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<1>
Accession Number
2010586256
Title
Dual Antiplatelet Therapy before Coronary Artery Bypass Grafting; a
Systematic Review andMeta-Analysis.
Source
Archives of Academic Emergency Medicine. 8(1) (pp e61), 2020. Date of
Publication: January 2020.
Author
Sadeghi R.; Babahajian A.; Sarveazad A.; Kachoueian N.; Bahardoust M.
Institution
(Sadeghi) Department of cardiovascular Medicine, School of Medicine,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Sadeghi) Cardiovascular Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Babahajian) Liver and Digestive Research Center, Research Institute for
Health Development, Kurdistan University of Medical Sciences, Sanandaj,
Iran, Islamic Republic of
(Sarveazad, Bahardoust) Colorectal Research Center, Iran University
ofMedical Sciences, Tehran, Iran, Islamic Republic of
(Sarveazad) Nursing Care Research center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Kachoueian) Department of Cardiac Surgery, School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Bahardoust) Department of Epidemiology, School of Public Health, Iran
University ofMedical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Shaheed Beheshti University of Medical Sciences and Health Services
Abstract
Introduction: Currently, the basis of acute coronary syndrome (ACS)
therapy is dual antiplatelet therapy (DAPT) with Aspirin as a nonsteroidal
anti-inflammatory drug and clopidogrel as adenosine diphosphate receptor
antagonists. Therefore, the aim of the present systematic review is to
answer that should DAPT with Aspirin and clopidogrel be continued until
coronary artery bypass grafting (CABG) in patients who have ACS?Methods:
The search for relevant studies in the present meta-analysis is based on
three approaches: A) systematic searches in electronic databases, B)
manual searches in Google and Google Scholar, and C) screening of
bibliography of related original and review articles. The endpoints
included mortality rate, myocardial infarction (MI), cerebrovascular
accident (CVA), reoperation, re-exploration, other cardiac events, renal
failure, length of ICU and hospital stay, chest tube drainage and blood
product transfusion after CABG. <br/>Result(s): After the initial
screening, 41 articles were studied in detail, and finally the data of 15
studies were included in the meta-analysis. DAPT before CABG in patients
with ACS does not increase the rate of mortality, CVA, renal failure, MI,
and other cardiac events, but increases reoperation, re-exploration,
length of ICU, and hospital stay. Chest tube drainage and blood product
transfusion rate significantly increased in the DAPT group compared to the
control group (non-antiplatelet or Aspirin alone). Increase in chest tube
drainage and blood product transfusion rate indicates an increase in
bleeding, so increase in reoperation, re-exploration to control bleeding,
and, subsequently, increase in the length of ICU and hospital stay are
expected. <br/>Conclusion(s): DAPT with Aspirin and clopidogrel before
CABG in patients with ACS does not increase the rate of mortality, CVA,
renal failure, MI, and other cardiac events despite more bleedings, and it
may be suggested before CABG for better graft patency.<br/>Copyright
&#xa9; 2020, Archives of Academic Emergency Medicine. All Rights Reserved.

<2>
Accession Number
2016988853
Title
Preoperative screening of patients at high risk of obstructive sleep apnea
and postoperative complications: A systematic review and meta-analysis.
Source
Journal of Clinical Anesthesia. 79 (no pagination), 2022. Article Number:
110692. Date of Publication: August 2022.
Author
Wang S.; Li S.; Zhao Y.; Zhao X.; Zhou Z.; Hao Q.; Luo A.; Sun R.
Institution
(Wang, Li, Zhao, Zhou, Luo, Sun) Department of Anesthesiology, Tongji
Hospital, Tongji Medical College, Huazhong University of Science and
Technology, Wuhan 430030, China
(Zhao) Center of Stomatology, Tongji Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan 430030, China
(Hao) Department of Anesthesiology, Huanggang Central Hospital, Huanggang
438000, China
Publisher
Elsevier Inc.
Abstract
Study objective: To determine the association between postoperative
complications and a high versus low risk of obstructive sleep apnea (OSA)
as determined via screening tools. <br/>Design(s): Systematic review and
meta-analysis of cohort studies. PubMed, EMBASE, Web of Science, and the
Cochrane Library were searched from their inception to January 5, 2021.
<br/>Setting(s): Operating room, postoperative recovery area, and ward.
<br/>Patient(s): Adult patients scheduled for surgery.
<br/>Intervention(s): We used Review Manager 5.4 to pool the data. The
quality of evidence was rated using the Grading of Recommendations,
Assessment, Development and Evaluation system. Measurements: The primary
outcome was the composite endpoint of postoperative respiratory
complications. The secondary outcomes were postoperative cardiac and
neurological complications, intensive care unit (ICU) admission, and
mortality. <br/>Main Result(s): Twenty-six studies with 50,592 patients
were included. A STOP-Bang score >= 3 (versus <3) was associated with
higher incidences of postoperative respiratory (odds ratio [OR], 2.11; 95%
confidence interval [CI], 1.66-2.68) and neurological complications (OR,
3.60; 95% CI, 1.56-8.31). A STOP-Bang score >= 5 (versus <5) was
associated with higher incidences of postoperative respiratory (OR, 2.37;
95% CI, 1.11-5.04) and cardiac complications (OR, 4.95; 95% CI,
1.22-20.00) and higher in-hospital mortality (OR, 26.39; 95% CI,
2.89-241.30). A Berlin score >= 2 (versus <2) was not associated with the
incidence of postoperative complications, ICU admission, or mortality. The
quality of evidence for all outcomes was very low. <br/>Conclusion(s):
Very low-quality evidence suggested that a high risk of OSA, as assessed
using the STOP-Bang questionnaire, was associated with a higher incidence
of postoperative respiratory complications, and may also be associated
with higher incidences of postoperative cardiac and neurological
complications than a low risk of OSA. Since most of the included studies
did not adjust for confounding factors, our findings need to be
interpreted with caution. PROSPERO registration number:
CRD42021220236.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<3>
Accession Number
2007745324
Title
Effects of intravenous and transdermal photobiomodulation on the
postoperative complications of coronary artery bypass grafting surgery: a
randomized, controlled clinical trial.
Source
Lasers in Medical Science. 36(9) (pp 1891-1896), 2021. Date of
Publication: December 2021.
Author
Kazemikhoo N.; Kyavar M.; Razzaghi Z.; Ansari F.; Maleki M.; Ghavidel
A.A.; Gholampour M.; Ghaffarinejad M.H.
Institution
(Kazemikhoo) Skin and Stem Cell Research Center, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Kazemikhoo) Department of Dermatology at St George Hospital, University
of NSW, Sydney, Australia
(Kyavar, Maleki, Ghavidel, Gholampour, Ghaffarinejad) Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Razzaghi) Laser Application in Medical Sciences Research Center, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Ansari) Research Center for Evidence-Based Medicine, Health Management
and Safety Promotion Research Institute, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
(Ansari) Razi Vaccine and Serum Research Institute, Agricultural Research,
Education and Extension Organization (AREEO), Tehran, Iran, Islamic
Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Although coronary artery bypass graft (CABG) surgery is one of the most
worldwide commonly performed cardiac surgeries to enhance myocardial
perfusion in high-grade myocardial occlusion, it remains a high-risk
procedure. Photobiomodulation (PBM) is one of the methods which have been
shown to have positive effects on the healing process after CABG and
postoperative complications. The aim of this study was to evaluate the
efficacy of PBM in patients who underwent a coronary artery bypass graft
(CABG). Ths study was conducted with 192 volunteers who electively
submitted to CABG. The volunteers were randomly allocated into two groups:
laser-treated (transdermal: 980 nm, 200 mW, continuous, average energy
fluency of 6 J/cm² and intravenous: 405 nm, 1.5 mW, continuous
for 30 min) and standard treatment and control group (standard treatment
only). Intravenous laser was illuminated the day before the surgery,
immediately after transferring the patient to CCU post-operation and IV
laser in addition to transdermal laser was applied every day after surgery
for 6 days. A total of 170 out of 192 participants completed the study, 82
(48.2%) in the PBM group and 88 (51.8%) in the control group. Level of LDH
and CPK was significantly lower in the PBM group (P < 0.05) in the 4th day
postoperatively. The PBM group also showed significantly lower
post-surgery complications, including pericardial effusion, ejection
fraction, pathologic ST changes, pathologic Q, rehospitalization, heart
failure, and mediastinitis (P < 0.05). Likewise, the VAS pain score after
surgery was significantly lower in patients in the laser group (P < 0.05).
PBM seems a promising, safe, cost-benefit therapeutic modality to reduce
postoperative complications of CABG. Trial registration number:
IRCT2016052926069N4.<br/>Copyright &#xa9; 2021, The Author(s), under
exclusive licence to Springer-Verlag London Ltd. part of Springer Nature.

<4>
Accession Number
2013930152
Title
The Effect of a Quality Improvement Intervention on Sleep and Delirium in
Critically Ill Patients in a Surgical ICU.
Source
Chest. 160(3) (pp 899-908), 2021. Date of Publication: September 2021.
Author
Tonna J.E.; Dalton A.; Presson A.P.; Zhang C.; Colantuoni E.; Lander K.;
Howard S.; Beynon J.; Kamdar B.B.
Institution
(Tonna, Dalton) Division of Cardiothoracic Surgery, Department of Surgery,
University of Utah Health, Salt Lake City, UT, United States
(Tonna) Division of Emergency Medicine, Department of Surgery, University
of Utah Health, Salt Lake City, UT, United States
(Presson, Zhang) Division of Epidemiology, Department of Medicine,
University of Utah Health, Salt Lake City, UT, United States
(Lander) Cardiovascular Intensive Care Unit, University of Utah Health,
Salt Lake City, UT, United States
(Howard) Surgical Intensive Care Unit, Critical Care, University of Utah
Health, Salt Lake City, UT, United States
(Beynon) AirMed & Emergency Nursing, University of Utah Health, Salt Lake
City, UT, United States
(Colantuoni) Outcomes After Critical Illness and Surgery (OACIS) Group,
Johns Hopkins University, Baltimore, MD, United States
(Colantuoni) Department of Biostatistics, Bloomberg School of Public
Health, Johns Hopkins University, Baltimore, MD, United States
(Kamdar) Division of Pulmonary, Critical Care and Sleep Medicine,
University of California, San Diego, School of Medicine, La Jolla, CA,
United States
Publisher
Elsevier Inc.
Abstract
Background: Delirium is a deleterious condition affecting up to 60% of
patients in the surgical ICU (SICU). Few SICU-focused delirium
interventions have been implemented, including those addressing sleep-wake
disruption, a modifiable delirium risk factor common in critically ill
patients. Research Question: What is the effect on delirium and sleep
quality of a multicomponent nonpharmacologic intervention aimed at
improving sleep-wake disruption in patients in the SICU setting? Study
Design and Methods: Using a staggered pre-post design, we implemented a
quality improvement intervention in two SICUs (general surgery or trauma
and cardiovascular) in an academic medical center. After a preintervention
(baseline) period, a multicomponent unit-wide nighttime (ie, efforts to
minimize unnecessary sound and light, provision of earplugs and eye masks)
and daytime (ie, raising blinds, promotion of physical activity)
intervention bundle was implemented. A daily checklist was used to prompt
staff to complete intervention bundle elements. Delirium was evaluated
twice daily using the Confusion Assessment Method for the Intensive Care
Unit. Patient sleep quality ratings were evaluated daily using the
Richards-Campbell Sleep Questionnaire (RCSQ). <br/>Result(s): Six hundred
forty-six SICU admissions (332 baseline, 314 intervention) were analyzed.
Median age was 61 years (interquartile range, 49-70 years); 35% of the
cohort were women and 83% were White. During the intervention period,
patients experienced fewer days of delirium (proportion +/- SD of ICU
days, 15 +/- 27%) as compared with the preintervention period (20 +/- 31%;
P = .022), with an adjusted pre-post decrease of 4.9% (95% CI, 0.5%-9.2%;
P = .03). Overall RCSQ-perceived sleep quality ratings did not change, but
the RCSQ noise subscore increased (9.5% [95% CI, 1.1%-17.5%; P = .02).
<br/>Interpretation(s): Our multicomponent intervention was associated
with a significant reduction in the proportion of days patients
experienced delirium, reinforcing the feasibility and effectiveness of a
nonpharmacologic sleep-wake bundle to reduce delirium in critically ill
patients in the SICU. Trial Registry: ClinicalTrials.gov; No.:
NCT03313115; URL: www.clinicaltrials.gov<br/>Copyright &#xa9; 2021
American College of Chest Physicians

<5>
Accession Number
2013511613
Title
Yield of bone scintigraphy screening for transthyretin-related cardiac
amyloidosis in different conditions: Methodological issues and clinical
implications.
Source
European Journal of Clinical Investigation. 51(12) (no pagination), 2021.
Article Number: e13665. Date of Publication: December 2021.
Author
Tini G.; Sessarego E.; Benenati S.; Vianello P.F.; Musumeci B.; Autore C.;
Canepa M.
Institution
(Tini, Sessarego, Benenati, Vianello, Canepa) Cardiology Unit, Department
of Internal Medicine, University of Genoa, Genoa, Italy
(Tini, Musumeci, Autore) Division of Cardiology, Sapienza University of
Rome, Sant'Andrea Hospital, Rome, Italy
(Canepa) Cardiology Unit, Ospedale Policlinico San Martino IRCCS, Genoa,
Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Transthyretin-related cardiac amyloidosis (TTR-CA) is thought
to be particularly common in specific at-risk conditions, including aortic
stenosis (AS), heart failure with preserved ejection fraction (HFpEF),
carpal tunnel syndrome (CTS) and left ventricular hypertrophy or
hypertrophic cardiomyopathy (LVH/HCM). <br/>Method(s): We performed a
systematic revision of the literature, including only prospective studies
performing TTR-CA screening with bone scintigraphy in the above-mentioned
conditions. Assessment of other forms of CA was also evaluated. For
selected items, pooled estimates of proportions or means were obtained
using a meta-analytic approach. <br/>Result(s): Nine studies (3 AS, 2
HFpEF, 2 CTS and 2 LVH/HCM) accounting for 1375 screened patients were
included. One hundred fifty-six (11.3%) TTR-CA patients were identified
(11.4% in AS, 14.8% in HFpEF, 2.6% in CTS and 12.9% in LVH/HCM). Exclusion
of other forms of CA and use of genetic testing was overall puzzled. Age
at TTR-CA recognition was significantly older than that of the overall
screened population in AS (86 vs. 83 years, p =.04), LVH/HCM (75 vs. 63, p
<.01) and CTS (82 vs. 71), but not in HFpEF (83 vs. 79, p =.35). In terms
of comorbidities, hypertension, diabetes and atrial fibrillation were
highly prevalent in TTR-CA-diagnosed patients, as well as in those with an
implanted pacemaker. <br/>Conclusion(s): Screening with bone scintigraphy
found an 11-15% TTR-CA prevalence in patients with AS, HFpEF and LVH/HCM.
AS and HFpEF patients were typically older than 80 years at TTR-CA
diagnosis and frequently accompanied by comorbidities. Several studies
showed limitations in the application of recommended TTR-CA diagnostic
algorithm, which should be addressed in future prospective
studies.<br/>Copyright &#xa9; 2021 The Authors. European Journal of
Clinical Investigation published by John Wiley & Sons Ltd on behalf of
Stichting European Society for Clinical Investigation Journal Foundation.

<6>
Accession Number
2015142899
Title
Real-world anticoagulatory treatment after percutaneous mitral valve
repair using MitraClip: a retrospective, observational study on 1300
patients.
Source
Clinical Research in Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Hohmann C.; Ludwig M.; Walker J.; Iliadis C.; Schipper J.-H.; Baldus S.;
Pfister R.
Institution
(Hohmann, Iliadis, Schipper, Baldus, Pfister) Faculty of Medicine,
Department III for Internal Medicine, Heart Center, University Hospital of
Cologne, Kerpener Str. 62, Cologne 50937, Germany
(Ludwig, Walker) InGef - Institute for Applied Health Research Berlin
GmbH, Berlin, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Aims: This study sought to investigate current anticoagulatory treatment
patterns and clinical outcome in patients undergoing transcatheter mitral
valve repair (MitraClip). <br/>Methods and Results: In a retrospective
study of a German claims database (InGef research database),
anticoagulatory treatment regimens were assessed using any drug
prescription post discharge within the first 90 days after MitraClip
procedure. Clinical events between 30 days and 6 months were examined by
treatment regime. The study population comprised 1342 patients undergoing
MitraClip procedure between 2014 and 2018. 22.4% received antiplatelet
monotherapy, 20.8% oral anticoagulation (OAC) plus antiplatelet therapy,
19.4% OAC monotherapy, 11.7% dual antiplatelet therapy, 2.8% triple
therapy and 21.0% did not receive any anticoagulatory drugs. 63% of
patients with OAC received non-vitamin-K antagonist oral anticoagulants
(NOAC). A total of 168 patients were newly prescribed OAC after MitraClip,
of whom 12 patients (7.1%) had no diagnosis of atrial fibrillation or
venous thromboembolism. 40% of patients with OAC prior to MitraClip did
not have any OAC after MitraClip. The adjusted risk of all-cause mortality
was significantly increased in patients with no anticoagulatory treatment
(HR 3.84, 95% CI 2.33-6.33, p < 0.0001) when compared to antiplatelet
monotherapy whereas the other regimes were not significantly different.
<br/>Conclusion(s): This large real-world data analysis demonstrates a
heterogeneous spectrum of prescriptions for anticoagulant therapies after
MitraClip. Considering relevant differences in clinical outcome across
treatment groups, major effort is warranted for controlled trials in order
to establish evidence-based recommendations on anticoagulatory treatment
after percutaneous mitral valve repair. Graphical abstract: [Figure not
available: see fulltext.]<br/>Copyright &#xa9; 2022, The Author(s).

<7>
Accession Number
2014997155
Title
Peripheral access size evaluation in transfemoral transcatheter aortic
valve replacement.
Source
Journal of Cardiac Surgery. 37(4) (pp 801-807), 2022. Date of Publication:
April 2022.
Author
Hameed I.; Oakley C.T.; Hameed N.U.F.; Jiang Y.; Naeem N.; Morsi M.; Ahmed
A.; Amabile A.; Hirji S.; Truong Q.A.; Gaudino M.; Kaneko T.; Salemi A.
Institution
(Hameed, Amabile) Division of Cardiothoracic Surgery, Department of
Surgery, Yale School of Medicine, New Haven, CT, United States
(Oakley, Hameed, Jiang, Naeem, Morsi, Ahmed, Gaudino) Department of
Cardiothoracic Surgery, Weill Cornell Medical College, New York, NY,
United States
(Hirji) Department of Surgery, Brigham and Women's Hospital, Boston, MA,
United States
(Truong) Department of Radiology, Weill Cornell Medical College, New York,
NY, United States
(Kaneko) Division of Cardiac Surgery, Brigham and Women's Hospital,
Boston, MA, United States
(Salemi) Department of Cardiothoracic Surgery, Robert Wood
Johnson/Barnabas Health, West Orange, NJ, United States
Publisher
John Wiley and Sons Inc
Abstract
Background/Aim: Peripheral access vessel dimensions in the general patient
population screened for transcatheter aortic valve replacement (TAVR) can
offer insight into the indications for pre-TAVR computed tomography
angiography (CTA) assessment. We seek to determine peripheral access
vessel sizes in patients screened for TAVR and association with patient
characteristics. <br/>Material(s) and Method(s): All patients with severe,
symptomatic aortic stenosis screened for TAVR at a high-volume center from
April 2012 to March 2019 were retrospectively reviewed. For each patient,
contrast-enhanced CTA was used to determine the minimal luminal diameters
(MLDs) of the transfemoral access vessels, as measured between the
inguinal ligament and the deep femoral artery for the femoral artery, and
proximal to the inguinal ligament for the external and common iliac
arteries, respectively. Paired and independent samples t-tests were used
to compare means and regression analyses were performed to determine
factors associated with MLD. <br/>Result(s): A total of 1049 screened
patients were included of which 826 (78.7%) underwent TAVR and 551 (52.5%)
were male. The mean age was 80.6 (+/-9.6) years and the mean body mass
index (BMI) was 26.7 (+/-5.9) kg/m². About 152 (14.5%) had
peripheral vascular disease and 153 (14.6%) had chronic kidney disease.
The mean (+/-2 standard deviations) MLDs of the right and left femoral
arteries were 7.73 mm (4.68-10.78) and 7.68 mm (4.63-10.72), respectively.
Male sex and BMI were associated with larger average femoral MLD while
hyperlipidemia, hypertension, smoking, peripheral vascular disease, and
coronary artery disease were inversely associated. <br/>Conclusion(s):
Most patients screened for TAVR have minimum peripheral access vessel
sizes exceeding the recommended minimum access route diameters of modern
transcatheter heart valves. As sheath sizes decrease, clinicians must
carefully judge patient individual risk factors to determine whether a
pre-TAVR CTA assessing peripheral access vessel dimensions and anatomical
contraindications is indicated. Larger studies and randomized controlled
trials are required to compare the outcomes of TAVR with and without
preoperative CTA.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<8>
Accession Number
2014717037
Title
Valve endocarditis, to repair or not to repair, is that really the
question?.
Source
Journal of Cardiac Surgery. 37(4) (pp 1016-1018), 2022. Date of
Publication: April 2022.
Author
Di Mauro M.; Bonalumi G.; Calafiore A.M.; Lorusso R.
Institution
(Di Mauro, Lorusso) Cardio-Thoracic Surgery Unit, Heart and Vascular
Centre, Maastricht University Medical Centre (MUMC), Maastricht,
Netherlands
(Bonalumi) Department of Cardiac Surgery, Centro Cardiologico Monzino,
Milan, Italy
(Calafiore) Division of Cardiac Surgery A, Henry Dunant Hospital, Athens,
Greece
Publisher
John Wiley and Sons Inc
Abstract
The meta-analysis by He et al. has the worth to cover, as much as
possible, a gap of scientific evidence were conducting a randomized trial
appears very complex for ethical and logistical reasons. The authors
concluded that mitral valve repair (MVP) provides better-pooled results,
both early and late, with respect to mitral valve replacement. However,
the superiority of MVP is driven by some single large cohort studies where
surgeons had wide experience in the field of MVP for infective
endocarditis. This finding is also confirmed by other studies. But if
mitral repair produces such a better short- and long-term survival than
replacement, why are there no clear indications from consensus and
guidelines pushing surgeons toward the pursuit of a reconstructive
procedure at almost any cost? We wonder to repair or not to repair, is
that really the question? The AATS consensus suggests repairing "whenever
possible" but without providing more specific indications. If the two
primary goals of surgery are total removal of infected tissues and
reconstruction of cardiac morphology, including repair or replacement of
the affected valve(s), probably MVP should be performed in case of less
extensive tissue detriment by the infection. In more wide valve
involvement, MVP may be the choice but only in very expert hands and in
Centers with a very large volumes of valve repairing. This decision
cannot, therefore, be the result of the choice of an individual but must
derive from a careful multidisciplinary discussion to be held in an
EndoTeam.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<9>
Accession Number
2015769837
Title
Transcatheter versus surgical closure of atrial septal defects: a
systematic review and meta-analysis of clinical outcomes.
Source
Cardiology in the Young. 32(1) (pp 1-9), 2022. Date of Publication: 25 Jan
2022.
Author
Chambault A.-L.; Olsen K.; Brown L.J.; Mellor S.L.; Sorathia N.; Thomas
A.E.; Kothari N.; Harky A.
Institution
(Chambault) College of Medical and Dental Sciences, University of
Birmingham, Birmingham, United Kingdom
(Olsen) Department of General Surgery, University Hospitals Birmingham NHS
Foundation Trust, Birmingham, United Kingdom
(Brown) Foundation Programme Doctor in Surgery, North Cumbria Integrated
Care NHS Foundation Trust, Cumberland Infirmary, Carlisle, United Kingdom
(Mellor, Kothari) Department of General Surgery, Sandwell & West
Birmingham NHS Trust, Sandwell General Hospital, West Bromwich, United
Kingdom
(Sorathia) Institute of Medical and Biomedical Education, Georges,
University of London, London, United Kingdom
(Sorathia) Faculty of Medical Sciences, University College London, London,
United Kingdom
(Thomas) Peninsula Medical School, Peninsula College of Medicine and
Dentistry, Plymouth, United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest,
Liverpool, United Kingdom
Publisher
Cambridge University Press
Abstract
Background: Atrial septal defects are a common form of CHD and dependent
on the size and nature of atrial septal defects, closure may be warranted.
The paper aims to compare outcomes of transcatheter versus surgical repair
of atrial septal defects. <br/>Method(s): A comprehensive electronic
literature search was conducted. Primary studies were included if they
compared both closure techniques. Primary outcomes included procedural
success, mortality, and reintervention rate. Secondary outcomes included
residual defect and mean hospital stay. <br/>Result(s): A total of 33
studies were included in meta-analysis. Mean total hospital stay was
significantly shorter in the transcatheter cohort across both the adult
(95% confidence interval, mean difference -4.05 (-4.78, -3.32) p <
0.00001) and paediatric populations (95% confidence interval, mean
difference -4.78 (-5.97, -3.60) p < 0.00001). There were significantly
fewer complications in the transcatheter group across both the adult (odds
ratio 0.45, 95% confidence interval, [0.28, 0.72], p < 0.00001) and
paediatric cohorts (odds ratio 0.26, 95% confidence interval, [0.14,
0.49], p < 0.00001). No significant difference in overall mortality was
found between transcatheter versus surgical closure across the two groups,
adult (odds ratio 0.76, 95% confidence interval, [0.40, 1.45], p = 0.41),
paediatrics (odds ratio 0.62, 95% confidence interval, [0.21, 1.83], p =
0.39). <br/>Conclusion(s): Both transcatheter and surgical approaches are
safe and effective techniques for atrial septal defect closure. Our study
has demonstrated the benefits of transcatheter closure in terms of lower
complication rates and mean hospital stay. However, surgery still has a
place for more complex closure and, as we have demonstrated, shows no
difference in mortality.<br/>Copyright &#xa9; The Author(s), 2021.
Published by Cambridge University Press

<10>
Accession Number
2016891405
Title
Effect of trimetazidine on the functional capacity of ischemic heart
disease patients not suitable for revascularization: Metaanalysis of
randomized controlled trials.
Source
PLoS ONE. 17(2 February) (no pagination), 2022. Article Number: e0263932.
Date of Publication: February 2022.
Author
Ajabnoor A.; Mukhtar A.
Institution
(Ajabnoor) Faculty of Pharmacy, Department of Pharmacy Practice, King
Abdulaziz University, Jeddah, Saudi Arabia
(Mukhtar) Pharmaceutical Care Division, King Faisal Specialist Hospital
and Research Center, Jeddah, Saudi Arabia
Publisher
Public Library of Science
Abstract
Objective To explore the effect of adding trimetazidine to other
anti-anginal drugs on the functional capacity of ischemic heart disease
(IHD) patients not suitable for revascularization when compared to
first-line antianginal drugs alone. Methods MEDLINE and EMBASE databases
were searched for English-language peer-reviewed randomized controlled
trials (RCTs) comparing trimetazidine with first-line antianginal drugs
alone or with placebo in IHD patients not suitable for revascularization
and were included in this review. Quality of studies were assessed using
the Cochrane collaboration "risk of bias"tool. Results Six RCTs, three
were crossover studies. A total of 312 participants were included in this
review. Overall quality of studies was moderate. Two studies found
improvement in the 6- minute walking test (6-MWT) [standardized mean
differences (SMD) 1.75; 95% CI 1.35 to 2.14; p <0.001], and two trials
found improvement in the Canadian cardiovascular society (CCS) grading of
angina class (SMD -1.37; 95% CI -1.89 to -0.84) in the trimetazidine
group. Three of the better-quality trials found no increase in total
exercise duration (TED) (SMD 0.34; 95% CI -0.10 to 0.78; p < 0.13).
Significant heterogeneity was identified among trials describing outcomes
for the New York Heart Association (NYHA) functional classification and
left ventricular ejection fraction (LVEF %). Conclusion Trimetazidine
improve walking time and angina severity in IHD patients not suitable for
revascularization. Due to the inconsistency of available evidence, RCTs
targeting IHD patients with "no option"to undergo coronary
revascularization is required to clarify this review
question.<br/>Copyright &#xa9; 2022 Ajabnoor, Mukhtar. 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.

<11>
Accession Number
637199138
Title
Bariatric surgery in transplant recipients: A narrative review.
Source
Journal of Research in Medical Sciences. 26(1) (no pagination), 2021.
Article Number: 44. Date of Publication: 2021.
Author
Kermansaravi M.; Davarpanah Jazi A.; Talebian P.; Rokhgireh S.; Kabir A.;
Pazouki A.
Institution
(Kermansaravi, Talebian, Pazouki) Department of Surgery, Minimally
Invasive Surgery Research Center, Division of Minimally Invasive and
Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Kermansaravi, Pazouki) Center of Excellence of European Branch of
International Federation for Surgery of Obesity, Hazrat-e-Rasool Hospital,
Tehran, Iran, Islamic Republic of
(Davarpanah Jazi) Department of Surgery, Minimally Invasive Surgery
Research Center, Al Zahra Hospital, Isfahan University of Medical
Sciences, Isfahan, Iran, Islamic Republic of
(Davarpanah Jazi) Department of General Surgery, Shariati Hospital,
Isfahan, Iran, Islamic Republic of
(Rokhgireh, Kabir) Endometriosis Research Center, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Rokhgireh) Minimally Invasive Surgery Research Center, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Wolters Kluwer Medknow Publications
Abstract
Morbidity and mortality rates are increased due to obesity after organ
transplantation; in this regards, bariatric surgery (BS) is believed to be
an effective treatment for posttransplant obese patients. Nevertheless,
some studies are doubtful in terms of the effectiveness of BS, the most
suitable bariatric procedure, and management of immunosuppressant drugs in
some kinds of organ transplants. We evaluated nonsurgical therapies,
weight reduction, adjustment of immunosuppressants, comorbidities, and the
recommended surgical procedures for posttransplant BS for different types
of organ transplantations.<br/>Copyright &#xa9; 2022 Royal Society of
Chemistry. All rights reserved.

<12>
Accession Number
2017001383
Title
Structural valve degeneration of bioprosthetic aortic valves: A network
meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2022.
Date of Publication: 2022.
Author
Squiers J.J.; Robinson N.B.; Audisio K.; Ryan W.H.; Mack M.J.; Rahouma M.;
Cancelli G.; Kirov H.; Doenst T.; Gaudino M.; DiMaio J.M.
Institution
(Squiers, Ryan, Mack, Rahouma, DiMaio) Department of Cardiothoracic
Surgery, Baylor Scott & White The Heart Hospital, Plano, Tex, United
States
(Robinson, Audisio, Cancelli, Gaudino) Department of Cardiothoracic
Surgery, Weill Cornell Medicine, New York, NY, United States
(Kirov, Doenst) Department of Cardiothoracic Surgery, University of Jena,
Jena, Germany
Publisher
Elsevier Inc.
Abstract
Objective: To compare the rate of structural valve degeneration (SVD)
following surgical aortic valve replacement associated with the Trifecta
(TF) valve (St Jude Medical) versus other bioprosthetic valves.
<br/>Method(s): A systematic literature search was conducted for studies
comparing durability of the TF prosthesis to other valve types, including
Perimount (Edwards Lifesciences), Carpentier-Edwards Perimount Magna Ease
(ME) (Edwards Lifesciences), and Mitroflow (LivaNova USA) after surgical
aortic valve replacement. Random effect pairwise and network meta-analyses
were performed to compare the incident rate ratio of the composite primary
outcome of SVD or reintervention due to SVD. <br/>Result(s): Ten studies
with 31,029 patients were included, of whom 6832 received TF, 19,023
received Perimount, 3514 received ME, and 713 received Mitroflow. When
compared with TF, ME was associated with lower rates of SVD or
reintervention for SVD (incident rate ratio, 0.13; 95% CI, 0.02-0.92; P =
.04). Similarly, at network meta-analysis, when compared with TF, only ME
was associated with significantly lower rates of SVD or reintervention for
SVD (incident rate ratio, 0.13; 95% CI, 0.02-0.97). ME (incident rate
ratio, 0.18; 95% CI, 0.07-0.47) and PM (incident rate ratio, 0.34; 95% CI,
0.12-0.98) were associated with significantly lower rate of all-cause
reintervention when compared with TF. No differences in the other
secondary outcomes were found. <br/>Conclusion(s): The TF valve is
associated with significantly higher rates of SVD or reintervention for
SVD than the ME valve, but not the Mitroflow valve. The TF valve was also
associated with higher rates of all-cause reintervention than ME and
Perimount valves. The underlying mechanism(s) of these findings warrant
further investigation.<br/>Copyright &#xa9; 2022 The American Association
for Thoracic Surgery

<13>
Accession Number
2017001232
Title
Impact of stent types on in-hospital outcomes of patients with cancer
undergoing percutaneous coronary intervention: A nationwide analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2022. Date of
Publication: 2022.
Author
Munawar M.M.; Brgdar A.; Awan A.; Balogun A.F.; Ogunti R.; Ahmad B.;
Fatima U.; Prafulla M.; Opoku I.
Institution
(Brgdar, Ogunti, Ahmad) Department of Medicine, Howard University
Hospital, Washington, DC, United States
(Munawar, Awan, Balogun, Fatima, Prafulla, Opoku) Cardiovascular disease,
Howard University Hospital, Washington, DC, United States
Publisher
Elsevier Inc.
Abstract
Background: Cardiovascular disease and cancer frequently coexist, and
patients with cancer are at increased risk of cardiovascular events,
including myocardial infarction and stroke. However, the impact of stent
types on in-hospital outcomes of patients with malignancy is largely
unknown. <br/>Method(s): Patients with concomitant diagnosis of cancer
undergoing PCI between January 2005 and December 2014 were identified in
the National Inpatient Sample. They were then categorized into those who
have undergone coronary stenting with bare-metal stent (BMS) or
drug-eluting stent (DES). Primary outcomes were in-hospital mortality and
stent thrombosis. Adjusted and unadjusted analysis was employed on
appropriate variables of interest. <br/>Result(s): 8755 patients were
included in the BMS group and 11,611 patients in the DES group. Following
propensity matching, 4313 patients were randomly selected in both groups
using a 1:1 ratio. There was high use of BMS stent in cancer patient (BMS
43.0%, DES 57.0%) compared to general population (BMS 23.2%, DES 76.8%).
When comparing BMS to DES group, there was no statistically significant
difference in mortality (4.7% vs. 3.8%, p = 0.097), acute kidney injury
(11.3% vs. 10.6%, p = 0.425), bleeding complications (3.50% vs. 3.45%, p =
0.914), and length of hospital stay (5.4% vs. 5.2%, p = 0.119). However,
an increased incidence of stent thrombosis was observed in the DES group
(4.26% vs. 3.01%, p = 0.002). <br/>Conclusion(s): A higher incidence of
BMS placement was noted in patients with cancer than in the general
population. Paradoxically there was a high incidence of stent thrombosis
in the DES group without increasing mortality.<br/>Copyright &#xa9; 2022

<14>
[Use Link to view the full text]
Accession Number
637367160
Title
Surgical timing in infective endocarditis patients with intracranial
hemorrhage-A systematic review and meta-analysis.
Source
Stroke. Conference: 2022 International Stroke Conference and
State-of-the-Science Stroke Nursing Symposium. Virtual. 53(SUPPL 1) (no
pagination), 2022. Date of Publication: February 2022.
Author
Musleh R.; Schlattmann P.; Caldonazo T.; Kirov H.; Gunther A.; Witte O.;
Doenst T.; Diab M.
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Purpose: Cardiac surgery is indicated in more than half of
patients with infective endocarditis (IE); however, it is performed in
only 60% of the indicated cases. Majority of patients with surgical
indications who were denied surgery due to certain reasons die within 30
days. Intracranial hemorrhage (ICH) is one of the main causes for denial
of surgery despite the presence of surgical indications. We aimed to
evaluate the impact of early surgery (within 30 days) in IE-patients with
ICH on postoperative outcome and to elucidate the risk of 30-day mortality
in patients for whom surgery was denied. <br/>Method(s): Three libraries
(MEDLINE, EMBASE and Cochrane Library) were assessed for studies
evaluating the postoperative outcome in early vs. late surgery in
IE-patients with preoperative ICH. The primary outcome was all-cause
mortality, and the secondary outcome was neurological deterioration.
Inverse variance method and random model were performed. <br/>Result(s):
We identified 16 studies including 355 patients. Nine studies examined the
impact of surgical timing (early vs. late) and were included in the
meta-analyses. Only one study examined the fate of IE-patients with ICH
who were treated conservatively despite of having an indication for
cardiac surgery, showing higher mortality rates than those who were
operated (11.8 % vs. 2.5 %). We found no significant association between
early surgery, regardless of its definition, and a higher mortality
(relative risk [RR]= 1.46; 95% confidence interval [CI]: 0.98-2.17).
However, early surgery was associated with higher risk for neurological
deterioration (RR= 1.97; 95% CI: 1.15-3.38). <br/>Conclusion(s): Cardiac
surgery for IE within 30 days of ICH was not associated with higher
mortality, but with increased rate of neurological deterioration.
Thirty-day mortality in IE-patients with ICH for whom surgery was denied
has not yet been sufficiently investigated. This patient group should be
analysed in future studies in more detail. (Figure Presented).

