EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 134

Results Generated From:
Embase <1980 to 2023 Week 10>
Embase Weekly Updates (updates since 2023-03-03)

<1>
[Use Link to view the full text]
Accession Number
2022329898
Title
A New Era in Cardiac Rehabilitation Delivery: Research Gaps, Questions,
Strategies, and Priorities.
Source
Circulation. 147(3) (pp 254-266), 2023. Date of Publication: 17 Jan 2023.
Author
Beatty A.L.; Beckie T.M.; Dodson J.; Goldstein C.M.; Hughes J.W.; Kraus
W.E.; Martin S.S.; Olson T.P.; Pack Q.R.; Stolp H.; Thomas R.J.; Wu W.-C.;
Franklin B.A.
Institution
(Beatty) Department of Epidemiology and Biostatistics, University of
California, San Francisco, United States
(Beatty) Department of Medicine, Division of Cardiology, University of
California, San Francisco, United States
(Beckie) College of Nursing, University of South Florida, Tampa, United
States
(Beckie) College of Medicine, Division of Cardiovascular Sciences,
University of South Florida, Tampa, United States
(Dodson) Leon H. Charney Division of Cardiology, Department of Medicine,
New York University, School of Medicine, New York, United States
(Dodson) Department of Population Health, New York University, School of
Medicine, New York, United States
(Goldstein) The Weight Control and Diabetes Research Center, The Miriam
Hospital, Providence, RI, United States
(Goldstein) Department of Psychiatry and Human Behavior, The Warren Alpert
Medical School, Brown University, Providence, RI, United States
(Wu) Lifespan Cardiovascular Institute, Brown University, Providence, RI,
United States
(Hughes) Department of Psychological Sciences, Kent State University, OH,
United States
(Kraus) Department of Medicine, Division of Cardiology, Duke University,
Durham, NC, United States
(Martin) Department of Medicine, Division of Cardiology, Ciccarone Center
for the Prevention of Cardiovascular Disease, Johns Hopkins University,
School of Medicine, Baltimore, MD, United States
(Olson, Thomas) Department of Cardiovascular Medicine, Division of
Preventive Cardiology, Mayo Clinic, Rochester, MN, United States
(Pack) Department of Healthcare Delivery and Population Science,
University of Massachusetts Medical School-Baystate, Springfield, United
States
(Stolp) ASRT, Inc, Atlanta, GA, United States
(Stolp) Centers for Disease Control and Prevention, Atlanta, GA, United
States
(Wu) Division of Cardiology, Providence VA Medical Center, RI, United
States
(Franklin) William Beaumont Hospital, Royal Oak, MI, United States
(Franklin) Oakland University, William Beaumont School of Medicine,
Rochester, MI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Cardiac rehabilitation (CR) is a guideline-recommended, multidisciplinary
program of exercise training, risk factor management, and psychosocial
counseling for people with cardiovascular disease (CVD) that is beneficial
but underused and with substantial disparities in referral, access, and
participation. The emergence of new virtual and remote delivery models has
the potential to improve access to and participation in CR and ultimately
improve outcomes for people with CVD. Although data suggest that new
delivery models for CR have safety and efficacy similar to traditional
in-person CR, questions remain regarding which participants are most
likely to benefit from these models, how and where such programs should be
delivered, and their effect on outcomes in diverse populations. In this
review, we describe important gaps in evidence, identify relevant research
questions, and propose strategies for addressing them. We highlight 4
research priorities: (1) including diverse populations in all CR research;
(2) leveraging implementation methodologies to enhance equitable delivery
of CR; (3) clarifying which populations are most likely to benefit from
virtual and remote CR; and (4) comparing traditional in-person CR with
virtual and remote CR in diverse populations using multicenter studies of
important clinical, psychosocial, and cost-effectiveness outcomes that are
relevant to patients, caregivers, providers, health systems, and payors.
By framing these important questions, we hope to advance toward a goal of
delivering high-quality CR to as many people as possible to improve
outcomes in those with CVD.<br/>Copyright &#xa9; 2023 American Heart
Association, Inc.

<2>
[Use Link to view the full text]
Accession Number
2022996330
Title
Association between Length of Storage of Transfused Packed RBC Units and
Outcome of Surgical Critically Ill Adults: A Subgroup Analysis of the Age
of Blood Evaluation Randomized Trial*.
Source
Critical Care Medicine. 51(3) (pp E73-E80), 2023. Date of Publication: 01
Mar 2023.
Author
Lehr A.R.; Hebert P.; Fergusson D.; Sabri E.; Lacroix J.
Institution
(Lehr) Department of Pediatrics, Montreal Children Hospital, McGill
University, Montreal, QC, Canada
(Hebert) Department of Medicine, Bruyere Research Institute, University of
Ottawa, Ottawa, ON, Canada
(Fergusson, Sabri) Ottawa Hospital Research Institute, Department of
Clinical Epidemiology Program and University of Ottawa, Ottawa, ON, Canada
(Sabri) Departments of Medicine, Surgery Epidemiology and Community
Medicine, University of Ottawa, Ottawa, ON, Canada
(Lacroix) Centre Hospitalier Universitaire Sainte Justine, Departement de
Pediatrie de l'Universite de Montreal, Montreal, QC, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: The Age of Blood Evaluation (ABLE) study reported no clinical
benefit in fresher compared with standard delivery RBC units (length of
storage: 6.9 +/- 4.1 vs 22.0 +/- 8.4 d, respectively). Perioperative
patients are often anemic, at risk of blood loss, and more exposed to RBC
transfusions. We address the question whether fresh RBC units are safer
than standard delivery RBC units in perioperative ICU patients.
<br/>Design(s): Subgroup analysis of surgical nontrauma adults enrolled in
the ABLE randomized controlled trial. <br/>Setting(s): ICUs.
<br/>Patient(s): Three hundred twenty surgical patients among the 2,510
ICU adults recruited in the ABLE study who had a request for a first RBC
transfusion in the first week in ICU stay and an anticipated length of
mechanical ventilation greater than or equal to 48 hours. We included
perioperative patients but excluded elective cardiac surgery and trauma.
<br/>Intervention(s): Surgical participants were allocated to receive
either RBC units stored less than or equal to 7 days or standard issue
RBC. MEASUREMENTS AND MAIN RESULTS: The primary outcome was 90-day
all-cause mortality. One hundred seventy-Two perioperative patients were
allocated to the fresh and 148 to the standard group. Baseline data were
similar. The length of storage was 7.2 +/- 6.4 in fresh and 20.6 +/- 8.4
days in standard group (p < 0.0001). The 90-day mortality was 29.7% and
28.4%, respectively (absolute risk difference: 0.01; 95% CI-0.09 to 0.11;
p = 0.803). No significant differences were observed for all secondary
outcomes, including 6-month mortality, even after adjustment for age,
country, and Acute Physiology and Chronic Health Evaluation score.
<br/>Conclusion(s): There was no evidence that fresh red cells improved
outcomes as compared to standard issue red cells in critically ill
surgical patients, consistent with other patients enrolled in the ABLE
trial.<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins. All
rights reserved.

<3>
Accession Number
2019463534
Title
The safety of sotagliflozin in the therapy of diabetes mellitus type 1 and
type 2: A meta-analysis of randomized trials.
Source
Frontiers in Endocrinology. 13 (no pagination), 2022. Article Number:
968478. Date of Publication: 26 Sep 2022.
Author
Zhou F.; Du N.; Zhou L.; Wang C.; Ren H.; Sun Q.
Institution
(Zhou, Du, Zhou, Wang, Ren, Sun) Laboratory of Cell Engineering, Institute
of Biotechnology, Research Unit of Cell Death Mechanism, Chinese Academy
of Medical Science, Beijing, China
(Zhou, Du) The Second Clinical Medical College, Zhejiang Chinese Medical
University, Hangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: Diabetes mellitus (DM) is a global health problem, and it has
become a shocking threat in the contemporary era. The objective of this
study was to analyze the safety of sotagliflozin in patients with DM
systematically and intuitively. <br/>Method(s): On November 15, 2021,
literature retrieval was performed on PubMed, Web of Science, EBSCO, and
Cochrane libraries. The meta-analysis results included genital mycotic
infection, related-to-acidosis events, and other related adverse events,
including diarrhea, severe nocturnal hypoglycemia event, and volume
depletion. In addition, a subgroup analysis was also conducted based on
different doses of sotagliflozin. Moreover, the patient-treated years
analyzed in the study were 12 weeks, 24 weeks, and 52 weeks, respectively,
for type 1 diabetes, and were 12 weeks, 22 weeks, and 52 weeks,
respectively, for type 2 diabetes. <br/>Result(s): The results of this
meta-analysis illustrated that sotagliflozin could increase the risk of
genital mycotic infection for patients with T1D and T2D (RR: 3.49, 95% Cl:
2.54-4.79, p < 0.001; RR: 2.83, 95% Cl: 2.04-3.93, p < 0.001;
respectively). In addition, the subgroup analysis showed that the drug
doses that could increase the risk of genital mycotic infection were 400
mg and 200 mg (RR: 3.63, 95% Cl: 2.46-5.36, p < 0.001; RR: 3.21, 95% Cl:
1.84-5.62, p < 0.001; respectively) in T1D. Moreover, sotagliflozin could
increase the risk of events related to acidosis in the patients of T1D,
including acidosis-related adverse events, positively adjudicated diabetic
ketoacidosis, acidosis-related event, and diabetic ketoacidosis (RR: 7.49,
95% Cl: 3.20-17.52, p < 0.001; RR: 6.05, 95% Cl: 2.56-14.30, p < 0.001;
RR: 4.83, 95% Cl: 3.13-7.45, p < 0.001; RR: 8.12, 95% Cl: 3.06-21.52, p <
0.001; respectively). In the patients of T2D, sotagliflozin could not
increase the risk of DKA (RR: 1.30, 95% Cl: 0.34-4.99, p = 0.70). About
serious of acidosis-related adverse events, positively adjudicated
diabetic ketoacidosis (DKA) and acidosis-related event, the included
studies were not reported for T2D patients. As for the other related
adverse events, sotagliflozin was found to be a risk factor for diarrhea
and volume depletion in T1D patients (RR: 1.44, 95% Cl: 1.09-1.90, p =
0.01; RR: 2.50, 95% Cl: 1.33-4.69, p < 0.01; respectively) and T2D
patients (RR: 1.44, 95% Cl: 1.26-1.64, p < 0.001; RR: 1.25, 95% Cl:
1.07-1.45, p < 0.01; respectively). <br/>Conclusion(s): This meta-analysis
showed that the adverse events of sotagliflozin were tolerable to patients
with DM, in terms of the incidence of genital mycotic infection,
related-to-acidosis events, diarrhea, volume depletion, and severe
nocturnal hypoglycemia events. In addition, the subgroup analysis of
sotagliflozin dosage is considered to have great clinical significance for
future guidance of sotagliflozin application in patients with
DM.<br/>Copyright &#xa9; 2022 Zhou, Du, Zhou, Wang, Ren and Sun.

<4>
Accession Number
2020506462
Title
Opioid Free Anesthesia in Thoracic Surgery: A Systematic Review and Meta
Analysis.
Source
Journal of Clinical Medicine. 11(23) (no pagination), 2022. Article
Number: 6955. Date of Publication: December 2022.
Author
D'Amico F.; Barucco G.; Licheri M.; Valsecchi G.; Zaraca L.; Mucchetti M.;
Zangrillo A.; Monaco F.
Institution
(D'Amico, Barucco, Licheri, Valsecchi, Zaraca, Mucchetti, Zangrillo,
Monaco) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan 20132, Italy
(Zangrillo) Faculty of Medicine, Vita-Salute San Raffaele University,
Milan 20132, Italy
Publisher
MDPI
Abstract
Introduction: Recent studies showed that balanced opioid-free anesthesia
is feasible and desirable in several surgical settings. However, in
thoracic surgery, scientific evidence is still lacking. Thus, we conducted
the first systematic review and meta-analysis of opioid-free anesthesia in
this field. <br/>Method(s): The primary outcome was the occurrence of any
complication. Secondary outcomes were the length of hospital stay,
recovery room length of stay, postoperative pain at 24 and 48 h, and
morphine equivalent consumption at 48 h. <br/>Result(s): Out of 375
potentially relevant articles, 6 studies (1 randomized controlled trial
and 5 observational cohort studies) counting a total of 904 patients were
included. Opioid-free anesthesia compared to opioid-based anesthesia, was
associated with a lower rate of any complication (74 of 175 [42%] vs. 200
of 294 [68%]; RR = 0.76; 95% CI, 0.65-0.89; p < 0.001; I² =
0%), lower 48 h morphine equivalent consumption (MD -14.5 [-29.17/-0.22];
p = 0.05; I² = 95%) and lower pain at 48 h (MD -1.95
[-3.6/0.3]; p = 0.02, I = 98%). <br/>Conclusion(s): Opioid-free anesthesia
in thoracic surgery is associated with lower postoperative complications,
and less opioid demand with better postoperative analgesia at 48 h
compared to opioid-based anesthesia.<br/>Copyright &#xa9; 2022 by the
authors.

<5>
Accession Number
2018075616
Title
Edge-to-edge percutaneous mitral repair for functional ischaemic and
non-ischaemic mitral regurgitation: a systematic review and meta-analysis.
Source
ESC Heart Failure. 9(5) (pp 3177-3187), 2022. Date of Publication: October
2022.
Author
Chiarito M.; Sanz-Sanchez J.; Pighi M.; Cannata F.; Rubbio A.P.; Munafo
A.; Cao D.; Roccasalva F.; Pini D.; Pagnotta P.A.; Ettori F.; Petronio
A.S.; Tamburino C.; Reimers B.; Colombo A.; Di Mario C.; Grasso C.; Mehran
R.; Godino C.; Stefanini G.G.
Institution
(Chiarito, Cannata, Roccasalva, Pini, Pagnotta, Reimers, Stefanini)
Department of Biomedical Sciences, Humanitas University, Milan, Italy
(Chiarito, Cannata, Roccasalva, Pini, Reimers, Stefanini) IRCCS Humanitas
Research Hospital, Milan, Italy
(Sanz-Sanchez) Hospital Universitari i Politecnic La Fe, Valencia, Spain
(Sanz-Sanchez) Centro de Investigacion Biomedica en Red (CIBERCV), Madrid,
Spain
(Pighi) Division of Cardiology, Azienda Ospedaliera Universitaria
Integrata of Verona, Verona, Italy
(Rubbio, Tamburino, Grasso) Cardiology Division, CAST Policlinico
Hospital, University of Catania, Catania, Italy
(Munafo, Godino) Cardiology Unit, San Raffaele Scientific Institute,
Milan, Italy
(Cao, Mehran) The Zena and Michael A. Wiener Cardiovascular Institute,
Icahn School of Medicine at Mount Sinai, New York, United States
(Ettori) Cardiothoracic Department, Spedali Civili, Brescia, Italy
(Petronio) Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
(Colombo) GVM Care and Research, Maria Cecilia Hospital, Ravenna, Italy
(Colombo) Centro Cuore Columbus, GVM care and research, Milan, Italy
(Di Mario) Structural Interventional Cardiology, Careggi University
Hospital, Florence, Italy
Publisher
John Wiley and Sons Inc
Abstract
Aim: Randomized controlled trials comparing the use of the MitraClip
device in addition to guideline directed medical therapy (GDMT) to GDMT
alone in patients with secondary mitral regurgitation (MR) have shown
conflicting results. However, if these differences could be due to the
underlying MR aetiology is still unknown. Therefore, we aimed to evaluate
if the effects of percutaneous edge-to-edge repair with MitraClip
implantation could differ in patients with ischaemic (I-MR) and
non-ischaemic mitral regurgitation (NI-MR). <br/>Methods and Results:
PubMed, Embase, BioMed Central, and the Cochrane Central Register of
Controlled Trials were searched for all studies including patients with
secondary MR treated with the MitraClip device. Data were pooled using a
random-effects model. Primary endpoint was the composite of all-cause
death and heart failure-related hospitalization. Secondary endpoints were
the single components of the primary endpoint, New York Heart Association
functional Classes III and IV, and mitral valve re-intervention. Seven
studies enrolling 2501 patients were included. Patients with I-MR compared
with patients with NI-MR had a similar risk of the primary endpoint (odds
ratio: 1.17; 95% confidence interval: 0.93 to 1.46; I²: 0%).
The risk of all-cause death was increased in patients with I-MR (odds
ratio: 1.31; 95% confidence interval: 1.07 to 1.62; I²: 0%),
while no differences were observed between the two groups in terms of the
other secondary endpoints. <br/>Conclusion(s): The risk of mortality after
MitraClip implantation is lower in patients with NI-MR than in those with
I-MR. No absolute differences in the risk of heart failure related
hospitalization were observed between groups.<br/>Copyright &#xa9; 2021
The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on
behalf of European Society of Cardiology.

<6>
Accession Number
2021931845
Title
Full-endoscopic discectomy for thoracic disc herniations: a single-arm
meta-analysis of safety and efficacy outcomes.
Source
European Spine Journal. (no pagination), 2023. Date of Publication: 2023.
Author
Silva J.D.S.; Carelli L.E.; de Oliveira J.A.A.; de Araujo R.M.L.
Institution
(Silva) Division of Medicine, Department of Neurosurgery, Hospital of
Federal University of Piaui - UFPI, Piaui, Teresina, Brazil
(Carelli) Division of Traumatology and Orthopedics, Department of
Medicine, National Institute of Traumatology and Orthopedics - INTO, Rio
de Janeiro, Brazil
(de Oliveira) Division of Traumatology and Orthopedics, Department of
Medicine, Federal University of Ceara - UFC, Ceara, Fortaleza, Brazil
(de Araujo) Division of Neurosurgery, Department of Medicine, University
of Sao Paulo - USP, Sao Paulo, Brazil
(Silva) Division of Neurosurgery, University Hospital, Federal University
of Piaui, University Camp Petronio Portela Minister w/n. Ininga, Piaui,
Teresina 64049-550, Brazil
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Introduction: Surgical intervention is the treatment of choice in patients
with thoracic disc herniation with refractory symptoms and progressive
myelopathy. Due to high occurrence of complications from open surgery,
minimally invasive approaches are desirable. Nowadays, endoscopic
techniques have become increasingly popular and full-endoscopic surgery
can be performed in the thoracic spine with low complication rates.
<br/>Method(s): Cochrane Central, PubMed, and Embase databases were
systematically searched for studies that evaluated patients who underwent
full-endoscopic spine thoracic surgery. The outcomes of interest were
dural tear, myelopathy, epidural hematoma, recurrent disc herniation, and
dysesthesia. In the absence of comparative studies, a single-arm
meta-analysis was performed. <br/>Result(s): We included 13 studies with a
total of 285 patients. Follow-up ranged from 6 to 89 months, age from 17
to 82 years, with 56.5% male. The procedure was performed under local
anesthesia with sedation in 222 patients (77.9%). A transforaminal
approach was used in 88.1% of the cases. There were no cases of infection
or death reported. The data showed a pooled incidence of outcomes as
follows, with their respective 95% confidence intervals (CI)-dural tear
(1.3%; 95% CI 0-2.6%); dysesthesia (4.7%; 95% CI 2.0-7.3%); recurrent disc
herniation (2.9%; 95% CI 0.6-5.2%); myelopathy (2.1%; 95% CI 0.4-3.8%);
epidural hematoma (1.1%; 95% CI 0.2-2.5%); and reoperation (1.7%; 95% CI
0.1-3.4%). <br/>Conclusion(s): Full-endoscopic discectomy has a low
incidence of adverse outcomes in patients with thoracic disc herniations.
Controlled studies, ideally randomized, are warranted to establish the
comparative efficacy and safety of the endoscopic approach relative to
open surgery.<br/>Copyright &#xa9; 2023, The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature.

<7>
Accession Number
640445855
Title
Minimally Invasive Direct Coronary Artery Bypass Versus Percutaneous
Coronary Intervention for Isolated Left Anterior Descending Artery
Stenosis: An Updated Meta-Analysis.
Source
The heart surgery forum. 26(1) (pp E114-E125), 2023. Date of Publication:
28 Feb 2023.
Author
Zhang S.; Chen S.; Yang K.; Li Y.; Yun Y.; Zhang X.; Qi X.; Zhou X.; Zhang
H.; Zou C.; Xiaochun Ma
Institution
(Zhang) Department of Cardiovascular Surgery, Shandong Provincial
Hospital, Shandong University, Jinan, China
(Chen) Department of Cardiovascular Surgery, Shandong Provincial Hospital,
Shandong University, Jinan, China
(Yang) Shandong First Medical University, Jinan, China
(Li, Zou, Xiaochun Ma) Department of Cardiovascular Surgery, Shandong
Provincial Hospital, Shandong University, Jinan, China
(Yun) Department of Radiology, Qilu Hospital of Shandong University,
Jinan, China
(Zhang) Department of Cardiovascular Surgery, Shandong Provincial
Hospital, Shandong First Medical University, Jinan, China
(Qi) Key Laboratory for Experimental Teratology of the Ministry of
Education and Department of Medical Genetics, School of Basic Medical
Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
(Zhou) Department of Endocrinology, Shandong Provincial Hospital, Shandong
First Medical University, Jinan, China
(Zhang) Department of Cardiovascular Surgery, Shandong Provincial
Hospital, Shandong University, Jinan, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The optimal revascularization strategy for isolated left
anterior descending (LAD) coronary artery lesion between minimally
invasive direct coronary artery bypass (MIDCAB) and percutaneous coronary
intervention (PCI) remains controversial. This updated meta-analysis aims
to compare the long- and short-term outcomes of MIDCAB versus PCI for
patients with isolated LAD coronary artery lesions. <br/>METHOD(S): The
Pubmed, Web of Science, and Cochrane databases were searched for
retrieving potential publications from 2002 to 2022. The primary outcome
was long-term survival. Secondary outcomes were long-term target vessel
revascularization (TVR), long-term major adverse cardiovascular events
(MACEs), and short-term outcomes, including postoperative mortality,
myocardial infarction (MI), TVR, and MACEs of any cause in-hospital or 30
days after the revascularization. <br/>RESULT(S): Six randomized
controlled trials (RCTs) and eight observational studies were included in
this updated meta-analysis. In total, 1757 patients underwent MIDCAB and
15245 patients underwent PCI. No statistically significant difference was
found between the two groups in the rates of long-term survival. MIDCAB
had a lower long-term MACE rate compared with PCI. Besides, PCI resulted
in an augmented risk of TVR. Postoperative mortality, MI, TVR, and MACEs
were similar between the two groups. <br/>CONCLUSION(S): The updated
meta-analysis presents the evidence that MIDCAB has a reduced risk of
long-term TVR and MACEs, with no benefit in terms of long-term mortality
and short-term results, in comparison with PCI. Large multicenter RCTs,
including patients treated with newer techniques, are warranted in the
future.

<8>
Accession Number
640445532
Title
Effects of Percutaneous Coronary Intervention and Coronary Artery Bypass
Grafting on Clinical Outcomes in Patients with Reduced Ejection Fraction
Heart Failure and Coronary Heart Disease: A Meta-Analysis.
Source
The heart surgery forum. 26(1) (pp E062-E073), 2023. Date of Publication:
10 Feb 2023.
Author
Yu Z.-X.; Yan J.; Wang M.-Y.; Chen R.; Luo J.-Y.; Li X.-M.; Xie X.; Ma
Y.-T.
Institution
(Yu, Wang, Luo, Xie) Department of Cardiology, Heart Center, First
Affiliated Hospital of Xinjiang Medical University, Urumqi, China
(Yan) Department of Cardiology, Heart Center, First Affiliated Hospital of
Xinjiang Medical University, Urumqi, China
(Chen) Department of Cardiology, Heart Center, First Affiliated Hospital
of Xinjiang Medical University, Urumqi, China
(Li) Department of Cardiology, Heart Center, First Affiliated Hospital of
Xinjiang Medical University, Urumqi, China
(Ma) Department of Cardiology, Heart Center, First Affiliated Hospital of
Xinjiang Medical University, Urumqi, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To clarify the effects of percutaneous coronary intervention
(PCI) and coronary artery bypass grafting (CABG) on the clinical outcomes
of patients with coronary heart disease (CHD) complicated with reduced
ejection fraction heart failure (HFrEF) through meta-analysis.
<br/>METHOD(S): Three major literature databases - PubMed, Web of Science,
and Cochrane - were searched by search terms and the literature retrieval
time was publications dating from January 2007 to December 2021. To search
for observational studies and randomized controlled trials (RCT) comparing
the efficacy of PCI and CABG in patients with CHD and HFrEF, the abstract
or full text of the literature was read and the final included literature
was determined, according to inclusion and exclusion criteria. The quality
of the included literature was evaluated using the Ottawa scale and data
extraction was further completed. Data analysis was made using RevMan5.4
and R4.1 software; relevant forest plots and funnel plots were made,
according to the extracted data. Egger's test was used to evaluate whether
the data had publication bias. Outcomes were the major adverse
cardiovascular events (MACE). <br/>RESULT(S): A total of 10 studies were
included and 11,032 subjects were included, made up of 5,521 cases of PCI
and 5,511 cases of CABG. The results showed no significant difference
between the two groups in cardiac mortality (CM) (RR=1.13, 95% CI
0.98-1.30, P = 0.10) and in overall all-cause mortality (ACM) (RR=1.12,
95% CI 0.92-1.37, P = 0.25). In the subgroup analysis of ACM, in the
subgroups with left ventricular ejection fraction (LVEF) less than 35% and
exceeding 35% and less than 50% (RR=1.12, 95% CI 0.92-1.37, P = 0.25)
between the two groups, there was no statistical difference. However,
among other MACE, compared with the PCI group, the CABG group had a lower
risk of MACE (RR=1.58, 95%CI 1.49-1.70, P < 0.00001), myocardial
infarction (MI) (RR=1.99, 95% CI 1.02-3.88, P = 0.04), heart failure (HF)
(RR=1.29, 95% CI 1.17-1.43, P < 0.00001) and revascularization (RR=2.74,
95% CI 1.93-3.90, P < 0.00001). Finally in the CABG group, the risk of
stroke or transient ischemic attack (TIA) was higher (RR=0.71, 95% CI
0.58-0.86, P = 0.0006) than the PCI group. <br/>CONCLUSION(S): The
mortality rates of PCI and CABG were similar in patients with CHD
complicated with HFrEF. Compared with PCI, CABG had a lower incidence of
MACE, MI, HF, and revascularization, and a higher incidence of stroke or
TIA.

<9>
Accession Number
640445479
Title
Effect of Individualized Cardiac Rehabilitation on Cardiac Function, Time
Consumption, and Quality of Life in Patients After CABG.
Source
The heart surgery forum. 26(1) (pp E074-E080), 2023. Date of Publication:
10 Feb 2023.
Author
Guan H.-Q.; Hang C.; Zhang M.; Yuan L.-Y.; Ding Y.-J.
Institution
(Guan) Nursing Department, Affiliated Changzhou Second People's Hospital
of Nanjing Medical University, Jiangsu Province, Changzhou, China
(Hang) Nursing Department, Affiliated Changzhou Second People's Hospital
of Nanjing Medical University, Jiangsu Province, Changzhou, China
(Zhang) Division of Cardiothoracic Surgery, Affiliated Changzhou Second
People's Hospital of Nanjing Medical University, Jiangsu Province,
Changzhou, China
(Yuan) Division of Cardiothoracic Surgery, Affiliated Changzhou Second
People's Hospital of Nanjing Medical University, Jiangsu Province,
Changzhou, China
(Ding) Division of Cardiothoracic Surgery, Affiliated Changzhou Second
People's Hospital of Nanjing Medical University, Jiangsu Province,
Changzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: To investigate the effect of individualized cardiac
rehabilitation (CR) on cardiac function, time consumption, and quality of
life (QoL) in post-CABG patients. <br/>METHOD(S): Two different CR
strategy: basic rehabilitation and individualized rehabilitation was
designed. The patients were screened and randomized into the two groups:
the basic rehabilitation group (BRG) and individualized rehabilitation
group (IRG). Data, such as clinical characteristics, LVEF, 6MWD (6-min
walk distance), BNP, LVEDD (left ventricular end diastolic dimension),
SF-36 score, and time consumption were collected and recorded.
<br/>RESULT(S): There was no difference between the IRG and BRG patients
in the clinical characteristics. The 6MWD and LVEF on post-op
significantly were higher, while BNP and LVEDD significantly was lower in
the IRG than in BRG. The time to first out-of-bed activity, ICU stay time,
and post-op hospital stay time of the IRG in post-op was significantly
shorter than BRG. The IRG patients scored significantly higher on the
SF-36. <br/>CONCLUSION(S): Individualized CR is safe and can reduce the
time consumption and improve the cardiac function and QoL of patients
undergoing CABG.

<10>
[Use Link to view the full text]
Accession Number
640485905
Title
Efficacy of dexmedetomidine on myocardial ischemia/reperfusion injury in
patients undergoing cardiac surgery with cardiopulmonary bypass: A
protocol for systematic review and meta-analysis.
Source
Medicine. 102(9) (pp e33025), 2023. Date of Publication: 03 Mar 2023.
Author
Liang G.; Li Y.; Li S.; Huang Z.
Institution
(Liang, Li) Department of Emergency, Affiliated Hospital of Youjiang
Medical University for Nationalities, Guangxi, China
(Li) Department of Intervention Medicine, Affiliated Hospital of Youjiang
Medical University for Nationalities, Guangxi, China
(Huang) Graduate School, Youjiang Medical University for Nationalities,
Guangxi, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cardiac surgery using cardiopulmonary bypass has been shown to
cause reversible postischemic cardiac dysfunction and is associated with
reperfusion injury and myocardial cell death. Therefore, it is very
important to have a series of measures in place to reduce oxygen
consumption and provide myocardial protection. We performed a protocol for
systematic review and meta-analysis to evaluate the effect of
dexmedetomidine administration on myocardial ischemia/reperfusion injury
in patients undergoing cardiac surgery with cardiopulmonary bypass.
<br/>METHOD(S): This review protocol is registered in the PROSPERO
International Prospective Register of systematic reviews, registration
number CRD42023386749. A literature search is performed in January 2023
without restriction to regions, publication types or languages. The
primary sources were the electronic databases of PubMed, Embase, Web of
Science, the Cochrane Central Register of Controlled Trials, Chinese
National Knowledge Infrastructure database, Chinese Biomedical Database,
and Chinese Science and Technology Periodical database. Risk of bias will
be assessed according to the Cochrane Risk of Bias Tool. The meta-analysis
is performed using Reviewer Manager 5.4. <br/>RESULT(S): The results of
this meta-analysis will be submitted to a peer-reviewed journal for
publication. <br/>CONCLUSION(S): This meta-analysis will evaluate the
efficacy and safety of dexmedetomidine in patients undergoing cardiac
surgery with cardiopulmonary bypass.<br/>Copyright &#xa9; 2023 the
Author(s). Published by Wolters Kluwer Health, Inc.

<11>
Accession Number
2021893682
Title
Outcomes After Anatomic Versus Physiologic Repair of Congenitally
Corrected Transposition of the Great Arteries: A Systematic Review and
Meta-Analysis.
Source
World Journal for Pediatric and Congenital Heart Surgery. 14(1) (pp
70-76), 2023. Date of Publication: January 2023.
Author
Anzai I.; Zhao Y.; Dimagli A.; Pearsall C.; LaForest M.; Bacha E.; Kalfa
D.
Institution
(Anzai, Zhao, Bacha, Kalfa) Department of Surgery, Division of Cardiac,
Thoracic, and Vascular Surgery, Section of Pediatric and Congenital
Cardiac Surgery, New-York Presbyterian - Morgan Stanley Children's
Hospital, Columbia University Medical Center, New York, NY, United States
(Dimagli) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Pearsall) Columbia University Vagelos College of Physicians and Surgeons,
New York, NY, United States
(LaForest) Augustus C. Long Health Sciences Library, Columbia University
Irving Medical Center, New York, NY, United States
Publisher
SAGE Publications Inc.
Abstract
Surgical treatment for congenitally corrected transposition of the great
arteries is widely debated, with both physiologic repair and anatomic
repair holding advantages and disadvantages. This meta-analysis, which
includes 44 total studies consisting of 1857 patients, compares mortality
at different time points (operative, in-hospital, and post-discharge),
reoperation rates, and postoperative ventricular dysfunction between these
two categories of procedures. Although anatomic and physiologic repair had
similar operative and in-hospital mortality, anatomic repair patients had
significantly less post-discharge mortality (6.1% vs 9.7%; P =.006), lower
reoperation rates (17.9% vs 20.6%; P <.001), and less postoperative
ventricular dysfunction (16% vs 43%; P <.001). When anatomic repair
patients were subdivided into those who had atrial and arterial switch
versus those who had atrial switch with Rastelli, the double switch group
had significantly lower in-hospital mortality (4.3% vs 7.6%; P =.026) and
reoperation rates (15.6% vs 25.9%; P <.001). The results of this
meta-analysis suggest a protective benefit of favoring anatomic repair
over physiologic repair.<br/>Copyright &#xa9; The Author(s) 2022.

<12>
Accession Number
2023020014
Title
Methodological transparency of preoperative clinical practice guidelines
for elective surgery. Systematic review.
Source
PLoS ONE. 18(2 Feburary) (no pagination), 2023. Article Number: e0272756.
Date of Publication: February 2023.
Author
Angel G.; Trujillo C.; Mallama M.; Alonso-Coello P.; Klimek M.; Calvache
J.A.
Institution
(Angel, Trujillo, Mallama, Calvache) Department of Anesthesiology,
Universidad del Cauca, Cauca, Colombia
(Alonso-Coello) Iberoamerican Cochrane Centre, Clinical Epidemiology and
Public Health Department, Hospital de la Santa Creu i Sant Pau,
Universitat Autonoma de Barcelona, Barcelona, Spain
(Klimek, Calvache) Department of Anesthesiology, Erasmus University
Medical Centre Rotterdam, Rotterdam, Netherlands
Publisher
Public Library of Science
Abstract
Background Clinical practice guidelines (CPG) are statements that provide
recommendations regarding the approach to different diseases and aim to
increase quality while decreasing the risk of complications in health
care. Numerous guidelines in the field of perioperative care have been
published in the previous decade but their methodological quality and
transparency are relatively unknown. Objective To critically evaluate the
transparency and methodological quality of published CPG in the
preoperative assessment and management of adult patients undergoing
elective surgery. Design Systematic review and methodological appraisal
study. Data sources We searched for eligible CPG published in English or
Spanish between January 1, 2010, and June 30, 2022, in Pubmed MEDLINE,
TRIP Database, Embase, the Cochrane Library, as well as in
representatives' medical societies of Anaesthesiology and developers of
CPG. Eligibility criteria CPG dedicated on preoperative fasting, cardiac
assessment for non-cardiac surgery, and the use of routine preoperative
tests were included. Methodological quality and transparency of CPG were
assessed by 3 evaluators using the 6 domains of the AGREE-II tool. Results
We included 20 CPG of which 14 were classified as recommended guidelines.
The domain of "applicability" scored the lowest (44%), while the domains
"scope and objective" and "editorial interdependence" received the highest
median scores of 93% and 97% respectively. The remaining domains received
scores ranging from 44% to 84%. The top mean scored CPG in preoperative
fasting was ASA 2017 (93%); among cardiac evaluation, CPG for noncardiac
surgery were CCS 2017 (91%), ESC-ESA 2014 (90%), and AHA-ACC 2014 (89%);
in preoperative testing ICSI 2020 (97%). Conclusions In the last ten
years, most published CPG in the preoperative assessment or management of
adult patients undergoing elective surgery focused on preoperative
fasting, cardiac assessment for non-cardiac surgery, and use of routine
preoperative tests, present moderate to high methodological quality and
can be recommended for their use or adaptation. Applicability and
stakeholder involvement domains must be improved in the development of
future guidelines.<br/>Copyright &#xa9; 2023 Angel 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.

<13>
Accession Number
2023130781
Title
Design and rationale of re-energize fontan: Randomized exercise
intervention designed to maximize fitness in fontan patients.
Source
American Heart Journal. 259 (pp 68-78), 2023. Date of Publication: May
2023.
Author
Selamet Tierney E.S.; Palaniappan L.; Leonard M.; Long J.; Myers J.;
Davila T.; Lui M.C.; Kogan F.; Olson I.; Punn R.; Desai M.; Schneider
L.M.; Wang C.-H.; Cooke J.P.; Bernstein D.
Institution
(Selamet Tierney, Davila, Lui, Olson, Punn, Bernstein) Department of
Pediatrics, Division of Pediatric Cardiology, Stanford University, School
of Medicine, Palo Alto, CA, United States
(Palaniappan) Department of Medicine, Stanford University, School of
Medicine, Palo Alto, CA, United States
(Leonard, Long) Department of Pediatrics, Division of Pediatric
Nephrology, Stanford University, School of Medicine, Palo Alto, CA, United
States
(Myers) Department of Medicine, Health Research Science, Palo Alto VA
Health Care System, Palo Alto, CA, United States
(Kogan) Department of Radiology, Stanford University, School of Medicine,
Palo Alto, CA, United States
(Desai) Department of Biomedical Data Science, Stanford University, School
of Medicine, Palo Alto, CA, United States
(Schneider) Psychiatry and Behavioral Sciences - Child & Adolescent
Psychiatry and Child Development, Palo Alto, CA, United States
(Wang) Department of Pediatrics, Health Policy, Stanford University,
School of Medicine, United States
(Cooke) Houston Methodist Research Institute Houston Methodist Hospital &
Research Institute, Houston, Texas, United States
Publisher
Elsevier Inc.
Abstract
In this manuscript, we describe the design and rationale of a randomized
controlled trial in pediatric Fontan patients to test the hypothesis that
a live-video-supervised exercise (aerobic+resistance) intervention will
improve cardiac and physical capacity; muscle mass, strength, and
function; and endothelial function. Survival of children with single
ventricles beyond the neonatal period has increased dramatically with the
staged Fontan palliation. Yet, long-term morbidity remains high. By age
40, 50% of Fontan patients will have died or undergone heart
transplantation. Factors that contribute to onset and progression of heart
failure in Fontan patients remain incompletely understood. However, it is
established that Fontan patients have poor exercise capacity which is
associated with a greater risk of morbidity and mortality. Furthermore,
decreased muscle mass, abnormal muscle function, and endothelial
dysfunction in this patient population is known to contribute to disease
progression. In adult patients with 2 ventricles and heart failure,
reduced exercise capacity, muscle mass, and muscle strength are powerful
predictors of poor outcomes, and exercise interventions can not only
improve exercise capacity and muscle mass, but also reverse endothelial
dysfunction. Despite these known benefits of exercise, pediatric Fontan
patients do not exercise routinely due to their chronic condition,
perceived restrictions to exercise, and parental overprotection. Limited
exercise interventions in children with congenital heart disease have
demonstrated that exercise is safe and effective; however, these studies
have been conducted in small, heterogeneous groups, and most had few
Fontan patients. Critically, adherence is a major limitation in pediatric
exercise interventions delivered on-site, with adherence rates as low as
10%, due to distance from site, transportation difficulties, and missed
school or workdays. To overcome these challenges, we utilize live-video
conferencing to deliver the supervised exercise sessions. Our
multidisciplinary team of experts will assess the effectiveness of a
live-video-supervised exercise intervention, rigorously designed to
maximize adherence, and improve key and novel measures of health in
pediatric Fontan patients associated with poor long-term outcomes. Our
ultimate goal is the translation of this model to clinical application as
an "exercise prescription" to intervene early in pediatric Fontan patients
and decrease long-term morbidity and mortality.<br/>Copyright &#xa9; 2023
Elsevier Inc.

<14>
Accession Number
2023106281
Title
Risk of coronary artery disease in patients with gout on treatment with
Colchicine: A systematic review and meta-analysis.
Source
IJC Heart and Vasculature. 45 (no pagination), 2023. Article Number:
101191. Date of Publication: April 2023.
Author
Siddiqui M.U.; Junarta J.; Sathyanarayanan S.; Kochar K.; Ullah W.;
Fischman D.L.
Institution
(Siddiqui, Ullah, Fischman) Jefferson Heart Institute, Thomas Jefferson
University Hospital, Philadelphia, PA, United States
(Junarta, Kochar) Division of Internal Medicine, Thomas Jefferson
University Hospital, Philadelphia, PA, United States
(Sathyanarayanan) Sanford School of Medicine, University of South Dakota,
United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Colchicine has anti-inflammatory properties, but its utility
in improving cardiovascular outcomes has been disputed. Here, we study the
impact of colchicine on cardiovascular outcomes in patients with gout with
and without coronary artery disease (CAD). <br/>Method(s): Medline, Web of
Science and Cochrane Central Register of Controlled Trials were
systematically searched to identify relevant studies. Primary outcomes
included myocardial infarction (MI), percutaneous coronary intervention
(PCI), and coronary artery bypass grafting (CABG). Secondary outcomes
included stroke and all-cause mortality. <br/>Result(s): We included 4
observational studies comprising 10,026 patients with gout on treatment
with colchicine. There was no significant difference in the risk of
myocardial infarction (risk ratio [RR] 0.71; 95% confidence interval [CI],
0.36-1.39), need for PCI, or need for CABG, between patients on colchicine
and those not receiving colchicine. Colchicine was associated with a
significantly lower risk of all-cause mortality (RR 0.58; 95% CI
0.43-0.79). <br/>Conclusion(s): Non-randomized studies suggest that risk
of MI, stroke and revascularization is not higher in gout patients treated
with colchicine compared to gout patients without colchicine
treatment.<br/>Copyright &#xa9; 2023 The Authors

<15>
Accession Number
2023106246
Title
Erector spinae plane block for postoperative analgesia in
robotically-assisted coronary artery bypass surgery: Results of a
randomized placebo-controlled trial.
Source
Journal of Clinical Anesthesia. 87 (no pagination), 2023. Article Number:
111088. Date of Publication: August 2023.
Author
Hoogma D.F.; Van den Eynde R.; Oosterlinck W.; Al Tmimi L.; Verbrugghe P.;
Tournoy J.; Fieuws S.; Coppens S.; Rex S.
Institution
(Hoogma, Van den Eynde, Al Tmimi, Coppens, Rex) Department of
Anesthesiology, University Hospitals of Leuven, Leuven, Belgium
(Hoogma, Oosterlinck, Al Tmimi, Verbrugghe, Coppens, Rex) Department of
Cardiovascular Sciences, Biomedical Sciences Group, University of Leuven,
Leuven, Belgium
(Oosterlinck, Verbrugghe) Department of Cardiac Surgery, University
Hospitals of Leuven, Leuven, Belgium
(Tournoy) Department of Public Health and Primary Care, Geriatric
Medicine, University Hospitals Leuven, Leuven, Belgium
(Fieuws) Leuven Biostatistics and Statistical Bioinformatics Centre
(L-BioStat), Biomedical Sciences Group, University of Leuven, Leuven,
Belgium
Publisher
Elsevier Inc.
Abstract
Study objective: To investigate if an erector spinae plane (ESP) block
decreases postoperative opioid consumption, pain and postoperative nausea
and vomiting in patients undergoing robotically-assisted minimally
invasive direct coronary artery bypass surgery (RAMIDCAB). <br/>Design(s):
A single-center, double-blind, prospective, randomized, placebo-controlled
trial. <br/>Setting(s): Postoperative period; operating room,
post-anesthesia care unit (PACU) and hospital ward in a university
hospital. <br/>Patient(s): Sixty-four patients undergoing RAMIDCAB surgery
via left-sided mini-thoracotomy and enrolled in the institutional enhanced
recovery after cardiac surgery program. <br/>Intervention(s): At the end
of surgery, patients received an ESP catheter at vertebra T5 under
ultrasound guidance and were randomized to the administration of either
ropivacaine 0.5% (loading dose of 30 ml and three additional doses of 20
ml each, interspersed with a 6 h interval) or normal saline 0.9% (with an
identical administration scheme). In addition, patients received
multimodal analgesia including acetaminophen, dexamethasone and
patient-controlled analgesia with morphine. Following the final ESP bolus
and before catheter removal, the position of the catheter was re-evaluated
by ultrasound. Patients, investigators and medical personnel were blinded
for the group allocation during the entire trial. Measurements: Primary
outcome was cumulative morphine consumption during the first 24 h after
extubation. Secondary outcomes included location and severity of pain,
presence/extent of sensory block, duration of postoperative ventilation
and hospital length of stay. Safety outcomes comprised the incidence of
adverse events. <br/>Main Result(s): Median (IQR) 24-h morphine
consumption was not different between the intervention- and
control-groups, 67 mg (35-84) versus 71 mg (52-90) (p = 0.25),
respectively. Likewise, no differences were detected in secondary and
safety endpoints. <br/>Conclusion(s): Following RAMIDCAB surgery, adding
an ESP block to a standard multimodal analgesia regimen did not reduce
opioid consumption and pain scores.<br/>Copyright &#xa9; 2023 Elsevier
Inc.

