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<1>
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Accession Number
637880009
Title
CT or Invasive Coronary Angiography in Stable Chest Pain.
Source
New England Journal of Medicine. 386(17) (pp 1591-1602), 2022. Date of
Publication: 28 Apr 2022.
Author
Maurovich-Horvat P.; Bosserdt M.; Kofoed K.F.; Rieckmann N.; Benedek T.;
Donnelly P.; Rodriguez-Palomares J.; Erglis A.; Stechovsky C.; Sakalyte
G.; Adic N.C.; Gutberlet M.; Dodd J.D.; Diez I.; Davis G.; Zimmermann E.;
Kepka C.; Vidakovic R.; Francone M.; Ilnicka-Suckiel M.; Plank F.; Knuuti
J.; Faria R.; Schroder S.; Berry C.; Saba L.; Ruzsics B.; Kubiak C.;
Gutierrez-Ibarluzea I.; Hansen K.S.; Muller-Nordhorn J.; Merkely B.;
Knudsen A.D.; Benedek I.; Orr C.; Valente F.X.; Zvaigzne L.; Suchanek V.;
Zajanckauskiene L.; Adic F.; Woinke M.; Hensey M.; Lecumberri I.; Thwaite
E.; Laule M.; Kruk M.; Neskovic A.N.; Mancone M.; Kusmierz D.; Feuchtner
G.; Pietila M.; Ribeiro V.G.; Drosch T.; Delles C.; Matta G.; Fisher M.;
Szilveszter B.; Larsen L.; Ratiu M.; Kelly S.; del Blanco B.G.; Rubio A.;
Drobni Z.D.; Jurlander B.; Rodean I.; Regan S.; Calabria H.C.; Boussoussou
M.; Engstrom T.; Hodas R.; Napp A.E.; Haase R.; Feger S.; Serna-Higuita
L.M.; Neumann K.; Dreger H.; Rief M.; Wieske V.; Estrella M.; Martus P.;
Dewey M.
Institution
(Maurovich-Horvat, Merkely, Szilveszter, Drobni, Boussoussou) The Heart
and Vascular Center, Semmelweis University, Budapest, Hungary
(Maurovich-Horvat) The Department of Radiology, Medical Imaging Cente,
Semmelweis University, Budapest, Hungary
(Bosserdt, Zimmermann, Napp, Haase, Feger, Rief, Wieske, Estrella, Dewey)
The Department of Radiology, Charite-Universitatsmedizin Berlin, Freie
Universitat Berlin, Berlin, Germany
(Laule, Dreger) The Department of Cardiology and Angiology,
Charite-Universitatsmedizin Berlin, Freie Universitat Berlin, Berlin,
Germany
(Rieckmann, Muller-Nordhorn) The Institute of Public Health,
Charite-Universitatsmedizin Berlin, Freie Universitat Berlin, Berlin,
Germany
(Neumann) The Institute of Biometry and Clinical Epidemiology,
Charite-Universitatsmedizin Berlin, Freie Universitat Berlin, Berlin,
Germany
(Dreger, Dewey) Humboldt-Universitat zu Berlin and DZHK (German Center for
Cardiovascular Research), Partner Site Berlin, Berlin, Germany
(Dewey) Berlin Institute of Health, Berlin University Alliance, Berlin,
Germany
(Gutberlet) The Department of Radiology, University of Leipzig Heart
Center, Leipzig, Germany
(Woinke) The Department of Cardiology, University of Leipzig Heart Center,
Leipzig, Germany
(Schroder, Drosch) The Department of Cardiology, Alb Fils Kliniken,
Goppingen, Germany
(Muller-Nordhorn) The Bavarian Cancer Registry, Bavarian Health and Food
Safety Authority, Munich, Germany
(Serna-Higuita, Martus) The Department of Clinical Epidemiology and
Applied Biostatistics, Universitatsklinikum Tubingen, Tubingen, Germany
(Kofoed, Knudsen, Engstrom) The Department of Cardiology, Rigshospitalet,
University of Copenhagen, Copenhagen, Denmark
(Kofoed, Knudsen) The Department of Radiology, Rigshospitalet, University
of Copenhagen, Copenhagen, Denmark
(Kofoed, Knudsen, Larsen, Jurlander, Engstrom) The Department of Clinical
Medicine, Faculty of Health and Medical Sciences, University of
Copenhagen, Copenhagen, Denmark
(Hansen) The Department of Public Health, Section for Health Services
Research, University of Copenhagen, Copenhagen, Denmark
(Larsen) The Department of Cardiology, Herlev-Gentofte Hospital, Hellerup,
Denmark
(Jurlander) The Department of Cardiology, Nordsjaellands Hospital,
Hillerod, Denmark
(Benedek, Hodas) The Department of Internal Medicine, Clinic of
Cardiology, Targu Mures, Romania
(Ratiu) The Department of Radiology and Medical Imaging, Targu Mures,
Romania
(Benedek) George Emil Palade University of Medicine, Pharmacy, Science,
and Technology, County Clinical Emergency Hospital Targu Mures, Targu
Mures, Romania
(Benedek, Rodean) The Center of Advanced Research in Multimodality Cardiac
Imaging, CardioMed Medical Center, Targu Mures, Romania
(Donnelly, Orr, Kelly, Regan) The Department of Cardiology, Southeastern
Health and Social Care Trust, Belfast, United Kingdom
(Davis) The Department of Cardiology, Aintree University Hospital,
Liverpool, United Kingdom
(Thwaite) The Department of Radiology, Aintree University Hospital,
Liverpool, United Kingdom
(Ruzsics, Fisher) The Department of Cardiology, Royal Liverpool University
Hospital, The Institute for Cardiovascular Medicine and Science, Liverpool
Heart and Chest Hospital, Liverpool, United Kingdom
(Fisher) The Faculty of Health and Life Sciences, University of Liverpool,
Liverpool, United Kingdom
(Davis) Edge Hill University, Ormskirk, United Kingdom
(Berry, Delles) The Institute of Cardiovascular and Medical Sciences,
University of Glasgow, Glasgow, United Kingdom
(Berry) Golden Jubilee National Hospital, Clydebank, United Kingdom
(Rodriguez-Palomares, Valente, del Blanco) The Department of Cardiology,
Hospital Universitario Vall d'Hebron, Institut de Recerca, Universitat
Autonoma de Barcelona, Barcelona, Spain
(Calabria) The Department of Radiology, Hospital Universitario Vall
d'Hebron, Institut de Recerca, Universitat Autonoma de Barcelona,
Barcelona, Spain
(Rodriguez-Palomares, Valente, del Blanco) Centro de Investigacion
Biomedica en Red, Madrid, Spain
(Diez, Rubio) The Department of Cardiology, Basurto Hospital, Bilbao,
Spain
(Lecumberri) The Department of Radiology, Basurto Hospital, Bilbao, Spain
(Gutierrez-Ibarluzea) Basque Foundation for Health Innovation and
Research, Barakaldo, Spain
(Gutierrez-Ibarluzea) The Basque Office for Health Technology Assessment,
Vitoria-Gasteiz, Spain
(Erglis) The Department of Cardiology, Paul Stradins Clinical University
Hospital, Riga, Latvia
(Zvaigzne) The Department of Radiology, Paul Stradins Clinical University
Hospital, Riga, Latvia
(Erglis) The University of Latvia, Riga, Latvia
(Stechovsky) The Department of Cardiology, Motol University Hospital,
Prague, Czechia
(Suchanek) The Department of Imaging Methods, Motol University Hospital,
Prague, Czechia
(Sakalyte, Zajanckauskiene) The Department of Cardiology, Medical Academy,
Lithuanian University of Health Sciences, Kaunas, Lithuania
(Sakalyte, Zajanckauskiene) The Department of Cardiology, Hospital of
Lithuanian University of Health Sciences, Kaunas, Lithuania
(Adic, Adic) The Faculty of Medicine, University of Novi Sad, Novi Sad,
Serbia
(Adic, Adic) The Department of Cardiology, Institute for Cardiovascular
Diseases of Vojvodina, Novi Sad, Serbia
(Vidakovic, Neskovic) The Department of Cardiology, Internal Medicine
Clinic, Clinical Hospital Center Zemun, University of Belgrade, Belgrade,
Serbia
(Vidakovic, Neskovic) The Faculty of Medicine, University of Belgrade,
Belgrade, Serbia
(Dodd) The Department of Radiology, University College Dublin, Dublin,
Ireland
(Hensey) The Department of Cardiology, University College Dublin, Dublin,
Ireland
(Dodd) St. Vincent's University Hospital, School of Medicine, University
College Dublin, Dublin, Ireland
(Kepka, Kruk) The National Institute of Cardiology, Warsaw, Poland
(Ilnicka-Suckiel) The Department of Cardiology, Provincial Specialist
Hospital in Wroclaw, Wroclaw, Poland
(Kusmierz) The Department of Radiology, Provincial Specialist Hospital in
Wroclaw, Wroclaw, Poland
(Mancone) The Department of Clinical Internal, Anesthesiologic, and
Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
(Francone) The Department of Biomedical Sciences, Humanitas University,
IRCCS Humanitas Research Hospital, Milan, Italy
(Saba) The Department of Radiology, University of Cagliari, Cagliari,
Italy
(Matta) The Department of Radiology, Azienda Ospedaliera Brotzu, Cagliari,
Italy
(Plank) The Department of Internal Medicine III, The Department of
Cardiology, Innsbruck Medical University, Innsbruck, Austria
(Feuchtner) The Department of Radiology, Innsbruck Medical University,
Innsbruck, Austria
(Knuuti) The Turku PET Center, Turku University Hospital, University of
Turku, Turku, Finland
(Pietila) Heart Center, Turku University Hospital, University of Turku,
Turku, Finland
(Pietila) The Administrative Center, Health Care District of Southwestern
Finland, Turku, Finland
(Faria, Ribeiro) The Department of Cardiology, Centro Hospitalar de Vila
Nova de Gaia-Espinho, Vila Nova de Gaia, Portugal
(Kubiak) The European Clinical Research Infrastructure Network-European
Research Infrastructure Consortium, Paris, France
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND In the diagnosis of obstructive coronary artery disease (CAD),
computed tomography (CT) is an accurate, noninvasive alternative to
invasive coronary angiography (ICA). However, the comparative
effectiveness of CT and ICA in the management of CAD to reduce the
frequency of major adverse cardiovascular events is uncertain. METHODS We
conducted a pragmatic, randomized trial comparing CT with ICA as initial
diagnostic imaging strategies for guiding the treatment of patients with
stable chest pain who had an intermediate pretest probability of
obstructive CAD and were referred for ICA at one of 26 European centers.
The primary outcome was major adverse cardiovascular events
(cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke)
over 3.5 years. Key secondary outcomes were procedure-related
complications and angina pectoris. RESULTS Among 3561 patients (56.2% of
whom were women), follow-up was complete for 3523 (98.9%). Major adverse
cardiovascular events occurred in 38 of 1808 patients (2.1%) in the CT
group and in 52 of 1753 (3.0%) in the ICA group (hazard ratio, 0.70; 95%
confidence interval [CI], 0.46 to 1.07; P=0.10). Major procedure-related
complications occurred in 9 patients (0.5%) in the CT group and in 33
(1.9%) in the ICA group (hazard ratio, 0.26; 95% CI, 0.13 to 0.55). Angina
during the final 4 weeks of follow-up was reported in 8.8% of the patients
in the CT group and in 7.5% of those in the ICA group (odds ratio, 1.17;
95% CI, 0.92 to 1.48). CONCLUSIONS Among patients referred for ICA because
of stable chest pain and intermediate pretest probability of CAD, the risk
of major adverse cardiovascular events was similar in the CT group and the
ICA group. The frequency of major procedure-related complications was
lower with an initial CT strategy.<br/>Copyright &#xa9; 2022 Massachusetts
Medical Society.

<2>
Accession Number
2022237642
Title
3-Factor versus 4-Factor Prothrombin Complex Concentrates for the Reversal
of Vitamin K Antagonist-Associated Coagulopathy: A Systematic Review and
Meta-analysis.
Source
Thrombosis and Haemostasis. 123(1) (pp 40-53), 2023. Date of Publication:
01 Jan 2023.
Author
Puchstein D.; Kork F.; Schochl H.; Rayatdoost F.; Grottke O.
Institution
(Puchstein, Kork, Rayatdoost, Grottke) Department of Anaesthesiology, RWTH
Aachen University Hospital, Aachen, Germany
(Schochl) Department for Anaesthesiology and Intensive Care Medicine, AUVA
Trauma Academic Teaching Hospital, Paracelsus Medical University Salzburg,
Salzburg, Austria
Publisher
Georg Thieme Verlag
Abstract
Long-term anticoagulation is used worldwide to prevent or treat thrombotic
events. Anticoagulant therapy using vitamin K antagonists (VKAs) is well
established; however, anticoagulants carry an increased risk of
potentially life-threatening bleeding. In cases of bleeding or need for
surgery, patients require careful management, balancing the need for rapid
anticoagulant reversal with risk of thromboembolic events. Prothrombin
complex concentrates (PCCs) replenish clotting factors and reverse
VKA-associated coagulopathy. Two forms of PCC, 3-factor (3F-PCC) and
4-factor (4F-PCC), are available. Using PRISMA methodology, we
systematically reviewed whether 4F-PCC is superior to 3F-PCC for the
reversal of VKA-associated coagulopathy. Of the 392 articles identified,
48 full texts were reviewed, with 11 articles identified using criteria
based on the PICOS format. Data were captured from 1,155 patients: 3F-PCC,
n=651; 4F-PCC, n=504. ROBINS-I was used to assess bias. Nine studies
showed international normalized ratio (INR) normalization to a predefined
goal, ranging from <=1.5 to <=1.3, following PCC treatment. Meta-analysis
of the data showed that 4F-PCC was favorable compared with 3F-PCC overall
(odds ratio [OR]: 3.50; 95% confidence interval [CI]: 1.88-6.52, p<0.0001)
and for patients with a goal INR of <=1.5 or <=1.3 (OR: 3.45; 95% CI:
1.42-8.39, p=0.006; OR: 3.25; 95% CI: 1.30-8.13, p=0.01, respectively).
However, heterogeneity was substantial (I2=62%, I2=70%, I2=64%). Neither a
significant difference in mortality (OR: 0.72; 95% CI: 0.42-1.24, p=0.23)
nor in thromboembolisms was reported. These data suggest that 4F-PCC is
better suited than 3F-PCC for the treatment of patients with
VKA-associated coagulopathy, but further work is required for a definitive
recommendation.<br/>Copyright &#xa9; 2023. Thieme. All rights reserved.

<3>
Accession Number
2020280144
Title
The prognostic value of elevated neutrophil-lymphocyte ratio for cardiac
surgery-associated acute kidney injury: A systematic review and
meta-analysis.
Source
Acta Anaesthesiologica Scandinavica. 67(2) (pp 131-141), 2023. Date of
Publication: February 2023.
Author
Wheatley J.; Liu Z.; Loth J.; Plummer M.P.; Penny-Dimri J.C.; Segal R.;
Smith J.; Perry L.A.
Institution
(Wheatley) Department of Anaesthesia, Perioperative Medicine and Pain
Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
(Wheatley) Department of Intensive Care Medicine, Royal Melbourne
Hospital, Melbourne, VIC, Australia
(Liu, Loth, Segal, Perry) Department of Anaesthesia, Royal Melbourne
Hospital, Melbourne, VIC, Australia
(Liu, Plummer, Segal, Perry) Department of Critical Care, Melbourne
Medical School, Faculty of Medicine, Dentistry and Health Sciences,
University of Melbourne, Melbourne, VIC, Australia
(Plummer) Department of Intensive Care Medicine, Royal Adelaide Hospital,
Adelaide, SA, Australia
(Penny-Dimri, Smith) Department of Surgery (School of Clinical Sciences at
Monash Health), Monash University, Melbourne, VIC, Australia
(Penny-Dimri, Smith) Department of Cardiothoracic Surgery, Monash Health,
Melbourne, VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
Background: Patients undergoing cardiac surgery are at significant risk of
developing postoperative acute kidney injury (AKI). Neutrophil-lymphocyte
ratio (NLR) is a widely available inflammatory biomarker which may be of
prognostic value in this setting. <br/>Method(s): We conducted a
systematic review and meta-analysis of studies reporting associations
between perioperative NLR with postoperative AKI. We searched Medline,
Embase and the Cochrane Library, without language restriction, from
inception to May 2022 for relevant studies. We meta-analysed the reported
odds ratios (ORs) with 95% confidence intervals (CIs) for both elevated
preoperative and postoperative NLR with risk of postoperative AKI and need
for renal replacement therapy (RRT). We conducted a meta-regression to
explore inter-study statistical heterogeneity. <br/>Result(s): Twelve
studies involving 10,724 participants undergoing cardiac surgery were
included, with eight studies being deemed at high risk of bias using
PROBAST modelling. We found statistically significant associations between
elevated preoperative NLR and postoperative AKI (OR 1.45, 95% CI
1.18-1.77), as well as postoperative need for RRT (OR 2.37, 95% CI
1.50-3.72). Postoperative NLR measurements were not of prognostic
significance. <br/>Conclusion(s): Elevated preoperative NLR is a reliable
inflammatory biomarker for predicting AKI following cardiac
surgery.<br/>Copyright &#xa9; 2022 The Authors. Acta Anaesthesiologica
Scandinavica published by John Wiley & Sons Ltd on behalf of Acta
Anaesthesiologica Scandinavica Foundation.

<4>
Accession Number
2021094682
Title
Music therapy for pain and anxiety in patients after cardiac valve
replacement: a randomized controlled clinical trial.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
32. Date of Publication: December 2023.
Author
Dong Y.; Zhang L.; Chen L.-W.; Luo Z.-R.
Institution
(Dong, Zhang, Chen, Luo) Department of Cardiovascular Surgery and Cardiac
Disease Center, Union Hospital, Fujian Medical University, Fuzhou 350001,
China
(Dong, Zhang, Chen, Luo) Key Laboratory of Cardio-Thoracic Surgery (Fujian
Medical University), Fujian Province University, Fuzhou, China
Publisher
BioMed Central Ltd
Abstract
Objective: This study aimed to assess how listening to music after cardiac
valve replacements affected patients' pain, anxiety, and vital signs.
<br/>Method(s): In Fuzhou, China's Fujian Medical University Union
Hospital, the cardiac surgery division conducted a randomized controlled
clinical experiment. 86 patients were enrolled, and 43 were assigned
randomly to each group (control and experimental group). The standard
treatment was given to the control group, while the experimental group was
given standard treatment + a 15-min music intervention 3 times. Indicators
include pain, anxiety and vital signs (respiratory rate, heart rate, and
blood pressure). <br/>Result(s): In comparison to the control group, the
experimental group, over time, demonstrated a statistically substantial
decrease in pain, anxiety, systolic blood pressure, heart rate and
respiratory rate (all P < 0.001), yet, there were no discernible
variations (P > 0.05) in diastolic blood pressure. <br/>Conclusion(s): In
conclusion, these results provide additional proof for using music therapy
to minimize cardiac postoperative pain and anxiety, as well as systolic
blood pressure, heart rate and respiratory rate. Moreover, it should be
regarded as a supplementary treatment for pain and anxiety after cardiac
valve replacement and other medical procedures with comparable
postoperative pain.<br/>Copyright &#xa9; 2023, The Author(s).

<5>
Accession Number
2020121884
Title
Prophylactic Left Atrial Appendage Exclusion in Cardiac Surgery Patients
With Elevated CHA<inf>2</inf>DS<inf>2</inf>-VASc Score: Results of the
Randomized ATLAS Trial.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 17(6) (pp 463-470), 2022. Date of Publication: November/December
2022.
Author
Gerdisch M.W.; Garrett H.E.; Mumtaz M.A.; Grehan J.F.; Castillo-Sang M.;
Miller J.S.; Zorn G.L.; Gall S.A.; Johnkoski J.A.; Ramlawi B.
Institution
(Gerdisch) Franciscan Health Indianapolis, IN, United States
(Garrett) Cardiovascular Surgery Clinic, Memphis, TN, United States
(Mumtaz) University of Pittsburgh Medical Center Central PA, Harrisburg,
PA, United States
(Grehan) Allina Health System, St. Paul, MN, United States
(Castillo-Sang) The Christ Hospital, Cincinnati, OH, United States
(Miller) Emory University Hospital, Atlanta, GA, United States
(Zorn) University of Kansas, Medical Center, Kansas City, KS, United
States
(Gall) CVA Heart Institute, Kingsport, TN, United States
(Johnkoski) Aspirus Wausau Hospital, WI, United States
(Ramlawi) Lankenau Heart Institute, Philadelphia, PA, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: Patients with elevated CHA<inf>2</inf>DS<inf>2</inf>-VASc
scores are at high risk for atrial fibrillation (AF) and thromboembolic
events (TE) after cardiac surgery. Left atrial appendage exclusion (LAAE)
is a permanent, continuous approach to stroke prevention in AF, overcoming
limitations of oral anticoagulation (OAC). We report ATLAS trial results
focused on LAAE technical success and perioperative safety and TE rates
with and without LAAE in cardiac surgery patients who developed
postoperative AF (POAF). <br/>Method(s): ATLAS (NCT02701062) was a
prospective, multicenter, feasibility trial. Patients age >=18 years,
undergoing structural heart procedure, with no preoperative AF,
CHA<inf>2</inf>DS<inf>2</inf>-VASc >=2, and HAS-BLED >=2 were randomized
2:1 to LAAE or no LAAE. Patients who developed POAF and/or received LAAE
were followed for 1 year. LAAE was evaluated with intraoperative
transesophageal echocardiography. <br/>Result(s): A total of 562 patients
were randomized to LAAE (n = 376) or no LAAE (n = 186). Mean
CHA<inf>2</inf>DS<inf>2</inf>-VASc (3.4 vs 3.4) and HAS-BLED (2.8 vs 2.9)
scores were similar for LAAE and no LAAE groups. LAAE success (no flow nor
residual stump >10 mm) was 99%. One LAAE-related serious adverse event
(0.27%) occurred and was resolved without sequelae. There were 44.3% of
patients who developed POAF. Through 1 year, 3.4% of LAAE patients and
5.6% of no LAAE patients had TE. OAC was used by 32.5% of POAF patients.
Bleeding was higher with OAC than without (16.1% vs 5.4%, P = 0.008).
<br/>Conclusion(s): ATLAS demonstrated a high rate of successful LAAE with
low LAAE-related serious adverse events in cardiac surgery patients. Study
results should be considered in future trial design to further evaluate
prophylactic LAAE for stroke prevention in cardiac surgery patients with
elevated stroke risk.<br/>Copyright &#xa9; The Author(s) 2022.

<6>
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Accession Number
2022081440
Title
Chlorthalidone vs. Hydrochlorothiazide for Hypertension-Cardiovascular
Events.
Source
New England Journal of Medicine. 387(26) (pp 2401-2410), 2022. Date of
Publication: 29 Dec 2022.
Author
Ishani A.; Cushman W.C.; Leatherman S.M.; Lew R.A.; Woods P.; Glassman
P.A.; Taylor A.A.; Hau C.; Klint A.; Huang G.D.; Brophy M.T.; Fiore L.D.;
Ferguson R.E.
Institution
(Ishani) Minneapolis Veterans Affairs (VA), Health Care System, Department
of Medicine, University of Minnesota, Minneapolis, United States
(Cushman) Medical Service, Memphis VA Medical Center, Department of
Preventive Medicine, University of Tennessee, Health Science Center,
Memphis, United States
(Leatherman, Lew, Woods, Hau, Klint, Brophy, Fiore, Ferguson) Cooperative
Studies Program Coordinating Center, VA Boston Healthcare System, United
States
(Leatherman, Lew) Department of Biostatistics, Boston University, School
of Public Health, United States
(Brophy, Ferguson) Department of Medicine, Boston University, School of
Medicine, Boston, United States
(Glassman) Pharmacy Benefits Management Services
(Huang) Office of Research and Development, Department of Veterans
Affairs, Washington, DC, United States
(Glassman) VA Greater Los Angeles Healthcare System, David Geffen School
of Medicine, University of California, Los Angeles, United States
(Taylor) Michael E. DeBakey VA Medical Center, Department of Medicine,
Baylor College of Medicine, Houston, United States
Publisher
Massachussetts Medical Society
Abstract
Background Whether chlorthalidone is superior to hydrochlorothiazide for
preventing major adverse cardiovascular events in patients with
hypertension is unclear. Methods In a pragmatic trial, we randomly
assigned adults 65 years of age or older who were patients in the
Department of Veterans Affairs health system and had been receiving
hydrochlorothiazide at a daily dose of 25 or 50 mg to continue therapy
with hydrochlorothiazide or to switch to chlorthalidone at a daily dose of
12.5 or 25 mg. The primary outcome was a composite of nonfatal myocardial
infarction, stroke, heart failure resulting in hospitalization, urgent
coronary revascularization for unstable angina, and non-cancer-related
death. Safety was also assessed. Results A total of 13,523 patients
underwent randomization. The mean age was 72 years. At baseline,
hydrochlorothiazide at a dose of 25 mg per day had been prescribed in
12,781 patients (94.5%). The mean baseline systolic blood pressure in each
group was 139 mm Hg. At a median follow-up of 2.4 years, there was little
difference in the occurrence of primary-outcome events between the
chlorthalidone group (702 patients [10.4%]) and the hydrochlorothiazide
group (675 patients [10.0%]) (hazard ratio, 1.04; 95% confidence interval,
0.94 to 1.16; P=0.45). There were no between-group differences in the
occurrence of any of the components of the primary outcome. The incidence
of hypokalemia was higher in the chlorthalidone group than in the
hydrochlorothiazide group (6.0% vs. 4.4%, P<0.001). Conclusions In this
large pragmatic trial of thiazide diuretics at doses commonly used in
clinical practice, patients who received chlorthalidone did not have a
lower occurrence of major cardiovascular outcome events or
non-cancer-related deaths than patients who received hydrochlorothiazide.
(Funded by the Veterans Affairs Cooperative Studies Program;
ClinicalTrials.gov number, NCT02185417.)<br/>Copyright &#xa9; 2022
Massachusetts Medical Society.

<7>
Accession Number
2018943829
Title
L-Arginine Enhances the Effects of Cardiac Rehabilitation on Physical
Performance: New Insights for Managing Cardiovascular Patients During the
COVID-19 Pandemic.
Source
Journal of Pharmacology and Experimental Therapeutics. 381(3) (pp
197-203), 2022. Date of Publication: 01 Jun 2022.
Author
Mone P.; Izzo R.; Marazzi G.; Manzi M.V.; Gallo P.; Campolongo G.;
Cacciotti L.; Tartaglia D.; Caminiti G.; Varzideh F.; Santulli G.;
Trimarco V.
Institution
(Mone, Varzideh, Santulli) Departments of Medicine (Cardiology) and
Molecular Pharmacology, Wilf Family Cardiovascular Research Institute,
Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein
Institute for Neuroimmunology and Inflammation, Einstein-Sinai Diabetes
Research Center, Einstein Institute for Aging Research, Albert Einstein
College of Medicine, New York, NY, United States
(Izzo, Manzi, Gallo, Santulli) Department of Advanced Biomedical Sciences,
University of Naples Federico II, Naples, Italy
(Marazzi, Caminiti) IRCCS San Raffaele, Rome, Italy
(Campolongo) San Carlo di Nancy Hospital, Rome, Italy
(Cacciotti) Madre Giuseppina Vannini Hospital, Rome, Italy
(Tartaglia) ASL AV, Avellino, Italy
(Trimarco) Department of Neuroscience, Reproductive Sciences and
Dentistry, University of Naples Federico II, Naples, Italy
Publisher
American Society for Pharmacology and Experimental Therapy (ASPET)
Abstract
Cardiac rehabilitation (CR) following acute myocardial infarction (AMI)
improves physical capacities and decreases hospitalizations and
cardiovascular mortality. L-arginine is the substrate used by nitric oxide
(NO) synthase to generate NO and it has been shown to exert its beneficial
effects on endothelium driving vasodilatation, reducing inflammation, and
ameliorating physical function. We hypothesized that L-arginine could
enhance physical capacities in patients who underwent CR after AMI.We
designed a study aimed to assess the effects of L-arginine administration
on the physical capacity of patients who underwent coronary
revascularization after AMI. The trial was carried out amid the COVID-19
pandemic. Patients were assigned, with a 2:1 ratio, to add to their
standard therapy one bottle containing 1.66 g of L-arginine or one bottle
of identical aspect apart from not containing L-arginine, twice a day
orally for 3 weeks. Patients performed a 6-minute walking test (6MWT), and
their Borg modified 0-10 rating of perceived exertion (BRPE) was assessed
before starting and at the end of the treatment. Seventy-five patients
receiving L-arginine, and 35 receiving placebo successfully completed the
study. The 6MWT distance increased significantly in the L-arginine group
compared with both baseline and placebo (P < 0.0001). Additionally, we
observed a significant improvement in the BRPE in patients treated with
L-arginine but not in the placebo group. Taken together, our data indicate
that L-arginine potentiates the response to CR independently of age, sex,
baseline functional capacity, and comorbid conditions. SIGNIFICANCE
STATEMENT This study shows for the first time that oral supplementation of
L-arginine potentiates the response to cardiac rehabilitation after
myocardial infarction and cardiac revascularization. Indeed, we observed a
significant improvement in two fundamental parameters, namely, the
6-minute walking test and the Borg modified 0-10 rating of perceived
exertion. Strikingly, the beneficial effects of L-arginine were
independent of age, sex, comorbid conditions, and baseline functional
capacity.<br/>Copyright &#xa9; 2022 by The American Society for
Pharmacology and Experimental Therapeutics.

<8>
Accession Number
2015360070
Title
A Randomized Pilot Trial Assessing the Role of Human Fibrinogen
Concentrate in Decreasing Cryoprecipitate Use and Blood Loss in Infants
Undergoing Cardiopulmonary Bypass.
Source
Pediatric Cardiology. 43(7) (pp 1444-1454), 2022. Date of Publication:
October 2022.
Author
Tirotta C.F.; Lagueruela R.G.; Gupta A.; Salyakina D.; Aguero D.; Ojito
J.; Kubes K.; Hannan R.; Burke R.P.
Institution
(Tirotta, Lagueruela, Aguero, Ojito, Kubes, Hannan, Burke) The Heart
Program, Nicklaus Children's Hospital, Miami, FL, United States
(Gupta, Salyakina) Nicklaus Children's Health System Research Institute,
Miami, FL, United States
(Tirotta, Lagueruela) Dept. Anesthesiology, The Heart Program, Nicklaus
Children's Hospital, 3100 SW 62nd Avenue, Miami, FL 33155, United States
Publisher
Springer
Abstract
The objective of this study was to determine whether treatment with human
fibrinogen concentrate decreases the need for component blood therapy and
blood loss in neonate and infant patients undergoing cardiopulmonary
bypass. Pediatric patients (N = 30) undergoing elective cardiac surgery
were randomized to receive human fibrinogen concentrate or placebo
following cardiopulmonary bypass termination. The primary endpoint was the
amount of cryoprecipitate administered. Secondary endpoints included
estimated blood loss during the 24 h post-surgery; perioperative blood
product transfusion; effects of fibrinogen infusion on global hemostasis,
measured by laboratory testing and rotational thromboelastometry; and
adverse events. No clinically significant differences were identified in
baseline characteristics between groups. A significantly lower volume of
cryoprecipitate was administered to the treatment group during the
perioperative period [median (interquartile range) 0.0 (0.0-0.0) cc/kg vs
12.0 (8.2-14.3) cc/kg; P < 0.0001] versus placebo. No difference was
observed between treatment groups in blood loss, laboratory coagulation
tests, use of other blood components, or incidence of adverse events.
FIBTEM amplitude of maximum clot firmness values was significantly higher
among patients treated with human fibrinogen concentrate versus placebo (P
<= 0.0001). No significant differences were observed in post-drug HEPTEM,
INTEM, and EXTEM results. Human fibrinogen concentrate (70 mg/kg)
administered after the termination of cardiopulmonary bypass reduced the
need for transfusion with cryoprecipitate in a neonate and infant patient
population. ClinicalTrials.gov identifier: NCT02822599.<br/>Copyright
&#xa9; 2022, The Author(s).

<9>
Accession Number
2019526593
Title
Dutogliptin in Combination with Filgrastim in Early Recovery
Post-Myocardial Infarction-The REC-DUT-002 Trial.
Source
Journal of Clinical Medicine. 11(19) (no pagination), 2022. Article
Number: 5728. Date of Publication: October 2022.
Author
von Lewinski D.; Benedikt M.; Alber H.; Debrauwere J.; Smits P.C.; Edes
I.; Kiss R.G.; Merkely B.; Nagy G.G.; Ptaszynski P.; Zarebinski M.; Kubica
J.; Kleinrok A.; Coats A.J.S.; Wallner M.
Institution
(von Lewinski, Benedikt, Wallner) Clinical Department of Cardiology,
Medical University of Graz, Graz 8036, Austria
(Alber) Clinic of Klagenfurt at Worthersee, Klagenfurt 9020, Austria
(Debrauwere) Algemeen Stedelijk Ziekenhuis, Aalst 9300, Belgium
(Smits) Department of Cardiology, Maasstad Ziekenhuis Rotterdam, Rotterdam
3079, Netherlands
(Edes) Debreceni Egyetem Klinikai Kozpont Regionalis es Intezmenyi
Kutatasetikai Bizottsag, Pf. 12, Debrecen 4012, Hungary
(Kiss) Magyar Honvedseg Egeszsegugyi Kozpont Intezmenyi es Regionalis
Kutatasetikai Bizottsag, Robert Karoly korut 44, Budapest 1134, Hungary
(Merkely) Heart and Vascular Center, Semmelweis University, Budapest 1122,
Hungary
(Nagy) Borsod-Abauj-Zemplen County Central Hospital and University
Teaching Hospital, 1st Department of Internal Medicine and Cardiology,
Miskolc 3526, Hungary
(Ptaszynski) Department of Electrocardiology, Central University Hospital,
Medical University of Lodz, Lodz 92-213, Poland
(Zarebinski) SPS Szpital Zachodni im. sw. Jana Pawla II, Invasive
Cardiology Department, Daleka 11, Grodzisk mzowiecki 05-825, Poland
(Kubica) Department of Cardiology, Collegium Medicum, Nicolaus Copernicus
University, Bydgoszcz 85-094, Poland
(Kleinrok) Academy of Zamosc, Institute of Humanities and Medicine, Pereca
2 St, Zamosc 22-400, Poland
(Coats) Heart Research Institute, 7 Eliza St, Newtown, NSW 2042, Australia
(Wallner) Cardiovascular Research Center, Lewis Katz School of Medicine,
Temple University, Philadelphia, PA 19140, United States
Publisher
MDPI
Abstract
Patients with acute myocardial infarction are at high risk for developing
heart failure due to scar development. Although regenerative approaches
are evolving, consistent clinical benefits have not yet been reported.
Treatment with dutogliptin, a second-generation DPP-4 inhibitor, in
co-administration with filgrastim (G-CSF) has been shown to enhance
endogenous repair mechanisms in experimental models. The REC-DUT-002 trial
was a phase 2, multicenter, double-blind placebo-controlled trial which
explored the safety, tolerability, and efficacy of dutogliptin and
filgrastim in patients with ST-elevation Myocardial Infarction (STEMI).
Patients (n = 47, 56.1 +/- 10.7 years, 29% female) with STEMI, reduced
left ventricular ejection fraction (EF <= 45%) and successful
revascularization following primary PCI were randomized to receive either
study treatment or matching placebo. Cardiac magnetic resonance imaging
(cMRI) was performed within 72 h post-PCI and repeated after 3 months. The
study was closed out early due to the SARS-CoV-2 pandemic. There was no
statistically significant difference between the groups with respect to
serious adverse events (SAE). Predefined mean changes within cMRI-derived
functional and structural parameters from baseline to 90 days did not
differ between placebo and treatment (left ventricular end-diastolic
volume: +13.7 mL vs. +15.7 mL; LV-EF: +5.7% vs. +5.9%). Improvement in
cardiac tissue health over time was noted in both groups: full-width at
half-maximum late gadolinium enhancement (FWHM LGE) mass (placebo: -12.7
g, treatment: -19.9 g; p = 0.23). Concomitant treatment was well
tolerated, and no safety issues were detected. Based on the results, the
FDA and EMA have already approved an adequately powered large outcome
trial.<br/>Copyright &#xa9; 2022 by the authors.