<15>
Accession Number
637359388
Title
Tranexamic acid versus placebo to reduce perioperative blood transfusion
in patients undergoing liver resection: protocol for the haemorrhage
during liver resection tranexamic acid (HeLiX) randomised controlled
trial.
Source
BMJ open. 12(2) (pp e058850), 2022. Date of Publication: 24 Feb 2022.
Author
Karanicolas P.J.; Lin Y.; McCluskey S.; Roke R.; Tarshis J.; Thorpe K.E.;
Ball C.G.; Chaudhury P.; Cleary S.P.; Dixon E.; Eeson G.; Moulton C.-A.;
Nanji S.; Porter G.; Ruo L.; Skaro A.I.; Tsang M.; Wei A.C.; Guyatt G.
Institution
(Karanicolas) Department of Surgery, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Karanicolas, Moulton, Tsang) Department of Surgery, University of
Toronto, Toronto, ON, Canada
(Lin) Department of Laboratory Medicine and Molecular Diagnostics,
Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Lin) Department of Laboratory Medicine and Pathobiology, University of
Toronto, Toronto, ON, Canada
(McCluskey) Department of Anesthesia and Pain Management, University
Health Network, Toronto, ON, Canada
(McCluskey) Department of Anesthesia, University of Toronto, Toronto, ON,
Canada
(Roke) Department of Evaluative Clinical Sciences, Sunnybrook Health
Sciences Centre, Toronto, ON, Canada
(Roke) Institute of Health Policy, Management and Evaluation, University
of Toronto, Toronto, ON, Canada
(Tarshis) Department of Anesthesia, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Thorpe) Dalla Lana School of Public Health, University of Toronto,
Toronto, ON, Canada
(Ball, Dixon) Department of Surgery, Foothills Medical Centre, Calgary,
AB, Canada
(Ball) Department of Medicine, University of Calgary, Calgary, AB, Canada
(Chaudhury) Department of Surgery, McGill University Health Centre,
Montreal, Quebec, Canada
(Cleary) Department of Surgery, Mayo Clinic, Rochester, MN, United States
(Dixon) Department of Surgery, University of Calgary, Calgary, AB, Canada
(Eeson) Department of Surgery, Kelowna General Hospital, Kelowna, BC,
Canada
(Eeson) Department of Surgery, University of British Columbia, Vancouver,
BC, Canada
(Moulton) Department of Surgery, University Health Network, Toronto, ON,
Canada
(Nanji) Department of Surgery, Kingston General Hospital, Kingston,
Ontario, Canada
(Nanji) Department of Surgery, Queen's University, Kingston, Ontario,
Canada
(Porter) Department of Surgery, Nova Scotia Health, Halifax, NS, Canada
(Porter) Department of Surgery, Dalhousie University, Halifax, NS, Canada
(Ruo) Department of Surgery, Juravinski Hospital and Cancer Centre,
Hamilton, Ontario, Canada
(Ruo) Deparment of Surgery, McMaster University, Hamilton, Ontario, Canada
(Skaro) Department of Surgery, London Health Sciences Centre, London, ON,
Canada
(Skaro) Department of Surgery, University of Western Ontario Schulich
School of Medicine and Dentistry, London, ON, Canada
(Tsang) Division of General Surgery, St. Joseph's Health Centre - Unity
Health Toronto, Toronto, ON, Canada
(Wei) Department of Surgery, Memorial Sloan Kettering Cancer Center, NY,
United States
(Guyatt) Department of Clinical Epidemiology and Biostatistics, McMaster
University, Hamilton, Ontario, Canada
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Despite use of operative and non-operative interventions to
reduce blood loss during liver resection, 20%-40% of patients receive a
perioperative blood transfusion. Extensive intraoperative blood loss is a
major risk factor for postoperative morbidity and mortality and receipt of
blood transfusion is associated with serious risks including an
association with long-term cancer recurrence and overall survival. In
addition, blood products are scarce and associated with appreciable
expense; decreasing blood transfusion requirements would therefore have
health system benefits. Tranexamic acid (TXA), an antifibrinolytic, has
been shown to reduce the probability of receiving a blood transfusion by
one-third for patients undergoing cardiac or orthopaedic surgery. However,
its applicability in liver resection has not been widely researched.
METHODS AND ANALYSIS: This protocol describes a prospective, blinded,
randomised controlled trial being conducted at 10 sites in Canada and 1 in
the USA. 1230 eligible and consenting participants will be randomised to
one of two parallel groups: experimental (2 g of intravenous TXA) or
placebo (saline) administered intraoperatively. The primary endpoint is
receipt of blood transfusion within 7 days of surgery. Secondary outcomes
include blood loss, postoperative complications, quality of life and
5-year disease-free and overall survival. ETHICS AND DISSEMINATION: This
trial has been approved by the research ethics boards at participating
centres and Health Canada (parent control number 177992) and is currently
enrolling participants. All participants will provide written informed
consent. Results will be distributed widely through local and
international meetings, presentation, publication and ClinicalTrials.gov.
TRIAL REGISTRATION NUMBER: NCT02261415.<br/>Copyright &#xa9; Author(s) (or
their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial
re-use. See rights and permissions. Published by BMJ.

<16>
Accession Number
637331081
Title
Non-Vitamin K Oral Anticoagulant After Transcatheter Aortic Valve
Replacement: A Systematic Review and Meta-Analysis.
Source
Frontiers in Pharmacology. 13 (no pagination), 2022. Article Number:
755009. Date of Publication: 11 Feb 2022.
Author
Li D.; Ma X.; Zhou X.; Qian Y.
Institution
(Li, Qian) Department of Cardiovascular Surgery, West China Hospital,
Sichuan University, Chengdu, China
(Ma) Department of Emergency Medicine, Emergency Medical Laboratory, West
China Hospital, Sichuan University, Chengdu, China
(Zhou) Evidence-based Medicine Research Center, Jiangxi University of
Traditional Chinese Medicine, Nanchang, China
(Qian) National Clinical Research Center for Geriatrics, West China
Hospital, Sichuan University, Chengdu, China
Publisher
Frontiers Media S.A.
Abstract
Objective: We aimed to compare non-vitamin K oral anticoagulants (NOACs)
with a traditional antithrombotic such as vitamin K antagonist (VKA) and
antiplatelet agents in patients after transcatheter aortic valve
replacement (TAVR). <br/>Method(s): We conducted a search in PubMed,
EMBASE, and the Cochrane Library until November 2021 for studies involving
comparisons of any type of NOACs, including dabigatran, apixaban,
rivaroxaban, and edoxaban, with VKA or antiplatelet agents after TAVR. A
comparison of NOACs versus VKA was performed in patients with an
indication for oral anticoagulation. In addition, we compared NOACs versus
antiplatelet in patients without such indication. We calculated the hazard
ratios with 95% confidence intervals (CIs) to determine long-term
outcomes. The primary outcome was a combined endpoint consisting of
all-cause mortality, stroke, major bleeding, or any related clinical
adverse events. Secondary outcomes were all-cause mortality, major
bleeding, and stroke, respectively. <br/>Result(s): A total of 10 studies
including 10,563 patients after TAVR were included in this meta-analysis.
There were no significant differences in any of the long-term outcomes
between the NOAC and VKA groups. Although there were no significant
differences in the combined endpoint, major bleeding, or stroke, a
significant difference was observed in the all-cause mortality (HR 1.74,
95% CI 1.25-2.43, p = 0.001) between the NOAC and antiplatelet groups.
<br/>Conclusion(s): For patients with an indication for oral
anticoagulation after TAVR, NOACs seem to be associated with noninferior
outcomes compared with VKA therapy. However, for patients without an
indication for oral anticoagulation, NOACs appear to be associated with a
higher risk of all-cause death as compared with antiplatelet treatment.
Systematic Review Registration: https://clinicaltrials.gov/, identifier
CRD42020155122.<br/>Copyright &#xa9; 2022 Li, Ma, Zhou and Qian.

<17>
Accession Number
2015777989
Title
Perioperative Management of Patients with Idiopathic Pulmonary Fibrosis
Undergoing Noncardiac Surgery: A Narrative Review.
Source
International Journal of General Medicine. 15 (pp 2087-2100), 2022. Date
of Publication: 2022.
Author
Carr Z.J.; Yan L.; Chavez-Duarte J.; Zafar J.; Oprea A.
Institution
(Carr, Yan, Chavez-Duarte, Zafar, Oprea) Yale University School of
Medicine, New Haven, CT 06520, United States
(Carr, Chavez-Duarte, Zafar, Oprea) Department of Anesthesiology, Yale New
Haven Hospital, New Haven, CT 06510, United States
Publisher
Dove Medical Press Ltd
Abstract
Purpose: The idiopathic interstitial pneumonias (IIP) constitute a large
cohort of the over 200 subtypes of interstitial lung disease (ILD).
Idiopathic pulmonary fibrosis (IPF) is the most widely studied, arguably
the most severe etiology of ILD and the most common IIP diagnosis. The
objective of this narrative review is to outline the current evidence on
optimal perioperative management of IPF. PubMed, Embase and Web of Science
were analyzed for appropriate peer-reviewed references by utilizing key
word search ("interstitial lung disease" OR "idiopathic pulmonary
fibrosis" OR "idiopathic interstitial pneumonitis" OR "ILD" OR "IPF" AND
"surgery" OR "anesthesia" OR "perioperative") within the past thirty years
(1990-current). Non-English language references were excluded. A total of
205 references were curated by the authors. Eighty-seven consensus
statements, clinical trials, retrospective cohort studies or case series
met criteria and were incorporated into the findings of this narrative
review. <br/>Conclusion(s): After review, we conclude that complications,
dominated by postoperative pulmonary complications, pose a significant
barrier to safe perioperative care of patients with IPF. Ensuring that the
preoperative IPF patient has been medically optimized is important for
minimizing this risk. Initial assessment of the ARISCAT score, pulmonary
function studies and cardiopulmonary exercise testing may identify IPF
patients at particularly high perioperative pulmonary risk. Identifying
IPF patients with 6-12-month declines in D<inf>LCO</inf> of >15%,
V<inf>02max</inf> <8.3 mL/kg/min, <80% predicted value FVC, a 50-meter
reduction in the 6MWT or preoperative home oxygen use may be helpful in
preoperative risk stratification. Medically optimizing treatable
co-morbidities should be a priority in preoperative assessment. Regional
or neuraxial anesthesia should be considered an optimal technique for the
avoidance of general anesthesia related complications when indicated.
Acute exacerbation and postoperative pneumonia have been identified as
important postsurgical complications in both thoracic and nonthoracic
surgical populations.<br/>Copyright &#xa9; 2022 Carr et al.

<18>
Accession Number
2017048257
Title
Transfemoral Tricuspid Valve Replacement in Patients With Tricuspid
Regurgitation: TRISCEND Study 30-Day Results.
Source
JACC: Cardiovascular Interventions. 15(5) (pp 471-480), 2022. Date of
Publication: 14 Mar 2022.
Author
Kodali S.; Hahn R.T.; George I.; Davidson C.J.; Narang A.; Zahr F.;
Chadderdon S.; Smith R.; Grayburn P.A.; O'Neill W.W.; Wang D.D.; Herrmann
H.; Silvestry F.; Elmariah S.; Inglessis I.; Passeri J.; Lim D.S.; Salerno
M.; Makar M.; Mack M.J.; Leon M.B.; Makkar R.
Institution
(Kodali, Hahn, George, Leon) Columbia University Irving Medical Center,
New York, NY, United States
(Hahn) Cardiovascular Research Foundation, New York, NY, United States
(Davidson, Narang) Northwestern University, Chicago, IL, United States
(Zahr, Chadderdon) Oregon Health and Science University, Portland, OR,
United States
(Smith, Grayburn, Mack) Baylor Scott and White The Heart Hospital Plano,
Plano, TX, United States
(O'Neill, Wang) Henry Ford Hospital, Detroit, MI, United States
(Herrmann, Silvestry) Hospital of the University of Pennsylvania,
Philadelphia, PA, United States
(Elmariah, Inglessis, Passeri) Massachusetts General Hospital, Boston, MA,
United States
(Lim, Salerno) University of Virginia, Charlottesville, VA, United States
(Makar, Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United
States
Publisher
Elsevier Inc.
Abstract
Objectives: The TRISCEND study (Edwards EVOQUE Tricuspid Valve
Replacement: Investigation of Safety and Clinical Efficacy after
Replacement of Tricuspid Valve with Transcatheter Device) is evaluating
the safety and performance of transfemoral transcatheter tricuspid valve
replacement in patients with clinically significant tricuspid
regurgitation (TR) and elevated surgical risk. <br/>Background(s):
Transcatheter valve replacement could lead to a paradigm shift in treating
TR and improving patient quality of life. <br/>Method(s): In the
prospective, single-arm, multicenter TRISCEND study, patients with
symptomatic moderate or greater TR, despite medical therapy, underwent
percutaneous transcatheter tricuspid valve replacement with the EVOQUE
system. A composite rate of major adverse events, echocardiographic
parameters, and clinical, functional, and quality-of-life measures were
assessed at 30 days. <br/>Result(s): Fifty-six patients (mean age of 79.3
years, 76.8% female, 91.1% TR severe or greater, 91.1% atrial
fibrillation, and 87.5% New York Heart Association functional class III or
IV) were treated. At 30 days, TR was reduced to mild or less in 98%. The
composite major adverse events rate was 26.8% at 30 days caused by 1
cardiovascular death in a patient with a failed procedure, 2
reinterventions after device embolization, 1 major access site or vascular
complication, and 15 severe bleeds, of which none were life-threatening or
fatal. No myocardial infarction, stroke, renal failure, major cardiac
structural complications, or device-related pulmonary embolism were
observed. New York Heart Association significantly improved to functional
class I or II (78.8%; P < 0.001), 6-minute walk distance improved 49.8 m
(P < 0.001), and Kansas City Cardiomyopathy Questionnaire score improved
19 points (P < 0.001). <br/>Conclusion(s): Early experience with the
transfemoral EVOQUE system in patients with clinically significant TR
demonstrated technical feasibility, acceptable safety, TR reduction, and
symptomatic improvement at 30 days. The TRISCEND II randomized trial
(NCT04482062) is underway.<br/>Copyright &#xa9; 2022

<19>
Accession Number
2017046937
Title
The PARTNER 3 Bicuspid Registry for Transcatheter Aortic Valve Replacement
in Low-Surgical-Risk Patients.
Source
JACC: Cardiovascular Interventions. 15(5) (pp 523-532), 2022. Date of
Publication: 14 Mar 2022.
Author
Williams M.R.; Jilaihawi H.; Makkar R.; O'Neill W.W.; Guyton R.; Malaisrie
S.C.; Brown D.L.; Blanke P.; Leipsic J.A.; Pibarot P.; Hahn R.T.; Leon
M.B.; Cohen D.J.; Bax J.J.; Kodali S.K.; Mack M.J.; Lu M.; Webb J.G.
Institution
(Williams, Jilaihawi) NYU Langone Medical Center, New York, NY, United
States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(O'Neill) Center for Structural Heart Disease, Henry Ford Health System,
Detroit, MI, United States
(Guyton) Emory University Medical Center, Atlanta, GA, United States
(Malaisrie) Northwestern University Feinberg School of Medicine, Chicago,
IL, United States
(Brown, Mack) Baylor Scott and White Health, Plano, TX, United States
(Blanke, Leipsic, Webb) St. Paul's Hospital, University of British
Columbia, Vancouver, BC, Canada
(Pibarot) Department of Medicine, Laval University, Quebec City, QC,
Canada
(Hahn, Leon, Kodali) Columbia University Irving Medical
Center/NewYork-Presbyterian Hospital, New York, NY, United States
(Hahn, Leon, Cohen) Cardiovascular Research Foundation, New York, NY,
United States
(Cohen) St. Francis Hospital, Roslyn, NY, United States
(Bax) Leiden University Medical Center, Leiden, Netherlands
(Lu) Edwards Lifesciences, Irvine, CA, United States
Publisher
Elsevier Inc.
Abstract
Objectives: The study compared 1-year outcomes between transcatheter
aortic valve replacement (TAVR) patients with bicuspid aortic valve (BAV)
morphology and clinically similar patients having tricuspid aortic valve
(TAV) morphology. <br/>Background(s): There are limited prospective data
on TAVR using the SAPIEN 3 device in low-surgical-risk patients with
severe, symptomatic aortic stenosis and bicuspid anatomy. <br/>Method(s):
Low-risk, severe aortic stenosis patients with BAV were candidates for the
PARTNER 3 (Placement of Aortic Transcatheter Valves 3) (P3) bicuspid
registry or the P3 bicuspid continued access protocol. Patients treated in
these registries were pooled and propensity score matched to TAV patients
from the P3 randomized TAVR trial. Outcomes were compared between groups.
The primary endpoint was the 1-year composite rate of death, stroke, and
cardiovascular rehospitalization. <br/>Result(s): Of 320 total submitted
BAV patients, 169 (53%) were treated, and most were Sievers type 1. The
remaining 151 patients were excluded caused by anatomic or clinical
criteria. Propensity score matching with the P3 TAVR cohort (496 patients)
yielded 148 pairs. There were no differences in baseline clinical
characteristics; however, BAV patients had larger annuli and they
experienced longer procedure duration. There was no difference in the
primary endpoint between BAV and TAV (10.9% vs 10.2%; P = 0.80) or in the
rates of the individual components (death: 0.7% vs 1.4%; P = 0.58; stroke:
2.1% vs 2.0%; P = 0.99; cardiovascular rehospitalization: 9.6% vs 9.5%; P
= 0.96). <br/>Conclusion(s): Among highly select bicuspid aortic stenosis
low-surgical-risk patients without extensive raphe or subannular
calcification, TAVR with the SAPIEN 3 valve demonstrated similar outcomes
to a matched cohort of patients with tricuspid aortic
stenosis.<br/>Copyright &#xa9; 2022 American College of Cardiology
Foundation

<20>
Accession Number
2017031030
Title
Timing of Intervention in Asymptomatic Aortic Stenosis.
Source
Circulation Journal. 86(3) (pp 376-382), 2022. Date of Publication: 2022.
Author
Lee S.-A.; Kang D.-H.
Institution
(Lee, Kang) Division of Cardiology, Asan Medical Center, College of
Medicine, University of Ulsan, Seoul, South Korea
Publisher
Japanese Circulation Society
Abstract
The decision to perform an intervention for asymptomatic severe aortic
stenosis (AS) requires careful weighing of the risks of early intervention
against those of watchful observation, and the optimal timing of
intervention remains controversial. With improvements in surgical and
postoperative care, long-term survival after surgical aortic valve (AV)
replacement (AVR) is excellent in low-risk patients, and the emergence of
transcatheter AVR may change the thresholds for early preemptive
intervention, although a durability issue has to be resolved. A watchful
observation strategy also has a risk of sudden death, irreversible
myocardial damage, and increase in operative risk while waiting for
symptoms to develop. We have been waiting for a prospective randomized
trial to solve the intense debate between early AVR and watchful
observation, and the RECOVERY (Randomized Comparison of Early Surgery
versus Conventional Treatment in Very Severe Aortic Stenosis) trial
provides the evidence to support early AVR for asymptomatic severe AS.
Risk assessment with severity of AS and staging classification may help to
facilitate the identification of patients who may benefit from early
intervention. Based on the results of the RECOVERY trial, early surgical
AVR is reasonable for asymptomatic patients with very severe AS (aortic
jet velocity >=4.5 m/s) and low surgical risk. Further evidence is
required to extend the indications of surgical AVR and to consider
transcatheter AVR in asymptomatic patients with severe AS.<br/>Copyright
&#xa9; 2022 Japanese Circulation Society. All rights reserved.

<21>
Accession Number
637370221
Title
Efficacy and safety of proton pump inhibitors versus histamine-2 receptor
blockers in the cardiac surgical population: insights from the PEPTIC
trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2022.
Date of Publication: 25 Feb 2022.
Author
van Diepen S.; Coulson T.; Wang X.; Opgenorth D.; Zuege D.J.; Harris J.;
Agyemang M.; Niven D.J.; Bellomo R.; Wright S.E.; Young P.J.; Bagshaw S.M.
Institution
(van Diepen, Opgenorth, Bagshaw) Department of Critical Care Medicine,
University of Alberta, Alberta Health Services, AB, Edmonton, Canada
(van Diepen) Division of Cardiology, Department of Medicine, University of
Alberta, AB, Edmonton, Canada
(Coulson) Department of Anaesthesiology and Perioperative Medicine, Alfred
Hospital, Melbourne, VIC, Australia
(Coulson, Bellomo, Young) Australian and New Zealand Intensive Care
Research Centre, Department of Epidemiology and Preventive Medicine,
School of Public Health and Preventive Medicine, Monash University,
Melbourne, VIC, Australia
(Coulson, Bellomo, Young) Department of Critical Care, University of
Melbourne, Parkville, VIC, Australia
(Wang) Health Services Statistical and Analytic Methods, Alberta Health
Services, AB, Calgary, Canada
(Zuege, Niven) Department of Critical Care Medicine, University of
Calgary, Alberta Health Services, AB, Calgary, Canada
(Zuege, Bagshaw) Critical Care Strategic Clinical Network, Alberta Health
Services, AB, Calgary, Canada
(Harris) Alberta Health Services, AB, Calgary, Canada
(Agyemang, Niven) Department of Community Health Sciences, University of
Calgary, AB, Calgary, Canada
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, VIC, Australia
(Bellomo) Data Analytics Research & Evaluation Centre, University of
Melbourne and Austin Hospital, Melbourne, VIC, Australia
(Wright) Intensive Care Unit, Freeman Hospital, Newcastle upon Tyne,
United Kingdom
(Young) Medical Research Institute of New Zealand, Wellington, New Zealand
(Young) Intensive Care Unit, Wellington Regional Hospital, Wellington, New
Zealand
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The comparative effectiveness and safety of proton pump
inhibitors (PPIs) versus histamine-2 receptor blockers for stress ulcer
prophylaxis in the cardiac surgical intensive care unit population is
uncertain. Although the Proton Pump Inhibitors versus Histamine-2 Receptor
Blockers for Ulcer Prophylaxis Therapy in the Intensive Care Unit (PEPTIC)
trial reported a higher risk of mortality in the PPI arm with no
difference in gastrointestinal bleeding, detailed information on surgical
variables and clinically relevant surgical subgroups was not available.
<br/>METHOD(S): The analysis included all Canadian cardiac surgery
patients enrolled in the PEPTIC trial. Data were electronically linked
using unique patient identifiers to a clinical information system.
Outcomes of interest included in-hospital mortality, gastrointestinal
bleeding, Clostridium difficile infections, ventilator-associated
conditions and length of stay. <br/>RESULT(S): We studied 823 (50.6%)
randomized to PPIs and 805 (49.4%) to histamine-2-receptor blockers. In
the intention-to-treat analysis, there were no differences in hospital
mortality [PPI: 4.3% vs histamine-2 receptor blockers: 4.8%, adjusted odds
ratio (aOR) 0.97, 95% confidence interval (CI) 0.55-1.70],
gastrointestinal bleeding (3.9% vs 4.8%, aOR 1.09, 95% CI 0.66-1.81), C.
difficile infections (0.9% vs 0.1%, aOR 0.18, 95% CI 0.02-1.59),
ventilator-associated conditions (1.6% vs 1.7%, aOR 0.92, 95% CI
0.85-1.00) or median length of stay (9.2 vs 9.8 days, adjusted risk ratio
1.06, 85% CI 0.99-1.13). No significant treatment differences were
observed among subgroups of interest or per-protocol populations.
<br/>CONCLUSION(S): In a secondary analysis of cardiac surgery patients
enrolled in the PEPTIC trial in Canada, no differences in effectiveness or
safety were observed between use of PPIs and histamine-2 receptor blockers
for stress ulcer prophylaxis. CLINICAL TRIAL REGISTRATION NUMBER:
anzctr.org.au identifier: ACTRN12616000481471.<br/>Copyright &#xa9; The
Author(s) 2022. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<22>
Accession Number
637369522
Title
Cytokine Hemoadsorption During Cardiac Surgery versus Standard Surgical
Care for Infective Endocarditis (REMOVE): Results from a Multicenter,
Randomized, Controlled Trial.
Source
Circulation. (no pagination), 2022. Date of Publication: 25 Feb 2022.
Author
Diab M.; Lehmann T.; Bothe W.; Akhyari P.; Platzer S.; Wendt D.; Deppe
A.-C.; Strauch J.; Hagel S.; Gunther A.; Faerber G.; Sponholz C.; Franz
M.; Scherag A.; Velichkov I.; Silaschi M.; Fassl J.; Hofmann B.; Lehmann
S.; Schramm R.; Fritz G.; Szabo G.; Wahlers T.; Matschke K.; Lichtenberg
A.; Pletz M.W.; Gummert J.F.; Beyersdorf F.; Hagl C.; Borger M.A.; Bauer
M.; Brunkhorst F.M.; Doenst T.
Institution
(Diab) Department of Cardiothoracic Surgery, Jena University Hospital,
Friedrich Schiller University of Jena, Jena, Germany; Center for Sepsis
Control and Care, Jena University Hospital, Friedrich Schiller University
of Jena, Jena, Germany
(Lehmann, Platzer, Brunkhorst) Center for Sepsis Control and Care, Jena
University Hospital, Friedrich Schiller University of Jena, Jena, Germany;
Center for Clinical Studies, Jena University Hospital, Friedrich Schiller
University, Jena, Germany
(Bothe, Beyersdorf) Department of Cardiovascular Surgery, University Heart
Center Freiburg-Bad Krozingen, Freiburg, Germany
(Akhyari, Lichtenberg) Department of Cardiothoracic Surgery,
Heinrich-Heine-University Duesseldorf, Germany
(Wendt) Department of Thoracic and Cardiovascular Surgery, University
Hospital Essen; Essen, Germany
(Deppe, Wahlers) Department of Cardiothoracic Surgery, Heart Center of the
University of Cologne, Germany
(Strauch) Department of Cardiac and Thoracic Surgery, Bergmannsheil
University Hospitals, Bochum, Germany
(Hagel, Pletz) Institute for Infectious Diseases and Infection Control,
Jena University Hospital, Friedrich Schiller University of Jena, Jena,
Germany
(Gunther) Department of Neurology, Jena University Hospital, Friedrich
Schiller University of Jena, Jena, Germany
(Faerber, Velichkov, Doenst) Department of Cardiothoracic Surgery, Jena
University Hospital, Friedrich Schiller University of Jena, Jena, Germany
(Sponholz) Department of Anesthesiology and Critical Care Medicine, Jena
University Hospital, Friedrich Schiller University of Jena, Jena, Germany
(Franz) Department of Internal Medicine I, Jena University Hospital,
Friedrich Schiller University of Jena, Jena, Germany
(Scherag) Center for Sepsis Control and Care, Jena University Hospital,
Friedrich Schiller University of Jena, Jena, Germany; Center for Clinical
Studies, Jena University Hospital, Friedrich Schiller University, Jena,
Germany; Institute of Medical Statistics, Computer and Data Sciences, Jena
University Hospital, Friedrich Schiller University, Jena, Germany
(Silaschi) Clinic and Polyclinic for Cardiac Surgery, University Hospital
Bonn, Bonn, Germany
(Fassl) Dresden Heart Center, University Hospital at the Technical
University Dresden, Dresden, Germany
(Hofmann, Szabo) Department of Cardiac Surgery, Mid-German Heart Center,
University Hospital Halle Saale, Halle, Germany
(Lehmann, Borger) Department of Cardiac Surgery, Heart Center Leipzig,
Leipzig, Germany
(Schramm, Gummert) Department of Thoracic and Cardiovascular Surgery,
Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
(Fritz) Department of Anesthesiology, Intensive Care and Pain Therapy,
Heart Center Brandenburg, Bernau, Germany
(Matschke) Department of Cardiac Surgery, Heart Center Dresden, Dresden,
Germany
(Hagl) Department of Cardiac Surgery, Ludwig Maximilian University Munich,
Munich, Germany
(Bauer) Center for Sepsis Control and Care, Jena University Hospital,
Friedrich Schiller University of Jena, Jena, Germany; Department of
Anesthesiology and Critical Care Medicine, Jena University Hospital,
Friedrich Schiller University of Jena, Jena, Germany
Publisher
NLM (Medline)
Abstract
Background: Cardiac surgery often represents the only treatment option in
patients with infective endocarditis (IE). However, IE surgery may lead to
a sudden release of inflammatory mediators, which is associated with the
severity of postoperative organ dysfunction. We investigated the impact of
hemoadsorption during IE surgery on postoperative organ dysfunction.
<br/>Method(s): This multi-center, randomized, non-blinded, controlled
trial assigned patients undergoing cardiac surgery for IE to
hemoadsorption [integration of CytoSorb to cardiopulmonary bypass (CPB)]
or control. The Primary outcome (DELTASOFA) was defined as the difference
between the mean total postoperative sequential organ failure assessment
score (SOFA), calculated maximally to the 9th postoperative day, and the
basal SOFA score. The analysis was by modified intention-to-treat. A
predefined inter-group comparison was done using a linear mixed model for
DELTASOFA including surgeon and baseline SOFA as fixed effect covariates
and with the surgical center as random effect. The SOFA score assesses
dysfunction in six organ systems, each scored from zero to four. Higher
scores indicate worsening dysfunction. Secondary outcomes were 30-day
mortality, durations of mechanical ventilation, vasopressor and renal
replacement therapy. Cytokines were measured in the first 50 patients.
<br/>Result(s): Between January 17, 2018 and January 31, 2020, A total of
288 patients were randomly assigned to hemoadsorption (n=142) or control
(n=146). Four patients in the hemoadsorption and two in the control group
were excluded as they did not undergo surgery. The primary outcome
DELTASOFA did not differ between the hemoadsorption and the control group
(1.79 +/- 3.75 and 1.93 +/- 3.53, respectively, 95% CI: -1.30 to 0.83,
p=0.6766). Mortality at 30 days (21% hemoadsorption vs 22% control,
p=0.782), the durations of mechanical ventilation, vasopressor and renal
replacement therapy did not differ between groups. Levels of IL-1beta and
IL-18 at the end of CPB were significantly lower in the hemoadsorption
than in the control group. <br/>Conclusion(s): This randomized trial
failed to demonstrate a reduction in postoperative organ dysfunction
through intraoperative hemoadsorption in patients undergoing cardiac
surgery for IE. Although hemoadsorption reduced plasma cytokines at the
end of CPB, there was no difference in any of the clinically relevant
outcome points.