<16>
Accession Number
2023094933
Title
Quality of life, patient satisfaction, and cardiovascular outcomes of the
randomised 2 x 3 factorial Copenhagen insulin and Metformin therapy (CIMT)
trial - A detailed statistical analysis plan.
Source
Contemporary Clinical Trials Communications. 33 (no pagination), 2023.
Article Number: 101095. Date of Publication: June 2023.
Author
Olsen M.H.; Almdal T.P.; Madsbad S.; Ovesen C.; Gluud C.; Sneppen S.B.;
Breum L.; Hedetoft C.; Krarup T.; Lundby-Christensen L.; Mathiesen E.R.;
Roder M.E.; Vestergaard H.; Wiinberg N.; Jakobsen J.C.
Institution
(Olsen, Ovesen, Gluud, Jakobsen) Copenhagen Trial Unit, Centre for
Clinical Intervention Research, Copenhagen University Hospital -
Rigshospitalet, The Capital Region, Copenhagen, Denmark
(Olsen) Department of Neuroanaesthesiology, The Neuroscience Centre,
Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
(Almdal, Mathiesen) Department of Endocrinology, Centre for Cancer and
Organ Diseases, Copenhagen University Hospital - Rigshospitalet,
Copenhagen, Denmark
(Madsbad) Department of Endocrinology, Copenhagen University Hospital -
Amager and Hvidovre, Copenhagen, Denmark
(Ovesen) Department of Neurology, Copenhagen University Hospital -
Bispebjerg and Frederiksberg, Copenhagen, Denmark
(Gluud, Jakobsen) Department of Regional Health Research, The Faculty of
Health Sciences, University of Southern Denmark, Odense, Denmark
(Sneppen) Section of Endocrinology, Department of Internal Medicine,
Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
(Breum, Hedetoft) Department of Medicine and Endocrinology, Zealand
University Hospital, Koge, Denmark
(Krarup, Lundby-Christensen) Steno Diabetes Centre Zealand, Holbaek,
Denmark
(Mathiesen) Department of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
(Roder) Steno Diabetes Center Odense, Odense University Hospital, Odense,
Denmark
(Vestergaard) Department of Medicine, Bornholms Hospital, Ronne, Denmark
(Vestergaard) Novo Nordisk Foundation Center for Basic Metabolic Research,
University of Copenhagen, Copenhagen, Denmark
(Wiinberg) Department of Clinical Physiology and Nuclear Medicine,
Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen,
Denmark
Publisher
Elsevier Inc.
Abstract
Background: The evidence on the effects of metformin and insulin in type 2
diabetes patients on quality of life, patient satisfaction, and
cardiovascular outcomes is unclear. <br/>Method(s): The Copenhagen Insulin
and Metformin Therapy (CIMT) trial is an investigator-initiated
multicentre, randomised, placebo-controlled trial with a 2 x 3 factorial
design conducted at eight hospitals in Denmark. Participants with type 2
diabetes were randomised to metformin (n = 206) versus placebo (n = 206);
in combination with open-label biphasic insulin aspart one to three times
daily (n = 137) versus insulin aspart three times daily in combination
with insulin detemir once daily (n = 138) versus insulin detemir once
daily (n = 137). We present a detailed description of the methodology and
statistical analysis of the clinical CIMT outcomes including a detailed
description of tests of the assumptions behind the statistical analyses.
The outcomes are quality of life (Short Form Health Survey (SF-36)),
Diabetes Medication Satisfaction Questionnaire, and Insulin Treatment
Satisfaction Questionnaire (assessed at entry and 18 months after
randomisation) and cardiovascular outcomes including time to a composite
of either myocardial infarction, stroke, peripheral amputation, coronary
revascularisation, peripheral revascularisation, or death.
<br/>Discussion(s): This statistical analysis plan ensure the highest
possible quality of the subsequent post-hoc analyses. Trial registration:
The protocol was approved by the Regional Committee on Biomedical Research
Ethics (H-D-2007-112), the Danish Medicines Agency (EudraCT:
2007-006665-33 CIMT), and registered within ClinicalTrials.gov
(NCT00657943, 8^th of April 2008).<br/>Copyright &#xa9; 2023 The
Authors

<17>
Accession Number
2023087204
Title
Acute Kidney Injury After General Thoracic Surgery: A Systematic Review
and Meta-Analysis.
Source
Journal of Surgical Research. 287 (pp 72-81), 2023. Date of Publication:
July 2023.
Author
Lei S.-H.; Guo G.-F.; Yan T.; Zhao B.-C.; Qiu S.-D.; Liu K.-X.
Institution
(Lei, Zhao, Qiu, Liu) Department of Anesthesiology, Nanfang Hospital,
Southern Medical University, Guangzhou, China
(Guo) Department of Anesthesiology and Perioperative Medicine, Henan
Provincial People's Hospital, People's Hospital of Zhengzhou University,
Zhengzhou, China
(Yan) Department of Anesthesiology, Fujian Medical University Union
Hospital, Fuzhou, China
Publisher
Academic Press Inc.
Abstract
Introduction: The clinical importance of postoperative acute kidney injury
(AKI) in patients undergoing general thoracic surgery is unclear. We aimed
to systematically review the incidence, risk factors, and prognostic
implications of AKI as a complication after general thoracic surgery.
<br/>Method(s): We searched PubMed, EMBASE, and the Cochrane Library from
January 2004 to September 2021. Observational or interventional studies
that enrolled >=50 patients undergoing general thoracic surgery and
reported postoperative AKI defined using contemporary consensus criteria
were included for meta-analysis. <br/>Result(s): Thirty-seven articles
reporting 35 unique cohorts were eligible. In 29 studies that enrolled
58,140 consecutive patients, the pooled incidence of postoperative AKI was
8.0% (95% confidence interval [CI]: 6.2-10.0). The incidence was 3.8
(2.0-6.2) % after sublobar resection, 6.7 (4.1-9.9) % after lobectomy,
12.1 (8.1-16.6) % after bilobectomy/pneumonectomy, and 10.5 (5.6-16.7) %
after esophagectomy. Considerable heterogeneity in reported incidences of
AKI was observed across studies. Short-term mortality was higher
(unadjusted risk ratio: 5.07, 95% CI: 2.99-8.60) and length of hospital
stay was longer (weighted mean difference: 3.53, 95% CI: 2.56-4.49, d) in
patients with postoperative AKI (11 studies, 28,480 patients). Several
risk factors for AKI after thoracic surgery were identified.
<br/>Conclusion(s): AKI occurs frequently after general thoracic surgery
and is associated with increased short-term mortality and length of
hospital stay. For patients undergoing general thoracic surgery, AKI may
be an important postoperative complication that needs early risk
evaluation and mitigation.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<18>
Accession Number
2017196916
Title
Predictors of quality of life after revascularization for ischemic heart
disease: A systematic review.
Source
Health Sciences Review. 2 (no pagination), 2022. Article Number: 100017.
Date of Publication: March 2022.
Author
Pons A.; Whalley G.; Sneddon K.; Williams M.; Coffey S.
Institution
(Pons, Whalley) Department of Medicine, Otago Medical School, Dunedin, New
Zealand
(Sneddon, Williams, Coffey) HeartOtago, Department of Medicine, Otago
Medical School, PO Box 56, Dunedin 9054, New Zealand
Publisher
Elsevier Ltd
Abstract
Background: Quality of life is a key outcome after coronary
revascularization for ischemic heart disease in the modern era. 6-12
months after coronary revascularization, recovery from the intervention
itself, especially coronary artery bypass grafting, is no longer the key
determinant of quality of life, while the benefits (or lack thereof) of
revascularization become more apparent. Potential determinants of quality
of life that are not directly related to the form of intervention have
been less frequently examined in this group of patients. <br/>Method(s):
This systematic review examined the association of published contributors
to quality of life in patients following coronary revascularization for
ischemic heart disease 6-12 months post intervention. Studies that
reported such associations were identified and assessed for quality. 11
were included in this review. Quality of life was measured by the Short
Forms 36 and 12, and the Seattle Angina Questionnaire. <br/>Result(s): Of
potentially modifiable factors, current smoking and hypertension displayed
the most consistent associations with reduced quality of life after
intervention. Quality of life was positively associated with baseline
quality of life and being partnered/married, and negatively associated
with female sex, diabetes, and lung or renal disease, and only minimally
associated with ejection fraction. Age and prior myocardial infarction
displayed conflicting associations. <br/>Conclusion(s): To improve patient
outcomes following coronary revascularization, other potentially
modifiable non-procedural factors that affect quality of life could be
targeted for more intensive management. Smoking cessation and
anti-hypertensive therapies treat the most consistent factors associated
with reduced quality of life after revascularization.<br/>Copyright &#xa9;
2022

<19>
Accession Number
640487872
Title
Effects of glucagon-like peptide-1 receptor agonists on major coronary
events in patients with type 2 diabetes.
Source
Diabetes, obesity & metabolism. (no pagination), 2023. Date of
Publication: 02 Mar 2023.
Author
Guo X.; Sang C.; Tang R.; Jiang C.; Li S.; Liu N.; Long D.; Du X.; Dong
J.; Ma C.
Institution
(Guo, Sang, Tang, Jiang, Li, Liu, Long, Du, Dong, Ma) Department of
Cardiology, Beijing Anzhen Hospital, Capital Medical University, National
Clinical Research Center for Cardiovascular Diseases, Beijing, China
Publisher
NLM (Medline)
Abstract
AIMS: In patients suffering from type 2 diabetes mellitus (T2DM), the
effect of glucagon-like peptide-1 receptor agonists (GLP-1RAs) treatment
on major coronary events, including myocardial infarction (MI), unstable
angina and coronary revascularization, is unclear. We performed a
meta-analysis to assess the benefits of GLP-1RAs for major coronary
events. MATERIALS AND METHODS: We systematically searched the PubMed,
CENTRAL, EMBASE, and clinicaltrial.gov databases to seek eligible studies
with a cardiovascular endpoint comparing GLP-1RAs with a placebo in T2DM
patients. Odds ratio (OR) and 95% confidence interval (CI) were calculated
for the outcomes. <br/>RESULT(S): Nine studies, with a total of 64236
patients, were conducted. GLP-1RA treatment reduced fatal and non-fatal MI
by 8% (OR 0.92, 95% CI 0.86-0.99; P =0.02; I2 =39%). Further, the
reduction reached 15% in human-based GLP-1RA treated patients. Similarly,
Once-weekly GLP-1RA treatment reduced the risk of MI by 13%. In contrast,
GLP-1RA treatment did not reduce the risk of hospitalization for unstable
angina (OR 1.11, 95% CI 0.97-1.28; P =0.13; I2 =21%). GLP-1RAs exhibited a
tendency to lower the risk of coronary revascularization (OR 0.95, 95% CI
0.89-1.02,P =0.15,I2 =22%), but without statistical significance. However,
human-based GLP-1RAs decreased the risk by 11%. <br/>CONCLUSION(S): In
high-risk patients suffering from T2DM, GLP-1RAs were associated with a
decrease in MI, especially the human-based and once-weekly GLP-1RAs. No
benefit was seen for hospitalization for unstable angina or coronary
revascularization. Further research is urgently needed to ascertain
improvements in coronary events. This article is protected by copyright.
All rights reserved.

<20>
Accession Number
640487463
Title
The Role of Pericardial Fluid Biomarkers in Predicting Post-Operative
Atrial Fibrillation, A Comprehensive Review of Current Literature.
Source
Trends in cardiovascular medicine. (no pagination), 2023. Date of
Publication: 28 Feb 2023.
Author
Liblik K.; Zucker J.; Baranchuck A.; Fernandez A.L.; Zhang S.; Diasty M.E.
Institution
(Liblik, Zucker, Diasty) Division of Cardiac Surgery, Queen's University,
Kingston, ON, Canada
(Baranchuck, Zhang) Division of Cardiology, Department of Medicine,
Queen's University, Kingston, ON, Canada
(Fernandez) Cardiac Surgery Department, University Hospital, Santiago de
Compostela, Spain
Publisher
NLM (Medline)
Abstract
Post-operative atrial fibrillation (POAF) is a common complication of
cardiac surgery which is associated with longer hospital stay, diminished
quality of life, and increased mortality. Yet, the pathophysiology of POAF
is poorly understood and it is unclear which patients are at highest risk.
Pericardial fluid (PCF) analysis is emerging as an important tool for the
early detection of biochemical and molecular changes in the cardiac
tissue. With the epicardium acting as a semi-permeable membrane, the
composition of PCF reflects the activity of the cardiac interstitium.
Emerging research on PCF composition has identified promising biomarkers
which may help stratify the risk for developing POAF. These include
inflammatory molecules, such as interleukin-6, mitochondrial
deoxyribonucleic acid, and myeloperoxidase, as well as natriuretic
peptides. Additionally, PCF appears to be superior to serum analysis in
detecting changes in these molecules during the early postoperative period
after cardiac surgery. The aim of the present narrative review is to
summarize the current literature on the temporal changes in the levels of
potential biomarkers in PCF after cardiac surgery and their association
with the development of new-onset postoperative atrial
fibrillation.<br/>Copyright &#xa9; 2023. Published by Elsevier Inc.

<21>
Accession Number
640486949
Title
Methylprednisolone for Cardiac Surgery in Infants: Findings From a
Large-scale, Randomized, Controlled Trial.
Source
Journal of cardiothoracic and vascular anesthesia. (no pagination), 2023.
Date of Publication: 09 Feb 2023.
Author
Townsley M.M.
Institution
(Townsley) Division of Congenital Cardiac Anesthesiology, University of
Alabama at Birmingham School of Medicine, Birmingham, AL; Bruno Pediatric
Heart Center, Children's of Alabama, Birmingham, AL
Publisher
NLM (Medline)

<22>
Accession Number
640478862
Title
Optimum heparin dose in off-pump coronary artery bypass grafting: A
systematic review and meta-analysis.
Source
Perfusion. (pp 2676591231159506), 2023. Date of Publication: 01 Mar 2023.
Author
Khalil M.A.; Kaddoura R.; Omar A.S.; Abohamar A.D.; Izham M.
Institution
(Khalil) Anesthesia Department, Faculty of Medicine, 63526Cairo
University, Giza, Egypt
(Kaddoura) Department of Clinical pharmacy, 36977Hamad Medical
Corporation, Doha, Qatar
(Omar) Department of Cardiothoracic Surgery/Cardiac Anesthesia & ICU,
Heart Hospital, 36977Hamad Medical Corporation, Doha, Qatar
(Omar) Department of Critical Care Medicine, Beni-Suef University, Egypt
(Omar) Weill Cornell Medical College, Ar-Rayyan, Qatar
(Abohamar) Anesthesia Department, Faculty of Medicine, 68782Tanta
University, Egypt
(Izham) Faculty of Pharmacy, 61780Qatar University, Doha, Qatar
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Off-pump coronary artery bypass grafting (OPCABG) was
introduced many years ago aiming to reduce the known complications of
conventional on-pump coronary surgeries. Heparin is required during the
procedures, but the available protocols have diverse dosage regimens. The
primary objective of this systematic review is to examine the effect of
different heparin doses on the outcomes of OPCABG. EVIDENCE ACQUISITION:
MEDLINE and EMBASE were searched. Four reviewers identified eligible
clinical trials. Two reviewers extracted data and independently assessed
the risk of bias using Cochrane tool. The primary outcome was the
activated clotting time (ACT) at three minutes. The secondary outcomes
were proportion of patients requiring blood products and the length of
hospital stay. An aggregate data approach was used. EVIDENCE SYNTHESIS:
Three single-center randomized studies recruiting 256 patients were
included. The studies compared low-dose (1.5-2 mg/kg) and high-dose (3
mg/kg) heparin boluses. The overall mean difference for ACT after three
minutes between low- and high-dose heparin is - 126.16 (95% CI: - 142.19,
- 110.14). The proportion of patients requiring blood products after
surgery [odd ratio 1.27 (95% CI: 0.69, 2.32)] or the overall length of
stay [mean difference -0.15 (95% CI: -0.84, 0.53)] did not differ between
the heparin doses. <br/>CONCLUSION(S): In OPCABG, high-dose compared with
low-dose heparin did not affect the utilization of more blood products or
increased the overall length of stay. Unsurprisingly, ACT values were
higher in the high-dose heparin group. Larger and adequately powered
randomized clinical trials are indicated to resolve the uncertainty.

<23>
Accession Number
2022851278
Title
Impact of Peripheral Artery Disease in Patients With Heart Failure
Undergoing Transcatheter Mitral Valve Repair: The COAPT Trial.
Source
Journal of the American Heart Association. 12(4) (no pagination), 2023.
Article Number: e028444. Date of Publication: 21 Feb 2023.
Author
Shahim B.; Cohen D.J.; Ben-Yehuda O.; Redfors B.; Kar S.; Lim D.S.; Arnold
S.V.; Li Y.; Lindenfeld J.; Abraham W.T.; Mack M.J.; Stone G.W.
Institution
(Shahim, Cohen, Ben-Yehuda, Redfors, Li) Clinical Trials Center,
Cardiovascular Research Foundation, New York, NY, United States
(Shahim) Division of Cardiology, Department of Medicine Solna, Karolinska
Institutet, Karolinska University Hospital, Stockholm, Sweden
(Cohen) St. Francis Hospital, Roslyn, NY, United States
(Ben-Yehuda, Redfors) New York-Presbyterian Hospital, Columbia University
Irving Medical Center, New York, NY, United States
(Ben-Yehuda) Division of Cardiology, University of California-San Diego,
San Diego, CA, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kar) Bakersfield Heart Hospital, Bakersfield, CA, United States
(Lim) Division of Cardiology, University of Virginia, Charlottesville, VA,
United States
(Arnold) University of Missouri-Kansas City School of Medicine, Kansas
City, MO, United States
(Arnold) Saint Luke's Mid America Heart Institute, Kansas City, MO, United
States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University,
Columbus, OH, United States
(Mack) Baylor Scott & White Health, Plano, TX, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Peripheral artery disease (PAD) and heart failure (HF) often
coexist. Whether PAD influences outcomes of tran-scatheter mitral valve
repair (TMVr) in patients with HF and severe secondary mitral
regurgitation is unknown. The objectives are to assess the impact of PAD
on outcomes of TMVr plus guideline-directed medical therapy (GDMT) versus
GDMT alone in patients with HF and secondary mitral regurgitation. METHODS
AND RESULTS: The COAPT trial (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients with Functional
Mitral Regurgitation) randomized patients with HF with
>=moderate-to-severe secondary mitral regurgitation to TMVr with MitraClip
implant plus GDMT versus GDMT alone. We evaluated the relationship between
PAD and 2-year outcomes in the COAPT trial and examined whether PAD
modified the benefits of TMVr. Among 614 patients enrolled, 109 (17.8%)
had PAD. By multivariable analysis, PAD was independently associated with
2-year mortality (adjusted hazard ratio [adjHR], 1.51 [95% CI, 1.07-2.15])
but not HF hospitalizations. Compared with GDMT alone, TMVr reduced the
2-year risk of death in patients without PAD (adjHR, 0.42 [95% CI, 0.30-
0.60]) but not those with PAD (adjHR, 1.27 [95% CI, 0.72-2.27];
P<inf>interaction</inf> =0.001). In con-trast, TMVr reduced HF
hospitalizations consistently in patients with (adjHR, 0.65 [95% CI,
0.35-1.23]) and without (adjHR, 0.42 [95% CI, 0.31- 0.57]) PAD
(P<inf>interaction</inf> =0.22). Improvements in health status and
exercise capacity at 2 years with TMVr compared with GDMT alone were
similar in degree, irrespective of PAD status (P<inf>interaction</inf>
=0.76 and 0.64, respectively). <br/>CONCLUSION(S): In patients with HF and
severe secondary mitral regurgitation, the reduced mortality with TMVr in
the overall COAPT study population was not observed in the subgroup of
patients with PAD. However, TMVr reduced HF hospitalizations and improved
health status and exercise capacity consistently in patients with and
without PAD. REGISTRATION: Clinical Trial Name: Cardiovascular Outocmes
Assessment of the MitraClip Percutaneous Therapy for Heart Failure
Patients with Functional Mitral Regurgitation (The COAPT Trial); URL:
https://www.clinicaltrials.gov/; Unique identifier: NCT01626079.
https://clinicaltrials.gov/ct2/show/NCT01626079.<br/>Copyright &#xa9; 2023
The Authors. Published on.

<24>
Accession Number
2022621897
Title
Kounis Syndrome Associated With the Use of Diclofenac.
Source
Texas Heart Institute Journal. 50(1) (no pagination), 2023. Article
Number: e217802. Date of Publication: January 2023.
Author
Pejcic A.V.; Milosavljevic M.N.; Jankovic S.; Davidovic G.; Folic M.M.;
Folic N.D.
Institution
(Pejcic, Milosavljevic, Jankovic) Department of Pharmacology and
Toxicology, Faculty of Medical Sciences, University of Kragujevac,
Kragujevac, Serbia
(Jankovic, Folic) Clinical Pharmacology Department, University Clinical
Centre Kragujevac, Kragujevac, Serbia
(Davidovic) Department of Internal Medicine, Faculty of Medical Sciences,
University of Kragujevac, Kragujevac, Serbia
(Folic) Department of Pharmacy, Faculty of Medical Sciences, University of
Kragujevac, Kragujevac, Serbia
(Folic) Pediatric Clinic, University Clinical Centre Kragujevac,
Kragujevac, Serbia
(Folic) Department of Pediatrics, Faculty of Medical Sciences, University
of Kragujevac, Kragujevac, Serbia
Publisher
Texas Heart Institute
Abstract
Background: Diclofenac is a widely used analgesic, anti-inflammatory,
antipyretic drug. In several case reports, its use was associated with the
occurrence of Kounis syndrome. The aim of this review was to in-vestigate
and summarize published cases of Kounis syndrome suspected to be
associated with the use of diclofenac. <br/>Method(s): Electronic searches
were conducted in PubMed/MEDLINE, Scopus, Web of Science, Google Scholar,
and the Serbian Citation Index. <br/>Result(s): Twenty publications
describing the 20 patients who met inclusion criteria were included in the
systematic review. Specified patient ages ranged from 34 to 81 years.
Eighteen (90.0%) patients were male. Five patients (25.0%) reported a
previous reaction to diclofenac. Reported time from the used dose of
diclofenac to onset of the first reaction symptoms ranged from immediately
to 5 hours. Diclofenac caused both type I and type II Kounis syndrome,
with the presence of various cardiovascular, gastrointestinal,
dermatolog-ic, and respiratory signs and symptoms. Most patients
experienced hypotension (n = 15 [75.0%]) and chest pain (n = 12 [60.0%]).
The most frequently reported finding on electrocardiogram was ST-segment
elevations (n = 17 [85.0%]). Coronary angiogram showed normal coronary
vessels in 9 patients (45.0%), with some pathologic findings in 8 patients
(40.0%). <br/>Conclusion(s): Clinicians should be aware that Kounis
syndrome may be an adverse effect of diclofenac. Prompt recognition and
withdrawal of the drug, with treatment of both allergic and cardiac
symptoms simul-taneously, is important.<br/>Copyright &#xa9; 2023 by The
Texas Heart Institute, Houston.

<25>
Accession Number
2022257125
Title
Direct intramyocardial injection of VEGF mRNA in patients undergoing
coronary artery bypass grafting.
Source
Molecular Therapy. 31(3) (pp 866-874), 2023. Date of Publication: 01 Mar
2023.
Author
Anttila V.; Saraste A.; Knuuti J.; Hedman M.; Jaakkola P.; Laugwitz K.-L.;
Krane M.; Jeppsson A.; Sillanmaki S.; Rosenmeier J.; Zingmark P.; Rudvik
A.; Garkaviy P.; Watson C.; Pangalos M.N.; Chien K.R.; Fritsche-Danielson
R.; Collen A.; Gan L.-M.
Institution
(Anttila, Saraste) Heart Centre, Turku University Hospital and University
of Turku, Turku, Finland
(Saraste, Knuuti) Turku PET Centre, Turku University Hospital and
University of Turku, Turku, Finland
(Hedman, Jaakkola) Heart Centre, Kuopio University Hospital, Kuopio,
Finland
(Hedman) Institute of Clinical Medicine, University of Eastern Finland,
Kuopio, Finland
(Laugwitz) First Medical Department (Cardiology, Angiology and
Pneumology), Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany
(Krane) German Centre for Cardiovascular Research (DZHK), Munich Heart
Alliance, Munich, Germany
(Krane) Department of Cardiovascular Surgery, German Heart Centre Munich,
Technical University of Munich, Munich, Germany
(Krane) Division of Cardiac Surgery, Yale School of Medicine, Yale
University, New Haven, CT, United States
(Jeppsson, Gan) Department of Molecular and Clinical Medicine, Institute
of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
(Jeppsson) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Sillanmaki) Department of Clinical Physiology and Nuclear Medicine,
Kuopio University Hospital, Kuopio, Finland
(Rosenmeier, Zingmark, Garkaviy, Fritsche-Danielson, Collen, Gan) Research
and Early Clinical Development, Cardiovascular, Renal and Metabolism,
BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
(Rudvik) Early Biometrics & Statistical Innovation, Data Science &
Artificial Intelligence, R&D, AstraZeneca, Gothenburg, Sweden
(Watson) Study Management Early, Cardiovascular, Renal, and Metabolism,
BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
(Pangalos) BioPharmaceuticals Research and Development, AstraZeneca,
Cambridge, United Kingdom
(Chien) Department of Cell and Molecular Biology, Karolinska Institutet,
Stockholm, Sweden
(Gan) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
Publisher
Cell Press
Abstract
Vascular endothelial growth factor A (VEGF-A) has therapeutic
cardiovascular effects, but delivery challenges have impeded clinical
development. We report the first clinical study of naked mRNA encoding
VEGF-A (AZD8601) injected into the human heart. EPICCURE
(ClinicalTrials.gov: NCT03370887) was a randomized, double-blind study of
AZD8601 in patients with left ventricular ejection fraction (LVEF) 30%-50%
who were undergoing elective coronary artery bypass surgery. Thirty
epicardial injections of AZD8601 (total 3 mg) or placebo in
citrate-buffered saline were targeted to ischemic but viable myocardial
regions mapped using quantitative [¹⁵O]-water positron emission
tomography. Seven patients received AZD8601 and four received placebo and
were followed for 6 months. There were no deaths or treatment-related
serious adverse events and no AZD8601-associated infections, immune
reactions, or arrhythmias. Exploratory outcomes indicated potential
improvement in LVEF, Kansas City Cardiomyopathy Questionnaire scores, and
N-terminal pro-B-type natriuretic peptide levels, but the study is limited
in size, and significant efficacy conclusions are not possible from the
dataset. Naked mRNA without lipid encapsulation may provide a safe
delivery platform for introducing genetic material to cardiac muscle, but
further studies are needed to confirm efficacy and safety in a larger
patient pool.<br/>Copyright &#xa9; 2023 The Authors

<26>
Accession Number
2021856730
Title
Assessment of redundant randomized clinical trials among patients with ST
segment elevation myocardial infarction.
Source
BMC Medicine. 21(1) (no pagination), 2023. Article Number: 69. Date of
Publication: December 2023.
Author
Jia Y.; Liang J.; Wang W.; Wei X.; Xiao S.; Robinson K.A.
Institution
(Jia) Shenzhen Institute of Advanced Technology, Chinese Academy of
Sciences, Shenzhen, China
(Liang) Blood Station, Beijing, Tongzhou, China
(Wang) Department of Cardiology and Institute of Vascular Medicine, Peking
University Third Hospital, Peking University, 49 Huayuan N Rd, Haidian
District, Beijing 100191, China
(Wei) Department of Cardiology, Virginia Commonwealth University,
Richmond, United States
(Xiao) Department of Pediatrics, School of Medicine, Johns Hopkins
University, Baltimore, United States
(Robinson) Department of Medicine, School of Medicine, Johns Hopkins
University, Baltimore, United States
Publisher
BioMed Central Ltd
Abstract
Background: Redundant clinical trials waste resources and unnecessarily
put patients at risk for harm. The objectives of the study were to assess
redundant randomized clinical trials (RCTs) conducted in mainland China or
the USA among patients with ST segment elevation myocardial infarction
(STEMI) and estimate the harm to patients enrolled in redundant RCTs.
<br/>Method(s): We searched bibliographic databases for eligible RCTs
comparing a routine therapy with a placebo or no treatment among patients
with STEMI in mainland China or the United States. The routine therapy for
STEMI included reperfusion (percutaneous coronary intervention or
fibrinolytic therapy), P2Y<inf>12</inf> receptor inhibitors, statins, and
anticoagulants. Redundant RCTs were defined as those initiated or
continued recruiting new patients 1 year after the experimental
intervention was established as routine therapy in clinical practice
guidelines. Cumulative meta-analyses were conducted to confirm the
efficacy of these routine therapies. The primary outcome was the number of
extra major adverse cardiac events (MACEs) attributable to the deprivation
of routine therapies among patients in the control groups of redundant
RCTs-that is, the number of extra MACEs that could have been prevented had
these patients received routine therapy. <br/>Result(s): Nine hundred
eighty-three eligible RCTs conducted in mainland China were identified, of
which 775 (78.8%) were redundant. None of the five eligible RCTs conducted
in the United States were redundant. All redundant RCTs have reiterated
the benefits of routine therapies for patients with STEMI, while none were
cited by the 2019 clinical practice guideline for the management of STEMI.
The 18,819 patients in the control groups of redundant RCTs experienced
3305 (95% CI: 3169-3441) extra MACEs, including 1091 (1014-1165) deaths,
576 (519-633) recurrent myocardial infarctions, 31 (19-42)
revascularizations, 39 (23-54) strokes, 744 (679-810) heart failures, and
823 (754-893) patients with recurrent or exacerbated angina pectoris.
Cumulative meta-analyses confirmed the efficacy of the routine therapies
among patients in mainland China and supported using practice guidelines
to define redundant RCTs. <br/>Conclusion(s): Redundant RCTs conducted in
mainland China have resulted in unnecessary MACEs among patients with
STEMI. While the reasons behind redundant RCTs need to be further
investigated, these results suggest potential research waste and violation
of research ethics.<br/>Copyright &#xa9; 2023, The Author(s).

<27>
Accession Number
2021752047
Title
Does an eHealth Intervention Reduce Complications and Healthcare
Resources? A mHeart Single-Center Randomized-Controlled Trial.
Source
Journal of Cardiovascular Development and Disease. 10(2) (no pagination),
2023. Article Number: 77. Date of Publication: February 2023.
Author
Gomis-Pastor M.; Mirabet Perez S.; De Dios Lopez A.; Brossa Loidi V.;
Lopez Lopez L.; Pelegrin Cruz R.; Mangues Bafalluy M.A.
Institution
(Gomis-Pastor) Digital Health Department and Pharmacy Department, Hospital
de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona 08025, Spain
(Mirabet Perez, Brossa Loidi, Lopez Lopez) Heart Failure and Heart
Transplant Unit, Cardiology Department, Hospital de la Santa Creu i Santa
Pau and CIBER de Enfermedades Cardiovasculares (CIBER-CV), IIB Sant Pau,
Barcelona 08025, Spain
(De Dios Lopez, Pelegrin Cruz) Pharmacy Department, Hospital de la Santa
Creu i Santa Pau, Barcelona 08025, Spain
(Mangues Bafalluy) Pharmacy Department, Hospital de la Santa Creu i Santa
Pau and CIBER de Bioingenieria, Biomateriales y Nanomedicina (CIBER-BBN),
Barcelona 08025, Spain
Publisher
MDPI
Abstract
(1) Background: In the mHeart trial, we showed that an eHealth
intervention, mHeart, improved heart transplant (HTx) recipients'
adherence to immunosuppressive therapy compared with the standard of care.
Herein, we present the analysis assessing whether mHeart reduces
complication frequency and healthcare resource use, and whether this
reduction depends on patients' adherence. (2) Methods: The mHeart was a
single-center randomized-controlled trial (IIBSP-MHE-2014-55) in 134 adult
HTx recipients (n = 71 intervention; n = 63 controls). The endpoints were
mortality, complications, and resource use during follow-up (mean 1.6 +/-
0.6 years). (3) Results: A significantly lower proportion of HTx
recipients in mHeart had echocardiographic alteration (2.8% vs. 13.8%; p =
0.02), cardiovascular events (0.35% vs. 2.4%; p = 0.006), infections
(17.2% vs. 56%; p = 0.03), and uncontrolled Hba1c (40.8% vs. 59.6%; p =
0.03) than controls. In addition, a significantly lower proportion of
patients in the intervention needed hospital (32.4% vs. 56.9%; p = 0.004)
or urgent admissions (16.9% vs. 41.4%; p = 0.002) and emergency room
visits (50.7% vs. 69.0%; p = 0.03). Adherence status (measured by the
self-reported SMAQ) influenced only controls regarding hospitalizations
and emergency room visits. Differences were not significant on deaths
(intervention 4.2% vs. control 9.5%; p = 0.4) (4) <br/>Conclusion(s): the
mHeart strategy significantly reduced the occurrence of the studied
post-transplant complications and the need for medical attention in HTx
recipients. Adherence status influenced controls in their need for medical
care.<br/>Copyright &#xa9; 2023 by the authors.

<28>
Accession Number
2021751986
Title
Early Mortality in Infants Born with Neonatally Operated Congenital Heart
Defects and Low or Very-Low Birthweight: A Systematic Review and
Meta-Analysis.
Source
Journal of Cardiovascular Development and Disease. 10(2) (no pagination),
2023. Article Number: 47. Date of Publication: February 2023.
Author
Derridj N.; Ghanchi A.; Bonnet D.; Adnot P.; Rahshenas M.; Salomon L.J.;
Cohen J.F.; Khoshnood B.
Institution
(Derridj, Ghanchi, Rahshenas, Cohen, Khoshnood) Centre of Research in
Epidemiology and Statistics (Inserm 1153, CRESS), Universite Paris Cite,
Paris 75004, France
(Derridj, Bonnet) M3C-Necker, National Reference Center for Complex
Congenital Heart Diseases, APHP, Universite Paris Cite, Hopital
Necker-Enfants Malades, CEDEX 15, Paris 75743, France
(Ghanchi, Salomon) Department of Obstetrics and Fetal Medicine, APHP,
Universite Paris Cite, Hopital Necker-Enfants Malades, CEDEX 15, Paris
75743, France
(Adnot, Cohen) Department of General Pediatrics and Pediatric Infectious
Diseases, APHP, Universite Paris Cite, Hopital Necker-Enfants Malades,
CEDEX 15, Paris 75743, France
Publisher
MDPI
Abstract
Mortality outcomes of children with isolated neonatally operated
congenital heart defects (CHDs) born with a low (LBW), moderately low
(MLBW) or very-low birthweight (VLBW) remain ambiguous. We searched
Medline and Embase (inception until October 2021) and included studies
that evaluated early mortality. The risk of bias was assessed using the
Critical Appraisal Skills Program cohort checklist. Meta-analysis involved
random-effects models. We explored variability in mortality across
birthweight subgroups, CHD types, and study designs. From 2035 reports, we
included 23 studies in qualitative synthesis, and the meta-analysis
included 11 studies (1658 CHD cases), divided into 30 subcohorts. The risk
of bias was low in 4/11 studies included in the meta-analysis. Summary
mortality before discharge or within one month after surgery was 37%
(95%CI 27-47). Early mortality varied by birthweight (VLBW 56%, MLBW 15%,
LBW 16%; p = 0.003) and CHD types (hypoplastic left heart syndrome (HLHS)
50%, total anomalous pulmonary venous return (TAPVR) 47%, transposition of
the great arteries (TGA) 34%, coarctation of the aorta (CoA) 16%; p =
0.13). Mortality was higher in population-based studies (49% vs. 10%; p =
0.006). One-third of infants born with neonatally operated isolated CHDs
and LBW, MLBW, or VLBW died within 30 days after surgery. Mortality varied
across infant and study characteristics. These results may help clinicians
assess neonatal prognosis. PROSPERO registration
CRD42020170289.<br/>Copyright &#xa9; 2023 by the authors.

<29>
Accession Number
2020606838
Title
Persistent diaphragm dysfunction after cardiac surgery is associated with
adverse respiratory outcomes: a prospective observational ultrasound
study.
Source
Canadian Journal of Anesthesia. 70(2) (pp 228-236), 2023. Date of
Publication: February 2023.
Author
Laghlam D.; Naudin C.; Srour A.; Monsonego R.; Malvy J.; Rahoual G.;
Squara P.; Nguyen L.S.; Estagnasie P.
Institution
(Laghlam, Srour, Monsonego, Malvy, Rahoual, Squara, Nguyen, Estagnasie)
Department of Cardiology and Critical Care, Neuilly-sur-Seine, France
(Naudin) Recherche et Innovation Clinique Ambroise Pare (RICAP),
Neuilly-sur-Seine, France
(Laghlam, Squara, Nguyen, Estagnasie) CERIC, Clinique Ambroise Pare, 27
Boulevard Victor Hugo, Neuilly-sur-Seine 92200, France
Publisher
Springer
Abstract
Background: Transient diaphragm dysfunction is common during the first
week after cardiac surgery; however, the precise incidence, risk factors,
and outcomes of persistent diaphragm dysfunction are not well described.
<br/>Method(s): In a single-centre prospective cohort study, we included
all consecutive patients over 18 yr who underwent elective cardiac
surgery. Diaphragm function was evaluated with ultrasound (M-mode) by
recording the excursion of both hemidiaphragms at two different time
points: preoperatively and after the seventh postoperative day in patients
breathing without assistance. Significant diaphragm dysfunction after the
seventh day of the index cardiac surgery was defined as a decrease in
diaphragm excursion below the lower limit of normal: at rest, < 9 mm for
women and < 10 mm for men; after a sniff test, < 16 mm for women and < 18
mm for men. <br/>Result(s): Overall, 122 patients were included in the
analysis. The median [interquartile range (IQR)] age was 69 [59-74] years
and 96/122 (79%) were men. Ten (8%) patients had diaphragm dysfunction
after the seventh postoperative day. We did not identify risk factors for
persistent diaphragm dysfunction. Persistent diaphragm dysfunction was
associated with a longer median [IQR] duration of noninvasive (8 [0-34] vs
0 [0-0] hr; difference in medians, 8 hr; 95% confidence interval [CI], 0
to 22; P < 0.001) and invasive mechanical ventilation (5 [3-257] vs 3[2-4]
hr; difference in medians, 2 hr; 95% CI, 0.5 to 41; P = 0.008); a higher
reintubation rate (4/10, 40% vs 1/112, 0.9%; relative risk, 45; 95% CI,
7.1 to 278; P < 0.0001), a higher incidence of pneumonia (4/10 [40%] vs
7/112 [6%]; relative risk, 6; 95% CI, 2 to 16; P < 0.001), and longer
median [IQR] length of stay in the intensive care unit (8 [5-29] vs 4
[2-6] days; difference in medians, 4 days; 95% CI, 2 to 12; P = 0.002).
<br/>Conclusion(s): The incidence of persistent diaphragm dysfunction was
8% in patients undergoing elective cardiac surgery and was associated with
adverse respiratory outcomes. Study registration: ClinicalTrials.gov
(NCT04276844); prospectively registered 19 February 2020.<br/>Copyright
&#xa9; 2022, Canadian Anesthesiologists' Society.

<30>
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. 101(3) (pp 639-650),
2023. Date of Publication: 15 Feb 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.

<31>
Accession Number
2021935965
Title
A series of experiences with TissuePatchTM for alveolar air leak after
pulmonary resection.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2023. Date
of Publication: 2023.
Author
Homma T.
Institution
(Homma) Division of Thoracic Surgery, Kurobe City Hospital, 1108-1
Mikkaichi, Toyama, Kurobe 938-8502, Japan
(Homma) Division of Thoracic Surgery, University of Toyama, Toyama, Japan
Publisher
Springer
Abstract
Objectives: Prolonged air leak after pulmonary resection strongly
influences chest tube duration and hospitalization. This prospective study
aimed to report a series of experiences with a synthetic sealant
(TissuePatchTM) and compare them with a combination covering method
(polyglycolic acid sheet + fibrin glue) for air leaks after pulmonary
surgery. <br/>Method(s): We included 51 patients (age: 20-89 years) who
underwent lung resection. Patients who presented with alveolar air leak
during the intraoperative water sealing test were randomly assigned to the
TissuePatchTM or combination covering method groups. The chest tube was
removed when there was no air leak over a period of 6 h, and no active
bleeding under continuous monitoring using a digital drainage system. The
chest tube duration was assessed, and various perioperative factors (such
as the index of prolonged air leak score) were evaluated. <br/>Result(s):
Twenty (39.2%) patients developed intraoperative air leak; ten patients
received TissuePatchTM; and one patient who was receiving TissuePatchTM
switched to the combination covering method because of broken
TissuePatchTM. The chest tube duration, index of prolonged air leak score,
prolonged air leak, other complications, and postoperative hospitalization
in both groups were similar. No TissuePatchTM-related adverse events were
reported. <br/>Conclusion(s): Results from the use of TissuePatchTM were
almost similar to those associated with the use of combination covering
method in preventing prolonged postoperative air leak after pulmonary
resection. Randomized, double-arm studies are required to confirm the
efficacy of TissuePatchTM observed during this study.<br/>Copyright &#xa9;
2023, The Author(s), under exclusive licence to The Japanese Association
for Thoracic Surgery.