<10>
Accession Number
2019525420
Title
Prediction and Prevention of Intraoperative Hypotension with the
Hypotension Prediction Index: A Narrative Review.
Source
Journal of Clinical Medicine. 11(19) (no pagination), 2022. Article
Number: 5551. Date of Publication: October 2022.
Author
Sidiropoulou T.; Tsoumpa M.; Griva P.; Galarioti V.; Matsota P.
Institution
(Sidiropoulou, Tsoumpa, Griva, Galarioti, Matsota) Second Department of
Anesthesiology, Attikon University Hospital, National and Kapodistrian
University of Athens, Athens 12462, Greece
Publisher
MDPI
Abstract
Intraoperative hypotension is common and has been associated with adverse
events. Although association does not imply causation, predicting and
preventing hypotension may improve postoperative outcomes. This review
summarizes current evidence on the development and validation of an
artificial intelligence predictive algorithm, the Hypotension Prediction
(HPI) (formerly known as the Hypotension Probability Indicator). This
machine learning model can arguably predict hypotension up to 15 min
before its occurrence. Several validation studies, retrospective cohorts,
as well as a few prospective randomized trials, have been published in the
last years, reporting promising results. Larger trials are needed to
definitively assess the usefulness of this algorithm in optimizing
postoperative outcomes.<br/>Copyright &#xa9; 2022 by the authors.

<11>
Accession Number
2019504222
Title
Central aortic or mesenteric malperfusion repair first in acute type A
aortic dissection: Still an unanswered question?.
Source
Journal of Cardiac Surgery. 37(12) (pp 4434-4436), 2022. Date of
Publication: December 2022.
Author
Acharya M.N.; Mariscalco G.
Institution
(Acharya, Mariscalco) University Hospital of leicster NHS Trust,
Leicester, United Kingdom
Publisher
John Wiley and Sons Inc

<12>
Accession Number
2020132798
Title
Differences in long-term survival outcomes after coronary artery bypass
grafting using single vs multiple arterial grafts: a meta-analysis with
reconstructed time-to-event data and subgroup analyses.
Source
General Thoracic and Cardiovascular Surgery. 71(2) (pp 77-89), 2023. Date
of Publication: February 2023.
Author
Magouliotis D.E.; Fergadi M.P.; Zotos P.-A.; Rad A.A.; Xanthopoulos A.;
Bareka M.; Spiliopoulos K.; Athanasiou T.
Institution
(Magouliotis, Zotos, Spiliopoulos) Department of Cardiothoracic Surgery,
University of Thessaly, Biopolis, Larissa 41110, Greece
(Fergadi) Department of Radiology, University of Thessaly, Larissa, Greece
(Rad, Athanasiou) Department of Surgery and Cancer, Imperial College
London, London, United Kingdom
(Xanthopoulos) Department of Cardiology, University of Thessaly, Larissa,
Greece
(Bareka) Department of Anesthesiology, University of Thessaly, Larissa,
Greece
Publisher
Springer
Abstract
Objective: We reviewed the available literature on patients with coronary
artery disease undergoing isolated coronary artery bypass grafting (CABG)
with either single (SAG) or multiple arterial grafting (MAG).
<br/>Method(s): Original research studies that evaluated the long-term
survival of MAG versus SAG were identified, from 1995 to 2022. The median
overall survival (OS) and event-free OS were the primary endpoints.
Comparison of median OS between the right internal mammary artery (RIMA)
and radial artery (RA) as a second arterial conduit was the secondary
endpoint. Subgroup analyses were performed regarding patients older than
70 years, with diabetes mellitus, and females. A sensitivity analysis was
performed with the leave-one-out method. <br/>Result(s): Forty-four
studies were included in the qualitative and thirty-nine in the
quantitative synthesis. After pooling data from 180 to 459 patients, the
MAG group demonstrated a higher OS (HR, 0.589; 95% CI, 0.58-0.60; p <
0.0001) and event-free OS compared with the SAG group (HR, 0.828; 95% CI,
0.80-0.86; p < 0.0001). In addition, RITA was associated with superior OS
compared with RA as a second arterial conduit (HR, 0.936; 95% CI,
0.89-0.98; p = 0.009). MAG was also superior to SAG in patients over 70
years, females, and patients with diabetes mellitus. Sensitivity analysis
demonstrated a small-size study effect on the female subgroup analysis.
<br/>Conclusion(s): The present meta-analysis indicates that MAG is
associated with enhanced survival outcomes compared to SAG for patients
undergoing isolated CABG.<br/>Copyright &#xa9; 2022, The Author(s).

<13>
Accession Number
2020568897
Title
The Early Effects of Bariatric Surgery on Cardiac Structure and Function:
a Systematic Review and Meta-Analysis.
Source
Obesity Surgery. 33(2) (pp 453-468), 2023. Date of Publication: February
2023.
Author
Huang S.; Lan Y.; Zhang C.; Zhang J.; Zhou Z.
Institution
(Huang, Lan, Zhang, Zhang, Zhou) National Clinical Research Center for
Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of
Diabetes Immunology, Ministry of Education, and Department of Metabolism
and Endocrinology, The Second Xiangya Hospital of Central South
University, Hunan, Changsha 410011, China
(Huang, Lan) Department of Ultrasound Diagnosis, The Second Xiangya
Hospital of Central South University, Hunan, Changsha 410011, China
Publisher
Springer
Abstract
Background: This meta-analysis was performed to investigate how cardiac
structures and functions change in the very early stage after bariatric
surgery. <br/>Material(s) and Method(s): We thoroughly searched the
PubMed, Embase, Cochrane Library, and Web of Science databases for
articles including patients who underwent bariatric surgery and examined
the changes of their cardiac indices. Results were pooled by using Review
Manager 5.1 and Stata 12.0. Weighted mean differences (WMDs) with 95%
confidence intervals (CIs) were obtained. The I-squared (I²)
test was used to determine the heterogeneity between studies. To identify
publication bias, funnel plots and Egger's test were utilized. The
leave-one-out method was used to conduct sensitivity analysis.
<br/>Result(s): In this meta-analysis, 24 research including 942 patients
were considered. According to our findings, most cardiac indices changed
3-6 months following bariatric surgery. An improvement in cardiac geometry
was reflected by a reduction in left ventricular mass (LVM) (WMD = -
22.06, 95% CI = (- 27.97, - 16.16)). The left ventricular diastolic
function improved, as reflected by the decrease in the E/e' ratio (WMD = -
0.90, 95% CI = (- 1.83, - 0.16)). Left ventricular ejection fraction
(LVEF) did not show an obvious change (WMD = 0.94, 95% CI = (- 0.19,
2.07)), while a more sensitive indicator of left ventricular systolic
function, left ventricular longitudinal strain (LV LS), increased (WMD = -
2.43, 95% CI = (- 3.96, - 0.89)). <br/>Conclusion(s): This meta-analysis
includes the newest and most comprehensive cardiac indices to prove that
cardiac structures and functions are improved early after bariatric
surgery, which has not been reported by any other studies. Graphical
Abstract: [Figure not available: see fulltext.]<br/>Copyright &#xa9; 2022,
The Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<14>
Accession Number
2021070893
Title
Early surgical intervention versus conservative management of asymptomatic
severe aortic stenosis: A systematic review and meta-analysis.
Source
Heart. 109(4) (pp 314-321), 2022. Date of Publication: 05 Oct 2022.
Author
Costa G.N.F.; Cardoso J.F.L.; Oliveiros B.; Goncalves L.; Teixeira R.
Institution
(Costa, Goncalves, Teixeira) Servico de Cardiologia, Centro Hospitalar e
Universitario de Coimbra, Coimbra, Portugal
(Costa, Oliveiros, Goncalves, Teixeira) Faculty of Medicine, University of
Coimbra, Coimbra, Portugal
(Cardoso) Centro Hospitalar de Vila Nova de Gaia, Servico de Cirurgia
Cardio-toracica, Vila Nova de Gaia, Portugal
Publisher
BMJ Publishing Group
Abstract
Objective Timing of intervention for patients with asymptomatic severe
aortic stenosis (AS) remains controversial. To compare the outcomes of
early aortic valve replacement (AVR) versus watchful waiting (WW) in
patients with asymptomatic severe AS. Methods We systematically searched
PubMed, Embase and Cochrane databases, in December 2021, for studies
comparing early AVR with WW in the treatment of asymptomatic severe AS.
Random-effects meta-analysis was performed. Results Twelve studies were
included in which two were randomised clinical trials. A total of 4130
patients were included, providing a 1092 pooled death events. Our
meta-analysis showed a significantly lower all-cause mortality for the
early AVR compared with WW group, although with a high amount of
heterogeneity between studies in the magnitude of the effect (pooled OR
0.40; 95% CI 0.35 to 0.45, p<0.01; I2=61%). An early surgery strategy
displayed a significantly lower cardiovascular mortality (pooled OR 0.33;
95% CI 0.19 to 0.56, p<0.01; I2=64%) and heart failure hospitalisation
(pooled OR 0.19; 95% CI 0.10 to 0.39, p<0.01, I2=7%). However, both groups
had similar rates of stroke (pooled OR 1.30; 95% CI 0.73 to 2.29, p=0.36,
I2=0%) and myocardial infarction (pooled OR 0.49; 95% CI 0.19 to 1.27,
p=0.14, I2= 0%). Conclusions This study suggests that for patients with
asymptomatic severe AS an early surgical intervention compared with a
conservative WW strategy was associated with a lower heart failure
hospitalisation and a similar rate of stroke or myocardial infarction,
although with significant risk of bias. PROSPERO registration number
CRD42021291144. <br/>Copyright &#xa9; 2022 Authors. All rights reserved.

<15>
Accession Number
2022447212
Title
Effects of Thoracic Paravertebral Block on Postoperative Analgesia in
Infants and Small Children undergoing Ultra-Fast Track Cardiac Anesthesia:
A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Feng J.; Wang H.; Peng L.; Xu H.; Song X.
Institution
(Feng, Wang, Peng, Xu, Song) Department of Anesthesiology, Guangzhou Women
and Children's Medical Center, Guangdong Provincial Clinical Research
Center for Child Health, Guangzhou, China
Publisher
W.B. Saunders
Abstract
Objectives: To assess whether a preoperative bilateral thoracic
paravertebral block (TPVB) would improve postoperative analgesia in
infants and small children undergoing open cardiac surgery in the protocol
of an ultra-fast track cardiac anesthesia (UFTCA). <br/>Design(s): A
single-center, prospective, randomized, controlled study. <br/>Setting(s):
At a tertiary children's medical center. <br/>Participant(s): A total of
180 children undergoing cardiac surgery, aged 1 month to 3 years.
<br/>Intervention(s): Patients are allocated randomly to TPVB and parent-
and/or nurse-controlled intravenous analgesia (PNCA) group (Group T) or
PNCA group (Group P). <br/>Measurements and Main Results: The primary
outcome is the postoperative pain scores. The secondary outcome are
intraoperative consumption of sufentanil, time to extubation, using of
neostigmine, cumulative total and invalid PCA attempts in 24 and 48 hours
after surgery, hospitalization characteristics, perioperative blood
glucose, postoperative arterial oxygen partial pressure, arterial carbon
dioxide partial pressure (PaCO<inf>2</inf>) and brain natriuretic peptide
(BNP). The postoperative pain scores within 24 hours, intraoperative
consumption of sufentanil, total, and invalid PCA attempts in 24 and 48
hours, perioperative blood glucose and BNP on the seventh day in Group T
were all significantly lower than those in Group P (p < 0.001). The time
to extubation, the use of neostigmine, and PaCO<inf>2</inf> on the sixth
hour, postoperatively, were significantly smaller in Group T than those in
Group P (p < 0.05). There were no significant differences in the
hospitalizations between the 2 groups. <br/>Conclusion(s): A combination
of bilateral single dose TPVB and PNCA pain management is superior to a
PNCA pain management alone in infants and small children undergoing open
cardiac surgery and contributes to a rapid recovery with preferable
perioperative outcomes in the protocol of UFTCA.<br/>Copyright &#xa9; 2022

<16>
Accession Number
640180590
Title
Neuromarkers which can predict neurodevelopmental impairment among
children with congenital heart defects after cardiac surgery: A systematic
literature review.
Source
Developmental neurorehabilitation. (pp 1-10), 2023. Date of Publication:
29 Jan 2023.
Author
Chiperi L.E.; Tecar C.; Toganel R.
Institution
(Chiperi) Department of Pediatric Cardiology, Emergency Institute for
Cardiovascular Diseases and Heart Transplant, Romania
(Chiperi) Doctoral School of I.O.S.U.D., George Emil Palade University of
Medicine, Pharmacy, Sciences and Technology, Romania
(Tecar) Department of Neurosciences, Iuliu Hatieganu University of
Medicine and Pharmacy, Cluj-Napoca, Romania
(Toganel) Department of Pediatrics, George Emil Palade University of
Medicine, Pharmacy, Sciences and Technology, Romania
Publisher
NLM (Medline)
Abstract
The aim of this systematic literature review was to assess the data
regarding neuromarkers used to evaluate the impact of cardiovascular
surgery on neurodevelopmental pattern of children with congenital heart
defects. A systematic search was performed on PubMed and Google Scholar
databases. Out of 713 publications screened, 10 studies (471 patients) met
the inclusion criteria. The included studies were coded on several
variables: number and heterogeneity of patients (age, congenital heart
defects), exclusion of patients with conditions that predispose to
neurological impairment, neuroimaging workup pre- and post-surgery,
neurodevelopmental assessment, interventions (part of a different study),
and follow-up period. Results were reported according to PRISMA
guidelines. Findings include: neuron-specific enolase and brain-derived
neurotrophic factor are not reliable neuromarkers, for protein S100B
different results were reported, for activin A there is lack of evidence,
and glial fibrillary acidic protein could represent a reliable neuromarker
for acute brain-injury. Directions for future research are discussed.

<17>
Accession Number
640152115
Title
A Randomized Trial of Lenient Versus Strict Arm Instruction Post Cardiac
Device Surgery (LENIENT).
Source
American heart journal. (no pagination), 2023. Date of Publication: 25
Jan 2023.
Author
Golian M.; Sadek M.M.; Aydin A.; Davis D.; Green M.; Klein A.; Nair G.M.;
Nery P.; Ramirez F.D.; Redpath C.; Hansom S.P.; Wells G.A.; Birnie D.H.
Institution
(Golian, Sadek, Aydin, Davis, Green, Klein, Nair, Nery, Ramirez, Redpath,
Hansom, Wells, Birnie) University of Ottawa Heart Institute, Ottawa, ON,
Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Arm restriction after cardiac implantable electronic device
(CIED) placement is common practice despite minimal supporting evidence.
Patients receive a range of restriction recommendations of variable
durations with the goal of reducing complications such as wound
dehiscence, infection, lead dislodgement, or hematoma formation. These
movement limitations can lead to emotional stress and anxiety,
complications such as frozen shoulder, and upper extremity venous
thrombosis due to immobilization. There are no published clinical trials
assessing the benefits and risks of arm restrictions post-CIED implant.
<br/>OBJECTIVE(S): The randomized trial of lenient versus strict arm and
activity instruction post-CIED surgery (LENIENT trial; NCT04915261) is a
single center non-blinded randomized prospective study designed to
evaluate lenient compared to restrictive post-CIED care instructions. We
hypothesize that there will be no significant difference in complications
between the arms. METHODS/DESIGN: All patients receiving a de novo CIED or
those with upgrades and revisions requiring a new lead implant will be
enrolled. Subjects are enrolled in a non-blinded randomized prospective
trial with 6 randomly assigned 8-month periods, during which either a
lenient or restrictive post-operative activity instructions will be given
to all patients. Post-operative instructions are given at the time of
discharge and further reinforced by recurrent interactive voice
recognition (IVR) phone calls, text messages and emails. The requirement
for individual consent has been waived. The primary endpoint is a
composite of (1) lead dislodgement, (2) frozen shoulder, (3) upper
extremity venous thrombosis, (4) clinically significant hematoma, and (5)
infection occurring within 52 weeks of index surgery. The study is a
non-inferiority trial with a sample size of 1250 per group. DISCUSSION:
This is the first large randomized clinical trial designed to establish an
evidence-based post-operative standard of care for patients undergoing
CIED implantation. This will improve the quality of care provided to
patients and help guide implanting physicians providing post-operative
care instructions.<br/>Copyright &#xa9; 2023. Published by Elsevier Inc.

<18>
Accession Number
2021993104
Title
External validation of the PROGRESS-CTO complication risk scores:
Individual patient data pooled analysis of 3 registries.
Source
International Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Simsek B.; Tajti P.; Carlino M.; Ojeda S.; Pan M.; Rinfret S.; Vemmou E.;
Kostantinis S.; Nikolakopoulos I.; Karacsonyi J.; Dens J.A.; Agostoni P.;
Alaswad K.; Megaly M.; Avran A.; Choi J.W.; Jaffer F.A.; Doshi D.;
Karmpaliotis D.; Khatri J.J.; Knaapen P.; La Manna A.; Spratt J.C.; Tanabe
M.; Walsh S.; Mastrodemos O.C.; Allana S.; Rempakos A.; Rangan B.V.;
Goktekin O.; Gorgulu S.; Poommipanit P.; Kearney K.E.; Lombardi W.L.;
Grantham J.A.; Mashayekhi K.; Brilakis E.S.; Azzalini L.
Institution
(Simsek, Kostantinis, Karacsonyi, Mastrodemos, Allana, Rempakos, Rangan,
Brilakis) Minneapolis Heart Institute, Minneapolis Heart Institute
Foundation, Minneapolis, MN, United States
(Tajti) The Gottsegen National Cardiovascular Center, Budapest, Hungary
(Carlino) Interventional Cardiology Division, Cardio-Thoracic-Vascular
Department, San Raffaele Scientific Institute, Milan, Italy
(Ojeda, Pan) Division of Interventional Cardiology, Reina Sofia Hospital,
University of Cordoba, Maimonides Institute for Research in Biomedicine of
Cordoba (IMIBIC), Cordoba, Spain
(Rinfret) Emory Heart and Vascular Center, Emory University School of
Medicine, Atlanta, GA, United States
(Vemmou, Nikolakopoulos) Department of Internal Medicine, Yale University
School of Medicine, New Haven, CT, United States
(Dens) Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium
(Agostoni) Hartcentrum, Ziekenhuis Netwerk Antwerpen Middelheim, Antwerp,
Belgium
(Alaswad) Henry Ford Health System, Detroit, MI, United States
(Megaly) Division of Cardiology, Willis Knighton Heart Institute,
Shreveport, LA, United States
(Avran) Department of Interventional Cardiology, Clinique Pasteur,
Essey-les-Nancy, France
(Choi) Presbyterian Hospital, Dallas, TX, United States
(Jaffer, Doshi) Massachusetts General Hospital, Harvard Medical School,
Boston, MA, United States
(Karmpaliotis) Morristown Medical Center, Morristown, NJ, United States
(Khatri) Cleveland Clinic Foundation, Cleveland, OH, United States
(Knaapen) Department of Cardiology, VU University Medical Center,
Amsterdam, Netherlands
(La Manna) University of Catania, Catania, Italy
(Spratt) St. George's University Healthcare NHS Trust, London, United
Kingdom
(Tanabe) Department of Cardiology, Nozaki Tokushukai Hospital, Osaka,
Japan
(Walsh) Belfast Health, Belfast, United Kingdom
(Goktekin) Division of Cardiology, Memorial Bahcelievler Hospital,
Istanbul, Turkey
(Gorgulu) Division of Cardiology, Biruni University School of Medicine,
Istanbul, Turkey
(Poommipanit) University Hospitals, Cleveland, OH, United States
(Kearney, Lombardi, Azzalini) Division of Cardiology, Department of
Medicine, University of Washington, Seattle, WA, United States
(Grantham) Saint Luke's Mid America Heart Institute, Kansas City, MO,
United States
(Mashayekhi) Heart Center Lahr, Department for Internal Medicine and
Cardiology, Germany
Publisher
Elsevier Ireland Ltd
Abstract
Background: Chronic total occlusion (CTO) percutaneous coronary
intervention (PCI) is associated with a considerable risk of
complications, and risk stratification is of utmost importance.
<br/>Aim(s): To assess the clinical usefulness of the recently developed
PROGRESS-CTO (NCT02061436) complication risk scores in an independent
cohort. <br/>Method(s): Individual patient data pooled analysis of 3
registries was performed. <br/>Result(s): Of the 4569 patients who
underwent CTO PCI, 102 (2.2%) had major adverse cardiovascular events
(MACE). Patients with MACE were older (69 +/- 11 vs. 65 +/- 10, p <
0.001), more likely to have a history of prior coronary artery bypass
graft surgery, and unfavorable angiographic characteristics J-CTO score
(2.4 +/- 1.2 vs. 2.1 +/- 1.3, p = 0.007), including blunt stump (59% vs.
49%, p = 0.047). Technical success was lower in patients with MACE (59%
vs. 86%, p < 0.001). The area under the receiver operating characteristic
curve of the PROGRESS-CTO complication risk models were as follows: MACE
0.72 (95% confidence interval [CI], 0.67-0.76), mortality 0.73 (95% CI,
0.61-0.85), and pericardiocentesis 0.69 (95% CI, 0.62-0.77) in the
validation dataset. The observed complication rates increased with higher
PROGRESS-CTO complication scores. The PROGRESS-CTO MACE score showed good
calibration in this external cohort, with MACE rates similar to the
original study: 0.7% (score 0-1), 1.5% (score 2), 2.2% (score 3), 3.8%
(score 4), 4.9% (score 5), 5.8% (score 6-7). <br/>Conclusion(s): Given the
good discriminative performance, calibration, and ease of calculation, the
PROGRESS-CTO complication scores could help assess the risk of
complications in patients undergoing CTO PCI.<br/>Copyright &#xa9; 2022
Elsevier B.V.

<19>
Accession Number
2018074434
Title
1,5-Anhydroglucitol as a Marker of Acute Hyperglycemia in Cardiovascular
Events.
Source
Review of Diabetic Studies. 18(2) (pp 68-75), 2022. Date of Publication:
2022.
Author
Migala M.; Chalubinska-Fendler J.; Zielinska M.
Institution
(Migala, Zielinska) Department of Intensive Cardiac Therapy, Medical
University of Lodz, Lodz, Poland
(Chalubinska-Fendler) Department of Radiation Oncology, Military Institute
of Medicine, Warsaw, Poland
Publisher
Lab and Life Press
Abstract
1,5-anhydroglucitol (1,5-AG) is a biomarker of acute hyperglycemia in
diabetology and also in cardiodiabetology. It is used to monitor
fluctuating glucose levels. 1,5-AG is a monosaccharide that is
biochemically similar to D-glucose and originates from the nutrition. The
presence of 1,5-AG in blood and tissue is nearly constant due to
reabsorption in the renal proximal tubule. In acute hyperglycemia, renal
reabsorption is inhibited by glucose and 1,5-AG is excreted in the urine,
while its serum level decreases rapidly. 1,5-AG reflects glucose
excursions over 1-3 days to 2 weeks. In this regard, low levels of serum
1,5-AG can be a clinical marker of short-term glycemic derangements such
as postprandial hyperglycemia, which is an important risk factor for the
pathogenesis of coronary artery disease (CAD) as low levels of 1,5-AG
reflect severe plaque calcification in CAD and correlate with high-density
lipoprotein cholesterol (HDL-C) levels. For these reasons, 1,5-AG may also
be a marker for atherosclerosis; in fact an even better marker than HbA1c
or fructosamine which are normally used. 1,5-AG may also be a predictor of
cardiovascular disease, left ventricular dysfunction after acute coronary
syndrome (ACS), and mortality after ACS. This articles reviews the current
knowledge on 1,5-AG related to its use as predictor for cardiovascular
events.<br/>Copyright &#xa9; 2022, Lab and Life Press. All rights
reserved.

<20>
Accession Number
2019055844
Title
Preclinical Large Animal In-Vivo Experiments for Surgically Implanted
Atrioventricular Valve: Reappraisal and Systematic Review.
Source
Current Cardiology Reviews. 19(1) (no pagination), 2023. Article Number:
e170622206130. Date of Publication: January 2023.
Author
Sazzad F.; Kollengode R.; Beverly C.L.X.; Kiat T.Y.; Ganesh G.; Kofidis T.
Institution
(Sazzad, Kollengode, Beverly, Kiat, Ganesh, Kofidis) Department of
Surgery, Yong Loo Lin School of Medicine, National University of
Singapore, Kent Ridge, Singapore
(Sazzad, Kollengode, Kofidis) Department of Cardiac, Thoracic and Vascular
Surgery, National University Heart Center, Kent Ridge, Singapore
Publisher
Bentham Science Publishers
Abstract
Background: The development of atrioventricular bioprosthesis has
witnessed an increasing drive toward clinical translation over the last
few decades. A significant challenge in the clinical translation of an
atrioventricular bioprosthesis from bench to bedside is the appropriate
choice of a large animal model to test the safety and effectiveness of the
device. <br/>Method(s): We conducted a systematic review of pre-clinical
in vivo studies that would enable us to synthesize a recommended
framework. PRISMA (Preferred Reporting Items for Systematic Reviews and
MetaAnalyses) guidelines were followed to identify and extract relevant
articles. <br/>Result(s): Sheep was the most common choice of animal, with
nine out of the 12 included studies being conducted on sheep. There were
acute and chronic studies based on our search criteria. An average of ~20
and 5 animals were used for chronic and acute studies. One out of three
acute studies and eight out of nine chronic studies were on stented heart
valve bioprosthesis. All analyses were conducted on the implantation of
atrioventricular valves with trileaflet, except for one chronic study on
unileaflet valves and one chronic and acute study on bileaflet valves.
<br/>Conclusion(s): Understanding the variance in past pre-clinical study
designs may increase the appropriate utilization of large animal models.
This synthesized evidence provides a pre-clinical in vivo studies
framework for future research on an atrioventricular
bioprosthesis.<br/>Copyright &#xa9; 2023 Bentham Science Publishers.

<21>
Accession Number
2019878570
Title
Evaluation of fibrinogen concentration by clot firmness using a dielectric
blood coagulation test system.
Source
Journal of Anesthesia. 37(1) (pp 56-63), 2023. Date of Publication:
February 2023.
Author
Zeng Y.; Yamamoto Y.; Hayashi Y.; Uchida T.
Institution
(Zeng, Yamamoto, Uchida) Department of Anesthesiology, Graduate School of
Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45
Yushima, Bunkyo-Ku, Tokyo 113-8519, Japan
(Hayashi) Biomedical R&D Department, R&D Division, Medical Business Group,
Sony Imaging Products & Solutions Inc., Bunkyo-Ku, Tokyo 113-8519, Japan
(Hayashi) Tokyo Laboratory 11, R&D Center, Sony Group Corporation,
Bunkyo-Ku, Tokyo 113-8519, Japan
Publisher
Springer
Abstract
Purpose: To determine if fibrinogen concentration can be evaluated by
dielectric permittivity changes in dielectric blood coagulation testing
(DBCM) during cardiovascular surgery with cardiopulmonary bypass (CPB).
<br/>Method(s): We performed a single-center prospective observational
study at a university hospital. One hundred patients undergoing
cardiovascular surgery with CPB were enrolled. Whole-blood samples were
obtained after weaning from CPB, and dielectric clot strength (DCS) was
measured by intrinsic pathway testing with or without heparinase in DBCM.
The FIBTEM test was performed during rotational thromboelastometry using
the same samples, and maximum clot firmness (MCF) was evaluated.
Spearman's correlation analysis was performed, and receiver operating
characteristics (ROC) curve analyses were used to evaluate the performance
of hypofibrinogenemia detection. <br/>Result(s): DCS showed a strong
positive correlation with plasma fibrinogen concentration (Rs = 0.76, P <
0.0001). The area under the ROC curve for evaluating plasma fibrinogen
concentration < 200 mg/dL was 0.91 (95% confidence interval (CI)
0.85-0.97) for DCS, compared with 0.88 (95% CI 0.81-0.94) for FIBTEM MCF.
The optimal cutoff value of DCS was 17.0 (sensitivity 94%, specificity
80%). <br/>Conclusion(s): DCS variables showed a significantly strong
correlation with plasma fibrinogen concentration, and the diagnostic
performance for hypofibrinogenemia was comparable to that for FIBTEM MCF.
This novel methodology has the potential to provide a point-of-care test
with sufficient accuracy for the detection of perioperative
hypofibrinogenemia during cardiovascular surgery with CPB.<br/>Copyright
&#xa9; 2022, The Author(s) under exclusive licence to Japanese Society of
Anesthesiologists.

<22>
Accession Number
2019845710
Title
Driving pressure-guided ventilation and postoperative pulmonary
complications in thoracic surgery: a multicentre randomised clinical
trial.
Source
British Journal of Anaesthesia. 130(1) (pp e106-e118), 2023. Date of
Publication: January 2023.
Author
Park M.; Yoon S.; Nam J.-S.; Ahn H.J.; Kim H.; Kim H.J.; Choi H.; Kim
H.K.; Blank R.S.; Yun S.-C.; Lee D.K.; Yang M.; Kim J.A.; Song I.; Kim
B.R.; Bahk J.-H.; Kim J.; Lee S.; Choi I.-C.; Oh Y.J.; Hwang W.; Lim B.G.;
Heo B.Y.
Institution
(Park, Ahn, Yang, Kim, Heo) Department of Anaesthesiology and Pain
Medicine, Samsung Medical Centre, Sungkyunkwan University School of
Medicine, Seoul, South Korea
(Yoon, Song, Kim, Bahk) Department of Anaesthesiology and Pain Medicine,
Seoul National University Hospital, University of Seoul National College
of Medicine, Seoul, South Korea
(Nam, Kim, Lee, Choi) Department of Anaesthesiology and Pain Medicine,
Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South
Korea
(Kim, Lim) Department of Anaesthesiology and Pain Medicine, Korea
University Guro Hospital, Korea University College of Medicine, Seoul,
South Korea
(Kim, Oh) Department of Anaesthesiology and Pain Medicine, and Anaesthesia
and Pain Research Institute, Yonsei University College of Medicine, South
Korea
(Choi, Hwang) Department of Anaesthesiology and Pain Medicine, Seoul St.
Mary's Hospital, College of Medicine, The Catholic University of Korea,
Seoul, South Korea
(Kim) Department of Thoracic and Cardiovascular Surgery, Samsung Medical
Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Blank) Department of Anaesthesiology, University of Virginia Health
System, Charlottesville, VA, United States
(Yun) Department of Biostatistics, Asan Medical Centre, University of
Ulsan College of Medicine, Seoul, South Korea
(Lee) Department of Anaesthesiology and Pain Medicine, Dongguk University
Hospital, Goyang-si, South Korea
Publisher
Elsevier Ltd
Abstract
Background: Airway driving pressure, easily measured as plateau pressure
minus PEEP, is a surrogate for alveolar stress and strain. However, the
effect of its targeted reduction remains unclear. <br/>Method(s): In this
multicentre trial, patients undergoing lung resection surgery were
randomised to either a driving pressure group (n=650) receiving an
alveolar recruitment/individualised PEEP to deliver the lowest driving
pressure or to a conventional protective ventilation group (n=650) with
fixed PEEP of 5 cm H<inf>2</inf>O. The primary outcome was a composite of
pulmonary complications within 7 days postoperatively. <br/>Result(s): The
modified intention-to-treat analysis included 1170 patients (mean
[standard deviation, SD]; age, 63 [10] yr; 47% female). The mean driving
pressure was 7.1 cm H<inf>2</inf>O in the driving pressure group vs 9.2 cm
H<inf>2</inf>O in the protective ventilation group (mean difference [95%
confidence interval, CI]; -2.1 [-2.4 to -1.9] cm H<inf>2</inf>O; P<0.001).
The incidence of pulmonary complications was not different between the two
groups: driving pressure group (233/576, 40.5%) vs protective ventilation
group (254/594, 42.8%) (risk difference -2.3%; 95% CI, -8.0% to 3.3%;
P=0.42). Intraoperatively, lung compliance (mean [SD], 42.7 [12.4] vs 33.5
[11.1] ml cm H<inf>2</inf>O^-1; P<0.001) and Pa<inf>o2</inf>
(median [inter-quartile range], 21.5 [14.5 to 30.4] vs 19.5 [13.5 to 29.1]
kPa; P=0.03) were higher and the need for rescue ventilation was less
frequent (6.8% vs 10.8%; P=0.02) in the driving pressure group.
<br/>Conclusion(s): In lung resection surgery, a driving pressure-guided
ventilation improved pulmonary mechanics intraoperatively, but did not
reduce the incidence of postoperative pulmonary complications compared
with a conventional protective ventilation. Clinical trial registration:
NCT04260451.<br/>Copyright &#xa9; 2022 The Author(s)

<23>
Accession Number
2018332458
Title
Comparison of MECHANISM of early and late vascular responses following
treatment of ST-elevation acute myocardial infarction with two different
everolimus-eluting stents: a randomized controlled trial of biodegradable
versus durable polymer stents.
Source
Cardiovascular Intervention and Therapeutics. 38(1) (pp 75-85), 2023. Date
of Publication: January 2023.
Author
Otake H.; Ishida M.; Nakano S.; Higuchi Y.; Hibi K.; Kuriyama N.; Iwasaki
M.; Kataoka T.; Kubo T.; Tsujita K.; Ashikaga T.; Shinke T.; Itoh T.;
Kimura T.; Morino Y.
Institution
(Otake, Nakano) Division of Cardiovascular Medicine, Department of
Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1
Kusunoki-cho, Chuo-ku, Hyogo, Kobe 650-0017, Japan
(Ishida, Itoh, Kimura, Morino) Division of Cardiology, Department of
Internal Medicine, Iwate Medical University, Yahaba, Japan
(Higuchi) Cardiovascular Division, Osaka Police Hospital, Osaka, Japan
(Hibi) Division of Cardiology, Yokohama City University Medical Center,
Yokohama, Japan
(Kuriyama) Department of Cardiology, Miyazaki Medical Association
Hospital, Miyazaki, Japan
(Iwasaki) Department of Cardiology, Hyogo Prefectural Awaji Medical
Center, Sumoto, Japan
(Kataoka) Division of Cardiology, Bell Land General Hospital, Sakai, Japan
(Kubo) Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan
(Tsujita) Department of Cardiovascular Medicine, Graduate School of
Medical Sciences, Kumamoto University, Kumamoto, Japan
(Ashikaga) Department of Cardiology, Japanese Red Cross Musashino
Hospital, Tokyo, Japan
(Shinke) Division of Cardiology, Department of Medicine, Showa University
School of Medicine, Tokyo, Japan
Publisher
Springer
Abstract
The early and mid-term arterial healing profile of biodegradable
polymer-coated everolimus-eluting stents (BP-EES) is unclear, especially
in ST-segment elevation myocardial infarction (STEMI) culprit lesions.
This study aimed to compare early- and mid-term arterial healing between
durable polymer-coated everolimus-eluting stents (DP-EES) and BP-EES in
STEMI patients. In a prospective, multicenter, non-inferiority trial,
STEMI patients were randomized to receive BP-EES (n = 60) or DP-EES (n =
60). The primary endpoint of this study was the mean percentage of covered
struts (%covered struts) on FD-OCT 2 weeks post-PCI. Key secondary
endpoints included the percentage of uncovered struts, frequency of
abnormal intra-stent tissue, and percentage of malapposed struts by FD-OCT
2 weeks and 12 months post-PCI. They underwent serial frequency-domain
optical coherence tomography (FD-OCT) evaluations immediately after
percutaneous coronary intervention, and at 2 weeks and at 12 months after
the procedure. The primary endpoint of %covered struts at 2 weeks was
71.4% in BP-EES and 72.3% in DP-EES [risk difference - 0.94%, lower limit
of one-sided 95% confidence interval (CI) - 5.6;
P<inf>non-inferiority</inf> = 0.0756]. At 12 months, the mean percentage
of uncovered struts was significantly lower [1.73% (95% CI 0.28-3.17) vs.
4.81% (95% CI 3.52-6.09); p = 0.002], and the average malapposed volume
was significantly smaller in the BP-EES group than in the DP-EES group (p
= 0.002). At 12 months, BP-EES had a significantly larger average
neointimal area with a significantly smaller average intra-stent tissue
unevenness score than DP-EES, suggesting more uniform neointimal coverage
with BP-EES. Strut coverage was comparable between BP-EES and DP-EES at 2
weeks. Non-inferiority could not be proven because of an insufficient
sample size. The significantly better arterial healing with BP-EES at 12
months suggests a safer profile for STEMI culprit lesions. Trial
registration: jRCTs022180024
https://jrct.niph.go.jp/en-latest-detail/jRCTs022180024<br/>Copyright
&#xa9; 2022, The Author(s) under exclusive licence to Japanese Association
of Cardiovascular Intervention and Therapeutics.