<23>
Accession Number
637359650
Title
Effect of Evolocumab in Patients With Prior Percutaneous Coronary
Intervention.
Source
Circulation. Cardiovascular interventions. (pp
CIRCINTERVENTIONS121011382), 2022. Date of Publication: 25 Feb 2022.
Author
Furtado R.H.M.; Fagundes A.A.; Oyama K.; Zelniker T.A.; Tang M.; Kuder
J.F.; Murphy S.A.; Hamer A.; Wang H.; Keech A.C.; Giugliano R.P.; Sabatine
M.S.; Bergmark B.A.
Institution
(Furtado) Academic Research Organization, Hospital Israelita Albert
Einstein, Sao Paulo, Brazil
(Furtado) Instituto do Coracao (InCor), Hospital das Clinicas da Faculdade
de Medicina, Universidade de Sao Paulo, Brazil
(Furtado, Fagundes, Oyama, Zelniker, Tang, Kuder, Murphy, Giugliano,
Sabatine, Bergmark) Thrombolysis in Myocardial Infarction (TIMI) Study
Group, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
(R.H.M.F., A.A.F., K.O., T.A.Z., M.T., J.F.K., S.AM., R.P.G., M.S.S.,
B.A.B.)
(Oyama) Department of Cardiovascular Medicine, Tohoku University Graduate
School of Medicine, Japan (K.O.), Sendai, Japan
(Zelniker) Division of Cardiology, Vienna General Hospital and Medical
University of Vienna, Austria
(Hamer) Cardiol Therapeutics, ON, Oakville, United States
(Wang) Amgen' Thousand Oaks' CA (H.W.)
(Keech) National Health and Medical Research Council Clinical Trials
Centre, Sydney Medical School, University of Sydney, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients with prior percutaneous coronary intervention (PCI)
are at high residual risk for multiple types of coronary events within and
beyond the stented lesion. This risk might be mitigated by more intensive
LDL-C (low-density lipoprotein cholesterol)-lowering beyond just with
statin therapy. <br/>METHOD(S): FOURIER (Further Cardiovascular Outcomes
Research With PCSK9 Inhibition in Subjects With Elevated Risk) randomized
27564 patients with stable atherosclerotic disease on statin to the PCSK9
(proprotein convertase subtilisin-kexin type 9) inhibitor evolocumab or
placebo with a median follow-up of 2.2 years. The end points of interest
were major adverse cardiovascular events (MACE; a composite of
cardiovascular death, myocardial infarction, stroke, unstable angina or
coronary revascularization), and major coronary events (a composite of
coronary heart death, myocardial infarction, or coronary
revascularization). We compared the risk of MACE and the magnitude of
relative and absolute risk reductions with evolocumab in patients with and
without prior PCI. <br/>RESULT(S): Seventeen thousand seventy-three
patients had prior PCI. In the placebo arm, those with prior PCI had
higher rates of MACE (13.2% versus 8.3%; hazard ratio [HR]adj 1.61 [95%
CI, 1.42-1.84]; P<0.0001) and major coronary events (11.5% versus 6.0%;
HRadj, 1.72 [95% CI, 1.49-1.99]; P<0.0001). Relative risk reductions with
evolocumab were similar in patients with and without prior PCI (MACE: HR,
0.84 [0.77-0.91] versus HR, 0.88 [0.77-1.01]; Pinteraction 0.51; major
coronary events: HR, 0.82 [0.75-0.90] versus HR, 0.88 [0.75-1.04];
Pinteraction 0.42). Absolute risk reductions for MACE were 2.0% versus
0.9% (Pinteraction 0.14) and for major coronary events 2.0% versus 0.7%
(Pinteraction 0.045). In those with prior PCI, the effect of evolocumab on
coronary revascularization (HR, 0.76 [0.69-0.85]) was directionally
consistent across types of revascularization procedures: coronary artery
bypass grafting (HR, 0.71 [0.54-0.94]); any PCI (HR, 0.77 [0.69-0.86]);
PCI for de novo lesions (HR, 0.76 [0.66-0.88]); and PCI for stent failure
or graft lesions (HR, 0.76 [0.63-0.91]). <br/>CONCLUSION(S): Evolocumab
reduces the risk of MACE in patients with prior PCI including the risk of
coronary revascularization, with directionally consistent effects across
several types of revascularization procedures, including coronary artery
bypass grafting and PCI for stent or graft failure. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier: NCT01764633.

<24>
Accession Number
637358622
Title
Infective endocarditis by Serratia species: a systematic review.
Source
Journal of chemotherapy (Florence, Italy). (pp 1-13), 2022. Date of
Publication: 24 Feb 2022.
Author
Ioannou P.; Alexakis K.; Spentzouri D.; Kofteridis D.P.
Institution
(Ioannou, Alexakis, Spentzouri, Kofteridis) Department of Internal
Medicine & Infectious Diseases, University Hospital of Heraklion,
Heraklion, Greece
Publisher
NLM (Medline)
Abstract
Serratia species are facultative anaerobes, non-spore-forming, motile
Gram-negative bacteria. Serratia spp. are currently thought to cause a
variety of infections, such as bacteremia, urinary tract infections, and
pneumonia, as well as other, less common infections, including ocular
infections or skin and soft tissue infections. On the other hand,
Infective Endocarditis (IE) is an infrequent disease with notable
morbidity and mortality. Even though IE is rarely caused by Serratia spp.,
these infections can be quite problematic due to the lack of experience in
their management. This study aimed to systematically review all published
cases of IE by Serratia spp. in the literature. A systematic review of
PubMed, Scopus, and Cochrane library (through 13th May 2021) for studies
providing epidemiological, clinical, microbiological data as well as data
on treatment and outcomes of IE by Serratia spp. was performed. In total,
50 studies, containing data for 72 patients, were included. A prosthetic
valve was present in 18.1%. The mitral valve was the most commonly
infected site, followed by the aortic valve. The diagnosis was facilitated
by transthoracic echocardiography in 34.7%, while the diagnosis was set at
autopsy in 22.4%. Fever, sepsis, and embolic phenomena were the most
common clinical presentations, followed by heart failure. Aminoglycosides,
cephalosporins, and carbapenems were the most commonly used
antimicrobials. Clinical cure was noted only in 53.5%, while overall
mortality was 47.2%. Having surgery along with antimicrobial treatment was
independently associated with reduced overall mortality. IE by Serratia
spp. was more likely to be associated with intravenous drug use, and to
present with heart failure and embolic phenomena compared to IE by other
non-HACEK Gram-negative bacilli, while mortality was also higher in IE by
Serratia spp.

<25>
Accession Number
2017049591
Title
Pericardial Involvement in Sarcoidosis.
Source
American Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Mahalwar G.; Kumar A.; Agrawal A.; Bhat A.; Furqan M.; Yesilyaprak A.;
Verma B.R.; Chan N.; Schleicher M.; Neto M.L.R.; Xu B.; Jellis C.L.; Klein
A.L.
Institution
(Mahalwar, Kumar, Agrawal, Bhat, Furqan, Yesilyaprak, Verma, Chan, Xu,
Jellis, Klein) Center for the Diagnosis and Treatment of Pericardial
Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular
Medicine, Heart, Vascular, and Thoracic Institute
(Neto) Department of Pulmonary Medicine, Respiratory Institute
(Yesilyaprak) Department of Internal Medicine, Wayne State University,
Detroit, Michigan, United States
(Schleicher) Floyd D. Loop Alumni Library, Cleveland Clinic, Cleveland,
Ohio, United States
Publisher
Elsevier Inc.
Abstract
Pericardial disease secondary to sarcoidosis is a rare clinical entity
with no observational studies in previous research. Therefore, we
evaluated reported cases of pericarditis because of sarcoidosis to further
understand its diagnosis and management. We performed a systematic review
of previous research until December 16, 2020 in MEDLINE, Embase, Scopus,
Cochrane Central Register of Controlled Trials, and Web of Science. Case
reports and case series demonstrating pericardial involvement in
sarcoidosis were included. Fourteen reports with a total of 27 patients
were identified. Dyspnea (82%) was the most common presentation, with the
lungs being the primary site of sarcoidosis in most patients (77%). The
most frequently encountered pericardial manifestations were pericardial
effusion (89%), constrictive pericarditis and cardiac tamponade (48%).
Management of these patients included use of corticosteroids (82%),
colchicine (11%), and nonsteroidal anti-inflammatory agents (7%). Similar
to the general population, the most common intervention in these patients
was pericardiocentesis (59%), pericardial window (30%), and
pericardiectomy (19%). Overall, the majority of this population (70%)
achieved clinical improvement during median follow-up time of 8 months. In
conclusion, the prevalence and incidence of sarcoid-induced pericarditial
disease remain unclear. Clinical manifestations of pericardial involvement
are variable, though many patients present with asymptomatic pericardial
effusions. No consensus exists on the treatment of this special
population, but corticosteroids and combination therapies are considered
first-line therapies because of their efficacy in suppressing pericardial
inflammation and underlying sarcoidosis. Patients with refractory cases of
pericarditis may also benefit therapeutically from the addition of
nonsteroidal anti-inflammatory agents, colchicine, and/or
biologics.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<26>
Accession Number
2017048533
Title
Impact of the Southern Thoracic Surgical Association James W. Brooks
Scholarship.
Source
Annals of Thoracic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Kim M.P.; Mavroudis C.; Jacobs J.P.; Yang S.C.
Institution
(Kim) Division of Thoracic Surgery, Department of Surgery, Houston
Methodist Hospital, Houston, Texas, United States
(Mavroudis) Pediatric Cardiothoracic Surgery, Peyton Manning Children's
Hospital, Indiana, Indianapolis
(Jacobs) Division of Cardiovascular Surgery, Department of Surgery,
University of Florida, Gainesville, FL, United States
(Yang) Division of Thoracic Surgery, Department of Surgery, The Johns
Hopkins Medical Institutions, Baltimore, Maryland, United States
Publisher
Elsevier Inc.
Abstract
Background: Medical students and general surgery residents often do not
get exposure to cardiothoracic surgery (CTS) because of a decreased
emphasis on CTS rotations during their training. The Southern Thoracic
Surgical Association (STSA) began offering the Brooks Scholarship to
medical students in 2010 and general surgery residents in 2014 to promote
CTS. This study examines the impact of the scholarship. <br/>Method(s): We
examined the history of the award and how STSA administers the award. Next
we examined the impact of the award by evaluating the number of medical
students and residents who are tracked to complete a CTS program. Finally
we performed an analysis of the academic output of the awardees who have
completed or were tracked to complete a CTS program. <br/>Result(s): The
scholarship was developed to honor the memory of past STSA President Dr
James W. Brooks. The award is administered through the STSA scholarship
committee and provides medical students and residents funds to attend the
STSA annual meeting and the opportunity to spend time with a mentor during
the meeting. Eighty-eight percent of medical student recipients (21/24)
and 100% of general surgery resident recipients (15/15) have completed or
are on track to complete a CTS program. The 36 recipients going into CTS
have published a total of 823 papers and 9240 articles have cited those
papers. <br/>Conclusion(s): The STSA medical student and general surgery
Brooks scholarship awards were associated with completing or pursuing a
career in CTS. STSA should continue the Brooks scholarship to attract
talented medical students and residents to CTS.<br/>Copyright &#xa9; 2022
The Society of Thoracic Surgeons

<27>
Accession Number
2015721696
Title
Reduced Cross-Sectional Muscle Growth Six Months after Botulinum Toxin
Type-A Injection in Children with Spastic Cerebral Palsy.
Source
Toxins. 14(2) (no pagination), 2022. Article Number: 139. Date of
Publication: February 2022.
Author
De Beukelaer N.; Weide G.; Huyghe E.; Vandekerckhove I.; Hanssen B.;
Peeters N.; Uytterhoeven J.; Deschrevel J.; Maes K.; Corvelyn M.;
Costamagna D.; Gayan-Ramirez G.; Van Campenhout A.; Desloovere K.
Institution
(De Beukelaer, Weide, Huyghe, Vandekerckhove, Hanssen, Peeters,
Uytterhoeven, Costamagna, Desloovere) Neurorehabilitation Group,
Department of Rehabilitation Sciences, KU Leuven, Leuven 3000, Belgium
(Weide) Laboratory for Myology, Faculty of Behavioural and Movement
Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences,
Amsterdam 1081, Netherlands
(Hanssen, Peeters) Department of Rehabilitation Science, Ghent University,
Ghent 9000, Belgium
(Deschrevel, Maes, Gayan-Ramirez) Laboratory of Respiratory Diseases and
Thoracic Surgery, Department of Chronic Diseases and Metabolism, KU
Leuven, Leuven 3000, Belgium
(Corvelyn, Costamagna) Stem Cell Biology and Embryology, Department of
Development and Regeneration, KU Leuven, Leuven 3000, Belgium
(Van Campenhout) Unit of Pediatric Orthopedics, Department of Orthopedics,
University Hospitals Leuven, Leuven 3000, Belgium
(Van Campenhout) Department of Development and Regeneration, KU Leuven,
Leuven 3000, Belgium
(Van Campenhout, Desloovere) Clinical Motion Analysis Laboratory,
University Hospitals Leuven, Pellenberg, Leuven 3212, Belgium
Publisher
MDPI
Abstract
Botulinum Neurotoxin type-A (BoNT-A) injections are widely used as
first-line spasticity treatment in spastic cerebral palsy (SCP). Despite
improved clinical outcomes, concerns regarding harmful effects on muscle
morphology have been raised. Yet, the risk of initiating BoNT-A to reduce
muscle growth remains unclear. This study investigated medial
gastrocnemius (MG) morphological muscle growth in children with SCP (n =
26, median age of 5.2 years (3.5)), assessed by 3D-freehand ultrasound
prior to and six months post-BoNT-A injections. Post-BoNT-A MG muscle
growth of BoNT-A naive children (n = 11) was compared to (a) muscle growth
of children who remained BoNT-A naive after six months (n = 11) and (b)
post-BoNT-A follow-up data of children with a history of BoNT-A treatment
(n = 15). Six months after initiating BoNT-A injection, 17% decrease in
mid-belly cross-sectional area normalized to skeletal growth and 5%
increase in echo-intensity were illustrated. These muscle outcomes were
only significantly altered when compared with children who remained BoNT-A
naive (+4% and -3%, respectively, p < 0.01). Muscle length growth
persevered over time. This study showed reduced cross-sectional growth
post-BoNT-A treatment suggesting that re-injections should be postponed at
least beyond six months. Future research should extend follow-up periods
investigating muscle recovery in the long-term and should include
microscopic analysis.<br/>Copyright &#xa9; 2022 by the authors. Licensee
MDPI, Basel, Switzerland.

<28>
Accession Number
632980316
Title
Pregnancy outcome in women with mechanical prosthetic heart valvesat their
first trimester of pregnancy treated with unfractionated heparin (UFH) or
enoxaparin: A randomized clinical trial.
Source
Journal of Cardiovascular and Thoracic Research. 12(3) (pp 209-213), 2020.
Date of Publication: 2020.
Author
Movahedi M.; Motamedi M.; Sajjadieh A.; Bahrami P.; Saeedi M.
Institution
(Movahedi, Motamedi) Department of Obstetrics and Gynecology, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Sajjadieh, Bahrami) Department of Internal Medicine, Isfahan University
of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Saeedi) Department of Cardiac Surgery, Isfahan University of Medical
Sciences, Isfahan, Iran, Islamic Republic of
(Saeedi) Department of General Medicine, Isfahan University of Medical
Sciences, Isfahan, Iran, Islamic Republic of
Publisher
Tabriz University of Medical Sciences
Abstract
Introduction: Pregnancy increases the risks of thromboembolism for the
mother and fetus in patients with mechanical heart valves. The results of
some studies have indicated that low molecular weight heparin (LMWH), in
comparison with unfractionated heparin (UFH), leads to a lower incidence
rate of thrombocytopenia and a decrease in bleeding. <br/>Method(s): The
present randomized clinical trial involved 31 pregnant women with
mechanical heart valves at their first trimester (0-14 weeks) of
pregnancy. To perform the study, the patients were divided into two
groups, i.e. group A (LMWH group-16 patients) and group B (UFH group-15
patients). The birth weight, mode of delivery, and gestational age at
birth as well as the maternal and fetal complications were compared
between the two groups. <br/>Result(s): The mean age of mothers in the UFH
and LMWH groups was 32.67+/-9.11 and 31.50+/-5.81 years, respectively (P
value > 0.05). Although the rate of maternal and fetal complications was
higher in the UFH group as compared with the LMWH group, the observed
difference was not significant (P value > 0.05). <br/>Conclusion(s): LMWH
can be regarded as a safer therapy for both the mother and fetus due to
its lower number of refill prescriptions and fewer changes in the blood
level.<br/>Copyright &#xa9; 2020 The Author (s).

<29>
Accession Number
631146426
Title
Comparing cardiac troponin levels using sevoflurane and isoflurane in
patients undergoing cardiac surgery: A systematic review and
meta-analysis.
Source
Journal of Cardiovascular and Thoracic Research. 12(1) (pp 1-9), 2020.
Date of Publication: 2020.
Author
Hosseinifard H.; Ghadimi N.; Kaveh S.; Shabaninejad H.; Lijassi A.;
Azarfarin R.
Institution
(Hosseinifard) Biostatistics, School of Health Management and Information
Sciences, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Kaveh) Health Technology Assessment, School of Health Management and
Information Sciences, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Shabaninejad) Department of Health Services Management, School of Health
Management and Information Sciences, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Shabaninejad) Population Health Sciences Institute, Newcastle University,
Newcastle, United Kingdom
(Lijassi) Faculty of Medicine and Pharmacy of Rabat, Mohammed V University
of Rabat, Rabat, Morocco
(Azarfarin) Echocardiography Research Center, Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
Publisher
Tabriz University of Medical Sciences
Abstract
Introduction: Cardiac troponin is one of the heart biomarkers and its high
levels correlates with a high risk of cardiomyocytes damage. This study
aimed to compare sevoflurane and isoflurane effect on troponin levels in
patients undergoing cardiac surgery. <br/>Method(s): We systematically
searched for RCTs which had been published in Cochrane library, PubMed,
Web of science, CRD, Scopus, and Google Scholar by the end of February
30th, 2019. The quality of articles was evaluated with the Cochrane
checklist. GRADE was used for quality of evidence for this meta-analysis.
Meta-analysis was done based on random or fixed effect model.
<br/>Result(s): Five studies with total of 190 (sevoflurane) and 191
(isoflurane) patients were included. The results showed that pooled mean
difference of troponin levels between the two groups was significant at
ICU admission time and 24 hours after entering. The comparison of troponin
level changes between the two groups (baseline = at time ICU) in 24 and 48
hours after ICU admission was significant. <br/>Conclusion(s): This
meta-analysis showed that blood troponin levels were significantly lower
at the time of arrival in ICU with isoflurane and after 24 hours with
sevoflurane. Generally, given the small mean difference between isoflurane
and sevoflurane, it seems that none of the medications has a negative
effect on the cardiac troponin level.<br/>Copyright &#xa9; 2020 The
Author(s). This is an open access article distributed under the terms of
the Creative Commons Attribution License
(http://creativecommons.org/licenses/by/4.0), which permits unrestricted
use, distribution, and reproduction in any medium, provided the original
work is properly cited.

<30>
Accession Number
2002716122
Title
Clinical Decision Support to Reduce Contrast-Induced Kidney Injury During
Cardiac Catheterization: Design of a Randomized Stepped-Wedge Trial.
Source
Canadian Journal of Cardiology. 35(9) (pp 1124-1133), 2019. Date of
Publication: September 2019.
Author
James M.T.; Har B.J.; Tyrrell B.D.; Ma B.; Faris P.; Sajobi T.T.; Allen
D.W.; Spertus J.A.; Wilton S.B.; Pannu N.; Klarenbach S.W.; Graham M.M.
Institution
(James, Ma) Department of Medicine, Cumming School of Medicine, University
of Calgary, Calgary, Alberta, Canada
(James, Faris, Sajobi, Wilton) Department of Community Health Sciences,
Cumming School of Medicine, University of Calgary, Calgary, Alberta,
Canada
(James, Har, Sajobi, Wilton) Libin Cardiovascular Institute of Alberta,
Cumming School of Medicine, University of Calgary, Calgary, Alberta,
Canada
(James, Sajobi, Wilton) O'Brien Institute of Public Health, Cumming School
of Medicine, University of Calgary, Calgary, Alberta, Canada
(Har, Wilton) Department of Cardiac Sciences, Cumming School of Medicine,
University of Calgary, Calgary, Alberta, Canada
(Tyrrell, Pannu, Klarenbach, Graham) Department of Medicine, University of
Alberta, Edmonton, Alberta, Canada
(Tyrrell) CK Hui Heart Centre, University of Alberta, Edmonton, Alberta,
Canada
(Faris) Alberta Health Services, Calgary, Alberta, Canada
(Allen) Department of Cardiac Sciences, University of Manitoba, Winnipeg,
Manitoba, Canada
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri-Kansas City, Kansas City, MO, United States
(Graham) Mazankowski Heart Centre, University of Alberta, Edmonton,
Alberta, Canada
Publisher
Elsevier Inc.
Abstract
Background: Contrast-induced acute kidney injury (CI-AKI) is a common and
serious complication of invasive cardiac procedures. Quality improvement
programs have been associated with a lower incidence of CI-AKI over time,
but there is a lack of high-quality evidence on clinical decision support
for prevention of CI-AKI and its impact on processes of care and clinical
outcomes. <br/>Method(s): The Contrast-Reducing Injury Sustained by
Kidneys (Contrast RISK) study will implement an evidence-based
multifaceted intervention designed to reduce the incidence of CI-AKI,
encompassing automated identification of patients at increased risk for
CI-AKI, point-of-care information on safe contrast volume targets,
personalized recommendations for hemodynamic optimization of intravenous
fluids, and follow-up information for patients at risk. Implementation
will use cardiologist academic detailing, computerized clinical decision
support, and audit and feedback. All 31 physicians practicing in all 3 of
Alberta's cardiac catheterization laboratories will participate using a
cluster-randomized stepped-wedge design. The order in which they are
introduced to this intervention will be randomized within 8 clusters. The
primary outcome is CI-AKI incidence, with secondary outcomes of CI-AKI
avoidance strategies and downstream adverse major kidney and
cardiovascular events. An economic evaluation will accompany the main
trial. <br/>Conclusion(s): The Contrast RISK study leverages information
technology systems to identify patient risk combined with evidence-based
protocols, audit, and feedback to reduce CI-AKI in cardiac catheterization
laboratories across Alberta. If effective, this intervention can be
broadly scaled and sustained to improve the safety of cardiac
catheterization.<br/>Copyright &#xa9; 2019 The Authors

<31>
[Use Link to view the full text]
Accession Number
2016817979
Title
Ambient temperature and infarct size, microvascular obstruction, left
ventricular function and clinical outcomes after ST-segment elevation
myocardial infarction.
Source
Coronary Artery Disease. 33(2) (pp 81-90), 2022. Date of Publication: 01
Mar 2022.
Author
Redfors B.; Simonato M.; Chen S.; Vincent F.; Zhang Z.; Thiele H.; Eitel
I.; Patel M.R.; Ohman E.M.; Maehara A.; Ben-Yehuda O.; Stone G.W.
Institution
(Redfors, Simonato, Chen, Vincent, Zhang, Maehara, Ben-Yehuda, Stone)
Clinical Trials Center, Cardiovascular Research Foundation, Irving Medical
Center, New York, United States
(Redfors, Chen, Maehara, Ben-Yehuda) Division of Cardiology, Department of
Medicine, NewYork-Presbyterian Hospital, Columbia University, Irving
Medical Center, New York, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Thiele) Heart Center Leipzig, University of Leipzig, Leipzig Heart
Institute, Leipzig, Germany
(Eitel) University Heart Center Lubeck, The German Center for
Cardiovascular Research, Lubeck, Germany
(Patel, Ohman) Division of Cardiology, Department of Medicine, Duke
University Hospital, Durham, NC, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, Cardiovascular Research Foundation,
1700 Broadway, NY 10019, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives Incidence and prognosis of ST-segment elevation myocardial
infarction (STEMI) vary according to ambient temperature and season. We
sought to assess whether season and temperature on the day of STEMI are
associated with infarct size, microvascular obstruction (MVO), left
ventricular ejection fraction (LVEF) and clinical outcomes after primary
percutaneous coronary intervention (PCI). Methods Individual patient data
from 1598 patients undergoing primary PCI in six randomized clinical
trials were pooled. Infarct size was evaluated by cardiac magnetic
resonance within 30 days in all trials. Patients were categorized either
by whether they presented on a day of temperature extremes (minimum
temperature <0 degreeC or maximum temperature >25 degreeC) or according to
season. Results A total of 558/1598 (34.9%) patients presented with STEMI
on a day of temperature extremes, and 395 (24.7%), 374 (23.4%), 481
(30.1%) and 348 (21.8%) presented in the spring, summer, fall and winter.
After multivariable adjustment, temperature extremes were independently
associated with larger infarct size (adjusted difference 2.8%; 95% CI,
1.3-4.3; P < 0.001) and smaller LVEF (adjusted difference -2.3%; 95% CI,
-3.5 to -1.1; P = 0.0002) but not with MVO (adjusted P = 0.12). In
contrast, infarct size, MVO and LVEF were unrelated to season (adjusted P
= 0.67; P = 0.36 and P = 0.95, respectively). Neither temperature extremes
nor season were independently associated with 1-year risk of death or
heart failure hospitalization (adjusted P = 0.79 and P = 0.90,
respectively). Conclusion STEMI presentation during temperature extremes
was independently associated with larger infarct size and lower LVEF but
not with MVO after primary PCI, whereas season was unrelated to infarct
severity.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins. All
rights reserved.

<32>
Accession Number
635319371
Title
Safety and Efficacy of Different Antithrombotic Strategies after
Transcatheter Aortic Valve Implantation: A Network Meta-Analysis.
Source
Thrombosis and Haemostasis. 122(2) (pp 216-225), 2022. Article Number:
210095. Date of Publication: 01 Feb 2022.
Author
Navarese E.P.; Grisafi L.; Spinoni E.G.; Mennuni M.G.; Rognoni A.;
Ratajczak J.; Podhajski P.; Koni E.; Kubica J.; Patti G.
Institution
(Navarese, Kubica) Department of Cardiology and Internal Medicine,
Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
(Grisafi, Spinoni, Patti) Department of Translational Medicine, University
of Eastern Piedmont, Via Solaroli 17, Novara, Italy
(Grisafi, Spinoni, Mennuni, Rognoni, Patti) Department of Thoracic, Heart
and Vascular Diseases, Maggiore della Carita Hospital, Novara, Italy
(Ratajczak) Department of Health Promotion, Nicolaus Copernicus
University, Bydgoszcz, Poland
(Ratajczak, Podhajski) Department of Cardiology and Internal Medicine,
Nicolaus Copernicus University, Bydgoszcz, Poland
(Koni) Department of Interventional Cardiology, Santa Corona Hospital,
Pietra Ligure, Italy
Publisher
Georg Thieme Verlag
Abstract
Background The optimal pharmacological therapy after transcatheter aortic
valve implantation (TAVI) remains uncertain. We compared efficacy and
safety of various antiplatelet and anticoagulant approaches after TAVI by
a network meta-analysis. Methods A total of 14 studies (both observational
and randomized) were considered, with 24,119 patients included. Primary
safety endpoint was the incidence of any bleeding complications during
follow-up. Secondary safety endpoint was major bleeding. Efficacy
endpoints were stroke, myocardial infarction, and cardiovascular
mortality. A frequentist network meta-analysis was conducted with a
random-effects model. The following strategies were compared: dual
antiplatelet therapy (DAPT), single antiplatelet therapy (SAPT), oral
anticoagulation (OAC), and OAC + SAPT. The mean follow-up was 15 months.
Results In comparison to DAPT, SAPT was associated with a 44% risk
reduction of any bleeding (odds ratio [OR]: 0.56 [95% confidence interval,
CI: 0.39-0.80]). SAPT was ranked as the safest strategy for the prevention
of any bleeding (p -score: 0.704), followed by OAC alone (p -score: 0.476)
and DAPT (p -score: 0.437). Consistent results were observed for major
bleeding. The incidence of cardiovascular death and secondary ischemic
endpoints did not differ among the tested antithrombotic approaches. In
patients with indication for long-term anticoagulation, OAC alone showed
similar rates of stroke (OR: 0.92 [95% CI: 0.41-2.05], p = 0.83) and
reduced occurrence of any bleeding (OR: 0.49 [95% CI: 0.37-0.66], p <
0.01) versus OAC + SAPT. Conclusion The present network meta-analysis
supports after TAVI the use of SAPT in patients without indication for OAC
and OAC alone in those needing long-term anticoagulation.<br/>Copyright
&#xa9; 2022 American Institute of Physics Inc.. All rights reserved.

<33>
Accession Number
637237426
Title
Comparison of dexmedetomidine and meperidine for the prevention of
shivering following coronary artery bypass graft: study protocol of a
randomised controlled trial.
Source
BMJ Open. 12(2) (no pagination), 2022. Article Number: e053865. Date of
Publication: 11 Feb 2022.
Author
Cao C.; Lv M.; Wei C.; Yan J.; Wang Y.; Gu C.
Institution
(Cao, Lv, Wei, Yan, Wang, Gu) Department of Anesthesiology and
Perioperative Medicine, The First Affiliated Hospital of Shandong First
Medical University, Jinan, China
(Cao, Yan) Shandong First Medical University, Jinan, China
(Wang, Gu) Shandong Institute of Anesthesia and Respiratory Critical
Medicine, Shandong Provincial Qianfoshan Hospital, Jinan, China
(Wang, Gu) Department of Anesthesiology and Perioperative Medicine,
Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
Publisher
BMJ Publishing Group
Abstract
IntroductionShivering is a common complication in the postoperative
period. The incidence of shivering has been reported to range from 5% to
65% under general anaesthesia and as 33% during epidural anaesthesia.
Shivering can increase perioperative risk in patients. Both
dexmedetomidine and meperidine are effective agents for the prevention of
postanaesthetic shivering. However, few studies have compared the
anti-shivering effects of different agents following coronary artery
bypass graft (CABG). This study aims to compare the effects of
dexmedetomidine and meperidine on the incidence of shivering in patients
undergoing CABG.Methods and analysisA total of 180 patients aged 18-75
years, with an American Society of Anesthesiologists (ASA) grade of II-IV,
undergoing elective CABG will be enrolled and randomly assigned to the
dexmedetomidine, meperidine and control groups (placebo) in an intended
1:1:1 allocation ratio. The patients will be followed up for 7 days after
surgery. The primary outcome is the incidence of shivering within 24 hours
postoperatively. The secondary outcomes are the number of remedial drugs
used after surgery, the incidence of postoperative hypotension and
bradycardia, sedation scores, endotracheal extubation time, intensive care
unit length of stay, incidence of postoperative delirium within 7 days
after surgery, incidence of postoperative arrhythmias, incidence of
postoperative nausea and vomiting, average hospital length of stay and
mortality rate 30 days after surgery.Ethics and disseminationThe study
protocol was approved by the ethics committee of The First Affiliated
Hospital of Shandong First Medical University on 20 January 2021
(YXLL-KY-2021(002)) and registered at ClinicalTrials.gov. The results of
this study will be presented at national and international scientific
meetings and conferences. We plan to publish the data in peer-reviewed
international scientific journals.Trial registration
numberNCT04735965.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ.

<34>
Accession Number
2012848820
Title
Safety and Efficacy of Colchicine in Patients with Stable CAD and ACS: A
Systematic Review and Meta-analysis.
Source
American Journal of Cardiovascular Drugs. 21(6) (pp 659-668), 2021. Date
of Publication: November 2021.
Author
Ullah W.; Haq S.; Zahid S.; Gowda S.N.; Ottman P.; Saleem S.; Hamzeh I.;
Virani S.S.; Alam M.; Fischman D.L.
Institution
(Ullah, Fischman) Department of Medicine, Section of Cardiology, Thomas
Jefferson University Hospitals, Philadelphia, PA, United States
(Haq, Ottman) Department of Internal Medicine, Abington Jefferson Health,
Abington, PA, United States
(Zahid) Department of Internal Medicine, Rochester General Hospital,
Rochester, NY, United States
(Gowda) Department of Internal Medicine, University of South Dakota,
Vermillion, SD, United States
(Saleem) Department of Medicine, Section of Cardiology, Medical Center
Health, Bowling Green, KY, United States
(Hamzeh, Virani, Alam) Department of Medicine, Section of Cardiology,
Baylor College of Medicine, Houston, TX, United States
(Virani) Michael E. DeBakey Veterans Affairs Medical Center, Houston,
United States
Publisher
Adis
Abstract
Background: Evidence from recent trials has shown conflicting results in
terms of the utility of colchicine in patients with coronary artery
disease (CAD). <br/>Method(s): Multiple databases were queried to identify
all randomized controlled trials (RCTs) comparing the merits of colchicine
in patients with acute coronary syndrome (ACS) or stable CAD. The pooled
relative risk ratio (RR) of major adverse cardiovascular events (MACE),
its components, and gastrointestinal (GI) adverse events were computed
using a random-effect model. <br/>Result(s): Ten RCTs comprising a total
of 12,761 patients were identified. At a median follow-up of 12 months,
there was a significantly lower risk of MACE [RR 0.66, 95% confidence
interval (CI) 0.45-96], ACS (RR 0.66, 95% CI 0.45-0.96), ischemic stroke
(RR 0.42, 95% CI 0.22-0.81), and need for revascularization (RR 0.61, 95%
CI 0.42-90) in patients receiving colchicine compared with placebo. A
subgroup analysis based on the clinical presentation showed that the
significantly lower incidence of MACE and stroke were driven by the
patients presenting with ACS. The use of colchicine in patients with
stable CAD did not reduce the incidence of MACE (RR 0.55, 95% CI
0.28-1.09), ACS (RR 0.52, 95% CI 0.25-1.08), or stroke (RR 0.61, 95% CI
0.33-1.13). There was no significant difference in the relative risk of
cardiac arrest, ACS, cardiovascular mortality, and all-cause mortality
between the two groups in both ACS and stable CAD populations. The risk of
GI adverse events was significantly higher in patients receiving
colchicine (RR 2.10, 95% CI 1.12-3.95). <br/>Conclusion(s): In patients
presenting with ACS, low-dose colchicine might reduce the incidence of
MACE, stroke, and the need for revascularization at long follow-up
durations. Colchicine might offer no benefits in reducing the risk of
ischemic events in patients with stable angina.<br/>Copyright &#xa9; 2021,
The Author(s), under exclusive licence to Springer Nature Switzerland AG.

<35>
Accession Number
2015677637
Title
Risk of postoperative urinary retention with early removal of the urinary
catheter after surgery with epidural analgesia: A systematic review and
meta-analysis.
Source
Annals of Cancer Research and Therapy. 29(2) (pp 178-187), 2021. Date of
Publication: 2021.
Author
Miyakawa T.; Kawamura H.; Yamamoto R.; Hashimoto K.; Kobayashi H.; Yue C.;
Hori S.; Hirano T.; Honda M.
Institution
(Miyakawa, Kawamura, Yamamoto, Hashimoto, Kobayashi, Yue, Hori, Honda)
Department of Minimally Invasive Surgical and Medical Oncology, Fukushima
Medical University, Fukushima, Fukushima, Japan
(Miyakawa, Kawamura, Yamamoto, Kobayashi, Hori, Honda) Department of
Surgery, Southern Tohoku General Hospital, Southern Tohoku Research
Institute for Neuroscience, Fukushima, Koriyama, Japan
(Hashimoto) Department of Emergency and General Practice, Southern Tohoku
General Hospital, Southern Tohoku Research Institute for Neuroscience,
Fukushima, Koriyama, Japan
(Yue) Department of Thoracic Surgery, Southern Tohoku General Hospital,
Southern Tohoku Research Institute for Neuroscience, Fukushima, Koriyama,
Japan
(Hirano) Department of Emergency and Anesthesiology, Ohta Nishinouchi
Hospital, Fukushima, Koriyama, Japan
Publisher
PJD Publications Ltd
Abstract
Introduction: It is unclear whether the early removal of urinary catheters
during epidural analgesia increases postoperative urinary retention. This
systematic review and meta-analysis aimed to evaluate the risk of
postoperative urinary retention by comparing early removal with late
removal of urinary catheters after surgery with epidural analgesia.
<br/>Method(s): We searched the Cochrane Central Register of Controlled
Trials, MEDLINE, EMBASE, World Health Organization International Clinical
Trials Registry Platform, and Clinical Trials.gov for randomized
controlled trials involving early versus late removal of urinary catheters
after surgery with epidural analgesia. Primary outcomes were postoperative
urinary retention and urinary tract infection, and we conducted a
meta-analysis using a random-effects model to calculate the pooled
estimates of risk differences. The Cochrane risk of bias tool and Grading
of Recommendations, Assessment, Development, and Evaluation approach were
used to assess the quality of individual studies and the overall body of
evidence, respectively. <br/>Result(s): Four studies involving 584
patients were included. The pooled risk difference of early versus late
removal was 0.05 (95% confidence interval,-0.01-0.10; I² = 59%)
for postoperative urinary retention and-0.03 (95% confidence
interval,-0.12-0.05; I² = 89%) for urinary tract infection. We
did not conduct a meta-analysis regarding length of stay.
<br/>Conclusion(s): Early urinary catheter removal may be associated with
a 5% increased risk of postoperative urinary retention. We could not
conclude whether this increased risk of postoperative urinary retention is
clinically acceptable or not.<br/>Copyright &#xa9; 2021, PJD Publications
Ltd. All rights reserved.