<32>
Accession Number
2022494478
Title
Efficacy of Auricular Acupuncture and Lavender Oil Aromatherapy in
Reducing Preinterventional Anxiety in Cardiovascular Patients: A
Randomized Single-Blind Placebo-Controlled Trial.
Source
Journal of Integrative and Complementary Medicine. 28(1) (pp 45-50), 2022.
Date of Publication: 01 Jan 2022.
Author
Patsalis P.C.; Malik-Patsalis A.B.; Rauscher H.G.; Schaefers C.; Useini
D.; Strauch J.T.; Zahn P.K.; Dobos G.J.; Mugge A.; Cramer H.
Institution
(Patsalis, Rauscher, Schaefers, Mugge) Department of Cardiology and
Angiology, University Hospital Bergmannsheil, Ruhr University Bochum,
Bochum, Germany
(Patsalis) Division of Cardiology and Emergency Medicine, Department of
Medicine, Knappschaft University Hospital, Ruhr University Bochum, Bochum,
Germany
(Malik-Patsalis, Dobos, Cramer) Department of Internal and Integrative
Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of
Duisburg-Essen, Essen, Germany
(Useini, Strauch) Department of Cardiothoracic Surgery, University
Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
(Zahn) Department of Anesthesiology, Intensive Care Medicine, Palliative
Care Medicine and Pain Management, University Hospital Bergmannsheil, Ruhr
University Bochum, Bochum, Germany
Publisher
Mary Ann Liebert Inc.
Abstract
Introduction: Auricular acupuncture at the "relaxation point"and lavender
oil aromatherapy can reduce preoperative anxiety associated with increased
mortality and morbidity. Data on the effect of combined auricular
acupuncture and lavender oil aromatherapy in patients undergoing
cardiovascular interventions with the use of local anesthesia or under
conscious sedation are sparse. The authors sought to evaluate the efficacy
of auricular acupuncture and lavender oil aromatherapy in reducing
preinterventional anxiety in cardiovascular patients. <br/>Material(s) and
Method(s): Data of 80 consecutive patients undergoing diagnostic coronary
angiography (n = 56) with or without percutaneous coronary intervention (n
= 9) and right heart catheterization (n = 6), transcatheter aortic valve
replacement (n = 17) and percutaneous mitral valve repair (MitraClip; n =
2) were analyzed. Patients were prospectively randomized to receive either
preinterventional auricular acupuncture and lavender oil (Lavandula
angustifolia) aromatherapy (verum group, n = 39) or combined sham
auricular acupuncture and placebo oil aromatherapy (placebo group, n =
41). For the verum group bilateral auricular acupuncture was performed at
the "relaxation point."State anxiety and blood pressure were assessed
before and at 30 min after acupuncture and presternal oil application.
State anxiety was defined as primary outcome measure and assessed using
the Spielberger State Anxiety Inventory (STAI) for Adults form Y6.
Intervention-specific anxiety was assessed by a 10-point numerical rating
scale, and perceived treatment success by a single dichotomous question.
Clinical blood pressure was further assessed. <br/>Result(s): After the
intervention, the verum group had significantly decreased anxiety on the
STAI compared with the placebo group (DELTA=-4.18; 95% confidence interval
=-8.31 to-0.05; p = 0.047). Significantly more patients reported
subjective treatment success in the verum group (87.2%) than in the
placebo group (65.9%, p = 0.035). No significant differences were observed
regarding intervention-specific anxiety and blood pressure between the two
groups. No serious adverse events occurred in any group.
<br/>Conclusion(s): Combined auricular acupuncture and lavender oil
aromatherapy can decrease preinterventional anxiety in cardiovascular
patients and requires further investigation. German Clinical Trials
Register (registration no. DRKS00023686).<br/>&#xa9; Copyright 2022, Mary
Ann Liebert, Inc., publishers 2022.

<33>
Accession Number
621406964
Title
Efficacy of continuous versus intermittent subglottic secretion drainage
in preventing ventilator-associated pneumonia in patients requiring
mechanical ventilation: A single-center randomized controlled trial.
Source
Oncotarget. 9(22) (pp 15876-15882), 2018. Date of Publication: 2018.
Author
Fujimoto H.; Yamaguchi O.; Hayami H.; Shimosaka M.; Tsuboi S.; Sato M.;
Takebayashi S.; Morita S.; Saito M.; Goto T.; Kurahashi K.
Institution
(Fujimoto, Yamaguchi, Hayami, Shimosaka, Tsuboi, Sato) Division of
Critical Care, Yokohama City University Medical Center, Minami-ku,
Yokohama, Kanagawa 232-0024, Japan
(Fujimoto, Yamaguchi, Goto) Department of Anesthesiology and Critical Care
Medicine, Yokohama City University Graduate School of Medicine,
Kanazawaku, Yokohama, Kanagawa 236-0004, Japan
(Takebayashi) Radiation Department, Yokohama City University Medical
Center, Minami-ku, Yokohama, Kanagawa 232-0024, Japan
(Morita, Saito) Department of Biostatistics and Epidemiology, Yokohama
City University Graduate School of Medicine, Kanazawa-ku, Yokohama,
Kanagawa 236-0004, Japan
(Kurahashi) Department of Anesthesiology and Intensive Care Medicine,
International University of Health and Welfare, School of Medicine,
Narita, Chiba 286-8686, Japan
Publisher
Impact Journals LLC
Abstract
Objective: Aspiration of subglottic secretion is a widely used
intervention to prevent ventilator-associated pneumonia (VAP). This study
aimed to compare the efficacy of continuous and intermittent subglottic
secretion drainage (SSD) in preventing VAP. <br/>Method(s): A
single-center randomized controlled trial was conducted on adult
postoperative patients who were expected to undergo mechanical ventilation
for more than 48 hours. Primary outcome measure was incidence of VAP and
secondary outcome measures were length of mechanical ventilation and
intensive-care unit (ICU) stay. <br/>Result(s): Fifty-nine patients
received continuous SSD, while 60 patients received intermittent SSD. Of
these 119 patients, 88 (74%) were excluded and 15 and 16 patients were
allocated to receive continuous and intermittent SSD, respectively. VAP
was detected in 4 (26.7%) and 7 (43.8%) patients in the continuous and
intermittent groups, respectively, (p=0.320). The length of mechanical
ventilation was significantly shorter (p=0.034) in the continuous group
(99.5+/-47.1 h) than in the intermittent group (159.9+/-94.5 h). The
length of ICU stay was also shorter (p=0.0097) in the continuous group
(6.3+/-2.1 days) than the intermittent group (9.8+/-4.8 days).
<br/>Conclusion(s): Although continuous SSD did not reduce the incidence
of VAP, it reduced the length of mechanical ventilation and ICU stay when
compared to intermittent SSD.<br/>Copyright &#xa9; Fujimoto et al.

<34>
Accession Number
2021753628
Title
Risk of Cardiovascular Events and Lipid Profile Change in Patients with
Breast Cancer Taking Aromatase Inhibitor: A Systematic Review and
Meta-Analysis.
Source
Current Oncology. 30(2) (pp 1831-1843), 2023. Date of Publication:
February 2023.
Author
Yoo J.-J.; Jung E.-A.; Kim Z.; Kim B.-Y.
Institution
(Yoo, Kim) Department of Internal Medicine, Soonchunhyang University
Bucheon Hospital, Soonchunhyaung University, College of Medicine, Bucheon
14584, South Korea
(Jung) Department of Medical Library, Soonchunhyang University Bucheon
Hospital, Soonchunhyaung University College of Medicine, Bucheon 14584,
South Korea
(Kim) Department of General Surgery, Soonchunhyang University Bucheon
Hospital, Soonchunhyaung University College of Medicine, Bucheon 14584,
South Korea
Publisher
MDPI
Abstract
Cardiovascular disease (CVD) is one of the most common comorbidities in
breast cancer survivors. Recently, the target population and treatment
period for aromatase inhibitor (AI) treatment in breast cancer patients
has been expanding. However, information on adverse CVD events from the
long-term use of AI is still lacking. The aim of this study was to
investigate the CVD side effects of AI treatment and to evaluate the
changes in lipid profile during AI treatment. A systematic search of
PubMed (Medline), EMBASE, and Cochrane Library databases reporting on
cardiovascular outcomes or lipid profiles change in adult female breast
cancer patients (>19 years old) with AI was performed. The pooled analysis
of 25 studies showed that the prevalence rate of any type of
cardiovascular disease was 6.08 per 100 persons (95% CI 2.91-10.31).
Angina was the most common type of heart-related cardiovascular event
accounting for 3.85 per 100 persons, followed by any type of stroke (3.34)
and venous thromboembolism (2.95). Ischemic stroke (OR 1.39, 95% CI
1.07-1.81) and myocardial infarction (OR 1.30, 95% CI 0.88-1.93) were more
common in AI compared with tamoxifen, whereas the prevalence of venous
thromboembolism (OR 0.61, 95% CI 0.37-1) was significantly lower in the AI
group. In addition, treatment with AI for 6-12 months showed a decrease in
HDL-cholesterol and an increase in LDL-cholesterol and total cholesterol.
Various CVDs can occur when using AI, and in particular, the risk of MI
and ischemic stroke increases in comparison with the adverse effect of
tamoxifen. The occurrence of CVD might be related to the deterioration of
the lipid profile after AI treatment. Therefore, a customized
individualization strategy considering each patient's CV risk factors is
needed during AI treatment.<br/>Copyright &#xa9; 2023 by the authors.

<35>
Accession Number
2021752061
Title
Virtual Reality Simulator versus Conventional Advanced Life Support
Training for Cardiopulmonary Resuscitation Post-Cardiac Surgery: A
Randomized Controlled Trial.
Source
Journal of Cardiovascular Development and Disease. 10(2) (no pagination),
2023. Article Number: 67. Date of Publication: February 2023.
Author
Peek J.J.; Max S.A.; Bakhuis W.; Huig I.C.; Rosalia R.A.; Sadeghi A.H.;
Mahtab E.A.F.
Institution
(Peek, Max, Bakhuis, Rosalia, Sadeghi, Mahtab) Department of
Cardiothoracic Surgery, Erasmus MC, University Medical Center Rotterdam,
Rotterdam 3015 GD, Netherlands
(Max) Medical Sciences Division, University of Oxford, Oxford OX1 2JD,
United Kingdom
(Huig) Department of Anesthesiology, Erasmus MC, University Medical Center
Rotterdam, Rotterdam 3015 GD, Netherlands
Publisher
MDPI
Abstract
External chest compressions are often ineffective for patients arresting
after cardiac surgery, for whom emergency resternotomy may be required. A
single-blinded randomized controlled trial (RCT) was performed, with
participants being randomized to a virtual reality (VR) Cardiac Surgical
Unit Advanced Life Support (CSU-ALS) simulator training arm or a
conventional classroom CSU-ALS training arm. Twenty-eight cardiothoracic
surgery (CTS) residents were included and subsequently assessed in a
moulage scenario in groups of two, either participating as a leader or
surgeon. The primary binary outcomes were two time targets: (1) delivering
three stacked shocks within 1 min and (2) resternotomy within 5 min.
Secondary outcomes were the number of protocol mistakes made and a
questionnaire after the VR simulator. The conventional training group
administered stacked shocks within 1 min in 43% (n = 6) of cases, and none
in the VR group reached this target, missing it by an average of 25 s. The
resternotomy time target was reached in 100% of the cases (n = 14) in the
conventional training group and in 83% of the cases (n = 10) in the VR
group. The VR group made 11 mistakes in total versus 15 for those who
underwent conventional training. Participants reported that the VR
simulator was useful and easy to use. The results show that the VR
simulator can provide adequate CSU-ALS training. Moreover, VR training
results in fewer mistakes suggesting that repetitive practice in an
immersive environment improves skills.<br/>Copyright &#xa9; 2023 by the
authors.

<36>
Accession Number
2021700046
Title
Effects of preoperative intravenous glutamine administration on cardiac
and renal functions in patients undergoing mitral valve replacement
surgeries: A randomized double-blind controlled trial.
Source
Egyptian Journal of Anaesthesia. 39(1) (pp 203-209), 2023. Date of
Publication: 2023.
Author
F. Mostafa M.; Ahmad Ibrahim Elmorabaa H.; Mahmoud Mostafa M.; Mostafa Abd
El Gawad R.; Ismail Seddik M.; Herdan R.; Hassanien Bakr M.; Zarief Kamel
E.
Institution
(F. Mostafa, Ahmad Ibrahim Elmorabaa, Mostafa Abd El Gawad, Herdan,
Hassanien Bakr, Zarief Kamel) Department of Anesthesia and Intensive Care,
Faculty of Medicine, Assiut University, Assiut, Egypt
(Mahmoud Mostafa) Department of Cardiothoracic Surgery, Faculty of
Medicine, Assiut University, Assiut, Egypt
(Ismail Seddik) Department of Clinical Pathology, Faculty of Medicine,
Assiut University, Assiut, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Preoperative poor nutrition greatly raises the risk of
complications and increases length of stay (LOS). Glutamine deficiency may
impair immune functions, reduce myocardial adenosine
triphosphate-adenosine diphosphate (ATP-ADP) substrate and decrease
myocardial glutathione level. We evaluated the effects of preoperative
glutamine administration in patients undergoing mitral valve replacement
surgery upon cardiac and renal outcomes or hospital/ICU LOS.
<br/>Method(s): This prospective randomized double-blinded study included
60 patients above 18 up to 60 years undergoing mitral valve replacement.
For 3 days preoperatively, Group N patients received glutamine
intravenously 0.4 g/kg/day while Group C patients received intravenous
normal saline as placebo. The primary outcome was to assess the effects of
glutamine on cardiac function as reflected on proBNP (brain natriuretic
peptide) during 4 postoperative days. Secondary outcomes included renal
function, vasoactive inotropic score, duration of mechanical ventilation,
and hospital/ICU stays. <br/>Result(s): Postoperative proBNP was
significantly lower in Group N during the entire period. It was
significantly decreased on the first postoperative day in both groups in
comparison to the preoperative values. No significant changes were
recorded regarding renal functions, and duration of mechanical ventilation
between groups. Also, there was signifiacant difference between the two
studied groups regarding the vasoactive inotropic score at the 12th, 18th,
24th and 48th hours with lower scores in Group N. ICU and hospital stays
were significantly lower in Group N than Group C. <br/>Conclusion(s):
Short term of preoperative intravenous glutamine 0.4 g/kg/day decreased
the postoperative proBNP level and hospital/ICU stays in mitral valve
replacement surgery. No significant implication was reported upon
postoperative human NGAL level or kidney functions.<br/>Copyright &#xa9;
2023 The Author(s). Published by Informa UK Limited, trading as Taylor &
Francis Group.

<37>
Accession Number
2018723594
Title
Digital Education in General Thoracic Surgery: A Narrative Review.
Source
Annals of Thoracic Surgery. 115(3) (pp 787-794), 2023. Date of
Publication: March 2023.
Author
Tokuno J.; Fried G.M.
Institution
(Tokuno, Fried) Division of Experimental Surgery, McGill University,
Montreal, QC, Canada
(Tokuno, Fried) Steinberg Centre for Simulation and Interactive Learning,
Faculty of Medicine and Health Science, Montreal, QC, Canada
(Fried) Department of Surgery, McGill University, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: Since advanced technologies were introduced into surgical
education, a variety of new programs have been developed. However, a
comprehensive review of digital education in general thoracic surgery has
not been performed. This narrative review was conducted was to identify
the current applications of digital education in general thoracic surgery.
<br/>Method(s): A literature search was performed using keywords related
to general thoracic surgery and digital education, including e-learning
and virtual simulation, up to September 2021. Studies published in English
investigating the effect of digital education in general thoracic surgery
were included. <br/>Result(s): Thirteen studies met the criteria. The
settings were in undergraduate (n = 6) and postgraduate education
(residency) (n = 5) and mixed audience with other disciplines (n = 2).
Theoretical knowledge (n = 5), technical skills (n = 4), and both
knowledge and technical skills (n = 4) were the stated educational
objectives for the studies. The didactic materials were transferred to
hardware, software, or online platforms and delivered with multimedia
materials. Technical skills training for bronchoscopy and chest tube
insertion (n = 5) were offered using virtual reality and computer-based
simulations. Subjective evaluation was done in 10 studies. Although after
the digital education training there was observed improvement in knowledge
or skills in 8 studies, studies were not designed to test for superiority
compared with controls through randomized controlled studies.
<br/>Conclusion(s): This review summarizes the current applications of
digital education in general thoracic surgery and helps establish the
needs for future studies in this field.<br/>Copyright &#xa9; 2023 The
Society of Thoracic Surgeons

<38>
Accession Number
2018635316
Title
15-year outcomes of the JOCRI study (JOCRIED study): a randomised
comparison of off-pump and on-pump multiple arterial coronary
revascularisation.
Source
General Thoracic and Cardiovascular Surgery. 71(3) (pp 151-157), 2023.
Date of Publication: March 2023.
Author
Tadokoro N.; Fukushima S.; Minami K.; Shimahara Y.; Kawamoto N.; Kakuta
T.; Numata S.; Yaku H.; Takemura H.; Iino K.; Ochi M.; Ishii Y.; Wada H.;
Minematsu N.; Shimizu H.; Kobayashi J.; Fujita T.
Institution
(Tadokoro, Fukushima, Shimahara, Kawamoto, Kakuta, Kobayashi, Fujita)
Department of Cardiovascular Surgery, National Cerebral and Cardiovascular
Center, 6-1 Kishibeshimmachi, Osaka, Suita, Japan
(Tadokoro, Shimizu) Department of Cardiovascular Surgery, Keio University
School of Medicine, Shinjuku-ku, Tokyo, Japan
(Minami) Department of Surgical Intensive Care, National Cerebral and
Cardiovascular Center, Osaka, Suita, Japan
(Numata, Yaku) Division of Cardiovascular Surgery, Kyoto Prefectural
University of Medicine, Kyoto, Kyoto, Japan
(Takemura, Iino) Department of Thoracic, Cardiovascular and General
Surgery, Kanazawa University, Takara-machi, Kanazawa, Japan
(Ochi, Ishii) Department of Cardiovascular Surgery, Nippon Medical School,
Bunkyo-Ku, Tokyo, Japan
(Wada, Minematsu) Department of Cardiovascular Surgery, Fukuoka
University, Fukuoka, Japan
Publisher
Springer
Abstract
Objective: The Japanese Off-Pump Coronary Revascularization Investigation
(JOCRI) study reported a non-significant difference in early outcomes and
graft patency between off-pump coronary artery bypass grafting and on-pump
coronary artery bypass grafting in 2005. The JOCRIED study aimed to review
the long-term outcomes of the JOCRI study participants. Method and
results: The JOCRIED study enrolled 123 of the JOCRI study participants
completing the clinical follow-up between August 2018 and August 2020; 61
patients in the off-pump group and 62 patients in the on-pump group. The
follow-up period was 13.8 +/- 2.8 years. The groups were compared
regarding mortality, the incidence of major adverse cardiac and
cerebrovascular events and repeat revascularisation. The 15-year
cumulative survival rate (off-pump vs on-pump, respectively; 77.7% vs
75.3%; p = 0.85), major adverse events-free survival rate (62.5% vs 55.6%;
p = 0.27) and repeat revascularisation-free rate (84.8% vs 78.0%; p =
0.16) were not significantly different between the two groups.
Revascularisation was the most common major adverse events in the JOCRIED
participants. Although percutaneous coronary intervention was performed in
8 patients (13%) in the off-pump group and in 14 patients (23%) in the
on-pump group (p = 0.23), no patients underwent redo coronary artery
bypass grafting. <br/>Conclusion(s): Off-pump coronary artery bypass
grafting provides comparable 15-year outcomes to on-pump coronary artery
bypass grafting.<br/>Copyright &#xa9; 2022, The Author(s), under exclusive
licence to The Japanese Association for Thoracic Surgery.

<39>
Accession Number
2022993286
Title
Large volume acute normovolemic hemodilution in patients undergoing
cardiac surgery with intermediate-high risk of transfusion: A randomized
controlled trial.
Source
Journal of Clinical Anesthesia. 87 (no pagination), 2023. Article Number:
111082. Date of Publication: August 2023.
Author
Ming Y.; Zhang F.; Yao Y.; Cheng Z.; Yu L.; Sun D.; Sun K.; Yu Y.; Liu M.;
Ma L.; HuangYang Y.; Yan M.
Institution
(Ming, Zhang, Yao, Cheng, Yu, Sun, Sun, Liu, Ma, HuangYang, Yan)
Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang
University, Hangzhou, Zhejiang 330100, China
(Yu) School of Anesthesiology, Weifang Medical University, Shandong,
Weifang 261053, China
(Yan) Key Laboratory of The Diagnosis and Treatment of Severe Trauma and
Burn of Zhejiang Province, Leading Health Talents of Zhejiang Province,
Zhejiang Health Office No. 18(2020), China
Publisher
Elsevier Inc.
Abstract
Study Objective: To investigate whether large volume acute normovolemic
hemodilution (L-ANH), compared with moderate acute normovolemic
hemodilution (M-ANH), can reduce perioperative allogeneic blood
transfusion in patients with intermediate-high risk of transfusion during
cardiac surgery with cardiopulmonary bypass (CPB). <br/>Design(s):
Prospective randomized controlled trial. <br/>Setting(s): University
hospital. <br/>Patient(s): Patients with transfusion risk understanding
scoring tool ("TRUST") >=2 points undergoing cardiac surgery with CPB in
the Second Affiliated Hospital of Zhejiang University from May 2020 to
January 2021 were included. <br/>Intervention(s): The patients were
randomly assigned with a 1:1 ratio to M-ANH (5 to 8 mL/kg) or L-ANH (12 to
15 mL/kg). Measurements: The primary outcome was perioperative red blood
cell (RBC) transfusion units. The composite outcome included new-onset
atrial fibrillation, pulmonary infection, cardiac surgery associated acute
kidney injury (CSA-AKI) class >=2, surgical incision infection,
postoperative excessive bleeding, and resternotomy. <br/>Main Result(s):
Total 159 patients were screened and 110 (55 L-ANH and 55 M-ANH) were
included for final analysis. Removed blood volume of L-ANH is
significantly higher than M-ANH (886 +/- 152 vs. 395 +/- 86 mL, P <
0.001). Perioperative RBC transfusion was median 0 unit ([25th, 75th]
percentiles: 0-4.4) in M-ANH group vs. 0 unit ([25th, 75th] percentiles:
0-2.0) in L-ANH group (P = 0.012) and L-ANH was associated with lower
incidence of transfusion (23.6% vs. 41.8%, P = 0.042, rate difference:
0.182, 95% confidence interval [0.007-0.343]). The incidence of
postoperative excessive bleeding was significantly lower in L-ANH vs.
M-ANH (3.6% vs. 18.2%, P = 0.029, rate difference: 0.146, 95% confidence
interval [0.027-0.270]) without significant difference for other second
outcomes. The volume of ANH was inversely related to perioperative RBC
transfusion units (Spearman r = -0.483, 95% confidence interval [-0.708 to
-0.168], P = 0.003), and L-ANH in cardiac surgery was associated with a
significantly reduced risk of perioperative RBC transfusion (odds ratio:
0.43, 95% confidence interval: 0.19-0.98, P = 0.044). <br/>Conclusion(s):
Compared with M-ANH, L-ANH during cardiac surgery inclined to be
associated with reduced perioperative RBC transfusion and the volume of
RBC transfusion was inversely proportional to the volume of ANH. In
addition, LANH during cardiac surgery was associated with a lower
incidence of postoperative excessive bleeding.<br/>Copyright &#xa9; 2023
Elsevier Inc.

<40>
Accession Number
2022945147
Title
The effect of using illustrated materials for communication on the anxiety
and comfort of cardiac surgery patients receiving mechanical ventilator
support: A randomized controlled trial.
Source
Heart and Lung. 59 (pp 157-164), 2023. Date of Publication: 01 May 2023.
Author
Kolcak B.; Ayhan H.; Tastan S.
Institution
(Kolcak) Vocational School Of Health Services, Yuksek Ihtisas University,
Ankara, Turkey
(Ayhan) Gulhane Faculty of Nursing, University of Health Sciences Turkey,
Turkey
(Tastan) Department of Nursing, Faculty of Health Sciences, Eastern
Mediterranean University, North Cyprus via Mersin 10, Famagusta, Turkey
Publisher
Elsevier Inc.
Abstract
Background: Using illustrated communication materials with patients
receiving mechanical ventilation support increases patient satisfaction
and reduces communication difficulties. However, there are no randomized
controlled clinical studies showing the effect of the use of these
materials on patient care outcomes. <br/>Objective(s): To determine the
effect of using illustrated communication materials on the anxiety and
comfort levels of patients receiving mechanical ventilation support.
<br/>Method(s): In this controlled clinical trial, patients were randomly
assigned to either the intervention group that used illustrated
communication materials or the control group that used routine
communication methods. In the first minute of contact with patients in the
intensive care unit, then at 30 min and 60 min, patients' numerical
pain-rating scale scores, hemodynamic values, and face-anxiety scale
scores were recorded. Satisfaction with communication and perianesthesia
comfort scale scores were obtained the day after operation.
<br/>Result(s): After 30 min of communication, the percentage of
face-anxiety points difference decreased in the intervention group
(-14.16) compared to the control group (-6.11), and the difference was
statistically significant (p < 0.05). In terms of perceived comfort during
postoperative mechanical ventilation, the mean score of the patients in
the intervention group (106.10) was higher than the control group (88.53),
and the difference was statistically significant (p < 0.05). Furthermore,
90% of the patients in the intervention group and 30% of the patients in
the control group were satisfied with the communication method used, and
the difference between the groups was statistically significant.
<br/>Conclusion(s): Using illustrated communication materials reduces
anxiety and increases patient satisfaction and comfort levels. In
communicating with intubated patients, the use of illustrated
communication materials is recommended.<br/>Copyright &#xa9; 2023 Elsevier
Inc.

<41>
Accession Number
2021057400
Title
Efficacy of omecamtiv mecarbil in heart failure with reduced ejection
fraction according to N-terminal pro-B-type natriuretic peptide level:
insights from the GALACTIC-HF trial.
Source
European Journal of Heart Failure. 25(2) (pp 248-259), 2023. Date of
Publication: February 2023.
Author
Docherty K.F.; McMurray J.J.V.; Claggett B.L.; Miao Z.M.; Adams K.F.;
Arias-Mendoza A.; Cleland J.G.F.; Diaz R.; Echeverria Correa L.E.; Felker
G.M.; Fonseca C.; Li J.; Metra M.; Sliwa-Hahnle K.; Solomon S.D.;
Vandekerckhove H.J.; Vinereanu D.; Voors A.A.; Heitner S.B.; Kupfer S.;
Malik F.I.; Meng L.; Teerlink J.R.
Institution
(Docherty, McMurray) British Heart Foundation Cardiovascular Research
Centre, University of Glasgow, Glasgow, United Kingdom
(Claggett, Miao, Solomon) Division of Cardiovascular Medicine, Brigham and
Women's Hospital and Harvard Medical School, Boston, MA, United States
(Adams) University of North Carolina, Chapel Hill, NC, United States
(Arias-Mendoza) Instituto Nacional de Cardiologia, Mexico City, Mexico
(Cleland) Robertson Centre for Biostatistics and Clinical Trials,
Institute of Health and Wellbeing, University of Glasgow, Glasgow, United
Kingdom
(Diaz) Estudios Clinicos Latino America, Rosario, Argentina
(Echeverria Correa) Fundacion Cardiovascular de Colombia, Floridablanca,
Colombia
(Felker) Division of Cardiology, Duke University School of Medicine and
Duke Clinical Research Institute, Durham, NC, United States
(Fonseca) Department of Internal Medicine, Hospital Sao Francisco Xavier,
Lisbon, Portugal
(Li) National Clinical Research Center for Cardiovascular Diseases, Fuwai
Hospital, Chinese Academy of Medical Sciences and Peking Union Medical
College, National Center for Cardiovascular Diseases, Beijing, China
(Metra) Cardiology, ASST Spedali Civili; Department of Medical and
Surgical Specialties, Radiological Sciences, and Public Health, University
of Brescia, Brescia, Italy
(Sliwa-Hahnle) University of Cape Town, Johannesburg, South Africa
(Vandekerckhove) Department of Cardiology, AZ-St-Lucas, Ghent, Belgium
(Vinereanu) University of Medicine and Pharmacy Carol Davila, University
and Emergency Hospital, Bucharest, Romania
(Voors) University of Groningen, Groningen, Netherlands
(Heitner, Kupfer, Malik, Meng) Cytokinetics, Inc., South San Francisco,
CA, United States
(Teerlink) Section of Cardiology, San Francisco Veterans Affairs Medical
Center and School of Medicine, University of California San Francisco, San
Francisco, CA, United States
Publisher
John Wiley and Sons Ltd
Abstract
Aim: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is predictive
of both outcomes and response to treatment in patients with heart failure
with reduced ejection fraction (HFrEF). The aim of this study was to
examine the effect of the cardiac myosin activator omecamtiv mecarbil
according to baseline NT-proBNP level in the Global Approach to Lowering
Adverse Cardiac outcomes Through Improving Contractility in Heart Failure
trial (GALACTIC-HF). <br/>Methods and Results: The primary outcome was the
composite of a worsening heart failure event (urgent clinic visit,
emergency department visit, or hospitalization) or cardiovascular death.
We prespecified analysis of the effect of treatment according to baseline
NT-proBNP (<= median, > median), excluding individuals with atrial
fibrillation/flutter (AF/AFL). Of the 8232 patients analysed, 8206 had an
available baseline NT-proBNP measurement. Among the 5971 patients not in
AF/AFL, the median (Q1-Q3) NT-proBNP level was 1675 (812-3579) pg/ml.
Hazard ratios (HR) for the effect of omecamtiv mecarbil, compared with
placebo, for the primary endpoint in patients without AF/AFL were: <=
median 0.94 (95% confidence interval [CI] 0.80-1.09), > median 0.81
(0.73-0.90) (p-interaction = 0.095); for the overall population (including
patients with AF/AFL) the HRs were <= median 1.01 (0.90-1.15) and > median
0.88 (0.80-0.96) (p-interaction = 0.035). There was an interaction between
treatment and NT-proBNP, examined as a continuous variable, with greater
effect of omecamtiv mecarbil on the primary outcome in patients with a
higher baseline NT-proBNP (p-interaction = 0.086). <br/>Conclusion(s): In
GALACTIC-HF, the benefit of omecamtiv mecarbil appeared to be larger in
patients with higher baseline NT-proBNP levels, especially in patients
without AF/AFL. Clinical Trial Registration: ClinicalTrials.gov Identifier
NCT02929329; EudraCT number, 2016-002299-28.<br/>Copyright &#xa9; 2023 The
Authors. European Journal of Heart Failure published by John Wiley & Sons
Ltd on behalf of European Society of Cardiology.

<42>
Accession Number
2022680091
Title
Effectiveness of precise and quantitative rapid pulmonary rehabilitation
nursing program for elderly patients with lung cancer during the
perioperative period: A randomized controlled trial.
Source
Pakistan Journal of Medical Sciences. 39(2) (pp 572-577), 2023. Date of
Publication: March-April 2023.
Author
Chen B.; Yan X.; Wang X.; Mao Y.
Institution
(Chen, Yan) Department of Thoracic Surgery, Shanghai Pulmonary Hospital,
Tongji University School of Medicine, Shanghai 200433, China
(Wang) Department of Operating Room, Shanghai Pulmonary Hospital, Tongji
University School of Medicine, Shanghai 200433, China
(Mao) Department of Nursing, Shanghai Pulmonary Hospital, Tongji
University School of Medicine, Shanghai 200433, China
Publisher
Professional Medical Publications
Abstract
Objective: Preoperative rehabilitation should improve the functional
condition of patients. Improvements in metabolism, lung mechanics,
cardiovascular function, and muscle-function can be achieved by pulmonary
rehabilitation. Hence, we focused on elderly patients with lung cancer
undergoing surgery, and assessed the effectiveness of a rapid and precise
pulmonary rehabilitation nursing program during the perioperative period.
<br/>Method(s): This randomized controlled trial at the department of
thoracic surgery; Shanghai pulmonary hospital, China during 2021 was
conducted amongst 218 elderly patients with lung cancer treated by
surgical operation into either a precision quantitative nursing model
nursing group (experimental group) or a perioperative routine nursing
group (control group). After individual planning of the pulmonary
rehabilitation nursing outpatient clinic, nurses distributed breathing
trainers, instructed the patients in breathing training, and supervised
the patients after the operation. For our evaluation we considered
pulmonary function tests, postoperative thoracic drainage tube indwelling
times, postoperative hospital stays, postoperative complication rates, and
postoperative quality of life results. <br/>Result(s): The experimental
group showed better pulmonary function, length of hospital stay, and
quality of life outcomes than the control group, but the differences were
not statistically significant. However, we found a significantly higher
postoperative complications rate in the control group (11.9%) than in the
experimental group (3.7%; p=0.02). <br/>Conclusion(s): Strengthening
pulmonary rehabilitation nursing interventions for elderly patients with
lung cancer during the perioperative period can reduce their postoperative
complications and promote their rapid recovery.<br/>Copyright &#xa9; 2023,
Professional Medical Publications. All rights reserved.

<43>
Accession Number
2013254253
Title
Comparison of Nebulized Versus Intravenous Milrinone on Reducing Pulmonary
Arterial Pressure in Patients with Pulmonary Hypertension Candidate for
Open-cardiac Surgery: A Double-Blind Randomized Clinical Trial.
Source
Anesthesiology and Pain Medicine. 12(3) (no pagination), 2022. Article
Number: e122994. Date of Publication: Jun 2022.
Author
Jorairahmadi S.; Javaherforooshzadeh F.; Babazadeh M.; Gholizadeh B.;
Bakhtiari N.
Institution
(Jorairahmadi, Javaherforooshzadeh) Department of Anesthesiology, Faculty
of Medicine, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran,
Islamic Republic of
(Babazadeh) Department of Biochemistry, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Babazadeh, Gholizadeh, Bakhtiari) Ahvaz Anesthesiology and Pain Research
Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,
Islamic Republic of
(Gholizadeh) Atherosclerosis Research Center, Ahvaz Jundishapur University
of Medical Sciences, Ahvaz, Iran, Islamic Republic of
Publisher
Brieflands
Abstract
Background: Regardless of the cause, pulmonary hypertension can increase
patient complications and mortality. This study com-pared the effect of
nebulized versus intravenous (IV) milrinone on reducing pulmonary arterial
pressure in patients with pulmonary hypertension candidates for
open-cardiac surgery. <br/>Method(s): This double-blind, randomized
clinical trial was performed on 32 patients undergoing elective on-pump
cardiac surgery during January 2021-January 2022 in the Cardiac Operating
Room of Golestan Hospital, Ahvaz, Iran. Patients were randomly divided
into test groups nebulize milrinone (N = 16) and IV milrinone (N = 16).
The medication was administered after the cross-clamp of the aorta
opening. The outcome variables included hemodynamic data, cardiac output,
cardiac index, stroke volume, mean arterial pressure (MAP), central venous
pressure, mean pulmonary artery pressure (mPAP), systemic vascular
resistance, pulmonary vascular resistance, MAP/mPAP ratio, time until
extubation, duration of hospitalization in the Intensive Care Unit (ICU),
and duration of hospital stay. <br/>Result(s): In the nebulized group, MAP
and MAP/mPAP were significantly higher than in the IV milrinone group (P =
0.09 and P < 0.0001, respectively). The time of extubation (P = 0.001),
duration of hospitalization in the ICU (P = 0.009), and duration of
hospital stay (P = 0.026) in the nebulized milrinone group were
significantly shorter than in the IV milrinone group. <br/>Conclusion(s):
Nebulized milrinone administration before weaning off cardiopulmonary
bypass (CPB) can be accelerated and facili-tate weaning off CPB. Moreover,
despite maintaining MAP, nebulized milrinone significantly reduces mPAP.
According to the results of this study, nebulized milrinone is recommended
in patients undergoing cardiac surgery with pulmonary
hypertension.<br/>Copyright &#xa9; 2022, Author(s).

<44>
Accession Number
2017931656
Title
Early computed tomography coronary angiography in adults presenting with
suspected acute coronary syndrome: The RAPID-CTCA RCT.
Source
Health Technology Assessment. 26(37) (no pagination), 2022. Date of
Publication: 2022.
Author
Gray A.J.; Roobottom C.; Smith J.E.; Goodacre S.; Oatey K.; O'Brien R.;
Storey R.F.; Curzen N.; Keating L.; Kardos A.; Felmeden D.; Lee R.J.;
Thokala P.; Lewis S.C.; Newby D.E.
Institution
(Gray) Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
(Gray, O'Brien) Department of Emergency Medicine, Royal Infirmary of
Edinburgh, Edinburgh, United Kingdom
(Roobottom) Department of Radiology, University Hospitals Plymouth NHS
Trust, Plymouth, United Kingdom
(Smith) Emergency Department, University Hospitals Plymouth NHS Trust,
Plymouth, United Kingdom
(Goodacre, Thokala) School of Health and Related Research, University of
Sheffield, Sheffield, United Kingdom
(Oatey, Lee, Lewis) Edinburgh Clinical Trials Unit, Usher Institute,
University of Edinburgh, Edinburgh, United Kingdom
(Storey) Department of Infection, Immunity and Cardiovascular Disease,
University of Sheffield, Sheffield, United Kingdom
(Curzen) Faculty of Medicine, University of Southampton and Coronary
Research Group, University Hospital Southampton NHS Foundation Trust,
Southampton, United Kingdom
(Keating) Department of Emergency Medicine, Royal Berkshire NHS Foundation
Trust, Reading, United Kingdom
(Kardos) Department of Cardiology, Milton Keynes University Hospital NHS
Foundation Trust, Milton Keynes, United Kingdom
(Felmeden) Department of Cardiology, Torbay and South Devon NHS Foundation
Trust, Torquay, United Kingdom
(Newby) Centre for Cardiovascular Science, University of Edinburgh,
Edinburgh, United Kingdom
(Newby) Department of Cardiology, Royal Infirmary of Edinburgh, Edinburgh,
United Kingdom
Publisher
NIHR Journals Library
Abstract
Background: Acute coronary syndrome is a common medical emergency. The
optimal strategy to investigate patients who are at intermediate risk of
acute coronary syndrome has not been fully determined. <br/>Objective(s):
To investigate the role of early computed tomography coronary angiography
in the investigation and treatment of adults presenting with suspected
acute coronary syndrome. <br/>Design(s): A prospective, multicentre, open,
parallel-group randomised controlled trial with blinded end-point
adjudication. <br/>Setting(s): Thirty-seven hospitals in the UK.
<br/>Participant(s): Adults (aged >= 18 years) presenting to the emergency
department, acute medicine services or cardiology department with
suspected or provisionally diagnosed acute coronary syndrome and at least
one of the following: (1) a prior history of coronary artery disease, (2)
a cardiac troponin level > 99th centile and (3) an abnormal 12-lead
electrocardiogram. <br/>Intervention(s): Early computed tomography
coronary angiography in addition to standard care was compared with
standard care alone. Participants were followed up for 1
year.<br/>Copyright &#xa9; 2022, NIHR Journals Library. All rights
reserved.

<45>
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. 37(4) (pp 539-546),
2023. Date of Publication: April 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

<46>
Accession Number
2022325539
Title
Clinical outcomes of MANTA vs suture-based vascular closure devices after
transcatheter aortic valve replacement: An updated meta-analysis.
Source
Indian Heart Journal. 75(1) (pp 59-67), 2023. Date of Publication: 01 Jan
2023.
Author
Doshi R.; Vasudev R.; Guragai N.; Patel K.N.; Kumar A.; Majmundar M.;
Doshi P.; Patel P.; Shah K.; Santana M.; Roman S.; Vallabhajosyula S.;
Virk H.; Bikkina M.; Shamoon F.
Institution
(Doshi, Vasudev, Guragai, Patel, Shah, Santana, Roman, Virk, Bikkina,
Shamoon) Department of Cardiology, St Joseph University Medical Center,
Paterson, NJ, United States
(Patel) Department of Internal Medicine, Saint Peter's University
Hospital, New Brunswick, NJ, United States
(Kumar) Department of Internal Medicine Cleveland Clinic Akron General,
Akron, OH, United States
(Majmundar) Department of Cardiology, University of Kansas Medical Center,
Kansas City, KS, United States
(Doshi) Department of Medicine, MS Ramaiah Medical College, Bengaluru,
India
(Vallabhajosyula) Section of Cardiovascular Medicine, Department of
Medicine, Wake Forest University School of Medicine, Winston-Salem, NC,
United States
Publisher
Elsevier B.V.
Abstract
Objective: A recently published randomized control trial showed different
results with suture-based vascular closure device (VCD) than plug-based
VCD in patients undergoing transfemoral transcatheter aortic valve
replacement (TAVR). The learning curve for MANTA device is steep, while
the learning curve for suture based VCD is shallow as the devices are
quite different. In this meta-analysis, we have compared suture-based
(ProGlide and Prostar XL) vs plug-based VCDs (MANTA). <br/>Method(s): We
performed a meta-analysis of all published studies (using PubMed/Medline
and Cochrane databases) reporting the clinical outcome of plug-based vs
suture-based VCDs in transfemoral TAVR patients. <br/>Result(s): We
included nine studies with a total of 2865 patients (plug-based n = 1631,
suture-based n = 1234). There was no significant difference in primary
outcome of all bleeding when using plug-based as opposed to suture-based
VCDs (RR 1.14 [0.62-2.06] I² = 72%). There was no significant
difference in the incidence of secondary outcomes between two groups
including major life threatening bleeding (RR 1.16 [0.38-3.58]
I² = 65%), major vascular complications (RR 0.84 [0.35-2.00]
I² = 55%), minor vascular complications (RR 1.05 [0.56-1.95]
I² = 42%), pseudo aneurysm (RR 1.84 [0.11-29.98] I²
= 44%), stenosis-dissection (RR 0.98 [0.66-1.47] I² = 0%), VCD
failure (RR 1.71 [0.96-3.04] I² = 0%), and blood transfusion
(RR 1.01 [0.38-2.71], I² = 61%). <br/>Conclusion(s): Large bore
arteriotomy closure with plug-based VCD was not superior to suture-based
VCDs in this transfemoral TAVR population. There was very frequent use of
secondary VCDs in suture-based VCD group which is not practical when using
MANTA. Additional high-powered studies are required to determine the
safety and efficacy of MANTA device.<br/>Copyright &#xa9; 2023
Cardiological Society of India

<47>
Accession Number
2022257134
Title
Heparin Rebound: An In-Depth Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(4) (pp 601-612),
2023. Date of Publication: April 2023.
Author
Stone M.E.; Vespe M.W.
Institution
(Stone, Vespe) Icahn School of Medicine at Mount Sinai, New York, NY,
United States
Publisher
W.B. Saunders
Abstract
The common conception of "heparin rebound" invokes heparin returning to
circulation in the postoperative period after apparently adequate
intraoperative reversal with protamine. This is believed to portend
increased postoperative bleeding and provides the rationale for
administering additional empiric doses of protamine in response to
prolonged coagulation tests and/or bleeding. However, the relevant
literature of the last 60+ years provides only a weak level of evidence
that "rebounded" heparin itself is a significant etiology of postoperative
bleeding after cardiac surgery with cardiopulmonary bypass. Notably, many
of the most frequently cited heparin rebound investigators ultimately
concluded that although exceedingly low levels of heparin activity could
be detected by anti-Xa assay in some (but not all) patients
postoperatively, there was no correlation with actual bleeding. An
understanding of the literature requires a careful reading of the details
because the investigators lacked standardized definitions for "heparin
rebound" and "adequate reversal" while studying the phenomenon with
significantly different experimental methodologies and laboratory tests.
This review was undertaken to provide a modern understanding of the
"heparin rebound" phenomenon to encourage an evidence-based approach to
postoperative bleeding. Literature searches were conducted via PubMed
using the following MeSH terms: heparin rebound, heparin reversal,
protamine, platelet factor 4, and polybrene. Relevant English language
articles were reviewed, with subsequent references obtained from the
internal citations. Perspective is provided for both those who use
HepCon-guided management and those who do not, as are practical
recommendations for the modern era based on the published data and
conclusions of the various investigators.<br/>Copyright &#xa9; 2022
Elsevier Inc.