<24>
Accession Number
2022275092
Title
Early Elective Replacement of Umbilical Venous Catheter with Peripherally
Inserted Central Catheter to Reduce Central Line-Associated Blood Stream
Infections in Premature Infants: A Randomized Trial.
Source
Journal of the Medical Association of Thailand. 106(1) (pp 63-69), 2023.
Date of Publication: January 2023.
Author
Phumyeesoon S.; Thanomsingh P.
Institution
(Phumyeesoon, Thanomsingh) Department of Pediatrics, Maharat Nakhon
Ratchasima Hospital, Nakhon Ratchasima, Thailand
Publisher
Medical Association of Thailand
Abstract
Background: Central-line umbilical venous catheter (UVC) insertion at
birth and replacement later with a peripherally inserted central catheter
(PICC) is often required in VLBW infants for medical and nutritional
support. A serious complication of central line is associated with
bloodstream infections (CLABSIs). There is no consistent evidence about
the effect of dwell time of UVC or the time of PICC replacement on the
risk of CLABSI in VLBW infants. <br/>Objective(s): To compare the CLABSI
rate in VLBW infants when replacing the UVC with the PICC at 72 hours of
age versus at seven days. <br/>Material(s) and Method(s): VLBW infants
with UVC placed at admission and clinically stable for three days were
randomly assigned to receive early replacement with PICC at 72 hours of
age as the 72-hour group, or at seven days as the 7-day group. The primary
outcome was the CLABSI rate. The secondary outcomes were the time from
birth to CLABSI and any other complications. <br/>Result(s): Fifty infants
in the 72-hour group and 51 infants in the 7-day group were enrolled. The
overall incidence of CLABSI was 10% in the 72-hour group and 27.4% in the
7-day group (RR 2.74, p=0.03). There were 4.6 CLABSIs per 1,000
catheter-days in the 72-hour group and 13.4 CLABSIs per 1,000
catheter-days in the 7-day group (p=0.02). The other complications and
mortality rates were not significantly different. <br/>Conclusion(s): The
early removal of a UVC and replacement with a PICC by 72 hours of age
significantly decreased the CLABSI rate compared to the routine
replacement of the UVC at seven days of age.<br/>Copyright &#xa9; 2023
JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND.

<25>
Accession Number
2019168270
Title
Ultrasound-guided, continuous erector spinae plane (ESP) block in
minimally invasive thoracic surgery-comparing programmed intermittent
bolus (PIB) vs continuous infusion on quality of recovery and
postoperative respiratory function: a double-blinded randomised controlled
trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 792. Date of
Publication: December 2022.
Author
Eochagain A.N.; Moorthy A.; O'Gara A.; Buggy D.J.
Institution
(Eochagain, Moorthy, Buggy) Division of Anaesthesiology & Perioperative
Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
(Moorthy, Buggy) School of Medicine, University College, Dublin, Ireland
(O'Gara) Department of Anaesthesia and Pain Medicine, St James's
University Hospital, Dublin, Ireland
Publisher
BioMed Central Ltd
Abstract
Background: Minimally invasive thoracic surgery (MITS) has been shown to
reduce postoperative pain and contribute to better postoperative quality
of life as compared to open thoracic surgery (Bendixen et al., Lancet
Oncol 17:836-44, 2016). However, it still causes significant
post-operative pain. Regional anaesthesia techniques including fascial
plane blocks such as the erector spinae plane block (ESP) have been shown
to contribute to post-operative pain control after MITS (Finnerty et al.,
Br J Anaesth 125:802-10, 2020). Case reports relating to ESP catheters
have described improved quality of pain relief using programmed
intermittent boluses (PIB) instead of continuous infusion (Bendixen et
al., Lancet Oncol 17:836-44, 2016). It is suggested that larger, repeated
bolus dose may provide superior pain relief, possibly because of improved
spread of the local anaesthetic medications (Ilfeld and Gabriel, Reg
Anesth Pain Med 44:285-86, 2019). Evidence for improved spread of local
anaesthetic may be found in one study which demonstrated that PIB
increased the spread of local anaesthetic medication compared to
continuous infusions for continuous paravertebral blocks, which are
another type of regional anaesthesia technique for the chest wall (Hida et
al., Reg Anesth Pain Med 44:326-32, 2019). Similarly, regarding labour
epidural analgesia, the weight of evidence is in favour of PIB providing
better pain relief compared with continuous infusion (Onuoha, Anesthesiol
Clin 35:1-14, 2017). Since fascial plane blocks, such as ESP, rely on the
spread of local anaesthetic medication between muscle layers of the chest
wall, intermittent boluses may be particularly useful for this group of
blocks. However, until recently, pumps capable of providing automated
boluses in addition to patient-controlled boluses were not widely
available. To best of our knowledge, there are no randomised controlled
trials comparing continuous infusion versus intermittent bolus strategies
for erector spinae plane block for MITS in terms of patient centred
outcomes such as quality of recovery. <br/>Method(s): This trial will be a
prospective, double-blinded, randomised controlled superiority trial. A
total of 60 eligible patients will be randomly assigned to receive an
intermittent bolus regime of local anaesthetic vs a continuous infusion of
local anaesthetic. The medication will be delivered via an
ultrasound-guided erector spinae plane block catheter which will be
inserted by an anaesthesiologist while the patient is under general
anaesthetic before their MITS surgery begins. The primary outcome being
measured is the Quality of Recovery (QoR-15) score between the two groups
24 h after surgery. Secondary outcomes include respiratory testing of
maximal inspiratory volume measured with a calibrated incentive
spirometer, area under the curve for Verbal Rating Score for pain at rest
and on deep inspiration versus time over 48 h, total opioid consumption
over 48 h, QoR-15 score at 48 h and time to first mobilisation.
<br/>Discussion(s): Despite surgical advancements in thoracic surgery,
severe acute post-operative pain following MITS is still prevalent. This
study will provide new knowledge and possible recommendations about the
efficacy of programmed intermittent bolus regimen of local anaesthetic vs
a continuous infusion of local anaesthetic via an ultrasound-guided
erector spinae plane catheter for patients undergoing MITS. Trial
registration: This trial was pre-registered on ClinicalTrials.gov
Identifier: NCT05181371. Registered on 6 January 2022. All item from the
World Health Organization Trial Registration Data set have been
included.<br/>Copyright &#xa9; 2022, The Author(s).

<26>
Accession Number
2022260477
Title
Risk of perioperative stroke and cerebral autoregulation monitoring: a
systematic review.
Source
Arquivos de Neuro-Psiquiatria. 80(12) (pp 1196-1203), 2022. Date of
Publication: December 2022.
Author
de Almeida dos Santos D.P.; Thirumala P.D.; Reddy G.; de Barros D.F.;
Faria V.N.R.; Shandal V.; Kurtz P.
Institution
(de Almeida dos Santos, de Barros) Hospital Copa Star, Centro de Terapia
Intensiva, RJ, Rio de Janeiro, Brazil
(de Almeida dos Santos, Reddy, Faria) Sinapse Clinica, RJ, Rio de Janeiro,
Brazil
(Reddy) Intraneuro, RJ, Rio de Janeiro, Brazil
(Thirumala, Shandal) University of Pittsburgh Medical Center, Pittsburgh,
PA, United States
(Faria) Universidade Federal de Uberlandia, Faculdade de Engenharia
Eletrica, Uberlandia MG, Brazil
(Kurtz) Instituto D'Or de Pesquisa e Ensino, Departamento de Cuidado
Intensivo, SP, Sao Paulo, Brazil
Publisher
Associacao Arquivos de Neuro-Psiquiatria
Abstract
Background Perioperative stroke, delirium, and cognitive impairment could
be related to management and to variations in blood pressure control,
cerebral hypoperfusion and raised blood volume. Cerebral autoregulation
(CAR) is a mechanism to maintain cerebral perfusion through the control of
the vascular tone and hemodynamic reactions in the circulation. Objective
The present systematic review addresses the relationship between impaired
CAR and perioperative stroke by evaluating the rate of neurological
complications after surgery in studies in which perioperative CAR was
tested or monitored. Methods We included randomized clinical trials and
prospective observational studies. All studies had adjusted the relative
risk, hazard ratio or 95% confidence interval (95%CI) values. These
estimation effects were tested using random-effects models. Heterogeneity
among the selected studies was assessed using the Higgins and Thompson
I² statistics. Results The Web of Science, PubMed and EMBASE
electronic databases were searched to retrieve articles. A total of 4,476
studies published between 1983 and 2019 were analyzed, but only 5
qualified for the data extraction and were included in the final analysis.
The combined study cohort comprised 941 patients who underwent CAR
monitoring during surgical procedures. All studies provided information
about perioperative stroke, which equated to 16% (158 of 941) of the
overall patient population. Conclusion The present meta-analysis showed
evidence of the impact of CAR impairment in the risk of perioperative
stroke. On the pooled analysis, blood fluctuations or other brain insults
large enough to compromise CAR were associated with the outcome of stroke
(odds ratio [OR]: 2.26; 95%CI: 1.54-2.98; p < 0.0001).<br/>Copyright
&#xa9; 2022. Academia Brasileira de Neurologia. All rights reserved.

<27>
Accession Number
2020352745
Title
Vascular Closure Devices versus Manual Compression in Cardiac
Interventional Procedures: Systematic Review and Meta-Analysis.
Source
Cardiovascular Therapeutics. 2022 (no pagination), 2022. Article Number:
8569188. Date of Publication: 2022.
Author
Pang N.; Gao J.; Zhang B.; Guo M.; Zhang N.; Sun M.; Wang R.
Institution
(Pang, Gao, Guo, Zhang, Sun, Wang) Department of Cardiology, First
Hospital of Shanxi Medical University, Shanxi, Taiyuan, China
(Pang, Zhang) First Clinical Medical College, Shanxi Medical University,
Shanxi, Taiyuan, China
Publisher
Hindawi Limited
Abstract
Backgrounds. Manual compression (MC) and vascular closure device (VCD) are
two methods of vascular access site hemostasis after cardiac
interventional procedures. However, there is still controversial over the
use of them and a lack of comprehensive and systematic meta-analysis on
this issue. Methods. Original articles comparing VCD and MC in cardiac
interventional procedures were searched in PubMed, EMbase, Cochrane
Library, and Web of Science through April 2022. Efficacy, safety, patient
satisfaction, and other parameters were assessed between two groups.
Heterogeneity among studies was evaluated by I2 index and the Cochran Q
test, respectively. Publication bias was assessed using the funnel plot
and Egger's test. Results. A total of 32 studies were included after
screening with inclusion and exclusion criteria (33481 patients). This
meta-analysis found that VCD resulted in shorter time to hemostasis,
ambulation, and discharge (p<0.00001). In terms of vascular complication
risks, VCD group might be associated with a lower risk of major
complications (p=0.0001), but the analysis limited to randomized
controlled trials did not support this result (p=0.68). There was no
significant difference in total complication rates (p=0.08) and
bleeding-related complication rates (p=0.05) between the two groups.
Patient satisfaction was higher in VCD group (p=0.002). Meta-regression
analysis revealed no specific covariate as an influencing factor for above
results (p>0.05). Conclusions. Compared with MC, the use of VCDs
significantly shortens the time of hemostasis and allows earlier
ambulation and discharge, meanwhile without increase in vascular
complications. In addition, use of VCDs achieves higher patient
satisfaction and leads cost savings for patients and
institutions.<br/>Copyright &#xa9; 2022 Naidong Pang et al.

<28>
Accession Number
2019540077
Title
Current state and future directions of endovascular ascending and arch
repairs: The motion towards an endovascular Bentall procedure.
Source
Seminars in Vascular Surgery. 35(3) (pp 350-363), 2022. Date of
Publication: September 2022.
Author
Gouveia e Melo R.; Stana J.; Prendes C.F.; Kolbel T.; Peterss S.;
Stavroulakis K.; Rantner B.; Pichlmaier M.; Tsilimparis N.
Institution
(Gouveia e Melo, Stana, Prendes, Stavroulakis, Rantner, Tsilimparis)
Vascular Surgery Department, Ludwig Maximilian University Hospital, Campus
Grosshadern, Marchioninistrasse 15, Munich 81377, Germany
(Kolbel) German Aortic Center Hamburg, Department of Vascular Medicine,
University Heart and Vascular Center, Hamburg, Germany
(Peterss, Pichlmaier) Cardiac Surgery Department, Ludwig Maximilian
University Hospital, Munich, Germany
Publisher
W.B. Saunders
Abstract
Endovascular repair of the ascending aorta and aortic arch has evolved at
an astonishing pace in the past several decades. Results of endovascular
arch repair in experienced centers have been improving and the technology
evolving, and it has begun to challenge the current gold standard status
of open surgery in some groups of patients. Hybrid strategies with
adjunctive cervical debranching for distal arch lesions are being replaced
by fenestrated arch repairs. Total endovascular repair for proximal aortic
arch pathologies with the use of inner branches has achieved the best
results; however, the main current limitations of endovascular arch repair
are diameter-, length-, and angulation-related issues with the ascending
aorta (proximal landing zone). Ascending aorta endovascular repair has
allowed extending treatment further proximally in patients with
post-surgical pseudoaneurysms of the ascending aorta or post-type A
chronic aortic dissections. However, sufficient proximal landing zone is
still needed in the proximal aorta for these repairs; in a significant
number of patients, this is not feasible with simple proximal tubular
grafts. Therefore, new technologies and techniques are being developed to
deal with this limitation, including the endovascular Bentall concept,
with incorporation of the aortic valve and coronary ostia. In this review,
the current state and future directions of endovascular ascending and arch
repairs and the motion towards an endovascular Bentall procedure are
discussed.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<29>
Accession Number
637534925
Title
Serratus anterior plane block and erector spinae plane block in
postoperative analgesia in thoracotomy: A randomised controlled study.
Source
Indian Journal of Anaesthesia. 66(2) (pp 119-125), 2022. Date of
Publication: February 2022.
Author
Hassan M.E.; Alfattah Wadod M.A.
Institution
(Hassan, Alfattah Wadod) Department of Anesthesia, Surgical Intensive Care
Unit and Pain Management, National Cancer Institute, Cairo University,
Cairo, Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Managing pain after thoracic surgery is crucial and
the traditional methods have many adverse effects. We aimed to evaluate
serratus anterior plane block (SAPB) and erector spinae plane block (ESPB)
in acute pain control in thoracic cancer surgeries. <br/>Method(s): This
randomised controlled, triple-blind study was performed on 90 patients,
between 18 and 70 years old, scheduled for elective thoracic cancer
surgery. Patients were allocated into three equal groups: Control group:
received sham ESPB and sham SAPB. SAPB group received SAPB (20 ml
bupivacaine 0.5%) and sham ESPB. ESBP group received ESPB (20 ml
bupivacaine 0.5%) and sham SAPB. <br/>Result(s): Postoperative morphine
consumption was significantly lower in ESBP and SAPB groups than control
group [ESPB (8.52 +/- 4.29 mg) < SAPB (19.57 +/- 7.63 mg) < control (36.37
+/- 8.27 mg)] (P < 0.001). Numerical rating scale pain score was
comparable among the groups at rest, but was significantly lower at 30
min, 2, 4 h in ESPB and SAPB groups, than control group on coughing. The
scores were better in SAPB compared to control group till 4 h. At 8, 12,
24 h, the difference between control and SAPB groups became insignificant,
but it remained the least in ESPB group. Postoperative forced vital
capacity and forced expiratory volume in the first second after 24 h were
the best in ESPB group and better in SAPB group compared to the control
group. <br/>Conclusion(s): Both ESPB and SAPB reduced intraoperative and
postoperative opioid consumptions and postoperative dynamic pain scores
with improved postoperative pulmonary functions in thoracic surgery with
the ESPB being superior.<br/>Copyright &#xa9; 2022 Indian Journal of
Anaesthesia.

<30>
Accession Number
2020657803
Title
A Systematic Review and Meta-Analysis of Robot-Assisted Mitral Valve
Repair.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 17(6) (pp 471-481), 2022. Date of Publication: November/December
2022.
Author
Fatehi Hassanabad A.; Nagase F.N.I.; Basha A.M.; Hammal F.; Menon D.; Kent
W.D.T.; Ali I.S.; Nagendran J.; Stafinski T.
Institution
(Fatehi Hassanabad, Basha, Kent, Ali) Section of Cardiac Surgery,
Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming
School of Medicine, University of Calgary, AB, Canada
(Nagase, Menon, Stafinski) Health Technology & Policy Unit (HTPU), School
of Public Health, University of Alberta, Edmonton, AB, Canada
(Hammal) School of Public Health, University of Alberta, Edmonton, AB,
Canada
(Nagendran) Division of Cardiac Surgery, Department of Surgery,
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB,
Canada
Publisher
SAGE Publications Ltd
Abstract
Objective: Robot-assisted surgery is a minimally invasive approach for
repairing the mitral valve. This study aimed to assess its safety and
clinical efficacy when compared with conventional sternotomy, partial
sternotomy, and right minithoracotomy. <br/>Method(s): A systematic review
of peer-reviewed studies comparing robot-assisted mitral valve repair with
conventional sternotomy, partial sternotomy, and right minithoracotomy was
conducted following Cochrane Collaboration guidelines. Meta-analyses were
performed where possible. <br/>Result(s): The search strategy yielded 15
primary studies, of which 12 compared robot-assisted with conventional
sternotomy, 2 compared robot-assisted with partial sternotomy, and 6
compared robot-assisted with right minithoracotomy. The overall quality of
evidence was low, and there was a lack of data on long-term outcomes.
Individual studies and pooled data demonstrated that robotic procedures
were comparable to conventional sternotomy and other minimally invasive
approaches with respect to the rates of stroke, renal failure, reoperation
for bleeding, and mortality. Robot-assisted mitral valve repair was
superior to conventional sternotomy with reduced atrial fibrillation,
intensive care unit and hospital stay, pain, time to return to normal
activities, and physical functioning at 1 year. However, robot-assisted
mitral valve repair had longer cardiopulmonary, aortic cross-clamp, and
procedure times compared with all other surgical approaches.
<br/>Conclusion(s): Based on current evidence, robot-assisted mitral valve
repair is comparable to other approaches for safety and early
postoperative outcomes, despite being associated with longer operative
times. Ideally, future studies will be randomized controlled trials that
compare between robot-assisted surgery, conventional surgery, and other
minimally surgery approaches focusing on hard clinical outcomes and
patient-reported outcomes.<br/>Copyright &#xa9; The Author(s) 2022.

<31>
Accession Number
2018488536
Title
Cardiovascular computed tomography in pediatric congenital heart disease:
A state of the art review.
Source
Journal of Cardiovascular Computed Tomography. 16(6) (pp 467-482), 2022.
Date of Publication: 01 Nov 2022.
Author
Cohen J.; Asrani P.; Lee S.; Frush D.; Han B.K.; Chelliah A.; Farooqi K.M.
Institution
(Cohen) Department of Pediatrics, Division of Pediatric Cardiology, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Asrani, Chelliah, Farooqi) Division of Pediatric Cardiology, Department
of Pediatrics, New York Presbyterian/Columbia University Irving Medical
Center, New York, NY, United States
(Lee) Department of Pediatrics, The Heart Center, Nationwide Children's
Hospital, The Ohio State University, Columbus, OH, United States
(Frush) Division of Pediatric Radiology, Department of Radiology, Medical
Physics Graduate Program, Duke University Medical Center, Durham, NC,
United States
(Han) The Children's Heart Clinic at The Children's Hospitals and Clinics
of Minnesota, Minneapolis, MN, United States
(Chelliah) Division of Pediatric Cardiology, Goryeb Children's Hospital,
Atlantic Health System, Morristown, NJ, United States
Publisher
Elsevier Inc.
Abstract
Cardiac computed tomography (CCT) has increasingly been used in the
assessment of both children and adults with congenital heart disease
(CHD), in part due to advances in CCT technology and an increased
prevalence of adults with palliated CHD. It serves as a complimentary
modality to echocardiography, cardiac magnetic resonance imaging and
cardiac catheterization. CCT can provide unique diagnostic information, is
less invasive and less likely to require sedation compared to other
modalities. Detailed knowledge of individual patient cardiac anatomy,
physiology, surgical repair and possible residual lesions are paramount to
optimal CCT imaging. This comprehensive review details the use of CCT both
pre- and postoperatively for the most common CHD diagnoses. We also aim to
highlight some new and innovative technologies that have become available
and can further optimize CCT imaging for CHD patients.<br/>Copyright
&#xa9; 2022 Society of Cardiovascular Computed Tomography

<32>
Accession Number
2018480294
Title
Late Infective Endocarditis After Transcatheter Mitral Valve
Reconstruction (MitraClip) :A Case Report and a Review of the Literature.
Source
Angiology. (no pagination), 2022. Date of Publication: 2022.
Author
Chourdakis E.; Koniari I.; Osman N.; Kounis N.; Hahalis G.; Werner N.
Institution
(Chourdakis, Osman, Werner) Krankenhaus der Barmherzigen Bruder, Trier,
Germany
(Koniari) University Hospital of South Manchester, Manchester, United
Kingdom
(Kounis, Hahalis) Patras University Hospital, Patras, Greece
Publisher
SAGE Publications Inc.
Abstract
Percutaneous transcatheter mitral valve reconstruction in edge to edge
fashion is a well-established option in inoperable or high peri-operative
risk patients with severe, symptomatic mitral valve regurgitation.
MitraClip in combination with medical treatment improves survival and
reduces hospitalization rates compared with optimal medical therapy alone
in well selected patients. Clip-associated endocarditis is a rare
complication with only few reported cases in the literature. We present a
case of late infective endocarditis post Mitral Clip implantation and also
review the literature regarding this new rare condition.<br/>Copyright
&#xa9; The Author(s) 2022.

<33>
Accession Number
2021280134
Title
Low dose ultra-slow infusion thrombolytic therapy (LDUSITT) as an
alternative option in a COVID-19 patient with free-floating right atrial
thrombus: a case report and review of literature.
Source
Thrombosis Journal. 21(1) (no pagination), 2023. Article Number: 12. Date
of Publication: December 2023.
Author
Mahjani M.; Gohari S.; Ahangar H.
Institution
(Mahjani) Endocrine Research Center, School of Medicine, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Mahjani, Gohari) Department of Family Medicine, Alborz University of
Medical Science, Alborz, Iran, Islamic Republic of
(Gohari) Student Research Center, School of Medicine, Zanjan University of
Medical Sciences, Zanjan, Iran, Islamic Republic of
(Ahangar) Department of Cardiology, Mousavi Hospital, School of Medicine,
Zanjan University of Medical Sciences, Zanjan, Iran, Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
The hyper-coagulopathy nature of COVID-19 is a prevalent consequence among
patients. Free-floating right atrial thrombi are a relatively rare finding
and the optimal therapy is a therapeutic dilemma. We present a 37-year-old
woman with acute dyspnea and fatigue. Several ground glass opacities were
shown on computed tomography of chest that further proved to be associated
with severe COVID-19 disease. A transthoracic echocardiography revealed a
mobile right atrial mass with bilateral pulmonary embolism. She was
considered high risk for surgical therapy by cardiovascular surgeons. She
was then started on anticoagulation therapy for 5 days however the size
regression of the thrombus remained unchanged. A regimen of low dose (24
mg) ultra-slow (24 h) intravenous infusion of alteplase, without bolus was
initiated. Following the third day of thrombolytic therapy, the control
echocardiography demonstrated complete resolution of the thrombus.
Prolonged infusion of low dose fibrinolytics can be an alternative
treatment to surgery for right heart thrombi.<br/>Copyright &#xa9; 2023,
The Author(s).

<34>
Accession Number
2021232036
Title
Conscious sedation/monitored anesthesia care versus general anesthesia in
patients undergoing transcatheter aortic valve replacement: A
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 1099959. Date of Publication: 10 Jan 2023.
Author
Hung K.-C.; Chen J.-Y.; Hsing C.-H.; Chu C.-C.; Lin Y.-T.; Pang Y.-L.;
Teng I.-C.; Chen I.-W.; Sun C.-K.
Institution
(Hung) School of Medicine, College of Medicine, National Sun Yat-sen
University, Kaohsiung City, Taiwan (Republic of China)
(Hung, Chen, Hsing, Chu, Lin, Pang, Teng) Department of Anesthesiology,
Chi Mei Medical Center, Tainan City, Taiwan (Republic of China)
(Hsing) Department of Medical Research, Chi Mei Medical Center, Tainan
City, Taiwan (Republic of China)
(Chen) Department of Anesthesiology, Chi Mei Medical Center, Liouying,
Tainan City, Taiwan (Republic of China)
(Sun) Department of Emergency Medicine, E-Da Hospital, Kaohsiung City,
Taiwan (Republic of China)
(Sun) College of Medicine, I-Shou University, Kaohsiung City, Taiwan
(Republic of China)
Publisher
Frontiers Media S.A.
Abstract
Background: To compare the merits and safety between conscious
sedation/monitored anesthesia (CS/MAC) and general anesthesia (GA) for
patients receiving transcatheter aortic valve replacement (TAVR).
Measurements: Databases including EMBASE, MEDLINE, and the Cochrane
Library databases were searched from inception to October 2022 to identify
studies investigating the impact of CS/MAC on peri-procedural and
prognostic outcomes compared to those with GA. The primary outcome was the
association of CS/MAC with the risk of 30-day mortality, while secondary
outcomes included the risks of adverse peri-procedural (e.g.,
vasopressor/inotropic support) and post-procedural (e.g., stroke)
outcomes. Subgroup analysis was performed based on study design [i.e.,
cohort vs. matched cohort/randomized controlled trials (RCTs)]. <br/>Main
Result(s): Twenty-four studies (observational studies, n = 22; RCTs, n =
2) involving 141,965 patients were analyzed. Pooled results revealed lower
risks of 30-day mortality [odd ratios (OR) = 0.66, p < 0.00001, 139,731
patients, certainty of evidence (COE): low], one-year mortality (OR =
0.72, p = 0.001, 4,827 patients, COE: very low), major bleeding (OR =
0.61, p = 0.01, 6,888 patients, COE: very low), acute kidney injury (OR =
0.71, p = 0.01, 7,155 patients, COE: very low), vasopressor/inotropic
support (OR = 0.25, p < 0.00001, 133,438 patients, COE: very low), shorter
procedure time (MD = -12.27 minutes, p = 0.0006, 17,694 patients, COE:
very low), intensive care unit stay (mean difference(MD) = -7.53 h p =
0.04, 7,589 patients, COE: very low), and hospital stay [MD = -0.84 days,
p < 0.00001, 19,019 patients, COE: very low) in patients receiving CS/MAC
compared to those undergoing GA without significant differences in
procedure success rate, risks of cardiac-vascular complications (e.g.,
myocardial infarction) and stroke. The pooled conversion rate was 3.1%.
Results from matched cohort/RCTs suggested an association of CS/MAC use
with a shorter procedural time and hospital stay, and a lower risk of
vasopressor/inotropic support. <br/>Conclusion(s): Compared with GA, our
results demonstrated that the use of CS/MAC may be feasible and safe in
patients receiving TAVR. However, more evidence is needed to support our
findings because of our inclusion of mostly retrospective studies.
Systematic review registration: https://www.crd.york.ac.uk/prospero/,
identifier CRD42022367417.<br/>Copyright &#xa9; 2023 Hung, Chen, Hsing,
Chu, Lin, Pang, Teng, Chen and Sun.

<35>
Accession Number
2021223645
Title
Risk factors of postoperative low cardiac output syndrome in children with
congenital heart disease: A systematic review and meta-analysis.
Source
Frontiers in Pediatrics. 10 (no pagination), 2023. Article Number: 954427.
Date of Publication: 10 Jan 2023.
Author
Wang P.; Fu C.; Bai G.; Cuan L.; Tang X.; Jin C.; Jin H.; Zhu J.; Xie C.
Institution
(Wang, Cuan, Tang, Zhu) Department of Pediatric Surgery, The Children's
Hospital, Zhejiang University School of Medicine, National Clinical
Research Center for Child Health, Hangzhou, China
(Fu) Department of Nursing, The Children's Hospital, Zhejiang University
School of Medicine, National Clinical Research Center for Child Health,
Hangzhou, China
(Bai, Jin) The Children's Hospital, Zhejiang University School of
Medicine, National Clinical Research Center for Child Health, Hangzhou,
China
(Jin) Cardiac Intensive Care Unit, The Children's Hospital, Zhejiang
University School of Medicine, National Clinical Research Center for Child
Health, Hangzhou, China
(Xie) Department of Cardiovascular Medicine, The Children's Hospital,
Zhejiang University School of Medicine, National Clinical Research Center
for Child Health, Hangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: Low cardiac output syndrome (LCOS) is the most common
complication after cardiac surgery, which is associated with the extension
of postoperative hospital stay and postoperative death in children with
congenital heart disease (CHD). Although there are some studies on the
risk factors of LCOS in children with CHD, an unified conclusion is lack
at present. <br/>Purpose(s): To synthesize the risk factors of LCOS after
CHD in children, and to provide evidence-based insights into the early
identification and early intervention of LCOS. <br/>Method(s): The
databases of the China National Knowledge Infrastructure (CNKI), Wanfang
Database, China Science and Technology Journal Database (VIP), PubMed,
Cochrane Library, Embase and Web of Science were searched for relevant
articles that were published between the establishing time of each
database and January 2022. Based on retrospective records or cohort
studies, the influencing factors of postoperative low cardiac output in
children with congenital heart disease were included in Meta analysis.This
study followed the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guidelines. The risk of bias was evaluated
according to the Newcastle-Ottawa Scale (NOS). RevMan 5.4 software was
used to conduct the meta-analysis. <br/>Result(s): A total of 1,886
records were screened, of which 18 were included in the final review. In
total, 37 risk factors were identified in the systematic review. Meta-
analysis showed that age, type of CHD, cardiac reoperation, biventricular
shunt before operation, CPB duration, ACC duration, postoperative residual
shunt, cTn-1 level 2 h after CPB > 14 ng/ml and postoperative 24 h
MR-ProADM level > 1.5 nmol/l were independent risk factors of LCOS.
Additionally, the level of blood oxygen saturation before the operation
was found to have no statistically significant relationship with LOCS.
<br/>Conclusion(s): The risk factors of postoperative LCOS in children
with CHD are related to disease condition, intraoperative time and
postoperative related indexes, so early prevention should be aimed at
high-risk children. Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/, identifier:
CRD42022323043.<br/>Copyright 2023 Wang, Chuan, Tang and Zhu.

<36>
Accession Number
2022388463
Title
Efficacy of Buteyko Breathing Technique on Anxiety, Depression and Self
Efficacy in Coronary Artery Bypass Graft Patients: A Randomised Clinical
Trial.
Source
Journal of Clinical and Diagnostic Research. 17(1) (pp YC11-YC14), 2023.
Date of Publication: January 2023.
Author
Jain M.; Vardhan V.; Yadav V.; Harjpal P.
Institution
(Jain, Vardhan, Yadav) Department of Cardio-respiratory Physiotherapy,
Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical
Sciences, Maharashtra, Wardha, India
(Harjpal) Department of Neuro Physiotherapy, Ravi Nair Physiotherapy
College, Datta Meghe Institute of Medical Sciences, Maharashtra, Wardha,
India
Publisher
Journal of Clinical and Diagnostic Research
Abstract
Introduction: Psychiatric issues, particularly depression and anxiety,
have been observed in the proportions of patients undergoing
cardiovascular surgery.Such findings provide a window of opportunity for
integrating intervention, targeting psychological components into
post-Coronary Artery Bypass Graft (CABG) patient management to provide
effective care. The Buteyko Breathing Technique (BBT), which is named
after its inventor Konstantin Pavlovich Buteyko, is one of the numerous
breathing techniques that aims to regulate breathing. By alternating
between periods of controlled breathing reduction and breath holding.
<br/>Aim(s): To explore the effect of BBT as a psychological
rehabilitation technique on anxiety, depression, and self-efficacy in
post-CABG subjects having anxiety and depression. <br/>Material(s) and
Method(s): This randomised clinical trial was performed at Cardiovascular
and Thoracic Surgery Unit, Acharya Vinobha Bhave Rural Hospital, Sawangi,
Wardha, Maharashtra, India, from June 2021 to May 2022. Total 44 post CABG
patients who all screened positive for anxiety and depression by General
Anxiety Disorder-7 (GAD-7) questionnaire and Patient Health
Questionnaire-9 (PHQ-9) were enrolled. They were randomly assigned using
computed generated block randomisation. They were allocated using the
Sequentially Numbered Opaque Sealed Envelope (SNOSE) method to group A
Conventional group (n=22) and group B Experimental group (n=22). Both
groups competed the in-hospital phase 1 cardiac rehabilitation as per
American Association of Cardiovascular and Pulmonary Rehab (AACVPR)
guidelines, whereas group B received additional BBT for psychosocial
rehabilitation for 2 weeks post surgery. The evaluations were performed
using the GAD-7 questionnaire, PHQ-9, General Self-Efficiency Scale (GSS),
Breath Holding Test (BHT), and Borg Rate of Perceived Exertion Scale
(RPE), at baseline on Post Operative Day (POD)1 and at their last
rehabilitation session. Patients in both groups were given self management
and education hand-outs at the time of discharge. Statistical Package for
Social Sciences (SPSS) version 27.0 was used for statistical analysis.
<br/>Result(s): The mean age of patients in A-group was 59.72+/-7.84 years
and in B-group 60.81+/-7.42 years, respectively. The age, gender, height,
weight, and BMI of the patients were similar between the groups. On intra
group comparison,there was statistically significant difference observed
for GAD-7, PHQ-9, GSS, BHT, and RPE in group A and group B following the
intervention, but the change was more pronounced in group B. The results
for the inter group comparison showed a significant difference in group B
on Anxiety, Depression, self-efficacy, BHT, and RPE as compared to the
group A, i.e. group B showed a larger improvement in outcome measure
scores than group A. <br/>Conclusion(s): The present study demonstrated
that On intra group weeks of BBT along with phase 1 cardiac rehabilitation
in post CABG patients brings favourable changes in levels of anxiety,
depression and self-efficacy.<br/>Copyright &#xa9; 2023 Journal of
Clinical and Diagnostic Research. All rights reserved.

<37>
Accession Number
2019114543
Title
Incorporating Insulin Growth Factor-1 into Regenerative and Personalized
Medicine for Cardiovascular Disease: A Systematic Review.
Source
Current Stem Cell Research and Therapy. 18(2) (pp 202-215), 2023. Date of
Publication: February 2023.
Author
Gan Q.F.; Lim Y.T.; Foo C.N.; Yu C.W.; Woon C.K.; Cheong S.K.; Leong P.P.
Institution
(Gan, Leong) Pre-Clinical Department, Faculty of Medicine and Health
Science, UTAR Sg Long Campus, Selangor, Malaysia
(Lim) Intensive Care Unit, Assunta Hospital, Jalan Templer, Selangor,
Petaling Jaya, Malaysia
(Foo) Population Medicine De-partment, Faculty of Medicine and Health
Science, UTAR Sg Long Campus, Selangor, Malaysia
(Yu) Faculty of Allied Health Science, AIMST, Kedah, Bedong, Malaysia
(Woon) Department of Anatomy, Faculty of Medicine, Universiti Teknologi
MARA, Selangor, Sungai Buloh, Malaysia
(Cheong) Medicine Department, Faculty of Medicine and Health Sciences,
UTAR Sg Long Campus, Selangor, Malaysia
Publisher
Bentham Science Publishers
Abstract
Background: Cardiovascular disease (CVD) is one of the world's leading
causes of increased morbidity and mortality. Current interventions for
CVD, including percutaneous transluminal coronary angioplasty (PTCA) and
coronary artery bypass grafting (CABG), carry certain risks and
complications, which may also affect the patient's quality of life. It is
important to minimize those risks and complications while speeding up the
recovery. Insulin Growth Factor-1 (IGF-1) is a growth factor responsible
for cellular migration, proliferation, differentiation, and angiogenesis,
which supports cardiovascular regen-eration. <br/>Method(s): In light of
the current trend of regenerative medicine, the present review aims to
pool data relat-ing to the incorporation of IGF-1 in regenerative medicine
and provide input on the current research gaps and concerns arising on
translating this approach from benchwork into clinical settings.
<br/>Result(s): Using the keywords IGF-1 'OR' Insulin Growth Factor 1
'AND' Mesenchymal Stem Cells 'AND' Tissue Healing from 2009 to 2020, we
identified 160 and 52 from Medline and PubMed, screen-ing out 202 articles
due to non-fulfilment of the inclusion criteria. <br/>Conclusion(s):
Incorporating IGF-1 into regenerative and personalized medicine may be
promising for treating CVD; however, the concerns include the role of
IGF-1 in inducing cancer growth and its ability to migrate to the specific
site of injury, especially for those who present with multiple pathologies
should be addressed prior to its translation from bench work into clinical
settings.<br/>Copyright &#xa9; 2023 Bentham Science Publishers.

