiology Department, Rangueil University
Hospital, Toulouse, France
(Cheema, Arif) Division of Cardiology, St Michaels Hospital, Toronto,
Canada
(Toggweiler, Moccetti) Heart Center Luzerne, Luzerner Kantonsspital,
Lucerne, Switzerland
(Saia, Compagnone) Cardiology Unit, Cardio-Thoracic-Vascular Department,
University Hospital of Bologna, Policlinico S. Orsola-Malpighi, Bologna,
Italy
(Amat-Santos) Instituto de Ciencias del Corazon (ICICOR), Hospital Clinico
Universitario de Valladolid, Valladolid, Spain
(Oteo) Department of Cardiology, Hospital Universitario Puerta de Hierro,
Majadahonda, Spain
(Serra) Hospital General Universitari Vall d'Hebron, Barcelona, Spain
(Dabrowski) Department of Interventional Cardiology and Angiology,
National Institute of Cardiology, Warsaw, Poland
(Rodes-Cabau) Hospital Clinic Barcelona, Barcelona, Spain
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Obesity may increase the risk of vascular complications in
transfemoral (TF) transcatheter aortic valve replacement (TAVR)
procedures. The transcarotid (TC) approach has recently emerged as an
alternative access in TAVR. We sought to compare vascular complications
and early clinical outcomes in obese patients undergoing TAVR either by TF
or TC vascular access. METHOD(S): Multicentre registry including
obese patients undergoing TF- or TC-TAVR in 15 tertiary centres. All
patients received newer-generation transcatheter heart valves. For
patients exhibiting unfavourable ileo-femoral anatomic characteristics,
the TC approach was favoured in 3 centres with experience with it. A
propensity score analysis was performed for overcoming unbalanced baseline
covariates. The primary end point was the occurrence of in-hospital
vascular complications (Valve Academic Research Consortium-2 criteria).
 RESULT(S): A total of 539 patients were included, 454 (84.2%) and 85
(15.8%) had a TF and TC access, respectively. In the propensity-adjusted
cohort (TF: 442 patients; TC: 85 patients), both baseline and procedural
valve-related characteristics were well-balanced between groups. A
significant decrease in vascular complications was observed in the TC
group (3.5% vs 12% in the TF group, odds ratio: 0.26, 95% CI: 0.07-0.95,
P=0.037). There were no statistically significant differences between
groups regarding in-hospital mortality (TC: 2.8%, TF: 1.5%), stroke (TC:
1.2%, TF: 0.4%) and life-threatening/major bleeding events (TC: 2.8%, TF:
3.8%). CONCLUSION(S): In patients with obesity undergoing TAVR with
newer-generation devices, the TC access was associated with a lower rate
of vascular complications. Larger randomized studies are warranted to
further assess the better approach for TAVR in obese
patients. Copyright © The Author(s) 2021. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery.

<110>
Accession Number
636952740
Title
Bilateral Internal Thoracic Artery Coronary Grafting: Risks and Benefits
in Elderly Patients.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2021. Date of Publication: 27 Dec 2021.
Author
Zhou Z.; Fu G.; Huang S.; Chen S.; Liang M.; Wu Z.
Institution
(Zhou, Fu, Huang, Chen, Liang, Wu) Department of Cardiac Surgery, First
Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
(Zhou, Fu, Huang, Chen, Liang, Wu) NHC Key Laboratory of Assisted
Circulation, Sun Yat-sen University, Guangzhou, China
Publisher
NLM (Medline)
Abstract
AIMS: Whether bilateral internal thoracic artery (BITA) grafting benefits
elderly patients in coronary artery bypass grafting (CABG) remains unclear
since they tend to have a limited life expectancy and severe
comorbidities. We aim to evaluate the outcomes of BITA versus single
internal thoracic artery (SITA) grafting in elderly patients. METHODS AND
RESULTS: A meta-analysis was performed by database searching until May
2021. Studies comparing BITA and SITA grafting among elderly patients were
included. One randomized controlled trial, nine propensity score matching
and six unmatched studies were identified, with a total of 18,146 patients
(7,422 received BITA, and 10,724 received SITA). Compared with SITA, BITA
grafting had a higher risk of deep sternal wound infection (DSWI) (OR:
1.67; 95% CI, 1.22-2.28), and this risk could not be significantly reduced
by skeletonized technique. Meanwhile, BITA grafting was associated with a
higher long-term survival (HR: 0.83; 95% CI, 0.77-0.90), except for the
octogenarian subgroup. Reconstructed Kaplan-Meier survival curves revealed
4-year, 8-year and 12-year overall survival rates of 85.5%, 66.7%, and
45.3%, respectively, in the BITA group and 79.3%, 58.6%, and 34.9%,
respectively, in the SITA group. No significant difference was observed in
early mortality, perioperative myocardial infarction, perioperative
cerebral vascular accidents or re-exploration for bleeding.