<48>
Accession Number
2023053171
Title
PREHABILITATION FOR PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE
REPLACEMENT: A PILOT RANDOMIZED CLINICAL TRIAL.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 868), 2023. Date of
Publication: 07 Mar 2023.
Author
Harvey J.; Tolerico P.H.; Bell T.; Mason L.; McKinney H.; Shaeffer C.;
Kashyap R.
Institution
(Harvey, Tolerico, Bell, Mason, McKinney, Shaeffer, Kashyap) WellSpan
Health, York, PA, United States
Publisher
Elsevier Inc.
Abstract
Background Patients with frailty have worse outcomes after transcatheter
aortic valve replacement (TAVR). Additionally, pre-procedural conditioning
or "prehabilitation," (prehab) is effective at reducing postoperative
complication rates and length of stay post-surgery. However, the effect of
prehab on frail patients undergoing TAVR has not been studied. We aimed to
assess the safety and efficacy of prehab to improve frailty indices by the
time of TAVR, to sustain benefits post-procedure, and to determine its
effect on patient outcomes. Methods In this study, frail patients were
randomized to the prehab or control group prior to TAVR. The prehab group
was provided with at least 8 visits. Control subjects underwent the
standard workup without prehab intervention. All participants completed
the 6-minute walk test (6MWT), Timed Up and Go (TUG) Test, Four Square
Step Test (FSST) and Kansas City Cardiomyopathy Questionnaire (KCCS) at
intake, pre-operatively, and 30-days and one year post-operatively. Length
of stay and 30-day readmissions was compared between the groups. The study
was Institutional Review Board approved. Results Total patients enrolled
N=35 (n=18 prehab, n=17 controls) didn't differ at baseline. Prehab FSST
showed significant improvement from intake to pre-op (19.1 vs 16.8; p=0.04
in prehab group. There were significant improvements in prehab group in
6MWT (132.7 feet more; p=0.006), FSST (2.4 seconds less; p=0.03) and KCCQ
(12.7 points up, p=0.001) from baseline to 30 days post-op. The prehab
improvement in KCCQ was still significant at one year (12.6 points up;
p=0.01). There were no improvements in 6MWT, TUG Test, FSST or KCCQ for
the controls. Also, no differences were found when comparing improvements
between both groups for all time points compared to baseline. There were
no differences in days for length of stay in ICU (1.4 vs. 1.2, p=0.5) and
hospital (3.5 vs. 3.44, p=0.9) or in 30-day readmission (19% vs. 13%,
p=1.0) between the groups. Conclusion In frail patients, prehab prior to
TAVR is safe and results in improvement in measures of physical
conditioning preoperatively and at 30 days and it persisted at one year.
It has no impact ICU or hospital length of stay or
readmissions.<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<49>
Accession Number
2023053100
Title
OUTCOMES OF FETAL PULMONARY VALVULOPLASTY IN PULMONARY ATRESIA WITH INTACT
VENTRICULAR SEPTUM COMPARED TO DEFINITIVE REPAIR: A SYSTEMATIC REVIEW AND
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 2201), 2023. Date of
Publication: 07 Mar 2023.
Author
Mendel B.; Kohar K.; Amirah S.; Prakoso R.; Siagian S.N.
Institution
(Mendel, Kohar, Amirah, Prakoso, Siagian) National Cardiovascular Center
of Harapan Kita, Jakarta, Indonesia
(Mendel, Kohar, Amirah, Prakoso, Siagian) Sultan Sulaiman Government
Hospital, Serdang Bedagai, Indonesia
Publisher
Elsevier Inc.
Abstract
Background Pulmonary atresia with intact ventricular septum (PA-IVS) is a
heterogeneous lesion with a significant rate of early mortality in the
absence of treatment. In this meta-analysis, we sought to discover several
cardiac interventions that might affect patients' survival. Methods This
systematic review and meta-analysis was carried out according to the
PRISMA statement. Four databases were used to conduct a thorough search on
Fetal Pulmonary Valvuloplasty (FPV), Fontan, Biventricular (2V), and
One-and-Half Ventricular (1.5V) repair as the recognized and potential
interventions for PA-IVS. Overall mortality was the primary outcome. The
overall proportion was estimated with R software (version 4.1.3) using a
random-effects model of proportional meta-analysis. Results In 142
patients, the FPV procedure was performed successfully in 80% (95% CI:
68-91%), and attained biventricular circulation postnatally [53% (95% CI:
34-74%)]. The mortality rate for FPV was slightly greater [16% (95%CI:
3-28%)] than the three currently available definitive therapies, namely
the Fontan procedure [10% (95%CI: 4-17%)], 1.5V repair [11% (95%CI:
5-17%), and 2V repair [8% (95%CI: 1-15%)]. Conclusion Surgical approach
for definitive repair is more well-established than FPV, which
demonstrated a lower death rate. However, FPV has the potential to
increase the likelihood of biventricular circulation earlier in life.
[Formula presented]<br/>Copyright &#xa9; 2023 American College of
Cardiology Foundation

<50>
Accession Number
2023052877
Title
EFFICACY OF CEREBRAL PROTECTION DEVICE DURING TRANSCATHETER AORTIC VALVE
REPLACEMENT (TAVR): AN UPDATED META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1061), 2023. Date of
Publication: 07 Mar 2023.
Author
Rivera F.B.; De Luna D.; Ansay M.F.; Collado F.S.
Institution
(Rivera, De Luna, Ansay, Collado) Lincoln Medical Center, New York, NY,
United States
Publisher
Elsevier Inc.
Abstract
Background Stroke is a major cause of morbidity and mortality in
transcatheter aortic valve replacement (TAVR). Despite the relatively high
safety profile of newly developed cerebral embolic protection device
(CEPDs) and advanced TAVR techniques, recent data on efficacy of CEPDs is
still inconclusive. The aim of this meta-analysis is to determine the
efficacy of CEPDs in reducing in-hospital stroke, in-hospital mortality
and other safety outcomes among patients who underwent TAVR. Methods A
comprehensive literature search published between January 2015 and
September 2022 was done through MEDLINE and Cochrane databases. Full text
of eligible articles was obtained and evaluated for final analysis.
Statistical analysis was performed using a random-effects model to
calculate for the risk ratio (RR). Results Seven randomized controlled
trials (RCTs) and 6 observational cohort studies (OCSs) involving 126,635
patients were included for analysis. CEPD was associated with a
significant reduction of in-hospital mortality = in-hospital stroke and
30-day mortality. No significant difference was observed in other efficacy
and safety outcomes. (See figure 1) Conclusion CEPD device use in TAVR is
associated with a reduction of in-hospital mortality, in-hospital stroke
and 30-day mortality. However, these results are driven mainly by
observational studies. Large RCTs are needed to determine efficacy and
safety of CEPD use during TAVR. [Formula presented]<br/>Copyright &#xa9;
2023 American College of Cardiology Foundation

<51>
Accession Number
2023052458
Title
TRANSCATHETER VERSUS SURGICAL AORTIC VALVE REPLACEMENT FOR STENOTIC
BICUSPID AORTIC VALVE: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 873), 2023. Date of
Publication: 07 Mar 2023.
Author
Sakurai Y.; Yokoyama Y.; Kuno T.; Takagi H.; Mentias A.G.; Thourani V.H.;
Kaneko T.
Institution
(Sakurai, Yokoyama, Kuno, Takagi, Mentias, Thourani, Kaneko) Montefiore
Medical Center, Bronx, NY, United States
Publisher
Elsevier Inc.
Abstract
Background Bicuspid aortic valve (BAV) has been excluded from randomized
trials comparing transcatheter aortic valve replacement (TAVR) with
surgical aortic valve replacement (SAVR).We aimed to evaluate the outcomes
of TAVR versus SAVR in patients with severe BAV stenosis using a
meta-analysis. Methods MEDLINE and EMBASE were searched through March 2022
to identify observational studies comparing TAVR and SAVR for severe BAV
stenosis. Outcomes of interest were in-hospital outcomes, including
all-cause mortality, stroke, vascular complication, permanent pacemaker
implantation, acute kidney injury, any transfusion, paravalvular leak, and
all-cause mortality during follow-up. Results Four propensity
score-matched studies and 58,108 patients (TAVR, n = 3,841; SAVR, n =
50,206) yielding 3,142 pairs using propensity score were included. Median
follow-up periods were 21 to 36 months. There was no significant
difference in in-hospital mortality or stroke (Risk Ratio [RR]: 0.69; 95%
confidence interval [CI]: 0.40-1.20; p = 0.19, RR: 0.86; 95% CI:
0.64-1.14; p = 0.29, respectively). While TAVR was associated with higher
risks of permanent pacemaker implantation rate (RR: 1.87; 95% CI:
1.23-2.84; p = 0.0003), TAVR was associated with lower risks of acute
kidney injury (RR: 0.58; 95% CI: 0.38-0.88; p = 0.01), and transfusion
(RR: 0.25; 95% CI: 0.21- 0.29; p = 0.0001). In-hospital vascular
complication, paravalvular leak, and all-cause mortality during follow-up
were similar in both groups. Conclusion In selected patients with severe
BAV stenosis, TAVR was associated with similar in-hospital mortality,
stroke, or paravalvular leak compared with SAVR. Further investigation
with long-term follow-up, including a randomized trial, is
warranted.<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<52>
Accession Number
2023051388
Title
IATROGENIC VENTRICULAR SEPTAL DEFECT AFTER TRANSCATHETER AORTIC VALVE
IMPLANTATION: A RARE COMPLICATION.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 3990), 2023. Date of
Publication: 07 Mar 2023.
Author
Muhammadzai H.Z.U.; Janga C.; Checchio L.; Memon R.A.; Qadir S.; Saeed R.
Institution
(Muhammadzai, Janga, Checchio, Memon, Qadir, Saeed) Jefferson Abington
Health, Abington, PA, United States
Publisher
Elsevier Inc.
Abstract
Background Iatrogenic ventricular septal defect (VSD) is a rare
complication after a transcatheter aortic valve implantation (TAVI). Case
83-year-old male who presented to the hospital due to a black tarry bowel
movement and coffee-ground emesis. Past medical history includes
hypertension, hyperlipidemia, ischemic cardiomyopathy, atrial fibrillation
on apixaban, coronary artery disease requiring a coronary artery bypass
graft, severe aortic stenosis requiring TAVI procedure 2 weeks prior to
presentation, which was complicated by complete heart block requiring
dual-chamber pacemaker. Physical examination was significant for lethargy,
tachypnea, tachycardia and a continuous systolic murmur on cardiac
examination. Blood work included Hb of 4.9 which had decreased from
baseline of 9.8. He also underwent an echocardiogram which showed evidence
of membranous VSD. Decision-making Patient was stabilized with blood
transfusions. Anticoagulation was held. He underwent endoscopy which
showed a duodenal ulcer which was the likely source of the bleeding.
Patient was stabilized. To evaluate the extent of the VSD and to see if he
needs intervention, the patient underwent a right heart catheterization to
evaluate right heart hemodynamics. Study revealed mild pulmonary
hypertension and a small left-to-right shunt at level of the high right
ventricle (RV) with oximetry saturation of 72% in high RV and 76% in the
RV outflow tract and pulmonary-systemic shunt ratio (QP:QS) of 1.46. The
patient continued to improve and stabilize and was discharged with close
follow-up with cardiology as an outpatient. Conclusion VSD is a rare
complication of TAVI procedure as illustrated by a systematic review of 18
case reports and retrospective study of 5 cases in 400 patients. It mostly
involves the membranous or perimembranous part of the septum. Symptoms are
mostly benign; however, some patients can have dyspnea and VSD should be
considered in patients with a recent history of TAVI. Further studies are
needed to elucidate the pros and cons of VSD closure.<br/>Copyright &#xa9;
2023 American College of Cardiology Foundation

<53>
Accession Number
2023051355
Title
USE OF COMPUTED TOMOGRAPHY CORONARY ANGIOGRAPHY PRIOR TO INVASIVE CORONARY
ANGIOGRAPHY IN PATIENTS WITH PREVIOUS CORONARY ARTERY BYPASS GRAFTING.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1489), 2023. Date of
Publication: 07 Mar 2023.
Author
Upadhaya S.; Upreti A.; Subedi R.; Madala S.
Institution
(Upadhaya, Upreti, Subedi, Madala) Tulane University School of Medicine,
New Orleans, LA, United States
Publisher
Elsevier Inc.
Abstract
Background Invasive coronary angiography (ICA) in patients with history of
previous coronary artery bypass grafting (CABG) is challenging and
associated with complications. Computed tomography coronary angiography
(CTCA) is being increasingly used for evaluation of bypass grafts.
However, there is paucity of data regarding use of CTCA prior to ICA to
improve outcomes in patients with prior CABG. Methods We performed
systematic search of PubMed, EMBASE, major cardiology conferences for
studies comparing CTCA prior to ICA in patients with CABG to ICA only.
Random-effects model was used for pooled calculation of odds ratio (OR)
and mean difference (MD). Results Our search identified 2 studies (449 in
CTCA group and 1071 in control group). CTCA prior to ICA was associated
with significant reduction in incomplete evaluation of graft (OR:
0.01[0.00-0.05], I² = 0%, p value <0.00001) (Figure 1A),
cumulative contrast used (MD: -39.14 milliliter [-68.61, -9.67],
I² = 95%, p value = 0.009) (Figure 1B) and fluoroscopy time
(MD: -4.98 minutes [-8.47, -1.48], I² = 98 %, p value = 0.005)
(Figure 1C) and use of femoral access (OR: 0.53[0.42-0.69], I²
= 0%, p value <0.00001). However, we did not find any significant
difference in the combined radiation dose (MD: 2.63 millisievert [-2.12,
-7.39], I² = 100%, p value = 0.28). Conclusion CTCA prior to
ICA in patients with prior CABG decreased rates of incomplete evaluation
of grafts, total contrast used and femoral access use. There was no
difference in combined radiation doses. [Formula presented]<br/>Copyright
&#xa9; 2023 American College of Cardiology Foundation

<54>
Accession Number
2023050312
Title
IN-HOSPITAL OUTCOMES OF TRANSCATHETER AORTIC VALVE REPLACEMENT VERSUS
SURGICAL AORTIC VALVE REPLACEMENT IN OBESE PATIENTS: A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1070), 2023. Date of
Publication: 07 Mar 2023.
Author
Al-Asad K.S.; Martinez A.; Yavari M.; Panama G.; Abela G.S.
Institution
(Al-Asad, Martinez, Yavari, Panama, Abela) Michigan State University, East
Lansing, MI, United States
Publisher
Elsevier Inc.
Abstract
Background The incidence of aortic stenosis (AS) has been significantly
increasing and obesity is a very prevalent characteristic among its
patient population. We aimed to compare the in-hospital outcomes of obese
patients who underwent transcatheter aortic valve replacement (TAVR)
versus surgical aortic valve replacement (SAVR). Methods We searched the
databases systematically from inception to July of 2022 and included
studies comparing TAVR versus SAVR in obese patients (BMI>= 30
kg/m²). The primary outcome was in-hospital mortality.
Additional outcomes included acute myocardial infarction (MI), acute
kidney injury (AKI), need for permanent pacemaker (PPM) and need for blood
transfusion. Results We included 4 cohort studies with a total of 37,743
patients. In-hospital mortality was lower in TAVR (odds ratio [OR] 0.64;
95% confidence interval [CI] 0.42-0.96; p=0.04, I²=64%). TAVR
patients had lower rate of AKI (odds ratio [OR] 0.54; 95% confidence
interval [CI] 0.39-0.85; p=0.0002, I²=85%) and lower rate of
blood transfusion (odds ratio [OR] 0.27; 95% confidence interval [CI]
0.15-0.49; p<0.0001, I²=89%). Need for PPM, however, was higher
in the TAVR group (odds ratio [OR] 2.43; 95% confidence interval [CI]
1.87-3.15; p<0.00001, I²=70%). The rate of MI was similar
between both groups. Conclusion TAVR is associated with lower in-hospital
mortality, peri-operative AKI and need for blood transfusion compared to
SAVR in obese patients. However, it is associated with higher rate of PPM
placement. [Formula presented]<br/>Copyright &#xa9; 2023 American College
of Cardiology Foundation

<55>
Accession Number
2023050276
Title
COMPARISON OF WARFARIN VS DIRECT ORAL ANTICOAGULANTS AFTER LEFT ATRIAL
APPENDAGE OCCLUSION: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1084), 2023. Date of
Publication: 07 Mar 2023.
Author
Saju S.; Akhtar K.H.; Krishan S.; Nasir Y.; Khosla J.; Baber U.
Institution
(Saju, Akhtar, Krishan, Nasir, Khosla, Baber) University of Oklahoma
Health Sciences Center, Oklahoma City, OK, United States
Publisher
Elsevier Inc.
Abstract
Background The optimal anticoagulation strategy after left atrial
appendage occlusion (LAAO) is not clearly established. We hypothesized
that clinical outcomes would be similar between patients taking warfarin
and direct oral anticoagulants (DOACs) post-procedurally after LAAO.
Methods A systematic search was performed in MEDLINE and EMBASE databases
for studies comparing clinical and procedural outcomes between warfarin
and DOACs after LAAO. Mantel-Haenszel Odds Ratio (OR) with corresponding
95% confidence intervals (CI) were calculated. Results 7 retrospective and
3 prospective studies with total patient population of 2,446 patients
(Warfarin= 1,044 and DOAC=1,402) were included for analysis. Warfarin use
was associated with higher rates of any bleeding (OR 2.16; 1.45-3.22;
p=0.0002) and minor bleeding (OR 3.39; 1.76-6.51; p=0.0003). There was a
non-statistically significant trend towards higher major bleeding (OR
1.63; 0.94-2.82; p=0.08) and stroke (OR 2.12; 0.96-4.67; p=0.06) with
warfarin use. No difference was observed in terms of all-cause mortality
or device related thrombosis between the two groups. Conclusion Use of
Warfarin after LAAO was associated with higher rates of bleeding,
particularly minor bleeding, but does not reduce the risk of stroke when
compared to DOACs. [Formula presented]<br/>Copyright &#xa9; 2023 American
College of Cardiology Foundation

<56>
Accession Number
2023050242
Title
COMPARISON OF RISK SCORES FOR PREDICTING MORTALITY AFTER INFECTIVE
ENDOCARDITIS SURGERY: A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1976), 2023. Date of
Publication: 07 Mar 2023.
Author
Agrawal A.; Shekhar S.; Unai S.; Griffin B.P.; Wang T.K.M.
Institution
(Agrawal, Shekhar, Unai, Griffin, Wang) Cleveland Clinic Foundation,
Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Background Infective endocarditis (IE) is a heterogeneous disease with
high incidence of mortality and morbidity. Surgery is recommended in
approximately half of these patients. The accuracy of risk scores in IE
surgery is seldom studied. This meta-analysis compared the prognostic
utility of risk scores to predict operative mortality after IE surgery.
Methods Following the PRISMA guidelines, we searched PubMed for relevant
studies until 6/30/2022. Studies must include the area under the curve
(AUC) and 95% confidence intervals (95%CI) for one or more risk score to
predict operative mortality after IE surgery. Data was pooled using random
effects models and OpenMeta-Analyst software. Results Among 2590 studies
searched, 11 studies totaling 4328 patients undergoing IE surgery were
studied. Pooled analyses are indicated in Table 1. All scores were able to
moderately discriminate operative mortality after IE surgery (AUC
0.71-0.78), with the endocarditis specific scores AEPEI having the highest
AUC (95%CI) of 0.783 (0.752-0.815, P<0.001), along with RISK-E and De
Feo-Cotrufo scores performing marginally better than the general EuroSCORE
I and EuroSCORE II. Significant heterogeneity was observed in the pooled
analysis of 5 of the 7 scores. Conclusion Contemporary surgical risk
scores have moderate discriminative ability for operative mortality after
IE surgery, and endocarditis specific scores may perform slightly better
than general cardiac surgery scores. [Formula presented]<br/>Copyright
&#xa9; 2023 American College of Cardiology Foundation

<57>
Accession Number
2023049964
Title
OUTCOMES OF TRANSCATHETER VERSUS SURGICAL AORTIC VALVE REPLACEMENT IN
PATIENTS WITH PRIOR CHEST RADIATION THERAPY. A SYSTEMATIC REVIEW AND
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1027), 2023. Date of
Publication: 07 Mar 2023.
Author
Ang S.P.; Chia J.E.; Jaiswal V.; Aamir N.; Okoh N.; Lali M.; Chia T.H.
Institution
(Ang, Chia, Jaiswal, Aamir, Okoh, Lali, Chia) Rutgers Health/Community
Medical Center, Toms River, NJ, United States
Publisher
Elsevier Inc.
Abstract
Background Patients with severe aortic stenosis and prior chest radiation
therapy (CRT) were shown to have worse outcomes after surgical aortic
valve replacement (SAVR). However, there was paucity of data comparing
transcatheter aortic valve replacement (TAVR) against SAVR in this
specific population. We aimed to compare the outcomes between TAVR and
SAVR among patients with prior CRT. Methods We comprehensively searched
PubMed, Embase, and Cochrane Library from its inception until August 20,
2022 for relevant studies. Outcomes were pooled using the DerSimonian and
Laird random-effects model and reported as odd ratios (OR) or standarized
mean difference (SMD) and 95% confidence intervals (CI). Results 7 studies
involving 5803 patients (3194 TAVR, 2609 SAVR) were included in the final
analysis. Compared with SAVR, patients with prior CRT undergoing TAVR had
significantly lower in-hospital mortality (OR 0.56, 95% CI: 0.33 to 0.93,
p=0.03), 30-day mortality (OR 0.57, 95% CI: 0.36 to 0.89, p=0.01),
post-operative atrial fibrillation (OR 0.19, 95% CI: 0.15 to 0.26,
p<0.001), AKI (OR 0.63, 95% CI: 0.42 to 0.94, p=0.03) and shorter length
of hospital stay (SMD -1.09, 95% CI: -1.40 to -0.78, p<0.001) but higher
odds of pacemaker implantation (OR 1.80, 95% CI: 1.05 to 3.10, p=0.03).
One-year mortality appeared to be similar between both groups of patients
(OR 0.59, 95% CI: 0.29 to 1.20, p=0.15). Conclusion TAVR showed desirable
outcomes and could be a safe alternative to SAVR in patients with prior
CRT. [Formula presented]<br/>Copyright &#xa9; 2023 American College of
Cardiology Foundation

<58>
Accession Number
2023049556
Title
MITRAL VALVE REPAIR IS BETTER THAN MITRAL VALVE REPLACEMENT IN REDUCING
LONG-TERM MORTALITY AMONG RHEUMATIC MITRAL VALVE DISEASE: AN UPDATED
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 888), 2023. Date of
Publication: 07 Mar 2023.
Author
Faraj H.; Khaled A.; Benghatnsh A.T.S.; Elfaituri A.; Msherghi A.;
Elfaituri M.K.
Institution
(Faraj, Khaled, Benghatnsh, Elfaituri, Msherghi, Elfaituri) Hamad Medical
corporation, Doha, Qatar
Publisher
Elsevier Inc.
Abstract
Background Rheumatic heart disease (RHD) remains a cause of mitral valve
disease worldwide. RHD causes mitral stenosis, regurgitation, or both,
resulting in aberrant hemodynamics and heart failure, necessitating
surgical intervention, including mitral valve (MV) repair and MR
replacement. Methods PubMed/Medline, EMBASE, Cochrane and Scopus were
searched up to May 2022 for studies that reported the outcomes of MV
replacement compared to MV repair for patients with RHD. The primary
outcome was early mortality and freedom from reoperation after the
intervention. The secondary outcomes were long-term survival, infective
endocarditis, bleeding complications, and arterial and venous
thromboembolic events. The statistical analysis was performed using R
version 4.0.3. Results A total of 11 studies were included in the analysis
comprising 6,902 patients (2009 MV repair and 4893 MV replacement). All
studies reported early mortality (30 days post-operatively); although not
significant, the results showed that MV repair was associated with a lower
mortality risk than MV replacement (RR: 0.62; 95% CI, 0.39-0.99; P =
0.14). However, in long-term survival outcomes, MV repair showed a
significantly higher survival rate than MV replacement (HR: 0.90; 95% CI,
0.76-1.07; P < 0.01). In terms of freedom from reoperation, the MV repair
patients had a significantly higher rate than MV replacement patients (HR
2.47; 95% CI, 1.82-3.36; P < 0.04). For postoperative complications,
comparing MV repair to MV replacement, although not significant, it showed
lower rate of venous and arterial thromboembolic events (RR: 0.80; 95% CI,
0.56-1.13; P = 0.11), lower infective endocarditis rates (RR: 0.62; 95%
CI, 0.39-0.99; P = 0.14), lower bleeding (RR: 0.71; 95% CI, 0.50-1.02; P =
0.12). Conclusion Our study demonstrated that patients with RHD undergoing
MV repair have better long-term survival and freedom from reoperation than
MV replacement patients. However, no significant differences in early
mortality, thromboembolic events, infective endocarditis, and bleeding. In
2022, MV repair is still an appropriate approach for RHD with MV
involvement<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<59>
Accession Number
2023049417
Title
EXTERNAL VALIDATION OF THE PROGRESS-CTO COMPLICATION RISK SCORES:
INDIVIDUAL PATIENT DATA POOLED ANALYSIS OF 3 REGISTRIES.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 777), 2023. Date of
Publication: 07 Mar 2023.
Author
Simsek B.; Tajti P.; Carlino M.; Rinfret S.; Vemmou E.; Kostantinis S.;
Nikolakopoulos I.; Karacsonyi J.; Agostoni P.; Alaswad K.; Megaly M.;
Avran A.; Choi J.W.; Khatri J.J.; Knaapen P.; La Manna A.; Spratt J.C.S.;
Rangan B.V.; Goktekin O.; Kearney K.E.; Lombardi W.L.; Grantham J.A.;
Mashayekhi K.; Brilakis E.S.; Azzalini L.
Institution
(Simsek, Tajti, Carlino, Rinfret, Vemmou, Kostantinis, Nikolakopoulos,
Karacsonyi, Agostoni, Alaswad, Megaly, Avran, Choi, Khatri, Knaapen, La
Manna, Spratt, Rangan, Goktekin, Kearney, Lombardi, Grantham, Mashayekhi,
Brilakis, Azzalini) Minneapolis Heart Institute Foundation, Minneapolis,
MN, United States
Publisher
Elsevier Inc.
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. Methods To
assess the utility of the recently developed PROGRESS-CTO (NCT02061436)
complication risk scores in individual patient data pooled analysis of 3
registries. Results Of the 4,569 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). Technical success was lower in patients with MACE (59% vs. 86%,
p<0.001). The c-statistics 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 complication rates increased
with higher PROGRESS-CTO complication scores. The score had 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), and 5.8% (score 6-7) (Figure). Conclusion 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. [Formula
presented]<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<60>
Accession Number
2023049329
Title
THE IMPACT OF LATE PULMONIC VALVE REPLACEMENT ON VENTRICULAR ARRHYTHMIAS
ASSOCIATED WITH TETRALOGY OF FALLOT (TOF) IN ADULTS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 33), 2023. Date of
Publication: 07 Mar 2023.
Author
Khalid Y.; Dasu N.; Dasu K.; Shetty S.; Beshai R.; Sindhupavani A.; Chhoun
C.
Institution
(Khalid, Dasu, Dasu, Shetty, Beshai, Sindhupavani, Chhoun) Wright Center
for GME/Geisinger Health, Scranton, PA, United States
(Khalid, Dasu, Dasu, Shetty, Beshai, Sindhupavani, Chhoun) Jefferson
Health NJ, CH, NJ, United States
Publisher
Elsevier Inc.
Abstract
Background For survivors of Tetralogy of Fallot (TOF) following repair,
arrhythmias are a known complication. However, there is no consensus yet
on when there should be pulmonary valve replacement (PVR) for patients
with TOF or the impact of PVR on the subsequent development of ventricular
tachycardias. Methods Aggregate data meta-analysis was performed using 12
studies. 1,740 patients with both TOF and the development of ventricular
arrhythmias following initial repair were identified for analysis.
Patients who had late PVR years after initial repair versus those who had
no further intervention were compared. Additionally, a meta-regression
analysis to evaluate the effect of age and time to PVR on the incidence of
ventricular arrhythmias. Summary odds ratio (OR) and 95% confidence
intervals (CI) were estimated using a random-effects model. Results In
1,740 patients with TOF, the cumulative incidence of ventricular
arrhythmias in patients with late PVR was noted to be almost 60% less than
in patients without PVR (OR 0.40, 95% CI 0.22-0.73, p<0.003). Similar
results were noted both in fixed and random effect models. The difference
in means for RV-EDV after PVR did show a significant reduction after PVR
(random-effects model: -1.44, SE = 0.188, p<0.0001). Patients with a
reduction in RV-EDV following late PVR had a significant reduction in the
incidence of ventricular arrhythmias. With regard to pre-operative RVEDV,
we observed statistically significant coefficients for changes in
post-operative RV-EF and postoperative QRS but not for VT by
meta-regression. With regard to pre-operative QRS, we observed
statistically significant coefficients for changes in post-operative RV EF
and post-operative RV-EDV, but not for incidence of VT. Conclusion For
patients with TOF and survival after repair, there was a markedly higher
rate of ventricular arrhythmias in patients who never received PVR
compared to patients who had late PVR. Meta-regression showed a trend
towards decreased incidence of ventricular arrhythmias in patients with
late PVR and increased incidence with increasing age. Late PVR in patients
after TOF repair was associated with a lower mortality rate.<br/>Copyright
&#xa9; 2023 American College of Cardiology Foundation

<61>
Accession Number
2023049192
Title
CLINICAL OUTCOMES OF PERCUTANEOUS LEFT ATRIAL APPENDAGE OCCLUSION VS
DIRECT ORAL ANTICOAGULATION IN PATIENTS WITH ATRIAL FIBRILLATION: AN
UPDATED META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 890), 2023. Date of
Publication: 07 Mar 2023.
Author
Jiang H.; Koh T.H.; Vengkat V.; Ding Z.P.; Ewe S.H.; Jappar I.A.; Lim
S.T.; Yap J.
Institution
(Jiang, Koh, Vengkat, Ding, Ewe, Jappar, Lim, Yap) National Heart Center
Singapore, Singapore, Singapore
(Jiang, Koh, Vengkat, Ding, Ewe, Jappar, Lim, Yap) Lee Kong Chian School
of Medicine, Singapore, Singapore
Publisher
Elsevier Inc.
Abstract
Background The availability of direct oral anticoagulants (DOACs) with
known lower bleeding risk compared to warfarin have raised questions about
the role of left atrial appendage closure (LAAC). Methods All studies
comparing LAAC to DOACs up to August 2022 were included. Outcomes studied
include overall stroke, ischemic stroke, hemorrhagic stroke, major
bleeding, all-cause and cardiovascular mortality. A random-effects model
using R statistical software was used to calculate odds ratios (OR) and
95% confidence interval. Results 6 studies (1 randomized controlled trial,
4 propensity-matched observational studies, 1 non-propensity-matched
prospective study) were finally included with a pooled population of 2592
DOAC and 2406 LAAC patients. There were no significant differences in
terms of baseline age p=0.20), CHA<inf>2</inf>DS<inf>2</inf>-VASc score
(p=0.28), or HASBLED score (p=0.33). After a mean weighted follow-up of
23.1 months, there were no significant differences between LAAC vs DOAC in
overall strokes, ischemic stroke, hemorrhagic stroke, or all-cause
mortality (all p>0.05). However, there were significantly lower rates of
major bleeding (OR 0.59 [0.44-0.80], p = 0.006), and cardiovascular
mortality (OR 0.57 [0.41-0.80], p = 0.01) with LAAC vs DOAC. Conclusion In
this largest updated meta-analysis, percutaneous LAAC was found to be as
efficacious as DOACs for stroke prevention with an improved safety
profile. LAAC has an important role to play in stroke prevention in AF
patients even in the era of DOACs. [Formula presented]<br/>Copyright
&#xa9; 2023 American College of Cardiology Foundation

<62>
Accession Number
2023049003
Title
IMPACT OF UNTREATED AORTIC STENOSIS ON POST-NON-CARDIAC SURGERY OUTCOMES:
A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1957), 2023. Date of
Publication: 07 Mar 2023.
Author
Sousa J.; teixeira R.; Azevedo A.
Institution
(Sousa, teixeira, Azevedo) Instituto Portugues de Oncologia do Porto
Francisco Gentil, EPE, Porto, Portugal
(Sousa, teixeira, Azevedo) Faculdade de Medicina da Universidade do Porto,
Porto, Portugal
Publisher
Elsevier Inc.
Abstract
Background Aortic stenosis (AS) frequently poses a perioperative
management dilemma, as far as non-cardiac surgery (NCS) is concerned. The
purpose of this study is to ascertain the extent to which documented yet
untreated AS associates with clinical outcomes in patients undergoing NCS.
Methods We systematically searched MEDLINE and Embase for studies gauging
mortality and major adverse cardiovascular events (MACE) in patients with
and without AS undergoing NCS. The primary endpoint was 30-day
postoperative all-cause mortality, while MACE, myocardial infarction,
stroke, acute heart failure, intensive care unit admission and length of
hospital stay constituted secondary ones. Study-specific risk ratios (RRs)
and mean differences (MDs) were pooled using traditional meta-analytic
techniques, under a random-effects model. Results Literature search
ultimately yielded 10 studies, all retrospective in nature. Together, they
featured 48931 individuals, of whom 19133 were AS patients. AS was not
found to be associated with 30-day postoperative all-cause mortality (RR
1.14 [0.92-1.41], I2=58%), a finding that held true when only cohort,
nationwide, propensity matched, and hip surgery-focused studies were
considered. On the other hand, AS was associated with a higher risk of
post-NCS MACE (RR 1.67 [1.27-2.19], I2=76%) and myocardial infarction (RR
1.49 [1.00-2.22], I2=52%), as well as with a slightly longer length of
hospital stay (MD 0.73, [0.09-1.37], I2=34%). Postoperative stroke (RR
0.77 [0.39-1.55], I2=54%), acute heart failure (RR 1.45 [0.72-2.95],
I2=71%) and intensive care unit admission (RR 1.09 [0.80-1.49], I2=47%)
rates did not differ significantly between the two groups. Conclusion In
the setting of NCS, the presence of documented yet untreated AS does not
associate with higher mortality. On the other hand, MACE and myocardial
infarction seem to occur more often, in such scenario. These findings
stress the importance of performing randomized trials in this space,
particularly to determine the hypothetical role of preoperative balloon
valvuloplasty or transcatheter valve implantation.<br/>Copyright &#xa9;
2023 American College of Cardiology Foundation

<63>
Accession Number
2023048506
Title
TRANSCATHETER AORTIC VALVE REPLACEMENT OUTCOMES IN ASIA: A SYSTEMATIC
REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1101), 2023. Date of
Publication: 07 Mar 2023.
Author
Rivera F.B.; De Luna D.; Ansay M.F.; Nguyen R.T.; Flores G.; Ong K.; Goel
S.S.; Inohara T.; Volgman A.S.
Institution
(Rivera, De Luna, Ansay, Nguyen, Flores, Ong, Goel, Inohara, Volgman)
Lincoln Medical Center, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background Transcatheter aortic valve replacement (TAVR) is widely
available, yet adapting this procedure in Asia has been slow due to
several socioeconomic and political factors resulting in relatively low
case volume. Methods A literature search of TAVR performed in Asian
countries published between January 2015 and June 2022 was done through
MEDLINE and manual searches of bibliographies. Full text of eligible
articles was evaluated for final analysis. Results A total of 15,295
patients were included in 20 studies. See figures 1 and 2. Conclusion
Compared to Americans and Europeans, Asian patients who underwent TAVR
experienced less 1-year all-cause mortality, bleeding, and vascular
complications. More studies with greater sample sizes are needed among
Asian patients for a more robust comparison. [Formula
presented]<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<64>
Accession Number
2023048491
Title
OUTCOMES OF TRANSCATHETER AORTIC VALVE IMPLANTATION IN PATIENTS WITH
PARADOXICAL LOW FLOW LOW GRADIENT AORTIC STENOSIS: A NETWORK
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 926), 2023. Date of
Publication: 07 Mar 2023.
Author
Ullah W.; Sana M.K.; Mukhtar M.; Syed S.H.; Zahid S.; Vishnevsky A.
Institution
(Ullah, Sana, Mukhtar, Syed, Zahid, Vishnevsky) Thomas Jefferson
University Hospitals, Philadelphia, PA, United States
Publisher
Elsevier Inc.
Abstract
Background Clinical outcomes of transcatheter aortic valve implantation
(TAVI) in paradoxical low-flow low-gradient (pLFLG) aortic stenosis (AS)
remains unknown. Methods Digital databases were searched to identify all
studies comparing TAVI in patients with pLFLG, classic LFLG, low flow high
gradient (LFHG), normal flow high gradient (NFHG), and normal flow low
gradient (NFLG) AS. A frequentist network meta-analysis model was used to
obtain the net risk ratio (RR). Results A total of 21 studies comprising
18,024 (12,364 experimental, 5,660 control) patients were included.
Patients undergoing TAVI for AS with LFLG had a significantly higher risk
of MACE (RR 1.64, 95% CI 1.11-2.43) compared with those with pLFLG. There
was no significant difference in the incidence of MACE between TAVI in
pLFLG and NFLG (RR 0.86, 95% CI 0.34-2.21), NFHG (RR 0.99, 95% CI
0.71-1.38), and LFHG (RR 1.20, 95% CI 0.45-3.23) at a median follow-up of
1-year after TAVI. LFLG (vs. pLFLG) patients had a significantly higher
risk of periprocedural (RR 1.98), 1-month (RR 1.43), 6-month (RR 2.31),
and 12-month (RR 1.23) mortality. There was no significant difference in
the incidence of myocardial infarction, bleeding, and other postprocedure
complications between all other types of AS. Conclusion TAVI in pLFLG is
safe and effective due to a lower incidence of MACE, and mortality
compared with LFLG-AS, with no concomitant significant difference in the
risk of periprocedural complications. [Formula presented]<br/>Copyright
&#xa9; 2023 American College of Cardiology Foundation

<65>
Accession Number
2023048348
Title
CEREBRAL EMBOLIC PROTECTION DEVICES ARE PROTECTIVE AGAINST DISABLING
STROKE IN TRANSCUTANEOUS AORTIC VALVE REPLACEMENT: A META-ANALYSIS OF
RANDOMIZED TRIALS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 925), 2023. Date of
Publication: 07 Mar 2023.
Author
Palicherla A.; Gill G.S.; Chakrala T.; Kanmanthareddy A.; Alla V.M.
Institution
(Palicherla, Gill, Chakrala, Kanmanthareddy, Alla) Creighton University
School of Medicine, Omaha, NE, United States
(Palicherla, Gill, Chakrala, Kanmanthareddy, Alla) University of Florida,
Gainville, FL, United States
Publisher
Elsevier Inc.
Abstract
Background Cerebral embolization of debris from transcutaneous aortic
valve replacement (TAVR) may lead to stroke, some of which can be
debilitating. Several retrospective studies investigating benefits of
cerebral embolic protection (CEP) devices have shown conflicting results,
while randomized control trials (RCTs) have previously been limited by
small number of patients. Methods PubMed and Cochrane databases were
queried for RCTs comparing outcomes among patients with and without CEP
who underwent TAVR. Data from the selected studies were extracted and
analyzed using random effects model. Results Data from seven RCTs with
4,031 patients were included. Although there was no difference in the risk
of stroke (OR 0.81, 95% CI [0.57-1.14]; p=0.23), CEP was associated with a
lower risk of disabling stroke (0.45, [0.23-0.87]; p=0.02) (Figure). There
was no difference in procedure related complications, including mortality
(1.26, [0.55-2.87]; p=0.59), major vascular complications (1.40,
[0.62-3.17]; p=0.42) and AKI (0.96, [0.43-2.13]; p=0.92), between the two
groups. In sensitivity analyses that excluded individual studies by
jack-knife approach, excluding studies with TriGuard device or studies by
follow up (30-day events vs. in-hospital), the findings remained
consistent except association with disabling stroke was no longer
significant after excluding PROTECTED-TAVR Conclusion Among patients who
underwent TAVR, use of CEP was associated with a lower risk of disabling
stroke. [Formula presented]<br/>Copyright &#xa9; 2023 American College of
Cardiology Foundation

<66>
Accession Number
2023048224
Title
COMPARISON OF ULTRASOUND-GUIDED VERSUS FLUOROSCOPY-GUIDED ACCESS IN
FEMORAL ARTERY CANNULATION FOR CARDIAC PROCEDURES.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1458), 2023. Date of
Publication: 07 Mar 2023.
Author
Shoemaker E.; Tangri A.; Vaz I.; Agarwal K.; Silberman H.B.
Institution
(Shoemaker, Tangri, Vaz, Agarwal, Silberman) Baylor University, Waco, TX,
United States
Publisher
Elsevier Inc.
Abstract
Background Major bleeding is the most common complication from femoral
arterial access for cardiac procedures. Vascular complications from access
are more common than complications arising from the angiography itself.
The use of ultrasound (US) allows direct visualization of the artery and
can potentially reduce the rates of complication in comparison the use of
fluoroscopy alone. Methods The study followed the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for
meta-analysis. A systematized search of Medline, Embase, and Cochrane
Register of clinical trials databases from inception until September 2022
was conducted for studies comparing the use of US-guided femoral access
comparing to fluoroscopy guided access. Results The search yielded 612
results and 10 studies met our inclusion criteria. A total of 5,022
patients were included in the final analysis. The Mantel Haenszel
random-effects model was used to calculate odds ratio (OR) and 95%
confidence intervals (CI). The relative risk (RR) for major bleeding was
0.52 (95% CI 0.37, 0.74; p value =0.0002) [Figure 1] in US-guided group
when compared to fluoroscopy only group. Conclusion The findings of this
study highlight that the use of US-guided access for femoral artery
cannulation significantly reduces the rate of major bleeding in cardiac
procedure. This is an important finding and shows that the US-guided must
be standard of care for femoral arterial access, increasing the safety of
the procedure. [Formula presented]<br/>Copyright &#xa9; 2023 American
College of Cardiology Foundation