<38>
Accession Number
640141101
Title
Routine cerebral embolic protection in transcatheter aortic valve
implantation: rationale and design of the randomised British Heart
Foundation PROTECT-TAVI trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2023. Date of Publication: 26 Jan 2023.
Author
Kharbanda R.K.; Perkins A.D.; Kennedy J.; Banning A.P.; Baumbach A.;
Blackman D.J.; Dodd M.; Evans R.; Hildick-Smith D.; Jamal Z.; Ludman P.;
Palmer S.; Stables R.; Clayton T.
Institution
(Kharbanda, Banning) NIHR Oxford Biomedical Research Centre, Oxford
University Hospitals NHS Foundation Trust, Oxford, United Kingdom
(Kharbanda, Dodd, Evans, Jamal, Clayton) Department of Cardiovascular
Medicine, University of Oxford, Oxford, United Kingdom
(Perkins) Clinical Trials Unit and Department of Medical Statistics,
London School of Hygiene and Tropical Medicine, London, United Kingdom
(Kennedy) Acute Vascular Imaging Centre, Radcliffe Department of Medicine,
University of Oxford, Oxford, United Kingdom
(Baumbach) Centre for Cardiovascular Medicine and Devices, William Harvey
Research Institute, Queen Mary University of London, UK and Barts Heart
Centre, London, United Kingdom
(Blackman) Department of Cardiology, Leeds Teaching Hospitals NHS Trust,
Leeds, United Kingdom
(Hildick-Smith) Cardiac Surgery, Cardiac Center, Royal Sussex County
Hospital, UK and Sussex University Hospitals Trust, Brighton, United
Kingdom
(Ludman) Institute of Cardiovascular Sciences, University of Birmingham
(Palmer) Centre for Health Economics, University of York, York, United
Kingdom
(Stables) Liverpool Centre for Cardiovascular Science, University of
Liverpool, UK and Liverpool Heart & Chest Hospital, Liverpool, United
Kingdom
Publisher
NLM (Medline)
Abstract
Transcatheter aortic valve implantation (TAVI) is an established treatment
for aortic stenosis. Cerebral embolic protection (CEP) devices may impact
periprocedural stroke by capturing debris destined for the brain. However,
there is a lack of high-quality randomised trial evidence supporting the
use of CEP during TAVI. The British Heart Foundation (BHF) PROTECT-TAVI
trial will address whether the routine use of CEP reduces the incidence of
stroke in patients undergoing TAVI. BHF PROTECT-TAVI is a prospective,
open-label, outcome-adjudicated, multicentre randomised controlled trial.
The trial is open to all adult patients scheduled for TAVI at
participating specialist cardiac centres across the United Kingdom who are
able to receive the CEP device. The trial will recruit 7,730 participants.
Participants will be randomised in a 1:1 ratio to undergo TAVI with CEP or
TAVI without CEP (standard of care). The primary outcome is the incidence
of stroke at 72 hours post-TAVI. Key secondary outcomes include the
incidence of stroke and all-cause mortality up to 12 months post-TAVI,
disability and cognitive outcomes, stroke severity, access site
complications and a health economics analysis. The sample size of 7,730
participants has 80% power to detect a 33% relative risk reduction from a
3% incidence of the primary outcome in the controls. Trial recruitment
commenced in October 2020. As of October 2022, 3,068 patients have been
enrolled. BHF PROTECT-TAVI is designed to provide definitive evidence on
the clinical efficacy and cost-effectiveness of using routine CEP with the
SENTINEL device to reduce stroke in TAVI.

<39>
Accession Number
640139973
Title
Effectiveness of iodine-impregnated incise drapes for preventing surgical
site infection in patients with clean or clean contaminated wounds: A
systematic literature review and cost-consequence analysis.
Source
Journal of perioperative practice. (pp 17504589221139603), 2023. Date of
Publication: 27 Jan 2023.
Author
Sworn K.; Poku E.; Thokala P.; Sutton A.; Foster S.; Siddall I.; Reuter H.
Institution
(Sworn, Poku, Thokala, Sutton) School of Health and Related Research
(ScHARR), University of Sheffield, Sheffield, United Kingdom
(Foster, Siddall) 3M UK PLC, Loughborough, United Kingdom
(Reuter) Medical Solutions Division, 3M Deutschland GmbH, Neuss, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: Surgical site infection is a serious complication associated
with significant morbidity, mortality and health care expenditure. AIMS:
To determine the clinical effectiveness and economic impact of using
iodine-impregnated incise drapes for preventing surgical site infection.
<br/>METHOD(S): MEDLINE, Embase, Cochrane Library and CINAHL databases
were systematically searched. Critical appraisal and synthesis of clinical
evidence informed a decision analytical cost-consequence model. FINDINGS:
Nine studies were included in the systematic literature review. Evidence
from cardiac surgery patients was considered appropriate to inform the
cost analysis. The economic model evaluation estimated cost savings of 549
per patient with the iodophor-impregnated drape in the deterministic
analysis and a mean cost saving per patient of 554,172 per 1000 in the
probabilistic analysis. <br/>CONCLUSION(S): Using iodine-impregnated
drapes in cardiac surgery patients may effectively reduce infections and
provide cost-savings, but further research is required.

<40>
Accession Number
640139539
Title
Sex Hormone-Binding Globulin and Risk of Coronary Heart Disease in Men and
Women.
Source
Clinical chemistry. (no pagination), 2023. Date of Publication: 25 Jan
2023.
Author
Li J.; Zheng L.; Chan K.H.K.; Zou X.; Zhang J.; Liu J.; Zhong Q.; Madsen
T.E.; Wu W.-C.; Manson J.E.; Yu X.; Liu S.
Institution
(Li, Zheng, Zou, Zhong, Yu, Liu) Global Health Research Center, Guangdong
Provincial People's Hospital, Guangdong Academy of Medical Sciences,
Guangzhou, China
(Li) Second School of Clinical Medicine, Southern Medical University,
Guangzhou 510280, China
(Li) School of Medicine, South China University of Technology, Guangzhou
510006, China
(Li, Chan, Madsen, Wu, Liu) Department of Epidemiology and Center for
Global Cardiometabolic Health, School of Public Health, Brown University,
Providence, RI, United States
(Chan, Liu) Departments of Biomedical Sciences and Electrical Engineering,
City University of Hong Kong, Hong Kong SAR, China
(Zhang) Guangdong Mental Health Center, Guangdong Provincial People's
Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
(Madsen) Department of Emergency Medicine, Warren Alpert Medical School,
Brown University, Providence, RI, United States
(Wu) Department of Medicine, Division of Cardiology, Providence VA Medical
Center and Warren Alpert Medical School of Brown University, Providence,
RI, United States
(Manson) Department of Medicine, Brigham and Women's Hospital, Harvard
Medical School, Department of Epidemiology, Harvard T.H. Chan School of
Public Health, Boston, MA, United States
(Yu) Department of Nephrology, Guangdong-Hong Kong Joint Laboratory on
Immunological and Genetic Kidney Diseases, Guangdong Provincial People's
Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
(Liu) Departments of Medicine and Surgery, Warren Alpert Medical School,
Brown University, Providence, RI, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: The role of sex hormone-binding globulin (SHBG) levels in
clinical risk stratification and intervention for coronary heart disease
(CHD) remains uncertain. We aimed to examine whether circulating levels of
SHBG are predictive of CHD risk in men and women. <br/>METHOD(S): We
investigated the association between SHBG and the risk of incident CHD in
128 322 men and 135 103 women free of CHD at baseline in the prospective
United Kingdom Biobank (UKB) cohort. The unconfounded associations were
estimated using Mendelian randomization (MR) analysis. We further
conducted a meta-analysis to integrate currently available prospective
evidence. CHD events included nonfatal and fatal myocardial infarction and
coronary revascularization. <br/>RESULT(S): In the UKB, during a median of
11.7 follow-up years, 10 405 men and 4512 women developed CHD. Serum
levels of SHBG were monotonically associated with a decreased risk of CHD
in both men (adjusted hazard ratio [HR] per log nmol/L increase in SHBG:
0.88 [0.83-0.94]) and women (HR: 0.89 [0.83-0.96]). MR-based analyses
suggested causality and a dose-response relationship of SHBG with CHD
risk. A cumulative meta-analysis including 216 417 men and 138 282 women
from 11 studies showed that higher levels of SHBG were prospectively
associated with decreased CHD risk in men comparing the highest with the
lowest quartile: pooled relative risk (RR) 0.81 (0.74-0.89) and women
(pooled RR: 0.86 [0.78-0.94]). <br/>CONCLUSION(S): Higher circulating SHBG
levels were directly and independently predictive of lower CHD risk in
both men and women. The utility of SHBG for CHD risk stratification and
prediction warrants further study.<br/>Copyright &#xa9; American
Association for Clinical Chemistry 2023. All rights reserved. For
permissions, please e-mail: journals.permissions@oup.com.

<41>
Accession Number
640139285
Title
Factors influencing post-surgical survival in degenerative mitral
regurgitation.
Source
European heart journal. (no pagination), 2023. Date of Publication: 26
Jan 2023.
Author
Butcher S.C.; Essayagh B.; Steyerberg E.W.; Benfari G.; Antoine C.;
Grigioni F.; Le Tourneau T.; Roussel J.-C.; van Wijngaarden A.; Marsan
N.A.; Tribouilloy C.; Rusinaru D.; Hochstadt A.; Topilsky Y.; Michelena
H.I.; Delgado V.; Bax J.J.; Enriquez-Sarano M.
Institution
(Butcher, van Wijngaarden, Marsan, Bax) Department of Cardiology, Leiden
University Medical Center, Albinusdreef 2, ZA Leiden 2333, Netherlands
(Butcher) Department of Cardiology, Royal Perth Hospital, Victoria Square,
Australia
(Essayagh, Benfari, Antoine, Michelena, Enriquez-Sarano) Mayo Clinic
Cardiovascular Medicine, 200 First St. SW Rochester, United States
(Essayagh) Department of Cardiovascular Medicine, Simone Veil Hospital, 15
Avenue des Broussailles, Cannes 06400, France
(Steyerberg) Department of Biomedical Data Sciences, Leiden University
Medical Center, Albinusdreef 2, ZA Leiden 2333, Netherlands
(Grigioni) University Campus Bio-Medico, Department of Cardiology, 00128
Roma RM, Via Alvaro del Portillo 200, Italy
(Le Tourneau, Roussel) University of Nantes, Department of Cardiology, CHU
de Nantes, Nantes 44093, France
(Tribouilloy, Rusinaru) University of Amiens, Department of Cardiology,
Centre Hospitalier Universitaire d'Amiens-Picardie, Amiens 80000, France
(Hochstadt, Topilsky) Tel-Aviv Medical Center and Sackler Faculty of
Medicine, Department of Cardiology, 6 Weizmann Street, Tel Aviv 6423906,
Israel
(Delgado) Department of Cardiology, Universtiy Hospital Germans Trias i
Pujol, Carretera de Canyet, Badalona 08916, Spain
(Bax) Turku Heart Center, University of Turku and Turku University
Hospital, Kiinamyllynkatu 4-8, Turku 20521, Finland
(Enriquez-Sarano) Department of Cardiovascular Diseases, Minneapolis Heart
Institute, Abbott Northwestern Hospital, 800 E 28th St, Minneapolis,
United States
Publisher
NLM (Medline)
Abstract
AIMS: Indications for surgery in patients with degenerative mitral
regurgitation (DMR) are increasingly liberal in all clinical guidelines
but the role of secondary outcome determinants (left atrial volume index
>=60 mL/m2, atrial fibrillation, pulmonary artery systolic pressure >=50
mmHg and moderate to severe tricuspid regurgitation) and their impact on
post-operative outcome remain disputed. Whether these secondary outcome
markers are just reflective of the DMR severity or intrinsically affect
survival after DMR surgery is uncertain and may have critical importance
in the management of patients with DMR. To address these gaps of knowledge
the present study gathered a large cohort of patients with quantified DMR,
accounted for the number of secondary outcome markers and examined their
independent impact on survival after surgical correction of the DMR.
METHODS AND RESULTS: The Mitral Regurgitation International
DAtabase-Quantitative registry includes patients with isolated DMR from
centres across North America, Europe, and the Middle East. Patient
enrolment extended from January 2003 to January 2020. All patients
undergoing mitral valve surgery within 1 year of registry enrolment were
selected. A total of 2276 patients [65 (55-73) years, 32% male] across
five centres met study eligibility criteria. Over a median follow-up of
5.6 (3.6 to 8.7) years, 278 patients (12.2%) died. In a comprehensive
multivariable Cox regression model adjusted for age, EuroSCORE II,
symptoms, left ventricular ejection fraction (LVEF), left ventricular
end-systolic diameter (LV ESD) and DMR severity, the number of secondary
outcome determinants was independently associated with post-operative
all-cause mortality, with adjusted hazard ratios of 1.56 [95% confidence
interval (CI): 1.11-2.20, P = 0.011], 1.78 (95% CI: 1.23-2.58, P = 0.002)
and 2.58 (95% CI: 1.73-3.83, P < 0.0001) for patients with one, two, and
three or four secondary outcome determinants, respectively. A model
incorporating the number of secondary outcome determinants demonstrated a
higher C-index and was significantly more concordant with post-operative
mortality than models incorporating traditional Class I indications alone
[the presence of symptoms (P = 0.0003), or LVEF <=60% (P = 0.006), or LV
ESD >=40 mm (P = 0.014)], while there was no significant difference in
concordance observed compared with a model that incorporated the number of
Class I indications for surgery combined (P = 0.71). <br/>CONCLUSION(S):
In this large cohort of patients treated surgically for DMR, the presence
and number of secondary outcome determinants was independently associated
with post-surgical survival and demonstrated better outcome discrimination
than traditional Class I indications for surgery. Randomised controlled
trials are needed to determine if patients with severe DMR who demonstrate
a cardiac phenotype with an increasing number of secondary outcome
determinants would benefit from earlier surgery.<br/>Copyright &#xa9; The
Author(s) 2023. Published by Oxford University Press on behalf of the
European Society of Cardiology. All rights reserved. For permissions,
please e-mail: journals.permissions@oup.com.

<42>
Accession Number
640142424
Title
Gender Disparities in Cardiac Surgery Trials: Leadership, Authorship, and
Patient Enrollment.
Source
The Annals of thoracic surgery. (no pagination), 2023. Date of
Publication: 24 Jan 2023.
Author
Soletti G.J.; Perezgrovas-Olaria R.; Dimagli A.; Harik L.; Rong L.; Bairey
Merz C.N.; Rahouma M.; Sandner S.E.; Gelijns A.C.; Gaudino M.
Institution
(Soletti, Perezgrovas-Olaria, Dimagli, Harik, Rahouma) Department of
Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
(Rong) Department of Anesthesiology, Weill Cornell Medicine/ New York
Presbyterian Hospital, New York, NY, USA
(Bairey Merz) Barbra Streisand Women's Heart Center, Cedars-Sinai Medical
Center, Los Angeles, CA, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Gelijns) Department of Population Health Science and Policy, Icahn School
of Medicine at Mount Sinai, New York, NY, USA
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, USA. Electronic address: mfg9004@med.cornell.edu
Publisher
NLM (Medline)
Abstract
BACKGROUND: Studies have highlighted the paucity of women-led randomized
controlled trials (RCTs) in cardiovascular medicine. Whether this finding
also applies to cardiac surgery has not been evaluated. In this study, we
evaluate women authorship, leadership, and women enrollment in cardiac
surgery RCTs. <br/>METHOD(S): A systematic literature search was conducted
to identify RCTs comparing two or more adult cardiac surgical procedures
published from 2000 to 2022. Women-led RCTs were defined as those with a
woman either as a first or last author. Linear regression and correlation
analyses were used. <br/>RESULT(S): Of fifty-eight RCTs, eight (13.8%)
were women-led. Seventeen (29.3%) RCTs had no women authors. Overall,
17.9% of all authors were women, but only 1.2% of all authors were women
cardiac surgeons and only 19% of the RCTs had a women cardiac surgeon
among the authors. The median proportion of women authors was 14.3% by
RCT, which was significantly higher in women- compared to men-led RCTs
(28.6% vs 11.8%, P=0.01). No significant change in the proportion of women
authors was observed over the study period. North American RCTs had a
higher proportion of women authors compared to other geographical regions
(28.6% vs 12.5%, P=0.01). No correlation was found between the proportion
of women authors and the proportion of women participants enrolled in
individual RCTs. <br/>CONCLUSION(S): Over the last two decades, only a
minority of cardiac surgery RCTs were women-led and no significant
increase in women authorship occurred. There are important geographical
differences in women authorship.<br/>Copyright &#xa9; 2023. Published by
Elsevier Inc.

<43>
Accession Number
2019682806
Title
Outcomes of Myocardial Revascularization in Diabetic Patients With Left
Main Coronary Artery Disease: A Multicenter Observational Study From Three
Gulf Countries.
Source
Cardiovascular Revascularization Medicine. 46 (pp 52-61), 2023. Date of
Publication: January 2023.
Author
Daoulah A.; Elfarnawany A.; Al Garni T.; Hersi A.S.; Alshehri M.;
Almahmeed W.; Yousif N.; Abuelatta R.; Alasmari A.; Elsheikh-Mohamed N.E.;
Alzahrani B.; Ghani M.A.; Amin H.; Hashmani S.; Hiremath N.; Alshali K.Z.;
Elmahrouk Y.; Kazim H.M.; Refaat W.; Selim E.; Jamjoom A.; Feteih M.N.;
El-Sayed O.; Al-Faifi S.M.; Dahdouh Z.; Aithal J.; Ibrahim A.M.; Elganady
A.; Qutub M.A.; Alama M.N.; Abohasan A.; Hassan T.; Balghith M.; Hussien
A.F.; Abdulhabeeb I.A.M.; Ahmad O.; Ramadan M.; Alqahtani A.H.; Abumelha
B.K.; Qenawi W.; Shawky A.; Ghonim A.A.; Elmahrouk A.; Alhamid S.;
Maghrabi M.; Haddara M.M.; Aljohar A.; Hurley W.T.; Alshahrani S.S.; Lotfi
A.
Institution
(Daoulah, Elfarnawany, Alasmari, Elsheikh-Mohamed, Jamjoom, El-Sayed,
Elmahrouk) Department of Cardiovascular Medicine, King Faisal Specialist
Hospital & Research Center, Jeddah, Saudi Arabia
(Al Garni, Alzahrani) Department of Cardiology, Prince Sultan Cardiac
Center, Riyadh, Saudi Arabia
(Hersi, Aljohar) Department of Cardiac Sciences, King Fahad Cardiac
Center, King Saud University, Riyadh, Saudi Arabia
(Alshehri, Qenawi, Shawky) Department of Cardiology, Prince Khaled Bin
Sultan Cardiac Center, Khamis Mushait, Saudi Arabia
(Almahmeed, Hashmani, Hiremath) Heart & Vascular Institute, Cleveland
Clinic Abu Dhabi, United Arab Emirates
(Yousif, Amin) Department of Cardiology, Mohammed Bin Khalifa Specialist
Cardiac Center, Awali, Bahrain
(Abuelatta, Ghani) Department of Cardiology, Madinah Cardiac Center,
Madinah, Saudi Arabia
(Alshali) Department of Medicine, Faculty of Medicine, King Abdulaziz
University, Jeddah, Saudi Arabia
(Elmahrouk) Faculty of Medicine, Tanta University, Tanta, Egypt
(Kazim, Selim, Maghrabi) Department of Cardiology, Alhada Armed Forces
Hospital, Taif, Saudi Arabia
(Refaat, Ramadan) Department of Cardiology, Prince Sultan Cardiac Center,
Al Hassa, Saudi Arabia
(Feteih, Al-Faifi) Department of Medicine, King Faisal Specialist Hospital
& Research Center, Jeddah, Saudi Arabia
(Dahdouh, Ahmad) Department of Cardiovascular Medicine, King Faisal
Specialist Hospital & Research Center, Riyadh, Saudi Arabia
(Aithal) Department of Cardiology, Yas Clinic, Khalifa City A, Abu Dhabi,
United Arab Emirates
(Ibrahim) Department of Cardiology, Saudi German Hospital, Jeddah, Saudi
Arabia
(Elganady) Department of Cardiology, Dr Erfan and Bagedo General Hospital,
Jeddah, Saudi Arabia
(Qutub, Alama, Ghonim) Cardiology Center of Excellence, Department of
Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
(Abohasan) Department of Cardiology, Prince Sultan Cardiac Center, Qassim,
Saudi Arabia
(Hassan) Department of Cardiology, Bugshan General Hospital, Jeddah, Saudi
Arabia
(Balghith) King Abdulaziz Cardiac Center, College of Medicine, King Saud
Bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
(Hussien) Department of Cardiology, International Medical Center, Jeddah,
Saudi Arabia
(Abdulhabeeb) Department of Cardiology, King Abdulaziz Specialist
Hospital, Al Jawf, Saudi Arabia
(Alqahtani) Department of Emergency Medicine, King Abdulaziz Medical City,
Riyadh, Saudi Arabia
(Abumelha) Department of Family Medicine, King Abdulaziz Medical City,
National Guard Hospital, Riyadh, Saudi Arabia
(Elmahrouk) Department of Cardiothoracic Surgery, Tanta University, Tanta,
Egypt
(Alhamid) Department of Emergency Medicine, King Fahad Medical City,
Riyadh, Saudi Arabia
(Haddara) Department of Anesthesia, King Faisal Specialist Hospital &
Research Center, Riyadh, Saudi Arabia
(Hurley) Department of Emergency Medicine, Cleveland Clinic Foundation,
Cleveland, OH 44195, United States
(Alshahrani) Department of Emergency Medicine, King Faisal Specialist
Hospital & Research Center, Riyadh, Saudi Arabia
(Lotfi) Department of Cardiovascular Medicine, Baystate Medical Center,
Tufts University School of Medicine, Springfield, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Real-world data for managing patients with diabetes and left
main coronary artery (LMCA) disease are scarce. We compared percutaneous
coronary intervention (PCI) outcomes versus coronary artery bypass
grafting (CABG) in diabetes and LMCA disease patients. <br/>Method(s): We
retrospectively studied patients with LMCA presented to 14 centers from
2015 to 2019. The study included 2138 patients with unprotected LMCA
disease; 1468 (68.7 %) had diabetes. Patients were grouped into; diabetes
with PCI (n = 804) or CABG (n = 664) and non-diabetes with PCI (n = 418)
or CABG (n = 252). <br/>Result(s): In diabetes, cardiac (34 (5.1 %) vs. 22
(2.7 %); P = 0.016), non-cardiac (13 (2 %) vs. 6 (0.7 %); P = 0.027) and
total hospital mortality (47 (7.1 %) vs. 28 (3.5 %); P = 0.0019),
myocardial infarction (45 (6.8 %) vs. 11 (1.4 %); P = 0.001),
cerebrovascular events (25 (3.8 %) vs. 12 (1.5 %); P = 0.005) and minor
bleeding (65 (9.8 %) vs. 50 (6.2 %); P = 0.006) were significantly higher
in CABG patients compared to PCI; respectively. The median follow-up time
was 20 (10-37) months. In diabetes, total mortality was higher in CABG (P
= 0.001) while congestive heart failure was higher in PCI (P = 0.001).
There were no differences in major adverse cerebrovascular events and
target lesion revascularization between PCI and CABG. Predictors of
mortality in diabetes were high anatomical SYNTAX, peripheral arterial
disease, chronic kidney disease, and cardiogenic shock.
<br/>Conclusion(s): In this multicenter retrospective study, we found no
significant difference in clinical outcomes during the short-term
follow-up between PCI with second-generation DES and CABG except for lower
total mortality and a higher rate of congestive heart failure in PCI group
of patients. Randomized trials to characterize patients who could benefit
from each treatment option are needed.<br/>Copyright &#xa9; 2022 Elsevier
Inc.

<44>
Accession Number
636682518
Title
Pyoderma Gangrenosum after Cardiac Surgery.
Source
Thoracic and Cardiovascular Surgeon. 71(1) (pp 53-61), 2023. Date of
Publication: 01 Jan 2023.
Author
Petrov A.; Kappert U.; Schmidt T.; Matschke K.E.; Wilbring M.
Institution
(Petrov, Kappert, Matschke, Wilbring) Department of Cardiac Surgery,
University Heart Center Dresden, Dresden, Germany
(Schmidt) Department of Cardiac Anesthesiology, University Heart Center
Dresden, Dresden, Germany
Publisher
Georg Thieme Verlag
Abstract
Background-Pyoderma gangrenosum after cardiac surgery is a rare,
noninfectious ulcerating skin disease mimicking sternal wound infection.
Methods-A systematic search of literature for pyoderma gangrenosum
complicating cases of cardiac surgery was conducted between September 1985
and September 2020 on PubMed and Cochrane databases. A systematic review
and detailed overview of clinical presentation, diagnostic, treatment, and
outcome is provided. Results-A total of 15 studies enclosing 15 patients
suffering from pyoderma gangrenosum following cardiac surgery were
identified. Onset of symptoms was observed after a median of 5 days.
Patients were predominantly male (81.3%) with a median age of 64 years.
Typical clinical presentation mimicked sternal site infection, mainly by
means of mediastinitis. Specific signs were rapid progression,
erythematous to violaceous color of the wound border, accompanied by
unspecific symptoms including fever, malaise, and severe pain.
Additionally, pathergy (development of ulcers at the sites of minor
cutaneous trauma) was reported frequently. Biopsy is mandatory with a
cutaneous neutrophilic inflammation confirming the diagnosis. Initial
treatment mostly (75.0% of reported cases) was misled, addressing
suspicion of surgical site infection. After correct diagnosis, the
treatment was switched to an immunosuppressive therapy. Full sternal wound
closure took between 5 weeks and 5 months. Reported case mortality was
12.5% in actually low-risk surgeries. Conclusion-Despite pyoderma
gangrenosum has typical signs, it remains an exclusion diagnosis. The
treatment is completely opposite to the main differential diagnosis-The
typical surgical site infection. Knowledge about diagnosis and treatment
is essential in the context of avoiding fatal mistreatment.<br/>Copyright
&#xa9; 2023 Georg Thieme Verlag. All rights reserved.

<45>
Accession Number
2019340102
Title
Mortality after multivessel revascularisation involving the proximal left
anterior descending artery.
Source
Heart. 108(22) (pp 1784-1791), 2022. Date of Publication: 22 Jun 2022.
Author
Ono M.; Hara H.; Gao C.; Kawashima H.; Wang R.; O'Leary N.; Wykrzykowska
J.J.; Piek J.J.; Mack M.J.; Holmes D.; Morice M.-C.; Head S.; Kappetein
A.P.; Noack T.; Davierwala P.M.; Mohr F.W.; Garg S.; Onuma Y.; Serruys
P.W.
Institution
(Ono, Hara, Kawashima, Wykrzykowska, Piek) Department of Cardiology,
University of Amsterdam, Amsterdam, Netherlands
(Ono, Hara, Gao, Wang, O'Leary, Onuma, Serruys) Department of Cardiology,
National University of Ireland Galway, Galway, Ireland
(Gao, Wang) Department of Cardiology, Radboud University Nijmegen,
Nijmegen, Netherlands
(Wykrzykowska) Department of Cardiology, University Medical Centre
Groningen, Groningen, Netherlands
(Mack) Department of Cardiothoracic Surgery, Baylor University Medical
Center at Dallas, Dallas, TX, United States
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Morice) Interventional Cardiology, Ramsay Generale de Sante, Paris,
France
(Head, Kappetein) Department of Cardiothoracic Surgery, Erasmus
Universiteit Rotterdam, Rotterdam, Netherlands
(Noack, Davierwala, Mohr) University Department of Cardiac Surgery,
Leipzig Heart Center University Hospital, Leipzig, Germany
(Davierwala) Department of Surgery, University of Toronto, Toronto, ON,
Canada
(Davierwala) Division of Cardiovascular Surgery, Peter Munk Cardiac
Centre, Toronto General Hospital, Toronto, ON, Canada
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
Publisher
BMJ Publishing Group
Abstract
Objective We sought to investigate whether long-term clinical outcomes
differ following percutaneous coronary intervention (PCI) or coronary
artery bypass grafting (CABG) in patients with three-vessel disease (3VD)
and lesions in the proximal left anterior descending artery (P-LAD).
Methods This post-hoc analysis of the Synergy between PCI with Taxus and
Cardiac Surgery (SYNTAX) Extended Survival study included patients with
3VD who were classified according to the presence or absence of lesions
located in the P-LAD. Ten-year all-cause death and 5-year major adverse
cardiac or cerebrovascular events (MACCE) were assessed. Results Among
1088 patients with 3VD, 559 (51.4%) had involvement of P-LAD and their
10-year mortality was numerically higher following PCI versus CABG (28.9%
vs 21.9%; HR: 1.39, 95% CI 0.99 to 1.95). Although patients without P-LAD
lesions had significantly higher 10-year mortality following PCI compared
with CABG, there was no evidence of a treatment-by-subgroup interaction
(28.8% vs 20.2%; HR: 1.47, 95% CI 1.03 to 2.09, p interaction =0.837). The
incidence of MACCE at 5 years was significantly higher with PCI than CABG,
irrespective of involvement of P-LAD (with P-LAD: HR: 1.86, 95% CI 1.36 to
2.55; without P-LAD: HR: 1.54, 95% CI 1.11 to 2.12; p interaction =0.408).
Individualised assessment using the SYNTAX Score II 2020 established that
a quarter of patients with P-LAD lesions had significantly higher
mortality with PCI than CABG, whereas in the remaining three-quarters CABG
had similar mortality. Conclusions Among patients with 3VD, the presence
or absence of a P-LAD lesion was not associated with any treatment effect
on long-term outcomes following PCI or CABG. Trial registration number
SYNTAXES: NCT03417050; SYNTAX: NCT00114972.<br/>Copyright &#xa9; 2022 BMJ
Publishing Group. All rights reserved.

<46>
Accession Number
2020486668
Title
Meta-Analysis Comparing Clinical Outcomes of Fractional-Flow-Reserve- and
Angiography-Guided Multivessel Percutaneous Coronary Intervention.
Source
American Journal of Cardiology. 184 (pp 160-162), 2022. Date of
Publication: 01 Dec 2022.
Author
Matthews C.J.; Naylor K.; Blaxill J.M.; Greenwood J.P.; Mozid A.M.;
Rossington J.A.; Veerasamy M.; Wheatcroft S.B.; Bulluck H.
Institution
(Matthews, Naylor, Blaxill, Greenwood, Mozid, Rossington, Veerasamy,
Wheatcroft, Bulluck) Yorkshire Heart Centre, Leeds General Infirmary,
Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
(Blaxill, Greenwood, Mozid, Rossington, Veerasamy, Wheatcroft, Bulluck)
Leeds Institute of Cardiovascular and Metabolic Medicine, University of
Leeds, Leeds, United Kingdom
Publisher
Elsevier Inc.

<47>
Accession Number
2013570815
Title
Impact of atrial flow regulator (AFR) implantation on 12-month mortality
in heart failure: Insights from a single site in the PRELIEVE study.
Source
Herz. 47(4) (pp 366-373), 2022. Date of Publication: August 2022.
Author
Bakhshaliyev N.; Celikkale I.; Enhos A.; Karacop E.; Uluganyan M.; Ozdemir
R.
Institution
(Bakhshaliyev, Celikkale, Enhos, Karacop, Uluganyan, Ozdemir) Cardiology
Department, Bezmialem Vakif University, Adnan Menderes bulvari,
Fatih/Istanbul, Turkey
Publisher
Springer Medizin
Abstract
Background: Implantation of the atrial flow regulator (AFR) to create an
interatrial left-to-right shunt has been shown to be safe and feasible to
reduce intracardiac filling pressures in patients with heart failure (HF).
<br/>Objective(s): We aimed to assess the effect of AFR implantation on
12-month mortality and hospitalization rates in patients with reduced
(HFrEF) or preserved HF (HFpEF). <br/>Method(s): One-year follow-up data
from 34 subjects enrolled at a single PRELIEVE center were analyzed. The
12-month predicted mortality was calculated using the Meta-Analysis Global
Group in Chronic Heart Failure (MAGGIC) risk score. Patients were divided
into two groups, according to their history of hospitalizations for HF.
<br/>Result(s): Study data of 34 patients (HFrEF: 24 [70.6%]; HFpEF: 10
[29.4%]) were assessed. Median follow-up duration was 355 days. In total,
14 (41.2%) patients were hospitalized during the follow-up period and 6
(17.6%) of these patients were hospitalization for HF (HHF). A total of 24
hospitalizations occurred in this period and 8 (33%) hospitalizations were
for HHF. The median baseline MAGGIC score was 23 and the median predicted
mortality was 13.4/100 patient years. Observed mortality was 3.1/100
patient years. The observed survival (97%) was 10.3% (95% confidence
interval 3.6-17.5%, p= 0.004) better than the predicted survival (86.6%).
<br/>Conclusion(s): Our results suggest that AFR implantation has
favorable effects on mortality in patients with heart failure, regardless
of ejection fraction. Furthermore, compared to baseline, left ventricular
filling pressure (assessed by echocardiography) decreased significantly
without right side volume overload at the 1-year follow-up.<br/>Copyright
&#xa9; 2021, Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

<48>
Accession Number
2021252861
Title
Feasibility of concomitant left atrial appendage closure and percutaneous
coronary intervention in patients with acute coronary syndrome and atrial
fibrillation: a randomized pilot study.
Source
Heart and Vessels. (no pagination), 2023. Date of Publication: 2023.
Author
Losik D.; Romanov A.; Grazhdankin I.; Shabanov V.; Ponomarev D.; Mikheenko
I.; Peregudov I.; Filippenko A.; Bondar N.; Boersma L.; Steinberg J.S.
Institution
(Losik, Romanov, Grazhdankin, Shabanov, Ponomarev, Mikheenko, Peregudov,
Filippenko) E. Meshalkin National Medical Research Center of the Ministry
of Health of the Russian Federation, Novosibirsk, Russian Federation
(Bondar) Federal Center of Cardiovascular Surgery, Khabarovsk, Russian
Federation
(Boersma) Department of Cardiology, St Antonius Hospital Nieuwegein,
Amsterdam UMC, Amsterdam, Netherlands
(Steinberg) Cardiovascular Research Center, University of Rochester School
of Medicine and Dentistry, Rochester, NY, United States
Publisher
Springer
Abstract
The optimal approach for prevention of cardiovascular events and reduction
of bleeding in patients with acute coronary syndrome (ACS) and atrial
fibrillation (AF) is still controversial. The aim of our study is to asses
our single-center experience with concomitant left atrial appendage
occlusion (LAAO) and percutaneous coronary intervention (PCI). 50 patients
with ACS without ST elevation and history of AF were randomized after
successful PCI to LAAO or conventional medical therapy. The primary
endpoints were safety and length of hospitalization. The follow-up period
was 30 days. The mean procedural times were 113 +/- 23 min PCI + LAAO
implantation and 39 +/- 19 min of PCI only (p < 0.001), while mean
fluoroscopy times were 18 +/- 8 min and 12 +/- 8 min (p < 0.001),
respectively. No procedure-related complications were observed. There was
no difference observed for length of hospitalization between two groups.
LAAO in patients with ACS and AF undergoing PCI appears safe. Graphical
abstract: [Figure not available: see fulltext.].<br/>Copyright &#xa9;
2023, Springer Nature Japan KK, part of Springer Nature.

<49>
Accession Number
639539495
Title
Inspiratory muscle training improves cardiopulmonary function in patients
after transcatheter aortic valve replacement: a randomized clinical trial.
Source
European journal of preventive cardiology. 30(2) (pp 191-202), 2023. Date
of Publication: 24 Jan 2023.
Author
Xu L.; Wei J.; Liu J.; Feng Y.; Wang L.; Wang S.; Li Q.; He S.; Chen Y.;
Peng Y.; Bao Y.; Yang X.; He C.; Chen M.; Wei Q.
Institution
(Xu, Liu, Wang, Wang, He, Wei) Rehabilitation Medicine Center and
Institute of Rehabilitation Medicine, West China Hospital, Sichuan
University, Chengdu, Sichuan, China
(Xu, Liu, Wang, Wang, He, Wei) Key Laboratory of Rehabilitation Medicine
in Sichuan Province, Chengdu, Sichuan, China
(Wei, Feng, Li, He, Chen, Peng, Bao, Yang, Chen) Department of Cardiology,
West China Hospital, Sichuan University, Chengdu, China
Publisher
NLM (Medline)
Abstract
AIMS: Inspiratory muscle training (IMT) can increase the strength or
endurance of the diaphragm and accessory muscles of inspiration, yet there
is no evidence that endorses the role of IMT in patients of transcatheter
aortic valve replacement (TAVR). This study for the first time tested the
effects of IMT plus usual cardiac rehabilitation (CR) function in patients
after TAVR. METHODS AND RESULTS: A double-blinded, randomized controlled,
single-centre clinical trial was undertaken. Participants who had a
confirmed diagnosis of valve heart disease and were clinically stable
after TAVR were recruited and received a CR programme during the hospital
stay. A total of 96 patients were recruited and randomly assigned to the
IMT + CR group (n = 48) or the CR group (n = 48) in a 1:1 ratio. The group
difference in the primary outcome, the 6-min walk distance at the
discharge of the hospital, significantly favoured the IMT + CR group (mean
difference -33.52, 95% CI: -64.42 to -2.62, P = 0.034). The significant
difference was maintained at the 1-month and 3-month follow-ups (mean
difference: 41.51, 95% CI: 1.82-81.21, P = 0.041). In addition, the mean
hospital stays of subjects in the IMT + CR group was 11 days, which was
significantly shorter than the 12.5 days in the CR group (P = 0.016).
Sensitivity analysis using per-protocol analysis supported these findings.
No adverse treatment-related events were reported. <br/>CONCLUSION(S):
Compared with usual CR, IMT plus CR can effectively improve exercise
endurance, pulmonary ventilation function, and inspiratory muscle strength
in patients after TAVR and shorten the length of hospital
stay.<br/>Copyright &#xa9; The Author(s) 2022. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For permissions, please email:
journals.permissions@oup.com.