 CONCLUSION(S): Compared with SITA, BITA grafting could provide a
long-term survival benefit for elderly patients, though this benefit
remained uncertain in octogenarians. Meanwhile, elderly patients recieved
BITA were associated with a higher risk of DSWI and such a risk could not
be eliminated by the skeletonized technique. Copyright © The
Author(s) 2021. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<111>
Accession Number
636952256
Title
Major adverse cardiovascular events in homozygous familial
hypercholesterolaemia: a systematic review and meta-analysis.
Source
European journal of preventive cardiology. (no pagination), 2021. Date of
Publication: 27 Dec 2021.
Author
Kramer A.I.; Akioyamen L.E.; Lee S.; Belanger A.; Ruel I.; Hales L.;
Genest J.; Brunham L.R.
Institution
(Kramer, Brunham) Department of Medicine, University of British Columbia,
Vancouver V5Z 1M9, Canada
(Akioyamen) Department of Medicine, University of Toronto, Toronto ON M5S
1A8, Canada
(Lee) Department of Internal Medicine, Yale University School of Medicine,
CT 06510, New Haven, United States
(Belanger, Ruel, Genest) Research Institute of the McGill University
Health Centre, Montreal, Canada
(Hales) McGill University Health Center Medical Libraries, Montreal,
Canada
(Brunham) Centre for Heart Lung Innovation, University of British
Columbia, 1081 Burrard Street - Room 166, Vancouver V6Z 1Y6, Canada
Publisher
NLM (Medline)
Abstract
AIMS: Homozygous familial hypercholesterolaemia (HoFH) is a genetic
condition characterized by extremely elevated levels of low-density
lipoprotein cholesterol and premature atherosclerotic cardiovascular
disease and death. Due to its rarity, accurate assessment of
cardiovascular outcomes associated with HoFH and how they have changed
over time has been challenging. The goal of this study was to assess the
prevalence and age-of-onset of major adverse cardiovascular events (MACE)
among patients with HoFH. METHODS AND RESULTS: We searched MEDLINE,
EMBASE, Pubmed, Cochrane Central Register of Controlled Trials, Scopus,
Africa-Wide, Google Scholar, Open Grey, and various clinical trial
registries from inception to February 2020 to identify studies reporting
on MACE in HoFH patients. We determined the pooled prevalence and mean
age-of-onset of MACE outcomes individually using a random effects inverse
variance model. We identified 94 studies that met our eligibility
criteria. Myocardial infarction and coronary revascularization were common
with a prevalence of 15.1% [95% confidence interval (95% CI) 10.7-20.0]
and 28.3% (95% CI 22.5-34.3), respectively. The mean age-of-onset was 24.5
(95% CI 19.2-29.8) years for myocardial infarction and 32.2 (95% CI
26.6-37.8) years for revascularization. Sub-group analyses based on the
year of publication revealed significant delays in the onset of MACE
outcomes post-1990 compared to pre-1990. Egger's regression suggested
possible bias, likely due to small study effects. CONCLUSION(S):
Atherosclerotic cardiovascular disease is common among HoFH patients and
occurs at a young age. Age-of-onset of myocardial infarction was delayed
by more than a decade from pre-1990 to post-1990, likely attributable to
widespread use of statins and other therapies, reflecting substantial
progress in the management of this rare but severe disorder. Copyright
Published on behalf of the European Society of Cardiology. All rights
reserved. © The Author(s) 2021. For permissions, please email:
journals.permissions@oup.com.

<112>
Accession Number
636950982
Title
Five-Year Outcomes of Concomitant Maze Procedure Using Nitrous Oxide
versus Argon-Based Cryoablation.
Source
The Annals of thoracic surgery. (no pagination), 2021. Date of
Publication: 22 Dec 2021.
Author
Park I.; Jeong D.S.; Ahn J.H.; Park P.W.
Institution
(Park) Department of Thoracic and Cardiovascular Surgery, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Jeong) Department of Thoracic and Cardiovascular Surgery, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Ahn) Biostatistics and Clinical Epidemiology Center, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Park) Department of Thoracic and Cardiovascular Surgery, Incheon Sejong
Hospital, Gyeonggi-do, Incheon, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cryoablation is effective for ablating the myocardium but
maintaining the structure of the ablated tissue. However, data comparing
nitrous oxide (N2O)-based and argon gas-based cryoprobes are limited.