<67>
Accession Number
2023048197
Title
THE COMPLICATION-RIDDEN DESTINY OF THE SYSTEMIC RIGHT VENTRICLE IN
L-TRANSPOSITION OF THE GREAT ARTERIES: MANAGEMENT DILEMMAS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 3056), 2023. Date of
Publication: 07 Mar 2023.
Author
Almajed M.R.; Stephan J.; Khan N.; Gregerson S.; Ananthasubramaniam K.
Institution
(Almajed, Stephan, Khan, Gregerson, Ananthasubramaniam) Henry Ford
Hospital, Detroit, MI, United States
Publisher
Elsevier Inc.
Abstract
Background Congenitally corrected levo-transposition of the great arteries
(L-TGA) is a congenital heart disease in which the ventricles and great
arteries are transposed from their typical anatomy. In L-TGA, the double
discordance, atrioventricular and ventriculoarterial, create an acyanotic
milieu which allows patients to survive their early decades, however,
progressive systemic right ventricle (sRV) dysfunction creates
complications later on. Case A 40-year-old male with L-TGA presented with
symptoms of acute decompensated heart failure (ADHF). In childhood, he had
surgical repair of a ventricular septal defect. In adulthood, he developed
sRV dysfunction, systemic tricuspid valve (sTV) regurgitation, and
left-bundle branch block for which he underwent cardiac resynchronization
therapy. Transthoracic echocardiogram obtained during the admission showed
a sRV ejection fraction of 40%, severe sTV regurgitation, and a newly
identified sRV apical thrombus; the thrombus was confirmed by
ultrasound-enhancing agents and transesophageal echocardiography.
Decision-making Our patient was optimized with guideline-directed medical
therapy and diuresis. The presence of a sRV thrombus posed a dilemma given
the limited literature. Guidelines for intracardiac thrombus in patients
with structurally typical hearts recommend anticoagulation with a vitamin
K antagonist (VKA) followed by echocardiography to assess for resolution.
However, multiple case reports and small-scale studies support the use of
direct oral anticoagulants. It is unknown whether these principles can be
extrapolated to patients with congenital heart disease. Review of
literature identified no cases of sRV thrombus making this one of the
first reports. Our patient was anticoagulated with a VKA and later
referred for evaluation by advanced heart failure and heart transplant
services. Conclusion We describe one of the first reported cases of sRV
thrombus in L-TGA presenting with ADHF. This case illustrates the natural
history of L-TGA and highlights the importance of surveillance and
monitoring in these patients with dedicated cardiac imaging including
advanced imaging modalities to identify complications.<br/>Copyright
&#xa9; 2023 American College of Cardiology Foundation

<68>
Accession Number
2023048019
Title
COMPARISON OF INTRACARDIAC ECHOCARDIOGRAPHY WITH TRANSESOPHAGEAL
ECHOCARDIOGRAPHY FOR LEFT ATRIAL APPENDAGE OCCLUSION: AN UPDATED
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 150), 2023. Date of
Publication: 07 Mar 2023.
Author
Krishan S.; Hashim L.; Javed L.; Gomez-Perez J.; Khattab M.; Khan J.;
Muhammad R.; Gondal J.; Sacco J.W.; Tatah C.; Shahrukh S.; Farrukh F.;
Clifton S.; Munir B.; DeSimone C.; Deshmukh A.; Asad Z.U.A.
Institution
(Krishan, Hashim, Javed, Gomez-Perez, Khattab, Khan, Muhammad, Gondal,
Sacco, Tatah, Shahrukh, Farrukh, Clifton, Munir, DeSimone, Deshmukh, Asad)
University of Oklahoma Health Sciences Center, Oklahoma city, OK, United
States
Publisher
Elsevier Inc.
Abstract
Background The use of Intracardiac Echocardiography (ICE) to guide
implantation of Left Atrial Appendage Occlusion (LAAO) devices is a novel
as compared to conventional Transesophageal Echocardiography (TEE).
However, outcome data comparing ICE vs TEE is lacking. We hypothesized
that clinical outcomes with ICE would be similar to TEE for LAAO
implantation. Methods A systematic search was performed through MEDLINE
and EMBASE for studies comparing procedural and clinical outcomes between
ICE vs. TEE. Mantel-Haenszel risk ratios (RR) with 95% confidence interval
(CI) were calculated for categorical outcomes and Inverse Variance
standard mean differences (SMD) with 95% CI were calculated for continuous
outcomes. Results 9 prospective and 3 retrospective observational studies
with 3,138 total patients (ICE=1,023 and TEE=2,115) were included. Use of
ICE during LAAO was associated with significantly fewer device
implantation attempts (SMD -0.24 [-0.43, -0.04]; p=0.02) but higher
residual atrial septal defect (ASD) at 45-day follow-up (RR 1.46 [1.2,
1.77]; p=0.0001). There was a non-statistically significant trend with
fewer major bleeding events with ICE (RR 0.62 [0.36, 1.05]; p=0.07). There
was no difference in procedure time, contrast volume used, procedural
success, peri-procedural complications or peri-device leak between the two
groups. Conclusion LAAO with ICE leads to fewer intraprocedural device
attempts but may be associated with higher rates of residual ASD at 45-day
follow up when compared to TEE.<br/>Copyright &#xa9; 2023 American College
of Cardiology Foundation

<69>
Accession Number
2023048006
Title
THE EFFECT OF SOCIOECONOMIC DEPRIVATION ON INTERVENTION AND OUTCOMES OF
ACUTE CORONARY SYNDROME PATIENTS - A META-ANALYSIS USING MULTIVARIATE
SOCIOECONOMIC STATUS INDICES.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1237), 2023. Date of
Publication: 07 Mar 2023.
Author
Anand V.V.; Lee E.; Chin Y.H.; Goh R.; Chaoxing L.; Lim J.; Shankar K.;
Chong B.; Kong G.; Tay P.; Loh P.H.; Chan M.; Chew N.
Institution
(Anand, Lee, Chin, Goh, Chaoxing, Lim, Shankar, Chong, Kong, Tay, Loh,
Chan, Chew) Lee Kong Chian School of Medicine, Singapore, Singapore
(Anand, Lee, Chin, Goh, Chaoxing, Lim, Shankar, Chong, Kong, Tay, Loh,
Chan, Chew) Yong Loo Lin School of Medicine, Singapore, Singapore
Publisher
Elsevier Inc.
Abstract
Background Low socioeconomic status (SES) is an important prognosticator
amongst patients with acute coronary syndrome (ACS). With a constantly
widening socioeconomic gap globally, this paper serves to analyse the
effect SES has on the uptake of intervention and prognosis of ACS
patients. Methods Medline and Embase were searched for articles discussing
outcomes of ACS patients stratified by SES using a multivariate index,
comprising at least 2 of the following 3 SES determinants: Income,
Education and Unemployment. A comparative meta-analysis was conducted
using random effects models to estimate the risk ratio of all-cause
mortality in low SES vs high SES populations, stratified according to
region, year of publication, follow-up duration and SES index. Results 29
studies comprising of 301,340 individuals were included, of which 43.7%
were of low SES. ACS patients of lower SES had significantly higher risk
of all-cause mortality than high SES patients over any duration (RR: 1.19,
95%CI: 1.01 to 1.40, p=0.04) and 1 year (RR: 1.08, 95%CI: 1.03 to 1.13,
p<0.01), but not 30 days (RR: 1.07, 95%CI: 0.98 to 1.16, p=0.10). They
also had significantly lower uptake of revascularisation (RR: 0.95, 95%CI:
0.91 to 0.99, p=0.01) and higher risk of cerebrovascular accident (RR:
1.25, 95%CI: 1.01 to 1.55, p=0.05). Mortality risk between the low and
high SES population was independent of region (p=0.26), publication year
(p=0.73) and duration of follow-up (p=0.06) but was dependent on index
used (p<0.01). Conclusion Patients with low SES had an increased risk of
mortality and cerebrovascular accidents post-ACS, and reduced access to
revascularisation. These results may suggest the dire necessity for
interventions to increase the accessibility of crucial cardiac procedures.
Being aware of the vulnerability of the low SES population will also allow
clinicians to exercise more diligent care for these patients. In doing so,
this may alleviate the disparities in health outcomes due to SES and bring
us closer to a truly equitable healthcare system.<br/>Copyright &#xa9;
2023 American College of Cardiology Foundation

<70>
Accession Number
2023047891
Title
EFFECT OF PRE-PROCEDURAL THROMBOCYTOPENIA ON TAVR OUTCOMES: EVIDENCE FROM
A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1105), 2023. Date of
Publication: 07 Mar 2023.
Author
Srikanth S.; Katukuri N.; Mohammed A.S.; Gurram P.; Sanku K.; Mohammed
B.K.; Zubair M.; Desai R.
Institution
(Srikanth, Katukuri, Mohammed, Gurram, Sanku, Mohammed, Zubair, Desai)
East Carolina University, Brody School Of Medicine, Greenville, NC, United
States
Publisher
Elsevier Inc.
Abstract
Background We conducted the first-ever Meta-Analysis to assess the
clinical outcomes in patients with pre-procedural thrombocytopenia (TCP)
undergoing Transcatheter Aortic Valve Replacement (TAVR). Methods
PubMed/Medline, EMBASE, and SCOPUS databases were systematically reviewed
to find studies through August 2022 reporting data on pre-procedural TCP
and clinical outcomes in patients undergoing TAVR. Random effects models
were used to estimate pooled outcomes, and I2 statistics were used to
report inter-study heterogeneity. Results A total of 5 studies (142,418
total patients) met the criteria and the prevalence of pre-procedural TCP
was 41.9%. Our study showed that patients with pre-procedural TCP
undergoing TAVR had higher odds of in-hospital mortality (adjusted OR
2.72; 95% CI 1.26-5.90, p<0.01), bleeding complications (adjusted OR 2.69;
95% CI 2.32-3.11; p<0.01), and acute kidney injury (AKI) (adjusted OR
1.18; 95% CI 1.10-2.98; p-0.019) (Fig. 1) vs. no pre-procedural TCP. A
similar odds ratio was obtained for in-hospital mortality using both
leave-oneout sensitivity analysis and random effects models. Sensitivity
analysis showed overall and subgroup stability in OR. Conclusion
Pre-procedural TCP is associated with significantly higher in-hospital
mortality rates, bleeding complications, and AKI following TAVR. More
prospective studies are needed to understand the role of pre-procedural
TCP on TAVR outcomes and to investigate ways to improve management in such
patients. [Formula presented]<br/>Copyright &#xa9; 2023 American College
of Cardiology Foundation

<71>
Accession Number
2023047788
Title
SEX DIFFERENCES IN OUTCOMES AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT
WITH NEWER GENERATION DEVICES: A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1095), 2023. Date of
Publication: 07 Mar 2023.
Author
El Sherbini A.; Ya'Qoub L.; Servito M.; Elsherif S.; Ko G.; Elgendy I.
Institution
(El Sherbini, Ya'Qoub, Servito, Elsherif, Ko, Elgendy) Queen's University,
Kingston, Canada
(El Sherbini, Ya'Qoub, Servito, Elsherif, Ko, Elgendy) Gill Heart
Institute, University of Kentucky, Lexington, KY, United States
Publisher
Elsevier Inc.
Abstract
Background Transcatheter aortic valve replacement (TAVR) is a reasonable
strategy among patients with severe aortic stenosis irrespective of
surgical risk. Data regarding sex-specific differences in the outcomes
with newer generation valves are limited. Methods Electronic databases
were searched for studies assessing sex differences in the outcomes of
patients treated with TAVR with newer generation valves (SAPIEN 3 or
Evolut). Random effects model was utilized for summary estimates. Results
Four observational studies with 4,522 patients (44.8% women) were included
in the meta-analysis. Women were older and had a lower prevalence of
coronary disease and mean STS/EuroScore. Women had higher incidence of
short-term mortality (up to 30 days) (risk ratio [RR] 1.60, 95% confidence
interval [CI] 1.14-2.25), but no difference in long-term mortality (RR
0.92, 95% CI 0.72-1.17). There was no significant difference in the
incidence of major bleeding (RR 1.16, 95% CI 0.86-1.57), permanent
pacemaker (PPM) (RR 0.80, 95% CI 0.62- 1.04) or disabling stroke (RR 1.16,
95% CI 0.54-2.45) (Figure 1). Conclusion In this meta-analysis, we found
that women undergoing TAVR with newer generation devices were older and
had lower prevalence of co-morbidities. Women had a higher incidence of
short-term mortality but no difference in the long-term mortality,
bleeding, PPM, or stroke compared with men. Future studies are required to
confirm these findings. [Formula presented]<br/>Copyright &#xa9; 2023
American College of Cardiology Foundation

<72>
Accession Number
2023047625
Title
IMPACT OF PERI-DEVICE LEAK ON LONG-TERM OUTCOMES AFTER LEFT
ATRIALAPPENDAGE CLOSURE. A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 964), 2023. Date of
Publication: 07 Mar 2023.
Author
Mostafa M.R.; Eid M.; Abuelazm M.; Al-Abdouh A.; El-Sakka A.; Hassan A.R.;
Renjithlal S.L.M.; Nand N.; Ismayl M.
Institution
(Mostafa, Eid, Abuelazm, Al-Abdouh, El-Sakka, Hassan, Renjithlal, Nand,
Ismayl) Rochester Regional Health/Unity Hospital, Rochester, NY, United
States
Publisher
Elsevier Inc.
Abstract
Background Left atrial appendage closure (LAAC) effectively reduces the
risk of systemic embolization. However, peri-device leak (PDL) is a
significant limitation and is thought to be linked to an increased risk of
stroke/TIA. Methods This meta-analysis was conducted according to PRISMA
guidelines. A search strategy was designed to utilize PubMed/Medline,
EMBASE, and Google scholar to locate studies whose primary objective was
to analyze the long-term outcomes of the detectable peri-device leak after
LAAC. Results A total of 11 studies comprising 54,393 patients were
included in thefinal analysis with an average follow-up of 5 years. A
detectable PDL is associated with a significant increase in the composite
of stroke, TIA and systemic embolization (RR 1.51; 95% CI 1.11-2.05;
p=0.009; I2=40%. On the contrary, the presence of PDL did not increase the
risk of hemorrhagic stroke (RR 1.35; 95% CI 0.96-1.9; p=0.08; I2=0%,
all-cause mortality (RR 1.08; 95% CI 1,00- 1.16; p=0.04; I2=35%, mortality
due to cardiovascular causes (RR 1.35; 95% CI 0.88 to 2.06; p=0.16; I2=0%,
or device-related thrombosis (RR 1.35; 95% CI 0.80-2.27; p=0.27; I2=0%).
Conclusion A peri-device leak is linked to a significant increase in the
risk of stroke and TIA up to 5 years after the implantation of left atrial
appendage closure. [Formula presented]<br/>Copyright &#xa9; 2023 American
College of Cardiology Foundation

<73>
Accession Number
2023047476
Title
TRANSCATHETER REPAIR FOR TRICUSPID REGURGITATION: A SYSTEMATIC REVIEW OF
PRIOR TRIALS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1090), 2023. Date of
Publication: 07 Mar 2023.
Author
Hong J.; Thakker R.A.; Shalaby M.; Khalife W.; Motiwala A.; Gilani S.;
Rangasetty U.C.; Jneid H.
Institution
(Hong, Thakker, Shalaby, Khalife, Motiwala, Gilani, Rangasetty, Jneid)
University of Texas Medical Branch, Galveston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background Tricuspid regurgitation (TR) is associated with increased
mortality with a perioperative mortality risk of 8-10% for surgery. In the
case of functional TR, repair is proposed when left-sided surgery is also
required. Our systematic review of current trials looks at outcomes of
transcatheter tricuspid valve (TV) repair. Methods We performed a
comprehensive search through MEDLINE, Cochrane and SCOPUS databases from
inception through September 20, 2022. Keyword(s) included "tricuspid
regurgitation" AND "repair." The search was narrowed to clinical trials.
Trials evaluating patients with symptomatic and at least moderate TR were
included. Trials evaluating TV repair in patients with TR and mitral
regurgitation were excluded. Results Four trials were included in the
systematic review. The TRILUMINATE early feasibility study (EFS) evaluated
the outcomes of the TriClip transcatheter tricuspid valve repair system
and revealed that 71% of patients had TR reduced to moderate or less at
1-year follow-up (p<0.0001). The CLASP TR EFS evaluated the PASCAL
transcatheter valve repair system and discovered that 85% of patients had
a TR severity reduction of at least 1 grade at 30-day follow-up (p<0.001).
The TRI-REPAIR study evaluated the outcomes of the Cardioband tricuspid
valve reconstruction system in inoperable patients with at least moderate
TR. At 2-year follow-up, 72% of patients had moderate TR or better
(p=0.016). The US EFS of the FORMA repair system discovered statistically
significant reductions in TR severity grading in the 25 available patients
of the total 29 (p=0.001). Conclusion Our systematic review demonstrated
that transcatheter TV repair can reduce TR severity in patients with
symptomatic and at least moderate TR. TR previously had limited treatment
options due to high risk with surgery, and greater TR severity is
associated with increased mortality. Transcatheter TV repair has been
proven to safely and effectively reduce TR severity and can improve
symptoms and functional capacity. The TRILUMINATE trial and CLASP TR EFS
also had no greater than 7.1% major adverse event rate. Symptomatic
patients with at least moderate TR may benefit from transcatheter TV
repair.<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<74>
Accession Number
2023047352
Title
SAFETY AND STROKE OUTCOMES WITH LEFT ATRIAL APPENDAGE OCCLUSION DEVICE
IMPLANTATION IN END-STAGE RENAL DISEASE: A SYSTEMATIC REVIEW AND
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1091), 2023. Date of
Publication: 07 Mar 2023.
Author
Gill G.S.; Shailly S.; Chakrala T.; Palicherla A.; Kanmanthareddy A.; Alla
V.M.
Institution
(Gill, Shailly, Chakrala, Palicherla, Kanmanthareddy, Alla) Creighton
University College of Medicine, Omaha, NE, United States
(Gill, Shailly, Chakrala, Palicherla, Kanmanthareddy, Alla) University of
Florida, Gainesville, FL, United States
Publisher
Elsevier Inc.
Abstract
Background Warfarin for atrial fibrillation in end stage renal disease
(ESRD) has shown increased risk of hemorrhagic stroke and bleeding events
with no significant benefit in ischemic stroke risk. Additionally, with
only one of the newer oral anticoagulants having approval for use in ESRD
based on a small study, left atrial appendage occlusion (LAAO) devices are
gaining popularity in this population. However, less is known about the
safety outcomes in with LAAO in ESRD. Methods PubMed and Google Scholar
databases were queried for studies comparing outcomes among patients with
and without ESRD who underwent LAAO. Data on outcomes from the selected
studies were extracted and analyzed using random effects model. Results
Data from three studies with 71,129 patients were included. There was no
difference in the risk of ischemic stroke (OR 1.21, 95% CI [0.64-2.30];
p=0.55) during follow-up period. Patients with ESRD were associated with a
higher risk of significant pericardial effusion (OR 2.06, 95% CI
[1.15-3.66]; p=0.01), bleeding (OR 1.79, 95% CI [1.21-2.65]; p<0.01),
blood transfusions (OR 2.10, 95% CI [1.42-3.11]; p<0.01) and in-hospital
mortality (OR 9.54, 95% CI [6.76-13.47]; p<0.01) with LAAO. There was a
trend towards increased risk of vascular complications (OR 1.42, 95% CI
[0.96-2.10]; p=0.08) among ESRD patients. Conclusion Among patients who
underwent LAAO, group with ESRD was associated with a higher risk of
peri-procedural complications while there was no difference in ischemic
stroke [Formula presented]<br/>Copyright &#xa9; 2023 American College of
Cardiology Foundation

<75>
Accession Number
2023047279
Title
SELF-EXPANDING VERSUS BALLOON-EXPANDABLE VALVES FOR VALVE-IN-VALVE
TRANSCATHETER AORTIC VALVE IMPLANTATION (VIV-TAVI): A SYSTEMATIC REVIEW
AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1103), 2023. Date of
Publication: 07 Mar 2023.
Author
Yasmin F.; Aamir M.; Iqbal K.; Moeed A.; Qasim M.; Kumar A.; Nazif K.;
Patel N.C.; Kalra A.
Institution
(Yasmin, Aamir, Iqbal, Moeed, Qasim, Kumar, Nazif, Patel, Kalra) Indiana
University School of Medicine, Indianapolis, IN, United States
(Yasmin, Aamir, Iqbal, Moeed, Qasim, Kumar, Nazif, Patel, Kalra) Dow
Medical College, Karachi, Pakistan
Publisher
Elsevier Inc.
Abstract
Background Valve-in-valve transcatheter aortic valve implantation
(ViV-TAVI) has emerged as a feasible alternative to re-do surgery in
patients with degenerated surgical bio-prosthesis. However, data regarding
the choice of valve type in ViV-TAVI remains inconclusive. This
meta-analysis aims to compare the procedural, and clinical outcomes of
self-expanding (SE) vs. balloon-expandable (BE) valves in ViV-TAVI.
Methods MEDLINE and Scopus were queried till August 2022 to identify
studies comparing outcomes between SE or BE valves for ViV-TAVI. The
primary outcome was all-cause mortality at 30-days. Data were analysed via
random effects model using inverse variance method with 95% confidence
intervals. Results 27 studies with 13,182 patients (SE: 7346; BE: 5836)
were included. No significant differences were found between SE vs. BE
valves in terms of 30-day mortality (BE 4% vs. SE 3%, p = 0.44) (Figure
1), 1-year mortality (BE 12% vs. SE 10%, p = 0.60), and moderate-to-severe
AR at 1-year (BE 1% vs. SE 3%, p = 0.36). However, patients with SE valves
had higher rates of new permanent pacemaker insertion (BE 4% vs. SE 9%, p
= 0.0019). There were no significant differences in the incidence of
30-day safety outcomes, including stroke, AKI, coronary obstruction, major
bleeding, and major vascular complications. Conclusion Both BE and SE
valve types showed comparable mortality and safety outcomes in ViV-TAVI,
with the exception of pacemaker insertion, which was higher in SE compared
to BE valves. [Formula presented]<br/>Copyright &#xa9; 2023 American
College of Cardiology Foundation

<76>
Accession Number
2023047160
Title
DIRECT ORAL ANTICOAGULANTS VERSUS STANDARD OF CARE IN PATIENTS WITHOUT AN
INDICATION OF ANTI-COAGULANTS AFTER TRANSCATHETER AORTIC VALVE
REPLACEMENT: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 988), 2023. Date of
Publication: 07 Mar 2023.
Author
Abuelazm M.; Abdelazeem B.; Gamal M.; Katamesh B.; Abbas K.S.; Savarapu
P.K.; Kheiri B.; Paul T.K.
Institution
(Abuelazm, Abdelazeem, Gamal, Katamesh, Abbas, Savarapu, Kheiri, Paul)
Tanta University, Tanta, Egypt
Publisher
Elsevier Inc.
Abstract
Background We aimed to evaluate the efficacy and safety of Direct oral
anticoagulants (DOACs) versus the standard of care (dual antiplatelet
therapy) in patients without an indication of anticoagulants after
transcatheter aortic valve replacement (TAVR). Methods A systematic review
and meta-analysis synthesizing evidence from randomized controlled trials
(RCTs) were obtained from PubMed, Embase Cochrane, Scopus, and Web of
Science until August 18^th, 2022. We used the fixed-effects
model to report dichotomous outcomes using risk ratio (RR) and 95%
confidence interval (CI). Results Three RCTs with 2924 patients were
inclded. DOACs were significantly associated with more incidence of
all-cause mortality (RR: 1.68 with 95% CI [1.22, 2.30], P= 0.001),
mortality due to non-cardiovascular causes (RR: 2.34 with 95% CI [1.36,
4.02], P= 0.002), and the composite outcome of death, myocardial
infarction, or stroke (RR: 1.41 with 95% CI [1.13, 1.76], P= 0.002).
However, there was no difference in mortality due to cardiovascular causes
(RR: 1.36 with 95% CI [0.92, 2.03], p= 0.13) and major or life-threatening
bleeding according to Valve Academic Research Consortium (VARC)-2 criteria
(RR: 1.18 with 95% CI [0.90, 1.55], p= 0.24). [Formula presented]
Conclusion In patients without an indication of oral anticoagulation after
TAVR, DOACs are associated with higher incidence of all-cause mortality,
non cardiovascular mortality, the composite outcome of death, myocardial
infarction, or stroke compared to standard of care.<br/>Copyright &#xa9;
2023 American College of Cardiology Foundation

<77>
Accession Number
2023046941
Title
COMPARING OUTCOMES FOR PATIENTS WITH PREVIOUS CORONARY ARTERY BYPASS
SURGERY UNDERGOING CARDIAC COMPUTED TOMOGRAPHY PRIOR TO INVASIVE CORONARY
ANGIOGRAPHY VERSUS INVASIVE CORONARY ANGIOGRAPHY ALONE - A METANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1431), 2023. Date of
Publication: 07 Mar 2023.
Author
Kohli V.; Patel D.A.
Institution
(Kohli, Patel) University of Tennessee College of Medicine, Chattanooga,
TN, United States
Publisher
Elsevier Inc.
Abstract
Background Invasive coronary angiogram (ICA) is often challenging in
patients with prior grafts, given the complex and variable anatomy for
each individual. The aim of this study is to assess if prior cardiac
computed tomography (CCTA) aids in better visualization of coronary artery
bypass graft (CABG) anatomy in patients with prior bypass surgery who are
planned to undergo ICA. Methods PubMed, Cochran, Clinicaltrials.gov, and
Google Scholar databases were searched through September 2022 to identify
comparative studies between CCTA prior to ICA versus ICA alone in patients
with CABG. Effect size of each study was computed and compared using the
random-effect, inverse variance method. Results Three randomized
controlled trials and two prospective studies with a total of 1777 people
who underwent CCTA prior to ICA [N= 567 (group 1) and ICA alone, N=1210
(group 2)] met the eligibility criteria to be included in the analysis.
Fluoroscopy time and total contrast volume were significantly lower in
group 1 compared to group 2; however, the procedural time was lower in
group 1 but did not achieve significant difference between the two groups.
Significantly lower number of femoral access and catheters were used in
group 1. Conclusion Due to CCTA prior to ICA, there was increase in radial
approach and decrease in number of catheters which likely resulted in
decreased contrast volume use and fluoroscopic time as well. [Formula
presented]<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<78>
Accession Number
2023046915
Title
OUTCOMES OF ISOLATED TRICUSPID VALVE SURGERY: A META-ANALYSIS AND
META-REGRESSION.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1046), 2023. Date of
Publication: 07 Mar 2023.
Author
Al-abcha A.; Al-Asad K.S.; Saleh Y.; Abbasi M.; El-Am E.; Alkhouli M.A.
Institution
(Al-abcha, Al-Asad, Saleh, Abbasi, El-Am, Alkhouli) Mayo Clinic,
Rochester, MN, United States
Publisher
Elsevier Inc.
Abstract
Background Isolated tricuspid valve (TV) regurgitation is associated with
high mortality. There is a critical gap in our knowledge of operative and
long-term outcomes in patients undergoing isolated TV surgery. This has
limited the expansion of indication of transcatheter TV interventions.
Methods We performed a meta-analysis and meta-regression of studies that
reported outcomes of isolated TV surgery (repair and replacement) from
inception till September, 2022. The primary outcome was long-term
mortality. Additional outcomes included in-hospital mortality, rate of
post-op permanent pacemaker (PPM), post-op acute kidney injury (AKI). We
used R package, Metafor, version 4.1.3 (R foundation) for all analyses.
Results A total of 43 studies, and 13,633 patients were included. Mean age
of the population was 57.2 years, 58% were females, and 2,071 patients had
a history of previous cardiac surgery. Long-term mortality with a median
weighted follow up of 7.2 years was 39%. Meta-regression analysis
demonstrated decreasing rate of long-term mortality with increasing year
of surgery (p=0.03) (Figure). The higher rate of repeat surgical
exploration, and the higher rate of patients with hypertension were
associated with increasing rate long-term mortality. Additionally, the
rate of In-hospital mortality was 8%, post-op PPM was 10%, and post-op AKI
was 15%. Conclusion In patients undergoing isolated TV surgery, short- and
long-term complications are high. [Formula presented]<br/>Copyright &#xa9;
2023 American College of Cardiology Foundation

<79>
Accession Number
2023046871
Title
THE OUTCOME OF DISPROPORTIONATE VERSUS PROPORTIONATE FUNCTIONAL MITRAL
REGURGITATION AFTER TRANSCATHETER MITRAL VALVE REPAIR: SYSTEMATIC REVIEW
AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1049), 2023. Date of
Publication: 07 Mar 2023.
Author
Thangjui S.; Trongtorsak A.; Leelaviwat N.; Kewcharoen J.; Bischof E.
Institution
(Thangjui, Trongtorsak, Leelaviwat, Kewcharoen, Bischof) Bassett Medical
Center, Cooperstown, NY, United States
Publisher
Elsevier Inc.
Abstract
Background Severe functional mitral valve regurgitation (SMR) is
associated with worsening outcomes in heart failure with reduced ejection
fraction (HFrEF) patients. Treating SMR with transcatheter mitral valve
repair (TMVr) has conflicting outcomes, especially in disproportionate SMR
(dSMR) vs. proportionate SMR (pSMR). Therefore, we conducted a systematic
review and meta-analysis to determine the effect of TMVr on dSMR vs. pSMR
in HFrEF patients. Methods We searched PubMed and EMBASE for literature
published from inception to August 2022 for studies conducted in HFrEF
patients with SMR who had TMVR and reported mortality or heart failure
hospitalization (HFH) outcomes. The proportionality of SMR was determined
by a different cut-off of an effective regurgitant orifice area
(EROA)/Left ventricular end-diastolic volume (LVEDV). An odds ratio (OR)
was used to determine the effect outcome. Results Five studies with 1514
patients were included. Patients with HFrEF who underwent TMVR for dSMR
had lower mortality or HFH rate compared to pSMR with an OR of 0.78
(95%CI: 0.61-0.99) if the definition of dSMR was EROA/LVEDV?> median
value. If dSMR was defined by EROA/LVEDV >= 0.15, the OR between dSMR vs.
pSMR was 0.74 (95%CI: 0.58-0.96). Conclusion Patients with HFrEF who
underwent TMVr for dSMR had less mortality or heart failure
hospitalization rate compared to pSMR. Further randomized controlled
studies are needed to confirm this finding to differentiate the
appropriate candidate for this treatment. [Formula
presented]<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<80>
Accession Number
2023046689
Title
DEEP LEARNING PROCESS AND BUILDING OF ARTIFICIAL INTELLIGENCE AS PRECISION
TOOLS FOR 30-DAY MORTALITY RISK PREDICTION AFTER CARDIAC SURGERY.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 2356), 2023. Date of
Publication: 07 Mar 2023.
Author
Rosler A.; Ferreira G.; Prediger V.; Nascimento J.; Silva G.; Sales M.;
Lucchese F.
Institution
(Rosler, Ferreira, Prediger, Nascimento, Silva, Sales, Lucchese) Hospital
Sao Francisco - Santa Casa de Misericordia de Porto Alegre, Porto Alegre,
Brazil
Publisher
Elsevier Inc.
Abstract
Background The risk prediction of in-hospital death after cardiac surgery
still has important gaps. In this scenario, the computational tools and
advanced math modeling, as the artificial neural networks, can represent a
safe and effective solution to this problem. Thus, our purpose was
developing a 30-day mortality prediction model for cardiac surgery based
in a deep learning process and compare with EuroScore 2 (ES2) and STS
Score (STS). Methods Were analyzed 56 baseline variables of 5,011 patients
consecutively submitted to cardiac surgery between 2010 and 2022. First,
we applied the Extremely Randomized Trees Classifier algorithm to identify
variables with highest association with 30-day mortality and so it was
possible to reduce the number of interest variables for the model from 56
to 15. Next, the dataset was randomly divided into two: training (70% of
the sample) and test (30%). With the training dataset an artificial neural
network (ANN) was designed with 1,000 cycles of learning. The ANN model,
the ES2 and STS were evaluated and compared in the testing dataset. The
predictive accuracies of the ANN model and of the risk scores were
obtained for comparison through Areas Under Curves (AUC) of ROC curves and
DeLong Tests. Results For aortic replacement, aortic replacement plus
coronary artery bypass graft surgery (CABG) and mitral replacement plus
CABG, the predictive accuracies of ANN were above 80%, while the
traditional scores showed significantly lower values (p<0.05). For CABG
and mitral replacement, the ANN even was better, but with less difference
in comparison with the scores (p<0.05). For the five cardiac surgeries
considered, the ANN model prediction was significantly better, and the
same pattern of predictive accuracies was also observed when analyzing the
general group (ES2 AUC: 0.733, STS AUC: 0.690, ANN AUC: 0.808; p<0.05).
Conclusion ANN model presented better results than traditional risk scores
in all scenarios evaluated in this study. Analyzing and comparing the
predictive accuracies in the testing dataset, we can conclude that math
modeling based on deep learning techniques has great potential and it is
viable to develop useful and solid predictive tools for cardiac
surgery.<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<81>
Accession Number
2023046647
Title
OUTCOMES WITH CEREBRAL EMBOLIC PROTECTION DEVICES DURING TRANSCATHETER
AORTICVALVE REPLACEMENT: AN UPDATED META-ANALYSIS OF RANDOMIZED CONTROLLED
TRIALS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 820), 2023. Date of
Publication: 07 Mar 2023.
Author
Al-Abdouh A.; Mhanna M.; Jabri A.; Alhuneafat L.; Zaalouk M.; Ghanem F.H.;
Altibi A.; Dewaswala N.; Bhopalwala H.; Barbarawi M.; Kundu A.; Elgendy I.
Institution
(Al-Abdouh, Mhanna, Jabri, Alhuneafat, Zaalouk, Ghanem, Altibi, Dewaswala,
Bhopalwala, Barbarawi, Kundu, Elgendy) University of Kentucky, Lexington,
KY, United States
Publisher
Elsevier Inc.
Abstract
Background Stroke due to cerebral embolization of debris is a devastating
complication of transcatheter aortic-valve replacement (TAVR). We present
this updated meta-analysis of randomized controlled trials (RCTs) to
assess the efficacy of cerebral embolic protection (CEP) in reducing the
risk of stroke and other clinical outcomes during TAVR. Methods A
comprehensive search was conducted from inception to September 2022 using
multiple databases (PubMed, Cochrane, and ClinicalTrials.gov) for RCTs
comparing the use of CEP to standard of care in during TAVR. The
Mantel-Haenszel method was used with Paule-Mandel estimator of
tau² and Hartung-Knapp-Sidik-Jonkman adjustment to estimate the
risk ratio (RR) with 95% confidence interval (CI). We used R version 4.0.3
to perform the forest plots. Results A total of 7 RCTs were included:
2,031 had CEP during TAVR and 1804 had TAVR without CEP. In patients
undergoing TAVR, there were no significant differences between CEP and
control groups in terms of stroke (RR 0.81;95%CI 0.61-1.07; P=0.11;
I²=0%) [Figure], mortality (RR 1.01;95%CI 0.43-2.38; P=0.97;
I²=0%), major adverse cardiovascular events (MACE) (RR
0.84;95%CI 0.58-1.21; P=0.27; I²=0%), or acute kidney injury
(RR 0.91;95%CI 0.32-2.60; P=0.82; I²=0%). Conclusion In
patients undergoing TAVR, routine CEP is not associated with a reduction
in the risk of stroke, mortality, MACE, or acute kidney injury. [Formula
presented]<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<82>
Accession Number
2023046632
Title
ANALYSIS OF AFRICA'S CLINICAL TRIAL OUTPUT IN CARDIOVASCULAR MEDICINE:
WAKING A SLEEPING GIANT.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 2319), 2023. Date of
Publication: 07 Mar 2023.
Author
Abushouk A.; Sayed A.; Mentias A.G.; Kapadia S.R.
Institution
(Abushouk, Sayed, Mentias, Kapadia) Cleveland Clinic Foundation,
Cleveland, OH, United States
(Abushouk, Sayed, Mentias, Kapadia) Ain Shams University, Cairo, Egypt
Publisher
Elsevier Inc.
Abstract
Background Considering the increasing burden of cardiovascular disease in
Africa, we assessed Africa's output of clinical trials in cardiovascular
medicine over the past three decades. Methods Eligible trials were
retrieved by a comprehensive PubMed search. A clinical trial was deemed
eligible if it was planned and implemented in Africa. We excluded trials
that were planned or managed outside Africa, even if implemented by
Africa-based researchers. We analyzed the visibility, themes, risk of
bias, and funding sources of eligible trials. Results 179 trials were
published from African countries between 1990 and 2019, 147 (82%) of which
originated from Egypt, South Africa, and Nigeria. Only 22 trials (12.3%)
were multicenter. The dominant themes were preventive cardiology, followed
by ischemic heart disease and heart failure & cardiac transplantation.
Only 95 trials (52.5%) were published open-access. Overall, only 4 (2.5%)
trials had a low risk of bias, while 79 (48.5%) and 80 (49%) studies had
unclear and high risks of bias, respectively, often due to issues with
randomization and outcome reporting. Only 68 trials reported receiving
funding, most commonly from academic or governmental sources. Conclusion
Africa's output of clinical trials in cardiovascular medicine has been low
with methodological limitations and lack of funding. Extensive and
collaborative measures are needed to strengthen Africa's research
infrastructure and balance the distribution of resources for all African
countries. [Formula presented]<br/>Copyright &#xa9; 2023 American College
of Cardiology Foundation

<83>
Accession Number
2023045542
Title
A CASE OF TOO MANY ANTIBODIES: NOVEL USE OF DARATUMUMAB IN A PRE-HEART
TRANSPLANT PATIENT.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 2496), 2023. Date of
Publication: 07 Mar 2023.
Author
Rabadia S.; Kamath M.Y.; Vucicevic D.; Nsair A.
Institution
(Rabadia, Kamath, Vucicevic, Nsair) University of California, Los Angeles,
Los Angeles, CA, United States
Publisher
Elsevier Inc.
Abstract
Background Highly sensitized pre-heart transplant patients wait longer for
transplant due limited suitable donors and prolonged desensitization
protocols. Daratumumab has rarely been used to desensitize pre-heart
transplant patients. Case A 36 year old female with history of end stage
non-ischemic cardiomyopathy, kidney transplant with graft failure on
hemodialysis, and prior opportunistic infections presented for combined
heart and kidney transplant evaluation. Upon anti-HLA antibody screening,
she was found to have 100% calculated panel reactive antibodies (CPRA).
Despite treatment with intravenous immunoglobulin and plasmapheresis, CPRA
level continued to remain high. Decision-making Due to persistent
sensitization, daratumumab was added to her treatment regimen. After 23
daratumumab infusions over the course of 1 year, CPRA level was
undetectable (Figure 1). Complications were limited to mild neutropenia.
Current recommended treatment for pre-heart transplant desensitization
focuses on antibody removal. Daratumumab is an IgG CD38-targeting
monoclonal antibody that directly inhibits antibody development by
targeting plasma B-cells. It is only FDA approved for multiple myeloma
treatment and has not been studied in desensitizing pre-heart transplant
patients. [Formula presented] Conclusion Here, we demonstrate the safe and
effective use of daratumumab for desensitization. Randomized control trial
data is needed to standardize its use in pre-heart transplant
patients.<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<84>
Accession Number
2023045237
Title
IS CT SURGERY BACK UP NECESSARY FOR LEFT ATRIAL APPENDAGE OCCLUSION
PROCEDURE?.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 49), 2023. Date of
Publication: 07 Mar 2023.
Author
Bawa D.; Ahmed A.; Garg J.; Shah K.B.; Darden D.; Kabra R.; Pothineni
N.V.K.; Gopinathannair R.; Lakkireddy D.R.
Institution
(Bawa, Ahmed, Garg, Shah, Darden, Kabra, Pothineni, Gopinathannair,
Lakkireddy) Kansas City Heart Rhythm Institute, Overland Park, KS, United
States
Publisher
Elsevier Inc.
Abstract
Background Procedural complications requiring emergent CT surgery post
ablation of atrial fibrillation (AF), ventricular tachycardia (VT), and
left atrial appendage occlusion (LAAO) is the most feared outcome.
Operator experience, technological advancements have significantly reduced
the risk of needing CT surgery. After FDA approval in 2015, Medicare
mandated the presence of an in house CT surgeon for LAAO, however no such
requirement exists for AF or VT ablation. Methods A systematic review and
meta-analysis of RCTs performed in last 15 years to compare outcomes of
AF, VT or LAAO were included. A pooled cohort analysis for procedural
complications, pericardial tamponade (PT) and cardiac perforation (CP)
requiring CT surgery were compared in pooled cohort analysis of RCTs
between LAAO vs. AF and VT ablation. Results Overall, screening of 8538
studies yielded 42 RCTs, enrolling 10,682 patients (4,483 in LAAO and
6,199 in AF and VT arm). There was no significant difference in incidence
of PT requiring CT surgery intervention in LAAO arm vs. AF and VT arm
(0.15% vs. 0.22%, [95% CI: 0.00-0.08; p=0.29]). Similarly there was no
difference in CP between the 2 arms (0.09% vs. 0.14%, [95% CI: 0.00-0.05;
p=0.11]). Conclusion The incidence of serious complications requiring CT
surgery was less than 1% for both the LAAO vs. AF and VT ablation with no
statistically significant difference. Requirement of an in house CT
surgeon may not be necessary for LAAO and calls for revision of the
previously created mandate. [Formula presented]<br/>Copyright &#xa9; 2023
American College of Cardiology Foundation

<85>
Accession Number
2023045200
Title
VENTRICULAR SEPTAL MYECTOMY VERSUS ALCOHOL SEPTAL ABLATION IN THE
TREATMENT OF OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY: A META-ANALYSIS OF
MULTIVARIABLE ADJUSTED STUDIES.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 864), 2023. Date of
Publication: 07 Mar 2023.
Author
Calomeni P.A.-K.B.; Carvalho L.V.R.; Melo P.; De Miranda Gauza M.; Ribeiro
H.B.; Pirez J.; Fernandes A.
Institution
(Calomeni, Carvalho, Melo, De Miranda Gauza, Ribeiro, Pirez, Fernandes)
InCor, Heart Institute, Sao Paulo, Brazil
(Calomeni, Carvalho, Melo, De Miranda Gauza, Ribeiro, Pirez, Fernandes)
University of Sao Paulo Medical School, Sao Paulo, Brazil
Publisher
Elsevier Inc.
Abstract
Background The relative efficacy and safety of septal myectomy (SM)
compared with alcohol septal ablation (ASA) in patients with severely
symptomatic hypertrophic cardiomyopathy (HCM) and left ventricular outflow
tract obstruction is not well established. Prior studies have been limited
by univariate analysis, which are highly prone to confounding. Methods We
performed a systematic review and meta-analysis comparing the effects of
SM vs. ASA in the treatment of obstructive HCM. The outcomes of interest
were all-cause mortality, sudden cardiac death (SCD), and pacemaker
implantation. PubMed, Scopus and Cochrane Central were searched. To
minimize the risk of confounding, we excluded observational studies
without propensity-matching or multivariable analyses. Results Seven
studies were included, all of which reported multivariable adjusted hazard
ratios. There were 5,976 (68%) patients in the SM group and 2,761 (32%) in
the ASA group. All-cause mortality was slightly higher for the ASA group
(HR 1.28; 95% CI 1.03-1.60; p=0.03; Figure 1). There were also more
pacemaker implantations in the ASA group (HR 2.17; 95% CI 1.63 - 2.88;
p<0.001). SCD was not statistically different between groups (HR 1.06; 95%
CI 0.71-1.57; p=0.79). Conclusion In multivariable-adjusted analyses, ASA
is associated with increased all-cause mortality and pacemaker
implantation as compared with SM in patients with obstructive HCM.
[Formula presented]<br/>Copyright &#xa9; 2023 American College of
Cardiology Foundation