<50>
Accession Number
640130802
Title
CSM 2023 Cardiovascular and Pulmonary Platform Abstracts.
Source
Cardiopulmonary Physical Therapy Journal. Conference: Combined Sections
Meeting of the American Physical Therapy Association, CSM 2023. San Diego,
CA United States. 34(1) (no pagination), 2023. Date of Publication:
January 2023.
Author
Anonymous
Publisher
Lippincott Williams and Wilkins
Abstract
The proceedings contain 63 papers. The topics discussed include: the CAT
is significantly correlated to DLCO and 6-minute walk test in patients
with long-COVID; cardiac and non-cardiac pain and sleep in patients
participating in outpatient cardiac rehabilitation; the PEM/PESE activity
questionnaire: a novel health-related quality of life measure for
post-exertional disablement; comparison of AM-PAC and FSS-ICU in patients
recovering from open heart surgery in ICU; assessment of physical therapy
students' self-efficacy and accuracy measuring blood pressure using a task
trainer; functional improvements observed in long-covid patients following
participation in pulmonary rehabilitation; effects of a
virtually-delivered program on breathing strength and lung function - a
retrospective study; the influence of kinesiology tape on posture and
breathing mechanics in healthy individuals; is there a role for increasing
daily lifestyle walking bouts in asymptomatic peripheral arterial
disease?; and impact of standard vs. modified sternal precautions on
function following median sternotomy: a systematic review.

<51>
Accession Number
640130794
Title
IMPACT OF STANDARD VS. MODIFIED STERNAL PRECAUTIONS ON FUNCTION FOLLOWING
MEDIAN STERNOTOMY: A SYSTEMATIC REVIEW.
Source
Cardiopulmonary Physical Therapy Journal. Conference: Combined Sections
Meeting of the American Physical Therapy Association, CSM 2023. San Diego,
CA United States. 34(1) (pp a6), 2023. Date of Publication: January 2023.
Author
Coval A.C.; Bailey B.L.; Bonilla D.; Haddican C.B.; Maida D.R.; Scardillo
J.M.
Publisher
Lippincott Williams and Wilkins
Abstract
PURPOSE/HYPOTHESIS: Experts in the field have questioned the continued use
of standard sternal precautions due to the impact on functional outcomes.
The purpose of this systematic review was to determine the functional
impact of standard sternal precautions (SSP) compared to modified sternal
precautions (MSP) on mobility in adults following median sternotomy.
NUMBER OF SUBJECTS: N/A. MATERIALS AND METHODS: A literature search using
PubMed, CINAHL, ScienceDirect, and APTA EBSCOhost was conducted using
search terms: (coronary artery bypass graft OR CABG OR sternotomy) AND
(function OR ADL OR activities of daily living') AND (modified OR
restrictive) AND precaution. Search limits: Human subjects, peer reviewed,
English language. <br/>Selection Criteria: adult (181), median sternotomy.
Two reviewers independently assessed each study for methodological quality
and came to a consensus based on OCEBM Levels of Evidence (2011).
<br/>RESULT(S): Twenty-one reports were assessed for eligibility. After
detailed appraisals, 4 studies met selection criteria. All articles ranked
as OCEBM Level 2 evidence (1 RCT, 1 quasiexperimental design, 1
observational study and 1 crosssectional design). Sample size ranged from
72 to 1104 (n = 1744; avg age 64.96 yrs). SSP prohibited lifting, pushing,
pulling >5 lbs (4), driving (2), reaching behind back (2), reaching
overhead (2), leaning forward with head below heart (1), arm use with
sitting or standing (1) and required splint chest during coughing (2). MSP
was defined as keep your move in the tube (3) or less restrictive (1).
Function was assessed through Short Physical Performance Battery (SPPB),
Health Assessment Questionnaire (HAQ), level of assistance for bed
mobility and transfers, and functional self-report. Two studies concluded
no statistically significant differences between groups (SPPB at 4 weeks
MD 1.0 point, 95%, CI -0.2-2.3; at 12 weeks MD 0.4 point, 95% CI -0.9-1.6;
and self-report with P = .14). Two studies found significant improvements
forMSP groups with greater return to function (HAQ P<001) and decreased
functional assistance required (P< 001). Two adverse events unrelated to
sternal precaution adherence occurred in both the SSP (1) and MSP (1)
groups. <br/>CONCLUSION(S): Moderate levels of evidence indicated either
equally effective or more favorable outcomes with use ofMSP as compared
with SSP. Limitations included non-standardized and varied functional
outcome measures, and multiple sternal precaution protocols. Future
research should include standardization of functional outcome measures and
well-defined precautions to justify the use of MSP as a means to improve
functional outcomes. CLINICAL RELEVANCE: Experts suggest SSP may
inadvertently impede recovery when compared to patientspecific sternal
precautions, which may facilitate more favorable outcomes. Inconsistencies
in reported sternal precaution protocols contribute to insufficient
evidence in support of their universal use. With a lack of evidence to
support adherence to SSP, clinicians should advocate to the medical team
for incorporating MSP in standard sternotomy care. Permitting activity
with MSP may improve functional outcomes and optimize discharge
destination.

<52>
Accession Number
640133979
Title
Diagnostic accuracy of CCTA for the evaluation of obstructive CAD in
patients referred for TAVI: a systematic review and meta-analysis.
Source
Insights into Imaging. Conference: European Congress of Radiology, ECR
2022. Vienna Austria. 14(Supplement 4) (pp 428), 2022. Date of
Publication: December 2022.
Author
Serafini A.N.A.; Strazzarino G.A.; Tore D.; Gatti M.; Faletti R.
Institution
(Serafini, Strazzarino, Tore, Gatti, Faletti) TurinItaly
Publisher
Springer Science and Business Media B.V.
Abstract
Purpose: 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). Methods or Background: EMBASE, PubMed/MEDLINE and
CENTRAL were searched for studies reporting accuracy of CCTA for the
evaluation of obstructive CAD compared to invasive coronary angiography
(ICA). The QUADAS-2 tool was used to assess the risk of bias. A bivariate
random-effects model was used to analyse, pool and plot the diagnostic
performance measurements across studies. Pooled sensitivity, specificity,
positive (+LR) and negative (-LR) likelihood ratio and diagnostic odds
ratio (DOR) and hierarchical summary ROC curve (HSROC) were evaluated.
Prospero id: CRD42021252527. Results or Findings: Fourteen studies (2533
patients) were included. In the intention-to-diagnose patient-level
analysis sensitivity and specificity for CCTA were 97% (94-98%) and 68%
(56-68%) respectively, and +LR and -LR were 3.0 (2.1-4.3) and 0.05
(0.03-0.09), with DOR 60 (30-121). The HSROC had AUC = 0.96 (0.94-0.98).
No difference in sensitivity was found when comparing single-heartbeat
scanner CTs to others [96% (91-98%) vs 97% (94-99%); p=0.37], whereas the
specificity was higher [81% (67-90%) vs 58% (43-71%); p<0.0001].
<br/>Conclusion(s): CCTA proved to have an excellent diagnostic accuracy
for assessing obstructive CAD in patients referred for TAVI. Routine CCTA
in the pre-TAVI work-up could save more than 40% of ICAs. The use of
singleheartbeat scanners can further improve such data.

<53>
Accession Number
2022348198
Title
The economics of TAVI: A systematic review.
Source
IJC Heart and Vasculature. 44 (no pagination), 2023. Article Number:
101173. Date of Publication: February 2023.
Author
Petrou P.
Institution
(Petrou) University of Nicosia, School of Sciences and Engineering,
Pharmacy School, Pharmacoepidemiology-Pharmacovigilance, Nicosia, Cyprus
(Petrou) University of Nicosia, Department of Life and Health Sciences,
School of Sciences and Engineering,
Pharmacoepidemiology-Pharmacovigilance, Nicosia, Cyprus
Publisher
Elsevier Ireland Ltd
Abstract
Objective: The scope of this systematic review is to update the existing
body of evidence regarding the cost-effectiveness of transcatheter aortic
valve implantation, stratified across all risk categories, and to assess
their methodological quality. <br/>Method(s): A systematic review was
performed including published cost-effectiveness analyses of heart valve
implantations. The quality was assessed with the Quality of Health
Economics Tool. <br/>Result(s): We identified 33 economic evaluations of
transcatheter aortic heart valve implantations. Results were not
consistent, ranging from dominant to dominating. Moreover, the models were
sensitive to an array of variables. The methodological quality of the
studies was good. <br/>Conclusion(s): This systematic review led to
inconclusive and inconsistent results pertinent to the economic profile of
TAVI technology. It also highlighted areas which merit further research
regarding the pillars of cost-effectiveness analysis such as modeling, the
extrapolation of available data and the uncertainty of the evidence. A
thorough assessment of the patient should proceed any
decision-making.<br/>Copyright &#xa9; 2023 The Author

<54>
Accession Number
2022380473
Title
Intraoperative infusion of dexmedetomidine for prevention of postoperative
delirium in elderly patients undergoing craniotomy: A protocol of
randomised clinical trial.
Source
BMJ Open. 13(1) (no pagination), 2023. Article Number: e063976. Date of
Publication: 23 Jan 2023.
Author
Cui Q.; Ma T.; Liu M.; Shen Z.; Li S.; Zeng M.; Liu X.; Zhang L.; Peng Y.
Institution
(Cui, Ma, Liu, Shen, Li, Zeng, Liu, Zhang, Peng) Anesthesiology, Beijing
Tiantan Hospital, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium (POD) is a common surgical
complication. The incidence is 19% in neurological procedures, and
advanced age is a risk factor for neurological procedures. Many studies
have shown that dexmedetomidine (DEX) reduced the incidence of delirium
after non-cardiac surgery in elderly patients. However, there are few
studies focus on the effect of DEX on POD in elderly patients undergoing
neurosurgery. Methods and analysis This is a randomised, double-blinded,
paralleled-group and controlled trial. Patients older than 65 years and
scheduled for elective craniotomy will be randomly assigned to the DEX
group and the control group. After endotracheal intubation, patients in
the DEX group will be administered with continuous DEX infusion at rate of
0.4 mug/kg/hour until the surgical haemostasis. In the control group,
patients will receive the identical volume of normal saline in the same
setting. The primary outcome is the incidence of POD during the first 5
days. Delirium will be evaluated through a combination of three methods,
including the Richmond Agitation Sedation Scale (RASS), the confusion
assessment method for ICU (CAM-ICU) and the 3 min diagnostic interview for
CAM (3D-CAM). The RASS, CAM-ICU and 3D-CAM will be evaluated two times per
day (08:00-10:00 and 18:00-20:00 hours) during the first postoperative 5
days. Secondary outcomes include pain severity score, quality of recovery,
quality of sleep, cognitive function, psychological health state,
intraoperative data, physiological status, length of stay in ICU and
hospital, hospitalisation costs, non-delirium complications, and 30-day
all-cause mortality. Ethics and dissemination The protocol (V.4.0) has
been approved by the medical ethics committee of Beijing Tiantan Hospital,
Capital Medical University (KY2021-194-03). The findings of the study will
be disseminated in a peer-reviewed journal and at a scientific conference.
Trial registration number NCT05168280. <br/>Copyright &#xa9; Author(s) (or
their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial
re-use. See rights and permissions. Published by BMJ.

<55>
Accession Number
2021261206
Title
Effect of intubation in the lateral position under general anesthesia
induction on the position of double-lumen tube placement in patients
undergoing unilateral video-assisted thoracic surgery: study protocol for
a prospective, single-center, parallel group, randomized, controlled
trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 67. Date of
Publication: December 2023.
Author
Zhang X.; Wang D.-X.; Zhang Q.; Shen Q.-B.; Tong F.; Hu Y.-H.; Zhang
Z.-D.; Liu F.-F.; Tang Y.-W.; Chen J.-L.; Liu H.; Zhou F.; Hu S.-P.
Institution
(Zhang, Wang, Zhang, Tong, Hu, Zhang, Liu, Tang, Liu, Hu) Department of
Anesthesiology & Huzhou Key Laboratory of Basic Research and Clinical
Translation for Neuromodulation, Huzhou Central Hospital

The Affiliated Huzhou Hospital, Zhejiang University School of Medicine

Affiliated Central Hospital Huzhou University, No. 1558 Sanhuan North
Road, Wuxing District, Zhejiang Province, Huzhou 313000, China
(Zhang) Department of Anesthesiology, The First Affiliated Hospital,
Zhejiang University School of Medicine, Hangzhou, China
(Shen) Department of Cardiothoracic Surgery, Huzhou Central Hospital

The Affiliated Huzhou Hospital, Zhejiang University School of Medicine

Affiliated Central Hospital Huzhou University, No. 1558 Sanhuan North
Road, Wuxing District, Zhejiang Province, Huzhou 313000, China
(Chen) Department of Operating Room Nursing, Huzhou Central Hospital

The Affiliated Huzhou Hospital, Zhejiang University School of Medicine

Affiliated Central Hospital Huzhou University, No. 1558 Sanhuan North
Road, Wuxing District, Zhejiang Province, Huzhou 313000, China
(Zhou) Medical Department, Huzhou Central Hospital

The Affiliated Huzhou Hospital, Zhejiang University School of Medicine

Affiliated Central Hospital Huzhou University, No. 1558 Sanhuan North
Road, Wuxing District, Zhejiang Province, Huzhou 313000, China
Publisher
BioMed Central Ltd
Abstract
Background: The double-lumen tube (DLT) is an essential equipment for
thoracic anesthesia and the precise position of DLT placement is
particularly important for anesthesia and surgery. However, the incidence
of DLT malposition remains high and it leads to lung isolation failure and
hypoxemia during one-lung ventilation. This trial aims to explore the
clinical application and efficacy of intubation in the lateral position
under general anesthesia induction to reduce the incidence of DLT
malposition in patients undergoing unilateral video-assisted thoracic
surgery (VATS). <br/>Method(s): In this prospective, single-center,
parallel group, randomized, controlled trial, we will recruit 108
patients, aged 18-80 years, scheduled for elective unilateral VATS with
DLT intubation under general anesthesia, and they will be randomly
assigned to two groups: a lateral DLT intubation group (group L) and a
conventional supine DLT intubation group (group C). The left-sided DLT
will be used to intubate in patients of both groups. The position of DLT
will be confirmed and adjusted by using the fiberoptic bronchoscopy (FOB).
The primary outcome is the incidence of DLT malposition observed via the
FOB, and the secondary outcomes include the time of intubation, the
frequency and duration of re-adjustments of DLT placement under FOB,
whether to re-intubate, intraoperative vital signs, and postoperative
recovery. <br/>Discussion(s): Accurate DLT positioning is crucially
important for thoracic surgery, but the incidence of DLT malposition is
still high in the present clinical practice of thoracic anesthesia. This
trial aims to investigate whether lateral DLT intubation can reduce the
incidence of DLT malposition, with more stable intraoperative vital signs
and less postoperative complications. Trial registration: The study
protocol was registered at Chinese Clinical Trial Registry
(http://www.chictr.org.cn) with registration number: ChiCTR2200060794 on
June 11, 2022.<br/>Copyright &#xa9; 2023, The Author(s).

<56>
Accession Number
640127172
Title
Advances in the available pharmacotherapy for the management of acute
coronary syndromes in patients presenting without persistent ST-segment
elevation.
Source
Expert opinion on pharmacotherapy. (no pagination), 2023. Date of
Publication: 24 Jan 2023.
Author
Greco A.; Finocchiaro S.; Angiolillo D.J.; Capodanno D.
Institution
(Greco, Finocchiaro, Capodanno) Division of Cardiology, Azienda
Ospedaliero-Universitaria Policlinico "G. Rodolico - San Marco",
University of Catania, Catania, Italy
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Non-ST-segment elevation acute coronary syndromes
(NSTE-ACS), including non-ST-segment-elevation myocardial infarction
(NSTEMI) and unstable angina, represent a leading cause of mortality
worldwide, with important socio-economic consequences. NSTEMI accounts for
the majority of acute coronary syndromes and usually develops on the
background of a nonocclusive thrombus. We searched for relevant literature
in the field in PubMed and clinicaltrials.gov as of July 2022. AREAS
COVERED: A number of pharmacotherapies are currently available for
treatment and secondary prevention, mainly including antithrombotic,
lipid-lowering and anti-inflammatory drugs. Pretreatment with aspirin,
anticoagulant and statin therapy is of key importance in the preprocedural
phase, while pretreating with an oral P2Y12 inhibitor is not routinely
indicated in patients undergoing early invasive management. For patients
undergoing percutaneous coronary revascularization, pharmacotherapy
essentially consists of antithrombotic drugs, which should be carefully
selected. Finally, antithrombotic, lipid-lowering and anti-inflammatory
drugs are important components of long-term secondary prevention after a
NSTE-ACS. EXPERT OPINION: This article reviews the evidence supporting
recommendation on pharmacotherapy in patients presenting with a NSTE-ACS.
Several randomized clinical trials are still ongoing and are expected to
further inform scientific knowledge and clinical practice, with the final
aim to improve the treatment of NSTE-ACS patients.

<57>
Accession Number
2022159089
Title
The Prognostic Significance of Red Cell Distribution Width in Cardiac
Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Frentiu A.A.; Mao K.; Caruana C.B.; Raveendran D.; Perry L.A.; Penny-Dimri
J.C.; Ramson D.M.; Segal R.; Bellomo R.; Smith J.A.; Liu Z.
Institution
(Frentiu, Penny-Dimri, Ramson, Smith) Department of Surgery (School of
Clinical Sciences at Monash Health), Monash University, Clayton, Australia
(Mao, Raveendran, Perry, Segal, Bellomo, Liu) Department of Critical Care,
Melbourne Medical School, Faculty of Medicine, Dentistry and Health
Sciences, The University of Melbourne, Parkville, Australia
(Caruana, Bellomo) Department of Intensive Care, Austin Hospital, 145
Studley Road, Heidelberg, Victoria, Australia
(Perry, Segal, Liu) Department of Anaesthesia and Pain Management, Royal
Melbourne Hospital, Parkville, Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Heidelberg,
Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Melbourne, Australia
(Bellomo) Monash University School and Public Health and Preventive
Medicine, Monash University, Clayton, Australia
(Bellomo) Data Analytics Research and Evaluation (DARE) Centre, Austin
Hospital, Heidelberg, Australia
(Smith) Department of Cardiothoracic Surgery, Monash Health, Clayton,
Australia
Publisher
W.B. Saunders
Abstract
RED CELL DISTRIBUTION WIDTH (RDW) is a routinely available biomarker of
likely erythropoietic dysfunction, which may be associated with adverse
outcomes after cardiac surgery. This systematic review and meta-analysis
aimed to clarify the prognostic value of RDW in patients undergoing
cardiac surgery. The authors searched MEDLINE, Embase, and the Cochrane
Library from inception to May 10, 2022 for studies investigating the
association between elevated RDW (as defined by the authors of included
studies) and adverse outcomes after cardiac surgery. Herein, the authors
extracted maximally adjusted hazard ratios (HRs) and odds ratios (ORs)
with associated CIs, and pooled them using random-effects inverse-
variance modeling. The authors explored interstudy heterogeneity using
metaregression. The authors included 26 studies involving 48,092 patients
who had undergone cardiac surgery. Elevated preoperative RDW was
associated with long-term mortality (pooled HR 1.63, 95% CI 1.05-2.52),
short-term mortality (pooled OR 2.16, 95% CI 1.21-3.87), acute kidney
injury (AKI; pooled OR 1.30, 95% CI 1.19-1.41) and postoperative atrial
fibrillation (POAF; pooled OR 1.44, 95% CI 1.05-1.96). Some studies
suggested a significant association between preoperative RDW elevation and
neurologic complications; however, their number was insufficient for
meta-analysis. The postoperative RDW levels were less consistently
reported and could not be meta-analyzed. In conclusion, the authors found
that elevated preoperative RDW was associated with increased short- and
long-term mortality, POAF, and AKI after cardiac surgery. Further research
is needed to investigate its role in the risk stratification of patients
undergoing cardiac surgery.<br/>Copyright &#xa9; 2022

<58>
Accession Number
2021100815
Title
Cusp-overlap versus coplanar view in transcatheter aortic valve
implantation with self-expandable valves: A meta-analysis of comparative
studies.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2023.
Date of Publication: 2023.
Author
Michel Pompeu S.; Van den Eynde J.; Jacquemyn X.; Erten O.; Dokollari A.;
Sicouri S.; Ramlawi B.
Institution
(Michel Pompeu, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Michel Pompeu, Erten, Dokollari, Sicouri, Ramlawi) Department of
Cardiothoracic Surgery Research, Lankenau Institute for Medical Research,
Wynnewood, PA, United States
(Van den Eynde, Jacquemyn) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
Publisher
John Wiley and Sons Inc
Abstract
Background: Permanent pacemaker implantation (PPI) is a common
complication after transcatheter aortic valve implantation (TAVI). The
cusp-overlap view (COV) was adopted to reduce PPI risk after TAVI with
self-expandable valves (SEVs); however, the evidence remains scarce. We
performed a systematic review with meta-analysis comparing COV and the
standard coplanar view (CPV) technique to evaluate their effectiveness and
safety. <br/>Method(s): Following the PRISMA statement, data were
extracted from studies published by August 2022 and found in
PubMed/MEDLINE, EMBASE, CENTRAL/CCTR, ClinicalTrials.gov, SciELO, LILACS,
and Google Scholar. The primary outcome of interest was post-procedural
PPI and the secondary outcomes were new left bundle branch block (LBBB),
moderate/severe paravalvular leak (PVL), valve dislocation (pop-out); need
of second transcatheter heart valve, 30-day mortality, stroke, conversion
to surgery, coronary obstruction, implantation depth (mm), and post-TAVI
mean gradients (mmHg). <br/>Result(s): Eleven studies met our eligibility
criteria and included 1464 patients in the COV group and 1743 patients in
the CPV group. Patients who underwent TAVI with COV had lower risk of PPI
(odds ratio 0.48; 95% confidence interval [CI] 0.33-0.70; p = 0.001) and
higher implantation depths with COV (mean difference -0.83; 95% CI -1.2 to
-0.45; p < 0.001). We did not observe any statistically significant
differences in the rates of new LBBB, moderate/severe PVL, valve
dislocation, need of second transcatheter heart valve, 30-day mortality,
stroke, conversion to surgery, coronary obstruction, and post-TAVI mean
gradients (mmHg). <br/>Conclusion(s): In TAVI with SEVs, the application
of COV is associated with lower risk of PPI compared with the standard CPV
without increasing risk for adverse outcomes.<br/>Copyright &#xa9; 2023
Wiley Periodicals LLC.

<59>
Accession Number
2021057442
Title
Transcatheter edge-to-edge repair for secondary mitral regurgitation with
third-generation devices in heart failure patients - results from the
Global EXPAND Post-Market study.
Source
European Journal of Heart Failure. (no pagination), 2023. Date of
Publication: 2023.
Author
Orban M.; Rottbauer W.; Williams M.; Mahoney P.; von Bardeleben R.S.;
Price M.J.; Grasso C.; Lurz P.; Zamorano J.L.; Asch F.M.; Maisano F.; Kar
S.; Hausleiter J.
Institution
(Orban, Hausleiter) Medizinische Klinik I, Ludwig-Maximilians Universitat,
Munich, Germany
(Orban, Hausleiter) Munich Heart Alliance, Partner site German Centre for
Cardiovascular Research (DZHK), Munich, Germany
(Rottbauer) Department of Internal Medicine II, Ulm University Medical
Center, Ulm, Germany
(Williams) Heart Valve Center, New York University Langone Health, New
York, NY, United States
(Mahoney) Sentera Heart and Valve and Structural Disease Center, Norfolk,
VA, United States
(von Bardeleben) Department of Cardiology, University Medical Center of
Mainz, Mainz, Germany
(Price) Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, CA,
United States
(Grasso) Department of Cardiology, Ferrarotto Hospital, University of
Catania, Catania, Italy
(Lurz) Department of Cardiology, Heart Center Leipzig - University
Hospital, Leipzig, Germany
(Zamorano) Hospital Ramon y Cajal, Madrid, Spain
(Asch) Cardiovascular Core Laboratories, MedStar Health Research
Institute, Washington, DC, United States
(Maisano) San Raffaele University Hospital, Milan, Italy
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Mitral valve transcatheter edge-to-edge repair is a
guideline-recommended treatment option for patients with secondary mitral
regurgitation (SMR). The purpose of this analysis was to report
contemporary real-world outcomes in SMR patients treated with
third-generation MitraClip systems. <br/>Methods and Results: EXPAND is a
prospective, multicentre, international, single-arm study with 1041
patients treated for mitral regurgitation (MR) with MitraClip NTR/XTR,
with 30-day and 1-year follow-up. All echocardiograms were analysed by an
independent echocardiographic core lab. Study outcomes included procedural
outcomes, durability of MR reduction, and major adverse events including
all-cause mortality and heart failure hospitalizations (HFH). A subgroup
of 413 symptomatic patients (age 74.7 +/- 10.1 years, 58% male) with
severe SMR were included. MR reduction to MR <= 1+ and MR <= 2+ was
achieved in 93.0% and 98.5% of patients, respectively, which was sustained
at 1-year follow-up. All-cause mortality was 17.7% at 1-year- follow-up,
and the combined endpoint of all-cause mortality or first HFH occurred in
34% of patients. This combined endpoint was significantly less frequently
observed in MR <= 1+ patients (Kaplan-Maier estimates: 29.7% vs. 69.6% for
MR <= 1+ vs. MR >= 2 +; p < 0.0001). New York Heart Association (NYHA)
functional class improved significantly from baseline (NYHA <= II: 17%) to
1-year follow-up (NYHA <= II: 78%) (p < 0.0001). While MR reduction was
comparable between NTR-only vs. XTR-only treated patients, less XTR clips
were required for achieving MR reduction. <br/>Conclusion(s): Under
real-world conditions, optimal sustained MR reduction to MR <= 1+ was
achieved in a high percentage of patients with third-generation MitraClip,
which translated into symptomatic improvement and low event rates. These
results appear to be comparable with recent randomized clinical
trials.<br/>Copyright &#xa9; 2023 The Authors. European Journal of Heart
Failure published by John Wiley & Sons Ltd on behalf of European Society
of Cardiology.

<60>
Accession Number
2020239493
Title
Intravenous ferric derisomaltose in iron-deficient patients undergoing
transcatheter aortic valve implantation due to severe aortic stenosis:
study protocol of the randomised controlled IIISAS trial.
Source
BMJ Open. 12(9) (no pagination), 2022. Article Number: e059546. Date of
Publication: 02 Sep 2022.
Author
Bardan S.; Kvaslerud A.B.; Andresen K.; Klove S.F.; Edvardsen T.;
Gullestad L.; Broch K.
Institution
(Bardan, Kvaslerud, Andresen, Edvardsen, Gullestad) Faculty of Medicine,
Institute for Clinical Medicine, University of Oslo, Oslo, Norway
(Kvaslerud, Andresen, Klove, Edvardsen, Gullestad, Broch) Department of
Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
(Kvaslerud, Gullestad) K.G. Jebsen Cardiac Research Center, Center for
Heart Failure Research, Faculty of Medicine, University of Oslo, Oslo,
Norway
Publisher
BMJ Publishing Group
Abstract
Introduction Iron deficiency is a prevalent comorbidity in patients with
severe aortic stenosis and may be associated with procedural and clinical
outcomes after transcatheter aortic valve implantation (TAVI). In the
Intravenous Iron Supplement for Iron Deficiency in Patients with Severe
Aortic Stenosis (IIISAS) trial, we aim to examine whether a single
administration of ferric derisomaltose can improve physical capacity after
TAVI. Methods and analysis This randomised, double-blind,
placebo-controlled trial aims to enrol 150 patients with iron deficiency
who are scheduled for TAVI due to severe aortic stenosis. The study drug
and matching placebo are administered approximately 3 months prior to
TAVI, and the patients are followed for 3 months after TAVI. Inclusion
criteria are iron deficiency, defined as serum ferritin<100 mug/L or
ferritin between 100 and 300 mug/L in combination with a transferrin
saturation<20% and written informed consent. Exclusion criteria include
haemoglobin<10 g/dL, red blood cell disorders, end-stage kidney failure,
intolerance to ferric derisomaltose, and ongoing infections. The primary
endpoint is the baseline-adjusted distance walked on a 6 min walk test
(6MWT) 3 months after TAVI. Secondary end points include quality of life,
New York Heart Association functional class (NYHA functional class), and
skeletal muscle strength. Ethics and dissemination Ethical approval was
obtained from the Regional Committee for Medical and Health Research of
South-Eastern Norway and The Norwegian Medicines Agency. Enrolment has
begun, and results are expected in 2022. The results of the IIISAS trial
will be disseminated by presentations at international and national
conferences and by publications in peer-reviewed journals. Trial
registration number NCT04206228<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.

<61>
Accession Number
2020239485
Title
Comparative efficacy of eight therapeutic methods in the treatment of left
main coronary artery disease: a Bayesian network meta-analysis protocol.
Source
BMJ Open. 12(9) (no pagination), 2022. Article Number: e058886. Date of
Publication: 06 Sep 2022.
Author
Hou B.; Chen M.; Li Q.; Huang W.; Wang L.
Institution
(Hou, Li, Huang, Wang) Inner Mongolia Medical University, Hohhot, China
(Chen) Bazhong Central Hospital, Sichuan, China
(Wang) Cardiothoracic Surgery Department, Inner Mongolia Baotou City
Central Hospital, Mongolia, Baotou, China
Publisher
BMJ Publishing Group
Abstract
Introduction As for coronary artery bypass grafting, although there are
many direct comparative studies on different minimally invasive methods
and traditional thoracotomy (off-pump/on-pump), there is still a lack of
further ranking and summary of the efficacy of all surgical methods for
left main coronary artery (LMCA) lesions. Combined with the current
controversial views, this study aims to introduce a planned network
meta-analysis (NMA) in detail, with a view to comparing the long-term
efficacy and safety of multiple therapeutic methods in the treatment of
patients with LMCA disease, and finally providing some reference bases for
the best selection of clinical schemes. Method and analysis PubMed,
Embase, Web of Science and The Cochrane Library databases will be
collected from inception to June 2022 to compare the efficacy of different
surgical methods in randomised controlled trials (RCTs) for LMCA disease.
Main outcome endpoints: major adverse cardiovascular events, including
mortality, myocardial infarction, stroke and revascularisation. Secondary
outcome endpoints: (1) operation-related time, (2) the amount of blood
transfusion, (3) complications including secondary thoracotomy,
postoperative new atrial fibrillation, wound infection, (4) physiological
score and psychological score, (5) time return to work and (6) total
hospitalisation costs. The methodological quality of included RCTs will be
assessed according to the Cochrane bias risk table. The Bayesian NMA will
be conducted by STATA V.16.0. Ethics and dissemination The essence of this
study is to summarise and analyse the original data without the approval
of the ethics committee. Our research does not involve ethical issues, and
the results will be published in peer-review journals. PROSPERO
registration number CRD42021274712.<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.

<62>
Accession Number
638187185
Title
Real-time seizure detection in paediatric intensive care patients: the
RESET child brain protocol.
Source
BMJ Open. 12(6) (no pagination), 2022. Article Number: e059301. Date of
Publication: 03 Jun 2022.
Author
Waak M.; Gibbons K.; Sparkes L.; Harnischfeger J.; Gurr S.; Schibler A.;
Slater A.; Malone S.
Institution
(Waak, Sparkes, Harnischfeger, Slater) Queensland Children's Hospital
Paediatric Intensive Care Unit, South Brisbane, QLD, Australia
(Waak, Gibbons, Sparkes) Centre for Children's Health Research, Brisbane,
QLD, Australia
(Gibbons, Malone) The University of Queensland, Saint Lucia, QLD,
Australia
(Gurr, Malone) Neurosciences, Queensland Children's Hospital, South
Brisbane, QLD, Australia
(Schibler) St Andrew's War Memorial Hospital, Spring Hill, QLD, Australia
Publisher
BMJ Publishing Group
Abstract
Introduction Approximately 20%-40% of comatose children with risk factors
in intensive care have electrographic-only seizures; these go unrecognised
due to the absence of continuous electroencephalography (EEG) monitoring
(cEEG). Utility of cEEG with high-quality assessment is currently limited
due to high-resource requirements. New software analysis tools are
available to facilitate bedside cEEG assessment using quantitative EEG
(QEEG) trends. The primary aim of this study is to describe accuracy of
interpretation of QEEG trends by paediatric intensive care unit (PICU)
nurses compared with cEEG assessment by neurologist (standard clinical
care) in children at risk of seizures and status epilepticus utilising
diagnostic test statistics. The secondary aims are to determine time to
seizure detection for QEEG users compared with standard clinical care and
describe impact of confounders on accuracy of seizure detection. Methods
and analysis This will be a single-centre, prospective observational
cohort study evaluating a paediatric QEEG programme utilising the full 19
electrode set. The setting will be a 36-bed quaternary PICU with medical,
cardiac and general surgical cases. cEEG studies in PICU patients
identified as at risk of seizures' will be analysed. Trained bedside
clinical nurses will interpret the QEEG. Seizure events will be marked as
seizures if >3 QEEG criteria occur. Post-hoc dedicated neurologists, who
remain blinded to the QEEG analysis, will interpret the cEEG.
Determination of standard test characteristics will assess the primary
hypothesis. To calculate 95% (CIs) around the sensitivity and specificity
estimates with a CI width of 10%, the sample size needed for sensitivity
is 80 patients assuming each EEG will have approximately 9 to 18 1-hour
epochs. Ethics and dissemination The study has received approval by the
Children's Health Queensland Human Research Ethics Committee
(HREC/19/QCHQ/58145). Results will be made available to the funders,
critical care survivors and their caregivers, the relevant societies, and
other researchers. Trial registration number Australian New Zealand
Clinical Trials Registry (ANZCTR) 12621001471875.<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.