<36>
Accession Number
2013908486
Title
Association of metabolic syndrome with cardiovascular outcomes in
hypertensive patients: a systematic review and meta-analysis.
Source
Journal of Endocrinological Investigation. 44(11) (pp 2333-2340), 2021.
Date of Publication: November 2021.
Author
Liu J.; Chen Y.; Cai K.; Gong Y.
Institution
(Liu) Department of Cardiology, Yantai Affiliated Hospital of Binzhou
Medical University, Yantai, Shandong 264100, China
(Chen, Cai, Gong) Department of General Practice, Ruijin Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: The association between metabolic syndrome (MetS) and
cardiovascular outcomes in patients with hypertension is still
controversial. This meta-analysis sought to evaluate the association of
MetS with cardiovascular outcomes in hypertensive patients.
<br/>Method(s): Two authors comprehensively searched PubMed and Embase
databases from their inception to April 18, 2020 for the longitudinal
studies that evaluated the association of MetS with cardiovascular
outcomes in patients with hypertension. The main outcomes were major
adverse cardiovascular events (myocardial infarction, revascularization,
stroke, hospitalization due to heart failure, etc.) and stroke.
<br/>Result(s): Eight studies consisting of 36,614 hypertensive patients
were identified and analyzed. Meta-analysis indicated that MetS was
associated with an increased risk of major adverse cardiovascular events
(risk ratio [RR] 1.55; 95% confidence intervals [CI] 1.28-1.87),
cardiovascular mortality (RR 1.44; 95%CI 1.13-1.82), and stroke (RR 1.46;
95%CI 1.22-1.75), respectively. Sensitivity analysis further confirmed the
robustness of the prognostic value of MetS. <br/>Conclusion(s): MetS is
associated with higher risk of major adverse cardiovascular events,
cardiovascular mortality, and stroke in patients with hypertension.
Determination of MetS may contribute to improving cardiovascular risk
stratification in hypertension.<br/>Copyright &#xa9; 2021, Italian Society
of Endocrinology (SIE).

<37>
Accession Number
2014243457
Title
Radial versus femoral access in patients with coronary artery bypass
surgery: Frequentist and Bayesian meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 99(2) (pp 462-471),
2022. Date of Publication: February 1, 2022.
Author
Nikolakopoulos I.; Vemmou E.; Xenogiannis I.; Karacsonyi J.; Rao S.V.;
Romagnoli E.; Tsigkas G.; Milkas A.; Velagapudi P.; Alaswad K.; Rangan
B.V.; Garcia S.; Burke M.N.; Brilakis E.S.
Institution
(Nikolakopoulos, Vemmou, Xenogiannis, Karacsonyi, Rangan, Garcia, Burke,
Brilakis) Minneapolis Heart Institute and Minneapolis Heart Institute
Foundation, Abbott Northwestern Hospital, Minneapolis, MN, United States
(Rao) Duke Clinical Research Institute, Durham, NC, United States
(Romagnoli) Department of Cardiovascular and Thoracic Sciences, Institute
of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS,
Universita Cattolica del Sacro Cuore, Rome, Italy
(Tsigkas) Department of Cardiology, University of Patras Medical School,
Patras, Greece
(Milkas) Acute Cardiac Care Unit, Athens Naval and Veterans Hospital,
Athens, Greece
(Velagapudi) University of Nebraska Medical Center, Omaha, NE, United
States
(Alaswad) Department of Cardiology, Henry Ford Hospital, Detroit, MI,
United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The optimal access site for cardiac catheterization in
patients with prior coronary artery bypass surgery (CABG) continues to be
debated. <br/>Method(s): We performed a random effects frequentist and
Bayesian meta-analysis of 4 randomized trials and 18 observational
studies, including 60,192 patients with prior CABG (27,236 in the radial
group; 32,956 in the femoral group) that underwent cardiac
catheterization. Outcomes included (1) access-site complications, (2)
crossover to a different vascular access, (3) procedure time, and (4)
contrast volume. Mean differences (MD) and 95% confidence interval (CI)
were calculated for continuous outcomes and odds ratios (OR) and 95% CI
for binary outcomes. <br/>Result(s): Among randomized trials, crossover
(OR: 7.63; 95% CI: 2.04, 28.51; p = 0.003) was higher in the radial group,
while access site complications (OR: 0.96; 95% CI: 0.34, 2.87; p = 0.94)
and contrast volume (MD: 15.08; 95% CI: -10.19, 40.35; p = 0.24) were
similar. Among observational studies, crossover rates were higher (OR:
5.09; 95% CI: 2.43, 10.65; p < 0.001), while access site complication
rates (OR: 0.52; 95% CI: 0.30, 0.89; p = 0.02) and contrast volume (MD:
-7.52; 95% CI: -13.14, -1.90 ml; p = 0.009) were lower in the radial
group. Bayesian analysis suggested that the odds of a difference existing
between radial and femoral are small for all endpoints except crossover to
another access site. <br/>Conclusion(s): In a frequentist and Bayesian
meta-analysis of patients with prior CABG undergoing coronary
catheterization, radial access was associated with lower incidence of
vascular access complications and lower contrast volume but also higher
crossover rate.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC.

<38>
Accession Number
2013401953
Title
Effects of remote ischemic postconditioning on HIF-1alpha and other
markers in on-pump cardiac surgery.
Source
General Thoracic and Cardiovascular Surgery. 70(3) (pp 239-247), 2022.
Date of Publication: March 2022.
Author
Garcia-de-la-Asuncion J.; Moreno T.; Duca A.; Garcia-del-Olmo N.;
Perez-Griera J.; Belda J.; Soro M.; Garcia-del-Olmo E.
Institution
(Garcia-de-la-Asuncion, Moreno, Duca, Belda, Soro) Department of
Anaesthesiology and Critical Care, Hospital Clinico Universitario,
Instituto de Investigacion Sanitaria-INCLIVA, Valencia, Spain
(Garcia-del-Olmo) Department of General Surgery, Hospital Lluis Alcanyis,
Xativa, Spain
(Perez-Griera) Laboratory of Biochemistry, Hospital Clinico Universitario,
Instituto de Investigacion Sanitaria-INCLIVA, Valencia, Spain
(Garcia-del-Olmo) Department of Thoracic Surgery, Consorcio Hospital
General Universitario, Valencia, Spain
Publisher
Springer Japan
Abstract
Background: There is a lack of data about the effects of remote ischemic
postconditioning (RIPostC) on hypoxia-inducible factor-1alpha (HIF-1alpha)
plasma levels after on-pump cardiac surgery (OPCS). This study aimed to
measure the effects of RIPostC on postoperative HIF-1alpha plasma levels,
cardiac markers and arterial oxygenation in patients undergoing OPCS.
<br/>Method(s): This single-centre randomized, double blind, controlled
trial, enrolled 70 patients (35 control and 35 RIPostC). RIPostC was
performed by 3 cycles (5 min of ischemia followed by 5 min of reperfusion)
administered in upper arm immediately after the pump period. The primary
outcome was to measure HIF-1alpha plasma levels: before surgery (T0), and
2 h (T1), 8 h (T2), 24 h (T3), 36 h (T4) and 48 h (T5) after RIPostC. As
secondary endpoint, Troponin T, CK-MB, CPK plasma levels and
PaO<inf>2</inf>/FiO<inf>2</inf> ratio were measured. <br/>Result(s):
HIF-1alpha plasma levels were increased at T1-T3 compared to T0 in both
groups (P < 0.001). In the RIPostC group HIF-1alpha increased compared to
the control group: differences between means (95% CI) were 0.034
(0.006-0.06) P = 0.019 at T1; 0.041 (0.013-0.069) P = 0.005 at T2; and
0.021 (0.001-0.042) P = 0.045 at T3. PaO<inf>2</inf>/FiO<inf>2</inf> was
higher in the RIPostC group than in the control group: at T3, T4 and T5.
Moreover, Troponin T, CK-MB and CPK values decreased in the RIPostC group
compared to the control group. <br/>Conclusion(s): HIF-1alpha plasma
levels increased in control patients during for at least 36 h after OPCS.
RIPostC resulted in even higher HIF-1alpha levels during at least the
first 24 h and improved arterial oxygenation and cardiac
markers.<br/>Copyright &#xa9; 2021, The Japanese Association for Thoracic
Surgery.

<39>
Accession Number
637335792
Title
Implantable cardioverter-defibrillators in heart transplant patients: A
systematic review and meta-analysis.
Source
European Heart Journal. Conference: 3rd European Society of Cardiology
Asia with APSC and AFC Congress. Online. 43(SUPPL 1) (pp i52-i53), 2022.
Date of Publication: February 2022.
Author
Cho K.; Lo P.; Subbiah R.
Institution
(Cho) Campbelltown Hospital, Cardiology, Sydney, Australia
(Lo, Subbiah) St Vincents Hospital, Cardiology, Sydney, Australia
Publisher
Oxford University Press
Abstract
Background: Whilst implantable cardioverter-defibrillator (ICD)
implantation is beneficial in a select group of patients, heart transplant
patients were excluded from landmark clinical trials. Thus, controversy
remains about the utility of ICD in high-risk heart transplant patients.
<br/>Purpose(s): To understand the utility, benefits and side-effects of
ICD in heart transplant patients. <br/>Method(s): Five electronic
databases were systematically searched from their inception to August
2021, in order to identify all studies which explored the role of ICD in
heart transplant patients. We used a random-effects model for data
analysis based on event rates (ER) and 95% confidence interval (CI).
Publication bias was assessed using funnel plots and Egger's regression
analysis. <br/>Result(s): Eleven studies with 4648 heart transplant
patients, 129 of whom received ICD, met the inclusion criteria for the
meta-analysis. Studies included two multicentre retrospective cohort
studies, four single centre retrospective cohort studies, two case series
and three case reports. Of the 129 heart transplant patients with ICD, 74%
were men, mean age at ICD implantation was 48.5 years, mean time from
transplant to ICD was 99 months, and mean follow-up duration was 40
months. The indication for ICD implantation was often multifactorial and
included severe allograft vasculopathy (40%), the presence of left
ventricular systolic dysfunction (37%), documented VT/VF (14%),
unexplained syncope (14%), and history of cardiac arrest (13%).
Appropriate ICD therapy for patients occurred as an average event rate of
19% (95% CI 13%-27%) (I2 = 0% p = 0.66), Figure 1. Inappropriate therapy
for patients occurred as an average event rate of 9% (95% CI 5%-16%) (I2 =
0% p = 0.96), Figure 2. There was no evidence of publication bias. In
total, nine ICD-related complications were reported including pocket
haematoma (n = 1), pocket site infection (n = 2), infection of the ICD
system (n = 1), lead displacement (n = 2) and lead fracture (n = 1).
Mortality occurred in 28 patients, with heart failure being the leading
primary cause of death (n = 10), followed by sepsis (n = 6), arrhythmia (n
= 3) and electromechanical disassociation (n = 3). <br/>Conclusion(s):
Heart transplant patients with ICD more often received appropriate than
inappropriate ICD shock therapy. The 19% appropriate ICD shock rate
suggests a high burden of ventricular arrhythmias in high-risk heart
transplant patients. Thus, ICD therapy may be beneficial in a select
subset of heart transplant patients, keeping in mind even with appropriate
shock therapy, subsequent terminal electromechanical disassociation and
arrhythmias may imply ICD are not fully protective against arrhythmic
aetiologies of mortality. (Figure Presented).

<40>
Accession Number
637335642
Title
Sex-specific differences in mortality after first time, isolated coronary
artery bypass graft surgery: A systematic review and meta-analysis of
randomized controlled trials.
Source
European Heart Journal. Conference: 3rd European Society of Cardiology
Asia with APSC and AFC Congress. Online. 43(SUPPL 1) (pp i170), 2022. Date
of Publication: February 2022.
Author
Matthews S.; O'neil A.; Sanders J.; Buttery A.; Maraosco S.; Fredericks
S.; Martorella G.; Keenan N.; Ganes A.; Wynne R.
Institution
(Matthews, Buttery) National Heart Foundation of Australia, Melbounre,
Australia
(O'neil) Deakin University, Melbourne, Australia
(Sanders) St Bartholomew's Hospital, London, United Kingdom
(Maraosco) Alfred Hospital, Melbourne, Australia
(Fredericks) Ryerson University, Toronto, Canada
(Martorella) Florida State University, Tallahasse, United States
(Keenan) St James Hospital, Dublin, Ireland
(Ganes) Barwon Health, Geelong, Australia
(Wynne) Western Sydney Local Health District, Sydney, Australia
Publisher
Oxford University Press
Abstract
BACKGROUND: Evidence quantifying sex-specific differences in cardiac
surgical outcomes is scant. PURPOSE: The purpose of this review was to
determine whether contemporary evidence indicates Coronary Artery Bypass
Graft Surgery (CABGS) is differentially efficacious than alternative
procedures by sex on mortality outcomes. <br/>METHOD(S): EMBASE, CINAHL,
Medline and Cochrane Library databases were searched (January 2010-April
2020). English language, randomized controlled trials, comparing isolated
CABGS to an alternative revascularization strategy in adults, with
analyses comparing sexspecific differences in mortality were included.
Analyses of incidence data was performed using Mantel-Haenszel
fixed-effects modelling, Cochrane RoB2 tool and CONSORT checklist.
PROSPERO Registration ID: CRD42020181673. <br/>RESULT(S): The search
yielded 4459 citations, with 29 articles for full-text review revealing 9
eligible studies with variability in time to followup. In contrast to men,
mortality risk for women was lower in pooled analyses (RR 0.95, 95% CI
0.85-1.05, p = 0.33) but higher in sensitivity analyses excluding
'high-risk' patients (RR 1.18, 95% CI 0.99-1.40, p = 0.07). At 30-days and
10 years, women had an 18% (RR 0.82, 95% CI 0.66-1.02, p = 0.08) and 19%
(RR 0.81, 95% CI 0.69-0.95, p = 0.01) mortality risk reduction. At 1-2
years women had a 7% (RR 1.07, 95% CI 0.69-1.64, p = 0.77), and at 2-5
years a 25% increase in risk of mortality compared to men (RR 1.25, 95% CI
1.03-1.53, p = 0.03). Women were increasingly under represented (23.2%)
over time, comprising 29% (30-days) to 16% (10 years) of the pooled
population. <br/>CONCLUSION(S): Trials with sex-specific stratification
are required to ensure appropriate treatment options for coronary
revascularization.

<41>
Accession Number
637335184
Title
The effect of high intensity interval training on patients with heart
transplantation: A systematic review.
Source
European Heart Journal. Conference: 3rd European Society of Cardiology
Asia with APSC and AFC Congress. Online. 43(SUPPL 1) (pp i215-i216), 2022.
Date of Publication: February 2022.
Author
Rajandekar T.; John G.
Institution
(Rajandekar, John) Narayana Hrudayalaya Institute of Physiotherapy,
Bangalore, India
Publisher
Oxford University Press
Abstract
BACKGROUND: Exercise rehabilitation after heart transplant is of major
importance in order to improve physical capacity and prognosis.
High-intensity interval training (HIIT) has repeatedly proven to be a
highly efficient form of exercise for improving the physical capacity of
both normal subjects and patients with coronary artery diseases (CAD) and
heart failure. In contrast to the chronotropic response of a normal heart
to exercise, a newly transplanted heart is denervated, which causes higher
resting heart rate (HR) and reduced heart response (chronotropic
incompetence). The HR response during exercise is mainly controlled by
catecholamine's from the adrenal glands, resulting in a significantly
slower increase of the HR at onset of exercise, a reduced peak HR, and a
delayed return towards resting values after cessation of exercise. A study
conducted in 2013 concluded that high-intensity, aerobic training,
especially interval-based training, is a favourable type of exercise that
yields improvements in both peripheral and central factors.The review was
conducted to determine the effect of HIIT on heart transplant patients.I
PURPOSE: Heart transplant patients have benefitted from aerobic exercises,
but the protocol is mostly focussed on moderate intensity exercises.
Chronotropic incompetence and safety have been two issues while
considering high intensity exercises in heart transplant patients. HIIT
has been proved to be effective in coronary artery disease and heart
failure patients. METHODOLOGY Criteria for considering these studies for
the review: PRISMA guidelines of systematic review used. Physiotherapy
Evidence Database scale used for assessing risk of bias. GRADE System of
evaluation used for data extraction and quality assessment. "Mesh" terms
used to search the article. Various databases like PubMed, Scopus, Google
scholar, Cochrane screened. Inclusion and exclusion criteria stated.
Studies done between 2010-2020 taken.Out of all the studies screened,
which 3 studies fulfilled the full text eligibility and were included in
the systematic review. <br/>RESULT(S): The heart transplant patients
demonstrated a great improvement in VO2 peak, anaerobic threshold, peak
expiratory flow, extensor muscle capacity, general health, systolic blood
pressure and endothelial function post HIIT. One of the screened studies
compared HIIT with moderate intensity exercises in heart transplant
patients and found out that patients receiving HIIT demonstrated better
improvement that moderate intensity exercises.The studies also emphasised
that long term and community based HIIT is effective in improving the
overall quality of life of the patients. <br/>CONCLUSION(S): According to
the three studies reviewed in this article, HIIT proved to be effective as
exercise intervention on heart transplant patients. (Figure Presented).

<42>
Accession Number
637334601
Title
Infective endocarditis post-transcatheter aortic valve replacement: A
systematic review of epidemiology, clinical findings and prognosis.
Source
European Heart Journal. Conference: 3rd European Society of Cardiology
Asia with APSC and AFC Congress. Online. 43(SUPPL 1) (pp i131), 2022. Date
of Publication: February 2022.
Author
Vikash J.; Akash J.; Angela I.; Ruchika K.; Aditi U.; Nitya B.; Zouina S.;
Azza S.; Prachi S.; Jack M.; Gaurav C.
Institution
(Vikash) AMA School of Medicine, Makati, Philippines
(Akash) All India Institute of Medical Sciences (AIIMS), New Delhi, India
(Angela, Aditi, Zouina, Azza, Jack) Larkin Community Hospital, Miami,
United States
(Ruchika) JJM Medical College, Banglore, India
(Nitya) Maulana Azad Medical College, New Delhi, India
(Prachi, Gaurav) King George's Medical University, Lucknow, India
Publisher
Oxford University Press
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is a minimally
invasive, catheter-based procedure to replace calcified narrow aortic
valves. Available data on prosthetic valve endocarditis (PVE) post TAVR is
limited to small subject populations in the form of case reports and case
series. This systematic review aims to evaluate first the incidence of
infective endocarditis post TAVR, second the microorganism profile and
clinical findings, and third associated mortality/morbidity.
<br/>Method(s): By adhering to the 2020 PRISMA statement guidelines, a
systematic search was conducted to identify studies reporting the
incidence of PVE post TAVR. An analysis of patient data including baseline
characteristics, clinical findings, and outcomes was conducted. The
following keywords were used by applying the BOOLEAN (and/or) logic:
infective endocarditis, prosthetic endocarditis, transcatheter aortic
valve replacement. <br/>Result(s): In total, 18 studies were included,
comprising 63,604 patients who underwent TAVR. All included studies were
observational, i.e., seven multicenter registries, five retrospective
studies, three cohort studies, two single-center observational studies,
and one prospective study. The analysis yielded that 2.9% (1891) of the
included patients suffered from post-TAVR infective endocarditis (IE). The
patients with post-TAVR IE had a mean age of 79.2 +/- 3.5 years, and 59.6%
were males. Nine studies reported theuse of antibiotics for prophylaxis,
with beta-lactams being the most commonly used. Seventeen studies reported
the type of bacteria isolated in cultures; all studies found enterococcus
and staphylococcus species, whereas Streptococcus was isolated in 7 of the
18 studies. Only 3% (60) of the patients had a prior history of IE. Of the
reported complications post-TAVR, heart failure was the leading
complication, with 0.2% of patients experiencing neurological symptoms,
including stroke. The overall mortality rate ofpost-TAVR IE, estimated to
be 23%, was alarmingly high. <br/>Conclusion(s): This synthesis collates a
low (2.9%) incidence of infective endocarditis post-TAVR, however high
mortality and morbidity by means of heart failure and stroke is
documented. Ultimately, appropriate medical care ought to be taken to
reduce post-TAVR complications, with cautious and warranted measures of
antibiotics prophylaxis to avoid valve complications.

<43>
Accession Number
637343641
Title
Evaluation of volatile sedation in the postoperative intensive care of
patients recovering from heart valve surgery: protocol for a randomised,
controlled, monocentre trial.
Source
BMJ open. 12(2) (pp e057804), 2022. Date of Publication: 23 Feb 2022.
Author
Flinspach A.N.; Herrmann E.; Raimann F.J.; Zacharowski K.; Adam E.H.
Institution
(Flinspach, Raimann, Zacharowski, Adam) Department of Anaesthesiology,
Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt,
Goethe University Frankfurt, Germany, Klinikum der Johann Wolfgang
Goethe-Universitat Frankfurt, Frankfurt am Main, Hessen, Germany
(Herrmann) Department of Biostatistic and Mathematic Modeling, Goethe
University, Frankfurt, Germany, Goethe-Universitat Frankfurt am Main,
Frankfurt am Main, Hessen, Germany
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Patients undergoing heart valve surgery are predominantly
transferred postoperatively to the intensive care unit (ICU) under
continuous sedation. Volatile anaesthetics are an increasingly used
treatment alternative to intravenous substances in the ICU. As subject to
inhalational uptake and elimination, the resulting pharmacological
benefits have been repeatedly demonstrated. Therefore, volatile
anaesthetics appear suitable to meet the growing demands of fast-track
cardiac surgery. However, their use requires special preparation at the
bedside and trained medical and nursing staff, which might limit the
pharmacological benefits. The aim of our work is to assess whether the
temporal advantages of recovery under volatile sedation outweigh the
higher effort of special preparation. METHODS AND ANALYSIS: The study is
designed to evaluate the differences between intravenous sedatives (n=48)
and volatile sedatives (n=48) in continued intensive care sedation. This
study will be conducted as a prospective, randomised, controlled,
single-blinded, monocentre trial at a German university hospital in
consenting adult patients undergoing heart valve surgery at a university
hospital. This observational study will examine the necessary preparation
time, staff consultation and overall feasibility of the chosen sedation
method. For this purpose, the continuation of sedation in the ICU with
volatile sedatives is considered as one study arm and with intravenous
sedatives as the comparison group. Due to rapid elimination and quick
awakening after the termination of sedation, closer consultation between
the attending physician and the ICU nursing staff is required, in addition
to a prolonged setup time. Study analysis will include the required setup
time, time from admission to extubation as primary outcome and
neurocognitive assessability. In addition, possible operation-specific
(blood loss, complications), treatment parameters (catecholamine dosages,
lung function) and laboratory results (acute kidney injury, acid base
balance (lactataemia), liver failure) as influencing factors will be
collected. The study-relevant data will be extracted from the continuous
digital records of the patient data management system after the patient
has been discharged from the ICU. For statistical evaluation, 95% CIs will
be calculated for the median time to extubation and neurocognitive
assessability, and the association will be assessed with a Cox regression
model. In addition, secondary binary outcome measures will be evaluated
using Fisher's exact tests. Further descriptive and exploratory
statistical analyses are also planned. ETHICS AND DISSEMINATION: The study
was approved by the Institutional Ethics Board of the University of
Frankfurt, Germany (#20-1050). Informed consent of all individual patients
will be obtained before randomisation. Results will be disseminated via
publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: Clinical
trials registration (NCT04958668) was completed on 1 July
2021.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2022. Re-use
permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<44>
Accession Number
637343026
Title
Clinical outcomes of patients with hepatic insufficiency undergoing
transcatheter aortic valve implantation: a systematic review and
meta-analysis.
Source
BMC cardiovascular disorders. 22(1) (pp 67), 2022. Date of Publication: 23
Feb 2022.
Author
Jiang W.; Cheng Z.; Tu S.; Wang X.; Xiang C.; Zhou W.; Chen L.
Institution
(Jiang, Tu, Wang) First Clinical Medical College of Lanzhou University,
Tianshui Road (South) ,Chengguan DistrictGansu Province 730000, China
(Cheng) Department of Cardiac Surgery, Ruijin Hospital affiliated to
School of Medicine, Shanghai Jiao Tong University, Ruijin Road (Second)
200025, China
(Xiang) Second Clinical Medical College of Lanzhou University, Tianshui
Road (South) ,Chengguan DistrictGansu Province 730000, China
(Zhou) Department of General Surgery, First Hospital of Lanzhou
University, No. 1 ,Donggangxi Road ,Chengguan DistrictGansu Province
730000, China
(Chen) Department of Infectious Diseases, First Hospital of Lanzhou
University, No. 1 ,Donggangxi Road ,Chengguan DistrictGansu Province
730000, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is currently a
common treatment in high-risk aortic stenosis patients, but the impact of
hepatic insufficiency on prognosis after TAVI is debatable and whether
TAVI is superior to surgical aortic valve replacement (SAVR) in patients
with hepatic insufficiency is uncertain. <br/>OBJECTIVE(S): To investigate
the effect of abnormal liver function on the outcome and safety after TAVI
and whether TAVI is superior to SAVR in patients with hepatic
insufficiency. <br/>METHOD(S): PubMed, Embase, the Cochrane Library and
Web of Science were systematically searched from inception up to 26
November 2021. Studies were eligible if mortality and complications after
TAVI in patients with and without hepatic insufficiency, or mortality and
complications for TAVI versus SAVR in patients with hepatic insufficiency
were reported. The Newcastle-Ottawa scale (NOS) was used to evaluate the
quality of each study. This meta-analysis was registered with PROSPERO
(CRD42021253423) and was carried out by using RevMan 5.3 and Stata 14.0.
<br/>RESULT(S): This meta-analysis of 21 studies assessed a total of
222,694 patients. Hepatic insufficiency was associated with higher
short-term (in-hospital or 30-day) mortality [OR = 1.62, 95% CI (1.18 to
2.21), P = 0.003] and 1-2 years mortality [HR = 1.64, 95% CI (1.42 to
1.89), P < 0.00001] after TAVI. Between TAVI and SAVR in patients with
hepatic insufficiency, there was a statistically significant difference in
in-hospital mortality [OR = 0.46, 95% CI (0.27 to 0.81), P = 0.007], the
occurrence rate of blood transfusions [OR = 0.29, 95% CI (0.22 to 0.38), P
< 0.00001] and the occurrence rate of acute kidney injury [OR = 0.55, 95%
CI (0.33 to 0.91), P = 0.02]. <br/>CONCLUSION(S): TAVI patients with
hepatic insufficiency may have negative impact both on short-term
(in-hospital or 30-day) and 1-2-years mortality. For patients with hepatic
insufficiency, TAVI could be a better option than SAVR.<br/>Copyright
&#xa9; 2022. The Author(s).

<45>
Accession Number
637282027
Title
Donor-Transmitted Cancer in Orthotopic Solid Organ Transplant Recipients:
A Systematic Review.
Source
Transplant International. 35 (no pagination), 2022. Article Number: 10092.
Date of Publication: 04 Feb 2022.
Author
Greenhall G.H.B.; Ibrahim M.; Dutta U.; Doree C.; Brunskill S.J.; Johnson
R.J.; Tomlinson L.A.; Callaghan C.J.; Watson C.J.E.
Institution
(Greenhall, Ibrahim, Johnson) Department of Statistics and Clinical
Research, NHS Blood and Transplant, Bristol, United Kingdom
(Greenhall, Ibrahim, Callaghan) School of Immunology and Microbial
Sciences, King's College London, London, United Kingdom
(Dutta) GKT School of Medical Education, King's College London, London,
United Kingdom
(Doree, Brunskill) Systematic Review Initiative, NHS Blood and Transplant,
Oxford, United Kingdom
(Tomlinson) Department of Non-Communicable Disease Epidemiology, London
School of Hygiene and Tropical Medicine, London, United Kingdom
(Callaghan) Department of Nephrology and Transplantation, Guy's Hospital,
Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
(Watson) Department of Surgery, University of Cambridge, Cambridge, United
Kingdom
(Watson) The Cambridge NIHR Biomedical Research Centre, Cambridge, United
Kingdom
(Watson) NIHR Blood and Transplant Research Unit in Organ Donation and
Transplantation, University of Cambridge, Cambridge, United Kingdom
Publisher
European Society for Organ Transplantation
Abstract
Donor-transmitted cancer (DTC) has major implications for the affected
patient as well as other recipients of organs from the same donor. Unlike
heterotopic transplant recipients, there may be limited treatment options
for orthotopic transplant recipients with DTC. We systematically reviewed
the evidence on DTC in orthotopic solid organ transplant recipients
(SOTRs). We searched MEDLINE, EMBASE, PubMed, Scopus, and Web of Science
in January 2020. We included cases where the outcome was reported and
excluded donor-derived cancers. We assessed study quality using published
checklists. Our domains of interest were presentation, time to diagnosis,
cancer extent, management, and survival. There were 73 DTC cases in liver
(n = 51), heart (n = 10), lung (n = 10) and multi-organ (n = 2) recipients
from 58 publications. Study quality was variable. Median time to diagnosis
was 8 months; 42% were widespread at diagnosis. Of 13 cases that underwent
re-transplantation, three tumours recurred. Mortality was 75%; median
survival 7 months. Survival was worst in transmitted melanoma and central
nervous system tumours. The prognosis of DTC in orthotopic SOTRs is poor.
Although re-transplantation offers the best chance of cure, some tumours
still recur. Publication bias and clinical heterogeneity limit the
available evidence. From our findings, we suggest refinements to clinical
practice. Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020165001,
Prospero Registration Number: CRD42020165001.<br/>Copyright &#xa9; 2022
Greenhall, Ibrahim, Dutta, Doree, Brunskill, Johnson, Tomlinson, Callaghan
and Watson.

<46>
Accession Number
637224763
Title
Efficacy of prothrombin complex concentrate (PCC) versus fresh frozen
plasma (FFP) in reducing perioperative blood loss in cardiac surgery:
Study protocol for a non-inferiority, randomised controlled trial.
Source
BMJ Open. 12(2) (no pagination), 2022. Article Number: e051072. Date of
Publication: 10 Feb 2022.
Author
Pei L.; Sun C.; Lv H.; Zhang Y.; Shi J.
Institution
(Pei, Sun) Department of Anaesthesiology, Peking Union Medical College
Hospital, Chinese Academy of Medical Sciences, Peking Union Medical
College, Beijing, China
(Pei) Outcomes Research Consortium, Cleveland, OH, United States
(Lv, Shi) Department of Anaesthesiology, State Key Laboratory of
Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular
Diseases, Chinese Academy of Medical Sciences, Peking Union Medical
College, Beijing, China
(Zhang) Medical Research Center, Peking Union Medical College Hospital,
Chinese Academy of Medical Sciences, Peking Union Medical College,
Beijing, China
Publisher
BMJ Publishing Group
Abstract
Objective To explore whether prothrombin complex concentrate (PCC) is not
inferior to fresh frozen plasma (FFP) with regard to reducing
perioperative blood loss in patients undergoing cardiac surgery under
cardiopulmonary bypass (CPB). Setting Fu Wai Hospital, and Peking Union
Medical College Hospital in China. Participants Patients undergoing
elective coronary artery bypass grafting, valve replacement or
valvuloplasty under CPB, between 18 and 80 years old, will be included.
Design This study is a non-inferiority, randomised controlled clinical
trial. A total of 594 subjects will be randomly assigned to two groups
(group PCC and group FFP) and given corresponding interventions when at
least one of the following criteria is met: (1) international normalised
ratio >1.7 measured 20 min after CPB, (2) prolonged prothrombin time or
activated partial thromboplastin time (>1.5 times baseline) measured 20
min after CPB and (3) excessive bleeding observed. 4-factor PCC (15 IU/kg)
and FFP (10 mL/kg) will be given to group PCC and group FFP, respectively.
Preoperative management, anaesthetic and surgical techniques will be
standardised for both groups. Primary and secondary outcome measures The
primary outcome is the volume of blood loss during and within 24 hours
after surgery. The secondary outcomes include (1) the total units of
allogeneic red blood cells transfused during and within 7 days after
surgery, (2) re-exploration due to postoperative bleeding within 7 days
after surgery, (3) adverse events and serious adverse events within 30
days after surgery and (4) length of intensive care unit stay and hospital
stay. Trial registration number Registered under NCT04244981 at
ClinicalTrials.gov on 28 January 2020,
https://clinicaltrials.gov/ct2/show/NCT04244981?cond=NCT04244981&draw=2&ra
nk=1. Ethics and dissemination This study has been approved by the
Institutional Review Board of Peking Union Medical College Hospital
(ZS-2242). <br/>Copyright &#xa9;

<47>
Accession Number
2017030560
Title
Mechanical vs Bioprosthetic Aortic Valve Replacement in Patients Younger
Than 70 Years of Age: A Hazard Ratio Meta-analysis.
Source
Canadian Journal of Cardiology. 38(3) (pp 355-364), 2022. Date of
Publication: March 2022.
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
(Leviner, Shiran, Sharoni) Technion-Israel Institute of Technology,
Faculty of Medicine, Haifa, Israel
(Witberg, Levi, Kornowski) Department of Cardiology, Rabin Medical Center,
Petach Tikva, Israel
(Landes) Departmetnt of Cardiology, Wolfson Medical Centre, Tel Aviv,
Israel
(Schwartz) Department of Biostatistics, Carmel Medical Centre, Haifa,
Israel
(Shiran) Department of Cardiology, Carmel Medical Centre, Haifa, Israel
(Witberg, Levi, Landes, Kornowski) Sackler School of Medicine, Tel Aviv
University, Tel Aviv, Israel
Publisher
Elsevier Inc.
Abstract
Background: The choice between mechanical valves (MVs) and bioprosthetic
valves (BVs) 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 the middle age group (< 70 years), which has seen an
increased use of BV over recent years. <br/>Method(s): A meta-analysis of
randomised controlled trials (RCTs), observational studies using
propensity score matching (PSM) and inverse probability weighting (IPW)
was conducted to examine the clinical outcomes of patients < 70 years of
age undergoing aortic valve replacement. The primary outcome was overall
long-term mortality. Secondary outcomes included bleeding events,
reoperation, systemic thromboembolism, and cerebrovascular accident.
<br/>Result(s): Fifteen studies (1 RCT, 12 PSM studies, and 2 IPW studies;
aggregated sample size 16,876 patients) were included. Median follow-up
was 7.8 years. Mortality was higher with BVs vs MVs (hazard ratio [HR]
1.22, 95% confidence interval [CI] 1.00-1.49), as was reoperation (HR
3.05, 95% CI 2.22-4.19). Bleeding risk was lower with BVs (HR 0.58, 95% CI
0.48-0.69), and the risk of stroke was similar in both valve types (HR
0.96, 95% CI 0.83-1.11) <br/>Conclusion(s): This broadest meta-analysis
comparing BV and MV suggests a survival benefit for MVs 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.<br/>Copyright &#xa9; 2021 Canadian Cardiovascular Society

<48>
[Use Link to view the full text]
Accession Number
2017015220
Title
Remote Ischemic Preconditioning Reduces Acute Kidney Injury after Cardiac
Surgery: A Systematic Review and Meta-analysis of Randomized Controlled
Trials.
Source
Anesthesia and Analgesia. 134(3) (pp 592-605), 2022. Date of Publication:
01 Mar 2022.
Author
Long Y.-Q.; Feng X.-M.; Shan X.-S.; Chen Q.-C.; Xia Z.; Ji F.-H.; Liu H.;
Peng K.
Institution
(Long, Shan, Chen, Ji, Peng) Department of Anesthesiology, First
Affiliated Hospital, Soochow University, 188 Shizi St, Jiangsu, Suzhou
215006, China
(Feng) Department of Anesthesiology, University of Utah Health, Salt Lake
City, UT, United States
(Feng) Transitional Residency Program, Intermountain Medical Center,
Murray, UT, United States
(Xia, Liu) Department of Anesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Results from previous studies evaluating the effects of remote
ischemic preconditioning (RIPC) on morbidity and mortality after cardiac
surgery are inconsistent. This meta-analysis of randomized controlled
trials (RCTs) aims to determine whether RIPC improves cardiac and renal
outcomes in adults undergoing cardiac surgery. <br/>METHOD(S): PubMed,
EMBASE, and Cochrane Library were comprehensively searched to identify
RCTs comparing RIPC with control in cardiac surgery. The coprimary
outcomes were the incidence of postoperative myocardial infarction (MI)
and the incidence of postoperative acute kidney injury (AKI).
Meta-analyses were performed using a random-effect model. Subgroup
analyses were conducted according to volatile only anesthesia versus
propofol anesthesia with or without volatiles, high-risk patients versus
non-high-risk patients, and Acute Kidney Injury Network (AKIN) or Kidney
Disease Improving Global Outcomes (KDIGO) criteria versus other criteria
for AKI diagnosis. <br/>RESULT(S): A total of 79 RCTs with 10,814 patients
were included. While the incidence of postoperative MI did not differ
between the RIPC and control groups (8.2% vs 9.7%; risk ratio [RR] = 0.87,
95% confidence interval [CI], 0.76-1.01, P =.07, I²= 0%), RIPC
significantly reduced the incidence of postoperative AKI (22% vs 24.4%; RR
= 0.86, 95% CI, 0.77-0.97, P =.01, I²= 34%). The subgroup
analyses showed that RIPC was associated with a reduced incidence of MI in
non-high-risk patients, and that RIPC was associated with a reduced
incidence of AKI in volatile only anesthesia, in non-high-risk patients,
and in the studies using AKIN or KDIGO criteria for AKI diagnosis.
<br/>CONCLUSION(S): This meta-analysis demonstrates that RIPC reduces the
incidence of AKI after cardiac surgery. This renoprotective effect of RIPC
is mainly evident during volatile only anesthesia, in non-high-risk
patients, and when AKIN or KDIGO criteria used for AKI
diagnosis.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins. All
rights reserved.