<86>
Accession Number
2023044586
Title
ASSOCIATION BETWEEN PRE-HEART TRANSPLANT AMIODARONE USE, POST-TRANSPLANT
PRIMARY GRAFT DYSFUNCTION, AND ALL-CAUSE MORTALITY: A SYSTEMATIC REVIEW
AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 355), 2023. Date of
Publication: 07 Mar 2023.
Author
Ko E.; Ahmed M.; Nudy M.; Bussa R.; Bussa J.; Gonzalez M.D.; Naccarelli
G.V.; Soleimani B.; Maheshwari A.
Institution
(Ko, Ahmed, Nudy, Bussa, Bussa, Gonzalez, Naccarelli, Soleimani,
Maheshwari) Penn State Hershey Medical Center, Hershey, PA, United States
(Ko, Ahmed, Nudy, Bussa, Bussa, Gonzalez, Naccarelli, Soleimani,
Maheshwari) University of Massachusetts Amherst, Amherst, MA, United
States
Publisher
Elsevier Inc.
Abstract
Background Effect of pre-heart transplant (HTx) amiodarone use on post-HTx
primary graft dysfunction (PGD) and mortality is not well established.
Methods A systematic search for studies reporting the incidence of PGD and
all-cause mortality in adult HTx recipients who received amiodarone prior
to HTx was conducted. The primary outcome was PGD, and the secondary
outcomes was 30-day mortality. Results Nine studies were identified that
included 28,268 participants. The mean age (+/-SD) was 52.59 (+/-6.01)
years, and 24.91% of all patients were female. The mean BMI (+/-SD) was
25.27 (+/-3.81) kg/m2. Overall incidence of PGD was 3.45%. The cohort
exposed to amiodarone pre-HTx had higher rate of PGD, 4.42%, as compared
to the cohort not exposed to amiodarone 2.98% (OR 1.99, 95% CI 1.27 to
3.11, p = 0.003). There was significant interstudy heterogeneity (I2 =
83.71%). Four studies (n = 26,263) reported 30-day mortality based on
amiodarone use. Overall, 30-day mortality was 3.71%. The cohort exposed to
amiodarone pre-HTx had a higher rate of mortality, 4.53%, as compared to
the cohort not exposed to amiodarone 3.33% (OR 1.37, 95% CI 1.20 to 1.56,
p < 0.001). There was no interstudy heterogeneity (I2 = 0.00%). Conclusion
Pre-HTx amiodarone use was associated with a higher risk of PGD and 30-day
mortality, however, the increase in absolute risk was small. Caution
should be taken in interpreting findings due to selection bias inherent in
observational, retrospective analyses. [Formula presented]<br/>Copyright
&#xa9; 2023 American College of Cardiology Foundation

<87>
Accession Number
2023043917
Title
PREVENTION OF CONTRAST-INDUCED NEPHROPATHY WITH THE RENALGUARD SYSTEM: A
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 985), 2023. Date of
Publication: 07 Mar 2023.
Author
Mujer M.T.P.; Kashlan B.; Malik M.; Chahine N.; Elkaryoni A.; Bruno E.;
Darki A.
Institution
(Mujer, Kashlan, Malik, Chahine, Elkaryoni, Bruno, Darki) Loyola
University Medical Center, Maywoord, IL, United States
Publisher
Elsevier Inc.
Abstract
Background The RenalGuard System is a device that administers matched IV
normal saline with furosemide-induced diuresis with the aim of decreasing
the risk of contrast-induced nephropathy (CIN) in patients undergoing
cardiac procedures. Data on the clinical benefits of the device are
conflicting. Methods A systematic search was performed for studies on
patients that compared outcomes between RenalGuard and other strategies
for volume expansion for the prevention of CIN in patients with chronic
kidney disease who are undergoing cardiovascular procedures. Odds Ratio
(OR) for categorical variables with 95% confidence intervals were used.
Results 6 randomized controlled trials with a total of 1,052 patients were
included in the analysis. The use of RenalGuard was associated with a
lower risk of contrast-induced nephropathy with OR 0.51 [CI 0.26-0.99,
p=0.05]. There was no significant difference in risk of renal replacement
therapy (RRT), in-hospital mortality, and 30-day MACE between the two
groups. Conclusion RenalGuard can reduce the risk of CIN in patients
undergoing cardiovascular procedures when compared to other strategies of
volume expansion; however, the results of this study do not demonstrate
significant reduction in the risk of RRT, in-hospital mortality, or 30-day
MACE for these patients. [Formula presented]<br/>Copyright &#xa9; 2023
American College of Cardiology Foundation

<88>
Accession Number
640464508
Title
How Hospital Tours Affect Preoperative Anxiety in Mothers with Children
Undergoing Open-Heart Surgery in Iran: A Quasi-Experimental Study.
Source
International journal of community based nursing and midwifery. 8(3) (pp
264-274), 2020. Date of Publication: 01 Jul 2020.
Author
Amintojari A.; Nourian M.; Nikfarid L.; Ojian P.; Nasiri M.
Institution
(Amintojari, Nourian, Nikfarid, Ojian) Department of Pediatric Nursing,
School of Nursing and Midwifery, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Nasiri) Department of Biostatistics, School of Nursing and midwifery,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
NLM (Medline)
Abstract
BACKGROUND: Parents tend to experience considerable amounts of anxiety
before their children undergo open heart surgery. This study was conducted
to assess the effects of taking a hospital tour on preoperative anxiety in
the mothers of children undergoing open heart surgery. <br/>METHOD(S): In
this quasi-experimental study, 96 mothers from Shahid Modarres Hospital in
Tehran, Iran, during April to December 2018, were selected through
convenience sampling and were assigned to three groups using simple
randomization. The oral instruction group (N=32) attended two oral
instruction sessions; the hospital tour group (N=32) participated in tours
of the operation room and intensive care unit; the control group (N=32)
was prepared according to the ward's routine. Preoperative anxiety was
evaluated using the Amsterdam Preoperative Anxiety and Information Scale
and the State Trait Anxiety Inventory. Data were analyzed in SPSS-20. The
ANOVA, paired t-test and Tukey's test were used for the data analysis. The
level of statistical significance was set at P<0.05. <br/>RESULT(S): The
mothers' anxiety about surgery (F=30.99, P<=0.001) and their scores of
state anxiety (F=6.02, P<0.001) differed significantly among the three
groups after the intervention. A significant difference was observed
between the oral instruction and control groups (P<0.001) and the hospital
tour and control groups (P<0.001) regarding the surgery-related anxiety
scores. A significant difference was also observed between the oral
instruction and control groups (P=0.002) regarding the mothers' state
anxiety scores. <br/>CONCLUSION(S): The results suggest the greater
efficiency of oral instructions versus hospital tours. Nurses can use oral
instructions for reducing surgery-related anxiety and state anxiety of
mothers before their toddlers' open heart surgery.Trial Registration
Number: IRCT20180904040944N1.<br/>Copyright: &#xa9; International Journal
of Community Based Nursing and Midwifery.

<89>
Accession Number
2023065502
Title
A Randomized Trial of Lenient Versus Strict Arm Instruction Post Cardiac
Device Surgery (LENIENT).
Source
American Heart Journal. 259 (pp 52-57), 2023. Date of Publication: May
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
Elsevier Inc.
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 vs strict arm and
activity instruction post-CIED surgery (LENIENT trial; NCT04915261) is a
single center nonblinded 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 nonblinded randomized prospective
trial with 6 randomly assigned 8-month periods, during which either a
lenient or restrictive postoperative activity instructions will be given
to all patients. Postoperative 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 end point 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
noninferiority trial with a sample size of 1,250 per group.
<br/>Discussion(s): This is the first large randomized clinical trial
designed to establish an evidence-based postoperative standard of care for
patients undergoing CIED implantation. This will improve the quality of
care provided to patients and help guide implanting physicians providing
postoperative care instructions. Trial registration: ClinicalTrials.gov
NCT04915261<br/>Copyright &#xa9; 2023 Elsevier Inc.

<90>
Accession Number
2022818501
Title
A randomized trial comparing left distal radial versus femoral approach
for coronary artery bypass graft angiography: a pilot study.
Source
Minerva Cardiology and Angiology. 71(1) (pp 27-34), 2023. Date of
Publication: February 2023.
Author
Aksoy M.N.; Sahinkus S.; Agac M.T.; Tatli E.
Institution
(Aksoy, Sahinkus, Agac, Tatli) Department of Cardiology, Faculty of
Medicine, Sakarya University, Sakarya, Turkey
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: Left distal transradial angiography (ldTRA) is a new technique
for radial coronary angiography and may be an alternative to conventional
transfemoral angiography (TFA) in patients who had previously undergone
coronary artery bypass graft (CABG) surgery. In this study we compared
ldTRA with TFA in patients who had undergone CABG surgery in terms of
procedural details. <br/>METHOD(S): Fifty-seven consecutive patients with
history of previous CABG among 459 patients who were admitted to coronary
angiography unit (elective and acute coronary syndromes) in our center
between October 2019 and February 2020 were included in the study.
Consecutive patients were randomized to ldTRA (34 patients) and TFA (23
patients) group. The difference in total procedure times was defined as
primary endpoint. The difference in sheat times, fluoroscopy times,
contrast volume used and radiation exposure were designated as secondary
endpoints. Post angiographic complications were compared between two
groups. <br/>RESULT(S): Out of 34 patients, successful distal radial
access was obtained in 25 patients (74%). Baseline demographics, contrast
use and radiation exposure were similar between groups. Sheath times in
ldTRA was significantly longer (P<0.001), but total procedure times were
not different (18.4+/-7.8 vs. 14.6+/-6.1, P=0.07). Non-standard
angiographic equipment usage was significantly higher in ldTRA procedures
(80% vs. 13%, P<0.001). There was no major bleeding in neither of groups,
and three minor bleedings in FA group (0% vs.13%, P=0.10).
<br/>CONCLUSION(S): ldTRA in patients with a palpable pulse and successful
access might be used successfully for angiography in patient with previous
CABG even early in an operator's experience.<br/>Copyright &#xa9; 2021
EDIZIONI MINERVA MEDICA.

<91>
Accession Number
618510594
Title
Percutaneous coronary intervention using drug-eluting stents versus
coronary artery bypass graft surgery in left main coronary artery disease
an updated meta-analysis of randomized clinical trials.
Source
Oncotarget. 8(39) (pp 66449-66457), 2017. Date of Publication: 2017.
Author
Gao L.; Liu Y.; Sun Z.; Wang Y.; Cao F.; Chen Y.
Institution
(Gao, Liu, Sun, Wang, Cao, Chen) Department of Cardiology, PLA General
Hospital, Beijing 100853, China
Publisher
Impact Journals LLC
Abstract
Objectives: To compare the safety and efficacy of percutaneous coronary
intervention (PCI) using drug-eluting stent (DES) and coronary artery
bypass graft (CABG) for the treatment of left main coronary artery (LMCA)
disease. <br/>Background(s): Several new randomized trials have recently
examined the clinical outcomes of PCI and CABG in LMCA disease. However,
the results of these studies were inconsistent. <br/>Material(s) and
Method(s): We searched five online electronic databases to identify all
the randomized clinical trials assessing the outcomes of PCI using DES and
CABG in patients with LMCA. The clinical outcomes were the major adverse
cardiac and cerebrovascular event (MACCE), all-cause death, myocardial
infarction (MI), stroke, and repeat revascularization (RR).
<br/>Result(s): A total of 5 randomized clinical trials with 4595 LMCA
patients were included in this meta-analysis. For one year follow-up, the
results indicated that PCI were associated with a lower risk of stroke (RR
= 0.21, 95% CI = 0.07-0.65, P = 0.007), a higher risk of RR (RR = 1.72,
95% CI = 1.28-2.33, P < 0.001) than CABG. Moreover, for long-term
follow-up, there were significant higher risks of MACCE and RR with PCI
versus CABG (MACCE: HR = 1.26, 95% CI = 1.11-1.44, P = 0.001; RR: HR =
1.70, 95% CI = 1.42-2.05, P < 0.001). However, there were no significant
differences between the two groups in all-cause death and MI risks,
regardless of follow-up duration. <br/>Conclusion(s): PCI is noninferior
to CABG in short term follow-up of patients with LMCA disease, but CABG is
more safety and efficacy than PCI using DES in long-term
follow-up.<br/>Copyright &#xa9; Gao et al.

<92>
Accession Number
614635335
Title
Impact of diabetes on the risk of bedsore in patients undergoing surgery:
An updated quantitative analysis of cohort studies.
Source
Oncotarget. 8(9) (pp 14516-14524), 2017. Date of Publication: 2017.
Author
Liang M.; Chen Q.; Zhang Y.; He L.; Wang J.; Cai Y.; Li L.
Institution
(Liang, He, Wang, Cai) Department of Psychiatry, The Second Xiangya
Hospital, Central South University, Changsha, Hunan Province, China
(Chen, Li) Department of Nursing, The Second Xiangya Hospital, Central
South University, Hunan Province, Changsha, China
(Zhang) Nursing Teaching and Research Institute, Medical College of
Guangxi University of Science and Technology, Liuzhou, Guangxi Province,
China
Publisher
Impact Journals LLC
Abstract
Diabetes is a major cause of morbidity for patients undergoing surgery and
can increase the incidence of some postoperative complications such as
bedsores. We conducted a meta-analysis of observational studies to examine
whether patients with diabetes undergoing surgery had high risk of
bedsore. We performed a systematic literature search in Pubmed, Embase and
the Cochrane Library Central Register of Controlled Trials database from
inception to November 2016. Studies were selected if they reported
estimates of the relative risk (RR) for bedsore risk in postoperative
diabetic patients compared with that of in non-diabetic patients.
Random-effects meta-analysis was conducted to pool the estimates. A total
of 16 studies with 24,112 individuals were included in our meta-analysis.
The pooled RR of bedsore development for patients with diatetes was 1.77
(95% CI 1.45 to 2.16). The results of subgroup analyses were consistent
when stratified by surgery type, study design, research region, sample
size, inclusion period, analysis method and study quality. There was
evidence of publication bias among studies and a sensitivity analysis
using the Duval and Tweedie "trim-and-fill" method did not significantly
alter the pooled results (adjusted RR 1.17, 95% CI 1.02 to 1.36).This
meta-analysis provides indications that diabetic patients undergoing
surgery could have a higher risk of developing bedsores. Further
large-scale prospective trials should be implemented to comfirm the
association.

<93>
Accession Number
614127992
Title
Coronary computed tomographic angiography for patients with
low-to-intermediate risk chest pain: A systematic review and
meta-analysis.
Source
Oncotarget. 8(2) (pp 2096-2103), 2017. Date of Publication: 2017.
Author
Chen Y.; Fan Y.; Yin Z.; Zhang H.; Zhang Y.; Han Z.; Wang C.
Institution
(Chen, Fan, Yin, Zhang, Zhang, Han, Wang) Department of Cardiology,
Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of
Medicine, Shanghai, China
Publisher
Impact Journals LLC
Abstract
Coronary computed tomographic angiography (CCTA) can image the coronary
vasculature rapidly and detect the presence and severity of luminal
stenosis accurately. However, whether CCTA based care strategy could gain
more benefits than conventional strategy with functional tests for
patients with low-to-intermediate risk chest pain remains unknown. In this
study we performed a meta-analysis to compare the clinical efficacy of
CCTA versus conventional strategy. Eight randomized controlled trials with
14749 patients were finally included in this review after database
searching. Compared with conventional strategy, CCTA significantly
increased the rates of invasive coronary angiography (RR 1.44; 95% CI 1.28
to 1.63) and revascularization (RR 1.94; 95% CI 1.65 to 2.29), but did not
change the rates of major adverse cardiovascular events (RR 1.10; 95% CI
0.92 to 1.30), death (RR 0.95; 95% CI 0.64 to 1.40) and hospital
readmission (RR 0.96; 95% CI 0.66 to 1.40). Consequently, compared with
conventional strategy, CCTA seemed not to improve clinical outcomes for
patients with low-to-intermediate risk chest pain.

<94>
Accession Number
2018197887
Title
Postoperative Application of Dexmedetomidine is the Optimal Strategy to
Reduce the Incidence of Postoperative Delirium After Cardiac Surgery: A
Network Meta-Analysis of Randomized Controlled Trials.
Source
Annals of Pharmacotherapy. 57(3) (pp 221-231), 2023. Date of Publication:
March 2023.
Author
Shang L.; Hou M.; Guo F.
Institution
(Shang, Hou, Guo) Department of Anesthesiology, The First Affiliated
Hospital of Shandong First Medical University, Shandong Provincial
Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory
Critical Medicine, Shandong, Jinan, China
Publisher
SAGE Publications Inc.
Abstract
Background: Previous pairwise meta-analyses demonstrated the efficacy and
safety of dexmedetomidine in preventing postoperative delirium (POD) after
cardiac surgery; however, the optimal time of applying dexmedetomidine
remains unclear. <br/>Objective(s): This network meta-analysis aimed to
determine the optimal time of using dexmedetomidine to reduce the
incidence of POD following cardiac surgery. <br/>Method(s): We first
retrieved eligible randomized controlled trials (RCTs) from previous
meta-analyses, and then an updated search was performed to identify
additional RCTs in PubMed, Embase, and the Cochrane library from January
1, 2021 to October 31, 2021. Two authors screened literature, collected
data, and evaluated bias risk of eligible studies. Finally, we performed
Bayesian network analysis using R version 3.6.1 with the "gemtc" and
"rjags" package. <br/>Result(s): Eighteen studies with 2636 patients were
included, and all studies were identified from previous meta-analyses.
Results showed that postoperative dexmedetomidine reduced the risk of POD
compared with normal saline (NS) (odds ratio [OR], 0.13; 95% credible
interval [CrI], 0.03-0.35) and propofol (PRO) (OR, 0.19; 95%CrI,
0.04-0.66). Postoperative dexmedetomidine was associated with a lower
incidence of POD compared with perioperative dexmedetomidine (OR, 0.21;
95% CrI, 0.04-0.82). Moreover, postoperative dexmedetomidine had the
highest probability of ranking best (90.98%), followed by intraoperative
dexmedetomidine (46.83%), PRO (36.94%), perioperative dexmedetomidine
(30.85%), and NS (60.02%). Conclusion and Relevance: Dexmedetomidine
reduces the incidence of POD compared with PRO and NS in patients
undergoing cardiac surgery, and postoperative application of
dexmedetomidine is the optimal time.<br/>Copyright &#xa9; The Author(s)
2022.

<95>
Accession Number
2022804290
Title
Effect of Rivaroxaban vs Enoxaparin on Major Cardiac Adverse Events and
Bleeding Risk in the Acute Phase of Acute Coronary Syndrome: The H-REPLACE
Randomized Equivalence and Noninferiority Trial.
Source
JAMA Network Open. 6(2) (pp E2255709), 2023. Date of Publication: 10 Feb
2023.
Author
Zhou S.; Xiao Y.; Zhou C.; Zheng Z.; Jiang W.; Shen Q.; Zhu C.; Pan H.;
Liu C.; Zeng G.; Ge L.; Zhang Y.; Ouyang Z.; Fu G.; Pan G.; Chen F.; Huang
L.; Liu Q.
Institution
(Zhou, Xiao, Liu) Department of Cardiology, Second Xiangya Hospital of
Central South University, Changsha 410011, China
(Zhou) Department of Cardiology, Xiangxiang People's Hospital, Xiangxiang,
China
(Zheng, Pan) Department of Cardiology, Hunan Provincial People's Hospital,
First Affiliated Hospital of Hunan Normal University, Changsha, China
(Jiang) Department of Cardiology, Third Xiangya Hospital of Central South
University, Changsha, China
(Shen) Department of Cardiology, First People's Hospital of Huaihua,
Huaihua, China
(Zhu) Department of Cardiology, First Affiliated Hospital of Jishou
University, Jishou, China
(Liu) Department of Cardiology, First Affiliated Hospital of University of
South China, Hengyang, China
(Zeng) Department of Cardiology, Second Affiliated Hospital of University
of South China, Hengyang, China
(Ge) Department of Cardiology, First People's Hospital of Changde City,
Changde, China
(Zhang) Department of Cardiology, Third Hospital of Changsha, Changsha,
China
(Ouyang) Department of Cardiology, Central Hospital of Shaoyang, Shaoyang,
China
(Fu) Department of Cardiology, First Hospital of Changsha, Changsha, China
(Pan) Department of Cardiology, First People's Hospital of Yueyang,
Yueyang, China
(Chen) Department of Biostatistics, School of Public Health, Nanjing
Medical University, Nanjing, China
(Huang) Department of Biostatistics, Zhongshan Hospital, Fudan University,
Shanghai, China
Publisher
American Medical Association
Abstract
Importance: Parenteral enoxaparin is a preferred anticoagulant used in the
acute phase for patients with acute coronary syndrome (ACS). The safety
and efficacy of short-term low-dose rivaroxaban in this clinical setting
remain unknown. <br/>Objective(s): To compare the safety and efficacy of
rivaroxaban vs enoxaparin in the acute phase of ACS. <br/>Design, Setting,
and Participant(s): This multicenter, prospective, open-label,
active-controlled, equivalence and noninferiority trial was conducted from
January 2017 through May 2021 with a 6-month follow-up at 21 hospitals in
China. Participants included patients with ACS missing the primary
reperfusion window or before selective revascularization. Data were
analyzed from November 2021 to November 2022. <br/>Intervention(s):
Participants were randomized 1:1:1 to oral rivaroxaban 2.5 mg or 5 mg or 1
mg/kg subcutaneous enoxaparin twice daily in addition to dual antiplatelet
therapy (DAPT; aspirin 100 mg and clopidogrel 75 mg once daily) for a mean
of 3.7 days. <br/>Main Outcomes and Measures: The primary safety end point
was bleeding events, as defined by the International Society on Thrombosis
and Haemostasis, and the primary efficacy end point was major adverse
cardiovascular events (MACEs), including cardiac death, myocardial
infarction, rerevascularization, or stroke during the 6-month follow-up.
<br/>Result(s): Of 2055 enrolled patients, 2046 (99.6%) completed the
trial (mean [SD] age 65.8 [8.2] years, 1443 [70.5%] male) and were
randomized to enoxaparin (680 patients), rivaroxaban 2.5 mg (683
patients), or rivaroxaban 5 mg (683 patients). Bleeding rates were 46
patients (6.8%) in the enoxaparin group, 32 patients (4.7%) in the
rivaroxaban 2.5 mg group, and 36 patients (5.3%)in the rivaroxaban 5 mg
group (rivaroxaban 2.5 mg vs enoxaparin: noninferiority hazard ratio [HR],
0.68; 95% CI, 0.43 to 1.07; P =.005; rivaroxaban 5 mg vs enoxaparin:
noninferiority HR, 0.88; 95% CI, 0.70 to 1.09; P =.001). The incidence of
MACEs was similar among groups, and noninferiority was reached in the
rivaroxaban 5 mg group (HR, 0.60; 95% CI, 0.31 to 1.16, P =.02) but not in
the rivaroxaban 2.5 mg group (HR, 0.68; 95% CI, 0.36 to 1.30; P =.05)
compared with the enoxaparin group. <br/>Conclusions and Relevance: In
this equivalence and noninferiority trial, oral rivaroxaban 5 mg showed
noninferiority to subcutaneous enoxaparin (1 mg/kg) for patients with ACS
treated with DAPT during the acute phase. Results of this feasibility
study provide useful information for designing future randomized clinical
trials with sufficient sample sizes. Trial Registration:
ClinicalTrials.gov Identifier: NCT03363035.<br/>Copyright &#xa9; 2023
American Medical Association. All rights reserved.

<96>
Accession Number
2022750398
Title
A Prospective Randomized Comparative Study of Oxiport Laryngoscope Blade
versus Miller Laryngoscope Blade for Intubation in Neonates and Infants
during General Anesthesia.
Source
International Journal of Pharmaceutical and Clinical Research. 15(2) (pp
491-496), 2023. Date of Publication: 2023.
Author
Kumar J.; Saurabh K.; Kumar S.
Institution
(Kumar, Saurabh, Kumar) Department of Anesthesiology, IGIMS, Bihar, Patna,
India
Publisher
Dr Yashwant Research Labs Pvt Ltd
Abstract
Aim: To compare oxiport laryngoscope blade and miller laryngoscope blade
for neonatal and infant intubations. Methodology: This controlled
interventional study conducted in the Department of Anesthesiology, IGIMS,
Bihar for one year in which 120 neonates/infants in groups of 60 each
posted for surgery in paediatric operation theatre over a period of 6
months were included in the study. Patients posted for elective surgery
were assessed during the preanaesthetic check a day prior whereas those
taken up for emergency procedures were assessed on the day of surgery.
Full-term neonates and infants up to 6 months of age of either sex
requiring general anaesthesia with endotracheal intubation for elective as
well as emergency surgery were included in the study. This comprised three
groups: thoracic, abdominal and miscellaneous surgeries. Monitoring used
included electrocardiogram and pulse rate on cardioscope, pulse oximetry,
capnometry, noninvasive BP, nasopharyngeal and skin temperature. For the
purpose of this study to quantify desaturation data, it was graded as mild
desaturation (lowest SpO2 up to 90%), moderate desaturation (lowest SpO2
between 85% and 89%) and severe desaturation (lowest SpO2< 0.05 was
considered as statistically significant. <br/>Result(s): The mean lowest
level of saturation attained in Group O was 98.37% +/- 2.28% as compared
to 97.38% +/- 3.83% in Group M and p value was <0.001 which was
statistically significant. The incidence of mild desaturation (SpO2 up to
90%) was 87.24% in Miller group and 93.75% in Oxiport group. The incidence
of moderate desaturation (SpO2 between 85% and 92.5%) was 3.26% in Miller
group and 6.25% in Oxiport group. Incidence of severe desaturation (SpO2
<85%) was 9.5% in Miller group and 0% in Oxiport group (Chi-square test P
= 0.028). Both groups were comparable with respect to the type of surgery
(abdominal, thoracic, miscellaneous). Abdominal surgeries were associated
with a higher number of severe desaturations (80%) compared to thoracic
(10%) and miscellaneous (10%) surgeries. <br/>Conclusion(s): Apneic
laryngeal oxygen insufflation with Oxiport laryngoscope blade decreases
the incidence and rate of desaturation with a better hemodynamic stability
as compared to Miller blade while intubating neonates and
infants.<br/>Copyright &#xa9; 2023, Dr Yashwant Research Labs Pvt Ltd. All
rights reserved.

<97>
Accession Number
2021725771
Title
Prognostic value of growth differentiation factor-15 in patients with
coronary artery disease: A meta-analysis and systematic review.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1054187. Date of Publication: 10 Feb 2023.
Author
Zhang S.; Hao P.; Li J.; Zhang Q.; Yin X.; Wang J.; Chen Y.
Institution
(Zhang, Li, Zhang, Yin, Wang, Chen) Department of Emergency and Chest Pain
Center, Qilu Hospital of Shandong University, Jinan, China
(Zhang, Li, Zhang, Yin, Wang, Chen) Shandong Provincial Clinical Research
Center for Emergency and Critical Care Medicine of Shandong Province,
Institute of Emergency and Critical Care Medicine of Shandong University,
Qilu Hospital of Shandong University, Jinan, China
(Zhang, Hao, Li, Zhang, Yin, Wang, Chen) The Key Laboratory of
Cardiovascular Remodeling and Function Research, Chinese Ministry of
Education, Chinese Ministry of Health and Chinese Academy of Medical
Sciences, Jinan, China
(Zhang, Hao, Li, Zhang, Yin, Wang, Chen) The State and Shandong Province
Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu
Hospital of Shandong University, Jinan, China
Publisher
Frontiers Media S.A.
Abstract
Background and aims: The predictive value of growth differentiation
factor-15 (GDF-15) for individual cardiovascular outcomes remained
controversial in patients with coronary artery disease (CAD). We aimed to
investigate the effects of GDF-15 on all-cause death, cardiovascular
death, MI and stroke in CAD patients. <br/>Method(s): We searched PubMed,
EMBASE, Cochrane library and Web of Science till 30 December, 2020. Hazard
ratios (HRs) were combined with fixed or random effect meta-analyses.
Subgroup analyses were performed in different disease types. Sensitivity
analyses were used to evaluate the stability of the results. Publication
bias was tested using funnel plots. <br/>Result(s): A total of 10 studies
with 49,443 patients were included in this meta-analysis. Patients with
the highest GDF-15 concentrations had significantly increased risk of
all-cause death (HR 2.24; 95% CI: 1.95-2.57), cardiovascular death (HR
2.00; 95% CI: 1.66-2.42), MI (HR 1.42; 95% CI: 1.21-1.66) after adjusting
clinical characteristics and prognostic biomarkers (hs-TnT, cystatin C,
hs-CRP, and NT-proBNP) but except for stroke (HR 1.43; 95% CI: 1.01-2.03,
p = 0.05). For the outcome of all-cause death and cardiovascular death,
subgroup analyses revealed consistent results. Sensitivity analyses showed
that the results were stable. Funnel plots showed that there was no
publication bias. <br/>Conclusion(s): In CAD patients with elevated GDF-15
levels on admission, there were independently significant risks for
all-cause death and cardiovascular death. The highest concentrations of
GDF-15 had a lower predictive effect on MI than all-cause death and
cardiovascular death. The association of GDF-15 with the outcome of stroke
needs to be further studied.<br/>Copyright &#xa9; 2023 Zhang, Hao, Li,
Zhang, Yin, Wang and Chen.

<98>
Accession Number
2021685774
Title
Additional improvement in regional myocardial ischemia after intracardiac
injection of bone marrow cells during CABG surgery.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1040188. Date of Publication: 07 Feb 2023.
Author
Gowdak L.H.W.; Schettert I.T.; Rochitte C.E.; de Carvalho L.P.; Vieira
M.L.C.; Dallan L.A.O.; de Oliveira S.A.; Cesar L.A.M.; Brito J.O.R.;
Guarita-Souza L.C.; de Carvalho A.C.C.; Krieger J.E.
Institution
(Gowdak, Schettert, Rochitte, de Carvalho, Vieira, Dallan, de Oliveira,
Cesar, Krieger) Laboratory of Genetics and Molecular Cardiology, Heart
Institute (InCor-HCFMUSP), University of Sao Paulo Medical School, Sao
Paulo, Brazil
(Brito) Department of Cardiovascular Surgery, National Institute of
Cardiology, Rio de Janeiro, Brazil
(Guarita-Souza) Department of Cardiovascular Surgery, Pontifical Catholic
University of Parana, Curitiba, Brazil
(de Carvalho) Cell Technology Center, National Institute of Cardiology,
Rio de Janeiro, Brazil
(de Carvalho) Carlos Chagas Filho Biophysics Institute, Federal University
of Rio de Janeiro, Rio de Janeiro, Brazil
Publisher
Frontiers Media S.A.
Abstract
Background: Post-procedure residual ischemia is associated with worse
prognosis in patients with coronary artery diasease (CAD).
<br/>Objective(s): We evaluated whether autologous bone marrow-derived
cells (BMC) contribute to additional reduction in regional stress-induced
myocardial ischemia (SIMI) in patients undergoing incomplete coronary
artery bypass graft surgery (CABG). <br/>Method(s): In a double-blind,
randomized, placebo-controlled trial, we enrolled 143 patients (82% men,
58 +/- 11 years) with stable CAD and not candidates for complete CABG.
They received 100 million BMC (n = 77) or placebo (n = 66) injected into
ischemic non-revascularized segments during CABG. The primary outcome was
improvement on SIMI quantified as the area at risk in injected segments
assessed by cardiovascular magnetic resonance (CMR) 1, 6, and 12 months
after CABG. <br/>Result(s): The reduction in global SIMI after CABG was
comparable (p = 0.491) in both groups indicating sustained beneficial
effects of the surgical procedure over 12 month period. In contrast, we
observed additional improvement in regional SIMI in BMC treated group (p =
0.047). Baseline regional SIMI values were comparable [18.5 (16.2-21.0)
vs. 18.5 (16.5-20.7)] and reached the lowest values at 1 month [9.74
(8.25; 11.49) vs. 12.69 (10.84; 14.85)] for BMC and placebo groups,
respectively. The ischemia's improvement from baseline represented a 50%
difference in regional SIMI in favor of the BMC transplanted group at 30
days. We found no differences in clinical and LVEF% between groups during
the 12 month follow-up period. The 1 month rate of major adverse cerebral
and cardiovascular events (MACCE) (p = 0.34) and all-cause mortality (p =
0.08) did not differ between groups 1 month post intervention.
<br/>Conclusion(s): We provided evidence that BMC leads to additional
reduction in regional SIMI in chronic ischemic patients when injected in
segments not subjected to direct surgical revascularization. This adjuvant
therapy deserves further assessment in patients with advanced CAD
especially in those with microcirculation dysfunction. Clinical trial
registration: https://clinicaltrials.gov/, identifier
NCT01727063<br/>Copyright &#xa9; 2023 Gowdak, Schettert, Rochitte, de
Carvalho, Vieira, Dallan, de Oliveira, Cesar, Brito, Guarita-Souza, de
Carvalho and Krieger.

<99>
Accession Number
2022860462
Title
Impact of a clinical pharmacist on optimising the quality use of medicines
according to the acute coronary syndrome (ACS) secondary prevention
guidelines and medication adherence following discharge in patients with
ACS in Sri Lanka: A prospective non-randomised controlled trial study
protocol.
Source
BMJ Open. 13(2) (no pagination), 2023. Article Number: e059413. Date of
Publication: 09 Feb 2023.
Author
Bagyawantha N.M.Y.; Coombes I.D.; Gawarammana I.; Fahim M.
Institution
(Bagyawantha) Department of Pharmacy, Faculty of Allied Health Sciences,
University of Peradeniya, Central, Peradeniya, Sri Lanka
(Bagyawantha, Gawarammana, Fahim) South Asian Clinical Toxicology Research
Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya,
Peradeniya, Sri Lanka
(Coombes) School of Pharmacy, The University of Queensland, Saint Lucia,
QLD, Australia
(Coombes) Collaboration of Australians and Sri Lankans for Pharmacy
Practice, Education and Research (CASPPER), Brisbane, QLD, Australia
(Gawarammana) Department of Medicine, Faculty of Medicine, University of
Peradeniya, Central, Peradeniya, Sri Lanka
(Fahim) School of Pharmacy, University of Sydney, Sydney, NSW, Australia
Publisher
BMJ Publishing Group
Abstract
Objectives Ensuring quality use of medicines (QUM) through clinical
pharmacy services can improve therapeutic outcomes of patients diagnosed
with acute coronary syndrome (ACS). The major objective of this study is
to demonstrate the added value of a clinical pharmacist to the medical and
nursing team providing care to patients with ACS on the continuation of
quality use of the patients' medicine after discharge. Study design This
protocol outlines a prospective, non-blinded, non-randomised, controlled
interventional study. Study setting The study will be conducted at the
professorial medical wards of a tertiary care teaching hospital in Sri
Lanka. Participants Sample size will be 746 patients in both control and
intervention arms. Patients diagnosed with ACS who are 18 years old or
above and expected to visit the hospital for their routine clinic
follow-ups after discharge will be recruited and randomised 1:1 to either
the intervention group or the control group. Patients who are diagnosed
and suffering from psychological disorders will be excluded from this
study. Interventions The planned interventions that will be delivered at
discharge include review and optimisation of medications, assessing
patient adherence and providing discharge medication counselling. Data
will be collected at recruitment, 1 month, 3 months and 6 months' time
intervals in both groups. Improvement of patients' medication adherence,
reduction of hospital readmissions, reduction of drug-related problems,
the attitude of doctors and nurses towards clinical pharmacy services and
the cost-effectiveness of the clinical pharmacy services will be the major
outcomes of this study. Ethics and dissemination Ethical approval for this
study has been obtained from the ethics review committee, Faculty of
Medicine, University of Peradeniya (2019/EC/26) and the trial is
registered at the Sri Lanka Clinical Trials Registry. The results of this
study will be disseminated via conference proceedings, journal
publications and thesis presentations. Trial registration number
SLCTR/2019/039.<br/>Copyright &#xa9; 2023 BMJ Publishing Group. All rights
reserved.

<100>
Accession Number
2021766866
Title
Transcriptomic Responses to Polymyxin B and Analogues in Human Kidney
Tubular Cells.
Source
Antibiotics. 12(2) (no pagination), 2023. Article Number: 415. Date of
Publication: February 2023.
Author
Li M.; Azad M.A.K.; Thompson P.E.; Roberts K.D.; Velkov T.; Zhu Y.; Li J.
Institution
(Li, Azad, Roberts, Velkov, Zhu, Li) Monash Biomedicine Discovery
Institute, Infection Program and Department of Microbiology, Monash
University, Melbourne, VIC 3800, Australia
(Thompson) Medicinal Chemistry, Monash Institute of Pharmaceutical
Sciences, Monash University, Parkville, VIC 3052, Australia
Publisher
MDPI
Abstract
Polymyxins are last-line antibiotics for the treatment of Gram-negative
'superbugs'. However, nephrotoxicity can occur in up to 60% of patients
administered intravenous polymyxins. The mechanisms underpinning
nephrotoxicity remain unclear. To understand polymyxin-induced
nephrotoxicity, human renal proximal tubule cells were treated for 24 h
with 0.1 mM polymyxin B or two new analogues, FADDI-251 or FADDI-287.
Transcriptomic analysis was performed, and differentially expressed genes
(DEGs) were identified using ANOVA (FDR < 0.2). Cell viability following
treatment with polymyxin B, FADDI-251 or FADDI-287 was 66.0 +/- 5.33%,
89.3 +/- 3.96% and 90.4 +/- 1.18%, respectively. Transcriptomics
identified 430, 193 and 150 DEGs with polymyxin B, FADDI-251 and
FADDI-287, respectively. Genes involved with metallothioneins and
Toll-like receptor pathways were significantly perturbed by all
polymyxins. Only polymyxin B induced perturbations in signal transduction,
including FGFR2 and MAPK signaling. SIGNOR network analysis showed all
treatments affected essential regulators in the immune system, autophagy,
cell cycle, oxidative stress and apoptosis. All polymyxins caused
significant perturbations of metal homeostasis and TLR signaling, while
polymyxin B caused the most dramatic perturbations of the transcriptome.
This study reveals the impact of polymyxin structure modifications on
transcriptomic responses in human renal tubular cells and provides
important information for designing safer new-generation
polymyxins.<br/>Copyright &#xa9; 2023 by the authors.

<101>
Accession Number
2022818426
Title
Perioperative hyperoxia and myocardial injury after surgery: a randomized
controlled trial.
Source
Minerva Anestesiologica. 89(1-2) (pp 40-47), 2023. Date of Publication:
January 2023.
Author
Sadurni M.; Castelltort L.; Rivera P.; Gallart L.; Pascual M.; Duran X.;
Grocott M.P.
Institution
(Sadurni, Castelltort, Rivera, Gallart) Department of Anaesthesiology,
Parc de Salut Mar, Barcelona, Spain
(Gallart) Universitat Autonoma de Barcelona, Barcelona, Spain
(Gallart, Duran) Institute Hospital del Mar for Medical research (IMIM),
Barcelona, Spain
(Pascual) Department of General Surgery, Parc de Salut Mar, Barcelona,
Spain
(Pascual) Universitat Pompeu Fabra, Barcelona, Spain
(Grocott) Perioperative and Critical Care Research Theme, NIHRSouthampton
Biomedical research Centre, University Hospital Southampton, Southampton,
United Kingdom
(Grocott) University Hospital of Southampton, Southampton, United Kingdom
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: The World Health Organization recommends hyperoxia (80%
fraction of inspired oxygen, FiO2) during and for 2-6 hours following
surgery to reduce surgical site infection (SSI). However, some studies
suggest increased cardiovascular complications with such a high
perioperative FiO2. The goal of our study was to compare the appearance of
cardiovascular complications in elective adult colorectal surgery
comparing the use of FiO2>0.8 versus conventional therapy (FiO2<0.4).
<br/>METHOD(S): We performed a randomized controlled trial in intubated
patients undergoing elective major colorectal surgery. Patients were
randomly assigned to receive perioperative FiO2>0.8 or FiO2<0.4. The
primary outcome, expressed as Odds Ratio (OR) +/-95% Confidence Interval
(95%CI), was the incidence of MINS (myocardial injury after noncardiac
surgery evaluated for the first 4 postoperative days). Secondary outcomes
included MACCE (major adverse cardiovascular and cerebral events) up to 30
postoperative days, SSI, other postoperative complications (according to
Clavien-Dindo classification) and length of stay. <br/>RESULT(S): We
included in the final analyses 403 patients. Comparing the FiO2>0.8 and
FiO2<0.4 groups, there was no difference in the appearance of MINS(6.0%
vs. 10.4%; OR0.55; 95% CI: 0.26-1.14; P=0.945). There were no differences
between the groups for important secondary outcomes including MACCEto 30
days, SSI, postoperative complications or length of stay.
<br/>CONCLUSION(S): Perioperative hyperoxia therapy (FiO2>0.8) with the
aim of decreasing SSIdid not increase cardiovascular complications after
elective colorectal surgery in a general population.<br/>Copyright &#xa9;
2023 Authors. All rights reserved.