<63>
Accession Number
2019022376
Title
Revascularization with Coronary Artery Bypass Grafting in Non-ST-elevation
Acute Coronary Syndromes: A Snapshot of Randomized Trials and Registries.
Source
Arquivos Brasileiros de Cardiologia. 120(1) (no pagination), 2023. Article
Number: e20220248. Date of Publication: 2023.
Author
Borovac J.A.; Ferri-Certic J.; Miric D.; Zanchi J.; Lozo M.; Bradaric A.;
Schwarz K.; Kwok C.S.
Institution
(Borovac, Miric, Zanchi, Lozo, Bradaric) Cardiovascular Diseases
Department, University Hospital of Split, Split, Croatia
(Ferri-Certic) Department of Cardiology, Dubrovnik General Hospital,
Dubrovnik, Croatia
(Schwarz) Department of Internal Medicine 3, University Hospital St.
Polten, Karl Landsteiner University of Health Sciences, Krems, Austria
(Kwok) Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
Publisher
Sociedade Brasileira de Cardiologia

<64>
Accession Number
2016927068
Title
Processed electroencephalography-guided general anaesthesia to reduce
postoperative delirium: a systematic review and meta-analysis.
Source
British Journal of Anaesthesia. 130(2) (pp e243-e253), 2023. Date of
Publication: February 2023.
Author
Sumner M.; Deng C.; Evered L.; Frampton C.; Leslie K.; Short T.; Campbell
D.
Institution
(Sumner, Deng, Short, Campbell) Auckland City Hospital, Auckland, New
Zealand
(Evered) St. Vincent's Hospital, Melbourne, Australia
(Evered) Weill Cornell Medicine, New York, NY, United States
(Evered, Leslie) University of Melbourne, Melbourne, Australia
(Frampton) University of Otago, Christchurch, New Zealand
(Leslie) Royal Melbourne Hospital, Melbourne, Australia
(Leslie) Monash University, Melbourne, Australia
(Short, Campbell) University of Auckland, Auckland, New Zealand
Publisher
Elsevier Ltd
Abstract
Background: Postoperative delirium (POD) is the most common serious
postoperative complication in older adults. It has uncertain aetiology,
limited preventative strategies, and poor long-term outcomes. This updated
systematic review and meta-analysis aimed to estimate the effect of
processed electroencephalography (pEEG)-guided general anaesthesia during
surgery on POD incidence. <br/>Method(s): We performed a systematic review
and meta-analysis by searching OVID MEDLINE, EMBASE, and the Cochrane
Central Register of Controlled Trials (CENTRAL) electronic databases.
Studies of adult patients having general anaesthesia for any surgery where
pEEG was used and POD was an outcome measure were included. Full-text
reports of RCTs published from database inception until August 28, 2021,
were included. Trials were excluded if sedation rather than general
anaesthesia was administered, or the setting was intensive care. The
primary outcome was POD assessed by validated tools. The study was
prospectively registered with PROSPERO. <br/>Result(s): Nine studies,
which included 4648 eligible subjects, were identified. The incidence of
POD in the pEEG-guided general anaesthesia or lighter pEEG target group
was 19.0% (440/2310) compared with 23.3% (545/2338) in the usual care or
deeper pEEG target group (pooled odds ratio=0.78; 95% confidence interval,
0.60-1.00; P=0.054). Significant heterogeneity was detected
(I²=53%). <br/>Conclusion(s): Our primary analysis demonstrated
a highly sensitive result with a pooled analysis of trials in which the
intervention group adhered to manufacturer's recommended guidelines,
showing reduced incidence of POD with pEEG guidance. High clinical
heterogeneity limits inferences from this and any future meta-analyses.
Clinical trial registration: CRD42020199404 (PROSPERO).<br/>Copyright
&#xa9; 2022 British Journal of Anaesthesia

<65>
Accession Number
2020399304
Title
Long-Term Outcomes of Randomized Controlled Trials Comparing Percutaneous
Left Atrial Appendage Closure to Oral Anticoagulation for Nonvalvular
Atrial Fibrillation: A Meta-Analysis.
Source
Structural Heart. 7(1) (no pagination), 2023. Article Number: 100096. Date
of Publication: January 2023.
Author
Madhavan M.V.; Howard J.P.; Brener M.I.; Der Nigoghossian C.; Chen S.;
Makkar R.; Osmancik P.; Reddy V.Y.; Holmes D.R.; Stone G.W.; Leon M.B.;
Ahmad Y.
Institution
(Madhavan, Brener, Der Nigoghossian, Leon) Division of Cardiology,
Department of Medicine, NewYork-Presbyterian Hospital and the Columbia
University Irving Medical Center, New York, NY, United States
(Madhavan, Chen, Leon) Cardiovascular Research Foundation, New York, NY,
United States
(Howard) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Makkar) Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles,
CA, United States
(Osmancik) Cardiocenter, Third Faculty of Medicine, Charles University
Prague and University Hospital Kralovske Vinohrady, Prague, Czechia
(Reddy) The Helmsley Electrophysiology Center, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Reddy, Stone) The Zena and Michael A. Wiener Cardiovascular Institute,
Icahn School of Medicine at Mount Sinai, New York, NY, United States
(Holmes) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Ahmad) Yale School of Medicine, Yale University, New Haven, CT, United
States
Publisher
Cardiovascular Research Foundation
Abstract
Background: Oral anticoagulation (OAC) has been considered the standard of
care for stroke prophylaxis for patients with nonvalvular atrial
fibrillation; however, many individuals are unable or unwilling to take
long-term OAC. The safety and efficacy of percutaneous left atrial
appendage closure (LAAC) have been controversial, and new trial data have
recently emerged. We therefore sought to perform an updated meta-analysis
of randomized clinical trials (RCTs) comparing OAC to percutaneous LAAC,
focusing on individual clinical endpoints. <br/>Method(s): We performed a
systematic search of the MEDLINE, EMBASE, and Cochrane Central Register of
Controlled Trials from January 2000 through December 2021 for all RCTs
comparing percutaneous LAAC to OAC in patients with nonvalvular atrial
fibrillation. Fixed and random effects meta-analyses of hazard ratios
(HRs) were performed using the longest follow-up duration available by
intention-to-treat. The prespecified primary endpoint was all-cause
mortality. <br/>Result(s): Three RCTs enrolling 1516 patients were
identified. The weighted mean follow-up was 54.7 months. LAAC was
associated with a reduced risk of all-cause mortality (HR 0.76; 95%
confidence interval [CI], 0.59-0.96; p = 0.023), hemorrhagic stroke (HR
0.24; 95% CI, 0.09-0.61; p = 0.003), and major nonprocedural bleeding (HR
0.52; 95% CI, 0.37-0.74; p < 0.001). There was no significant difference
between LAAC and OAC for any other endpoints. <br/>Conclusion(s): The
available evidence from RCTs suggests LAAC therapy is associated with
reduced long-term risk of death compared with OAC. This may be driven by
reductions in hemorrhagic stroke and major nonprocedural bleeding. There
were no significant differences in the risk of all stroke. Further
large-scale clinical trials are needed to validate these
findings.<br/>Copyright &#xa9; 2022 The Authors

<66>
Accession Number
2021131813
Title
Meta-Analysis on the Clinical Outcomes of Transcatheter Aortic Valve
Implantation in Low-Surgical Risk Patients With Bicuspid Aortic Valves.
Source
American Journal of Cardiology. 187 (pp 26-29), 2023. Date of Publication:
15 Jan 2023.
Author
Mahmoudi E.; Gupta R.; Behnoush A.H.; Vyas A.V.; Patel N.C.
Institution
(Mahmoudi) Universal Scientific Education and Research Network and
Non-communicable Diseases Research Center, Endocrinology and Metabolism
Population Sciences Institute, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Gupta, Vyas, Patel) Lehigh Valley Heart Institute, Lehigh Valley Health
Network, AllentownPennsylvania
(Behnoush) Non-communicable Diseases Research Center, Endocrinology and
Metabolism Population Sciences Institute, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Elsevier Inc.

<67>
Accession Number
2021131386
Title
Factor XIII levels, clot strength, and impact of fibrinogen concentrate in
infants undergoing cardiopulmonary bypass: a mechanistic sub-study of the
FIBCON trial.
Source
British Journal of Anaesthesia. 130(2) (pp 175-182), 2023. Date of
Publication: February 2023.
Author
Siemens K.; Hunt B.J.; Parmar K.; Taylor D.; Salih C.; Tibby S.M.
Institution
(Siemens, Tibby) Paediatric Intensive Care Unit, Evelina London Children's
Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United
Kingdom
(Hunt) Thrombosis and Haemophilia Centre and Thrombosis and Vascular
Biology Group, Guy's and St Thomas' NHS Foundation Trust, London, United
Kingdom
(Parmar) Thrombosis and Vascular Biology Group, Guy's and St Thomas' NHS
Foundation Trust, London, United Kingdom
(Taylor) Department of Anaesthesia, Evelina London Children's Hospital,
Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
(Salih) Department of Cardiac Surgery, Evelina London Children's Hospital,
Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: Acquired factor XIII (FXIII) deficiency after major surgery
can increase postoperative bleeding. We evaluated FXIII contribution to
clot strength and the effect of fibrinogen concentrate administration on
FXIII activity in infants undergoing cardiac surgery using cardiopulmonary
bypass. <br/>Method(s): We conducted a prospectively planned, mechanistic
sub-study, nested within the Fibrinogen Concentrate Supplementation in the
Management of Bleeding During Paediatric Cardiopulmonary Bypass: A Phase
1B/2A, Open-Label Dose Escalation Study (FIBCON) trial, which investigated
fibrinogen concentrate supplementation during cardiopulmonary bypass
(ISRCTN: 50553029) in 111 infants (median age 6.4 months). The
relationships between platelet number, fibrinogen concentration, and FXIII
activity with rotational thromboelastometry clot strength (EXTEM-MCF) in
blood taken immediately before cardiopulmonary bypass and after separation
from bypass were estimated using multivariable linear regression. Changes
in coagulation variables over time were quantified using a generalised
linear model comparing three groups: fibrinogen concentrate-supplemented
infants, placebo, and a third cohort with lower bleeding risk.
<br/>Result(s): Overall, 48% of the variability (multivariable
R²) in EXTEM-MCF clot strength was explained by three factors:
the largest contribution was from FXIII activity (partial
R²=0.21), followed by platelet number (partial
R²=0.14), and fibrinogen concentration (partial
R²=0.095). During cardiopulmonary bypass, mean platelet count
fell by a similar amount in the three groups (-36% to -41%; interaction
P=0.98). Conversely, fibrinogen concentration increased in all three
groups: 132% in the fibrinogen concentrate-supplemented group, 26% in the
placebo group, and 51% in the low-risk group. A similar increase was
observed for FXIII activity (61%, 23%, and 25%, respectively; interaction
P<0.0001). <br/>Conclusion(s): FXIII contribution to clot strength is
considerable in infants undergoing cardiac surgery. Fibrinogen concentrate
supplementation also increased FXIII activity, and hence clot strength.
Clinical trial registration: ISRCTN: 50553029.<br/>Copyright &#xa9; 2022
British Journal of Anaesthesia

<68>
Accession Number
2019558118
Title
Prevalence and Predictors of Chronic Postsurgical Pain After
Video-Assisted Thoracoscopic Surgery: A Systematic Review and
Meta-analysis.
Source
Pain and Therapy. 12(1) (pp 117-139), 2023. Date of Publication: February
2023.
Author
Chen W.-C.; Bai Y.-Y.; Zhang L.-H.; Liu Y.-B.; Liu C.-Y.; Liang J.-W.; He
H.-F.
Institution
(Chen, Bai, Zhang, Liu, Liu, Liang, He) Department of Anesthesiology, The
Second Affiliated Hospital, Fujian Medical University, 34 Zhongshan North
Road, Quanzhou, China
Publisher
Adis
Abstract
Introduction: Determining the prevalence of chronic postsurgical pain
(CPSP) after video-assisted thoracoscopic surgery (VATS) and identifying
CPSP predictors should improve the prognosis of patients undergoing VATS.
Although several studies have investigated predictors of CPSP after VATS,
there were significant dissimilarities in the findings due to the
confounding of predictors. <br/>Method(s): PubMed, Cochrane, MEDLINE, Web
of Science, Chinese Biomedical Literature, and China National Knowledge
Infrastructure databases were comprehensively searched using the Medical
Subject Headings terms "pain, postoperative," "thoracic surgery,
video-assisted," and all related free terms from inception until March 27,
2022. The Stata metaprop package was used to comprehensively analyze the
incidence of CPSP following VATS. Furthermore, the pooled odds ratios (OR)
or the standardized mean differences (SMD) and their corresponding 95%
confidence intervals (95% CI) were calculated, and qualitative analyses
were performed for predictors that could not be assessed quantitatively to
evaluate the effects of the included risk factors on the occurrence of
CPSP. Unadjusted odds ratios were utilized to consider the impact of
non-significant estimates if the original study did not report them.
<br/>Result(s): Of the 4302 studies, 183 were considered eligible, and 17
were finally included in this study. The overall incidence of CPSP after
VATS was 35.3% (95% CI 27.1-43.5%). The qualitative synthesis results
revealed that female sex, age, and acute postoperative pain were definite
predictors of CPSP after VATS. The number of ports, operation time,
duration of drainage, and insufficient analgesia were also considered
predictors. Consistent, quantitative synthesis results also showed that
the aforementioned predictors were closely related to the occurrence of
CPSP after VATS. Only by quantitative analysis, postoperative chemotherapy
and an educational level less than junior school were also risk factors
for CPSP. Other predictors displayed no evidence or unclear evidence of
association with CPSP after VATS. <br/>Conclusion(s): This study
preliminarily determined the incidence of CPSP after VATS based on the
existing literature. Female sex, age, and acute pain were identified as
risk factors for CPSP after VATS, and other potential risk factors were
also identified and analyzed. However, as a result of the inclusion of
retrospective studies and inevitable limitations in this systematic review
and meta-analysis, the results of this study still need to be verified by
large-scale prospective clinical studies. Trial Registration:
CRD42022323179.<br/>Copyright &#xa9; 2022, The Author(s).

<69>
Accession Number
2019037143
Title
Strategies for Reducing Vascular and Bleeding Risk for Percutaneous Left
Ventricular Assist Device-supported High-risk Percutaneous Coronary
Intervention.
Source
Heart International. 16(2) (pp 105-111), 2022. Date of Publication: 2022.
Author
Vetrovec G.W.; Kaki A.; Wollmuth J.; Dahle T.G.
Institution
(Vetrovec) VCU Pauley Heart Center, Virginia Commonwealth University, 3126
W. Cary St. #693, Richmond, VA 23221-3504, United States
(Kaki) Division of Cardiology, St. John's Hospital, Wayne State
University, Detroit, MI, United States
(Wollmuth) Providence Heart and Vascular Institute, Providence, OR, United
States
(Dahle) CentraCare Heart & Vascular Center, St. Cloud Hospital, St. Cloud,
MN, United States
Publisher
Touch Medical Media
Abstract
In patients at high risk for haemodynamic instability during percutaneous
coronary intervention (PCI), practitioners are increasingly opting for
prophylactic mechanical circulatory support, such as the Impella heart
pump (Abiomed, Danvers, MA, USA). Though Impella-supported high-risk PCI
(HRPCI) ensures haemodynamic stability during the PCI procedure,
access-related complication rates have varied significantly in published
studies. Reported variability in complication rates relates to many
factors, including anticoagulation practices, access and closure strategy,
post-procedure care and variations in event definitions. This article aims
to outline optimal strategies to minimize vascular and bleeding
complications during Impella-supported HRPCI based on previously
identified clinical, procedural and post-procedural risk factors.
Practices to reduce complications include femoral skills training,
standardized protocols to optimize access, closure, anticoagulation
management and post-procedural care, as well as the application of
techniques and technological advances. Protocols integrating these
strategies to mitigate access-related bleeding and vascular complications
for Impella-supported procedures can markedly limit vascular access risk
as a barrier to appropriate large-bore mechanical circulatory support use
in HRPCI.<br/>Copyright &#xa9; Touch Medical Media 2022.

<70>
Accession Number
2014389923
Title
Effects of percutaneous balloon mitral valvuloplasty in patients with
mitral stenosis and atrial fibrillation: a systematic review and
meta-analysis.
Source
Acta Cardiologica. 77(10) (pp 890-899), 2022. Date of Publication: 2022.
Author
Liu B.; Wang Y.; Liu Y.; Wu P.; Li T.
Institution
(Liu, Wang, Liu, Wu, Li) Heart Central, Third Central Hospital of Tianjin,
Tianjin, China
(Liu) Tianjin Key Laboratory of Extracorporeal Life Support for Critical
Diseases, Tianjin, China
(Liu) Artificial Cell Engineering Technology Research Center, Tianjin,
China
(Liu) Tianjin Institute of Hepatobiliary Disease, Tianjin, China
Publisher
Taylor and Francis Ltd.
Abstract
Objective: The study aimed to systematically review the existing
literature and assess the effects of percutaneous balloon mitral
valvuloplasty (PBMV) in patients with mitral stenosis and atrial
fibrillation (AF) as opposed to sinus rhythm (SR). <br/>Method(s):
Eligible studies were identified from six electronic databases before June
2021. The primary outcome was mitral valve area (MVA), and secondary
outcomes were hemodynamic measurements, in-hospital complications, and
long-term outcomes. Relative risks (RRs) or weighted mean differences
(WMDs) with 95% confidence intervals (CIs) were used as effect sizes.
<br/>Result(s): Fifteen studies were included involving 6351 patients. For
the primary outcome, the AF group obtained less favourable changes in MVA
(WMD: -0.10, 95%CI: -0.14, -0.06) and a significantly smaller
postoperative and long-term MVA (WMD: -0.13, 95%CI: -0.18, -0.08 and WMD:
-0.10, 95%CI: -0.17, -0.03, respectively) compared to the SR group. For
secondary outcome, the AF group was associated with suboptimal outcomes as
following (WMD/RR, [95%CI]): higher LAP (1.37, [0.86, 1.87]), more
embolism (2.85, [1.44, 5.63]), lower event-free survival (0.89, [0.80,
1.00]), higher incidences of mitral valve replacement (2.20, [1.40,
3.46]), re-PBMV (2.28, [1.63, 3.19]), and mortality (3.28, [2.42, 4.44]).
No significant differences were found in other outcomes.
<br/>Conclusion(s): The currently available evidence suggests that PBMV
may be less effective in patients with AF than in those with SR. However,
early treatment and appropriate management of AF patients undergoing PBMV
may benefit the immediate and long-term outcomes.<br/>Copyright &#xa9;
2021 Belgian Society of Cardiology.

<71>
Accession Number
2019113631
Title
Erector spinae plane block versus its combination with superficial
parasternal intercostal plane block for postoperative pain after cardiac
surgery: a prospective, randomized, double-blind study.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 295. Date
of Publication: December 2022.
Author
Dost B.; Kaya C.; Turunc E.; Dokmeci H.; Yucel S.M.; Karakaya D.
Institution
(Dost, Kaya, Turunc, Dokmeci, Karakaya) Department of Anesthesiology and
Reanimation, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
(Yucel) Department of Cardiovascular Surgery, Faculty of Medicine, Ondokuz
Mayis University, Samsun, Turkey
Publisher
BioMed Central Ltd
Abstract
Background: We aimed to compare the effectiveness of bilateral erector
spinae plane (ESP) block and superficial parasternal intercostal plane
(S-PIP) + ESP block in acute post-sternotomy pain following cardiac
surgery. <br/>Method(s): Forty-seven patients aged between 18 and 80 years
of age with American Society of Anesthesiologists class II-III due to
undergo median sternotomy for cardiac surgery were included in this
prospective, randomized, double-blinded study. Following randomization
into two groups, one group received bilateral ultrasound-guided ESP and
the other S-PIP plus ESP block. Morphine consumption within the first 24 h
after surgery was the primary outcome of the study while NRS scores at
rest, NRS scores when coughing, time taken until extubation, use of rescue
analgesic, presence of nausea/vomiting, length of hospital and intensive
care unit (ICU) stay, and patient satisfaction were secondary outcome
measures. <br/>Result(s): Morphine use up to 24 h following surgery was
statistically significantly different between the ESP block and ESP +
S-PIP block groups (18.63 +/- 6.60 [15.84-21.41] mg/24 h vs 14.41 +/- 5.38
[12.08-16.74] mg/24 h, p = 0.021). The ESP + S-PIP block group had
considerably reduced pain scores compared to the ESP block group across
all time points. Rescue analgesics were required in 21 (87.5%) patients in
the ESP block group and seven (30.4%) in the ESP + S-PIP group (p <
0.001). PONV, length of stay in the ICU and hospital, and time to
extubation were similar between groups. <br/>Conclusion(s): In open
cardiac surgery, the combination of ESP and S-PIP blocks lowers pain
scores and postoperative morphine requirement of patients. Trial
registration: Clinicaltrials Registration No: NCT05191953, Registration
Date: 14/01/2022.<br/>Copyright &#xa9; 2022, The Author(s).

<72>
Accession Number
2019076107
Title
Effect of low-dose dexmedetomidine on sleep quality in postoperative
patients with mechanical ventilation in the intensive care unit: A pilot
randomized trial.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 931084.
Date of Publication: 31 Aug 2022.
Author
Sun Y.-M.; Zhu S.-N.; Zhang C.; Li S.-L.; Wang D.-X.
Institution
(Sun, Li) Department of Critical Care Medicine, Peking University First
Hospital, Beijing, China
(Zhu) Department of Biostatistics, Peking University First Hospital,
Beijing, China
(Zhang) Department of Respiratory and Critical Care Medicine, Peking
University First Hospital, Beijing, China
(Wang) Departments of Anesthesiology and Critical Care Medicine, Peking
University First Hospital, Beijing, China
(Wang) Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH,
United States
Publisher
Frontiers Media S.A.
Abstract
Background: Sleep disturbances are prevalent in patients requiring
invasive mechanical ventilation in the intensive care unit (ICU) and are
associated with worse outcomes. Sedative-dose dexmedetomidine may improve
sleep quality in this patient population but is associated with adverse
events. Herein, we tested the effect of low-dose dexmedetomidine infusion
on nighttime sleep quality in postoperative ICU patients with invasive
ventilation. <br/>Method(s): In this pilot randomized trial, 80 adult
patients who were admitted to the ICU after non-cardiac surgery and
required invasive mechanical ventilation were randomized to receive either
low-dose dexmedetomidine (0.1 to 0.2 mug/kg/h, n = 40) or placebo (n = 40)
for up to 72 h. The primary endpoint was overall subjective sleep quality
measured using the Richards-Campbell Sleep Questionnaire (score ranges
from 0 to 100, with a higher score indicating better quality) in the night
of surgery. Secondary outcomes included sleep structure parameters
monitored with polysomnography from 9:00 PM on the day of surgery to the
next 6:00 AM. <br/>Result(s): All 80 patients were included in the
intention-to-treat analysis. The overall subjective sleep quality was
median 52 (interquartile 20, 66) with placebo vs. 61 (27, 79) with
dexmedetomidine, and the difference was not statistically significant
(median difference 8; 95% CI: -2, 22; P = 0.120). Among 68 patients
included in sleep structure analysis, those in the dexmedetomidine group
tended to have longer total sleep time [median difference 54 min (95% CI:
-4, 120); P = 0.061], higher sleep efficiency [median difference 10.0%
(95% CI: -0.8%, 22.3%); P = 0.060], lower percentage of stage N1 sleep
[median difference -3.9% (95% CI: -11.8%, 0.5%); P = 0.090], higher
percentage of stage N3 sleep [median difference 0.0% (95% CI: 0.0%, 0.4%);
P = 0.057], and lower arousal index [median difference -0.9 (95% CI -2.2,
0.1); P = 0.091] but not statistically significant. There were no
differences between the two groups regarding the incidence of adverse
events. <br/>Conclusion(s): Among patients admitted to the ICU after
surgery with intubation and mechanical ventilation, low-dose
dexmedetomidine infusion did not significantly improve the sleep quality
pattern, although there were trends of improvement. Our findings support
the conduct of a large randomized trial to investigate the effect of
low-dose dexmedetomidine in this patient population. Clinical trial
registration: ClinicalTrial.gov, identifier: NCT03335527.<br/>Copyright
&#xa9; 2022 Sun, Zhu, Zhang, Li and Wang.

<73>
Accession Number
2016545459
Title
The early and long-term outcomes of coronary artery bypass grafting added
to aortic valve replacement compared to isolated aortic valve replacement
in elderly patients: a systematic review and meta-analysis.
Source
Heart and Vessels. 37(10) (pp 1647-1661), 2022. Date of Publication:
October 2022.
Author
D'Alessandro S.; Tuttolomondo D.; Singh G.; Hernandez-Vaquero D.; Pattuzzi
C.; Gallingani A.; Maestri F.; Nicolini F.; Formica F.
Institution
(D'Alessandro) Cardiac Surgery Unit, San Gerardo Hospital, Monza, Italy
(Tuttolomondo) Cardiology Unit, University Hospital of Parma, Parma, Italy
(Singh) Department of Critical Care Medicine and Division of Cardiac
Surgery, Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, AB, Canada
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo, Spain
(Pattuzzi, Gallingani, Maestri, Nicolini, Formica) Cardiac Surgery Unit,
University Hospital of Parma, Parma, Italy
(Nicolini, Formica) Department of Medicine and Surgery, University of
Parma, Parma, Italy
(Formica) UOC Cardiochirurgia, Azienda Ospedaliera Universitaria di Parma,
Via A. Gramsci, 14, Parma 43126, Italy
Publisher
Springer
Abstract
In aged population, the early and long-term outcomes of coronary
revascularization (CABG) added to surgical aortic valve replacement (SAVR)
compared to isolated SAVR (i-SAVR) are conflicting. To address this
limitation, a meta-analysis comparing the early and late outcomes of SAVR
plus CABG with i-SAVR was performed. Electronic databases from January
2000 to November 2021 were screened. Studies reporting early-term and
long-term comparison between the two treatments in patients over 75 years
were analyzed. The primary endpoints were in-hospital/30-day mortality and
overall long-term survival. The pooled odd ratio (OR) and hazard ratio
(HR) with 95% confidence interval (CI) were calculated for in-early
outcome and long-term survival, respectively. Random-effect model was used
in all analyses. Forty-four retrospective observational studies reporting
on 74,560 patients (i-SAVR = 36,062; SAVR + CABG = 38,498) were included
for comparison. The pooled analysis revealed that i-SAVR was significantly
associated with lower rate of early mortality compared to SAVR plus CABG
(OR = 0.70, 95% CI 0.66-0.75; p < 0.0001) and with lower incidence of
postoperative acute renal failure (OR = 0.65; 95% CI 0.50-0.91; p = 0.02),
need for dialysis (OR = 0.65; 95% CI 0.50-0.86; p = 0.002) and prolonged
mechanical ventilation (OR = 0.57; 95% CI 0.42-0.77; p < 0.0001).
Twenty-two studies reported data of long-term follow-up. No differences
were reported between the two groups in long-term survival (HR = 0.95; 95%
CI 0.87-1.03; p = 0.23). CABG added to SAVR is associated with worse early
outcomes in terms of early mortality, postoperative acute renal failure,
and prolonged mechanical ventilation. Long-term survival was comparable
between the two treatments.<br/>Copyright &#xa9; 2022, The Author(s).

<74>
Accession Number
2016800696
Title
Meta-Analysis of Aortic Valve Replacement in Asymptomatic Patients With
Severe Aortic Stenosis.
Source
American Journal of Cardiology. 168 (pp 174-176), 2022. Date of
Publication: 01 Apr 2022.
Author
Mohamed M.M.G.; Taha M.; Kheiri B.; Osman M.
Institution
(Mohamed) Internal Medicine Department, SSM Health, St. Mary's
Hospital-St. Louis, Missouri
(Taha) Internal Medicine Department, University of Nevada, Nevada, Reno
(Kheiri, Osman) Knight Cardiovascular Institute, Oregon Health & Science
University, Oregon, Portland
Publisher
Elsevier Inc.

<75>
Accession Number
2020317224
Title
Factor XIa inhibition with asundexian after acute non-cardioembolic
ischaemic stroke (PACIFIC-Stroke): an international, randomised,
double-blind, placebo-controlled, phase 2b trial.
Source
The Lancet. 400(10357) (pp 997-1007), 2022. Date of Publication: 24 Sep
2022.
Author
Shoamanesh A.; Mundl H.; Smith E.E.; Masjuan J.; Milanov I.; Hirano T.;
Agafina A.; Campbell B.; Caso V.; Mas J.-L.; Dong Q.; Turcani P.;
Christensen H.; Ferro J.M.; Veltkamp R.; Mikulik R.; De Marchis G.M.;
Robinson T.; Lemmens R.; Stepien A.; Greisenegger S.; Roine R.; Csiba L.;
Khatri P.; Coutinho J.; Lindgren A.G.; Demchuk A.M.; Colorado P.; Kirsch
B.; Neumann C.; Heenan L.; Xu L.; Connolly S.J.; Hart R.G.
Institution
(Shoamanesh, Hart) Division of Neurology, McMaster University, Population
Health Research Institute, Hamilton, ON, Canada
(Connolly) Department of Medicine, McMaster University, Population Health
Research Institute, Hamilton, ON, Canada
(Heenan, Xu) Department of Statistics, McMaster University, Population
Health Research Institute, Hamilton, ON, Canada
(Mundl) TA Thrombosis and Vascular Medicine, Bayer AG, Wuppertal, Germany
(Neumann) Bayer AG, Wuppertal, Germany
(Smith, Demchuk) Department of Clinical Neurosciences, Hotchkiss Brain
Institute, Cumming School of Medicine, University of Calgary, Calgary, AB,
Canada
(Smith, Demchuk) Department of Radiology, Hotchkiss Brain Institute,
Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
(Masjuan) Neurology Department, Hospital Universitario Ramon y Cajal,
Madrid, Spain
(Masjuan) Departamento de Medicina, Facultad de Medicina, Universidad de
Alcala, IRYCIS, RICORS-ICTUS, Madrid, Spain
(Milanov) Medical University, University Hospital for Neurology and
Psychiatry "St Naum", Sofia, Bulgaria
(Hirano) Department of Stroke and Cerebrovascular Medicine, School of
Medicine, Kyorin University, Tokyo, Japan
(Agafina) Clinical Research Department, City Hospital #40, Saint
Petersburg, Russian Federation
(Campbell) Department of Medicine and Neurology, Melbourne Brain Centre at
the Royal Melbourne Hospital, University of Melbourne, Parkville, VIC,
Australia
(Caso) Stroke Unit, Santa Maria della Misericordia Hospital, University of
Perugia, Perugia, Italy
(Mas) Department of Neurology, GHU Paris, Hopital Sainte-Anne, Universite
Paris-Cite, Inserm U1266, Paris, France
(Dong) Department of Neurology, Huashan Hospital, Fudan University,
Shanghai, China
(Turcani) 1st Department of Neurology, Medical Faculty, Comenius
University, Bratislava, Slovakia
(Christensen) Department of Neurology, University Hospital of Copenhagen,
Bispebjerg, Denmark
(Ferro) Instituto de Medicina Molecular Joao Lobo Antunes, Faculdade de
Medicina, Universidade de Lisboa, Lisbon, Portugal
(Veltkamp) Neurology Department, Alfried-Krupp Hospital, Essen, Germany
(Mikulik) International Clinical Research Center and Neurology Department,
St Anne's University Hospital, Brno, Czechia
(Mikulik) Medical Faculty, Masaryk University, Brno, Czechia
(De Marchis) Department of Neurology and Stroke Center, University
Hospital of Basel and University of Basel, Basel, Switzerland
(Robinson) College of Life Sciences, University of Leicester, Leicester,
United Kingdom
(Lemmens) Department of Neurosciences, Experimental Neurology, KU Leuven -
University of Leuven, Leuven, Belgium
(Lemmens) VIB-KU Leuven Center for Brain and Disease Research, Leuven,
Belgium
(Lemmens) Department of Neurology, University Hospitals Leuven, Leuven,
Belgium
(Stepien) Department of Neurology, Military Institute of Medicine, Warsaw,
Poland
(Greisenegger) Department of Neurology, Medical University of Vienna,
Vienna, Austria
(Roine) Division of Clinical Neurosciences, University of Turku, Turku,
Finland
(Csiba) DE Clinical Center (DEKK), Health Service Units, Clinics,
Department of Neurology, University of Debrecen, Debrecen, Hungary
(Khatri) Department of Neurology and Rehabilitation Sciences, University
of Cincinnati, Cincinnati, OH, United States
(Coutinho) Department of Neurology, Amsterdam UMC, University of
Amsterdam, Amsterdam, Netherlands
(Lindgren) Department of Clinical Sciences Lund (Neurology), Lund
University, Lund, Sweden
(Lindgren) Department of Neurology, Skane University Hospital, Lund,
Sweden
(Colorado) Bayer US Pharmaceuticals, Whippany, NJ, United States
(Kirsch) Statistics and Data Insights, Bayer AG, Berlin, Germany
Publisher
Elsevier B.V.
Abstract
Background: Asundexian (Bayer AG, Leverkusen, Germany), an oral small
molecule factor XIa (FXIa) inhibitor, might prevent thrombosis without
increasing bleeding. Asundexian's effect for secondary prevention of
recurrent stroke is unknown. <br/>Method(s): In this randomised,
double-blind, placebo-controlled, phase 2b dose-finding trial
(PACIFIC-Stroke), patients with acute (within 48 h) non-cardioembolic
ischaemic stroke were recruited from 196 hospitals in 23 countries.
Patients were eligible if they were aged 45 years or older, to be treated
with antiplatelet therapy, and able to have a baseline MRI (either before
or within 72 h of randomisation). Eligible participants were randomly
assigned (1:1:1:1), using an interactive web-based response system and
stratified according to anticipated antiplatelet therapy (single vs dual),
to once daily oral asundexian (BAY 2433334) 10 mg, 20 mg, or 50 mg, or
placebo in addition to usual antiplatelet therapy, and were followed up
during treatment for 26-52 weeks. Brain MRIs were obtained at study entry
and at 26 weeks or as soon as possible after treatment discontinuation.
The primary efficacy outcome was the dose-response effect on the composite
of incident MRI-detected covert brain infarcts and recurrent symptomatic
ischaemic stroke at or before 26 weeks after randomisation. The primary
safety outcome was major or clinically relevant non-major bleeding as
defined by International Society on Thrombosis and Haemostasis criteria.
The efficacy outcome was assessed in all participants assigned to
treatment, and the safety outcome was assessed in all participants who
received at least one dose of study treatment. This study is registered
with ClinicalTrials.gov, NCT04304508, and is now complete.
<br/>Finding(s): Between June 15, 2020, and July 22, 2021, 1880 patients
were screened and 1808 participants were randomly assigned to asundexian
10 mg (n=455), 20 mg (n=450), or 50 mg (n=447), or placebo (n=456). Mean
age was 67 years (SD 10) and 615 (34%) participants were women, 1193 (66%)
were men, 1505 (83%) were White, and 268 (15%) were Asian. The mean time
from index stroke to randomisation was 36 h (SD 10) and median baseline
National Institutes of Health Stroke Scale score was 2.0 (IQR 1.0-4.0).
783 (43%) participants received dual antiplatelet treatment for a mean
duration of 70.1 days (SD 113.4) after randomisation. At 26 weeks, the
primary efficacy outcome was observed in 87 (19%) of 456 participants in
the placebo group versus 86 (19%) of 455 in the asundexian 10 mg group
(crude incidence ratio 0.99 [90% CI 0.79-1.24]), 99 (22%) of 450 in the
asundexian 20 mg group (1.15 [0.93-1.43]), and 90 (20%) of 447 in the
asundexian 50 mg group (1.06 [0.85-1.32]; t statistic -0.68; p=0.80). The
primary safety outcome was observed in 11 (2%) of 452 participants in the
placebo group versus 19 (4%) of 445 in the asundexian 10 mg group, 14 (3%)
of 446 in the asundexian 20 mg group, and 19 (4%) of 443 in the asundexian
50 mg group (all asundexian doses pooled vs placebo hazard ratio 1.57 [90%
CI 0.91-2.71]). <br/>Interpretation(s): In this phase 2b trial, FXIa
inhibition with asundexian did not reduce the composite of covert brain
infarction or ischaemic stroke and did not increase the composite of major
or clinically relevant non-major bleeding compared with placebo in
patients with acute, non-cardioembolic ischaemic stroke. <br/>Funding(s):
Bayer AG.<br/>Copyright &#xa9; 2022 Elsevier Ltd

<76>
Accession Number
2018993974
Title
Continuous Pecto-Intercostal Fascial Block Provides Effective Analgesia in
Patients Undergoing Open Cardiac Surgery: A Randomized Controlled Trial.
Source
Pain Medicine (United States). 23(3) (pp 440-447), 2022. Date of
Publication: 01 Mar 2022.
Author
Zhang Y.; Min J.; Chen S.
Institution
(Zhang, Min, Chen) Department of Anesthesiology, First Affiliated Hospital
of Nanchang University, Nanchang, China
Publisher
Oxford University Press
Abstract
Background: The optimal analgesia regimen after open cardiac surgery has
been unclear. The aim of this study was to investigate the beneficial
effects of continuous pecto-intercostal fascial blocks (PIFB) initiated
before surgery on outcomes after open cardiac surgery. <br/>Method(s): A
group of 116 patients were randomly allocated to receive either bilateral
continuous PIFB (PIF group) or the same block with saline (SAL group). The
primary endpoint was postoperative pain at 4, 8, 16, 24, 48, and 72 hours
after extubation at rest and during exercise. The secondary outcome
measures included analgesia requirements (sufentanil and flurbiprofen
consumption), time to extubation, length of stay in the intensive care
unit, incidence of postoperative nausea and vomiting, time until return of
bowel function, time to mobilization, time to urinary catheter removal,
and the length of hospital stay. <br/>Result(s): The length of stay in the
intensive care unit (29 +/- 7 hours vs 13 +/- 4 hours, P < 0.01) and
length of hospital stay (8.9 +/- 0.9 days vs 6.5 +/- 1.1 days, P < 0.01)
were significantly longer in the SAL group than in the PIF group. Resting
pain scores (2 hours after extubation: 1.1 vs 3.3, P < 0.01; 4 hours after
extubation: 1.0 vs 3.5, P < 0.01; 8 hours after extubation: 1.2 vs 3.7, P
< 0.01; 16 hours after extubation: 1.3 vs 3.7, P < 0.01; 24 hours after
extubation: 1.4 vs 2.8, P < 0.01; 48 hours after extubation: 0.9 vs 2.2, P
< 0.01; 72 hours after extubation: 0.8 vs 2.1, P < 0.01) and dynamic pain
scores (2 hours after extubation: 1.4 vs 3.7, P < 0.01; 4 hours after
extubation: 1.3 vs 3.8, P < 0.01; 8 hours after extubation: 1.4 vs 3.5, P
< 0.01; 16 hours after extubation: 1.2 vs 3.4, P < 0.01; 24 hours after
extubation: 1.1 vs 3.1, P < 0.01; 48 hours after extubation: 1.0 vs 2.9, P
< 0.01; 72 hours after extubation: 0.9 vs 2.8, P < 0.01) were
significantly lower in the PIF group than in the SAL group at all time
points. The PIF group required significantly less intraoperative
sufentanil consumption (123 +/- 32 mug vs 63 +/- 16 mug, P < 0.01),
postoperative sufentanil consumption (102 +/- 22 mug vs 52 +/- 17 mug, P <
0.01), and postoperative flurbiprofen consumption (350 +/- 100 mg vs 100
+/- 100 mg, P < 0.01) than the SAL groups. Time to extubation (8.9 +/- 2.4
hours vs 3.2 +/- 1.3 hours, P < 0.01), time to first flatus (43 +/- 6
hours vs 30 +/- 7 hours, P < 0.01), time until mobilization (35 +/- 5
hours vs 24 +/- 7 hours, P < 0.01), and time until urinary catheter
removal (47 +/- 9 hours vs 31 +/- 4 hours, P < 0.01) were significantly
earlier in the PIF group than in the SAL group. The incidence of
postoperative nausea and vomiting was significantly lower in the PIF group
(9.1% vs 27.3%, P < 0.01). <br/>Conclusion(s): Bilateral continuous PIFB
reduced the length of hospital stay and provided effective postoperative
pain relief for 3 days.<br/>Copyright &#xa9; 2021 The Author(s). Published
by Oxford University Press on behalf of the American Academy of Pain
Medicine. All rights reserved.