<49>
Accession Number
637342009
Title
The effect of Preoperative threshold inspiratory muscle training in adults
undergoing cardiac surgery on postoperative hospital stay: a systematic
review.
Source
Physiotherapy theory and practice. (pp 1-14), 2022. Date of Publication:
23 Feb 2022.
Author
Cook A.; Smith L.; Anderson C.; Ewing N.; Gammack A.; Pecover M.; Sime N.;
Galley H.F.
Institution
(Cook, Smith, Anderson, Ewing, Gammack, Pecover, Sime, Galley) School of
Medicine, Medical Sciences and Nutrition, University of Aberdeen,
Aberdeen, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Systematic reviews have reported benefits of preoperative
inspiratory muscle training in adults undergoing cardiac surgery, however
there have been inconsistencies with the devices used. Threshold devices
generate a constant inspiratory load independent of respiratory rate.
<br/>OBJECTIVE(S): To assess the effect of preoperative inspiratory muscle
training using threshold devices in adults undergoing cardiac surgery.
<br/>METHOD(S): A literature search was conducted across five electronic
databases. Seven randomized controlled trials met the inclusion criteria
and were critically appraised. The primary outcome was length of hospital
stay. Secondary outcomes included postoperative pulmonary complications,
quality of life and mortality. <br/>RESULT(S): Seven eligible randomized
controlled trials were identified with a total of 642 participants. One
study was a post hoc analysis of one of the included studies. Three out of
five studies reported a decrease in length of postoperative hospital stay
(p < 0.05). A significant reduction in postoperative pulmonary
complications was reported by three studies (p < 0.05). There were
concerns with bias across all papers. <br/>CONCLUSION(S): Preoperative
threshold inspiratory muscle training has potential to reduce
postoperative length of hospital stay and pulmonary complications after
cardiac surgery. The evidence on quality of life and mortality is
inconclusive. The overall evidence for these conclusions may be influenced
by bias.

<50>
Accession Number
637220858
Title
Advances in the management of cardioembolic stroke associated with patent
foramen ovale.
Source
The BMJ. 376 (no pagination), 2022. Article Number: e063161. Date of
Publication: 09 Feb 2022.
Author
Grory B.M.; Magnus Ohman E.; Feng W.; Xian Y.; Yaghi S.; Kamel H.; Reznik
M.E.
Institution
(Grory, Feng) Department of Neurology, Duke University School of Medicine,
Durham, NC, United States
(Grory, Magnus Ohman) Duke Clinical Research Institute, Durham, NC, United
States
(Magnus Ohman) Division of Cardiology, Department of Medicine, Duke
University School of Medicine, Durham, NC, United States
(Xian) Department of Neurology, UT Southwestern Medical Center, Dallas,
TX, United States
(Yaghi, Reznik) Department of Neurology, Warren Alpert Medical School of
Brown University, Providence, RI, United States
(Kamel) Department of Neurology, Weill Cornell Medicine, New York, NY,
United States
Publisher
BMJ Publishing Group
Abstract
Patent foramen ovale (PFO) describes a valve in the interatrial septum
that permits shunting of blood or thrombotic material between the atria.
PFOs are present in approximately 25% of the healthy population and are
not associated with any pathology in the vast majority of cases. However,
comparisons between patients with stroke and healthy controls suggest that
PFOs may be causative of stroke in certain patients whose stroke is
otherwise cryptogenic. Options for the diagnosis of PFO include
transthoracic echocardiography, transesophageal echocardiography, and
transcranial Doppler ultrasonography. PFOs associated with an interatrial
septal aneurysm seem to be more strongly linked to risk of recurrent
stroke. Therapeutic options for secondary stroke prevention in the setting
of a PFO include antiplatelet therapy, anticoagulation, and percutaneous
device closure. Recent randomized clinical trials suggest that
percutaneous closure reduces the subsequent risk of stroke in
appropriately selected patients, with a large relative benefit but small
absolute benefit. Referral for percutaneous PFO closure should therefore
be considered in certain patients after a multidisciplinary, patient
centered discussion. Areas for future study include structural biomarkers
to aid in determining the role of PFO closure in older people with
possible PFO associated stroke, the role of direct oral anticoagulants,
and very long term outcomes after device closure.<br/>Copyright &#xa9;
Published by the BMJ Publishing Group Limited. For permission to use
(where not already granted under a licence) please go to.

<51>
Accession Number
636681291
Title
Outcomes of a Delirium Prevention Program in Older Persons after Elective
Surgery: A Stepped-Wedge Cluster Randomized Clinical Trial.
Source
JAMA Surgery. 157(2) (pp E216370), 2022. Date of Publication: February
2022.
Author
Deeken F.; Sanchez A.; Rapp M.A.; Denkinger M.; Brefka S.; Spank J.; Bruns
C.; Von Arnim C.A.F.; Kuster O.C.; Conzelmann L.O.; Metz B.R.; Maurer C.;
Skrobik Y.; Forkavets O.; Eschweiler G.W.; Thomas C.
Institution
(Deeken, Sanchez, Rapp) Department of Social and Preventive Medicine,
University of Potsdam, Potsdam, Germany
(Rapp) Social and Preventive Medicine, Department of Sports and Health
Sciences, Intrafaculty Unit of Cognitive Sciences, Faculty of Human
Science, Faculty of Health Sciences Brandenburg, Research Area Services
Research and E-Health, University of Potsdam, Potsdam, Germany
(Denkinger, Brefka) Agaplesion Bethesda Clinic Ulm, Institute for
Geriatric Research, Ulm University, Geriatric Center Ulm, Ulm, Germany
(Brefka) Department of Cardiothoracic and Vascular Surgery, Ulm University
Hospital, Ulm, Germany
(Spank, Bruns, Thomas) Department of Geriatric Psychiatry and
Psychotherapy, Klinikum Stuttgart, Krankenhaus Bad Cannstatt,
Priessnitzweg 24, Stuttgart 70374, Germany
(Von Arnim) Division of Geriatrics, University Medical Center Goettingen,
Gottingen, Germany
(Von Arnim, Kuster, Forkavets) Department of Neurology, University
Hospital Ulm, Ulm, Germany
(Conzelmann) Helios Clinic for Cardiac Surgery Karlsruhe, Karlsruhe,
Germany
(Metz) Geriatric Center Karlsruhe, ViDia Christian Clinics Karlsruhe,
Karlsruhe, Germany
(Maurer) Center for Geriatrics and Gerontology, Medical Center University
of Freiburg, Freiburg, Germany
(Skrobik) Department of Medicine, McGill University, Montreal, QC, Canada
(Forkavets, Eschweiler) Geriatric Center, The University Hospital
Tubingen, Tubingen, Germany
(Eschweiler, Thomas) Department of Psychiatry and Psychotherapy,
University Hospital of Tubingen, Tubingen, Germany
Publisher
American Medical Association
Abstract
Importance: Delirium significantly worsens elective surgery outcomes and
costs. Delirium risk is highest in elderly populations, whose surgical
health care resource consumption (50%) exceeds their demographic
proportion (15% to 18%) in high-resource countries. Effective
nonpharmacologic delirium prevention could safely improve care in these
vulnerable patients, but data from procedure-specific studies are
insufficiently compelling to drive changes in practice. Delirium
prevention approaches applicable to different surgical settings remain
unexplored. <br/>Objective(s): To examine whether a multifaceted
prevention intervention is effective in reducing postoperative delirium
incidence and prevalence after various major surgical procedures.
<br/>Design, Setting, and Participant(s): This stepped-wedge cluster
randomized trial recruited 1470 patients 70 years and older undergoing
elective orthopedic, general, or cardiac surgery from November 2017 to
April 2019 from 5 German tertiary medical centers. Data were analyzed from
December 2019 to July 2021. <br/>Intervention(s): First, structured
delirium education was provided to clinical caregivers at each site. Then,
the study delirium prevention team assessed patient delirium risk factors
and symptoms daily. Prevention was tailored to individual patient needs
and could include: cognitive, motor, and sensory stimulation; meal
companionship; accompaniment during diagnostic procedures; stress
relaxation; and sleep promotion. <br/>Main Outcomes and Measures:
Postoperative delirium incidence and duration. <br/>Result(s): Of 1470
included patients, 763 (51.9%) were male, and the median (IQR) age was 77
(74-81) years. Overall, the intervention reduced postoperative delirium
incidence (odds ratio, 0.87; 95% CI, 0.77-0.98; P =.02) and percentage of
days with delirium (intervention, 5.3%; control, 6.9%; P =.03). The effect
was significant in patients undergoing orthopedic or abdominal surgery
(odds ratio, 0.59; 95% CI, 0.35-0.99; P =.047) but not cardiac surgery
(odds ratio, 1.18; 95% CI, 0.70-1.99; P =.54). <br/>Conclusions and
Relevance: This multifaceted multidisciplinary prevention intervention
reduced postoperative delirium occurrence and days with delirium in older
patients undergoing different elective surgical procedures but not cardiac
procedures. These results suggest implementing this delirium prevention
program will improve care and outcomes in older patients undergoing
elective general and orthopedic procedures..<br/>Copyright &#xa9; 2022
American Medical Association. All rights reserved.

<52>
[Use Link to view the full text]
Accession Number
2016887625
Title
A Systematic Review and Meta-analysis of Randomized Controlled Trials
Comparing Intraoperative Red Blood Cell Transfusion Strategies.
Source
Annals of Surgery. 275(3) (pp 456-466), 2022. Date of Publication: 01 Mar
2022.
Author
Lenet T.; Baker L.; Park L.; Vered M.; Zahrai A.; Shorr R.; Davis A.;
McIsaac D.I.; Tinmouth A.; Fergusson D.A.; Martel G.
Institution
(Lenet, Baker, Park, Vered, Zahrai, Fergusson, Martel) Department of
Surgery, Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
(Lenet, Baker, Tinmouth, Fergusson) Clinical Epidemiology Program, Ottawa
Hospital Research Institute, Ottawa, ON, Canada
(Shorr, Davis) Library Services, Ottawa Hospital, Ottawa, ON, Canada
(McIsaac) Department of Anesthesiology, Ottawa Hospital, University of
Ottawa, Ottawa, ON, Canada
(McIsaac, Tinmouth, Fergusson, Martel) Department of Medicine, Ottawa
Hospital, University of Ottawa, Ottawa, ON, Canada
(Tinmouth, Fergusson) Canadian Blood Services, Ottawa, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Objective:The objective of this work was to carry out a meta-analysis of
RCTs comparing intraoperative RBC transfusion strategies to determine
their impact on postoperative morbidity, mortality, and blood product
use.Summary of Background Data:RBC transfusions are common in surgery and
associated with widespread variability despite adjustment for casemix.
Evidence-based recommendations guiding RBC transfusion in the operative
setting are limited. <br/>Method(s):The search strategy was adapted from a
previous Cochrane Review. Electronic databases were searched from January
2016 to February 2021. Included studies from the previous Cochrane Review
were considered for eligibility from before 2016. RCTs comparing
intraoperative transfusion strategies were considered for inclusion.
Co-primary outcomes were 30-day mortality and morbidity. Secondary
outcomes included intraoperative and perioperative RBC transfusion.
Meta-analysis was carried out using random-effects models.
<br/>Result(s):Fourteen trials (8641 patients) were included. One cardiac
surgery trial accounted for 56% of patients. There was no difference in
30-day mortality [relative risk (RR) 0.96, 95% confidence interval (CI)
0.71-1.29] and pooled postoperative morbidity among the studied outcomes
when comparing restrictive and liberal protocols. Two trials reported
worse composite outcomes with restrictive triggers. Intraoperative (RR
0.53, 95% CI 0.43-0.64) and perioperative (RR 0.70, 95% CI 0.62-0.79)
blood transfusions were significantly lower in the restrictive group
compared to the liberal group. <br/>Conclusion(s):Intraoperative
restrictive transfusion strategies decreased perioperative transfusions
without added postoperative morbidity and mortality in 12/14 trials. Two
trials reported worse outcomes. Given trial design and generalizability
limitations, uncertainty remains regarding the safety of broad application
of restrictive transfusion triggers in the operating room. Trials
specifically designed to address intraoperative transfusions are urgently
needed.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins. All
rights reserved.

<53>
[Use Link to view the full text]
Accession Number
2016817980
Title
A meta-analysis of optimal medical therapy with or without percutaneous
coronary intervention in patients with stable coronary artery disease.
Source
Coronary Artery Disease. 33(2) (pp 91-97), 2022. Date of Publication: 01
Mar 2022.
Author
Shah R.; Nayyar M.; Le F.K.; Labroo A.; Nasr A.; Rashid A.; Davis D.A.;
Weintraub W.S.; Boden W.E.
Institution
(Shah, Nayyar) Department of Medicine, University of Tennessee, School of
Medicine, Section of Cardiovascular Medicine, 1030 Jefferson Avenue,
Memphis, TN 38104, United States
(Shah, Le, Labroo, Davis) Department of Cardiology, Gulf Coast Medical
Center, Alabama University of Osteopathic Medicine, Panama City, FL,
United States
(Nasr) Department of Biology, University of Memphis, Memphis, TN, United
States
(Rashid) Department of Cardiology, University of Tennessee, Jackson, TN,
United States
(Weintraub) Department of Medicine, MedStar Washington Hospital Center,
Washington, DC, United States
(Boden) Department of Medicine, Veterans Affairs (VA) New England
Healthcare System, Boston University, United States
(Boden) Department of Medicine, Boston University, School of Medicine,
Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background Whether percutaneous coronary intervention (PCI) improves
clinical outcomes in patients with chronic angina and stable coronary
artery disease (CAD) has been a continuing area of investigation for more
than two decades. The recently reported results of the International Study
of Comparative Health Effectiveness with Medical and Invasive Approaches,
the largest prospective trial of optimal medical therapy (OMT) with or
without myocardial revascularization, provides a unique opportunity to
determine whether there is an incremental benefit of revascularization in
stable CAD patients. Methods Scientific databases and websites were
searched to find randomized clinical trials (RCTs). Pooled risk ratios
were calculated using the random-effects model. Results Data from 10 RCTs
comprising 12 125 patients showed that PCI, when added to OMT, were not
associated with lower all-cause mortality (risk ratios, 0.96; 95% CI,
0.87-1.08), cardiovascular mortality (risk ratios, 0.91; 95% CI,
0.79-1.05) or myocardial infarction (MI) (risk ratios, 0.90; 95% CI,
0.78-1.04) as compared with OMT alone. However, OMT+PCI was associated
with improved anginal symptoms and a lower risk for revascularization
(risk ratios, 0.52; 95% CI, 0.37-0.75). Conclusions In patient with
chronic stable CAD (without left main disease or reduced ejection
fraction), PCI in addition to OMT did not improve mortality or MI compared
to OMT alone. However, this strategy is associated with a lower rate of
revascularization and improved anginal symptoms.<br/>Copyright &#xa9; 2022
Lippincott Williams and Wilkins. All rights reserved.

<54>
Accession Number
2016808101
Title
Drug-Eluting versus Bare-Metal Stents in Saphenous Vein Grafts Compared to
Native Coronary Vessels: The Norwegian Coronary Stent Trial Study.
Source
Cardiology (Switzerland). 147(1) (pp 14-22), 2022. Date of Publication: 01
Jan 2022.
Author
Molstad P.M.; Nordrehaug J.E.; Steigen T.K.; Wilsgaard T.; Wiseth R.;
Rotevatn S.; Mannsverk J.; Larsen T.; Larsby K.E.; Skarstad S.i.; Fosse
E.i.; Dahl-Eriksen I.; Bonaa K.H.
Institution
(Molstad) Department of Cardiology, LHL Clinics Gardermoen, Jessheim,
Norway
(Nordrehaug) Department of Clinical Science, University of Bergen, Bergen,
Norway
(Steigen) Cardiovascular Research Group, UiT The Arctic University of
Norway, Tromso, Norway
(Steigen, Mannsverk, Larsby, Skarstad, Fosse, Dahl-Eriksen) Department of
Cardiology, University Hospital of North Norway, Tromso, Norway
(Wilsgaard) Department of Community Medicine, UiT The Arctic University of
Norway, Tromso, Norway
(Wiseth, Bonaa) Clinic of Cardiology, St. Olavs University Hospital,
Trondheim, Norway
(Wiseth, Bonaa) Department of Circulation and Medical Imaging, Norwegian
University of Science and Technology, Trondheim, Norway
(Rotevatn) Department of Heart Disease, Haukeland University Hospital,
Bergen, Norway
(Larsen) Cardiological Department, Akershus University Clinic Gardermoen,
Jessheim, Norway
Publisher
S. Karger AG
Abstract
Background: Drug-eluting stents (DES) reduce target lesion
revascularization (TLR) with no effect on mortality or myocardial
infarction (MI) compared to bare-metal stents (BMS) in native vessels.
Randomized stent studies in saphenous vein grafts (SVG) are few and the
reported effects are ambiguous. The Norwegian Coronary Stent Trial study
is the first to randomize lesions to percutaneous coronary intervention in
native vessels and SVG. <br/>Aim(s): The aim of this study was to compare
the rate of mortality, MI, and TLR across stent and vessel types.
<br/>Method(s): In this substudy, 6,087 patients with a single lesion in
native vessels and 164 in SVG were followed for 5 years. <br/>Result(s):
MI was more frequent in SVG (subdistributional hazard ratio [SHR] 4.95
(3.75-6.54, p < 0.001), but not affected by stent type. In the first 500
days, DES reduced TLR in native vessels (SHR 0.21 (0.15-0.30) p < 0.001)
and SVG (SHR 0.18 (0.04-0.80) p = 0.02). Thereafter, DES and BMS were
equivalent in native vessels, but DES had a higher TLR rate than BMS in
SVG (SHR 3.31 (1.23-8.94) p = 0.02). After 5 years, the TLR rate was still
significantly lower for DES in native vessels (3.2% vs. 7.8%, p < 0.001)
but not in SVG (21.4% vs. 18. 4%). <br/>Conclusion(s): In SVG, no
difference in TLR between DES and BMS was observed after 5 years in
contrast to persistent benefit in native vessels. The high rate of TLR and
MI in SVG makes treatment of native vessels a preference whenever feasible
and better treatment options for SVG are warranted.<br/>Copyright &#xa9;
2021 S. Karger AG, Basel.

<55>
Accession Number
2016808099
Title
Comparison of Prasugrel and Ticagrelor for Patients with Acute Coronary
Syndrome: A Systematic Review and Meta-Analysis.
Source
Cardiology (Switzerland). 147(1) (pp 1-13), 2022. Date of Publication: 01
Jan 2022.
Author
Fong L.C.W.; Lee N.H.C.; Yan A.T.; Ng M.-Y.
Institution
(Fong, Lee) Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong
Kong, Hong Kong
(Yan) Department of Medicine, University of Toronto, Division of
Cardiology, St. Michael's Hospital, Toronto, ON, Canada
(Ng) Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine,
University of Hong Kong, Hong Kong, Hong Kong
Publisher
S. Karger AG
Abstract
Introduction: There have been inconsistent data on the direct comparison
of prasugrel and ticagrelor. This meta-analysis was conducted to summarize
the current available evidence. <br/>Method(s): We performed a
meta-analysis (PROSPERO-registered CRD42020166810) of randomized trials up
to February 2020 that compared prasugrel and ticagrelor in acute coronary
syndrome with respect to the composite endpoint of myocardial infarction
(MI), stroke, or cardiovascular death and secondary endpoints including
MI, stroke, cardiovascular death, major bleeding (Bleeding Academic
Research Consortium (BARC) type 2 or above), stent thrombosis, all-cause
death, and other safety outcomes. <br/>Result(s): Of the 11 eligible RCTs
with 6,098 patients randomized to prasugrel (n = 3,050) or ticagrelor (n =
3,048), 180 and 207 had the composite endpoint events in the prasugrel arm
and the ticagrelor arm, respectively, over a weighted mean follow-up
period of 11 +/- 2 months. Compared with prasugrel, the ticagrelor group
had similar risk in the primary composite endpoint (risk ratio [RR] =
1.17; 95% CI = 0.96-1.42; p = 0.12, I² = 0%). Compared to
prasugrel, there was no significant difference associated with the
ticagrelor groups with respect to stroke (RR = 1.05; 95% CI = 0.66-1.67; p
= 0.84, I² = 0%), cardiovascular death (RR = 1.01; 95% CI =
0.75-1.36; p = 0.95, I² = 0%), BARC type 2 or above bleeding
(RR = 1.16; 95% CI = 0.89-1.52; p = 0.26, I² = 0%), stent
thrombosis (RR = 1.58; 95% CI = 0.90-2.76; p = 0.11, I² = 0%),
and all-cause death (RR = 1.10; 95% CI = 0.86-1.43; p = 0.45,
I² = 0%) except MI (RR = 1.38; 95% CI = 1.05-1.81; p = 0.02,
I² = 0%) <br/>Conclusion(s): Compared with prasugrel,
ticagrelor did not reduce the primary composite endpoint of MI, stroke,
and cardiovascular death at a weighted mean follow-up of 11 months. There
was no significant difference between the secondary outcomes except
MI.<br/>Copyright &#xa9; 2021 The Author(s). Published by S. Karger AG,
Basel.

<56>
Accession Number
2016799927
Title
Ten-year all-cause death after percutaneous or surgical revascularization
in diabetic patients with complex coronary artery disease.
Source
European Heart Journal. 43(1) (pp 56-67), 2022. Date of Publication: 01
Jan 2022.
Author
Wang R.; Serruys P.W.; Gao C.; Hara H.; Takahashi K.; Ono M.; Kawashima
H.; O'leary N.; Holmes D.R.; Witkowski A.; Curzen N.; Burzotta F.; James
S.; Van Geuns R.-J.; Kappetein A.P.; Morel M.-A.; Head S.J.; Thuijs
D.J.F.M.; Davierwala P.M.; O'Brien T.; Fuster V.; Garg S.; Onuma Y.
Institution
(Wang, Gao) Department of Cardiology, Xijing Hospital, Changle West Road
127, Xi'an 710032, China
(Wang, Serruys, Gao, Hara, Ono, Kawashima, O'leary, Morel, Onuma)
Department of Cardiology, National University of Ireland, Galway (NUIG),
University Road, Galway H91 TK33, Ireland
(Wang, Gao, Van Geuns) Department of Cardiology, Radboud University
Medical Center, Geert Grooteplein Zuid 8, Nijmegen 6525 GA, Netherlands
(Serruys) Department of Cardiology, Imperial College London, Exhibition
Rd, London SW7 2BX, United Kingdom
(Hara, Takahashi, Ono, Kawashima) Department of Cardiology, Academic
Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam 1105
AZ, Netherlands
(Holmes) Department of Cardiology, Mayo ClinicSchool of Medicine, 200
First St. SW, Rochester, MN 55905, United States
(Witkowski) Department of Interventional Cardiology and Angiology,
National Institute of Cardiology, ul. Alpejska 42, Warsaw 04-628, Poland
(Curzen) Cardiology Department, University Hospital Southampton, Coxford
Rd, Southampton SO16 5YA, United Kingdom
(Burzotta) Institute of Cardiology, Catholic University of the Sacred
Heart, Largo F. Vito 1, Rome 00168, Italy
(James) Department of Medical Sciences, Cardiology and Uppsala Clinical
Research Center, Uppsala University, Dag Hammarskjolds vag 14B SE-752 37,
Uppsala, Sweden
(Kappetein, Head, Thuijs) Department of Cardiothoracic Surgery, Erasmus
University Medical Centre, Dr Molewaterplein 40, Rotterdam 3015 GE,
Netherlands
(Davierwala) Department of Cardiac Surgery, Heart Centre Leipzig,
Strumpelstrasse 39, Leipzig 4289, Germany
(O'Brien) Regenerative Medicine Institute, CURAM, National University of
Ireland, Galway (NUIG), University Road, Galway H91 TK33, Ireland
(Fuster) Division of Cardiology, Zena and Michael A. Wiener Cardiovascular
Institute, Icahn School of Medicina at Mount Sinai School, 1 Gustave L.
Levy Place, New York, NY 10029-5674, United States
(Garg) Department of Cardiology, East Lancashire Hospitals NHS Trust,
Haslingden Rd, Blackburn, Lancashire BB2 3HH, United Kingdom
Publisher
Oxford University Press
Abstract
Aims: The aim of this article was to compare rates of all-cause death at
10 years following coronary artery bypass grafting (CABG) or percutaneous
coronary intervention (PCI) in patients with or without diabetes.
<br/>Methods and Results: The SYNTAXES study evaluated up to 10-year
survival of 1800 patients with three-vessel disease (3VD) and/or left main
coronary artery disease (LMCAD) randomized to receive either PCI or CABG
in the SYNTAX trial. Ten-year all-cause death according to diabetic status
and revascularization strategy was examined. In diabetics (n = 452), the
risk of mortality was numerically higher with PCI compared with CABG at 5
years [19.6% vs. 13.3%, hazard ratio (HR): 1.53, 95% confidence interval
(CI): 0.96, 2.43, P = 0.075], with the opposite seen between 5 and 10
years (PCI vs. CABG: 20.8% vs. 24.4%, HR: 0.82, 95% CI: 0.52, 1.27, P =
0.366). Irrespective of diabetic status, there was no significant
difference in all-cause death at 10 years between patients receiving PCI
or CABG, the absolute treatment difference was 1.9% in diabetics (PCI vs.
CABG: 36.4% vs. 34.5%, difference: 1.9%, 95% CI: -7.6%, 11.1%, P = 0.551).
Among insulin-treated patients (n = 182), all-cause death at 10 years was
numerically higher with PCI (47.9% vs. 39.6%, difference: 8.2%, 95% CI:
-6.5%, 22.5%, P = 0.227). <br/>Conclusion(s): The treatment effects of PCI
vs. CABG on all-cause death at 10 years in patients with 3VD and/or LMCAD
were similar irrespective of the presence of diabetes. There may, however,
be a survival benefit with CABG in patients with insulin-treated diabetes.
The association between revascularization strategy and very long-term
ischaemic and safety outcomes for patients with diabetes needs further
investigation in dedicated trials.<br/>Copyright &#xa9; 2022 Oxford
University Press. All rights reserved.

<57>
Accession Number
2016799921
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), 2022. Date of Publication: 01
Jan 2022.
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, New York, NY 10065, United States
(Alexander) Department of Medicine, Division of Cardiology, Duke Clinical
Research Institute, 40 Duke Medicine Cir, Durham, NC 27710, United States
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Carnegie Ave, Cleveland, OH 44103, United States
(Egorova) Department of Population Health Science and Policy, Icahn School
of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029,
United States
(Kurlansky) Department of Surgery, Center for Innovation and Outcomes
Research, Columbia University Medical Center, 622 W 168th St, New York, NY
10032, United States
(Boening) Department of Cardiovascular Surgery, Justus-Liebig University
Giesen, Ludwigstrase 23, Giesen 35390, Germany
(Chikwe) Department of Cardiac Surgery, Smidt Heart Institute,
Cedars-Sinai Medical Center, 8700 Beverly Blvd #2900A, Los Angeles, CA
90048, United States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, 525 East 68th Street, New York, 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, Von-Guttenberg-Strase 11, Saale 97616, 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, United
States
(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, ON M4N 3M5, Canada
Publisher
Oxford University Press
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. <br/>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 13 193 patients (10 479 males; 2714 females) were included. Over
5 years 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 75 years
and older. The use of off-pump surgery and multiple arterial grafting did
not modify the difference between sexes. <br/>Conclusion(s): Women have
worse outcomes than men in the first 5 years after CABG. This difference
is not significant in patients aged over 75 years and is not affected by
the surgical technique.<br/>Copyright &#xa9; 2021 Published on behalf of
the European Society of Cardiology. All rights reserved.

<58>
Accession Number
2016866246
Title
The effect of preoperative chest physiotherapy on oxygenation and lung
function in cardiac surgery patients: a randomized controlled study.
Source
Annals of Saudi Medicine. 42(1) (pp 8-16), 2022. Date of Publication:
January 2022.
Author
Shahood H.; Pakai A.; Rudolf K.; Bory E.; Szilagyi N.; Sandor A.; Zsofia
V.
Institution
(Shahood, Pakai, Zsofia) Doctoral School of Health Sciences, University of
Pecs Medical School, Pecs, Hungary
(Rudolf, Bory, Szilagyi, Sandor, Zsofia) Heart Institute Medical School,
University of Pecs Medical School, Pecs, Hungary
Publisher
King Faisal Specialist Hospital and Research Centre
Abstract
BACKGROUND: Postoperative pulmonary complications in patients who undergo
open heart surgery are serious life-threatening conditions. Few studies
have investigated the potentially beneficial effects of preoperative
physiotherapy in patients undergoing cardiac surgery. <br/>OBJECTIVE(S):
Assess the effects of preoperative chest physiotherapy on oxygenation and
lung function in patients undergoing open heart surgery. DESIGN:
Randomized, controlled. SETTING: University hospital. <br/>PATIENTS AND
METHODS: Patients with planned open heart surgery were randomly allocated
into an intervention group of patients who underwent a preoperative home
chest physiotherapy program for one week in addition to the traditional
postoperative program and a control group who underwent only the
traditional postoperative program. Lung function was assessed daily from
the day before surgery until the seventh postoperative day. MAIN OUTCOME
MEASURES: Differences in measures of respiratory function and oxygen
saturation. Length of postoperative hospital stay was a secondary outcome.
SAMPLE SIZE: 100 patients (46 in intervention group, 54 in control group).
<br/>RESULT(S): Postoperative improvements in lung function and oxygen
saturation in the intervention group were statistically significant
compared with the control group. The intervention group also had a
statistically significant shorter hospital stay (P<.01).
<br/>CONCLUSION(S): Preoperative chest physiotherapy is effective in
improving respiratory function following open heart surgery. LIMITATIONS:
Relatively small number of patients.<br/>Copyright &#xa9; 2022, Annals of
Saudi Medicine, Saudi Arabia.