<102>
Accession Number
640334464
Title
Drugs to reduce bleeding and transfusion in major open vascular or
endovascular surgery: a systematic review and network meta-analysis.
Source
Cochrane Database of Systematic Reviews. 2023(2) (no pagination), 2023.
Article Number: CD013649. Date of Publication: 17 Feb 2023.
Author
Beverly A.; Ong G.; Kimber C.; Sandercock J.; Doree C.; Welton N.J.; Wicks
P.; Estcourt L.J.
Institution
(Beverly, Ong, Kimber, Sandercock, Doree) Systematic Review Initiative,
NHS Blood and Transplant, Oxford, United Kingdom
(Welton) Population Health Sciences, Bristol Medical School, University of
Bristol, Bristol, United Kingdom
(Wicks) Cardiac Anaesthesia and Intensive Care, University Hospital
Southampton, Southampton, United Kingdom
(Estcourt) Haematology/Transfusion Medicine, NHS Blood and Transplant,
Oxford, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Background: Vascular surgery may be followed by internal bleeding due to
inadequate surgical haemostasis, abnormal clotting, or surgical
complications. Bleeding ranges from minor, with no transfusion
requirement, to massive, requiring multiple blood product transfusions.
There are a number of drugs, given systemically or applied locally, which
may reduce the need for blood transfusion. <br/>Objective(s): To assess
the effectiveness and safety of anti-fibrinolytic and haemostatic drugs
and agents in reducing bleeding and the need for blood transfusion in
people undergoing major vascular surgery or vascular procedures with a
risk of moderate or severe (> 500 mL) blood loss. <br/>Search Method(s):
We searched: Cochrane Central Register of Controlled Trials; MEDLINE;
Embase; CINAHL, and Transfusion Evidence Library. We also searched the WHO
ICTRP and ClinicalTrials.gov trial registries for ongoing and unpublished
trials. Searches used a combination of MeSH and free text terms from
database inception to 31 March 2022, without restriction on language or
publication status. <br/>Selection Criteria: We included randomised
controlled trials (RCTs) in adults of drug treatments to reduce bleeding
due to major vascular surgery or vascular procedures with a risk of
moderate or severe blood loss, which used placebo, usual care or another
drug regimen as control. <br/>Data Collection and Analysis: We used
standard Cochrane methods. Our primary outcomes were units of red cells
transfused and all-cause mortality. Our secondary outcomes included risk
of receiving an allogeneic blood product, risk of reoperation or repeat
procedure due to bleeding, risk of a thromboembolic event, risk of a
serious adverse event and length of hospital stay. We used GRADE to assess
certainty of evidence. <br/>Main Result(s): We included 22 RCTs with 3393
participants analysed, of which one RCT with 69 participants was reported
only in abstract form, with no usable data. Seven RCTs evaluated systemic
drug treatments (three aprotinin, two desmopressin, two tranexamic acid)
and 15 RCTs evaluated topical drug treatments (drug-containing
bioabsorbable dressings or glues), including fibrin, thrombin, collagen,
gelatin, synthetic sealants and one investigational new agent. Most trials
were conducted in high-income countries and the majority of the trials
only included participants undergoing elective surgery. We also identified
two ongoing RCTs. We were unable to perform the planned network
meta-analysis due to the sparse reporting of outcomes relevant to this
review. Systemic drug treatments. We identified seven trials of three
systemic drugs: aprotinin, desmopressin and tranexamic acid, all with
placebo controls. The trials of aprotinin and desmopressin were small with
very low-certainty evidence for all of our outcomes. Tranexamic acid
versus placebo was the systemic drug comparison with the largest number of
participants (2 trials; 1460 participants), both at low risk of bias. The
largest of these included a total of 9535 individuals undergoing a number
of different higher risk surgeries and reported limited information on the
vascular subgroup (1399 participants). Neither trial reported the number
of units of red cells transfused per participant up to 30 days. Three
outcomes were associated with very low-certainty evidence due to the very
wide confidence intervals (CIs) resulting from small study sizes and low
number of events. These were: all-cause mortality up to 30 days; number of
participants requiring an allogeneic blood transfusion up to 30 days; and
risk of requiring a repeat procedure or operation due to bleeding.
Tranexamic acid may have no effect on the risk of thromboembolic events up
to 30 days (risk ratio (RR) 1.10, 95% CI 0.88 to 1.36; 1 trial, 1360
participants; low-certainty evidence due to imprecision). There is one
large ongoing trial (8320 participants) comparing tranexamic acid versus
placebo in people undergoing non-cardiac surgery who are at high risk of
requiring a red cell transfusion. This aims to complete recruitment in
April 2023. This trial has primary outcomes of proportion of participants
transfused with red blood cells and incidence of venous thromboembolism
(DVT or PE). Topical drug treatments. Most trials of topical drug
treatments were at high risk of bias due to their open-label design
(compared with usual care, or liquids were compared with sponges). All of
the trials were small, most were very small, and few reported clinically
relevant outcomes in the postoperative period. Fibrin sealant versus usual
care was the topical drug comparison with the largest number of
participants (5 trials, 784 participants). The five trials that compared
fibrin sealant with usual care were all at high risk of bias, due to the
open-label trial design with no measures put in place to minimise
reporting bias. All of the trials were funded by pharmaceutical companies.
None of the five trials reported the number of red cells transfused per
participant up to 30 days or the number of participants requiring an
allogeneic blood transfusion up to 30 days. The other three outcomes were
associated with very low-certainty evidence with wide confidence intervals
due to small sample sizes and the low number of events, these were:
all-cause mortality up to 30 days; risk of requiring a repeat procedure
due to bleeding; and risk of thromboembolic disease up to 30 days. We
identified one large trial (500 participants) comparing fibrin sealant
versus usual care in participants undergoing abdominal aortic aneurysm
repair, which has not yet started recruitment. This trial lists death due
to arterial disease and reintervention rates as primary outcomes. Authors'
conclusions: Because of a lack of data, we are uncertain whether any
systemic or topical treatments used to reduce bleeding due to major
vascular surgery have an effect on: all-cause mortality up to 30 days;
risk of requiring a repeat procedure or operation due to bleeding; number
of red cells transfused per participant up to 30 days or the number of
participants requiring an allogeneic blood transfusion up to 30 days.
There may be no effect of tranexamic acid on the risk of thromboembolic
events up to 30 days, this is important as there has been concern that
this risk may be increased. Trials with sample size targets of thousands
of participants and clinically relevant outcomes are needed, and we look
forward to seeing the results of the ongoing trials in the
future.<br/>Copyright &#xa9; 2023 The Authors. Cochrane Database of
Systematic Reviews published by John Wiley & Sons, Ltd. on behalf of The
Cochrane Collaboration.

<103>
Accession Number
2020213763
Title
Postoperative delirium after transcatheter aortic valve replacement: An
updated systematic review and meta-analysis.
Source
Journal of the American Geriatrics Society. 71(2) (pp 646-660), 2023. Date
of Publication: February 2023.
Author
Ma X.; Chu H.; Han K.; Shao Q.; Yu Y.; Jia S.; Wang D.; Wang Z.; Zhou Y.
Institution
(Ma, Han, Shao, Yu, Jia, Wang, Zhou) Department of Cardiology, Beijing
Anzhen Hospital, Capital Medical University, Beijing, China
(Chu, Wang) Department of Anesthesia, Qingdao Women and Children's
Hospital, Qingdao University, Qingdao, China
Publisher
John Wiley and Sons Inc
Abstract
Aims: To perform an updated systematic review and meta-analysis of
postoperative delirium (POD) after transcatheter aortic valve replacement
(TAVR). <br/>Method(s): We conducted a systematic literature search of
PubMed, Embase, and Cochrane Library databases from the time of the first
human TAVR procedure in 2002 until December 24, 2021, which was
supplemented by manual searches of bibliographies. Data were collected on
incidence rates, risk factors, and/or associated mortality of POD after
TAVR. Pooled analyses were conducted using random effects models to yield
mean differences, odds ratios, hazard ratios, and risk ratios, with 95%
confidence intervals. <br/>Result(s): A total of 70 articles (69 studies)
comprising 413,389 patients were included. The study heterogeneity was
substantial. The pooled mean incidence of POD after TAVR in all included
studies was 9.8% (95% CI: 8.7%-11.0%), whereas that in studies using
validated tools to assess for delirium at least once a day for at least 2
consecutive days after TAVR was 20.7% (95% CI: 17.8%-23.7%). According to
the level of evidence and results of meta-analysis, independent
preoperative risk factors with a high level of evidence included increased
age, male sex, prior stroke or transient ischemic attack, atrial
fibrillation/flutter, weight loss, electrolyte abnormality, and impaired
Instrumental Activities of Daily Living; intraoperative risk factors
included non-transfemoral access and general anesthesia; and acute kidney
injury was a postoperative risk factor. POD after TAVR was associated with
significantly increased mortality (pooled unadjusted RR: 2.20, 95% CI:
1.79-2.71; pooled adjusted RR: 1.62, 95% CI: 1.25-2.10), particularly
long-term mortality (pooled unadjusted HR: 2.84, 95% CI: 1.91-4.23; pooled
adjusted HR: 1.88, 95% CI: 1.30-2.73). <br/>Conclusion(s): POD after TAVR
is common and is associated with an increased risk of mortality. Accurate
identification of risk factors for POD after TAVR and implementation of
preventive measures are critical to improve prognosis.<br/>Copyright
&#xa9; 2022 The American Geriatrics Society.

<104>
Accession Number
2021079244
Title
Speckle-tracking echocardiography for predicting improvement of myocardial
contractile function after revascularization: a meta-analysis of
prospective trials.
Source
International Journal of Cardiovascular Imaging. 39(3) (pp 541-553), 2023.
Date of Publication: March 2023.
Author
Ballo H.; Doghman F.; Hartikainen J.; Saraste A.; Knuuti J.
Institution
(Ballo, Saraste, Knuuti) Turku PET Centre, University of Turku and Turku
University Hospital, Turku, Finland
(Ballo, Saraste) Heart Center, Turku University Hospital, Turku, Finland
(Doghman) Department of Pulmonary Diseases, Turku University Hospital,
Turku, Finland
(Hartikainen) Heart Center, Kuopio University Hospital and University of
Eastern Finland, Kuopio, Finland
Publisher
Springer Science and Business Media B.V.
Abstract
Some studies have indicated that the use of 2D-Speckle tracking
echocardiography (2DSTE) aids in predicting recovery of myocardial
contractile function after revascularization in patients with chronic
ischemic left ventricular (LV) dysfunction or acute myocardial infarction
(MI). The purpose of this meta-analysis was to evaluate the diagnostic
accuracy of 2DSTE strain in the detection of myocardial viability at rest
and during low-dose dobutamine (LDD) stress. A systematic review for all
prospective trials using 2DSTE to assess myocardial viability until
January 2019 was done. Using a standard approach of meta-analysis for
diagnostic tests. Overall, nine studies including 525 patients with either
chronic ischemic heart disease or acute MI fulfilled the inclusion
criteria. Seven studies used longitudinal strain (LS) at rest, nine
studies used circumferential strain (CS) at rest, four studies used LS
during LDD stress, and four studies used CS during LDD stress. LS and CS
during LDD stress showed equally high sensitivity (81.5% and 81.5%
respectively) and specificity (81.3% and 81.4% respectively) for detecting
reversible dysfunction. At rest, LS and CS showed equally lower
sensitivity (67.1%, p < 0.0001 vs. LDD stress and 68.7%, p < 0.0001, vs.
LDD stress, respectively) and specificity (64%, p < 0.0001 vs. LDD stress
and 65.7%, p = 0.0008 vs. LDD stress, respectively) as compared with LDD
stress. LS and CS by 2DSTE during LDD stress accurately identify
reversible ischemic myocardial dysfunction in patients with chronic
ischemic LV dysfunction or after MI. The use of LDD stress can be
recommended over resting strain measures in this setting.<br/>Copyright
&#xa9; 2022, The Author(s).

<105>
Accession Number
2022983727
Title
Presence of retinopathy and incident kidney and cardiovascular events in
type 2 diabetes with normoalbuminuria - A post-hoc analysis of the
PRIORITY randomized clinical trial.
Source
Journal of Diabetes and its Complications. 37(4) (no pagination), 2023.
Article Number: 108433. Date of Publication: April 2023.
Author
Rotbain Curovic V.; Tofte N.; Lindhardt M.; Adamova K.; Bakker S.J.L.;
Beige J.; Beulens J.W.J.; Birkenfeld A.L.; Currie G.; Delles C.; Dimos I.;
Francova L.; Frimodt-Moller M.; Girman P.; Goke R.; Hansen T.W.; Havrdova
T.; Kooy A.; Laverman G.D.; Mischak H.; Navis G.; Nijpels G.; Noutsou M.;
Ortiz A.; Parvanova A.; Persson F.; Petrie J.R.; Ruggenenti P.L.; Rutters
F.; Rychlik I.; Siwy J.; Spasovski G.; Speeckaert M.; Trillini M.; Zurbig
P.; von der Leyen H.; Rossing P.
Institution
(Rotbain Curovic, Tofte, Lindhardt, Frimodt-Moller, Hansen, Persson,
Rossing) Steno Diabetes Center Copenhagen, Herlev, Denmark
(Lindhardt) Department of Medicine, Copenhagen University Hospital -
Holbaek, Holbaek, Denmark
(Lindhardt, Rossing) Department of Clinical Medicine, University of
Copenhagen, Copenhagen, Denmark
(Adamova) University Clinic of Endocrinology, Diabetes and Metabolic
Disorders, Skopje, North Macedonia
(Bakker, Navis) Division of Nephrology, Department of Internal Medicine,
University Medical Center Groningen, University of Groningen, Groningen,
Netherlands
(Beige) Division of Nephrology and KfH Renal Unit, Hospital St Georg,
Leipzig, Germany
(Beulens, Rutters) Amsterdam UMC, Department of Epidemiology and Data
Science, location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
(Beulens) Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
(Beulens, Rutters) Amsterdam Public Health, Amsterdam, Netherlands
(Beulens) Julius Center for Health Sciences and Primary Care, University
Medical Center Utrecht, Utrecht, Netherlands
(Birkenfeld) Department of Internal Medicine IV, Division of
Endocrinology, Diabetology, and Nephrology, University Hospital Tubingen,
Tubingen, Germany
(Currie, Delles) School of Cardiovascular and Metabolic Health, University
of Glasgow, Glasgow, United Kingdom
(Dimos) Diabetespraxis, Leipzig, Germany
(Francova, Rychlik) Department of Internal Medicine, Charles University,
Third Faculty of Medicine, Prague, Czechia
(Girman, Havrdova) Diabetes Center, Institute for Clinical and
Experimental Medicine, Prague, Czechia
(Goke) Diabetologische Schwerpunktpraxis, Diabetologen Hessen, Marburg,
Germany
(Kooy) Bethesda Diabetes Research Center, Hoogeveen, Netherlands
(Laverman) Department of Internal Medicine/Nephrology, Ziekenhuisgroep
Twente Hospital, Almelo, Netherlands
(Mischak, Siwy, Zurbig) Mosaiques Diagnostics GmbH, Hannover, Germany
(Nijpels) Department General Practice and Elderly Care, Amsterdam,
Netherlands
(Noutsou) Diabetes Center, 2nd Department of Internal Medicine, National
and Kapodistrian University of Athens, Medical School, Hippokratio General
Hospital, Athens, Greece
(Ortiz) Instituto de Investigacion Sanitaria de la Fundacion Jimenez Diaz
UAM, Madrid, Spain
(Parvanova, Ruggenenti, Trillini) Department of Renal Medicine, Clinical
Research Centre for Rare Diseases "Aldo e Cele Dacco": Istituto di
Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Ranica, Italy
(Petrie) School of Health and Wellbeing, University of Glasgow, Glasgow,
United Kingdom
(Spasovski) Department of Nephrology, Cyril and Methodius University in
Skopje, Skopje, North Macedonia
(Speeckaert) Department of Nephrology, Ghent University Hospital, Ghent,
Belgium
(von der Leyen) Orgenesis Germany GmbH, Munich, Germany
(Beige) Martin-Luther University Halle, Wittenberg, Germany
(Francova) Faculty Hospital Kralovske Vinohrady, Prague, Czechia
Publisher
Elsevier Inc.
Abstract
Aims: Baseline diabetic retinopathy (DR) and risk of development of
microalbuminuria, kidney function decline, and cardiovascular events
(CVEs) in type 2 diabetes. <br/>Method(s): Post-hoc analysis of the
PRIORITY study including 1758 persons with type 2 diabetes and
normoalbuminuria followed for a median of 2.5 (IQR: 2.0-3.0) years. DR
diagnosis included non-proliferative and proliferative abnormalities,
macular oedema, or prior laser treatment. Cox models were fitted to
investigate baseline DR presence with development of persistent
microalbuminuria (urinary albumin-creatinine ratio > 30 mg/g); chronic
kidney disease (CKD) G3 (eGFR <60 ml/min/1.73m²); and CVE.
Models were adjusted for relevant risk factors. <br/>Result(s): At
baseline, 304 (17.3 %) had DR. Compared to persons without DR, they were
older (mean +/- SD: 62.7 +/- 7.7 vs 61.4 +/- 8.3 years, p = 0.019), had
longer diabetes duration (17.9 +/- 8.4 vs. 10.6 +/- 7.0 years, p < 0.001),
and higher HbA<inf>1c</inf> (62 +/- 13 vs. 56 +/- 12 mmol/mol, p < 0.001).
The adjusted hazard ratios of DR at baseline for development of
microalbuminuria (n = 197), CKD (n = 166), and CVE (n = 64) were: 1.50
(95%CI: 1.07, 2.11), 0.87 (95%CI: 0.56, 1.34), and 2.61 (95%CI: 1.44,
4.72), compared to without DR. <br/>Conclusion(s): Presence of DR in
normoalbuminuric type 2 diabetes was associated with an increased risk of
developing microalbuminuria and CVE, but not with kidney function
decline.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<106>
Accession Number
2022528371
Title
Prognostic value of N-terminal pro-form B-type natriuretic peptide
(NT-proBNP) in patients with congenital heart disease undergoing cardiac
surgery: a systematic review and meta-analysis of cohort studies.
Source
Cardiovascular Diagnosis and Therapy. 12(6) (pp 853-867), 2022. Date of
Publication: December 2022.
Author
Gong Z.; Xing D.; Wu R.; Zhang S.; Ye C.; Chen Y.; Liu X.; Chen L.; Wang
T.
Institution
(Gong, Wu, Zhang, Ye, Chen, Liu, Chen, Wang) Department of Epidemiology
and Health Statistics, Xiangya School of Public Health, Central South
University, Changsha, China
(Xing) Medical Records Statistics Room of Medical Affair Department, Hunan
Provincial People's Hospital, The First Affiliated Hospital of Hunan
Normal University, Changsha, China
(Chen) Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha,
China
(Wang) National Health Commission Key Laboratory for Birth Defect Research
and Prevention, Hunan Provincial Maternal and Child Health Care Hospital,
Changsha, China
Publisher
AME Publishing Company
Abstract
Background: To perform an updated and comprehensive meta-analysis on the
prognostic value of N-terminal pro-form B-type natriuretic peptide
(NT-proBNP) in patients with congenital heart disease (CHD) undergoing
cardiac surgery. <br/>Method(s): A systematic search was conducted until
September 2021 for relevant studies published in PubMed, Web of Science
Database and Embase. Based on the average values, NT-proBNP concentrations
were classified as high and low levels. The outcomes of interest were
mortality, cardiovascular events, and other postoperative outcomes. A
random-effects model was used to calculate composite risk estimates and
corresponding 95% confidence intervals (CIs). Possible sources of
heterogeneity and stability of results were analyzed using subgroup and
sensitivity analyses. <br/>Result(s): A total of 32 studies published
between 2008 and 2021 involving 7,571 participants were included. Results
showed CHD patients at high NT-proBNP levels yielded an increased risk of
mortality [risk ratio (RR) =1.14; 95% CI: 1.08-1.20] and cardiovascular
events (RR =2.02; 95% CI: 1.26-3.24) compared with those at low NT-proBNP
levels. No significant association was found between NT-proBNP and risks
for other postoperative outcomes in CHD patients undergoing cardiac
surgery (RR =1.73; 95% CI: 0.86-3.47). Significant heterogeneity was
detected across studies regarding these risk estimates. Subgroup analysis
found heterogeneity in the risk estimate of mortality was explained by
geographic region, type of CHD, and assay method of NT-proBNP. Sensitivity
analysis supported the robustness of results. <br/>Conclusion(s): Compared
with CHD patients at low NT-proBNP levels, CHD patients at high NTproBNP
levels had elevated risks of mortality and cardiovascular events. Further
large-scale and well-controlled studies are needed to confirm our
findings.<br/>Copyright &#xa9; Cardiovascular Diagnosis and Therapy. All
rights reserved.

<107>
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.

<108>
Accession Number
638088437
Title
Hematic Antegrade Repriming Reduces Emboli on Cardiopulmonary Bypass: A
Randomized Controlled Trial.
Source
ASAIO journal (American Society for Artificial Internal Organs : 1992).
69(3) (pp 324-331), 2023. Date of Publication: 01 Mar 2023.
Author
Blanco-Morillo J.; Salmeron Martinez D.; Morillo-Cuadrado D.V.;
Arribas-Leal J.M.; Puis L.; Verdu-Verdu A.; Martinez-Molina M.;
Tormos-Ruiz E.; Sornichero-Caballero A.; Ramirez-Romero P.; Farina P.;
Canovas-Lopez S.
Institution
(Blanco-Morillo) From the Cardiovascular Surgery, Extracorporeal Therapies
Group, Virgen de la Arrixaca University Hospital, Murcia, Spain
(Blanco-Morillo) Biomedical Research Institute of Murcia (IMIB), Murcia,
Spain
(Salmeron Martinez) Department of Health and Social Sciences, Murcia
University, Murcia, Spain
(Salmeron Martinez) IMIB-Arrixaca, Murcia, SpainCIBER Epidemiology and
Public Health CIBERESP, Madrid, Spain
(Morillo-Cuadrado) Network-Based Biomedical Research Consortium, Carlos
III Health Institute, Area of Mental Health (CiberSAM), Madrid, Spain
(Morillo-Cuadrado) World Health Organization Collaborating Centre for
Research and Training in Mental Health, Department of Psychiatry,
Autonomous University of Madrid, Spain
(Arribas-Leal, Canovas-Lopez) Cardiovascular Surgery, Virgen de la
Arrixaca University Hospital, Murcia, Spain
(Puis) Department of ExtraCorporeal Circulation, KU Leuven, UZ
Gasthuisberg, Belgium
(Verdu-Verdu, Martinez-Molina, Tormos-Ruiz, Sornichero-Caballero)
Cardiovascular Surgery, Extracorporeal Therapies Group, Virgen de la
Arrixaca University Hospital, Murcia, Spain
(Ramirez-Romero) General and Experimental Surgery and Transplantation
Departments, Virgen de la Arrixaca University Hospital, University of
Murcia, Murcia, Spain
(Farina) Cardiovascular Surgery, Agostino Gemelli University Policlinc,
Rome, Italy
Publisher
NLM (Medline)
Abstract
Particulate and gaseous microemboli (GME) are side effects of cardiac
surgery that interfere with postoperative recovery by causing endothelial
dysfunction and vascular blockages. GME sources during surgery are
multiple, and cardiopulmonary bypass (CPB) is contributory to this embolic
load. Hematic antegrade repriming (HAR) is a novel procedure that combines
the benefits of repriming techniques with additional measures, by
following a standardized procedure to provide a reproducible hemodilution
of 300ml. To clarify the safety of HAR in terms of embolic load delivery,
a prospective and controlled study was conducted, by applying Doppler
probes to the extracorporeal circuit, to determine the number and volume
of GME released during CPB. A sample of 115 patients (n = 115) was
considered for assessment. Both groups were managed under strict
normothermia, and similar clinical conditions and protocols, receiving the
same open and minimized circuit. Significant differences in GME volume
delivery (control group [CG] = 0.28ml vs. HAR = 0.08ml; p = 0.004) and
high embolic volume exposure (>1ml) were found between the groups (CG =
30.36% vs. HAR = 4.26%; p = 0.001). The application of HAR did not
represent an additional embolic risk and provided a four-fold reduction in
the embolic volume delivered to the patient (coefficient, 0.24; 95% CI,
0.08-0.72; p = 0.01), which appears to enhance GME clearance of the
oxygenator before CPB initiation.<br/>Copyright &#xa9; 2022 The Author(s).
Published by Wolters Kluwer Health, Inc. on behalf of the ASAIO.

<109>
Accession Number
2023033046
Title
Association of high-sensitivity troponin T with outcomes in asymptomatic
non-severe aortic stenosis: a post-hoc substudy of the SEAS trial.
Source
eClinicalMedicine. 58 (no pagination), 2023. Article Number: 101875. Date
of Publication: April 2023.
Author
Hadziselimovic E.; Greve A.M.; Sajadieh A.; Olsen M.H.; Kesaniemi Y.A.;
Nienaber C.A.; Ray S.G.; Rossebo A.B.; Wachtell K.; Nielsen O.W.
Institution
(Hadziselimovic, Sajadieh, Nielsen) Department of Cardiology, Bispebjerg
University Hospital, Copenhagen, Denmark
(Greve) Department of Clinical Biochemistry, Rigshospitalet, Copenhagen
3011, Denmark
(Sajadieh, Nielsen) Faculty of Health and Medical Sciences, University of
Copenhagen, Denmark
(Olsen) Department of Internal Medicine 1, Holbaek Hospital, Denmark
(Olsen) Department of Regional Health Research, University of Southern
Denmark, Denmark
(Kesaniemi) Research Unit of Internal Medicine, Medical Research Center
Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
(Nienaber) Royal Brompton and Harefield NHS Foundation Trust, Imperial
College, London, United Kingdom
(Ray) Manchester University Hospitals, Manchester, United Kingdom
(Rossebo) Department of Cardiology, Oslo University Hospital, Ulleval,
Oslo, Norway
(Wachtell) Division of Cardiology, Weill Cornell Medicine, New York,
United States
Publisher
Elsevier Ltd
Abstract
Background: High-sensitivity Troponin T (hsTnT), a biomarker of
cardiomyocyte overload and injury, relates to aortic valve replacement
(AVR) and mortality in severe aortic stenosis (AS). However, its
prognostic value remains unknown in asymptomatic patients with AS. We
aimed to investigate if an hsTnT level >14 pg/mL (above upper limit of
normal 99th percentile) is associated with echocardiographic AS-severity,
subsequent AVR, ischaemic coronary events (ICE), and mortality in
asymptomatic patients with non-severe AS. <br/>Method(s): In this post-hoc
sub-analysis of the multicentre, randomised, double-blind,
placebo-controlled SEAS trial (ClinicalTrials.gov, NCT00092677), we
included asymptomatic patients with mild to moderate-severe AS. We
ascertained baseline and 1-year hsTnT concentrations and examined the
association between baseline levels and the risk of the primary composite
endpoint, defined as the first event of all-cause mortality, isolated AVR
(without coronary artery bypass grafting (CABG)), or ICE. Multivariable
regressions and competing risk analyses examined associations of hsTnT
level >14 pg/mL with clinical correlates and 5-year risk of the primary
endpoint. <br/>Finding(s): Between January 6, 2003, and March 4, 2004, a
total of 1873 patients were enrolled in the SEAS trial, and 1739 patients
were included in this post-hoc sub-analysis. Patients had a mean (SD) age
of 67.5 (9.7) years, 61.0% (1061) were men, 17.4% (302) had
moderate-severe AS, and 26.0% (453) had hsTnT level >14 pg/mL. The median
hsTnT difference from baseline to 1-year was 0.8 pg/mL (IQR, -0.4 to 2.3).
In adjusted linear regression, log(hsTnT) did not correlate with
echocardiographic AS severity (p = 0.36). In multivariable Cox regression,
a hsTnT level >14 pg/mL vs. hsTnT <=14 pg/mL was associated with an
increased risk of the primary composite endpoint (HR, 1.41; 95% CI,
1.18-1.70; p = 0.0002). In a competing risk model of first of the
individual components of the primary endpoint, a hsTnT level >14 pg/mL was
associated with ICE risk (HR 1.71; 95% CI, 1.23-2.38; p = 0.0013), but not
with isolated AVR (p = 0.064) or all-cause mortality (p = 0.49) as the
first event. <br/>Interpretation(s): hsTnT level is within the reference
range (<=14 pg/mL) in 3 out of 4 non-ischaemic patients with asymptomatic
mild-to-moderate AS and remains stable during a 1-year follow-up
regardless of AS-severity. An hsTnT level >14 pg/mL was mainly associated
with subsequent ICE, which suggest that hsTnT concentration is primarily a
risk marker of subclinical coronary atherosclerotic disease.
<br/>Funding(s): Merck & Co., Inc., the Schering-Plough Corporation, the
Interreg IVA program, Roche Diagnostics Ltd., and Gangstedfonden. Open
access publication fee funding provided by prof. Olav W. Nielsen and
Department of Cardiology, Bispebjerg University Hospital,
Denmark.<br/>Copyright &#xa9; 2023 The Author(s)

<110>
Accession Number
2023037347
Title
The Effects of Inspiratory Muscle Training (IMT) on Patients Undergoing
Coronary Artery Bypass Graft (CABG) Surgery: A Systematic Review and
Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 24(1) (no pagination), 2023. Article
Number: 16. Date of Publication: January 2023.
Author
Zhang S.; Li B.; Meng X.; Zuo H.; Hu D.
Institution
(Zhang, Zuo, Hu) Division of Cardiology, Department of Internal Medicine,
Tongji Hospital, Tongji Medical College, Huazhong University of Science
and Technology, Hubei, Wuhan 430000, China
(Li) Department of Thoracic Surgery, Second Hospital of Jilin University,
Jilin, Changchun 130041, China
(Meng) Department of Cardiovascular and Cardiac Rehabilitation, Affiliated
Hospital of Changchun Traditional Chinese Medicine, Jilin, Changchun
130000, China
Publisher
IMR Press Limited
Abstract
Background: To determine the effects of inspiratory muscle training (IMT)
alone on inspiratory muscle strength and endurance, pulmonary function,
pulmonary complications, and length of hospital stay in patients
undergoing coronary artery bypass graft surgery (CABG). <br/>Method(s): We
conducted a literature search across databases (Ovid MEDLINE(R) and Epub
Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid
Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane
Database of Systematic Reviews, and Scopus) from inception to December
2021. The eligibility criteria were randomized controlled trials that
investigated the effects of IMT versus usual care or sham IMT in patients
undergoing CABG. <br/>Result(s): A total of 12 randomized clinical trials
with 918 patients were included in the meta-analysis. Postoperative IMT
was associated with improved maximal inspiratory pressure (MIP), maximum
inspiratory pressure (PImax), and six-minute walking test (6MWT) and with
a decrease in length of hospital stay (LOS). For preoperative IMT, there
was statistical significance between intervention and MIP, PImax, forced
expiratory volume in one second (FEV1), forced vital capacity (FVC),
postoperative pulmonary complications (PPCs), and LOS. Pre- and
postoperative IMT resulted in improvements in MIP. <br/>Conclusion(s):
Isolated IMT in patients who underwent CABG improved their inspiratory
muscle strength and endurance, pulmonary function, and 6MWT and helped
decrease postoperative pulmonary complications and the length of hospital
stay.<br/>Copyright &#xa9; 2023 The Author(s). Published by IMR Press.

<111>
Accession Number
2023037330
Title
Colchicine for Prevention of Post-Cardiac Surgery and Post-Pulmonary Vein
Isolation Atrial Fibrillation: A Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 23(12) (no pagination), 2022. Article
Number: 387. Date of Publication: December 2022.
Author
Wang X.; Peng X.; Li Y.; Lin R.; Liu X.; Ruan Y.; Ma C.; Liu N.
Institution
(Wang, Peng, Li, Lin, Liu, Ruan, Ma, Liu) Department of Cardiology,
Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
(Wang, Peng, Li, Lin, Liu, Ruan, Ma, Liu) National Clinical Research
Center for Cardiovascular Diseases, Beijing 100029, China
Publisher
IMR Press Limited
Abstract
Background: Post-cardiac procedure atrial fibrillation (PCP-AF) is a
significant medical problem. Inflammation is one of the key factors in the
pathogenesis of PCP-AF. As a classical anti-inflammatory drug, colchicine
may prevent the occurrence of PCP-AF. This meta-analysis of 12 randomized
controlled trials (RCTs) analyzed the feasibility and safety of colchicine
for the prevention of PCP-AF. <br/>Method(s): PubMed, EMBASE, Web of
Science, the Cochrane Library, and Google Scholar were retrieved for RCTs
on the efficacy of colchicine in preventing atrial fibrillation. The
primary endpoint was the diagnosis of PCP-AF, which includes cardiac
surgery or pulmonary vein isolation. Evaluation was performed with
estimated odds ratios (OR) and 95% confidence intervals (CI).
<br/>Result(s): In this meta-analysis, 12 RCTs were selected and a total
of 2297 patients were included. Colchicine therapy was associated with a
reduced incidence of PCP-AF both in post-cardiac surgery (OR: 0.62; 95%
CI: 0.49-0.78, p < 0.0001, I² = 0%), and in post-pulmonary vein
isolation (OR: 0.43; 95% CI: 0.30-0.62, p < 0.0001, I² = 0%).
Colchicine therapy was associated with increased side effects (OR: 2.81;
95% CI: 1.96-4.03, p < 0.00001, I² = 26%). <br/>Conclusion(s):
Colchicine can effectively prevent post-cardiac operative atrial
fibrillation and relapse of atrial fibrillation after pulmonary vein
isolation (PVI). However, colchicine can also increase the incidence of
side effects, mainly gastrointestinal adverse events. More studies are
needed to find a more appropriate treatment dose and time.<br/>Copyright
&#xa9; 2022 The Author(s). Published by IMR Press. This is an open access
article under the CC BY 4.0 license.

<112>
Accession Number
2023037329
Title
The Relationship between the Incidence of Postoperative Cognitive
Dysfunction and Intraoperative Regional Cerebral Oxygen Saturation after
Cardiovascular Surgery: A Systematic Review and Meta-Analysis of
Randomized Controlled Trials.
Source
Reviews in Cardiovascular Medicine. 23(12) (no pagination), 2022. Article
Number: 388. Date of Publication: December 2022.
Author
Wang L.; Lang Z.; Gao H.; Liu Y.; Dong H.; Sun X.
Institution
(Wang, Gao, Liu, Sun) Aortic and Vascular Surgery Center, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences, Peking Union Medical College, Beijing 100037, China
(Lang, Dong) First Clinical Medical College, Lanzhou University, Gansu,
Lanzhou 730000, China
Publisher
IMR Press Limited
Abstract
Background: To assess whether intraoperative monitoring and intervention
of regional cerebral oxygen saturation levels can reduce the incidence of
postoperative cognitive dysfunction in patients undergoing cardiovascular
surgery and contribute to patient prognosis. <br/>Method(s): The Cochrane
Library, PubMed, and the Web of Science were systematically searched for
relevant randomized controlled trials involving the effects of cerebral
oxygen saturation on the cognitive function of patients after
cardiovascular surgery from January 1, 2000 to May 1, 2022. The primary
outcome was the incidence of postoperative cognitive dysfunction. The
secondary outcomes were length of hospital stay, length of intensive care
unit (ICU) stay, length of mechanical ventilation, length of
cardiopulmonary bypass, and other major postoperative outcomes such as
renal failure, infection, arrhythmia, hospital mortality, and stroke. Data
were pooled using the risk ratio or standardized mean difference with 95%
confidence interval (CI). The original study protocol was registered
prospectively with PROSPERO (CRD42020178068). <br/>Result(s): A total of
13 randomized controlled trials involving 1669 cardiovascular surgery
patients were included. Compared with the control group, the risk of
postoperative cognitive dysfunction was significantly lower in the
intervention group (RR = 0.50; 95% CI: 0.30 to 0.85; p = 0.01;
I² = 71%). The Duration of stay in intensive care units in the
intervention group was also significantly shorter than that in the control
group (standard mean difference (SMD) = -0.14; 95% CI: -0.26 to -0.01; p =
0.03; I² = 26%). Univariate meta-regression analyses showed
that age is a major source of heterogeneity. <br/>Conclusion(s): Our
current study suggests that intraoperative cerebral oxygen saturation
monitoring and intervention can significantly reduce the incidence of
postoperative cognitive dysfunction, and the length of intensive care unit
stay after intervention is considerably reduced. Given that some limits in
this review, more high-quality, and long-term trials are still needed to
certify our findings.<br/>Copyright &#xa9; 2022 The Author(s). Published
by IMR Press. This is an open access article under the CC BY 4.0 license.

<113>
Accession Number
2023037326
Title
The Risk of Ventricular Arrhythmias between Alcohol Septal Ablation and
Septal Myectomy in Hypertrophic Cardiomyopathy: A Meta-Analysis on Septal
Reduction Therapy.
Source
Reviews in Cardiovascular Medicine. 23(12) (no pagination), 2022. Article
Number: 391. Date of Publication: December 2022.
Author
Tang W.; Liu M.; Li J.; Chang R.; Su C.; Zhang X.; Wang L.
Institution
(Tang, Liu, Li, Chang, Su, Zhang, Wang) Department of Cardiology, First
Affiliated Hospital of Sun Yat-sen University, Guangdong, Guangzhou
510080, China
(Tang, Liu, Li, Chang, Su, Zhang, Wang) Department of Medicine College,
Sun Yat-sen University, Guangdong, Guangzhou 510080, China
Publisher
IMR Press Limited
Abstract
Background: Alcohol septal ablation (ASA) has been more commonly applied
in medical refractory hypertrophic obstructive cardiomyopathy (HOCM)
compared with septal myectomy (SM), however its potential to create a
proarrhythmic substrate is increased. <br/>Method(s): A systematic search
was performed in PubMed, EMBASE, Web of Science, and the Cochrane Library
from inception to October 2020. Fixed or random effects models were used
to estimate the risk ratios (RR) for ventricular arrhythmia events or
other outcomes between the SM and ASA cohorts. <br/>Result(s): Twenty
studies with 8025 patients were included. Pool analysis showed that the
incidence of ventricular tachycardia (VT)/ventricular fibrillation (VF),
which included appropriate implantable cardioverter defibrillator (ICD)
intervention, was significantly higher in the ASA cohort than that in the
SM cohort (ASA vs SM: 10% (345/3312) vs 5% (161/3227) (RR = 1.98, 95% CI
(confidence interval), 1.65-2.37; p < 0.00001, I² = 0%). In
both groups, more than 90% of VT/VF events occurred in the early phase
(during the procedure, during hospitalization or within 30 days after the
procedure) (ASA: 94.20%; SM: 94.41%). Further subgroup analysis also
showed that the ASA group had a higher incidence of VT/VF in both the
early phase (RR = 1.94, 95% CI, 1.61-2.33; p < 0.0001, I² = 0%)
and the late phase (RR = 2.80, 95% CI, 1.00-7.89; p = 0.05, I²
= 33%). Furthermore, although the risks of sudden cardiac death (SCD) were
similar between the ASA and SM groups, a higher incidence of sudden
cardiac arrest (SCA), which included SCD and resuscitated SCA, was
observed in the ASA group (RR = 2.30, 95% CI, 1.35-3.94; p = 0.002,
I² = 0%). <br/>Conclusion(s): In patients with HOCM, those who
received ASA showed a higher incidence of VF/VT and SCD combined with
resuscitated SCA. The majority of VT/VF occurred in the early
phase.<br/>Copyright &#xa9; 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

<114>
Accession Number
2023037311
Title
Prognostic Value of Cardiac Magnetic Resonance in Assessing Right
Ventricular Strain in Cardiovascular Disease: A Systematic Review and
Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 23(12) (no pagination), 2022. Article
Number: 406. Date of Publication: December 2022.
Author
Bo K.; Zhou Z.; Sun Z.; Gao Y.; Zhang H.; Wang H.; Liu T.; Xu L.
Institution
(Bo, Zhou, Gao, Zhang, Wang, Xu) Department of Radiology, Beijing Anzhen
Hospital, Capital Medical University, Beijing 100029, China
(Sun) Discipline of Medical Radiation Science, Curtin Medical School,
Curtin University, Perth, WA 6845, Australia
(Liu) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical
University, Beijing 100029, China
Publisher
IMR Press Limited
Abstract
Objective: To evaluate the prognostic value of cardiac magnetic resonance
(CMR) imaging in assessing right ventricular strain via meta-analysis of
current literature. <br/>Background(s): Right ventricular strain recorded
with CMR serves as a novel indicator to quantify myocardial deformation.
Although several studies have reported the predictive value of right
ventricular strain determined using CMR, their validity is limited by
small sample size and low event number. <br/>Method(s): Embase, Medline
and Web of Science were searched for studies assessing the prognostic
value of myocardial strain. The primary endpoint was a composite of
all-cause mortality, cardiovascular death, aborted sudden cardiac death,
heart transplantation and heart failure admissions. <br/>Result(s): A
total of 14 studies met the selection criteria and were included in the
analysis (n = 3239 adults). The random-effects model showed the
association of parameters of right ventricular strain with major adverse
cardiac events. Absolute value of right ventricular global longitudinal
strain was negatively correlated with right ventricular ejection fraction
(hazard ratio: 1.07, 95% confidence interval: 1.05-1.08; p = 0.013).
Despite the small number of studies, right ventricular radial strain,
right ventricular circumferential strain and right ventricular long-axis
strain displayed potential prognostic value. <br/>Conclusion(s): Right
ventricular strain measured with CMR is an effective prognostic indicator
for cardiovascular disease.<br/>Copyright &#xa9; 2022 The Author(s).
Published by IMR Press. This is an open access article under the CC BY 4.0
license.

<115>
Accession Number
361741449
Title
Medical treatment of hypertension in Switzerland: The 2009 Swiss
Hypertension Survey (SWISSHYPE).
Source
Swiss Medical Weekly. 141(MARCH) (no pagination), 2011. Date of
Publication: March 2011.
Author
Brenner R.; Waeber B.; Allemann Y.
Institution
(Brenner, Allemann) Cardiology, Swiss Cardiovascular Centre Bern,
University Hospital Bern, CH-3010 Bern, Switzerland
(Waeber) Division of Pathophysiology, Centre Hospitalier Universitaire
Vaudois, University Hospital Lausanne, Switzerland
Publisher
SMW supporting association
Abstract
OBJECTIVES: Despite a broad and efficient pharmacological antihypertensive
armamentarium, blood pressure (BP) control is suboptimal and heterogeneous
throughout Europe. Recent representative data from Switzerland are
limited. The goal of the present survey was therefore to assess the actual
control rate of high BP in Switzerland in accordance with current
guidelines. The influence of risk factors, target organ damage and
medication on BP levels and control was also evaluated. <br/>METHOD(S): A
cross-sectional visit-based survey of ambulatory hypertensive patients was
performed in 2009 in Switzerland. 281 randomly selected physicians
provided data on 5 consecutive hypertensive patients attending their
practices for BP follow-up. Data were anonymously collected on
demographics, comorbidities and current medication, and BP was recorded.
Subsequent modification of pharmacological antihypertensive therapy was
assessed. <br/>RESULT(S): Data from 1376 patients were available. Mean age
was 65 +/- 12 years, 53.9% were male subjects. 26.4% had complicated
hypertension. Overall, BP control (<140/90 mm Hg for uncomplicated and
<130/80 mm Hg for complicated hypertension) was achieved in 48.9%.
Compared to patients with complicated hypertension, BP control was better
in patients with uncomplicated hypertension (59.4% vs. 19.2%, p <0.001).
As a monotherapy the most prescribed drug class were angiotensin receptor
blockers (ARB, 41%), followed by angiotensin converting enzyme (ACE)
inhibitors (21.5%), betablockers (20.8%) and calcium channel blockers
(CCB, 10.8%). The most prescribed drug combinations were ARB + diuretic
(30.1%) and ACE inhibitors + diuretic (15.3%). 46% were receiving a fixed
drug combination. In only 32.7% of patients with uncontrolled hypertension
was a change in drug therapy made. <br/>CONCLUSION(S): This representative
survey on treated adult hypertensive patients shows that, compared to
earlier reports, the control rate of hypertension has improved in
Switzerland for uncomplicated but not for complicated, particularly
diabetes-associated hypertension. ARBs and ACE inhibitors are the most
prescribed antihypertensive drugs for monotherapy, whereas diuretics and
ARBs were the most used for combination therapy.