 METHOD(S): This study was a follow-up study of a single-center,
prospective, randomized controlled trial in which 60 patients were
randomly allocated to either the N2O group or the argon group. The primary
endpoint of this study was sinus rhythm maintenance, and the key secondary
endpoint was a composite of major adverse cardiovascular and
cerebrovascular events (MACCEs) (i.e., cardiac death, stroke, major
bleeding, and readmission for heart failure). RESULT(S): The baseline
and operative characteristics of the patients in the N2O and argon groups
were comparable. At the 5-year follow-up, the rate of sinus rhythm
maintenance was 81.8% in the N2O group, whereas it was 78.5% in the argon
group (p > 0.999). No significant differences in the rate of freedom from
MACCEs (80.6% in the N2O group vs. 81.9% in the argon group; P = .978) was
observed at the 5-year follow-up. The left atrial volume index decreased
over time from 114.65 mL/m2 to 65.74 mL/m2 (P < .0001) and reached similar
values in the two groups (P = .279) at the 5-year follow-up.
 CONCLUSION(S): Both N2O- and argon gas-based cryoprobes showed
similar rates of sinus rhythm maintenance and freedom from MACCEs at the
5-year follow-up. Both cryoprobes might have similar efficacy and safety
in the arrested heart in the long term. Copyright © 2021 The
Society of Thoracic Surgeons. Published by Elsevier Inc. All rights
reserved.

<113>
Accession Number
636950674
Title
Mechanical vs. bioprosthetic aortic valve replacement in patients younger
than 70 years of age - a hazard ratio meta-analysis.
Source
The Canadian journal of cardiology. (no pagination), 2021. Date of
Publication: 23 Dec 2021.
Author
Leviner D.B.; Witberg G.; Levi A.; Landes U.; Schwartz N.; Shiran A.;
Kornowski R.; Sharoni E.
Institution
(Leviner, Sharoni) Department of Cardiothoracic Surgery, Carmel Medical
Center, Haifa, Israel; Technion-Israel Institute of Technology, Faculty of
Medicine, Haifa, Israel
(Witberg, Levi, Kornowski) Department of Cardiology, Rabin Medical Center,
Petach Tikva, Israel; Sackler school of Medicine, Tel-Aviv University,
Tel-Aviv, Israel
(Landes) Departmetnt of Cardiology, Wolfson Medical Center, Tel-Aviv,
Israel; Sackler school of Medicine, Tel-Aviv University, Tel-Aviv, Israel
(Schwartz) Department of Biostatistics, Carmel Medical Center, Haifa,
Israel
(Shiran) Department of Cardiology, Carmel Medical Center, Haifa, Israel;
Technion-Israel Institute of Technology, Faculty of Medicine, Haifa,
Israel
Publisher
NLM (Medline)
Abstract
BACKGROUND: The choice between mechanical valves (MV) and bioprosthetic
valves (BV) in patients undergoing aortic valve surgery is complex,
requiring a balance between the inferior durability of BV and the
indicated long-term anticoagulation therapy with MV. This is especially
challenging in middle age group (<70 years of age) that has seen an
increased use of BV over recent years. METHOD(S): A meta-analysis of
randomized controlled trials (RCTs), observational studies using
propensity score matching (PSM) and inverse-probability-weighing (IPW) was
conducted to examine the clinical outcomes of patients <70 years of age
undergoing aortic valve replacement. Primary outcome was overall long-term
mortality. Secondary outcomes included bleeding events, re-operation,
systemic thromboembolism, and cerebrovascular accident (CVA).
 RESULT(S): Fifteen studies (1 RCT, 12 PSM, and 2 IPW studies,
aggregated sample size 16,876 patients) were included. Median follow-up
was 7.8 years. Mortality was higher with BV vs. MV (HR 1.22 [1.00-1.49]),
as was re-operation (HR 3.05 [2.22-4.19]). Bleeding risk was lower with BV
(HR 0.58 [0.48-0.69]), and the risk of stroke was similar in both valve
types (HR 0.96 [0.83-1.11]) CONCLUSION(S): In this broadest
meta-analysis comparing BV and MV, results suggest a survival benefit for
MV in patients < 70 years of age. This should lead to reassessment of
current patterns used in the choice of valves for patients <70 among the
cardiothoracic surgery community. Copyright © 2021. Published by
Elsevier Inc.

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