<59>
Accession Number
2007879923
Title
Ten-year outcomes after drug-eluting stents or bypass surgery for left
main coronary disease in patients with and without diabetes mellitus: The
precombat extended follow-up study.
Source
Journal of the American Heart Association. 10(14) (no pagination), 2021.
Article Number: e019834. Date of Publication: 2021.
Author
Jeong Y.J.; Ahn J.-M.; Hyun J.; Lee J.; Kim J.H.; Yang Y.; Choe K.; Park
H.; Kang D.-Y.; Lee P.H.; Kang S.-J.; Lee S.-W.; Kim Y.-H.; Lee C.W.; Park
S.-W.; Park S.-J.; Park D.-W.
Institution
(Jeong, Ahn, Hyun, Lee, Kim, Yang, Choe, Park, Kang, Lee, Kang, Lee, Kim,
Lee, Park, Park, Park) Department of Cardiology, Asan Medical Center,
University of Ulsan College of Medicine, Seoul, South Korea
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Several trials reported differential outcomes after
percutaneous coronary intervention with drug-eluting stents (DES) and
coronary-artery bypass grafting (CABG) for multivessel coronary disease
according to the presence of diabetes mellitus (DM). However, it is not
well recognized how DM status affects very-long-term (10-year) outcomes
after DES and CABG for left main coronary artery disease. METHODS AND
RESULTS: In the PRECOMBAT (Premier of Randomized Comparison of Bypass
Surgery versus Angioplasty using Sirolimus-Eluting Stent in Patients with
Left Main Coronary Artery Disease) trial, patients with LMCA were randomly
assigned to undergo PCI with sirolimus-eluting stents (n=300) or CABG
(n=300). The primary outcome was the incidence of major adverse cardiac or
cerebrovascular events (MACCE; a composite of death from any cause,
myocardial infarction, stroke, or ischemia-driven target-vessel
revascularization). Outcomes were examined in patients with (n=192) and
without (n=408) medically treated diabetes. The follow-up was extended to
at least 10 years for all patients (median, 11.3 years). The 10-year rates
of MACCE were not significantly different between DES and CABG in patients
with DM (36.3% versus 26.7%, respectively; hazard ratio [HR], 1.35; 95%
CI, 0.83-2.19; P=0.23) and without DM (25.3% versus 22.9%, respectively;
HR, 1.15; 95% CI, 0.79-1.67; P=0.48) (P-for-interaction=0.48). There were
no significant between-group differences in composite of death, MI, or
stroke, and all-cause mortality, regardless of DM status. TVR rates were
consistently higher after DES than CABG. <br/>CONCLUSION(S): In this
10-year extended follow-up of PRECOMBAT, we found no significant
difference between DES and CABG with respect to the incidences of MACCE,
serious composite outcome, and all-cause mortality in patients with and
without DM with LMCA disease. However, owing to the limited number of
patients and no adjustment for multiple testing, overall findings should
be considered hypothesis-generating, highlighting the need for further
research. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique
identifier: NCT03871127 and NCT00422968.<br/>Copyright &#xa9; 2021 The
Authors.

<60>
Accession Number
2014659278
Title
Defining the relative utility of lumbar spine surgery: A systematic
literature review of common surgical procedures and their impact on health
states.
Source
Journal of Clinical Neuroscience. 93 (pp 160-167), 2021. Date of
Publication: November 2021.
Author
Gates M.; Tang A.R.; Godil S.S.; Devin C.J.; McGirt M.J.; Zuckerman S.L.
Institution
(Gates) Department of Neurological Surgery, Wellstar Health System,
Austell, GA, United States
(Tang) Vanderbilt University School of Medicine, Nashville, TN, United
States
(Godil, Zuckerman) Department of Neurosurgery, Vanderbilt University
Medical Center, Nashville, TN, United States
(Devin) Steamboat Orthopaedic and Spine Institute, Steamboat Springs, CO,
United States
(McGirt) Carolina Neurosurgery and Spine Associates, Charlotte, NC, United
States
Publisher
Churchill Livingstone
Abstract
Degenerative lumbar spondylosis is a common indication for patients
undergoing spine surgery. As healthcare costs rise, measuring quality of
life (QOL) gains after surgical procedures is critical in assessing value.
We set out to: 1) compare baseline and postoperative EuroQol-5D (EQ-5D)
scores for lumbar spine surgery and common surgical procedures to obtain
post-operative quality-adjusted life year (QALY) gain, and 2) establish
the relative utility of lumbar spine surgery as compared to other commonly
performed surgical procedures. A systematic literature review was
conducted to identify all studies reporting preoperative/baseline and
postoperative EQ-5D scores for common surgical procedures. For each study,
the number of patients included and baseline/preoperative and follow-up
mean EQ-5D scores were recorded, and mean QALY gained for each
intervention was calculated. A total of 67 studies comprising 95,014
patients were identified. Patients with lumbar spondylosis had the worst
reported QOL at baseline compared to other surgical cohorts. The greatest
QALY gain was seen in patients undergoing hip arthroplasty (0.38), knee
arthroplasty (0.35) and lumbar spine surgery (0.32), nearly 2.5-fold
greater QALY gained than for all other procedures. The low preoperative
QOL, coupled with the improvements offered with surgery, highlight the
utility and value of lumbar spine surgery compared to other common
surgical procedures.<br/>Copyright &#xa9; 2021 Elsevier Ltd

<61>
Accession Number
2015369354
Title
Early high-energy feeding in infants following cardiac surgery: A
randomized controlled trial.
Source
Translational Pediatrics. 10(10) (pp 2439-2448), 2021. Date of
Publication: October 2021.
Author
Chen X.; Zhang M.; Song Y.; Luo Y.; Wang L.; Xu Z.; Bao N.
Institution
(Chen, Zhang, Song, Luo, Wang, Xu) Cardiac Intensive Care Unit, Department
of Thoracic and Cardiovascular Surgery, Shanghai Children's Medical
Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang
Road, Shanghai 200127, China
(Bao) Department of Pediatric Surgery, Shanghai Children's Medical Center,
Shanghai JiaoTong University School of Medicine, 1678 Dongfang Road,
Shanghai 200127, China
Publisher
AME Publishing Company
Abstract
Background: Effective nutrition programs are beneficial for nutritional
recovery in infants. Few studies have focused on the effect of early
high-energy feeding after open heart surgery. This study sought to assess
the effects of early high-energy feeding in infants after congenital heart
surgery. <br/>Method(s): Patients at a tertiary pediatric cardiology
center who underwent open heart surgery between July 2016 and July 2018
were recruited and randomly allocated to 1 of the following 2 groups: (I)
the intervention group (postoperative early high-energy feeding; n=124);
and (II) the control group (no intervention; n=120). The primary endpoints
of average energy delivery and growth Z-scores [i.e., weight-for-height
Z-score (WHZ), weight-for-age Z-score (WAZ), and height-for-age Z-score
(HAZ)] were recorded preoperatively, during the intensive care unit (ICU)
stay, at discharge, and at 1 and 3 months postoperatively. The secondary
endpoints of malnutrition recovery, ventilator support time, infection
rate, and cardiac ICU (CICU) stay were also recorded. <br/>Result(s): A
total of 244 infants were included in the study. There were no significant
differences in the baseline features between the 2 groups. The
intervention group received higher calories on average than the control
group (44.5 vs. 34.7; P<0.001). At discharge from the ICU, the WHZ (-2.29
vs. -2.76; P<0.001) and WAZ (-3.08 vs. -3.43; P=0.005) of patients in the
intervention group were higher than those of patients in the control
group. Ventilator support time (P=0.004), CICU stay (P=0.045), and
infection rate (P=0.001) were significantly lower in the intervention
group than the control group. At 3 months post-surgery, the intervention
group exhibited a higher malnutrition recovery rate than the control group
(19.4% vs. 6.5%; P=0.002). <br/>Conclusion(s): The administration of early
high-energy feeding to infants after congenital heart surgery is
associated with improved growth, reduced CICU stay, decreased ventilator
support time, and reduced postoperative infection rates.<br/>Copyright
&#xa9; Translational Pediatrics. All rights reserved.

<62>
Accession Number
2014031125
Title
The effect of ultrasound-guided erector spinae plane block versus thoracic
epidural block on postoperative analgesia after nuss surgery in paediatric
patients: Study protocol of a randomized non-inferiority design trial.
Source
Journal of Pain Research. 14 (pp 3047-3055), 2021. Date of Publication:
2021.
Author
Ren Y.; Zheng T.; Hua L.; Zhang F.; Ma Y.; Zhang J.
Institution
(Ren, Zheng, Hua, Zhang, Ma, Zhang) Department of Anesthesiology, Beijing
Children's Hospital, Capital Medical University, National Center for
Children's Health, Beijing, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: The Nuss procedure is a recognized treatment for adolescent
pectus excavatum that results in severe postoperative pain. Erector spinae
plane block (ESPB) is a novel technique that provides postoperative
analgesia and reduces opioid consumption. Our aim is to explore whether
ESPB produces analgesia similar to thoracic epidural anaesthesia (TEA) in
paediatric patients undergoing Nuss procedure. Study Design and Methods:
This randomized, controlled, non-inferiority trial will enrol 300
paediatric patients undergoing Nuss surgery. Participants will be randomly
assigned 1:1 to receive ESPB or TEA preoperatively. The primary, joint
endpoint is the average numeric rating scale (NRS) score and cumulative
sufentanil consumption. The secondary endpoints are pain scores and
sufentanil consumption at different time points after surgery,
analgesia-related side effects, and other postoperative complications.
Data will be analysed by the intention-to-treat principle.
<br/>Discussion(s): This study investigates the effect of ESPB on
postoperative opioid consumption and pain scores and intend to provide a
new strategy of analgesia management for Nuss procedure in paediatric
patients.<br/>Copyright &#xa9; 2021 Ren et al.

<63>
Accession Number
2014142068
Title
Decellularized versus cryopreserved pulmonary allografts for right
ventricular outflow tract reconstruction during the Ross procedure: a
meta-analysis of short- and long-term outcomes.
Source
Egyptian Heart Journal. 73(1) (no pagination), 2021. Article Number: 100.
Date of Publication: December 2021.
Author
Ahmed A.; Ahmed S.; Varghese K.S.; Mathew D.M.; Pandey R.; Rogando D.O.;
Salazar S.A.; Fusco P.J.; Levy K.H.
Institution
(Ahmed, Varghese, Mathew, Rogando, Salazar, Fusco, Levy) CUNY School of
Medicine, 1589 Amsterdam Avenue, New York, NY 10031, United States
(Ahmed) New Dorp High School, New York, NY, United States
(Pandey) CUNY City College of New York, New York, NY, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The ideal conduit for repair of the right ventricular outflow
tract (RVOT) during the Ross procedure remains unclear and has yet to be
fully elucidated. We perform a pairwise meta-analysis to compare the
short-term and long-term outcomes of decellularized versus cryopreserved
pulmonary allografts for RVOT reconstruction during the Ross procedure.
Main body: After a comprehensive literature search, studies comparing
decellularized and cryopreserved allografts for patients undergoing RVOT
reconstruction during the Ross procedure were pooled to perform a pairwise
meta-analysis using the random-effects model. Primary outcomes were early
mortality and follow-up allograft dysfunction. Secondary outcomes were
reintervention rates and follow-up endocarditis. A total of 4 studies
including 1687 patients undergoing RVOT reconstruction during the Ross
procedure were included. A total of 812 patients received a decellularized
pulmonary allograft, while 875 received a cryopreserved pulmonary
allograft. Compared to cryopreserved allografts, the decellularized group
showed similar rates of early mortality (odds ratio, 0.55, 95% confidence
interval, 0.21-1.41, P = 0.22). At a mean follow-up period of 5.89 years,
no significant difference was observed between the two groups for
follow-up allograft dysfunction (hazard ratio, 0.65, 95% confidence
interval, 0.20-2.14, P = 0.48). Similarly, no difference was seen in
reintervention rates (hazard ratio, 0.54, 95% confidence interval,
0.09-3.12, P = 0.49) nor endocarditis (hazard ratio, 0.30, 95% confidence
interval, 0.07-1.35, P = 0.12) at a mean follow-up of 4.85 and 5.75 years,
respectively. <br/>Conclusion(s): Decellularized and cryopreserved
pulmonary allografts are associated with similar postoperative outcomes
for RVOT reconstruction during the Ross procedure. Larger
propensity-matched and randomized control trials are necessary to
elucidate the efficacy of decellularized allografts compared to
cryopreserved allografts in the setting of the Ross.<br/>Copyright &#xa9;
2021, The Author(s).

<64>
Accession Number
2014127445
Title
Mortality probabilities after revascularization and medical therapy in CAD
patients under 60 years old: a meta-analysis study.
Source
Egyptian Heart Journal. 73(1) (no pagination), 2021. Article Number: 99.
Date of Publication: December 2021.
Author
Afrouzi M.; Azar F.E.F.; Aboutorabi A.; Hajahmadi M.; Ebadi S.J.
Institution
(Afrouzi, Aboutorabi) Department of Health Economics, School of Health
Management and Information Sciences, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Azar) Health Promotion Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Hajahmadi) Cardiovascular Department, Rasoul Akram General Hospital, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Ebadi) Qazvin Army Hospital 553, Qazvin, Iran, Islamic Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
To estimate death probabilities after coronary artery bypass graft (CABG),
percutaneous coronary intervention (PCI), and medical therapy (MT) in
patients under 60 years old. We conducted a search systematic on PubMed,
Embase, Cochrane Library, and Web of Science up to January 2021. The study
included three parts. In the probabilities part (A), Comprehensive
Meta-Analysis, and in the comparison parts (B and C), Review Manager was
used in conducting meta-analyses. Nine studies consisting of 16,410 people
with a mean age of 51.2 +/- 6 years were included in the meta-analysis.
Over a mean follow-up of 3.7 +/- 2 years, overall mortality after CABG,
PCI and MT was 3.6% (95% CI 0.021-0.061), 4.3% (95% CI 0.023-0.080) and
9.7% (95% CI 0.036-0.235), respectively. The length of follow-up periods
was almost the same and did not differ much (p = 0.19). In Part B (without
adjustment of baseline characteristics), 495 (4.0%) of 12,198 patients
assigned to CABG died compared with 748 (4.5%) of 16,458 patients assigned
to PCI (risk ratio [RR]: 0.77, 95% CI 0.50-1.20; p = 0.25). Seventy-four
(3.5%) of 2120 patients assigned to CABG and 68 (4.2%) of 1621 patients
assigned to PCI died compared with 103 (9.5%) of 1093 patients assigned to
MT in equal follow-up periods (CABG-MT: RR 0.34; 95% CI 0.23-0.51; p <
0.002) (PCI-MT: RR 0.40; 95% CI 0.30-0.53; p = 0.02). In Part C, overall
mortality after PCI in PACD patients with STEMI was higher in elderly
versus young (RR 2.64; 95% CI 2.11-3.30) and is lower in men versus women
(RR 0.61; 95% CI 0.44-0.83). Mortality probabilities obtained are one of
the most important factors of effectiveness in the economic evaluation
studies; these rates can be used to determine the cost-effectiveness of
procedures in CAD patients aged < 60 years.<br/>Copyright &#xa9; 2021, The
Author(s).

<65>
Accession Number
2013135232
Title
Effectiveness of cervicothoracic and thoracic manual physical therapy in
managing upper quarter disorders-a systematic review.
Source
Journal of Manual and Manipulative Therapy. 30(1) (pp 46-55), 2022. Date
of Publication: 2022.
Author
Schenk R.; Donaldson M.; Parent-Nichols J.; Wilhelm M.; Wright A.; Cleland
J.A.
Institution
(Schenk, Donaldson, Parent-Nichols, Wilhelm, Wright, Cleland) Department
of Public Health and Community Medicine, Program in Physical Therapy,
Tufts University School of Medicine, Boston, MA, United States
Publisher
Taylor and Francis Ltd.
Abstract
Study Design: Systematic review. <br/>Background(s): Physical therapists
often use cervicothoracic and thoracic manual techniques to treat
musculoskeletal disorders of the upper quarter,however, the overall
effectiveness of this approach remains to be elucidated.
<br/>Objective(s): This systematic review explored studies that examined
the short- and long-term effectiveness of manual physical therapy directed
at the cervicothoracic and thoracic region in the management of upper
quarter musculoskeletal conditions. <br/>Method(s): The electronic
databases MEDLINE, AMED, CINAHL, and Embase were searched from their
inception through 30 October 2020. Eligible clinical trials included those
where human subjects treated with cervicothoracic and/or thoracic manual
procedures were compared with a control group or other interventions. The
methodological quality of individual studies was assessed using the PEDro
scale. <br/>Result(s): The initial search returned 950 individual
articles. After the screening of titles and abstracts, full texts were
reviewed by two authors, with 14 articles determined to be eligible for
inclusion. PEDro scores ranged from 66 to 10 (out of a maximum score of
10). In the immediate to 52-week follow-up period, studies provided
limited evidence that cervicothoracic and thoracic manual physical therapy
may reduce pain and improve function when compared to control/sham or
other treatments. <br/>Conclusion(s): Evidence provides some support for
the short-termeffectiveness of cervicothoracic and thoracic manual
physical therapy in reducing pain and improving function in people
experiencing upper quarter musculoskeletal disorders. Evidence is lacking
for long-term effectiveness as only two studies explored outcomes beyond
26 weeks and this was for patient-perceived improvement. Prospero ID:
CRD42020219456.<br/>Copyright &#xa9; 2021 Informa UK Limited, trading as
Taylor & Francis Group.

<66>
Accession Number
2014101907
Title
Should asymptomatic cervical stenosis be treated in the setting of
progressive thoracic myelopathy? A systematic review of the literature.
Source
European Spine Journal. 31(2) (pp 275-287), 2022. Date of Publication:
February 2022.
Author
Dowlati E.; Mualem W.; Black J.; Nunez J.; Girish A.; Fayed I.; McGrail
K.M.; Voyadzis J.-M.
Institution
(Dowlati, Fayed, McGrail, Voyadzis) Department of Neurosurgery, MedStar
Georgetown University Hospital, 3800 Reservoir Rd. NW, PHC 7, Washington,
DC 20007, United States
(Mualem, Black, Nunez, Girish) Georgetown University School of Medicine,
3900 Reservoir Rd. NW, Washington, DC, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Unlike tandem stenosis of the cervical and lumbar spine, tandem
cervical and thoracic stenosis (TCTS) of the spine is less common, and the
approach and order of intervention are controversial. We aim to review the
literature to evaluate the incidence and interventions for patients with
cervical and thoracic stenosis. We provide illustrative cases to
demonstrate that thoracic myelopathy in the setting of asymptomatic
cervical stenosis can be treated safely. <br/>Method(s): A systematic
review of the literature through electronic databases of PubMed, EMBASE,
Web of Science, and Cochrane Library was performed to present the current
literature that evaluates TCTS as it relates to incidence and surgical
interventions. We also present two cases of patients undergoing operative
intervention for thoracic myelopathy in the setting of concurrent cervical
stenosis. <br/>Result(s): A total of 26 English original studies and case
reports were identified. Nine studies evaluated the incidence of TCTS. 20
studies with a total of 168 patients with TCTS presented information on
surgical intervention options. There is an overall aggregate incidence of
11.6% (530/4751) based on incidence studies. 165 patients underwent
thoracic intervention. Of these patients, 63 patients underwent cervical
intervention first, 29 underwent thoracic intervention first, and 73
underwent simultaneous, single-stage intervention. <br/>Conclusion(s): In
patients presenting with myelopathy, both cervical and thoracic spine
should be evaluated for TCTS. Order of operative intervention is tailored
to clinical and radiographic information. In cases of thoracic myelopathy
with asymptomatic cervical stenosis, thoracic intervention can be pursued
with precautions to prevent further cervical cord injury.<br/>Copyright
&#xa9; 2021, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<67>
Accession Number
637334283
Title
Structural registration and discussion of patient outcome data for
improving quality of cardiac care: Approach of the Netherlands heart
registration.
Source
Portuguese Journal of Public Health. Conference: European Health
Management Association Annual Conference, EHMA 2021. Virtual. 39(SUPPL 1)
(pp 46), 2021. Date of Publication: 2021.
Author
Medendorp N.; Van Veghel D.
Institution
(Medendorp, Van Veghel) Netherlands Heart Registration, Netherlands
(Van Veghel) Department of Cardiothoracic Surgery, Catharina Hospital,
Netherlands
Publisher
S. Karger AG
Abstract
Context: Patient outcomes are increasingly important in the interests of
quality management in healthcare, for example by the introduction of
Value-Based Healthcare principles. Several indicators to assess the
quality of care for heart patients have been defined and/or published by
ICHOM and several national initiatives. Registries provide online
dashboards and yearly reports at different levels of transparency. Still,
one can question how to optimally use this information to improve cardiac
care and learn from each other. In this presentation, we will discuss how
patient outcomes are used to identify potentials for improvement of the
quality of care in nationwide transparent committees which are part of the
Netherlands Heart Registration (NHR). <br/>Method(s): The NHR is a
registry of all cardiac interventions performed in all Dutch hospitals.
Currently, a total of seven registries are facilitated by the NHR, i.e.
Ablation, Atrial fibrillation, Cardiothoracic surgery, Heart failure,
Pacemaker/ICD, Percutaneous coronary interventions (PCI) and Transcatheter
heart valve interventions (THI). For each registry, a so-called
registration committee is instituted that consists of cardiologists or
thorax surgeons from participating hospitals. The primary objective of
these committees is to monitor outcomes per hospital, discuss differences
in processes of healthcare delivery, initiate additional research, define
hypotheses and share good practices in case of clinically relevant or
significant variation of outcomes. <br/>Result(s): Yearly, three to four
meetings are organised for each registration committee. During committee
meetings, outcome data from all participating hospitals are discussed to
identify potentials for improvement. For this purpose, committee members
are regularly invited to present processes of care in their hospital, for
example when being identified as an outlier regarding a certain patient
outcome. Transparency of outcomes is essential here as this is required to
identify best practices. By creating a non-competitive and confidential
setting, cardiologists and thorax surgeons are encouraged to share
delicate information with colleagues. For example, in meetings of the THI
registration committee, high mortality scores after transcatheter aortic
valve implantation (TAVI) have been subject to discussion. For this
purpose, one of the members has presented the process of care in his/her
hospital to discuss differences between hospitals, seek explanations and
identify potentials for improvement together. Also, volumes and order of a
combined procedure of PCI and TAVI have been mapped to identify relevant
follow-up questions on these types of procedures and patients. Moreover,
additional research on the cardiogenic shock is currently performed on the
initiative of the PCI registration committee resulting from high numbers
of complications in these patients, while the committee of the
Cardiothoracic surgery has initiated a project in which additional data is
collected to gain more insight into re-interventions after an aortic valve
replacement. <br/>Discussion(s): Structural registration and monitoring of
patient data within the registries facilitated by the NHR allows insights
into outcomes of heart patients. This provides hospitals with the
opportunity to improve the quality of cardiac care. Additionally,
cardiologists and thorax surgeons accomplish a form of supervision by
themselves on their cardiac care in this way. To further optimise the use
of patient outcome data, the NHR (together with several partners) is
currently building an infrastructure for research based on the existing
registries, such as registry-based randomised controlled trials (RBRCT).
This infrastructure will enable research on real-world data from routine
clinical care and provides opportunities to evaluate and further improve
cardiovascular care.

<68>
Accession Number
637317707
Title
Efficacy of the hypothermic compression bandage in the surgical wound of
cardiac devices.
Source
European Journal of Cardiovascular Nursing. Conference: EuroHeartCare -
Annual Meeting of the Association of Cardiovascular Nursing and Allied
Professions, ACNAP 2021. Online. 20(SUPPL 1) (pp i156), 2021. Date of
Publication: July 2021.
Author
Cano A.; Diago C.; Domingo R.; Niebla M.; Marginet J.; Tolosana J.M.;
Perez S.
Institution
(Cano, Diago, Domingo, Niebla, Marginet, Tolosana, Perez) Hospital Clinic
of Barcelona, Barcelona, Spain
Publisher
SAGE Publications Inc.
Abstract
Introduction: Pocket hematoma is one of the most frequent complications
(10%) of the cardiac devices implant. To reduce the risk of bleeding, once
the wound is sutured and isolated with a sterile dressing, the nurse
performs a compression bandage over the area of the generator pocket. The
choice of the type of bandage on the wound of the generator pocket is the
responsibility of the nurse and there are several methods that vary
according to the center. The vasocontrictive property of ice is known but
its applicability is not demonstrated in these types of wounds.
<br/>Objective(s): Evaluate the efficacy of the hypothermic compression
bandage versus conventional compression bandage, for the prevention of
surgical wound post cardiac device implant hematoma in chronic oral
anticoagulant and / or platelet antiaggregant treatment. Methodology: This
is a randomized prospective study. The protocol was accepted by ethical
committee. The team of nurses from the arrhythmia laboratory recruited 310
patients (sample size with statistical calculation) who were going to
undergo an implant or replacement of a pacemaker or internal
defibrillator. Those patients who were under treatment with oral
anticoagulant and/or platelet antiaggregants were selected. Through a list
of random numbers two therapeutic branches were created: the intervention
group was applied a compressive bandage with ice and the usual group
lacked the conventional compressive bandage. Both bandages placed just at
the end of wound closure and for 6 hours post-implant. Skin status was
stratified between healthy, ecchymosis, mild hematoma and severe hematoma.
The assessment of the state of the skin was performed by a blinded nurse,
in the control of the wound at 7 days post intervention. The primary
endpoint was the appearance of hematoma. The secundary endpoint was the
appearance of severe hematoma, defined as bleeding with vital commitment
that required drainage or rehospitalization. <br/>Result(s): 310 patients
participated in the study. 156 patients were randomized to the
intervention group and 153 to usual care. The mean age of the sample was
73.77 +/- 10.68 years and 74.8% were men. There were no significant
differences between the intervention and usual care groups on any baseline
demographic or clinical characteristics. A total of 13 patients presented
hematoma and 36 patients presented ecchymosis. In the intervention group,
5.88% (n = 18) of ecchymosis and 1.3% (n = 4) of mild hematoma were
observed. In the usual care group, 5.88% (n = 18) of ecchymosis and 2.9%
(n = 9) of mild hematoma were observed. No patient in neither groups had
severe hematoma. No significant differences were observed between the two
types of bandage in any of the 3 levels of hematomas. There were also no
significant differences between hematoma and the type of platelet
antiaggregants or oral anticoagulant. <br/>Conclusion(s): After this study
it is observed that there is no difference between applying a compression
bandage with or without cold.

<69>
Accession Number
637317539
Title
Education in daily life activities as fundamental care in heart surgery
rehabilitation: A multifactorial approach to the patient and caregiver.
Source
European Journal of Cardiovascular Nursing. Conference: EuroHeartCare -
Annual Meeting of the Association of Cardiovascular Nursing and Allied
Professions, ACNAP 2021. Online. 20(SUPPL 1) (pp i116-i117), 2021. Date of
Publication: July 2021.
Author
Acqualagna R.; Mazzariol E.; Bernardi P.; Feltrin C.
Institution
(Acqualagna, Mazzariol, Bernardi, Feltrin) ULSS 2 Marca Trevigiana,
Treviso, Italy
Publisher
SAGE Publications Inc.
Abstract
INTRODUCTION: Education represents Fundamental Nursing Care that responds
to a psycho-social need of the patient. Acute Coronary Syndrome and
cardiac surgery have a strong impact from a psycho-emotional point of view
and in the approach to daily activities after discharge: nursing care in
this phase aims to obtain not only the full physical recovery of the
person but above all to restore awareness of what will be the
repercussions in everyday life. Therefore, it is necessary to develop a
path that actively involves the client and the caregiver and that aims to
recognize and analyse his potential and finally satisfy his educational
needs to guarantee a person's return home that is consistent with his
expectations. PURPOSE: identify the best nursing strategies in managing
the educational need of the cardiac surgery patient in the rehabilitation
phase involving the caregiver, and describe what aspects to be considered
as priorities in personalizing care. <br/>METHOD(S): a narrative
literature review. <br/>RESULT(S): 23 articles were included in the
analysis. The literature has shown that the educational need in cardiac
surgery patients in the rehabilitation phase can be detected through
semi-structured interviews or self-report questionnaires and should be
continued even after discharge. Once shared objectives were set with the
client, the care process proved to be more effective with the active
involvement of the caregiver, who also has educational and information
needs that ensure a return to daily life activities and early recognition
of any relapses. Furthermore, both for the client and for the caregiver,
the literature emphasizes how the consideration of socio-economic,
cultural and gender aspects are important in structuring the educational
plan: if not considered, feelings of discomfort and frustration can emerge
in the people involved and lead to further emotional problems that can
compromise the complete recovery of the person. At the base of the path,
however, relational competence is essential for the achievement of health
objectives, in a continuum of care between hospital and territory.
<br/>CONCLUSION(S): The educational path of the person after cardiac
surgery represents a central point of fundamental nursing care, even after
discharge. Given the need to monitor the achievement of the objectives
set, the use of nursing taxonomies could prove useful for this purpose in
guaranteeing a timely verification of the educational path both before and
after discharge: through the declination of objectives and diversified
interventions for patient and caregiver, nurses can share the progress
made in the care team and facilitate the transfer of care information
between professionals in different settings. (Figure Presented).

<70>
Accession Number
637316902
Title
Impact of COVID-19 pandemic on admissions and management of acute coronary
syndrome: a single tertiary cardiac centre experience in the United
Kingdom.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: ESC Acute
CardioVascular Care 2021. Online. 10(SUPPL 1) (pp i92-i93), 2021. Date of
Publication: April 2021.
Author
Tomson J.; Khanra D.; Ntoskas T.; Wrigley B.
Institution
(Tomson, Khanra, Ntoskas, Wrigley) New Cross Hospital, Wolverhampton,
United Kingdom
Publisher
SAGE Publications Inc.
Abstract
Background/Introduction: Global reports are suggestive of decline in
number of patients attending hospital with acute coronary syndromes (ACS)
and a reduction in the number of cardiac procedures since the onset of
COVID-19 pandemic. <br/>Purpose(s): The aim of the study was to compare
the trend of presentations and management among ACS patients in a single
tertiary cardiac centre in the West midlands of United Kingdom (UK) during
the early lock down period of COVID-19 pandemic (Group 2020) in comparison
to the same period of 2019 (Group 2019). <br/>Method(s): In this
descriptive study patients' records were extracted retrospectively from
the electronic database who presented with ST segment elevation myocardial
infarction (STEMI), non- ST segment elevation myocardial infarction
(NSTEMI) and Unstable angina (UA), during the 30 day period from mid-March
to mid-April of 2020 (Group 2020), and the same period of 2019 (Group
2019). <br/>Result(s): In comparison to group 2019, total number of ACS
(153 vs 91) including STEMI (70 vs 59), NSTEMI (76 vs 31) and UA (7 vs 1)
were lower in group 2020 (Fig 1A). Inter-hospital transfer (IHT) dropped
from 2019 to 2020 (55 vs 17). In group 2020, percutaneous coronary
angioplasty (PCI) for STEMI was similar to group 2019 (83.05% vs 88.57%)
but PCI for NSTEMI were higher (80.65% vs 48.68%). No coronary artery
bypass graft (CABG) services were available during the studied period (Fig
1B). In terms of troponin I (Trop I) levels at the time of admission,
47.25% of all ACS presentations were over 1000ng/L in group 2020 compared
to 28.76% in group 2019 (Fig 1C). On assessment of left ventricular
ejection fraction (LVEF) at the time of admission, 24% of all ACS were
severely impaired (LVEF < 40%) compared to 13.79% in 2019 (Fig 1D). 37 (31
IHT) patients in group 2019 and 16 (11 IHT) patients in group 2020 had no
transthoracic echocardiogram data. There was an overall reduction in
number of days spent in hospital per ACS patient from 4.78 days in 2019 to
3.70 days in 2020 and a further reduction for STEMI patients from 5.16
days in 2019 to 3.83 days in 2020. 5 ACS patients died in 2020 in
comparison to 6 patients in 2019. <br/>Conclusion(s): The reduced number
of admissions is likely to be a result of nation-wide lock-down and public
fear. Proportion of ACS patients with high level of troponin I values and
severely impaired LVEF may be explained due to late presentation. It
remains necessary to address public fear and to ensure that ACS patients
are managed in accordance with ACS management guidelines even in the times
of COVID-19 pandemic.

<71>
Accession Number
637316854
Title
Steroids for the prevention of postpericardiotomy syndrome: a
meta-analysis.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: ESC Acute
CardioVascular Care 2021. Online. 10(SUPPL 1) (pp i219), 2021. Date of
Publication: April 2021.
Author
Saleiro C.; Teixeira R.; Lopes J.; Decampos D.; Sousa J.P.; Puga L.; Gomes
A.R.M.; Costa M.; Goncalves L.
Institution
(Saleiro, Teixeira, Lopes, Decampos, Sousa, Puga, Gomes, Costa, Goncalves)
University Hospitals of Coimbra, Coimbra, Portugal
Publisher
SAGE Publications Inc.
Abstract
Background: Postpericardiotomy syndrome (PPS) can occur in up to 40% of
patients after cardiac surgery. Corticosteroid therapy has long been used
for pericarditis and pericardial effusion due to its anti-inflammatory
proprieties. The benefit of corticosteroids for the prevention of post
pericardiotomy syndrome (PPS) in not consensual. <br/>Purpose(s): We
performed a systematic review and meta-analysis of trials assessing the
efficacy of corticosteroids to prevent PPS in patients submitted to
cardiac surgery. <br/>Method(s): We searched MEDLINE, Google Scholar and
the Cochrane Library databases using the key terms 'corticosteroids' and
'post pericardiotomy syndrome' without language or date restriction.
Articles were considered for inclusion in the analysis if they comprised a
population of patients submitted to cardiac surgery and a comparison
between patients treated with corticosteroids for the prevention of PPS
and those who were not. Three studies were identified, comprehending a
total of 1268 patients. The primary endpoint was the occurrence of PPS.
Pooled odds ratios (OR) and 95% confidence intervals (CI) were estimated
based on a random effects meta-analysis and were obtained from the pooled
adjusted OR of primary studies. <br/>Result(s): Studies included in the
analysis comprehend a controlled randomized trial in children (1 mg/kg
methylprednisolone pre-operative and four additional doses over 24h vs
placebo); a controlled randomized trial in adults (1 mg/kg dexamethasone
intra-operative vs placebo) and a retrospective study in adults (1 mg/kg
intra-operative methylprednisolone vs standard care). Of the total 1268
patients included, 641 received glucocorticoids for the prevention of PPS.
Main reason for surgery was correction of a congenital heart defect in 19%
of the patients; coronary artery bypass graft in 15% and valvular disease
in 66% of the cases. 217 patients had PPS during the follow-up time; 15%
in the corticosteroid prophylaxis group and 18% in the placebo/standard
care group. Overall, corticosteroid prophylaxis was not useful for the
prevention of PPS compared to placebo/standard care (pooled OR: 0.78, 95%
CI: 0.51-1.20, I2 = 46%) - Figure 1. <br/>Conclusion(s): According to our
data, steroid therapy has no role as a preventive therapy of
post-pericardiectomy syndrome.