<77>
Accession Number
2020219751
Title
Hypothermia as an Adjunctive Therapy to Percutaneous Intervention in
ST-Elevation Myocardial Infarction: A Systematic Review and Meta-Analysis
of Randomized Control Trials.
Source
Cardiovascular Revascularization Medicine. 47 (pp 8-15), 2023. Date of
Publication: February 2023.
Author
Mhanna M.; Ranabothu M.; Al-Abdouh A.; Jabri A.; Sharma V.; Beran A.;
Sajdeya O.; Barbarawi M.; Hanna E.B.
Institution
(Mhanna, Sharma, Hanna) Division of Cardiology, Department of Medicine,
University of Iowa, Iowa City, IA, United States
(Ranabothu) University of Toledo College of Medicine and Life Sciences,
Toledo, OH, United States
(Al-Abdouh) Department of Internal Medicine, University of Kentucky,
Lexington, KY, United States
(Jabri) Department of Cardiology, Case Western Reserve
University/MetroHealth Medical Center, Cleveland, OH, United States
(Beran) Department of Gastroenterology, Indiana University, Indianapolis,
IN, United States
(Sajdeya) Department of Internal Medicine, The University of Toledo,
Toledo, OH, United States
(Barbarawi) Department of Cardiology, University of Connecticut,
Farmington, CT, United States
Publisher
Elsevier Inc.
Abstract
Introduction: In the setting of acute ST-elevation myocardial infarction
(STEMI), several randomized control trials (RCTs) suggested a potential
benefit with the use of therapeutic hypothermia (TH). However, results
from previous studies are contradictory. <br/>Method(s): We performed a
comprehensive literature search for studies that evaluated the efficacy
and safety of adjunctive TH compared to the standard percutaneous coronary
intervention (PCI) in awake patients with STEMI. The primary outcomes were
the infarct size (IS) and microvascular obstruction (MVO) assessed by
cardiac imaging at the end of follow-up. The secondary outcomes were major
adverse cardiovascular events (MACE), procedure-related complications, and
door-to-balloon time. Relative risk (RR) or the mean difference (MD) and
corresponding 95 % confidence intervals (CIs) were calculated using the
random-effects model. <br/>Result(s): A total of 10 RCTs, including 706
patients were included. As compared to standard PCI, TH was not associated
with a statistically significant improvement in the IS (MD: -0.87 %,
95%CI: -2.97, 1.23; P = 0.42) or in the MVO (MD: 0.11 %, 95%CI: -0.06,
0.27; P = 0.21). MACE and its components were comparable between the two
groups. However, the TH approach was associated with an increased risk of
infection and prolonged door-to-balloon time. Furthermore, there was a
trend in the TH group toward an increased incidence of stent thrombosis
and paroxysmal atrial fibrillation. <br/>Conclusion(s): According to our
meta-analysis of published RCTs, TH is not beneficial in awake patients
with STEMI and has a marginal safety profile with potential for care
delays. Larger-scale RCTs are needed to further clarify our
results.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<78>
Accession Number
2021589753
Title
Selection of the best of 2022 in heart failure.
Source
REC: CardioClinics. 58(Supplement 1) (pp S42-S48), 2023. Date of
Publication: January 2023.
Author
Recio-Mayoral A.; Santiago-Vacas E.; Dobarro-Perez D.; de Juan-Baguda J.;
Gonzalez-Costello J.
Institution
(Recio-Mayoral) Unidad de Insuficiencia Cardiaca Especializada e
Hipertension Pulmonar, Servicio de Cardiologia, Hospital Universitario
Virgen Macarena, Sevilla, Spain
(Santiago-Vacas) Unidad de Insuficiencia Cardiaca, Servicio de
Cardiologia, Hospital Germans Trias i Pujol, Barcelona, Badalona, Spain
(Dobarro-Perez) Unidad de Insuficiencia Cardiaca, Servicio de Cardiologia,
Hospital Alvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo,
Pontevedra, Vigo, Spain
(de Juan-Baguda) Unidad de Insuficiencia Cardiaca, Servicio de
Cardiologia, Hospital Universitario 12 de Octubre, Instituto de
Investigacion Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
(de Juan-Baguda) Centro de Investigacion en Red de Enfermedades
Cardiovasculares (CIBERCV), Spain
(de Juan-Baguda) Facultad de Medicina, Universidad Europea, Madrid, Spain
(Gonzalez-Costello) Unidad de Insuficiencia Cardiaca Avanzada y Trasplante
Cardiaco, Servicio de Cardiologia, Hospital Universitari de Bellvitge,
Barcelona, L'Hospitalet de Llobregat, Spain
(Gonzalez-Costello) Grupo de Enfermedades Cardiovasculares BIOHEART,
Institut d'Investigacio Biomedica de Bellvitge (IDIBELL), Universitat de
Barcelona, Barcelona, L'Hospitalet de Llobregat, Spain
Publisher
Elsevier Espana S.L.U
Abstract
Multiple studies of maximum interest have been published in the field of
heart failure during the last year. We have carried out a systematic
review of the most relevant publications (from 05-09-2021 to 05-09-2022),
selecting the most outstanding publications, ordering them by thematic
blocks. References to the American guidelines on heart failure and the
joint guidelines of the European societies of cardiology and respiration
in pulmonary hypertension, both published in this period, are
included.<br/>Copyright &#xa9; 2022 Sociedad Espanola de Cardiologia

<79>
Accession Number
640077347
Title
Transcatheter Aortic Valve Replacement vs. Surgical Aortic Valve
Replacement for Long-Term Mortality Due to Stroke and Myocardial
Infarction: A Meta-Analysis during the COVID-19 Pandemic.
Source
Medicina (Kaunas, Lithuania). 59(1) (no pagination), 2022. Date of
Publication: 21 Dec 2022.
Author
Ion A.C.; Serbanoiu L.I.; Plesu E.; Busnatu S.S.; Andrei C.L.
Institution
(Ion, Serbanoiu, Plesu, Busnatu, Andrei) Faculty of Medicine, Department
5, Cardiology, Carol Davila University of Medicine and Pharmacy, Bucharest
020021, Romania
(Ion, Serbanoiu, Plesu, Busnatu, Andrei) Cardiology Department, Bagdasar
Arseni Emergency Hospital, Bucharest 041915, Romania
Publisher
NLM (Medline)
Abstract
Background and objectives: One of the leading causes of mortality and
morbidity in people over the age of 50 is stroke. The acceptance of
transcatheter aortic valve replacement (TAVR) as a treatment option for
severe symptomatic aortic stenosis (AS) has increased as a result of
numerous randomized clinical trials comparing surgical aortic valve
replacement (SAVR) and TAVR in high- and intermediate-risk patients,
showing comparable clinical outcomes and valve hemodynamics.
<br/>Material(s) and Method(s): An electronic search of Medline, Google
Scholar and Cochrane Central was carried out from their inception to 28
September 2022 without any language restrictions. <br/>Result(s): Our
meta-analysis demonstrated that, as compared with SAVR, TAVR was not
linked with a lower stroke ratio or stroke mortality. It is clear from
this that the SAVR intervention techniques applied in the six studies were
successful in reducing cardiogenic consequences over time.
<br/>Conclusion(s): A significantly decreased rate of mortality from
cardiogenic causes was associated with SAVR. Additionally, when TAVR and
SAVR were compared for stroke mortality, the results were nonsignificant
with a p value of 0.57, indicating that none of these procedures could
decrease stroke-related mortality.

<80>
Accession Number
2022363755
Title
Low-Intensity vs. High-Intensity Antithrombotic Therapy After
Transcatheter Aortic Valve Replacement: Meta-Analysis of Randomized
Controlled Trials.
Source
Structural Heart. (no pagination), 2023. Article Number: 100133. Date of
Publication: 2023.
Author
Chakravarty T.; Leong D.; de la Rosa A.; Bhardwaj N.; Makkar R.R.
Institution
(Chakravarty, Leong, de la Rosa, Bhardwaj, Makkar) Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA, United States
Publisher
Cardiovascular Research Foundation
Abstract
Background: The optimal antithrombotic therapy after transcatheter aortic
valve replacement (TAVR) is controversial. We performed a systematic
review and meta-analysis of randomized controlled trials comparing
high-intensity vs. low-intensity antithrombotic therapy after TAVR in the
absence of an established indication for anticoagulation. <br/>Method(s):
The primary efficacy and safety endpoints were a composite of death or
thromboembolic events and Valve Academic Research Consortium 2-defined
significant bleeding, respectively. All analyses were by intention to
treat. Risk ratios (RRs) were calculated using the inverse variance
random-effects model. <br/>Result(s): Four studies comprising 3358
patients (mean age 81 years, mean Society of Thoracic Surgery score 3.3%)
were identified. Two studies compared anticoagulation vs. antiplatelet
therapy after TAVR; the other 2 trials compared dual-antiplatelet therapy
vs. mono-antiplatelet therapy after TAVR. The incidence of death or
thromboembolic events (RR 0.66 [95% confidence interval (CI) 0.55-0.80], p
< 0.0001, I² = 0%), death (RR 0.68 [95% CI 0.51-0.92],
I² = 11%, p = 0.01), and Valve Academic Research Consortium
2-defined major bleeding (RR 0.69 [95% CI 0.48 - 1.00], p = 0.003,
I² = 44%) was significantly lower in patients on low-intensity
antithrombotic therapy than in those on high-intensity antithrombotic
therapy. <br/>Conclusion(s): In an elderly patient population undergoing
TAVR, routine initiation of a high-intensity antithrombotic therapy in the
absence of a clinical indication for anticoagulation was associated with
increased risk of death or thromboembolic complications, increased risk of
death, and increased risk of significant bleeding. Routine initiation of
an anticoagulation therapy or dual-antiplatelet therapy after TAVR in the
absence of an established indication for anticoagulation may not be
advisable.<br/>Copyright &#xa9; 2022

<81>
Accession Number
2021228785
Title
Takotsubo cardiomyopathy after cardiac surgery: A case-series and
systematic review of literature.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 1067444. Date of Publication: 10 Jan 2023.
Author
Laghlam D.
Institution
(Laghlam) Research and Innovation Department, RICAP, CMC Ambroise Pare,
Neuilly-sur-Seine, France
Publisher
Frontiers Media S.A.
Abstract
Background: Takotsubo cardiomyopathy (TTC) is a rare entity after cardiac
surgery. <br/>Aim(s): To describe patients' profile who developed
postoperative TTC after cardiac surgery, management, and outcomes.
<br/>Method(s): We performed a systematic literature search to extract
cases of TTC after adult cardiac surgery (from 1990 to 2021).
Additionally, we extracted all cases of TTC in a prospective single-center
cohort database of 10,000+ patients (from 2007 to 2019). We then combined
all cases in a single cohort to describe its clinical features.
<br/>Result(s): From 694 screened articles, we retained 71 individual
cases published in 20 distinct articles (19 cases reports and 1
case-series). We combined these to 10 cases extracted from our cohort
[among 10,682 patients (0.09%)]. Overall, we included 81 cases. Patients
were aged 68 +/- 10 years-old and 64/81 (79%) were women. Surgery
procedures included mitral valve and/or tricuspid valve surgery in 70/81,
86%. TTC was diagnosed in the first days after surgery [median 4 (1-4)
days]. Incidence of cardiogenic shock, defined as requirement of
vasopressor and/or inotropic support was 24/29, 83% (data available on
29/81 patients). Refractory cardiogenic appeared in 5/81, 6% who required
implantation of arterio-venous extra-corporeal membrane oxygenation, and
6/81, 7%, intra-aortic balloon pump. In-hospital mortality was 5/81, 6%.
<br/>Conclusion(s): This systematic review, based on case reports and case
series, showed that postoperative TTC appears as a rare complication after
cardiac surgery and mainly occurred after mitral and/or tricuspid valve
repair procedures. In this population, TTC is associated with high rate of
cardiogenic shock.<br/>Copyright &#xa9; 2023 Laghlam, Touboul, Herry,
Estagnasie, Dib, Baccouche, Brusset, Nguyen and Squara.

<82>
Accession Number
2021223634
Title
Efficacy and safety of concomitant use of proton pump inhibitors with
aspirin-clopidogrel dual antiplatelet therapy in coronary heart disease: A
systematic review and meta-analysis.
Source
Frontiers in Pharmacology. 13 (no pagination), 2023. Article Number:
1021584. Date of Publication: 10 Jan 2023.
Author
Luo X.; Hou M.; He S.; Yang X.; Zhang P.; Zhao Y.; Xing H.
Institution
(Luo, Hou, He, Yang, Zhang, Zhao, Xing) Department of Pharmacy, Daping
Hospital, Army Medical University, Chongqing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Proton pump inhibitors (PPIs) are usually prescribed to
prevent gastrointestinal (GI) complications in patients receiving dual
antiplatelet therapy (DAPT). This systematic review and meta-analysis
aimed to explore the efficacy and safety of the concomitant use of PPIs
with aspirin-clopidogrel DAPT in patients with Coronary heart disease
(CHD). <br/>Method(s): The PubMed, Embase, Cochrane Library, and Web of
Science databases were searched from inception to August 2022 for eligible
studies. The adjusted hazard ratios (HRs) and 95% confidence intervals
(CIs) were calculated to evaluate the clinical outcomes. Subgroup analysis
was conducted according to different PPI subtypes, populations, follow-up
times and study types. This study was registered on PROSPERO
(CRD42022332195). <br/>Result(s): A total of 173,508 patients from 18
studies [2 randomized controlled trials (RCTs), 3 post hoc analyses of
RCTs, and 13 cohort studies] were included in this study. Pooled data
revealed that coadministration of PPIs significantly increased the risk of
major adverse cardiovascular events (MACEs) (HR = 1.15, 95% CI =
1.06-1.26, p =.001) and reduced the risk of gastrointestinal (GI)
complications (HR = 0.44, 95% CI = 0.30-0.64, p <.0001). Subgroup analysis
results showed that the esomeprazole users and patients with coronary
stenting in the PPI group were associated with an increased risk of MACEs
compared with the non-PPI group. The occurrence of MACEs in PPI users was
more common than that in non-PPI users in long-term follow-up (>=12
months) studies and in the observational studies. There was no significant
differences in the incidences of net clinical adverse events (NACEs),
all-cause mortality, or cardiac death between the two groups.
<br/>Conclusion(s): In patients with CHD, the concomitant use of PPIs with
aspirin and clopidogrel was associated with a reduced risk of GI
complications but could increase the rates of MACEs (particularly in
patients receiving esomeprazole or with coronary stenting). There was no
clear evidence of an association between PPI use and NACEs, all-cause
mortality, or cardiac death. The results could have been affected by the
follow-up time and study type. Further large-scale RCTs with long-term
follow-up are needed.<br/>Copyright &#xa9; 2023 Luo, Hou, He, Yang, Zhang,
Zhao and Xing.

<83>
Accession Number
2021216923
Title
Long-term follow-up of patients with chronic total coronary artery
occlusion previously randomized to treatment with optimal drug therapy or
percutaneous revascularization of chronic total occlusion (COMET-CTO).
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 1014664. Date of Publication: 09 Jan 2023.
Author
Juricic S.A.; Stojkovic S.M.; Galassi A.R.; Stankovic G.R.; Orlic D.N.;
Vukcevic V.D.; Milasinovic D.G.; Aleksandric S.B.; Tomasevic M.V.; Dobric
M.R.; Nedeljkovic M.A.; Beleslin B.D.; Dikic M.P.; Banovic M.D.; Ostojic
M.C.; Tesic M.B.
Institution
(Juricic, Stojkovic, Stankovic, Orlic, Vukcevic, Milasinovic, Aleksandric,
Tomasevic, Nedeljkovic, Beleslin, Dikic, Banovic, Tesic) Clinic for
Cardiology, University Clinical Center of Serbia, Belgrade, Serbia
(Stojkovic, Stankovic, Orlic, Vukcevic, Milasinovic, Aleksandric, Dobric,
Nedeljkovic, Beleslin, Banovic, Ostojic, Tesic) School of Medicine,
University of Belgrade, Belgrade, Serbia
(Galassi) Department of Health Promotion, Mother and Child Care, Internal
Medicine and Medical Specialties (ProMISE), University of Palermo,
Palermo, Italy
(Galassi) Royal Brompton & Harefield NHS Foundation Trust, London, United
Kingdom
(Stankovic, Ostojic) Serbian Academy of Sciences and Arts, Belgrade,
Serbia
(Tomasevic) Department of Internal Medicine, Faculty of Medical Sciences,
University of Kragujevac, Kragujevac, Serbia
(Dobric) Dedinje Cardiovascular Institute, Belgrade, Serbia
Publisher
Frontiers Media S.A.
Abstract
Background: The COMET-CTO trial was a randomized prospective study that
assessed long-term follow-up in patients with chronic total occlusion
(CTO) in coronary arteries treated with percutaneous coronary intervention
(PCI) or with optimal medical therapy (OMT). During the 9-month follow-up,
the incidence of major adverse cardiac events (MACE) did not differ
between the two groups; no death or myocardial infarction (MI) was
observed. There was a significant difference in quality of life (QoL),
assessed by the Seattle Angina Questionnaire (SAQ), in favor of the PCI
group. Here we report long-term follow-up results (56 +/- 12 months).
<br/>Method(s): Between October 2015 and May 2017, a total of 100 patients
with CTO were randomized into two groups of 50 patients: PCI CTO or OMT
group. The primary endpoint of the current study was the incidence of MACE
defined as cardiac death, MI, and revascularization [PCI or coronary
artery bypass graft (CABG)]. As the secondary exploratory outcome, we
analyzed all the cause-mortality rate. <br/>Result(s): Out of 100
randomized patients, 92 were available for long-term follow-up (44 in the
PCI group and 48 in the OMT group). The incidence of MACE did not differ
significantly between the two groups (p = 0.363). Individual components of
MACE were distributed, respectively: cardiac death (OMT vs. PCI group, 6
vs. 3, p = 0.489), MI (OMT vs. PCI group, 1 vs. 0, p = 1), and
revascularization (PCI: OMT vs. PCI group, 2 vs. 2, p = 1; CABG: OMT vs.
PCI group, 1 vs. 1, p = 1). There was no significant difference between
the two groups regarding the individual component of MACE. Six patients
died from non-cardiac causes [five deaths were reported in the OMT group
and one death in the PCI group (p = 0.206)]. Kaplan-Meier survival curves
for MACE did not differ significantly between the study groups (log-rank
0.804, p = 0.370). Regarding the secondary exploratory outcome, a total of
15 patients died at 56 +/- 12 months (11 in the OMT and 4 in the PCI
group) (p = 0.093). The Kaplan-Meier survival curves for all-cause
mortality rates did not differ significantly between the two groups (log
rank 3.404, p = 0.065). There were no statistically significant
differences between OMT and PCI groups in all five SAQ domains. There was
a significant improvement in three SAQ domains in the PCI group: PL (p <
0.001), AF (p = 0.007), and QoL (p = 0.001). <br/>Conclusion(s): After 56
+/- 12 months of follow-up, the incidence of MACE, as well as QoL measured
by SAQ, did not differ significantly between the PCI and OMT
groups.<br/>Copyright &#xa9; 2023 Juricic, Stojkovic, Galassi, Stankovic,
Orlic, Vukcevic, Milasinovic, Aleksandric, Tomasevic, Dobric, Nedeljkovic,
Beleslin, Dikic, Banovic, Ostojic and Tesic.

<84>
Accession Number
2021191505
Title
Comparison of Safety and Effectiveness of Local or General Anesthesia
after Transcatheter Aortic Valve Implantation: A Systematic Review and
Meta-Analysis.
Source
Journal of Clinical Medicine. 12(2) (no pagination), 2023. Article Number:
508. Date of Publication: January 2023.
Author
Wang L.; Liu Y.; Gao H.; Zhang B.; Zhou S.; Xie M.; Sun X.
Institution
(Wang, Liu, Gao, Zhang, Zhou, Xie, Sun) Aortic and Vascular Surgery
Center, Fuwai Hospital, National Center for Cardiovascular Diseases,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing 100037, China
Publisher
MDPI
Abstract
It remains controversial to choose anesthesia for transcatheter aortic
valve implantation (TAVI). A meta-analysis of cohort studies was conducted
to assess the efficacy and safety of local anesthesia (LA) compared to
general anesthesia (GA) in TAVI. All relevant studies published from 1
January 2002, to 31 June 2022, were searched in Ovid, PubMed, Embase, Web
of Science, and Cochrane Library. A total of 34 studies involving 23,480
patients were included in the meta-analysis. TAVI with LA was associated
with a significant reduction in hospital stay [WMD = -2.48, 95% CI (-2.80,
-2.16), p < 0.00001], operative [WMD = -12.25, 95% CI (-13.73, -10.78), p
< 0.00001] and fluoroscopy time [WMD = -3.30, 95% CI (-5.40, -1.19), p =
0.002], and an increased risk of acute kidney injury [OR = 1.31, 95% CI
(1.01, 1.69), p = 0.04] and a reduced incidence of major bleeding [OR =
0.59, 95% CI (0.46, 0.75), p < 0.0001] and the use of cardiovascular drugs
[OR = 0.17, 95% CI (0.05, 0.57), p = 0.004]. No differences were found
between LA and GA for 30-day mortality, procedural success rate,
myocardial infarction, permanent pacemaker implantation, paravalvular
leak, shock, and cerebrovascular events. Overall, 4.4% of LA converted to
GA. Based on current evidence, our results suggested that LA strategies
reduced hospital stay, operative time, fluoroscopy time, cardiovascular
drug consumption, and major bleeding rates in patients undergoing TAVI but
led to increased acute kidney injury rates. Further studies and randomized
trials are required to verify the presented findings and to identify
patients who might benefit from LA.<br/>Copyright &#xa9; 2023 by the
authors.

<85>
Accession Number
2021190849
Title
Redo Surgical Aortic Valve Replacement versus Valve-In-Valve Transcatheter
Aortic Valve Implantation: A Systematic Review and Reconstructed
Time-To-Event Meta-Analysis.
Source
Journal of Clinical Medicine. 12(2) (no pagination), 2023. Article Number:
541. Date of Publication: January 2023.
Author
Formica F.; Gallingani A.; Tuttolomondo D.; Hernandez-Vaquero D.;
D'Alessandro S.; Pattuzzi C.; Celik M.; Singh G.; Ceccato E.; Niccoli G.;
Lorusso R.; Nicolini F.
Institution
(Formica, Pattuzzi, Ceccato, Niccoli, Nicolini) Department of Medicine and
Surgery, University of Parma, Parma 43124, Italy
(Gallingani, Pattuzzi, Nicolini) Cardiac Surgery Clinic, University
Hospital of Parma, Via Gramsci 14, Parma 43125, Italy
(Tuttolomondo, Niccoli) Cardiology Unit, University Hospital of Parma, Via
Gramsci 14, Parma 43125, Italy
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo 33004, Spain
(D'Alessandro) Cardiac Surgery Unit, San Giovanni Bosco Hospital, Turin
10144, Italy
(Celik) Department of Cardiothoracic Surgery, Erasmus University Medical
Center, Rotterdam 3062, Netherlands
(Singh) Division of Cardiac Surgery, Department of Critical Care Medicine,
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB
11220, Canada
(Ceccato) Medical Library, University of Parma, Parma 43124, Italy
(Lorusso) Cardiovascular Research Institute Maastricht (CARIM), Maastricht
6200, Netherlands
Publisher
MDPI
Abstract
Objective. Valve-in-valve transcatheter aortic valve implantation
(ViV-TAVI) has emerged as a useful alternative intervention to
redo-surgical aortic valve replacement (Redo-SVAR) for the treatment of
degenerated bioprosthesis valve. However, there is no robust evidence
about the long-term outcome of both treatments. The aim of this
meta-analysis was to analyze the long-term outcomes of Redo-SVAR versus
ViV-TAVI by reconstructing the time-to-event data. Methods. The search
strategy consisted of a comprehensive review of relevant studies published
between 1 January 2000 and 30 September 2022 in three electronic
databases, PubMed, Cochrane Central Register of Controlled Trials
(CENTRAL) and EMBASE. Relevant studies were retrieved for the analysis.
The primary endpoint was the long-term mortality for all death. The
comparisons were made by the Cox regression model and by landmark analysis
and a fully parametric model. A random-effect method was applied to
perform the meta-analysis. Results. Twelve studies fulfilled the
eligibility criteria and were included in the final analysis. A total of
3547 patients were included. Redo-SAVR group included 1783 patients, and
ViV-TAVI included 1764 subjects. Redo-SAVR showed a higher incidence of
all-cause mortality within 30-days [Hazard ratio (HR) 2.12; 95% CI =
1.49-3.03; p < 0.0001)], whereas no difference was observed between 30
days and 1 year (HR = 1.03; 95% CI = 0.78-1.33; p = 0.92). From one year,
Redo-SAVR showed a longer benefit (HR = 0.52; 95% CI = 0.40-0.67; p <
0.0001). These results were confirmed for cardiovascular death (HR = 2.04;
95% CI = 1.29-3.22; p = 0.001 within one month from intervention; HR =
0.35; 95% CI = 0.18-0.71; p = 0.003 at 4-years follow-up). Conclusions.
Although the long-term outcomes seem similar between Redo-SAVR and
ViV-TAVI at a five-year follow-up, ViV-TAVI shows significative lower
mortality within 30 days. This advantage disappeared between 30 days and 1
year and reversed in favor of redo-SAVR 1 year after the
intervention.<br/>Copyright &#xa9; 2023 by the authors.

<86>
Accession Number
2021190830
Title
Are Viscoelastometric Assays of Old Generation Ready for Disposal? Comment
on Volod et al. Viscoelastic Hemostatic Assays: A Primer on Legacy and New
Generation Devices. J. Clin. Med. 2022, 11, 860.
Source
Journal of Clinical Medicine. 12(2) (no pagination), 2023. Article Number:
477. Date of Publication: January 2023.
Author
Bareille M.; Lecompte T.; Mullier F.; Roullet S.
Institution
(Bareille, Mullier) CHU UCL Namur, Namur Thrombosis and Hemostasis Center
(NTHC), Universite Catholique de Louvain, Yvoir 5530, Belgium
(Lecompte) Pharmacy Department, University of Namur, Namur 5000, Belgium
(Lecompte) Universite de Lorraine, Nancy 54000, France
(Roullet) Laboratory for Hemostasis, Inflammation Thrombosis (HITh), Unite
Mixte de Recherche (UMR)-1176, Institut National de la Sante et de la
Recherche Medicale (Inserm), Universite Paris-Saclay, Le Kremlin-Bicetre
94270, France
Publisher
MDPI
Abstract
With the advent of new viscoelastometric hemostatic assay (VHA) devices,
with ready-to-use cartridge reagents allowing for their use by people
without special laboratory skills, the appreciation of the actual clinical
value of VHAs in settings such as severe trauma, post-partum hemorrhage,
cardiac surgery and liver transplantation still needs to be fully
validated. While two of the newest versions remain based on a 'cup and
pin' system (ROTEM sigma, ClotPro), two other new
devices (TEG 6s, Quantra) rely on very different
technologies: clotting blood is no longer in contact with the probe and
challenged by oscillation of one of the components but explored with
ultrasound exposure. A systematic literature search (including
Sonoclot) retrieved 20 observational studies (19 prospective).
Most studies pointed to imperfect agreements, highlighting the
non-interchangeability of devices. Only a few studies, often with a
limited number of patients enrolled, used a clinical outcome. No study
compared VHA results with conventional laboratory assays obtained through
a rapid tests panel. Clinical evidence of the utility of the new VHAs
largely remains to be proven through randomized clinical trials, with
clinically relevant outcomes, and compared to rapid panel hemostasis
testing. The availability of new, improved VHA devices provides an impetus
and an opportunity to do so.<br/>Copyright &#xa9; 2023 by the authors.

<87>
Accession Number
2021133322
Title
The feasibility and safety of combining atrial septal defect/patent
foramen ovale and left atrial appendage closure: A systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 1080257. Date of Publication: 06 Jan 2023.
Author
Song Y.; Xing H.; Koch P.D.; Li X.; Zhang Y.
Institution
(Song, Zhang) Department of Ultrasound, The First Affiliated Hospital of
Zhengzhou University, Henan, Zhengzhou, China
(Xing) Department of Surgery, Rhode Island Hospital, Warren Alpert Medical
School of Brown University, Providence, RI, United States
(Koch) Center for Systems Biology, Massachusetts General Hospital, Boston,
MA, United States
(Li) Division of Cardiology, Department of Medicine, Cardiovascular
Research Center, Rhode Island Hospital, Warren Alpert Medical School of
Brown University, Providence, RI, United States
Publisher
Frontiers Media S.A.
Abstract
Introduction: Atrial Septal Defect/Patent Foramen Ovale (ASD/PFO)
occlusion is performed to prevent paradoxical embolism and reduce the risk
of recurrent ischemic stroke. Left atrial appendage (LAA) closure is used
as an alternative to medical therapy of non-valvular atrial fibrillation
for prevention of stroke. Multiple studies have examined performing LAA
and ASD/PFO occlusion. However, the feasibility and safety of combined
occlusion of the left atrial appendage and ASD/PFO are not clear,
furthermore, these studies are limited by their small sample sizes and
retrospective analysis. In this study, we aimed to systematically review
and meta-analyze the feasibility and safety of combining left atrial
appendage and ASD/PFO closure. <br/>Method(s): PubMed, Web of Science,
CNKI, Cochrane Library, Embase, and WanFang database were searched up to
April 2022 to identify peer-reviewed human studies on assessing the
feasibility, safety, and efficacy of combining left atrial appendage and
ASD/PFO closure. The primary outcome was calculated: procedural
feasibility outcome and procedural safety outcome. <br/>Result(s): A total
of 10 articles, including 340 patients from multiple countries, were
included in the analysis. The principal findings of our study are:
compared with single LAA closure, (i) combining PFO/ASD occlusion and LAA
closure had similar procedural success proportion (98.43%, 95% CI:
96.67-100.00%), (ii) similar safety event incidences developed (1.67%, 95%
CI: 0.24-3.92%), subgroup analyzed safety event incidences in death was
0.00 (95% CI: 0.00-0.33%), cardiac tamponade was 0.87% (95% CI:
0.00-2.77%), device embolization was 0.00 (95% CI: 0.00-0.60%), major
bleeding was 0.00 (95% CI: 0.00-0.33%), stroke was 0.00 (95% CI:
0.00-0.02%). <br/>Conclusion(s): Although this systematic review and
meta-analysis demonstrate the technical feasibility and safety of
combining closure of PFO/ASD and LAA, further studies of sufficient sample
size, long-term follow-up, and rigor endpoint criteria are yet needed to
fully evaluate this combination procedure for its role in clinical
outcomes.<br/>Copyright &#xa9; 2023 Song, Xing, Koch, Li and Zhang.

<88>
Accession Number
640119021
Title
The Role of Insulin-Like Growth Factor 1 in Delirium: A Systematic Review
and Meta-Analysis.
Source
Dementia and geriatric cognitive disorders. (pp 1-11), 2023. Date of
Publication: 23 Jan 2023.
Author
Adamis D.; Eikelenboom P.
Institution
(Adamis) Sligo Mental Health Services, Sligo, Ireland
(Eikelenboom) GGZinGeest, Amsterdam, Netherlands
(Eikelenboom) Department of Neurology, Academic Medical Center, Amsterdam,
Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: The relationship between delirium and low levels of
insulin-like growth factor 1 (IGF-1) is contradictory and uncertain. We
hypothesised that low levels of IGF-1 are a predisposing factor for
delirium in medical and abdominal surgical cohorts, in contrast to other
surgical cohorts. AIMS: Systematic review and meta-analysis investigating
the association between peripheral levels of IGF-1 and delirium in medical
and surgical patients to explore if there are distinct patterns of
associations by using subgroup meta-analysis. <br/>METHOD(S): PubMed,
Scopus, CINAHL, Cochrane, and Embase databases were searched. Inclusion
criteria were prospective studies in medical and surgical populations and
available data. The following were collected: the setting
(surgical/medical), the type (orthopaedic surgery, abdominal,
cardiovascular, or medical), the number of participants, mean age, the
number of delirious patients, scale/criteria for delirium, IGF-1 levels,
and MMSE. <br/>RESULT(S): Thirteen studies were included and analysed. Low
levels of IGF-1 are significantly associated with delirium in abdominal
surgical samples and medical samples but not in the other surgical
samples. Age, cognition, and the setting (medical vs. surgical) do not
have any significant effect on the differences in IGF-1 levels between
those with and without delirium. DISCUSSION: Delirium in acute medical and
abdominal surgery is triggered by low IGF-1 which may reflect chronic
conditions like frailty/cachexia/sarcopenia, while in other surgeries
perhaps from an inflammatory process. <br/>CONCLUSION(S): Low peripheral
levels of IGF-1 are a predisposing factor for delirium only in acute
medical and abdominal surgery. More studies are needed to confirm and to
explore further this finding.<br/>Copyright &#xa9; 2023 S. Karger AG,
Basel.

<89>
Accession Number
640118757
Title
Transfusion trigger after operations in high cardiac risk patients (TOP)
trial protocol. Protocol for a multicenter randomized controlled
transfusion strategy trial.
Source
Contemporary clinical trials. (pp 107095), 2023. Date of Publication: 20
Jan 2023.
Author
Kougias P.; Mi Z.; Zhan M.; Carson J.L.; Dosluoglu H.; Nelson P.; Sarosi
G.A.; Sm S.A.M.D.; Norman L.E.; Sharath S.; Scrymgeour A.; Ollison J.;
Calais L.A.; Biswas K.
Institution
(Kougias, Sharath, Ollison) Department of Surgery, State University of New
York (SUNY) Downstate Health Sciences University, VA New York Harbor
Healthcare System, Brooklyn, NY 11203, United States of America
(Mi, Zhan, Norman, Biswas) VA Cooperative Studies Program Coordinating
Center, Perry Point, MD, United States
(Carson) Division of General Internal Medicine, Department of Medicine,
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United
States of America
(Dosluoglu) Division of Vascular Surgery, Department of Surgery, SUNY at
Buffalo/VA Western NY Healthcare System, Buffalo, NY, United States
(Nelson) Division of Vascular Surgery, Department of Surgery, University
of Oklahoma School of Community Medicine, Tulsa, OK, United States
(Sarosi) University of Florida College of Medicine, General Surgery
Section, Department of Surgery, Malcolm Randall Veterans Affairs Medical
Center, Gainesville, FL, United States
(Sm) Division of Vascular Surgery, Department of Surgery, Stanford
University School of Medicine, Vascular Section, Surgery Service Line,
Palo Alto Veterans Affairs Medical Center, Palo Alto, CA, United States
(Scrymgeour) Cooperative Studies Program Clinical Research Pharmacy
Coordinating Center, Albuquerque, NM, United States
(Calais) Cooperative Studies Program Site Monitoring, Resource Team
(SMART), Albuquerque, NM, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: There is substantial uncertainty regarding the effects of
restrictive postoperative transfusion among patients who have underlying
cardiovascular disease. The TOP Trial's objective is to compare adverse
outcomes between liberal and restrictive transfusion strategies in
patients undergoing vascular and general surgery operations, and with a
high risk of postoperative cardiac events. <br/>METHOD(S): A two-arm,
single-blinded, randomized controlled superiority trial will be used
across 15 Veterans Affairs hospitals with expected enrollment of 1520
participants. Postoperative transfusions in the liberal arm commence when
Hb is <10g/ dL and continue until Hb is greater than or equal to 10g/dL.
In the restrictive arm, transfusions begin when Hb is <7g/dL and continue
until Hb is greater than or equal to 7g/dL. Study duration is estimated to
be 5years including a 3-month start-up period and 4years of recruitment.
Each randomized participant will be followed for 90days after
randomization with a mortality assessment at 1year. <br/>RESULT(S): The
primary outcome is a composite endpoint of all-cause mortality, myocardial
infarction (MI), coronary revascularization, acute renal failure, or
stroke occurring up to 90-days after randomization. Events rates will be
compared between restrictive and liberal transfusion groups.
<br/>CONCLUSION(S): The TOP Trial is uniquely positioned to provide high
quality evidence comparing transfusion strategies among patients with high
cardiac risk. Results will clarify the effect of postoperative transfusion
strategies on adverse outcomes and inform postoperative management
algorithms. TRIAL REGISTRATION: clinicaltrials.gov identifier:
NCT03229941.<br/>Copyright &#xa9; 2023. Published by Elsevier Inc.