<72>
Accession Number
637316756
Title
Safety and efficacy of direct oral anticoagulants (DOACs) vs warfarin in
patients with concurrent atrial fibrillation and bioprosthetic mitral or
aortic valve replacement-a meta analysis.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: ESC Acute
CardioVascular Care 2021. Online. 10(SUPPL 1) (pp i208-i209), 2021. Date
of Publication: April 2021.
Author
Abdul Razzack A.; Sattar Y.; Pothuru S.; Theja Reddy K.; Teja Challa K.;
Adeel Hassan S.; Kumar Ochani R.; Jamal Siddiqi T.; Mustafa A.; Chawla S.;
Rabii K.; Mehmood Lak H.
Institution
(Abdul Razzack) Dr NTR University of Health Sciences, Vijayawada, India
(Sattar) Icahn School of Medicine at Mount Sinai, New York, United States
(Pothuru) Ascension Via Christi Hospital, Department of Internal Medicine,
Kansas, United States
(Theja Reddy) UHS Southern California Medical Education Consortium,
Temecula, United States
(Teja Challa) Avalon University, School of Medicine, Willemstad, Curacao,
Netherlands
(Adeel Hassan) University of Louisville, School of Medicine, Louisville,
United States
(Kumar Ochani, Jamal Siddiqi) Dow University of Health Sciences, Karachi,
Pakistan
(Mustafa) Staten Island University Hospital, Department of Medicine, New
York City, United States
(Chawla, Mehmood Lak) Cleveland Clinic Foundation, Department of Medicine,
Cleveland, United States
(Rabii) Icahn School of Medicine at Mount Sinai, Department of Cardiology,
New York, United States
Publisher
SAGE Publications Inc.
Abstract
Background- Bioprosthetic valve (BPV) implantation is preferred over
mechanical valves for aortic and mitral valve replacement. BPV can have
concurrent atrial fibrillation (AF). Primary advantage of BPV is the
limited need of anticoagulation (AC) as compared to mechanical valves.
However, recommendations for use of AC in BPV are not clear.
<br/>Purpose(s): We studied direct oral anticoagulants (DOACs)
cardiovascular efficacy and safety in BPV as compared to Vitamin K
antagonist (VKA, or warfarin). Methods- Electronic databases (PubMed,
Embase, Scopus, Cochrane) were searched from inception to November 28th,
2020. Using a generic invariance weighted fixed effects model, Hazard
ratios (HRs) and their 95% confidence intervals (CIs) from individual
studies were converted to Log HRs and corresponding standard errors, which
were then pooled. The primary outcome of interest was stroke or systemic
embolisation (SSE), major bleeding and all-cause mortality. Results- A
total of four studies with 1386 participants (DOACs n = 723 ; VKA n = 656)
were included in analysis. Mean age was 63.7 and 62.4 years in the DOACs
and VKA group respectively. Average follow-up period was 1 year and 4
months. DOACs were more efficacious than VKAs in stroke or thromboembolism
prevention (HR 0.43, 95%CI 0.20-0.94; p = 0.03). There was no difference
in efficacy of DOACs as compared to VKAs in terms of major bleeding (HR
0.60; 95% CI 0.34-1.39; p = 0.09) and all-cause mortality (HR 0.99; 95%CI
0.57-1.7; p = 0.97) (Figure 1). We had no publication bias in our results
(Egger's regression p > 0.05). Conclusion- DOACs have similar mortality,
and major bleeding risks as that of VKA at a benefit of higher
stroke/thromboembolism prevention in patients with concurrent BPV and AF.

<73>
Accession Number
637316699
Title
Tocilizumab reduces cardiac injury after out-of-hospital cardiac arrest
primarily in patients without acute revascularization - Results from a
randomized trial, The IMICA trial.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: ESC Acute
CardioVascular Care 2021. Online. 10(SUPPL 1) (pp i203), 2021. Date of
Publication: April 2021.
Author
Meyer M.; Wiberg S.; Grand J.; Meyer A.S.P.; Obling L.; Kjaergaard J.;
Hassager C.
Institution
(Meyer, Wiberg, Grand, Meyer, Obling, Kjaergaard, Hassager) Rigshospitalet
- Copenhagen University Hospital, Department of Cardiology, Copenhagen,
Denmark
Publisher
SAGE Publications Inc.
Abstract
BACKGROUND: Patients remaining comatose after the initial resuscitation
from out-of-hospital cardiac arrest (OHCA) have a high risk of morbidity
and mortality as part of the ensuing post cardiac arrest syndrome (PCAS).
Systemic inflammation and myocardial dysfunction are constituents of PCAS.
The cytokine Interleukin-6 (IL-6) is associated with PCAS severity and
poor outcome. Also, the extend of cardiac injury is a prognostic marker.
We have recently shown that the IL-6 receptor antagonist tocilizumab
dampens systemic inflammation and cardiac injury after cardiac arrest.
PURPOSE: To investigate if the reduction in cardiac injury by tocilizumab
is differentiated in patients undergoing acute coronary revascularization
compared to those who do not. <br/>METHOD(S): Eighty comatose OHCA
patients were randomized 1:1 in a double-blinded placebo-controlled trial
to a single infusion of tocilizumab or placebo in addition to standard of
care including targeted temperature management. Trial registration:
Clinicaltrials.gov NCT03863015. Blood samples were sequentially drawn for
biomarker analysis. Endpoints were markers of cardiac injury and
inflammation: Troponin T (TnT), N-terminal pro B-type natriuretic peptide
(NT-proBNP), and C-reactive protein (CRP). Continuous variables were log2
transformed and analyzed using mixed models; values shown as geometric
mean with 95%-confidence limits [95%CL] after back-transformation.
<br/>RESULT(S): Thirty-nine patients were randomized to treatment with
tocilizumab and 41 to placebo. In the tocilizumab group 15 (39%) patients
underwent acute revascularization (all PCI), and this was 22 (54%) for
placebo. Patients not undergoing acute revascularization had a marked
reduction by treatment with tocilizumab in TnT at 6h, as well as NT-proBNP
at 48h (Figure). For patients treated with acute revascularization there
was no significant group difference in TnT at 6h, whereas there was a
marked reduction in NT-proBNP at 48h. There was a substantial reduction in
CRP by treatment with tocilizumab irrespective of whether acute
revascularization was performed. <br/>CONCLUSION(S): Treatment with
tocilizumab resulted in a significant reduction in myocardial injury as
measured by TnT primarily in patients not undergoing acute
revascularization, whereas the reduction in NT-proBNP, as well as CRP, was
seen irrespective of whether acute revascularization was performed.

<74>
Accession Number
637316582
Title
The burden of perioperative hypertension/hypotension: a systematic review.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: ESC Acute
CardioVascular Care 2021. Online. 10(SUPPL 1) (pp i187), 2021. Date of
Publication: April 2021.
Author
Lizano-Diez I.; Cerezales M.; Poteet S.
Institution
(Lizano-Diez) Ferrer, Barcelona, Spain
(Cerezales, Poteet) Axentiva Solutions, Tacoronte, Spain
Publisher
SAGE Publications Inc.
Abstract
Background: Hypertension/hypotension in the perioperative setting may
result in a high economic burden for healthcare systems and patients
affected in terms of clinical outcomes. Although previous systematic
reviews have shown IV antihypertensive treatments to be highly effective,
there is currently a clear gap in the literature regarding a review on the
implications of acute hypotensive/hypertensive episodes. <br/>Purpose(s):
Our goal is to review the outcomes of acute hypertensive/hypotensive
episodes from articles published in the past 10 years that assessed the
short- and long-term impact of acute hypertensive/hypotensive episodes in
the perioperative setting. <br/>Method(s): We conducted a systematic
peer-review based upon PROSPERO and Cochrane Handbook protocols. The
following study characteristics were collected: study type, author, year,
population, sample size, definition of acute hypertension, hypotension or
other measures, and outcomes (probabilities, odds ratio, hazard ratio, and
relative risk) and the p-values. Quality of the studies was graded with
the Scottish Intercollegiate Guidelines Network. <br/>Result(s): A total
of 4,197 articles were identified and 47 articles satisfied criteria for
data extraction. We present evidence on outcomes associated with acute
hypertension/hypotension distinguishing cardiac from non-cardiac
surgeries. For the perioperative setting, the number of articles varies by
outcome: 17 mortality, 11 renal outcomes, 3 stroke, 6 delirium, and 21
others. Hypotension was reported to be associated with mortality (OR
1.02-20.826) as well as changes from blood pressure patient's baseline (OR
1.02-1.36); hypotension had also a role in the development of acute kidney
injury (OR 1.03-14.11). Postsurgical delirium was found in relation with
lability (OR 1.018-1.038) and intraand postsurgical hypotension (OR
1.05-1.22), and hypertension (OR 1.44-2.34). However, no statistically
significant result was found for the relation between hypotension and
stroke, and no study investigating hypertension influence over stroke was
found. There was a wide range of additional diverse outcomes related to
hypo-, hypertension and blood pressure liability, for example myocardial
damage related to a 50% decrease in systolic blood pressure (SBP) (OR
4.4), increased odds 9.6 for new onset of atrial fibrillation associated
with intraoperative SBP below 80 mmHg for 15 min or more; myocardial
injury, length of stay in hospital, hematoma, or anastomotic leakage were
also found to be related to hypertension. <br/>Conclusion(s): The
perioperative management of blood pressure influences short- and long-term
effects of surgical procedures. These findings support the burden of blood
pressure fluctuations in this setting. It sounds pertinent to further
investigate the role of newer antihypertensive agents with favourable
pharmacodynamic and pharmacokinetic properties to guarantee the
fine-tuning of blood pressure and an individualised therapy for patients.

<75>
Accession Number
2016994049
Title
Effects of positive end-expiratory pressure on pulmonary atelectasis after
paediatric laparoscopic surgery as assessed by ultrasound: A randomised
controlled study.
Source
Anaesthesia Critical Care and Pain Medicine. 41(2) (no pagination), 2022.
Article Number: 101034. Date of Publication: April 2022.
Author
Lee H.-M.; Min J.Y.; Lee J.-R.; Lee M.H.; Byon H.-J.
Institution
(Lee) Department of Anaesthesiology and Pain Medicine, Yonsei University
College of Medicine, Yongin Severance Hospital, 363,
Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, Gyeonggi-do 169995, South
Korea
(Lee, Lee, Lee, Byon) Anaesthesia and Pain Research Institute, Yonsei
University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722,
South Korea
(Min) Department of Anaesthesiology and Pain Medicine, The Catholic
University College of Medicine, Eunpyeong St. Mary's Hospital, 1021,
Tongil-ro, Eunpyeong-gu, Seoul 03312, South Korea
(Lee, Lee, Byon) Department of Anaesthesiology and Pain Medicine, Yonsei
University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722,
South Korea
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: Positive end-expiratory pressure (PEEP) following alveolar
recruitment manoeuvre (RM) can effectively prevent anaesthesia-induced
atelectasis in children. We aimed to evaluate the individual effect of
PEEP following RM on atelectasis at the end of laparoscopic surgery in
infants and small children. <br/>Method(s): Children undergoing
laparoscopic inguinal hernia repair aged 5 weeks to 2 years were randomly
allocated to either the PEEP or control group. A progressive RM was
performed after intubation in all cases. The PEEP group received PEEP of 5
cmH<inf>2</inf>O until the end of mechanical ventilation, while the
control group did not receive any PEEP. Lung ultrasonography was performed
to compare the number of atelectatic regions between the two groups after
anaesthesia induction, after RM, and at the end of surgery in 12 thoracic
regions. <br/>Result(s): Overall, 432 ultrasonographic images were
acquired from 36 children. At the end of surgery, the number of
atelectatic regions (median [interquartile range]) was significantly lower
in the PEEP group compared to the control group (2.0 [1.0-3.0] versus 4.0
[3.0-4.0] out of 12 regions, respectively; p = 0.02). While no difference
was observed between the number of atelectatic regions after induction and
at the end of surgery in the control group (p = 0.30), a decrease was
observed in the PEEP group (3.0 [2.0-4.0] to 2.0 [1.0-3.0], respectively;
p = 0.02). <br/>Conclusion(s): RM followed by a PEEP of 5 cmH<inf>2</inf>O
can effectively reduce the regions of pulmonary atelectasis at the end of
laparoscopic surgery in infants and small children.<br/>Copyright &#xa9;
2022 Societe francaise d'anesthesie et de reanimation (Sfar)

<76>
Accession Number
2015748079
Title
Cardio-psycho-metabolic outcomes of bariatric surgery: design and baseline
of the WAS trial.
Source
Endocrine Connections. 11(2) (no pagination), 2022. Article Number:
e210338. Date of Publication: Feb 2022.
Author
Koschker A.-C.; Warrings B.; Morbach C.; Seyfried F.; Rickert N.; Jung P.;
Geier A.; Dischinger U.; Krauthausen M.; Herrmann M.J.; Stier C.; Frantz
S.; Malzahn U.; Stork S.; Fassnacht M.
Institution
(Koschker, Dischinger, Stier, Fassnacht) Division of Endocrinology and
Diabetology, Department of Internal Medicine I, University Hospital,
University of Wurzburg, Wurzburg, Germany
(Koschker, Warrings, Morbach, Frantz, Stork, Fassnacht) Comprehensive
Heart Failure Center, University & University Hospital Wurzburg, Wurzburg,
Germany
(Warrings, Herrmann) Department of Psychiatry, Psychosomatics and
Psychotherapy, University Hospital, University of Wurzburg, Wurzburg,
Germany
(Morbach, Frantz, Stork) Division of Cardiology, Department of Internal
Medicine I, University Hospital, University of Wurzburg, Wurzburg, Germany
(Seyfried, Stier) Department of General, Visceral, Transplant, Vascular,
and Pediatric Surgery, University Hospital, University of Wurzburg,
Wurzburg, Germany
(Rickert) Department of Radiology, University Hospital, University of
Wurzburg, Wurzburg, Germany
(Jung) Division of Pneumology, Department of Internal Medicine I,
University Hospital, University of Wurzburg, Wurzburg, Germany
(Geier) Division of Hepatology, Department of Internal Medicine II,
University Hospital, University of Wurzburg, Wurzburg, Germany
(Krauthausen) Department of General Practice, University Hospital,
University of Wurzburg, Wurzburg, Germany
(Malzahn) Center for Clinical Trials, University Hospital, University of
Wurzburg, Wurzburg, Germany
Publisher
BioScientifica Ltd.
Abstract
Obesity is a rapidly emerging health problem and an established risk
factor for cardiovascular diseases. Bariatric surgery profoundly reduces
body weight and mitigates sequelae of obesity. The open, randomized
controlled Wurzburg Adipositas Studie (WAS) trial compares the effects of
Roux-en-Y gastric bypass (RYGB) vs psychotherapy-supported lifestyle
modification in morbidly obese patients. The co-primary endpoint addresses
1-year changes in cardiovascular function (peak VO<inf>2</inf> during
cardiopulmonary exercise testing) and the quality of life (QoL)
(Short-Form-36 physical functioning scale). Prior to randomization, all
included patients underwent a multimodal anti-obesity treatment for 6-12
months. Thereafter, the patients were randomized and followed through
month 12 to collect the primary endpoints. Afterwards, patients in the
lifestyle group could opt for surgery, and final visit was scheduled for
all patients 24 months after randomization. Sample size calculation
suggested to enroll 90 patients in order to arrive at minimally 22
patients per group evaluable for the primary endpoint. Secondary
objectives were to quantify changes in body weight, left ventricular
hypertrophy, systolic and diastolic function (by echocardiography and
cardiac MRI), functional brain MRI, psychometric scales, and endothelial
and metabolic function. WAS enrolled 93 patients (72 women, median age 38
years, BMI 47.5 kg/m²) exhibiting a relevantly compromised
exercise capacity (median peakVO<inf>2</inf> 18.3 mL/min/kg) and the QoL
(median physical functioning scale 50). WAS is the first randomized
controlled trial focusing on the effects of RYGB on cardiovascular
function beyond hypertension. In addition, it will provide a wealth of
high-quality data on the cerebral, psychiatric, hepatic, and metabolic
function in obese patients after RYGB.<br/>Copyright &#xa9; 2022 The
authors Published by Bioscientifica Ltd.

<77>
Accession Number
2015759742
Title
Clinical Characteristics of Individuals Receiving Intrathecal Bupivacaine
with Clonidine or Bupivacaine with Fentanyl Spinal Anaesthesia.
Source
International Journal of Pharmaceutical and Clinical Research. 13(5) (pp
446-451), 2021. Date of Publication: 2021.
Author
Kumar D.; Das R.N.; Sinha P.K.
Institution
(Kumar, Das, Sinha) Department of Anaesthesiology, Anugrah Narayan Magadh
Medical College and Hospital, Bihar, Gaya, India
Publisher
Dr Yashwant Research Labs Pvt Ltd
Abstract
Aim: The aim of this study to assess the clinical characteristics of
individuals receiving intrathecal bupivacaine with clonidine or
bupivacaine with fentanyl spinal anaesthesia. <br/>Method(s): A
prospective double blind randomized controlled study was conducted in the
Department of Anaesthesiology, Anugrah Narayan Magadh Medical College and
Hospital, Gaya, Bihar, India, for 1 year. 100 adult patients were randomly
divided on an alternative basis into two groups of 50 each. Group
"A"-Bupivacaine plus clonidine group. Group "B"-Bupivacaine plus fentanyl
group. Patients with ASA grade 1 and 2 patients and age group of 18 -70
yrs. Those patients scheduled to undergo elective lower abdominal, lower
extremity, gynaecological or urological surgeries under subarachnoid block
were included in this study. Patients belonging to group 'A' received 3 ml
(15 mg) of hyperbaric bupivacaine 0.5% plus 1 microg.kg^-1 of
clonidine. Patients of group 'B' received 3 ml (15 mg) of hyperbaric
bupivacaine 0.5% plus (25 microg) of fentanyl. After injection, patient
was immediately turned to supine position. <br/>Result(s): Majority of
patients in the both the groups belonged to the group 30 to 40 years. The
number of males 42% and females 58%. Majority of female patients in the
both the groups belonged to the group 160 to 170 cms and males 171 to 175
cms, Samples were height matched. Most of the patient's 40 percent from
gynaecology surgery followed by lower limb surgery 35 percent and Lower
Abdominal Surgery 25 percent. <br/>Conclusion(s): We concluded that the
administration of local anaesthetics in combination with opioids
intrathecally is an established technique for managing postoperative pain
following abdominal, pelvic, thoracic or orthopaedic procedures on lower
extremities. Local anaesthetics with opioids demonstrate significant
synergy.<br/>Copyright &#xa9; 2021, Dr Yashwant Research Labs Pvt Ltd. All
rights reserved.

<78>
Accession Number
2015741082
Title
Clinical Characteristics of Individuals Having Spinal Anaesthesia with
Intrathecal Bupivacaine and Clonidine, as well as Intrathecal Bupivacaine
and Fentanyl.
Source
International Journal of Pharmaceutical and Clinical Research. 13(3) (pp
53-58), 2021. Date of Publication: 2021.
Author
Saurav S.; Bhurer S.C.; Kashyap B.K.
Institution
(Saurav) Department of Anaesthesiology and Critical Care, Patna Medical
College and Hospital, Bihar, Patna, India
(Bhurer) Department of Anaesthesiology and Critical Care, Patna Medical
College and Hospital, Bihar, Patna, India
(Kashyap) Department of Anaesthesiology and Critical Care, Patna Medical
College and Hospital, Bihar, Patna, India
Publisher
Dr Yashwant Research Labs Pvt Ltd
Abstract
Aim: The aim of this study is to assess the clinical profile of patients
undergoing spinal anesthesia with intrathecal bupivacaine with clonidine
and intrathecal bupivacaine with fentanyl. <br/>Method(s): A prospective
double blind randomized controlled study was conducted in the Department
of Anaesthesiology and Critical Care, Patna Medical College and Hospital,
Patna, Bihar, India for a period of 1 year. 100 adult patients were
randomly divided on an alternative basis into two groups of 50 each. Group
"A"-Bupivacaine plus clonidine group. Group "B"-Bupivacaine plus fentanyl
group. Patients with ASA grade 1and 2 and age group of 18-70yrs were
included in the study. Those patients scheduled to undergo elective lower
abdominal, lower extremity, gynaecological or urological surgeries under
subarachnoid block were included in this study. Patients in group 'A'
received 3 ml (15 mg) of hyperbaric bupivacaine 0.5% plus 1
microg.kg^-1 of clonidine. Patients in group 'B' received 3 ml
(15 mg) of hyperbaric bupivacaine 0.5% plus (25 microg) of fentanyl. After
injection, patient was immediately turned to supine position.
<br/>Result(s): Majority of patients in both the groups belonged were in
the age group of 35 to 45 years. The number of males was 45% and females
55%. Majority of female patients in the both the groups have the heights
in the range of 160 to 170 cms and males 171 to 175 cms. Samples were
height matched. 42 percent of the patients underwent gynaecological
surgery followed by lower limb surgeries 34 percent and Lower Abdominal
Surgeries 24 percent. <br/>Conclusion(s): The administration of local
anaesthetics in combination with opioids intrathecally is an established
technique for managing postoperative pain following abdominal, pelvic,
thoracic, or orthopaedic procedures on lower extremities. Local
anaesthetics with opioids demonstrate significant improvement in the
post-operative pain and decrease the requirement of rescue
analgesia.<br/>Copyright &#xa9; 2021, Dr Yashwant Research Labs Pvt Ltd.
All rights reserved.

<79>
Accession Number
637325606
Title
Cost Analysis From a Randomized Comparison of Immediate Versus Delayed
Angiography After Cardiac Arrest.
Source
Journal of the American Heart Association. (pp e022238), 2022. Date of
Publication: 23 Feb 2022.
Author
Camaro C.; Bonnes J.L.; Adang E.M.; Spoormans E.M.; Janssens G.N.; van der
Hoeven N.W.; Jewbali L.S.; Dubois E.A.; Meuwissen M.; Rijpstra T.A.;
Bosker H.A.; Blans M.J.; Bleeker G.B.; Baak R.; Vlachojannis G.J.;
Eikemans B.J.; van der Harst P.; van der Horst I.C.; Voskuil M.; van der
Heijden J.J.; Beishuizen B.; Stoel M.; van der Hoeven H.; Henriques J.P.;
Vlaar A.P.; Vink M.A.; van den Bogaard B.; Heestermans T.A.; de Ruijter
W.; Delnoij T.S.; Crijns H.J.; Jessurun G.A.; Oemrawsingh P.V.; Gosselink
M.T.; Plomp K.; Magro M.; Elbers P.W.; van de Ven P.M.; Lemkes J.S.; van
Royen N.
Institution
(Camaro, Bonnes, van Royen) Department of Cardiology Radboud University
Medical Center Nijmegen the Netherlands, Netherlands
(Adang) Department of Health EvidenceRadboudumc Technology Center for
Health Economics Nijmegen the Netherlands, Netherlands
(Spoormans, Janssens, van der Hoeven, Lemkes, van Royen) Department of
Cardiology Amsterdam University Medical Centerlocation VUmc Amsterdam the
Netherlands, Netherlands
(Jewbali, Dubois) Department of Cardiology and Intensive Care Medicine
Erasmus Medical Centre Rotterdam the Netherlands, Netherlands
(Meuwissen) Department of Cardiology Amphia Hospital Breda the
Netherlands, Netherlands
(Rijpstra) Department of Intensive Care Medicine Amphia Hospital Breda the
Netherlands, Netherlands
(Bosker) Department of Cardiology Rijnstate Hospital Arnhem the
Netherlands, Netherlands
(Blans) Department of Intensive Care Medicine Rijnstate Hospital Arnhem
the Netherlands, Netherlands
(Bleeker) Department of Cardiology HAGA Hospital Den Haag the Netherlands,
Netherlands
(Baak) Department of Intensive Care Medicine HAGA Hospital Den Haag the
Netherlands, Netherlands
(Vlachojannis) Department of Cardiology Maasstad Hospital Rotterdam and
University Medical Centre Utrecht Utrecht the Netherlands, Netherlands
(Eikemans) Department of Intensive Care Medicine Maasstad Hospital
Rotterdam the Netherlands, Netherlands
(van der Harst) Department of Cardiology University Medical Center
Groningen and University Medical Centre Utrecht Groningen and Utrecht the
Netherlands, Netherlands
(van der Horst) Department of Critical Care University Medical Center
Groningen and Maastricht University Medical Center+ Groningen and
Maastricht the Netherlands, Netherlands
(van der Horst, Delnoij) Department of Intensive Care Medicine Maastricht
University Medical Center+ Maastricht the Netherlands, Netherlands
(Voskuil) Department of Cardiology University Medical Center Utrecht
Utrecht the Netherlands, Netherlands
(van der Heijden) Department of Intensive Care Medicine University Medical
Center Utrecht Utrecht the Netherlands, Netherlands
(Beishuizen) Department of Intensive Care Medicine Medisch Spectrum Twente
Enschede The Netherlands, Netherlands
(Stoel) Department of Cardiology Medisch Spectrum Twente Enschede The
Netherlands, Netherlands
(van der Hoeven) Department of Intensive Care Medicine Radboud University
Medical Center Nijmegen the Netherlands, Netherlands
(Henriques) Department of Cardiology Amsterdam University Medical
Centerlocation AMC Amsterdam the Netherlands, Netherlands
(Vlaar) Department of Intensive Care Medicine Amsterdam University Medical
Centerlocation AMC Amsterdam the Netherlands, Netherlands
(Vink) Department of Cardiology OLVG Amsterdam the Netherlands,
Netherlands
(van den Bogaard) Department of Intensive Care Medicine OLVG Amsterdam the
Netherlands, Netherlands
(Heestermans) Department of Cardiology Noord West Ziekenhuisgroep Alkmaar
the Netherlands, Netherlands
(de Ruijter) Department of Intensive Care Medicine Noord West
Ziekenhuisgroep Alkmaar the Netherlands, Netherlands
(Delnoij, Crijns) Department of Cardiology Maastricht University Medical
Center+ Maastricht the Netherlands, Netherlands
(Jessurun) Department of Cardiology Scheper Hospital Emmen the
Netherlands, Netherlands
(Oemrawsingh) Department of Cardiology Haaglanden Medical Center Den Haag
the Netherlands, Netherlands
(Gosselink) Department of Cardiology Isala Hospital Zwolle the
Netherlands, Netherlands
(Plomp) Department of Cardiology Tergooi Hospital Blaricum the
Netherlands, Netherlands
(Magro) Department of Cardiology Elisabeth-Tweesteden Hospital Tilburg the
Netherlands, Netherlands
(Elbers) Department of Intensive Care Medicine Amsterdam University
Medical Centerlocation VUmc Amsterdam the Netherlands, Netherlands
(van de Ven) Department of Epidemiology and Data Science Amsterdam
University Amsterdam the Netherlands, Netherlands
Publisher
NLM (Medline)
Abstract
Background In patients with out-of-hospital cardiac arrest without
ST-segment elevation, immediate coronary angiography did not improve
clinical outcomes when compared with delayed angiography in the COACT
(Coronary Angiography After Cardiac Arrest) trial. Whether 1 of the 2
strategies has benefits in terms of health care resource use and costs is
currently unknown. We assess the health care resource use and costs in
patients with out-of-hospital cardiac arrest. Methods and Results A total
of 538 patients were randomly assigned to a strategy of either immediate
or delayed coronary angiography. Detailed health care resource use and
cost-prices were collected from the initial hospital episode. A
generalized linear model and a gamma distribution were performed. Generic
quality of life was measured with the RAND-36 and collected at 12-month
follow-up. Overall total mean costs were similar between both groups (EUR
33 575+/-19 612 versus EUR 33 880+/-21 044; P=0.86). Generalized linear
model: (beta, 0.991; 95% CI, 0.894-1.099; P=0.86). Mean procedural costs
(coronary angiography and percutaneous coronary intervention, coronary
artery bypass graft) were higher in the immediate angiography group (EUR
4384+/-3447 versus EUR 3028+/-4220; P<0.001). Costs concerning intensive
care unit and ward stay did not show any significant difference. The
RAND-36 questionnaire did not differ between both groups. Conclusions The
mean total costs between patients with out-of-hospital cardiac arrest
randomly assigned to an immediate angiography or a delayed invasive
strategy were similar during the initial hospital stay. With respect to
the higher invasive procedure costs in the immediate group, a strategy
awaiting neurological recovery followed by coronary angiography and
planned revascularization may be considered. Registration URL:
https://trialregister.nl; Unique identifier: NL4857.

<80>
Accession Number
637325132
Title
Meta-Analysis Comparing Risk Factors, Incidence, and Outcomes of Patients
With Versus Without Prosthesis-Patient Mismatch Following Transcatheter
Aortic Valve Implantation.
Source
The American journal of cardiology. (no pagination), 2022. Date of
Publication: 19 Feb 2022.
Author
Lim O.Z.H.; Mai A.S.; Ng C.H.; Tang A.; Chin Y.H.; Kong G.; Ho Y.J.; Ong
J.; Tay E.; Kuntjoro I.; Chew N.W.; Lim Y.
Institution
(Lim, Mai, Ng, Tang, Chin, Kong, Ho) Yong Loo Lin School of Medicine,
National University of Singapore, Singapore
(Ong, Tay, Chew) Department of Cardiology, National University Heart
Centre, Singapore
(Kuntjoro, Lim) Yong Loo Lin School of Medicine, National University of
Singapore, Singapore; Department of Cardiology, National University Heart
Centre, Singapore
Publisher
NLM (Medline)
Abstract
Current guidelines on the management of patients with aortic valvular
disease have widened the use of transcatheter aortic valve implantation
(TAVI) with an emphasis on avoidance of prosthesis-patient mismatch (PPM).
This study sought to examine the incidence, risk factors, and all-cause
mortality of PPM after TAVI. Medline and Embase databases were searched
from inception to August 10, 2021. Patients were compared along 2 arms:
(1) any degree of PPM and those without PPM, (2) severe PPM, and nonsevere
PPM. A total of 22 articles involving 115,442 patients after TAVI were
included. Pooled incidence for any degree of PPM was 30.1% and 10.7% in
severe PPM. Incidence was significantly higher (p <0.001) for any degree
of PPM in Europe (33.1%) and North America (34.4%) compared with Asia
(10.4%). Incidence of severe PPM was higher (p = 0.015) in older
generation (13.6%) compared with current-generation valves (6.3%). Severe
PPM increased the risk of all-cause mortality relative to nonsevere PPM
(hazard ratio: 1.86, 95% confidence interval: 1.05 to 3.29, p = 0.034).
Patients of younger age, increased body surface area, lower left
ventricular ejection fraction, and classified New York Heart Association
Class III/IV were at greater risk of both any degree and severe PPM.
Smaller prosthesis size increased the risk of any degree of PPM, whereas
postdilation and larger prostheses were protective factors. In conclusion,
all-cause mortality was significantly affected in severe PPM compared with
nonsevere cases, whereas this excess mortality was not observed between
those with any degree of PPM and those without. Closer attention to
patient and bioprosthetic valve factors is required to minimize the
occurrence of severe PPM.<br/>Copyright &#xa9; 2022 Elsevier Inc. All
rights reserved.

<81>
Accession Number
637323463
Title
Gender Differences and Outcomes of Hypoattenuated Leaflet Thickening
(HALT) Following Transcatheter Aortic Valve Replacement: A Meta-analysis
of Randomized and Cohort Studies.
Source
Current problems in cardiology. (pp 101155), 2022. Date of Publication:
19 Feb 2022.
Author
Salah H.M.; Almaddah N.; Xu J.; Al-Hawwas M.; Agarwal S.K.; Uretsky B.F.;
Dhar G.; Al Aref S.J.
Institution
(Salah) Department of Medicine, Division of Cardiology. University of
Arkansas for Medical Sciences, Little Rock, AR, United States
(Almaddah) Arkansas Heart Hospital, Little Rock, AR, United States
(Xu, Al-Hawwas, Dhar, Al Aref) Department of Medicine, Division of
Cardiology. University of Arkansas for Medical Sciences, Little Rock, AR,
United States
(Agarwal, Uretsky) Central Arkansas Veterans Health System, Little Rock,
AR, United States
Publisher
NLM (Medline)

<82>
Accession Number
637323439
Title
A Cardiovascular Risk Assessment model according to behavioral,
pSychosocial and traditional factors in patients with ST-segment elevation
Myocardial Infarction (CRAS-MI): review of literature and methodology of a
multi-center cohort study.
Source
Current problems in cardiology. (pp 101158), 2022. Date of Publication:
19 Feb 2022.
Author
Roohafza H.; Noohi F.; Hosseini S.G.; Alemzadeh-Ansari M.; Bagherieh S.;
Marateb H.; Mansourian M.; Mousavi A.F.; Seyedhosseini M.; Farshidi H.;
Ahmadi N.; Yazdani A.; Sadeghi M.
Institution
(Roohafza) Isfahan Cardiovascular Research Center, Cardiovascular Research
Institute, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
(Noohi, Alemzadeh-Ansari) Cardiovascular Intervention Research Center,
Rajaie Cardiovascular Medical and Research Center, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Hosseini, Sadeghi) Cardiac Rehabilitation Research Center, Cardiovascular
Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
(Bagherieh) Interventional Cardiology Research Center, Cardiovascular
Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
(Marateb) Biomedical Engineering Department, Engineering Faculty,
University of Isfahan, Isfahan, Iran; Department of Automatic Control,
Biomedical Engineering Research Center, Universitat Politecnica de
Catalunya, BarcelonaTech (UPC), Barcelona, Spain
(Mansourian) Department of Automatic Control, Biomedical Engineering
Research Center, Universitat Politecnica de Catalunya, BarcelonaTech
(UPC), Barcelona, Spain; Pediatric Cardiovascular Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Iran
(Mousavi) Cardiovascular Diseases Research Center, Department of
Cardiology, Heshmat Hospital, School of Medicine, Guilan University of
Medical Sciences, Rasht, Iran, Islamic Republic of
(Seyedhosseini, Ahmadi) Yazd Cardiovascular Research Center, Shahid
Sadoughi University of Medical Sciences, Yazd, Iran, Islamic Republic of
(Farshidi) Cardiovascular Research Center, Hormozgan University of Medical
Sciences, Bandar Abbas, Iran, Islamic Republic of
(Yazdani) Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
BACKGROUND: This study aims to provide a comprehensive risk-assessment
model including lifestyle, psychological parameters, and traditional risk
factors to determine the risk of major adverse cardiovascular events
(MACE) in patients with the first acute ST-segment elevation myocardial
infarction (STEMI) episode. <br/>METHOD(S): Patients were recruited from
new hospital admissions of acute STEMI and will be followed up to 3 years.
Clinical and paraclinical characteristics, lifestyle, psychological, and
MACE information are collected and will be used in the risk-assessment
model. <br/>RESULT(S): Totally, 1707 patients were recruited (male: 81.4%,
mean age: 56.60+/-10.34). Primary percutaneous coronary intervention was
the most prevalent type of coronary revascularization (81.9%). In case of
baseline psychological characteristics, mean depression score was
5.40+/-4.88, and mean distress score was 7.64+/-5.08. <br/>CONCLUSION(S):
A comprehensive approach, focusing on medical, lifestyle, and
psychological factors, will lead to better identification of
cardiovascular disease patients at risk of developing MACE through
comprehensive risk-assessment models.<br/>Copyright &#xa9; 2022 Elsevier
Inc. All rights reserved.

<83>
Accession Number
637321532
Title
Diagnostic accuracy of coronary computed tomography angiography for the
evaluation of obstructive coronary artery disease in patients referred for
transcatheter aortic valve implantation: a systematic review and
meta-analysis.
Source
European radiology. (no pagination), 2022. Date of Publication: 22 Feb
2022.
Author
Gatti M.; Gallone G.; Poggi V.; Bruno F.; Serafini A.; Depaoli A.; De
Filippo O.; Conrotto F.; Darvizeh F.; Faletti R.; De Ferrari G.M.; Fonio
P.; D'Ascenzo F.
Institution
(Gatti, Poggi, Serafini, Depaoli, Faletti, Fonio) Department of Surgical
Sciences, Radiology Unit, University of Turin, Via Genova 3, Turin 10126,
Italy
(Gallone, Bruno, De Filippo, Conrotto, De Ferrari, D'Ascenzo) Division of
Cardiology, Department of Medical Science, University of Turin, Turin,
Italy
(Darvizeh) School of Medicine, Vita-Salute San Raffaele University, Milan
20121, Italy
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To evaluate the diagnostic accuracy of coronary computed
tomography angiography (CCTA) for the evaluation of obstructive coronary
artery disease (CAD) in patients referred for transcatheter aortic valve
implantation (TAVI). <br/>METHOD(S): EMBASE, PubMed/MEDLINE, and CENTRAL
were searched for studies reporting accuracy of CCTA for the evaluation of
obstructive CAD compared with invasive coronary angiography (ICA) as the
reference standard. QUADAS-2 tool was used to assess the risk of bias. A
bivariate random effects model was used to analyze, pool, and plot the
diagnostic performance measurements across studies. Pooled sensitivity,
specificity, positive ( + LR) and negative (-LR) likelihood ratio,
diagnostic odds ratio (DOR), and hierarchical summary ROC curve (HSROC)
were evaluated. Prospero registration number: CRD42021252527.
<br/>RESULT(S): Fourteen studies (2533 patients) were included. In the
intention-to-diagnose patient-level analysis, sensitivity and specificity
for CCTA were 97% (95% CI: 94-98%) and 68% (95% CI: 56-68%), respectively,
and + LR and -LR were 3.0 (95% CI: 2.1-4.3) and 0.05 (95% CI: 0.03 -
0.09), with DOR equal to 60 (95% CI: 30-121). The area under the HSROC
curve was 0.96 (95% CI: 0.94-0.98). No significant difference in
sensitivity was found between single-heartbeat and other CT scanners (96%
(95% CI: 90 - 99%) vs. 97% (95% CI: 94-98%) respectively; p = 0.37),
whereas the specificity of single-heartbeat scanners was higher (82% (95%
CI: 66-92%) vs. 60% (95% CI: 46 - 72%) respectively; p < 0.0001). Routine
CCTA in the pre-TAVI workup could save 41% (95% CI: 34 - 47%) of ICAs if a
disease prevalence of 40% is assumed. <br/>CONCLUSION(S): CCTA proved an
excellent diagnostic accuracy for assessing obstructive CAD in patients
referred for TAVI; the use of single-heartbeat CT scanners can further
improve these findings. KEY POINTS: * CCTA proved to have an excellent
diagnostic accuracy for assessing obstructive CAD in patients referred for
TAVI. * Routine CCTA in the pre-TAVI workup could save more than 40% of
ICAs. * Single-heartbeat CT scanners had higher specificity than others in
the assessment of obstructive CAD in patients referred for
TAVI.<br/>Copyright &#xa9; 2022. The Author(s).

<84>
Accession Number
637321003
Title
Non-vitamin K oral anticoagulants versus vitamin K antagonists in post
transcatheter aortic valve replacement patients with clinical indication
for oral anticoagulation: A meta-analysis.
Source
Clinical cardiology. (no pagination), 2022. Date of Publication: 22 Feb
2022.
Author
Chen Y.-F.; Liu F.; Li X.-W.; Zhang H.-J.; Liu Y.-G.; Lin L.
Institution
(Chen, Li, Zhang, Liu, Lin) Department of Pharmacy, Xiamen Cardiovascular
Hospital of Xiamen University, School of Medicine, Xiamen University,
Xiamen, China
(Liu) Department of Cardiovascular Surgery, Xiamen Cardiovascular Hospital
of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Current guidelines recommend oral anticoagulation (OAC)
following transcatheter aortic valve replacement (TAVR) in patients with
clinical indication, but the optimal antithrombotic regimen remains
uncertain. We aimed to compare the efficacy and safety of non-vitamin K
oral anticoagulants (NOACs) versus vitamin K antagonists (VKAs) in
patients undergoing TAVR with concomitant indication of OAC. HYPOTHESIS:
Comparing with VKAs therapy, NOACs are similar in reducing the all-cause
mortality and major bleeding in post-TAVR patients requiring OAC
medication. <br/>METHOD(S): We searched the databases of PubMed, Embase,
and Cochrane library databases to identify studies that investigated NOACs
versus VKAs after TAVR in patients with another indication of OAC, which
were published before 28th September 28, 2021. The effectiveness of
outcomes was all-cause mortality and stroke or systemic embolism, while
the main safety outcome was major and/or life-threatening bleeding. The
hazard ratio (HR) with 95% confidence interval (CI) was used as a measure
of treatment effect. <br/>RESULT(S): Our search identified eight studies.
We included 4947 post-TAVR patients with another indication of OAC
allocated to the NOAC (n=2146) or VKA groups (n=2801). There were no
significant differences in the all-cause mortality (HR: 0.91, 95% CI:
0.77-1.08, p=.29, I2 =47%), stroke or systemic embolism (HR: 0.96, 95% CI:
0.68-1.37, p=.84, I2 =0%), and major and/or life-threatening bleeding (HR:
1.09, 95% CI: 0.89-1.32, p=.40, I2 =30%) in both groups.
<br/>CONCLUSION(S): Among post-TAVR patients who required OAC therapy,
NOACs therapy compared to VKAs is similar in reducing the all-cause
mortality, stroke or systemic embolism, and major and/or life-threatening
bleeding events.<br/>Copyright &#xa9; 2022 The Authors. Clinical
Cardiology published by Wiley Periodicals, LLC.

<85>
Accession Number
637319198
Title
Sex-Based Differences in Revascularization Outcomes: Is It Time for a
Dedicated Randomized Trial in Women?.
Source
Journal of the American Heart Association. (pp e024281), 2022. Date of
Publication: 22 Feb 2022.
Author
Malick W.A.; Soriano K.; Stone G.W.
Institution
(Malick, Soriano, Stone) Zena and Michael A. Wiener Cardiovascular
Institute Icahn School of Medicine at Mount Sinai New York NY
(Stone) Clinical Trials Center Cardiovascular Research Foundation New York
NY
Publisher
NLM (Medline)

<86>
Accession Number
2011332268
Title
Evidence for Above Cuff Vocalization in Patients With a Tracheostomy: A
Systematic Review.
Source
Laryngoscope. 132(3) (pp 600-611), 2022. Date of Publication: March 2022.
Author
Mills C.S.; Michou E.; King N.; Bellamy M.C.; Siddle H.J.; Brennan C.A.;
Bojke C.
Institution
(Mills) Speech and Language Therapy Department, Leeds Teaching Hospitals
NHS Trust, Leeds, United Kingdom
(Mills, King, Brennan, Bojke) Leeds Institute of Health Sciences,
University of Leeds, Leeds, United Kingdom
(Michou) Centre for Gastrointestinal Sciences, The University of
Manchester, Manchester, United Kingdom
(Michou) Speech and Language Therapy Department, University of Patras,
Patras, Greece
(Bellamy) Leeds Institute of Medical Research at St James's, University of
Leeds, Leeds, United Kingdom
(Siddle) Leeds Institute of Rheumatic and Musculoskeletal Medicine,
University of Leeds, Leeds, United Kingdom
(Siddle) Department of Podiatry, Leeds Teaching Hospitals NHS Trust,
Leeds, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Objectives/Hypothesis: To determine how above cuff vocalization (ACV) is
implemented in clinical practice, to identify what evidence exists on the
effectiveness and safety of ACV, and to evaluate the acceptability of ACV.
<br/>Study Design: Systematic review. <br/>Method(s): A literature search
was conducted in eight databases (MEDLINE, Embase, AMED, CINAHL, Cochrane
Library, PsycINFO, Scopus, and Web of Science) in May 2019 and updated in
June 2020. Two reviewers independently screened, selected, and extracted
data. Study quality was appraised using the Joanna Briggs Institute
Critical Appraisal Tools and a narrative synthesis was conducted.
Systematic review registration number: CRD42019133942. <br/>Result(s): The
searches identified 1327 records. The 13 eligible studies included four
case studies, three case series, four observational studies without a
control group, one quasi-experimental study, and one randomized controlled
trial. Study quality was low, with most studies having high risk of bias.
There was a high level of heterogeneity in study design and outcome
measures used. Detailed information on ACV application and dose-delivered
was lacking in 12 studies. Positive effects were reported for
communication (n = 7), swallowing (n = 4), cough response (n = 2), and
quality-of-life (n = 2), but with inconsistent use of objective outcome
measures. There is limited quantitative or qualitative evidence for
acceptability. Adverse events and complications were reported in nine
studies, and four highlighted the importance of involving an experienced
speech and language therapist. <br/>Conclusion(s): There is limited
evidence for the acceptability, effectiveness, safety, or optimal
implementation of ACV. The evidence is insufficient to provide
recommendations regarding optimal intervention delivery. Future research
should ensure detailed recording of ACV delivery and utilize a core
outcome set. Laryngoscope, 132:600-611, 2022.<br/>Copyright &#xa9; 2021
The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf
of The American Laryngological, Rhinological and Otological Society, Inc.

<87>
Accession Number
2016849409
Title
The burden of perioperative hypertension/ hypotension: A systematic
review.
Source
PLoS ONE. 17(2 February) (no pagination), 2022. Article Number: e0263737.
Date of Publication: February 2022.
Author
Lizano-Diez I.; Poteet S.; Burniol-Garcia A.; Cerezales M.
Institution
(Lizano-Diez) Ferrer, Barcelona, Spain
(Poteet, Burniol-Garcia, Cerezales) Axentiva Solutions SL, Barcelona,
Spain
Publisher
Public Library of Science
Abstract
Study objective Our goal is to review the outcomes of acute
hypertensive/hypotensive episodes from articles published in the past 10
years that assessed the short- and long-term impact of acute
hypertensive/hypotensive episodes in the perioperative setting. Methods We
conducted a systematic peer review based upon PROSPERO and Cochrane
Handbook protocols. The following study characteristics were collected:
study type, author, year, population, sample size, their definition of
acute hypertension, hypotension or other measures, and outcomes
(probabilities, odds ratio, hazard ratio, and relative risk) and the
p-values; and they were classified according to the type of surgery
(cardiac and non-cardiac). Results A total of 3,680 articles were
identified, and 66 articles fulfilled the criteria for data extraction.
For the perioperative setting, the number of articles varies by outcome:
20 mortality, 16 renal outcomes, 6 stroke, 7 delirium and 34 other
outcomes. Hypotension was reported to be associated with mortality (OR
1.02-20.826) as well as changes from the patient's baseline blood pressure
(BP) (OR 1.02-1.36); hypotension also had a role in the development of
acute kidney injury (AKI) (OR 1.03-14.11). Postsurgical delirium was found
in relation with BP lability (OR 1.018-1.038) and intra- and postsurgical
hypotension (OR 1.05-1.22), and hypertension (OR 1.44-2.34). Increased OR
(37.67) of intracranial hemorrhage was associated to postsurgical systolic
BP >130 mmHg. There was a wide range of additional diverse outcomes
related to hypo-, hypertension and BP lability. Conclusions The
perioperative management of BP influences short- and long-term effects of
surgical procedures in cardiac and non-cardiac interventions; these
findings support the burden of BP fluctuations in this
setting.<br/>Copyright: &#xa9; 2022 Lizano-Diez 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.

<88>
Accession Number
2015563296
Title
The effectiveness of home-based cardiac rehabilitation program on
cardiovascular stress indices in men and women with myocardial infarction:
a randomised controlled clinical trial.
Source
Revista Colombiana de Cardiologia. 28(2) (pp 128-135), 2021. Date of
Publication: March-April 2021.
Author
Cheragi M.; Namdari M.; Roshan V.D.; Dehghani M.
Institution
(Dehghani) Department of Cardiovascular and Respiration, University of
Mazandaran, Mazandaran, Iran, Islamic Republic of
(Dehghani, Cheragi, Namdari) Department of Cardiovascular Research Center,
Shahid Rahimi Hospital, Lorestan University of Medical Science,
Khorramabad, Iran, Islamic Republic of
(Roshan) Department of Sports Physiology, College of Physical Education
and Sport Sciences, University of Mazandaran, Mazandaran, Iran, Islamic
Republic of
(Dehghani) Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
Publisher
Permanyer Publications
Abstract
Background: cardiac rehabilitation is a structured program to prevent
secondary cardiovascular diseases. <br/>Objective(s): to investigate and
compare the effectiveness of home-based cardiac rehabilitation program
(HBCRP) on improving cardiovascular stress indices in men and women who
had experienced myocardial infarction (MI). <br/>Method(s): in this
randomized controlled clinical trial, 80 patients with MI were divided
into two groups of intervention and control (n = 40 per group). Analyses
were erformed separately in females and males in the both groups. The
HBCRP included receiving routine medications along with walking for 8
weeks. The control group only received the routine care along with
counseling about having adequate physical activity. Cardiovascular stress
indicators including heart rate at rest (HR<inf>rest</inf>), maximum heart
rate (HR<inf>max</inf>), recovery heart rate (RHR)at 1 and 2 minutes after
the exercise test (i.e. RHR1 and RHR2), systolic and diastolic blood
pressures at rest (SBPR and DBPR), and rate pressure product (RPP) were
measured by a researcher blinded to the intervention before and after the
test. <br/>Result(s): the results showed significant reductions in RHR1
(p<0.001), RHR2 (p<0.01), SBPR (p<0.01), DBPR (p<0.01), and RPP (p<0.001)
in both males and females in the intervention group. A significant
increase was also observed in HR<inf>max</inf> (p<0.001) in the
intervention group. However, there were no significant differences in
HR<inf>max</inf> and other variables comparing per-and post-experiment
values in the control group. <br/>Conclusion(s): our results showed that 8
weeks of HBCRP sex-independently reduced cardiovascular stress indices in
both men and women with MI.<br/>Copyright &#xa9; 2020 Sociedad Colombiana
de Cardiologia y Cirugia Cardiovascular.

<89>
Accession Number
2016940544
Title
The effect of delirium preventive measures on the occurrence of
postoperative cognitive dysfunction in older adults undergoing
cardiovascular surgery. The DelPOCD randomised controlled trial.
Source
Journal of Clinical Anesthesia. 78 (no pagination), 2022. Article Number:
110686. Date of Publication: June 2022.
Author
Olotu C.; Ascone L.; Wiede J.; Manthey J.; Kuehn S.; Scherwath A.;
Kiefmann R.
Institution
(Olotu, Wiede, Manthey, Kiefmann) Department of Anaesthesiology,
University Medical Centre Hamburg, Germany
(Ascone) Department of Psychiatry and Psychotherapy, University Medical
Centre Hamburg, Germany
(Kuehn, Scherwath) Institute of Medical Psychology, University Medical
Centre Hamburg, Germany
(Scherwath) Department of Stem Cell Transplantation, University Medical
Centre Hamburg, Germany
Publisher
Elsevier Inc.
Abstract
Study objective: This trial examines the effect of delirium preventive
measures on the incidence of postoperative cognitive dysfunction in older
adults. <br/>Design(s): In a randomised approach, a delirium prevention
and a standard care group were compared regarding manifestation of
postoperative cognitive dysfunction at seven days, three and twelve months
postoperatively (primary outcome). To correct for practice effects and
age-depended cognitive decline, a control group of age-matched healthy
subjects was included. <br/>Setting(s): The trial was conducted at the
University Medical Centre Hamburg between 2014 and 2018, data assessment
took place in the Anaesthesia Outpatient Clinic and on the surgical ward.
<br/>Patient(s): A total of 609 patients >=60 years scheduled for
cardiovascular surgery were enrolled, allocated treatment was received by
284 patients in the delirium prevention and 274 patients in the standard
care group. <br/>Intervention(s): The intervention consisted of a delirium
prevention bundle including reorientation measures, sleeping aids and
early mobilisation. Measurements: Cognitive functions were assessed via
neuropsychological testing of attention, executive functions including
word fluency, and verbal memory utilizing a computerised test of
attentional performance, the trail making test, the digit span subtest
from the Wechsler Adult Intelligence Scale-IV, the verbal learning and
memory test, and the Regensburg Word Fluency Test. Assessments were
performed preoperatively and at three time points postoperatively (one
week, three months and 12 months). <br/>Main Result(s): Postoperative
cognitive dysfunction was defined as a clinically meaningful decline in at
least two out of nine chosen test parameters compared to the preoperative
level (reliable change index <= - 1.96). The rates of postoperative
cognitive dysfunction were 25.9% (delirium prevention group, n = 284) vs.
28.1% (standard care group, n = 274) [X²(1,n = 433) = 0.245;p =
0.621] at postoperative day seven and declined to 7.8% vs. 6.8%
[X²(1,n = 219) = 0.081;p = 0.775] and 1.3% vs. 5.6% (p = 0.215,
Fisher's exact test) at three and 12 months following surgery,
respectively. The postoperative delirium rates did not differ between the
two groups (delirium prevention group: 13.4% vs. standard care group:
17.3%). Attentional performance was impaired shortly after surgery,
whereas verbal delayed recall was most frequently affected over the whole
postoperative period. <br/>Conclusion(s): These findings suggest that an
intervention combining specific measures extracted from established
postoperative delirium prevention programs did not reduce the rate of
postoperative cognitive dysfunction in older adults.<br/>Copyright &#xa9;
2022 Elsevier Inc.

<90>
Accession Number
636357115
Title
Patient-reported quality of life after stand-alone and concomitant
arrhythmia surgery: a systematic review and meta-analysis.
Source
Interactive cardiovascular and thoracic surgery. 34(3) (pp 339-348), 2022.
Date of Publication: 21 Feb 2022.
Author
Maesen B.; van der Heijden C.A.J.; Bidar E.; Vos R.; Athanasiou T.;
Maessen J.G.
Institution
(Maesen, van der Heijden, Bidar, Maessen) Department of Cardiothoracic
Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
(Maesen, Bidar, Maessen) Cardiovascular Research Institute Maastricht,
Maastricht, Netherlands
(Vos) Department of Methodology and Statistics, Maastricht University,
Maastricht, Netherlands
(Athanasiou) Department of Cardiothoracic Surgery, Imperial College
London, St Mary's Hospital, London, United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Patient-reported quality of life (QOL) has become an important
endpoint for arrhythmia surgery for atrial fibrillation (AF). While
studies specifically evaluating the effect of arrhythmia surgery on QOL
are scarce, we aimed to summarize current evidence of QOL following
concomitant and stand-alone arrhythmia surgery for AF. <br/>METHOD(S): All
studies reporting on QOL using questionnaires from patients undergoing
arrhythmia surgery for AF, both stand-alone and concomitant, were included
in this systematic review. A meta-analysis was performed on inter-study
heterogeneity of changes in QOL on 9 of 12 included studies that used the
Short-Form 36 tool and meta-regression based on rhythm outcome after 1
year was executed. Finally, differences in QOL following stand-alone
arrhythmia surgery and concomitant procedures were evaluated.
<br/>RESULT(S): Overall, QOL scores improved 1 year after surgical
ablation for AF evaluated by several questionnaires. In stand-alone
arrhythmia procedures, meta-regression showed significant improvements in
those who were in sinus rhythm compared to those in AF after 1 year. This
association between an improved QOL and the procedural effectiveness was
also suggested in concomitant procedures. However, when comparing QOL of
patients undergoing cardiac surgery with and without add-on surgical
ablation for AF, only the variable 'physical role' demonstrated a
significant improvement. <br/>CONCLUSION(S): In patients with AF, QOL
improves after both stand-alone and concomitant arrhythmia surgery. In the
concomitant group, this improvement can be attributed to both the cardiac
procedure itself as well as the add-on arrhythmia surgery. However, both
in stand-alone and concomitant procedures, the improvement in QOL seems to
be related to the effectiveness of the procedure to maintain sinus rhythm
after 12months.<br/>Copyright &#xa9; The Author(s) 2021. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<91>
Accession Number
635973528
Title
Beta-Blocker Landiolol Hydrochloride in Preventing Atrial Fibrillation
Following Cardiothoracic Surgery: A Systematic Review and Meta-Analysis.
Source
Annals of thoracic and cardiovascular surgery : official journal of the
Association of Thoracic and Cardiovascular Surgeons of Asia. 28(1) (pp
18-31), 2022. Date of Publication: 20 Feb 2022.
Author
Hao J.; Zhou J.; Xu W.; Chen C.; Zhang J.; Peng H.; Liu L.
Institution
(Hao, Zhou, Chen, Zhang, Peng, Liu) Department of Thoracic Surgery, West
China Hospital, Sichuan University, Chengdu, China
(Hao, Zhou, Xu, Chen) West China School of Medicine, Sichuan University,
Chengdu, China
(Zhang) Department of Thoracic Surgery, Chest Oncology Institute, West
China Hospital, Sichuan University, Chengdu, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The purpose of this article was to assess the benefit of
perioperative administration of the intravenous beta-blocker landiolol
hydrochloride in preventing atrial fibrillation (AF) after cardiothoracic
surgery. <br/>METHOD(S): We performed a systematic search in PubMed, Web
of Science, CNKI, and OVID to identify randomized controlled trials (RCTs)
and cohorts up to January 2021. Data regarding postoperative atrial
fibrillation (POAF) and safety outcomes were extracted. Odds ratios (ORs)
with 95% confidence intervals (CIs) were determined using the
Mantel-Haenszel method. Meanwhile, subgroup analyses were conducted
according to surgery type including lung cancer surgery, esophageal cancer
surgery, and cardiac surgery. <br/>RESULT(S): Seventeen eligible articles
involving 1349 patients within 13 RCTs and four cohorts were included in
our meta-analysis. Compared with control group, landiolol administration
was associated with a significant reduction of the occurrence of AF after
cardiothoracic surgery (OR = 0.32, 95% CI 0.23-0.43, P <0.00001). In
addition, the results demonstrated that perioperative administration of
landiolol hydrochloride minimized the occurrence of postoperative
complications (OR = 0.48, 95% CI 0.33-0.70, P = 0.0002). Funnel plots
indicated no obvious publication bias. <br/>CONCLUSION(S): Considering
this analysis, landiolol was effective in the prevention of AF after
cardiothoracic surgery and did not increase the risk of major
postoperative complications.

<92>
Accession Number
637184677
Title
Clinical Characteristics of a Zoonotic Occupational Disease- Brucella
endocarditis with Review of Literature.
Source
Indian Journal of Cardiovascular Disease in Women - WINCARS. 6(4) (pp
235-240), 2021. Date of Publication: 01 Oct 2021.
Author
Anilet V.K.; Tammiraju I.; Koduri M.
Institution
(Anilet, Tammiraju, Koduri) ASRAM Medical College, Andhra Pradesh, Eluru
534005, India
Publisher
Georg Thieme Verlag
Abstract
Background Brucellosis is a zoonotic bacterial infection caused by a
gram-negative aerobic coccobacillus. It can have varied presentation. Most
severe complications include neurological and cardiovascular involvement
(most commonly in the form of infective endocarditis). Aortic valve is
most commonly involved (75%). Blood culture is highly specific, while
serologic tests are more sensitive for diagnosing brucellosis.
Transthoracic and transesophageal echocardiography plays a major role in
diagnosing infective endocarditis. Treatment of Brucella endocarditis
includes combination of antibiotic therapy and surgical valve replacement.
We are presenting here a case series of seven cases of B. endocarditis
with different presentations and varied underlying cardiac conditions.
Materials and Methods Total seven cases of B. endocarditis were reported.
The age group ranges from 22 to 45 years. Majority of them were from
agriculture and dairy industry. All have presented with fever and three
patients had severe breathlessness. Three cases were rheumatic valve
diseases, one was bicuspid aortic valve, and one was congenital heart
disease with prosthetic valve. Six patients had native valve endocarditis
(four had predisposing cardiac condition with diseased valves, two had
normal valves), whereas one had prosthetic valve endocarditis. Four had
aortic valve involvement and three had mitral involvement. All cases were
diagnosed using blood culture, serology, and echocardiography. Conclusion
All were treated initially with antibiotics and valve replacement was done
in five cases. Mortality was the outcome in two cases on conservative
treatment and before surgery. Other five patients recovered after
surgery.<br/>Copyright &#xa9; 2021 Georg Thieme Verlag. All rights
reserved.

<93>
Accession Number
2015030975
Title
Comparison of erector spinae plane and paravertebral nerve blocks for
postoperative analgesia in children after the Nuss procedure: study
protocol for a randomized controlled non-inferiority clinical trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 139. Date of
Publication: December 2022.
Author
Xu M.; Zhang G.; Gong J.; Yang J.
Institution
(Xu, Zhang, Yang) Department of Anesthesiology and National Clinical
Research Center for Geriatrics, West China Hospital of Sichuan University,
Sichuan Province, Chengdu, China
(Gong) Department of Biomedical Engineering, Northwestern University,
Evanston, IL, United States
Publisher
BioMed Central Ltd
Abstract
Background: Thoracic paravertebral block (TPVB) is a widely advocated
regional technique for alleviating postoperative pain in children
undergoing elective pectus excavatum repair. However, this technique is
associated with some undesirable adverse events. Recently, the erector
spinae plane block (ESPB) has been introduced as a practical alternative
to the TPVB in thoracic surgery. This interfascial regional anesthesia
technique interrupts pain sensation by injecting local anesthetics between
the muscular layers of the thoracic wall. Several case series described it
as an effective pain management technique following pectus excavatum
repair. Therefore, this trial is designed to test the hypothesis that ESPB
is non-inferior to TPVB in postoperative pain control after pectus
excavatum repair. <br/>Method(s): This is a prospective randomized
double-blind non-inferiority trial. A total of 40 patients aged 4 to 18
years undergoing Nuss surgery will be randomly assigned to receive pain
treatment with either ESPB or TPVB. All patients will receive additional
systemic multimodal analgesia with an intravenous patient-controlled
analgesia pump and acetaminophen. The primary outcome is the pain
intensity at rest, 24 h postoperatively. Secondary outcomes include
accumulated morphine-equivalent consumption, postoperative pain scores,
emergence agitation incidence, time of the first mobilization, time to
first rescue analgesia, complications related to pain treatment, and
morphine-related adverse events. <br/>Discussion(s): This will the first
randomized controlled trial to compare ESPB with TPVB for analgesia after
pectus excavatum repair. This trial aims to provide important clinical
evidence to elaborate on the analgesic mechanism of ESPB in children.
Trial registration: ClinicalTrials.govNCT05034601. This trial was
prospectively registered.<br/>Copyright &#xa9; 2022, The Author(s).

<94>
Accession Number
2016907901
Title
What is the role of septal myectomy in aortic stenosis?.
Source
Revista Portuguesa de Cardiologia. (no pagination), 2022. Date of
Publication: 2022.
Author
Magro P.L.; Sousa Uva M.
Institution
(Magro, Sousa Uva) Department of Cardio-thoracic Surgery, Hospital de
Santa Cruz, Carnaxide, Portugal
Publisher
Sociedade Portuguesa de Cardiologia
Abstract
Asymmetric basal septal hypertrophy is present in 10% of patients with
hemodynamic significant aortic valve stenosis. From the surgeon's
standpoint, it represents a dilemma as it may be implicated in suboptimal
short and long-term results after aortic valve replacement (AVR), but also
heighten unwarranted complications at the time of surgical correction. To
provide insight about the usefulness and safety of concomitant septal
myectomy in this setting, we performed a literature review searching
Medline from its inception to November 2020 using the Pubmed interface.
Only five low evidence retrospective analyses, comprising a total of <200
patients undergoing AVR with concomitant septal myectomy, were found in
the literature. In summary, routine myectomy, in the presence of suspected
or directly visualized asymmetric septal hypertrophy on echocardiogram
during AVR, seems to be a safe procedure, with all authors reporting a low
rate or absence of complications. Overall, myectomy in this setting is
associated with superior echocardiographic results concerning surrogates
of LV remodelling (LVM; LVM index; LVM/height) and diastolic function
(E/E'), suggesting some benefit for hemodynamic outcomes. However, to what
extent hemodynamic improvement is exclusively attributable to myectomy is
uncertain, as is, the clinical significance of such an improvement, with
similar short and mid-term survival rates being reported.<br/>Copyright
&#xa9; 2022 Sociedade Portuguesa de Cardiologia

<95>
Accession Number
637312007
Title
CABG in patients with liver cirrhosis: to pump or not to pump?.
Source
Expert review of cardiovascular therapy. (no pagination), 2022. Date of
Publication: 19 Feb 2022.
Author
Jiang S.M.; Liblik K.; Baranchuk A.; Payne D.; El-Diasty M.
Institution
(Jiang, Payne, El-Diasty) Division of Cardiac Surgery, Queen's University,
ON, Kingston, Canada
(Liblik, Baranchuk) Department of Cardiology, Queen's University, ON,
Kingston, Canada
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Coronary artery bypass grafting in patients with established
liver cirrhosis is generally associated with poor outcomes. Avoiding
cardiopulmonary bypass (CPB) in these patients has not demonstrated any
advantage over the use of CPB. We review the current available literature
that compared the outcome of both on-pump (ONCABG) and off-pump (OPCAB)
techniques in cirrhotic patients in terms of morbidity and mortality.
AREAS COVERED: A comprehensive search was conducted in the PubMed/MEDLINE
and EMBASE databases in January 2021. Articles that reported outcomes of
OPCAB and/or ONCABG in cirrhotic patients with no concomitant surgical
procedures were included. 829 unique abstracts were retrieved with title
and abstract screening completed independently by two reviewers. Two case
studies and six retrospective cohort studies were included. The largest
study comprised more than 98% of the total population, showing some
survival benefit for OPCAB over ONCABG. However, it was population-based
and did not report the severity of liver. The remaining studies reported
no clear difference in outcome between the two techniques. EXPERT OPINION:
: Surgical myocardial revascularisation carries high peri-operative risk
in patients with liver cirrhosis irrespective of the surgical technique.
There is a lack of evidence to suggest that avoiding CPB in these patients
may be beneficial.

<96>
Accession Number
637304553
Title
Ten-Year Outcomes of Off-Pump vs On-Pump Coronary Artery Bypass Grafting
in the Department of Veterans Affairs: A Randomized Clinical Trial.
Source
JAMA Surgery. (no pagination), 2022. Date of Publication: 2022.
Author
Quin J.A.; Wagner T.H.; Hattler B.; Carr B.M.; Collins J.; Almassi G.H.;
Grover F.L.; Shroyer A.L.
Institution
(Quin) Department of Surgery, Veterans Affairs Boston Healthcare System,
West Roxbury, MA, United States
(Wagner) Research Office, Veterans Affairs Health Economics and Research
Center, Palo Alto, CA, United States
(Wagner) Department of Surgery, Stanford University, Palo Alto, CA, United
States
(Hattler) Department of Medicine, Rocky Mountain Regional Veterans Affairs
Medical Center, Aurora, CO, United States
(Hattler) Division of Cardiology, Department of Medicine, University of
Colorado, School of Medicine, Aurora, United States
(Carr) Department of Emergency Medicine, Mayo Clinic, Rochester, MN,
United States
(Collins) Research Office, Veterans Affairs Cooperative Studies Program,
Perry Point, MD, United States
(Almassi) Department of Surgery, Clement J. Zablocki Veterans Affairs
Medical Center, Milwaukee, WI, United States
(Almassi) Division of Cardiothoracic Surgery, Department of Surgery,
Medical College of Wisconsin, Milwaukee, United States
(Grover) Division of Cardiothoracic Surgery, Department of Surgery,
University of Colorado, School of Medicine, Aurora, United States
(Grover) Department of Surgery, Rocky Mountain Regional Veterans Affairs
Medical Center, Aurora, CO, United States
(Shroyer) Research and Development Office, Northport Veterans Affairs
Medical Center, 79 Middleville Rd, Northport, NY 11768, United States
(Shroyer) Department of Surgery, Stony Brook University Renaissance,
School of Medicine, Stony Brook, NY, United States
Publisher
American Medical Association
Abstract
Importance: The long-term benefits of off-pump ("beating heart") vs
on-pump coronary artery bypass grafting (CABG) remain controversial.
<br/>Objective(s): To evaluate the 10-year outcomes and costs of off-pump
vs on-pump CABG in the Department of Veterans Affairs (VA) Randomized
On/Off Bypass (ROOBY) trial. <br/>Design, Setting, and Participant(s):
From February 27, 2002, to May 7, 2007, 2203 veterans in the ROOBY trial
were randomly assigned to off-pump or on-pump CABG procedures at 18
participating VA medical centers. Per protocol, the veterans were observed
for 10 years; the 10-year, post-CABG clinical outcomes and costs were
assessed via centralized abstraction of electronic medical records
combined with merges to VA and non-VA databases. With the use of an
intention-to-treat approach, analyses were performed from May 7, 2017, to
December 9, 2021. <br/>Intervention(s): On-pump and off-pump CABG
procedures. <br/>Main Outcomes and Measures: The 10-year coprimary end
points included all-cause death and a composite end point identifying
patients who had died or had undergone subsequent revascularization (ie,
percutaneous coronary intervention [PCI] or repeated CABG); these 2 end
points were measured dichotomously and as time-to-event variables (ie,
time to death and time to composite end points). Secondary 10-year end
points included PCIs, repeated CABG procedures, changes in cardiac
symptoms, and 2018-adjusted VA estimated costs. Changes from baseline to
10 years in post-CABG, clinically relevant cardiac symptoms were evaluated
for New York Heart Association functional class, Canadian Cardiovascular
Society angina class, and atrial fibrillation. Outcome differences were
adjudicated by an end points committee. Given that pre-CABG risks were
balanced, the protocol-driven primary and secondary hypotheses directly
compared 10-year treatment-related effects. <br/>Result(s): A total of
1104 patients (1097 men [99.4%]; mean [SD] age, 63.0 [8.5] years) were
enrolled in the off-pump group, and 1099 patients (1092 men [99.5%]; mean
[SD] age, 62.5 [8.5] years) were enrolled in the on-pump group. The
10-year death rates were 34.2% (n = 378) for the off-pump group and 31.1%
(n = 342) for the on-pump group (relative risk, 1.05; 95% CI, 0.99-1.11; P
=.12). The median time to composite end point for the off-pump group (4.6
years; IQR, 1.4-7.5 years) was approximately 4.3 months shorter than that
for the on-pump group (5.0 years; IQR, 1.8-7.9 years; P =.03). No
significant 10-year treatment-related differences were documented for any
other primary or secondary end points. After the removal of conversions,
sensitivity analyses reconfirmed these findings. <br/>Conclusions and
Relevance: No off-pump CABG advantages were found for 10-year death or
revascularization end points; the time to composite end point was lower in
the off-pump group than in the on-pump group. For veterans, in the absence
of on-pump contraindications, a case cannot be made for supplanting the
traditional on-pump CABG technique with an off-pump approach. Trial
Registration: ClinicalTrials.gov Identifier: NCT01924442.<br/>Copyright
&#xa9; 2022 American Medical Association. All rights reserved.