<90>
Accession Number
2022297808
Title
Effect of Decompressive Craniectomy with stepwise Decompression of the
Intracranial Compartment on Postoperative Neurologic Function,
Hemodynamics, and Glasgow Outcome Scale Score of Patients with Severe
Traumatic Brain Injury.
Source
Journal of Neurological Surgery, Part A: Central European Neurosurgery.
(no pagination), 2022. Date of Publication: 2022.
Author
Wu H.; Jiang B.; Yan X.; Zhan C.; Dai W.; Yu G.
Institution
(Wu, Jiang, Yan, Zhan, Dai, Yu) Department of Neurosurgery, The Quzhou
Affiliated Hospital of Wenzhou Medical University, Quzhou People's
Hospital, Zhejiang Province, Quzhou, China
Publisher
Georg Thieme Verlag
Abstract
Background We assess the effects of standard decompressive craniectomy
with stepwise decompression of the intracranial compartment on the
postoperative neurologic function, hemodynamics, and Glasgow Outcome Scale
(GOS) score of patients with severe traumatic brain injury (sTBI). Methods
One hundred sTBI patients admitted from July 2017 to February 2019 were
enrolled and randomly divided into step and standard groups (n = 50) using
a random number table. The standard group received traditional standard
decompression during surgery, while the step group underwent multistep
decompression during surgery. Heart rate (HR), systolic blood pressure
(SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP)
were measured immediately after surgery (T0), 3 hours after surgery (T1),
6 hours after surgery (T2), and 12 hours after surgery (T3). The
postoperative Glasgow Coma Scale (GCS) score, neurologic function deficit
score, and GOS score were evaluated. Results After treatment, the
excellent/good rate of neurologic function improvement and GCS and GOS
scores of the step group significantly exceeded those of the standard
group (p < 0.05). Compared with the standard group, the HR, SBP, DBP, and
MAP decreased significantly in the step group at T1, T2, and T3 (p <
0.05). Conclusion Standard decompressive craniectomy under multistep
decompression can markedly improve the neurologic function, hemodynamics,
and prognosis of patients.<br/>Copyright &#xa9; 2022 Georg Thieme Verlag.
All rights reserved.

<91>
Accession Number
2021592221
Title
Immediate, medium- and long-term outcomes of percutaneous coronary
intervention with very long drug eluting stent : An observational
multicentric study.
Source
Annales de Cardiologie et d'Angeiologie. (no pagination), 2022. Date of
Publication: 2022.
Author
Hammami R.; Boughariou A.; Jdidi J.; Cheikhrouhou A.; Abdelmoula Y.;
Thabet H.; Gribaa R.; Kacem M.; Mrad I.B.; Belkahla N.; Abdessalem A.B.;
Ameur Z.B.; Hejri E.; Kraiem S.; Naffeti I.; Abid L.
Institution
(Hammami, Boughariou, Cheikhrouhou, Abdelmoula, Abid) Service de
Cardiologie de Sfax, Hopital Hedi Chaker Sfax, Faculte de medecine de
Sfax, Universite de Sfax 3029, Tunisia
(Jdidi) Service de Medecine preventive, Faculte de medecine de Sfax,
Universite de Sfax, Tunisia
(Thabet, Gribaa, Kacem, Naffeti) Service de Cardiologie, Hopital Sahloul,
Sousse, Tunisia
(Mrad, Belkahla, Kraiem) Service de Cardiologie, Hopital Habib Thameur,
Tunis, Tunisia
(Abdessalem, Ameur, Hejri) Service de Cardiologie, Hopital Farhat Hached,
Sousse, Tunisia
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: Very long coronary lesions account for 20% of coronary
stenoses in the real world. There are few data on the effectiveness of
angioplasty of these lesions with very long active stents (DES) in the
literature. We conducted this study to assess the long-term outcomes of
angioplasty with DES length >= 40 mm in a population with multiple
cardiovascular risk factors. <br/>Patients and Methods: This is a
retrospective, multicenter, descriptive, and prognostic study, conducted
between January 2015 and January 2020, in four Tunisian centers, including
all patients who underwent angioplasty with a DES of length >= 40 mm with
a follow-up of at least one year. The primary outcome was a combined
criteria (major cardiovascular and Cerebral events: MACCE) (stroke, acute
coronary syndrome, revascularization of the target lesion: TLR,
cardiovascular death: CVD). <br/>Result(s): We included 480 procedures.
More than half of the patients had at least three risk factors. The
prevalence of high blood pressure, diabetes and smoking were 61.1%, 56.6%
and 60.4%, respectively. The treated lesions were complex: 23.54%
calcified lesions, 8.75% chronic occlusions, 25% bifurcation lesions and
12.08% ostial lesions. The average length of the stents was 47.72 mm. We
noted 17 cases of per-procedural complications (3.55%). The median
follow-up was 35 months (extremes 1-60 months). The rate of stent
thrombosis was 0.83%. The incidence of MACCE, TLR and CVD were
respectively 16.25%, 8.12% and 5.2%. In multivariate analysis, diabetes
(HR = 1.7, 95% CI [1.01-2.9]), dyslipidemia (HR = 2.08, 95% CI [1.3-3.3]),
familial coronary artery disease (HR = 1.9, 95% CI [1.01-3.6]), left
ventricle dysfunction (HR = 2.07, 95% CI [1.1-3.6]) and bifurcation
lesions (HR = 1.9, 95% CI [1.2-3.14]) were the independent predictors of
MACCE, while statin intake (HR = 0.38, 95% CI [0.19-0.78]) was a
protective factor. <br/>Conclusion(s): Angioplasty with very long DES is
associated with low levels of MACCE, TLR, stent thrombosis and CVD in our
population. Therefore, it could be an interesting alternative to cardiac
surgery. Randomized comparative studies of the two treatment options are
needed.<br/>Copyright &#xa9; 2022

<92>
[Use Link to view the full text]
Accession Number
2022217289
Title
Sodium Restriction in Patients With Heart Failure: A Systematic Review and
Meta-Analysis of Randomized Clinical Trials.
Source
Circulation: Heart Failure. 16(1) (pp e009879), 2023. Date of Publication:
01 Jan 2023.
Author
Colin-Ramirez E.; Sepehrvand N.; Rathwell S.; Ross H.; Escobedo J.;
MacDonald P.; Troughton R.; Saldarriaga C.; Lanas F.; Doughty R.;
McAlister F.A.; Ezekowitz J.A.
Institution
(Colin-Ramirez) Universidad Anahuac Mexico, Huixquilucan, Mexico
(Sepehrvand, Rathwell, Escobedo, McAlister) Canadian Vigour Centre,
Department of Medicine, University of Alberta, Edmonton, Canada
(McAlister) Division of General Internal Medicine, Department of Medicine,
University of Alberta, Edmonton, Canada
(Ezekowitz) Division of Cardiology, Department of Medicine, University of
Alberta, Edmonton, Canada
(Ross) Division of Cardiology, Peter Munk Cardiac Center, University of
Toronto, ON, Canada
(Ezekowitz) Instituto Mexicano Del Seguro Social, Mexico City, Mexico
(MacDonald) Heart Failure and Transplant Unit, Cardiology Department, St.
Vincent's Hospital, Darlinghurst, Sydney, NSW, Australia
(Troughton) Department of Medicine, Christchurch Heart Institute,
University of Otago, New Zealand
(Saldarriaga) Centro Cardiovascular Colombiano Clinica Santa Maria,
Clinica Cardio Vid, Antioquia, Colombia
(Lanas) Departamento de Medicina Interna, Facultad de Medicina,
Universidad de la Frontera Temuco, Chile
(Doughty) Auckland UniServices, New Zealand
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Sodium restriction is a nonpharmacologic treatment suggested
by practice guidelines for the management of patients with heart failure
(HF). In this study, we synthesized the data from randomized controlled
trials (RCTs) evaluating the effects of sodium restriction on clinical
outcomes in patients with HF. <br/>Method(s): In this aggregate data
meta-analysis, Cochrane Central, MEDLINE (Medical Literature Analysis and
Retrieval System Online), Embase Ovid, and CINAHL (Cumulative Index to
Nursing and Allied Health Literature) Plus databases were searched up to
April 2, 2022. RCTs were included if they investigated the effects of
sodium/salt restriction as compared to no restriction on clinical outcomes
in patients with HF. Outcomes of interest included mortality,
hospitalization, change in New York Heart Association functional class,
and quality of life (QoL). <br/>Result(s): Seventeen RCTs were identified
(834 and 871 patients in intervention and control groups, respectively).
Sodium restriction did not reduce the risk of all-cause death (odds ratio,
0.95 [95% CI, 0.58-1.58]), hospitalization (odds ratio, 0.84 [95% CI,
0.62-1.13]), or the composite of death/hospitalization (odds ratio, 0.88
[95% CI, 0.63-1.23]). The results were similar in different subgroups,
except for the numerically lower risk of death with reduced sodium intake
reported in RCTs with dietary sodium at the 2000 to 3000 mg/d range as
opposed to <2000 mg/d (and in RCTs with versus without fluid restriction
as a co-intervention). Among RCTs reporting New York Heart Association
change, 2 RCTs (which accounted for two-thirds of the data) showed
improvement in New York Heart Association class with sodium restriction.
Substantial heterogeneity existed for QoL: 6 RCTs showed improvement of
QoL and 4 RCTs showed no improvement of sodium restriction on QoL.
<br/>Conclusion(s): In a meta-analysis of RCTs, sodium restriction was not
associated with fewer deaths or hospitalizations in patients with HF.
Dietary sodium restriction may be associated with improvements in symptoms
and QoL.<br/>Copyright &#xa9; 2022 American Heart Association, Inc.

<93>
Accession Number
2019160869
Title
Perioperative risk factors associated with increased incidence of
postoperative delirium: systematic review, meta-analysis, and Grading of
Recommendations Assessment, Development, and Evaluation system report of
clinical literature.
Source
British Journal of Anaesthesia. 130(2) (pp e254-e262), 2023. Date of
Publication: February 2023.
Author
Mevorach L.; Forookhi A.; Farcomeni A.; Romagnoli S.; Bilotta F.
Institution
(Mevorach, Forookhi, Bilotta) Department of Anaesthesiology, Critical Care
and Pain Medicine, Policlinico Umberto I Teaching Hospital, Sapienza
University of Rome, Rome, Italy
(Farcomeni) Department of Economics and Finance, Tor Vergata, University
of Rome, Rome, Italy
(Romagnoli) Department of Anaesthesia and Critical Care, Careggi
University Hospital, Florence, Italy
Publisher
Elsevier Ltd
Abstract
Background: Systematic reviews to date have neglected to exclusively
include studies using a validated diagnostic scale for postoperative
delirium and monitoring patients for more than 24 h. Evidence on current
risk factors is evolving with significantly heterogeneous study designs,
inconsistent reporting of results, and a lack of adjustment for bias.
<br/>Method(s): This systematic review and meta-analysis aimed to identify
risk factors for postoperative delirium in an adult patient population.
Study designs suitable for this review included full-text articles, RCTs,
observational studies, cohort studies, and case-control studies. Extracted
variables from the 169 (7.4%) selected studies were included in
qualitative synthesis, quantitative synthesis, and a postoperative
delirium checklist. The 16 variables included in the checklist were
selected based on consistency, direction of effect, number of studies, and
clinical utility as a reference for future studies. <br/>Result(s): A
total of 576 variables were extracted, but only six were eligible for
meta-analysis. Age (mean difference [MD]=4.94; 95% confidence interval
[CI], 2.93-6.94; P<0.001), American Society of Anesthesiologists physical
status >2 (odds ratio [OR]=2.27; 95% CI, 1.47-3.52; P<0.001), Charlson
Comorbidity Index >=2 (OR=1.9; 95% CI, 1.11-3.25; P=0.0202), and
Mini-Mental State Examination (MD=-1.94; 95% CI, -3.6 to -0.27; P=0.0224)
were statistically significant. <br/>Conclusion(s): Risk factors can
assist in clinical decision-making and identification of high-risk
patients. Literature analysis identified inconsistent methodology, leading
to challenges in interpretation. A standardised format and evidence-based
approach should guide future studies.<br/>Copyright &#xa9; 2022 British
Journal of Anaesthesia

<94>
Accession Number
2015259011
Title
Reported definitions of intraoperative hypotension in adults undergoing
non-cardiac surgery under general anaesthesia: a review.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 69. Date
of Publication: December 2022.
Author
Weinberg L.; Li S.Y.; Louis M.; Karp J.; Poci N.; Carp B.S.; Miles L.F.;
Tully P.; Hahn R.; Karalapillai D.; Lee D.-K.
Institution
(Weinberg, Li, Louis, Karp, Poci, Carp, Miles, Tully, Karalapillai)
Department of Anaesthesia, Austin Hospital, Austin Health, 145 Studley
Road, Heidelberg, Melbourne, VIC 3084, Australia
(Weinberg, Miles, Karalapillai) Department of Critical Care, The
University of Melbourne, Melbourne, Australia
(Weinberg) Department of Surgery, Austin Health, The University of
Melbourne, Melbourne, Australia
(Hahn) Karolinska Institute at Danderyd's Hospital (KIDS), Stockholm,
Sweden
(Hahn) Department of Research, Sodertalje Hospital, Sodertalje, Sweden
(Lee) Department of Anesthesiology and Pain Medicine, Dongguk University
Ilsan Hospital, Goyang, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: Intraoperative hypotension (IOH) during non-cardiac surgery is
common and associated with major adverse kidney, neurological and cardiac
events and even death. Given that IOH is a modifiable risk factor for the
mitigation of postoperative complications, it is imperative to generate a
precise definition for IOH to facilitate strategies for avoiding or
treating its occurrence. Moreover, a universal and consensus definition of
IOH may also facilitate the application of novel and emerging therapeutic
interventions in treating IOH. We conducted a review to systematically
record the reported definitions of intraoperative hypotension in adults
undergoing non-cardiac surgery under general anaesthesia. <br/>Method(s):
In accordance with Cochrane guidelines, we searched three online databases
(OVID [Medline], Embase and Cochrane Library) for all studies published
from 1 January 2000 to 6 September 2020. We evaluated the number of
studies that reported the absolute or relative threshold values for
defining blood pressure. Secondary aims included evaluation of the
threshold values for defining IOH, the methodology for accounting for the
severity of hypotension, whether the type of surgical procedure influenced
the definition of IOH, and whether a study whose definition of IOH aligned
with the Perioperative Quality Initiative-3 workgroup (POQI) consensus
statement for defining was more likely to be associated with determining
an adverse postoperative outcome. <br/>Result(s): A total of 318 studies
were included in the final qualitative synthesis. Most studies (n = 249;
78.3%) used an absolute threshold to define hypotension; 150 (60.5%)
reported SBP, 117 (47.2%) reported MAP, and 12 (4.8%) reported diastolic
blood pressure (DBP). 126 (39.6%) used a relative threshold to define
hypotension. Of the included studies, 153 (48.1%) did not include any
duration variable in their definition of hypotension. Among the selected
318 studies 148 (46.5%) studies defined IOH according to the POQI
statement. When studies used a "relative blood pressure change" to define
IOH, there was a weaker association in detecting adverse postoperative
outcomes compared to studies who reported "absolute blood pressure change"
(chi²(2) = 10.508, P = 0.005, Cramer's V = 0.182). When studies
used the POQI statement definition of hypotension or defined IOH by values
higher than the POQI statement definition there were statistical
differences observed between IOH and adverse postoperative outcomes
(chi²(1) = 6.581, P = 0.037, Cramer's V = 0.144). When both the
duration of IOH or the numbers of hypotensive epochs were evaluated, we
observed a significantly stronger relationship between the definition of
IOH use the development of adverse postoperative outcomes.
(chi²(1) = 4.860, P = 0.027, Cramer's V = 0.124).
<br/>Conclusion(s): Most studies defined IOH by absolute or relative
changes from baseline values. There are substantial inconsistencies in how
IOH was reported. Further, definitions differed across different surgical
specialities. Our findings further suggest that IOH should be defined
using the absolute values stated in the POQI statement i.e., MAP < 60-70
mmHg or SBP < 100 mmHg. Finally, the number of hypotensive epochs or
time-weighted duration of IOH should also be reported.<br/>Copyright
&#xa9; 2022, The Author(s).

<95>
Accession Number
2011635993
Title
Three-Dimensional Printed Anatomic Models Derived From Magnetic Resonance
Imaging Data: Current State and Image Acquisition Recommendations for
Appropriate Clinical Scenarios.
Source
Journal of Magnetic Resonance Imaging. 55(4) (pp 1060-1081), 2022. Date of
Publication: April 2022.
Author
Talanki V.R.; Peng Q.; Shamir S.B.; Baete S.H.; Duong T.Q.; Wake N.
Institution
(Talanki, Peng, Shamir, Duong, Wake) Department of Radiology, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, NY, United
States
(Baete, Wake) Center for Advanced Imaging Innovation and Research (CAI2R)
and Bernard and Irene Schwartz Center for Biomedical Imaging, Department
of Radiology, NYU Langone Health, NYU Grossman School of Medicine, New
York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Three-dimensional (3D) printing technologies have been increasingly
utilized in medicine over the past several years and can greatly
facilitate surgical planning thereby improving patient outcomes. Although
still much less utilized compared to computed tomography (CT), magnetic
resonance imaging (MRI) is gaining traction in medical 3D printing. The
purpose of this study was two-fold: 1) to determine the prevalence in the
existing literature of using MRI to create 3D printed anatomic models for
surgical planning and 2) to provide image acquisition recommendations for
appropriate clinical scenarios where MRI is the most suitable imaging
modality. The workflow for creating 3D printed anatomic models from
medical imaging data is complex and involves image segmentation of the
regions of interest and conversion of that data into 3D surface meshes,
which are compatible with printing technologies. CT is most commonly used
to create 3D printed anatomic models due to the high image quality and
relative ease of performing image segmentation from CT data. As compared
to CT datasets, 3D printing using MRI data offers advantages since it
provides exquisite soft tissue contrast needed for accurate organ
segmentation and it does not expose patients to unnecessary ionizing
radiation. MRI, however, often requires complicated imaging techniques and
time-consuming postprocessing procedures to generate high-resolution 3D
anatomic models needed for 3D printing. Despite these challenges, 3D
modeling and printing from MRI data holds great clinical promises thanks
to emerging innovations in both advanced MRI imaging and postprocessing
techniques. Evidence Level: 2. Technical Efficatcy: 5.<br/>Copyright
&#xa9; 2021 International Society for Magnetic Resonance in Medicine.

<96>
Accession Number
638873075
Title
Alerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized with
Heart Failure: The REVEAL-HF Randomized Clinical Trial.
Source
JAMA Cardiology. 7(9) (pp 905-912), 2022. Date of Publication: September
2022.
Author
Ahmad T.; Desai N.R.; Yamamoto Y.; Biswas A.; Ghazi L.; Martin M.; Simonov
M.; Dhar R.; Hsiao A.; Kashyap N.; Allen L.; Velazquez E.J.; Wilson F.P.
Institution
(Ahmad, Desai, Velazquez) Section of Cardiovascular Medicine, Yale
University, School of Medicine, New Haven, CT, United States
(Ahmad, Desai, Yamamoto, Biswas, Ghazi, Martin, Wilson) Clinical and
Translational Research Accelerator, Yale University, School of Medicine,
New Haven, CT, United States
(Simonov, Hsiao, Kashyap) Joint Data Analytics Team, Yale University,
School of Medicine, New Haven, CT, United States
(Wilson) Section of Nephrology, Yale University, School of Medicine, New
Haven, CT, United States
(Dhar) Department of Psychology, Yale University, New Haven, CT, United
States
(Dhar) Department of Management and Marketing, Yale School of Management,
New Haven, CT, United States
(Allen) Division of Cardiology, University of Colorado, School of
Medicine, Aurora, United States
Publisher
American Medical Association
Abstract
Importance: Heart failure is a major cause of morbidity and mortality
worldwide. The use of risk scores has the potential to improve targeted
use of interventions by clinicians that improve patient outcomes, but this
hypothesis has not been tested in a randomized trial. <br/>Objective(s):
To evaluate whether prognostic information in heart failure translates
into improved decisions about initiation and intensity of treatment, more
appropriate end-of-life care, and a subsequent reduction in rates of
hospitalization or death. <br/>Design, Setting, and Participant(s): This
was a pragmatic, multicenter, electronic health record-based, randomized
clinical trial across the Yale New Haven Health System, comprising small
community hospitals and large tertiary care centers. Patients hospitalized
for heart failure who had N-terminal pro-brain natriuretic peptide
(NT-proBNP) levels of greater than 500 pg/mL and received intravenous
diuretics within 24 hours of admission were automatically randomly
assigned to the alert (intervention) or usual-care groups.
<br/>Intervention(s): The alert group had their risk of 1-year mortality
calculated using an algorithm that was derived and validated using similar
historic patients in the electronic health record. This estimate,
including a categorical risk assessment, was presented to clinicians while
they were interacting with a patient's electronic health record. <br/>Main
Outcomes and Measures: The primary outcome was a composite of 30-day
hospital readmissions and all-cause mortality at 1 year. <br/>Result(s):
Between November 27, 2019, through March 7, 2021, 3124 patients were
randomly assigned to the alert (1590 [50.9%]) or usual-care (1534 [49.1%])
group. The alert group had a median (IQR) age of 76.5 (65-86) years, and
796 were female patients (50.1%). Patients from the following race and
ethnicity groups were included: 13 Asian (0.8%), 324 Black (20.4%), 136
Hispanic (8.6%), 1448 non-Hispanic (91.1%), 1126 White (70.8%), 6 other
ethnicity (0.4%), and 127 other race (8.0%). The usual-care group had a
median (IQR) age of 77 (65-86) years, and 788 were female patients
(51.4%). Patients from the following race and ethnicity groups were
included: 11 Asian (1.4%), 298 Black (19.4%), 162 Hispanic (10.6%), 1359
non-Hispanic (88.6%), 1077 White (70.2%), 13 other ethnicity (0.9%), and
137 other race (8.9%). Median (IQR) NT-proBNP levels were 3826 (1692-8241)
pg/mL in the alert group and 3867 (1663-8917) pg/mL in the usual-care
group. A total of 284 patients (17.9%) and 270 patients (17.6%) were
admitted to the intensive care unit in the alert and usual-care groups,
respectively. A total of 367 patients (23.1%) and 359 patients (23.4%) had
a left ventricular ejection fraction of 40% or less in the alert and
usual-care groups, respectively. The model achieved an area under the
curve of 0.74 in the trial population. The primary outcome occurred in 619
patients (38.9%) in the alert group and 603 patients (39.3%) in the
usual-care group (P =.89). There were no significant differences between
study groups in the prescription of heart failure medications at
discharge, the placement of an implantable cardioverter-defibrillator, or
referral to palliative care. <br/>Conclusions and Relevance: Provision of
1-year mortality estimates during heart failure hospitalization did not
affect hospitalization or mortality, nor did it affect clinical
decision-making. Trial Registration: ClinicalTrials.gov Identifier
NCT03845660.<br/>Copyright &#xa9; 2022 American Medical Association. All
rights reserved.

<97>
Accession Number
2020869964
Title
Effects of propofol and inhaled anesthetics on postoperative complications
for the patients undergoing one lung ventilation: A meta-analysis.
Source
PLoS ONE. 17(10 October) (no pagination), 2022. Article Number: e0266988.
Date of Publication: October 2022.
Author
Yang J.; Huang Q.; Cao R.; Cui Y.
Institution
(Yang, Huang, Cao, Cui) Department of Anesthesiology, The Affiliated
Hospital, School of Medicine, UESTC Chengdu Women's & Children's Central
Hospital, Chengdu, China
Publisher
Public Library of Science
Abstract
Introduction With the widespread use of one-lung ventilation (OLV) in
thoracic surgery, it is unclear whether maintenance anesthetics such as
propofol and inhaled anesthetics are associated with postoperative
complications. The purpose of this study was to compare the effects of
propofol and inhaled anesthetics on postoperative complications in OLV
patients. Methods PubMed, EMBASE, Medline, and Cochrane Library were
searched for relevant randomized controlled trials until 09/2021. All
randomized controlled trials comparing the effect of propofol versus
inhaled anesthetics on postoperative complications in OLV patients were
included. All randomized controlled trials comparing:(a) major
complications (b) postoperative pulmonary complications (c) postoperative
cognitive function (MMSE score) (d) length of hospital stay (e) 30-day
mortality, were included. Results Thirteen randomized controlled trials
involving 2522 patients were included in the analysis. Overall, there was
no significant difference in major postoperative complications between the
inhaled anesthetic and propofol groups (OR 0.78, 95%CI 0.54 to 1.13, p =
0.19; I² = 0%). However, more PPCs were detected in the
propofol group compared to the inhalation anesthesia group (OR 0.62, 95%CI
0.44 to 0.87, p = 0.005; I² = 37%). Both postoperative MMSE
score (SMD -1.94, 95%CI -4.87 to 0.99, p = 0.19; I² = 100%) and
hospital stay (SMD 0.05, 95%CI -0.29 to 0.39, p = 0.76; I² =
73%) were similar between the two groups. The 30-day mortality rate was
also not significantly different between groups (OR 0.79, 95%CI 0.03 to
18, p = 0.88; I² = 63%). Conclusions In patients undergoing
OLV, general anesthesia with inhaled anesthetics reduced PPC compared to
propofol, but did not provide clear benefits on other major complications,
cognitive function, length of hospital stay, or mortality.<br/>Copyright:
&#xa9; 2022 Yang 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.

<98>
Accession Number
2022341075
Title
Basic pathophysiology and options of treatment for surgical management of
functional tricuspid regurgitation: a systematic review.
Source
Journal of Thoracic Disease. 14(11) (pp 4521-4544), 2022. Date of
Publication: November 2022.
Author
Giuseppe G.; Dell'Angela L.; Fiore A.; Singh S.S.A.; Couetil J.-P.;
Folliguet T.; Sinagra G.; Mazzaro E.; Nappi F.
Institution
(Giuseppe, Sinagra, Mazzaro) Cardio-Thoracic & Vascular Department,
Trieste University Hospital, Trieste, Italy
(Dell'Angela) Division of Cardiology, Gorizia & Monfalcone Hospital,
Gorizia, Italy
(Fiore, Folliguet) Department of Cardiac Surgery, Hopitaux Universitaires
Henri Mondor, Assistance Publique-Hopitaux de Paris, Creteil, France
(Singh) Department of Cardiothoracic Surgery, Aberdeen Royal Infirmary,
Aberdeen, United Kingdom
(Couetil, Nappi) Department of Cardiac Surgery, Centre Cardiologique du
Nord, Saint-Denis, France
Publisher
AME Publishing Company
Abstract
Background: Functional tricuspid regurgitation (TR) appears frequently in
the presence of left-sided heart valve diseases, combined with symptoms of
heart failure, worsens if left untreated, and is associated with poor
patient survival. Correct indications for surgery and the choice of
suitable technique, which should be based on pathophysiology of disease
are of utmost importance to ensure longevity and durability of repair;
particularly given the risky nature of reoperations due to
residual/recurrent TR. <br/>Method(s): A systematic review was performed
using Embase, Ovid Medline, Cochrane, Web of Science, and Google to deepen
knowledge of major and controversial aspects of the subject.
<br/>Result(s): A total of 1,579 studies were reviewed, and 32 of these
were enclosed in the final review: 13 studies were primarily focused on
pathophysiology and preoperative assessment of functional TR; 19 studies
on surgical treatment of functional TR. A total of 15,509 patients were
included. <br/>Conclusion(s): Indications for treatment of TR are based on
the severity of regurgitation (grading), as well as on the presence of
signs and symtoms of right-sided heart failure and on the extent of
tricuspid annular dilation, leaflet tethering, and pulmonary hypertension
(staging of disease). Despite improved knowledge of the underlying
pathophysiology of TR, issues regarding indications for treatment and
options of repair remain present. There is no consensus within the
scientific community, for the preferred method to quantify the severity of
TR; the recently introduced 5-grade TR classification based on objective
quantitative parameters has not yet become common practice. The assessment
of TR during stress exercise is rarely performed, though it takes into
account the changes in severity of regurgitation that occur under
different physiological conditions. Magnetic resonance imaging, which is
the gold standard for the right heart evaluation is occasionally carried
out before surgery. The threshold beyond which the tricuspid annular
dilation should be repaired is unclear and recent studies put forward the
idea that it may be lower than current recommendations. Tricuspid valve
annuloplasty is the most adopted surgical option today. However, the ideal
annuloplasty device remains elusive. In addition, as severe leaflet
tethering cannot be addressed by annuloplasty alone, the addition of new
techniques further increasing leaflet coaptation might optimize long-term
valve continence. Further investigations are needed to address all these
issues, alongside the potential of percutaneous options.<br/>Copyright
&#xa9; Journal of Thoracic Disease. All rights reserved.

<99>
Accession Number
2022341074
Title
Identifying biomarkers of ventilator induced lung injury during one-lung
ventilation surgery: a scoping review.
Source
Journal of Thoracic Disease. 14(11) (pp 4506-4520), 2022. Date of
Publication: November 2022.
Author
Bruinooge A.J.G.; Mao R.; Gottschalk T.H.; Srinathan S.K.; Buduhan G.; Tan
L.; Halayko A.J.; Kidane B.
Institution
(Bruinooge, Srinathan, Buduhan, Tan, Kidane) Section of Thoracic Surgery,
Department of Surgery, Health Sciences Centre, Winnipeg, Canada
(Bruinooge, Mao, Gottschalk, Srinathan, Buduhan, Tan, Kidane) University
of Manitoba, Winnipeg, Canada
(Bruinooge, Halayko, Kidane) Children's Hospital Research Institute of
Manitoba, Winnipeg, Canada
(Halayko, Kidane) Department of Physiology and Pathophysiology, Rady
Faculty of Health Sciences, Max Rady College of Medicine, University of
Manitoba, Winnipeg, Canada
Publisher
AME Publishing Company
Abstract
Background: Ventilator-induced lung injury (VILI) can occur as a result of
mechanical ventilation to two lungs. Thoracic surgery often requires
one-lung ventilation (OLV). The potential for VILI is likely higher in
OLV. The impact of OLV on development of post-operative pulmonary
complications is not well understood. We aimed to perform a scoping review
to determine reliable biomarkers of VILI after OLV. <br/>Method(s): A
scoping review was performed using Cochrane Collaboration methodology. We
searched Medline, EMBASE and SCOPUS. Gray literature was searched. Studies
of adult human or animal models without pre-existing lung damage exposed
to OLV, with biomarker responses analyzed were included. <br/>Result(s):
After screening 5,613 eligible papers, 89 papers were chosen for full text
review, with 29 meeting inclusion. Approximately half (52%, n=15) of
studies were conducted in humans in an intra-operative setting.
Bronchoalveolar lavage (BAL) & serum analyses with enzyme-linked
immunosorbent assay (ELISA)-based assays were most commonly used. The
majority of analytes were investigated by a single study. Of the analytes
that were investigated by two or more studies (n=31), only 16 were
concordant in their findings. Across all sample types and studies 84%
(n=66) of the 79 inflammatory markers and 75% (n=6) of the 8
anti-inflammatory markers tested were found to increase. Half (48%) of all
studies showed an increase in TNF-alpha or IL-6. <br/>Conclusion(s): A
scoping review of the state of the evidence demonstrated that candidate
biomarkers with the most evidence and greatest reliability are general
markers of inflammation, such as IL-6 and TNF-alpha assessed using ELISA
assays. Studies were limited in the number of biomarkers measured
concurrently, sample size, and studies using human participants. In
conclusion these identified markers can potentially serve as outcome
measures for studies on OLV.<br/>Copyright &#xa9; Journal of Thoracic
Disease. All rights reserved.

<100>
Accession Number
640101578
Title
Cardiac rehabilitation in coronary artery bypass grafting patients: Effect
of eight weeks of moderate-intensity continuous training versus
high-intensity interval training.
Source
Clinical hemorheology and microcirculation. (no pagination), 2023. Date
of Publication: 14 Jan 2023.
Author
Shafie N.; Kordi N.; Gadruni K.; SalehFard Z.; Jung F.; Heidari N.
Institution
(Shafie) Department of Sport Physiology, Faculty of Sport Sciences,
University of Mazandaran, Babolsar, Iran, Islamic Republic of
(Kordi) Department of Exercise Physiology, Faculty of Sport Sciences, Razi
University, Kermanshah, Iran, Islamic Republic of
(Gadruni) Faculty of Physical Education, University of Tabriz, Tabriz,
Iran; Kurdistan Education Office, Ministry of Education, Kurdistan, Iran;
Uro-Oncology Research Center, Tehran University of Medical Sciences,
Tehran, Iran
(SalehFard) Department of Sport Physiology, School of Physical Education
and Sport Sciences, Alzahra University, Tehran, Iran, Islamic Republic of
(Jung) Faculty of Health Sciences Brandenburg, Brandenburg University of
Technology Cottbus-Senftenberg, Senftenberg, Germany
(Heidari) Faculty of Sport Science, Shahid Rajaei Teacher Training
University, Tehran, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
BACKGROUND: Physical training in patients with heart failure can affect
hemodynamic, cardiac and angiogenesis parameters. <br/>OBJECTIVE(S): The
aim of the present study was to investigate the effects of traditional
moderate-intensity rehabilitation training and interval training on some
angiogenesis factors in coronary artery bypass graft (CABG) patients.
<br/>METHOD(S): Thirty CABG patients (mean age+/-SD, 55+/-3 years) were
randomly assigned to one of three groups: high-intensity interval training
(HIIT) or moderate-intensity continuous training (MICT) or the control
group. After the initial assessments, eligible patients in the
experimental groups (HIIT and MICT) performed exercise training for 8
weeks, while the control group did not. Angiogenesis and angiostatic
indices, including pro-adrenomedullin (pro-ADM), basic fibroblast growth
factor (bFGF), and endostatin, were then measured. <br/>RESULT(S): The
results showed no significant difference between pro-ADM in the HIIT and
MICT groups (P = 0.99), but a significant difference was found between
MICT and the control group and between HIIT and the control group (P =
0.001). There is also no significant difference between the bFGF levels in
the HIIT and MICT training groups (P = 1.00), but the changes in this
factor between the training groups and the control group were significant
(P = 0.001). There was a significant difference between the levels of
endostatin in all three groups. <br/>CONCLUSION(S): Two methods of cardiac
rehabilitation (HIIT and MICT) may be useful for the recovery of patients
with coronary artery bypass grafting. This improvement manifested itself
in changes in angiogenesis and angiostatic indices in this study. However,
more extensive studies are needed to investigate the effects of these two
types of rehabilitation programs on other indicators of angiogenesis and
angiostatic.

<101>
Accession Number
640103361
Title
Alternative Approaches to Coronary Artery Bypass Grafting Versus
Percutaneous Coronary Intervention, How Do They Compare?: A Systematic
Review and Meta-Analysis.
Source
Cardiology in review. (no pagination), 2023. Date of Publication: 23 Jan
2023.
Author
El-Andari R.; Bozso S.J.; Fialka N.M.; Kang J.J.H.; Hassanabad A.F.;
Nagendran J.
Institution
(El-Andari, Bozso, Kang, Nagendran) From the Division of Cardiac Surgery,
Department of Surgery, University of Alberta, Edmonton, AB, Canada
(Fialka) Faculty of Medicine and Dentistry, University of Alberta,
Edmonton, AB, Canada
(Hassanabad) Section of Cardiac Surgery, Department of Cardiac Sciences,
Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary,
Canada
Publisher
NLM (Medline)
Abstract
Coronary artery disease (CAD) is a leading cause of mortality worldwide.
Severe symptomatic CAD is treated with coronary artery bypass grafting
(CABG) or percutaneous coronary intervention (PCI). Alternative CABG
(ACABG) approaches including thoracotomy, off-pump, total endoscopic, and
robotic-assisted CABG are increasing in prevalence to address the
increased early risk of CABG. This systematic review and meta-analysis
aims to review the contemporary literature comparing outcomes after ACABG
and PCI. Pubmed, Medline, and Embase were systematically searched by 2
authors for articles comparing the outcomes after ACABG and PCI. A total
of 1154 articles were screened, and 11 were included in this review. The
RevMan 5.4 software was used to perform a meta-analysis of the pooled
data. Individual studies found rates of long-term survival, major adverse
cardiovascular and cerebrovascular events (MACCE), myocardial infarction
(MI), and repeat revascularization either favored ACABG or did not differ
significantly. Pooled estimates of the compiled data identified rates of
MACCE, MI, and repeat revascularization favored ACABG. The results of this
review demonstrated the favorable rates of long-term mortality, MACCE, MI,
and repeat revascularization for ACABG in addition to similar short-term
mortality and stroke when compared with PCI. Advancement of both CABG and
PCI continues to improve patient outcomes. With the increasing prevalence
of ACABG, similar studies will need to be undertaken with further direct
comparisons between ACABG and PCI. Finally, hybrid revascularization
should continue to be explored for its combined benefits of long-term
outcomes, short-term safety, and ability to achieve complete
revascularization.<br/>Copyright &#xa9; 2023 Wolters Kluwer Health, Inc.
All rights reserved.