<116>
Accession Number
2022860532
Title
Protocol for the derivation and external validation of a 30-day
postoperative pulmonary complications (PPCs) risk prediction model for
elderly patients undergoing thoracic surgery: A cohort study in southern
China.
Source
BMJ Open. 13(2) (no pagination), 2023. Article Number: e066815. Date of
Publication: 10 Feb 2023.
Author
Wei W.; Zheng X.; Zhou C.W.; Zhang A.; Zhou M.; Yao H.; Jiang T.
Institution
(Wei, Zheng, Zhou, Zhang, Yao) Department of Anesthesiology, Affiliated
Cancer Hospital and Institute of Guangzhou Medical University, Guangdong,
Guangzhou, China
(Zhou) Department of Thoracic Surgery, Affiliated Cancer Hospital and
Institute of Guangzhou Medical University, Guangdong, Guangzhou, China
(Jiang) Department of Anaesthesiology, The University of Hong
Kong-Shenzhen Hospital, Shenzhen, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative pulmonary complications (PPCs) occur after up
to 60% of non-cardiac thoracic surgery (NCTS), especially for multimorbid
elderly patients. Nevertheless, current risk prediction models for PPCs
have major limitations regarding derivation and validation, and do not
account for the specific risks of NCTS patients. Well-founded and
externally validated models specific to elderly NCTS patients are
warranted to inform consent and treatment decisions. Methods and analysis
We will develop, internally and externally validate a multivariable risk
model to predict 30-day PPCs in elderly NCTS patients. Our cohort will be
generated in three study sites in southern China with a target population
of approximately 1400 between October 2021 and December 2023. Candidate
predictors have been selected based on published data, clinical expertise
and epidemiological knowledge. Our model will be derived using the
combination of multivariable logistic regression and bootstrapping
technique to lessen predictors. The final model will be internally
validated using bootstrapping validation technique and externally
validated using data from different study sites. A parsimonious risk score
will then be developed on the basis of beta estimates derived from the
logistic model. Model performance will be evaluated using area under the
receiver operating characteristic curve, max-rescaled Brier score and
calibration slope. In exploratory analysis, we will also assess the net
benefit of Probability of PPCs Associated with THoracic surgery in elderly
patients score in the complete cohort using decision curve analysis.
Ethics and dissemination Ethical approval has been obtained from the
Institutional Review Board of the Affiliated Cancer Hospital and Institute
of Guangzhou Medical University, the Second Affiliated Hospital of
Guangzhou University of Traditional Chinese Medicine and the University of
Hongkong - Shenzhen Hospital, respectively. The final risk prediction
model will be published in an appropriate journal and further disseminated
as an online calculator or nomogram for clinical application. Approved and
anonymised data will be shared. Trial registration number
ChiCTR2100051170.<br/>Copyright &#xa9; 2023 BMJ Publishing Group. All
rights reserved.

<117>
Accession Number
2022839566
Title
Efficacy of erector spinae plane block for minimally invasive mitral valve
surgery: Results of a double-blind, prospective randomized
placebo-controlled trial.
Source
Journal of Clinical Anesthesia. 86 (no pagination), 2023. Article Number:
111072. Date of Publication: June 2023.
Author
Hoogma D.F.; Van den Eynde R.; Al Tmimi L.; Verbrugghe P.; Tournoy J.;
Fieuws S.; Coppens S.; Rex S.
Institution
(Hoogma, Van den Eynde, Al Tmimi, Coppens, Rex) Department of
Anesthesiology, University Hospitals of Leuven, Leuven, Belgium
(Hoogma, Al Tmimi, Verbrugghe, Coppens, Rex) Department of Cardiovascular
Sciences, Biomedical Sciences Group, University of Leuven, Leuven, Belgium
(Verbrugghe) Department of Cardiac Surgery, University Hospitals of
Leuven, Leuven, Belgium
(Tournoy) Department of Public Health and Primary Care, Geriatric
Medicine, University Hospitals Leuven, Leuven, Belgium
(Fieuws) Leuven Biostatistics and Statistical Bioinformatics Centre
(L-BioStat), Biomedical Sciences Group, University of Leuven, Leuven,
Belgium
Publisher
Elsevier Inc.
Abstract
Study objective: To investigate if an erector spinae plane (ESP) block
decreases postoperative opioid consumption, pain and postoperative nausea
and vomiting in patients undergoing minimally invasive mitral valve
surgery (MIMVS). <br/>Design(s): A single-center, double-blind,
prospective, randomized, placebo-controlled trial. <br/>Setting(s):
Postoperative period; operating room, post-anesthesia care unit (PACU) and
hospital ward in a university hospital. <br/>Patient(s): Seventy-two
patients undergoing video-assisted thoracoscopic MIMVS via right-sided
mini-thoracotomy and enrolled in the institutional enhanced recovery after
cardiac surgery program. <br/>Intervention(s): At the end of surgery, all
patients received an ESP catheter at vertebra T5 under ultrasound guidance
and were randomized to the administration of either ropivacaine 0.5%
(loading of dose 30 ml and three additional doses of 20 ml with a 6 h
interval) or normal saline 0.9% (with an identical administration scheme).
In addition, patients received multimodal postoperative analgesia
including dexamethasone, acetaminophen and patient-controlled intravenous
analgesia with morphine. Following the final ESP bolus and before catheter
removal, the position of the catheter was re-evaluated by ultrasound.
Patients, investigators and medical personnel were blinded for the group
allocation during the entire trial. Measurements: Primary outcome was
cumulative morphine consumption during the first 24 h after extubation.
Secondary outcomes included severity of pain, presence/extent of sensory
block, duration of postoperative ventilation and hospital length of stay.
Safety outcomes comprised the incidence of adverse events. <br/>Main
Result(s): Median (IQR) 24-h morphine consumption was not different
between the intervention- and control-group, 41 mg (30-55) versus 37 mg
(29-50) (p = 0.70), respectively. Likewise, no differences were detected
for secondary and safety endpoints. <br/>Conclusion(s): Following MIMVS,
adding an ESP block to a standard multimodal analgesia regimen did not
reduce opioid consumption and pain scores.<br/>Copyright &#xa9; 2023
Elsevier Inc.

<118>
Accession Number
2020196615
Title
Association of Valproic Acid Use With Post-Myocardial Infarction Heart
Failure Development: A Meta-Analysis of Two Retrospective Case-Control
Studies.
Source
Journal of Cardiovascular Pharmacology and Therapeutics. 27 (no
pagination), 2022. Date of Publication: January-December 2022.
Author
English J.D.; Tian S.; Wang Z.; Luzum J.A.
Institution
(English, Luzum) Department of Clinical Pharmacy, University of Michigan
College of Pharmacy, Ann Arbor, MI, United States
(Tian, Wang) Department of Cardiac Surgery, Frankel Cardiovascular Center,
University of Michigan, Ann Arbor, MI, United States
Publisher
SAGE Publications Ltd
Abstract
Background: Despite advances in treatments, myocardial infarction (MI)
remains a significant cause of morbidity and mortality worldwide. Our team
has previously shown that valproic acid (VPA) is cardio-protective when
administered to rats post-MI. The aim of this study was to investigate the
association of VPA use with post-MI heart failure (HF) development in
humans. <br/>Method(s): This study was a random effects meta-analysis of
two retrospective case-control studies collected from electronic health
record (Michigan Medicine) and claims data (OptumInsight). Cases with an
active prescription for VPA at the time of their MI were matched 1:4 to
controls not taking VPA at the time of their MI by multiple demographic
and clinical characteristics. The primary outcome, time-to-HF development,
was analyzed using the Fine-Gray competing risks model of any VPA
prescription versus no VPA prescription. An exploratory analysis was
conducted to evaluate the association of different VPA doses (>=1000
mg/day vs <1000 mg/day vs 0 mg/day VPA). <br/>Result(s): In total, the
datasets included 1313 patients (249 cases and 1064 controls). In the
meta-analysis, any dose of VPA during an MI tended to be protective
against incident HF post-MI (HR = 0.87; 95% CI = 0.72-1.01). However, when
stratified by dose, high-dose VPA (>=1000 mg/day) significantly associated
with 30% reduction in risk for HF post-MI (HR = 0.70; 95% CI = 0.49-0.91),
whereas low-dose VPA (<1000 mg/day) did not (HR = 0.95; 95% CI =
0.78-1.13). <br/>Conclusion(s): VPA doses >=1000 mg/day may provide
post-MI cardio-protection resulting in a reduced incidence of
HF.<br/>Copyright &#xa9; The Author(s) 2022.

<119>
Accession Number
2020506612
Title
Artificial Intelligence in Pediatric Cardiology: A Scoping Review.
Source
Journal of Clinical Medicine. 11(23) (no pagination), 2022. Article
Number: 7072. Date of Publication: December 2022.
Author
Sethi Y.; Patel N.; Kaka N.; Desai A.; Kaiwan O.; Sheth M.; Sharma R.;
Huang H.; Chopra H.; Khandaker M.U.; Lashin M.M.A.; Hamd Z.Y.; Emran T.B.
Institution
(Sethi, Patel, Kaka, Kaiwan) PearResearch, Dehradun 248001, India
(Sethi) Department of Medicine, Government Doon Medical College, Dehradun
248001, India
(Patel, Kaka) Department of Medicine, GMERS Medical College, Himmatnagar
383001, India
(Desai) Department of Medicine, SMIMER Medical College, Surat 395010,
India
(Kaiwan) Department of Medicine, Northeast Ohio Medical University,
Rootstown, OH 44272, United States
(Sheth) Department of Medicine, GMERS Gandhinagar, Gandhinagar 382012,
India
(Sharma) Department of Medicine, Government Medical College, Nagpur
440003, India
(Huang) Faculty of Medicine and Health Science, Royal College of Surgeons
in Ireland, Dublin D02 YN77, Ireland
(Chopra) Chitkara College of Pharmacy, Chitkara University, Rajpura
140401, India
(Khandaker) Centre for Applied Physics and Radiation Technologies, School
of Engineering and Technology, Sunway University, Bandar Sunway 47500,
Malaysia
(Lashin) Department of Biomedical Engineering, College of Engineering,
Princess Nourah bint Abdulrahman University, P.O. 84428, Riyadh 11671,
Saudi Arabia
(Hamd) Department of Radiological Sciences, College of Health and
Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O.
84428, Riyadh 11671, Saudi Arabia
(Emran) Department of Pharmacy, BGC Trust University Bangladesh,
Chittagong 4381, Bangladesh
(Emran) Department of Pharmacy, Faculty of Allied Health Sciences,
Daffodil International University, Dhaka 1207, Bangladesh
Publisher
MDPI
Abstract
The evolution of AI and data science has aided in mechanizing several
aspects of medical care requiring critical thinking: diagnosis, risk
stratification, and management, thus mitigating the burden of physicians
and reducing the likelihood of human error. AI modalities have expanded
feet to the specialty of pediatric cardiology as well. We conducted a
scoping review searching the Scopus, Embase, and PubMed databases covering
the recent literature between 2002-2022. We found that the use of neural
networks and machine learning has significantly improved the diagnostic
value of cardiac magnetic resonance imaging, echocardiograms, computer
tomography scans, and electrocardiographs, thus augmenting the clinicians'
diagnostic accuracy of pediatric heart diseases. The use of AI-based
prediction algorithms in pediatric cardiac surgeries improves
postoperative outcomes and prognosis to a great extent. Risk
stratification and the prediction of treatment outcomes are feasible using
the key clinical findings of each CHD with appropriate computational
algorithms. Notably, AI can revolutionize prenatal prediction as well as
the diagnosis of CHD using the EMR (electronic medical records) data on
maternal risk factors. The use of AI in the diagnostics, risk
stratification, and management of CHD in the near future is a promising
possibility with current advancements in machine learning and neural
networks. However, the challenges posed by the dearth of appropriate
algorithms and their nascent nature, limited physician training, fear of
over-mechanization, and apprehension of missing the 'human touch' limit
the acceptability. Still, AI proposes to aid the clinician tomorrow with
precision cardiology, paving a way for extremely efficient
human-error-free health care.<br/>Copyright &#xa9; 2022 by the authors.

<120>
Accession Number
640421462
Title
Nociception Control of Bilateral Single-Shot Erector Spinae Plane Block
Compared to No Block in Open Heart Surgery-A Post Hoc Analysis of the NESP
Randomized Controlled Clinical Trial.
Source
Medicina (Kaunas, Lithuania). 59(2) (no pagination), 2023. Date of
Publication: 30 Jan 2023.
Author
Balan C.; Tomescu D.R.; Bubenek-Turconi S.I.
Institution
(Balan, Bubenek-Turconi) Cardiac Anesthesiology and Intensive Care
Department I, Prof. Dr. C.C. Iliescu Emergency Institute for
Cardiovascular Diseases, Bucharest 022328, Romania
(Balan, Tomescu, Bubenek-Turconi) Anesthesiology and Intensive Care
Department, Carol Davila University of Medicine and Pharmacy, Bucharest
050474, Romania
(Tomescu) 3rd Department of Anesthesiology and Intensive Care, Fundeni
Clinical Institute, Bucharest 022328, Romania
Publisher
NLM (Medline)
Abstract
Background and Objectives: The erector spinae plane block (ESPB) is an
analgesic adjunct demonstrated to reduce intraoperative opioid consumption
within a Nociception Level (NOL) index-directed anesthetic protocol. We
aimed to examine the ESPB effect on the quality of intraoperative
nociception control evaluated with the NOL index. <br/>Material(s) and
Method(s): This is a post hoc analysis of the NESP (Nociception Level
Index-Directed Erector Spinae Plane Block in Open Heart Surgery)
randomized controlled trial. Eighty-five adult patients undergoing on-pump
cardiac surgery were allocated to group 1 (Control, n = 43) and group 2
(ESPB, n = 42). Both groups received general anesthesia. Preoperatively,
group 2 received bilateral single-shot ESPB (1.5 mg/kg/side 0.5%
ropivacaine mixed with dexamethasone 8 mg/20 mL). Until cardiopulmonary
bypass (CPB) was initiated, fentanyl administration was individualized
using the NOL index. The NOL index was compared at five time points:
pre-incision (T1), post-incision (T2), pre-sternotomy (T3),
post-sternotomy (T4), and pre-CPB (T5). On a scale from 0 (no nociception)
to 100 (extreme nociception), a NOL index > 25 was considered an
inadequate response to noxious stimuli. <br/>Result(s): The average NOL
index across the five time points in group 2 to group 1 was 12.78 +/- 0.8
vs. 24.18 +/- 0.79 (p < 0.001). The NOL index was significantly lower in
the ESPB-to-Control group at T2 (12.95 +/- 1.49 vs. 35.97 +/- 1.47), T3
(13.28 +/- 1.49 vs. 24.44 +/- 1.47), and T4 (15.52 +/- 1.49 vs. 34.39 +/-
1.47) (p < 0.001) but not at T1 and T5. Compared to controls,
significantly fewer ESPB patients reached a NOL index > 25 at T2 (4.7% vs.
79%), T3 (0% vs. 37.2%), and T4 (7.1% vs. 79%) (p < 0.001).
<br/>Conclusion(s): The addition of bilateral single-shot ESPB to general
anesthesia during cardiac surgery improved the quality of intraoperative
nociception control according to a NOL index-based evaluation.

<121>
Accession Number
640421202
Title
Influence of Three Different Surgical Techniques on Microscopic Damage of
Saphenous Vein Grafts-A Randomized Study.
Source
Medicina (Kaunas, Lithuania). 59(2) (no pagination), 2023. Date of
Publication: 23 Jan 2023.
Author
Zivkovic I.; Krasic S.; Stankovic M.; Milacic P.; Milutinovic A.;
Zdravkovic D.; Tabakovic Z.; Peric M.; Krstic M.; Bojic M.; Milic D.;
Micovic S.
Institution
(Zivkovic, Milacic, Milutinovic, Zdravkovic, Tabakovic, Peric, Bojic,
Micovic) Cardiac Surgery Department, Dedinje Cardiovascular Institute,
Belgrade 11000, Serbia
(Zivkovic, Milacic, Peric, Bojic, Micovic) School of Medicine, University
of Belgrade, Belgrade 11000, Serbia
(Krasic) Cardiology Department, Mother and Child Health Care Institute,
Belgrade 11000, Serbia
(Stankovic, Krstic) Center for Pathology and Pathological Anatomy,
Clinical Center of Nis, Nis 18000, Serbia
(Krstic, Milic) Faculty of Medicine, University of Nis, Nis 18000, Serbia
(Milic) Cardiac Surgery Department, Clinical Center of Nis, Nis 18000,
Serbia
Publisher
NLM (Medline)
Abstract
Background and Objectives: The saphenous vein is one of the most common
used grafts (SVG) for surgical revascularization. The mechanism of the
SVGs occlusion is still unknown. Surgical preparation techniques have an
important role in the early and late graft occlusion. Our study analyzed
the influence of the three different surgical techniques on the
histological and immunohistochemical characteristics of the vein grafts.
<br/>Method(s): Between June 2019 and December 2020, 83 patients who
underwent surgical revascularization were prospectively randomly assigned
to one of the three groups, according to saphenous vein graft harvesting
(conventional (CVH), no-touch (NT) and endoscopic (EVH)) technique. The
vein graft samples were sent on the histological (hematoxylin-eosin
staining) and immunohistochemical (CD31, Factor VIII, Caveolin and eNOS)
examinations. <br/>Result(s): The CVH, NT, and EVH groups included 27
patients (mean age 67.66 +/- 5.6), 31 patients (mean age 66.5 +/- 7.4) and
25 patients (mean age 66 +/- 5.5), respectively. Hematoxylin-eosin
staining revealed a lower grade of microstructural vein damage in the NT
group (2, IQR 1-2) in comparison with CVH and EVH (3, IQR 2-4), (4, IQR
2-4) respectively (p < 0.001). Immunohistochemical examination revealed a
high grade of staining in the NT group compared to the CVH and EVH group
(CD 31 antibody p = 0.02, FVIII, p < 0.001, Caveolin, p = 0.001, and eNOS,
p = 0.003). <br/>Conclusion(s): The best preservation of the structural
vein integrity was in the NT group, while the lowest rate of leg wound
complication was in the EVH group. These facts increase the interest in
developing and implementing the endoscopic no-touch technique.

<122>
Accession Number
640421014
Title
Efficacy of Phrenic Nerve Block and Suprascapular Nerve Block in
Amelioration of Ipsilateral Shoulder Pain after Thoracic Surgery: A
Systematic Review and Network Meta-Analysis.
Source
Medicina (Kaunas, Lithuania). 59(2) (no pagination), 2023. Date of
Publication: 31 Jan 2023.
Author
Pipanmekaporn T.; Leurcharusmee P.; Punjasawadwong Y.; Khorana J.;
Samerchua A.; Sukhupragarn W.; Sukuam I.; Bunchungmongkol N.; Saokaew S.
Institution
(Pipanmekaporn, Leurcharusmee, Punjasawadwong, Samerchua, Sukhupragarn,
Bunchungmongkol) Department of Anesthesiology, Faculty of Medicine, Chiang
Mai University, Chiang Mai 50200, Thailand
(Pipanmekaporn, Khorana) Clinical Epidemiology and Statistic Center,
Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
(Khorana) Department of Surgery, Faculty of Medicine, Chiang Mai
University, Chiang Mai 50200, Thailand
(Sukuam) Maeramat Hospital, Tak 63140, Thailand
(Saokaew) Unit of Excellence on Clinical Outcomes Research and IntegratioN
(UNICORN), School of Pharmaceutical Sciences, University of Phayao, Phayao
56000, Thailand
(Saokaew) Center of Health Outcomes Research and Therapeutic Safety
(Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao
56000, Thailand
(Saokaew) Division of Social and Administrative Pharmacy, Department of
Pharmaceutical Care, School of Pharmaceutical Sciences, University of
Phayao, Phayao 56000, Thailand
Publisher
NLM (Medline)
Abstract
Background and Objectives: Ipsilateral shoulder pain (ISP) is a common
complication after thoracic surgery. Severe ISP can cause ineffective
breathing and impair shoulder mobilization. Both phrenic nerve block (PNB)
and suprascapular nerve block (SNB) are anesthetic interventions; however,
it remains unclear which intervention is most effective. The purpose of
this study was to compare the efficacy and safety of PNB and SNB for the
prevention and reduction of the severity of ISP following thoracotomy or
video-assisted thoracoscopic surgery. <br/>Material(s) and Method(s):
Studies published in PubMed, Embase, Scopus, Web of Science, Ovid Medline,
Google Scholar and the Cochrane Library without language restriction were
reviewed from the publication's inception through 30 September 2022.
Randomized controlled trials evaluating the comparative efficacy of PNB
and SNB on ISP management were selected. A network meta-analysis was
applied to estimate pooled risk ratios (RRs) and weighted mean difference
(WMD) with 95% confidence intervals (CIs). <br/>Result(s): Of 381 records
screened, eight studies were eligible. PNB was shown to significantly
lower the risk of ISP during the 24 h period after surgery compared to
placebo (RR 0.44, 95% CI 0.34 to 0.58) and SNB (RR 0.43, 95% CI 0.29 to
0.64). PNB significantly reduced the severity of ISP during the 24 h
period after thoracic surgery (WMD -1.75, 95% CI -3.47 to -0.04), but
these effects of PNB were not statistically significantly different from
SNB. When compared to placebo, SNB did not significantly reduce the
incidence or severity of ISP during the 24 h period after surgery.
<br/>Conclusion(s): This study suggests that PNB ranks first for
prevention and reduction of ISP severity during the first 24 h after
thoracic surgery. SNB was considered the worst intervention for ISP
management. No evidence indicated that PNB was associated with a
significant impairment of postoperative ventilatory status.

<123>
Accession Number
640418672
Title
Outcomes of Transcatheter Aortic Valve Implantation Comparing Medtronic's
Evolut PRO and Evolut R: A Systematic Review and Meta-Analysis of
Observational Studies.
Source
International journal of environmental research and public health. 20(4)
(no pagination), 2023. Date of Publication: 15 Feb 2023.
Author
Gozdek M.; Kuzma L.; Dabrowski E.J.; Janiak M.; Pietrzak M.; Skonieczna
K.; Woznica M.; Wydeheft L.; Makhoul M.; Matteucci M.; Litwinowicz R.;
Kowalowka A.; Wanha W.; Pasierski M.; Ronco D.; Massimi G.; Jiritano F.;
Fina D.; Martucci G.; Raffa G.M.; Suwalski P.; Lorusso R.; Meani P.;
Kowalewski M.
Institution
(Gozdek) Department of Cardiology, Hospital of the Ministry of Interior,
72-122 Bydgoszcz, Poland
(Gozdek, Janiak, Pietrzak, Skonieczna, Woznica, Wydeheft, Makhoul,
Matteucci, Litwinowicz, Kowalowka, Wanha, Pasierski, Ronco, Massimi,
Jiritano, Fina, Martucci, Raffa, Suwalski, Meani, Kowalewski) Thoracic
Research Centre, Collegium Medicum Nicolaus Copernicus University,
Innovative Medical Forum, Bydgoszcz 85-094, Poland
(Kuzma, Dabrowski) Department of Invasive Cardiology, Medical University
of Bialystok, Bialystok 15-540, Poland
(Makhoul) Department of Cardiac Surgery, Harefield Hospital, London UB9
6JH, United Kingdom
(Matteucci) Cardiac Surgery Unit, ASST dei Sette Laghi, Department of
Medicine and Surgery, University of Insubria, Varese 21100, Italy
(Matteucci, Ronco, Massimi, Lorusso, Kowalewski) Cardiothoracic Surgery
Department, Heart and Vascular Centre, Maastricht University Medical
Centre (MUMC), Cardiovascular Research Institute Maastricht (CARIM), ER
Maastricht 6229, Netherlands
(Litwinowicz) Department of Cardiac Surgery, Regional Specialist Hospital,
86-300 Grudziadz, Poland
(Kowalowka) Department of Cardiac Surgery, Upper-Silesian Heart Center,
Katowice 40-752, Poland
(Kowalowka) Department of Cardiac Surgery, Faculty of Medical Sciences,
Medical University of Silesia, Katowice 40-752, Poland
(Wanha) Department of Cardiac Surgery, School of Medicine in Katowice,
Medical University of Silesia, Katowice 40-752, Poland
(Pasierski, Suwalski, Kowalewski) Department of Cardiac Surgery and
Transplantology, Central Clinical Hospital of the Ministry of Interior,
Centre of Postgraduate Medical Education, Warsaw 02-507, Poland
(Jiritano) Department of Experimental and Clinical Medicine, Magna Graecia
University, Catanzaro 88100, Italy
(Fina, Meani) Department of Cardiothoracic, Vascular Anesthesia and
Intensive Care Unit, Istituto di Ricovero e Cura a Carattere Scientifico
(IRCCS) Policlinico, San Donato Milanese, 20097 Milan, Italy
(Martucci) Department of Anesthesia and Intensive Care, Istituto
Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione
(IRCCS-ISMETT), Palermo 90100, Italy
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, Istituto di Ricovero e Cura a
Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad
Alta Specializzazione (IRCCS-ISMETT), Palermo 90100, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become a
broadly acceptable alternative to AV surgery in patients with aortic
stenosis (AS). New valve designs are becoming available to address the
shortcomings of their predecessors and improve clinical outcomes.
<br/>METHOD(S): A systematic review and meta-analysis was carried out to
compare Medtronic's Evolut PRO, a new valve, with the previous Evolut R
design. Procedural, functional and clinical endpoints according to the
VARC-2 criteria were assessed. <br/>RESULT(S): Eleven observational
studies involving N = 12,363 patients were included. Evolut PRO patients
differed regarding age (p < 0.001), sex (p < 0.001) and STS-PROM estimated
risk. There was no difference between the two devices in terms of
TAVI-related early complications and clinical endpoints. A 35% reduction
of the risk of moderate-to-severe paravalvular leak (PVL) favoring the
Evolut PRO was observed (RR 0.66, 95%CI, [0.52, 0.86] p = 0.002; I2 = 0%).
Similarly, Evolut PRO-treated patients demonstrated a reduction of over
35% in the risk of serious bleeding as compared with the Evolut R (RR
0.63, 95%CI, [0.41, 0.96]; p = 0.03; I2 = 39%), without differences in
major vascular complications. <br/>CONCLUSION(S): The evidence shows good
short-term outcomes of both the Evolut PRO and Evolut R prostheses, with
no differences in clinical and procedural endpoints. The Evolut PRO was
associated with a lower rate of moderate-to-severe PVL and major bleeding.

<124>
Accession Number
2021874437
Title
3D liver model-based surgical education improves preoperative
decision-making and patient satisfaction-a randomized pilot trial.
Source
Surgical Endoscopy. (no pagination), 2023. Date of Publication: 2023.
Author
Giehl-Brown E.; Dennler S.; Garcia S.A.; Seppelt D.; Oehme F.; Schweipert
J.; Weitz J.; Riediger C.
Institution
(Giehl-Brown, Dennler, Garcia, Oehme, Schweipert, Weitz, Riediger)
Department of Visceral, Thoracic and Vascular Surgery, University Hospital
Carl Gustav Carus, Technische Universitat Dresden, Dresden, Germany
(Giehl-Brown, Dennler, Garcia, Oehme, Schweipert, Weitz, Riediger)
National Center for Tumor Diseases (NCT/UCC), Dresden, Germany
(Giehl-Brown, Dennler, Garcia, Oehme, Schweipert, Weitz, Riediger) German
Cancer Research Center (DKFZ), Heidelberg, Germany
(Giehl-Brown, Dennler, Garcia, Oehme, Schweipert, Weitz, Riediger) Faculty
of Medicine, University Hospital Carl Gustav Carus, Technische Universitat
Dresden, Dresden, Germany
(Giehl-Brown, Dennler, Garcia, Oehme, Schweipert, Weitz, Riediger)
Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
(Seppelt) Department of Radiology, University Hospital Carl Gustav Carus
Dresden, Technische Universitat Dresden, Dresden, Germany
Publisher
Springer
Abstract
Objective: Hepatobiliary surgery bares obstacles to informed consent for
the patients due to its complexity and related risk of postoperative
complications. 3D visualization of the liver has been proven to facilitate
comprehension of the spatial relationship between anatomical structures
and to assist in clinical decision-making. Our objective is to utilize
individual 3D-printed liver models to enhance patient satisfaction with
surgical education in hepatobiliary surgery. Design, setting: We conducted
a prospective, randomized pilot study comparing 3D liver model-enhanced
(3D-LiMo) surgical education against regular patient education during
preoperative consultation at the department of Visceral, Thoracic and
Vascular Surgery, University Hospital Carl Gustav Carus, Dresden, Germany.
<br/>Participant(s): Of 97 screened patients, undergoing hepatobiliary
surgery, 40 patients were enrolled from July 2020 to January 2022.
<br/>Result(s): The study population (n = 40) was predominantly of male
gender (62.5%) with a median age of 65.2 years and a high prevalence of
preexisting diseases. Underlying disease, warranting hepatobiliary
surgery, was malignancy in the majority of cases (97.5%). Patients in the
3D-LiMo group were more likely to feel very thoroughly educated and
exhibited a higher level of satisfaction following surgical education than
the control group (80 vs. 55%, n.s.; 90 vs. 65%, n.s.; respectively).
Applying 3D models was also associated with enhanced understanding of the
underlying disease with regard to amount (100% vs. 70%, p = 0.020) and
location of liver masses (95 vs. 65%, p = 0.044). 3D-LiMo patients also
demonstrated enhanced understanding of the surgical procedure (80 vs. 55%,
n.s.), leading to better awareness for the occurrence of postoperative
complications (88.9, vs. 68.4%, p = 0.052). Adverse event profiles were
similar. <br/>Conclusion(s): In conclusion, individual 3D-printed liver
models increase patient satisfaction with surgical education and
facilitate patients' understanding of the surgical procedure as well as
awareness of postoperative complications. Therefore, the study protocol is
feasible to apply to an adequately powered, multicenter, randomized
clinical trial with minor modifications.<br/>Copyright &#xa9; 2023, The
Author(s).

<125>
Accession Number
2023026258
Title
Anesthetic Management of Patients With Kartagener Syndrome: A Systematic
Review of 99 Cases.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Cheng L.; Dong Y.; Liu S.
Institution
(Cheng, Dong, Liu) Department of Anesthesiology, Shengjing Hospital of
China Medical University, Shenyang, China
Publisher
W.B. Saunders
Abstract
KARTAGENER SYNDROME (KS) is characterized by the triad of chronic
sinusitis, bronchiectasis, and situs inversus. The mirrored anatomy and
respiratory infections in patients with KS patients pose great challenges
for anesthetic management. The aim of this review is to summarize
published cases with the hope of helping anesthesiologists perform
anesthesia in patients with KS more safely. A comprehensive literature
search for all cases of anesthetic management of KS patients was performed
in Pubmed, EMBASE, CNKI, and Wanfang Database. The extracted data included
age, sex, type of surgery, preoperative treatment, type of anesthesia,
anesthetic agents, airway management, central venous catheterization,
transesophageal echocardiogram, reversal of neuromuscular blockade,
adverse events during the surgery, and postoperative complications. The
study authors included 82 single-case reports, 3 case series, and 1 case
cohort, with a total number of 99 patients. The most common surgical
procedures were thoracic surgery (51.5%), which was followed by ear, nose,
and throat surgery (16.5%), and general surgery (14.5%). The preoperative
treatment of the patients was reported in only 20 patients, and included
antibiotics, bronchodilators, steroids, chest physiotherapy, and postural
drainage. General anesthesia was performed for 85.4% of the surgeries, and
regional anesthesia was performed in 14.6% of the cases. For nonthoracic
surgery, an endotracheal tube was the most commonly used airway device.
For thoracic surgery, a double-lumen tube was the most commonly used
airway device. The intraoperative process was uneventful in most patients,
and most patients recovered smoothly in the postoperative
course.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<126>
Accession Number
2022788823
Title
The Effect and Possible Mechanism of Cardiac Rehabilitation in Partial
Revascularization Performed on Multiple Coronary Artery Lesions.
Source
Clinical Interventions in Aging. 18 (pp 235-248), 2023. Date of
Publication: 2023.
Author
Gao Y.; Yue L.; Hao W.; Miao Z.; Wang F.; Wang S.; Luan B.
Institution
(Gao, Hao, Miao, Luan) Department of Cardiology, The People's Hospital of
Liaoning Province, Liaoning Province, Shenyang, China
(Yue) Department of Ultrasound, The Fourth Affiliated Hospital of China
Medical University, Liaoning Province, Shenyang, China
(Wang, Wang) Department of Cardiology, The First Affiliated Hospital of
Liaoning University of Traditional Chinese Medicine, Liaoning Province,
Shenyang, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: To observe the effect of cardiac rehabilitation (CR) in patients
with partial revascularization performed on multiple coronary artery
lesions and explore its possible mechanism. <br/>Patients and Methods: A
total of 400 patients with multiple coronary artery lesions were enrolled
and randomly divided into a complete revascularization group and a CR
group, with 200 cases in each group. Target lesion revascularization was
performed radically in the complete revascularization group, while it was
partially completed in the CR group, and postoperative CR was performed.
All the patients were put under conventional treatment. Left ventricular
end diastolic dimension (LVEDD), left ventricular ejection fraction
(LVEF), 6-minute walking distance (6-MWD), quality-of-life scores, safety
and levels of serum nitric oxide (NO), nitric oxide synthase (NOS),
superoxide dismutase (SOD), and vascular endothelial growth factor (VEGF)
were evaluated and compared between two groups before and after training.
<br/>Result(s): There was no significant difference in LVEDD, LVEF, 6-MWD,
quality-of-life scores, levels of serum NO, NOS, SOD, and VEGF between two
groups before training (p>0.05). 1 year later, compared with the complete
revascularization group, the occurrence of major adverse events in the CR
group declined (p>0.05); the measurements of LVEDD decreased and LVEF
increased (p>0.05), 6-MWD increased significantly (p<0.05),
quality-of-life scores were higher (p<0.05), the levels of serum NO, NOS,
and SOD increased noticeably, and the levels of serum VEGF decreased
significantly in the CR group (p<0.05). There were significant differences
within the same group, before and after training (p<0.05).
<br/>Conclusion(s): Cardiac rehabilitation training, not increase in the
incidence of adverse events, is effective and safe after partial
revascularization in patients with multiple coronary artery lesions, which
has notable clinical advantages in promoting patients' exercise endurance
and quality-of-life by improving the nitric oxide synthase system and
antioxidant system and reducing the level of VEGF.<br/>Copyright &#xa9;
2023 Gao et al. This work is published and licensed by Dove Medical Press
Limited.

<127>
Accession Number
2023052841
Title
LACK OF DIVERSITY IN TRANSCATHETER AORTIC VALVE REPLACEMENT RANDOMIZED
TRIALS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 833), 2023. Date of
Publication: 07 Mar 2023.
Author
Xu J.-L.J.; Wessler B.S.; Mohanty S.; Trinquart L.
Institution
(Xu, Wessler, Mohanty, Trinquart) Lahey Hospital and Medical Center,
Burlington, MA, United States
(Xu, Wessler, Mohanty, Trinquart) Tufts Medical Center, Boston, MA, United
States
Publisher
Elsevier Inc.
Abstract
Background Transcatheter aortic valve replacement (TAVR) has been
extensively studied as a treatment for severe aortic stenosis (AS). The
diversity of TAVR clinical trial cohorts is unknown and may influence the
generalizability of treatment effect estimates. Methods We performed a
systematic review of MEDLINE for all randomized clinical trials (RCTs)
studying TAVR from 2012 to 2022. We included studies of?> 100 patients
evaluating clinical outcomes. We extracted information on the baseline
demographics of randomized participants for each study. Results We
screened 286 abstracts, of which 37 RCTs met our inclusion criteria
representing a total of 22,974 patients. There were 10,753 (46.8%) women
enrolled in those studies. The median sample size was 280 patients (IQR
622). The median trial length was 36 months (IQR 36). TAVR vs surgical
aortic valve replacement (SAVR) trials make up 5/37 (13.5%) of the
studies. Adjunct pharmacotherapies were studied in 12/37 (32.4%) trials.
Mortality was the primary outcome in 26/37 (70.3%) trials. Racial or
ethnic demographics were reported in 5/37 (13.5%) trials. 3,393/3,867
(87.7%) participants were White. Conclusion There is systematic
under-reporting of information about racial and ethnic identity in TAVR
RCTs. Among RCTs providing the information, racially / ethnically
minoritized groups were under-represented. These findings raise
significant concerns about the generalizability of these data. Deliberate
recruiting strategies to make AS study populations more representative are
needed.<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<128>
Accession Number
2023047638
Title
ARRHYTHMIA BURDEN IN CHRONIC TOTAL CORONARY OCCLUSION IN THE ABSENCE OF
ADVANCED LEFT VENTRICULAR DYSFUNCTION IN PATIENTS TREATED WITH OPTIMAL
MEDICAL THERAPY VS INTERVENTION.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1045), 2023. Date of
Publication: 07 Mar 2023.
Author
Alhuneafat L.; Jabri A.; Al-Abdouh A.; Shahrori Z.M.; Mkhaimer Y.; Mhanna
M.; Radaideh Q.; Verma B.; Siraj A.
Institution
(Alhuneafat, Jabri, Al-Abdouh, Shahrori, Mkhaimer, Mhanna, Radaideh,
Verma, Siraj) metrohealth, Cleveland, OH, United States
(Alhuneafat, Jabri, Al-Abdouh, Shahrori, Mkhaimer, Mhanna, Radaideh,
Verma, Siraj) Allegheny health network, pittsburgh, PA, United States
Publisher
Elsevier Inc.
Abstract
Background Rates of ventricular arrhythmias (VA) present in chronic total
coronary occlusions (CTOs) in the absence of advanced left ventricular
dysfunction are not well described. Moreover, little is known about how VA
rates differ with revascularization in this population. Methods In this
single-center retrospective cohort study from the year 2010 to 2018. We
identified 100 patients with CTO on cardiac catheterization with a left
ventricular ejection fraction (LVEF)?>35% who did not undergo coronary
artery bypass surgery following CTO diagnosis. Percutaneous
revascularization was performed for 44 patients. The primary outcome was
VA; the secondary outcome was mortality. Outcomes were compared between
the intervention and non-intervention group after 2 years of the index
procedure and at the end of the study period. Survival analysis was
performed via Kaplan Meier calculation for VA and mortality. Results The
overall population mean age was 59.91(+/-13.1) and BMI 31.8(+/- 7.4).
Patients were 66% male and 64% white and 23% black. Baseline
characteristics, initial LVEF, and CTO characteristics were not
significantly different between both cohorts. During a median follow-up of
4.1(+/-2.5) years, the non-intervention cohort experienced higher rates of
VA (21.4% vs 7.7 %, p = 0.011), and mortality (37.5% vs 15.9%, p=0.031).
Conclusion Even those with an LVEF?>35% experience VA, with higher rates
in those without revascularization. Larger randomized control trials are
needed to confirm these findings. [Formula presented]<br/>Copyright &#xa9;
2023 American College of Cardiology Foundation

<129>
Accession Number
2023047618
Title
TRENDS, PREDICTORS, AND OUTCOMES OF TRANSCATHETER AORTIC VALVE REPLACEMENT
AS SALVAGETHERAPY IN PATIENTS WITH CARDIOGENIC SHOCK-INSIGHTS FROM THE
UNITED STATES NATIONWIDEREADMISSION DATABASE.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 929), 2023. Date of
Publication: 07 Mar 2023.
Author
Zahid S.; Ullah W.; Salman F.; Altibi A.; Rajapreyar I.; Brailovsky Y.;
Fischman D.L.
Institution
(Zahid, Ullah, Salman, Altibi, Rajapreyar, Brailovsky, Fischman) Rochester
General Hospital, Rochester, NY, United States
(Zahid, Ullah, Salman, Altibi, Rajapreyar, Brailovsky, Fischman) Thomas
Jefferson University Hospital, Philadelphia, PA, United States
Publisher
Elsevier Inc.
Abstract
Background Data on the outcomes of transcatheter aortic valve replacement
(TAVR) for patients with severe aortic stenosis and cardiogenic shock (CS)
remains scarce. Methods The Nationwide Readmission Database from 2015 to
2019 was utilized to identify patients with CS and aortic valve disease
who did or did not undergo TAVR. A propensity score matched (PSM) analysis
was used to obtain adjusted pooled estimates. Results A total of 39,038
patients were included, of these, 8.1% underwent TAVR and 91.9% did not
undergo TAVR. Patients undergoing TAVR (79 years, IQR 72-85) were
significantly older than those without TAVR (75 years, IQR 66-83). The
frequency of congestive heart failure (91.2% vs. 76.5%, p=0.01), chronic
kidney disease (49.3% vs. 43.5%, p=0.01), and use of mechanical
circulatory support devices (21.2% vs. 14%, p=0.01) were significantly
higher in TAVR compared with the non-TAVR group, respectively. On PSM
comparison the rate of in-hospital all-cause mortality was significantly
higher in non-TAVR vs. TAVR group. The 30-day survival rate was lower
(38.7% vs. 21.6%, p=0.01), while the 30-day all-cause readmission rate was
higher (20.2% vs 13.5%) in non-TAVR compared with TAVR group,
respectively. The mean length of stay and costs of hospitalization on
index hospitalization were significantly higher in the TAVR vs. non-TAVR
group. Conclusion TAVR in patients with CS is associated with
significantly lower 30 day readmission, in-hospital and 30-day mortality
as compared with the non-TAVR group. [Formula presented]<br/>Copyright
&#xa9; 2023 American College of Cardiology Foundation

<130>
Accession Number
2023035783
Title
Comparison of Dacron Band versus Segmental Annuloplastyin Treatment of
Tricuspid Valve Repair.
Source
Pakistan Journal of Medical and Health Sciences. 17(1) (pp 235-237), 2023.
Date of Publication: January 2023.
Author
Hassan A.; Gul S.; Riaz W.; Aziz S.; Ali B.; Ejaz F.
Institution
(Hassan, Gul, Riaz, Aziz, Ali, Ejaz) Cardiac Surgery, Punjab Institute of
Cardiology, Lahore, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Objective: The objective of this study was to compare outcome of Dacron
Band versus Segmental Annuloplasty in treatment of TV repair. <br/>Study
Design: This was a randomized controlled trial. Place and Duration: This
study was conducted at the Cardiac surgery Department, PIC, Jail Road,
Lahore from 25 October 2021 to 25 Oct, 2022. Methodology:A total of 148
patients were enrolled in this study and divided into two groups equally.
For categorical data like gender, and grades of Tricuspid regurgitation,
frequency and percentages was used. For quantitative data mean +/- S.D was
computed. P-value <= 0.05 was taken as significant. <br/>Result(s): The
mean age of the cases in Group-A was 47.97 +/- 8.29 and in Group-B was
51.01 +/- 7.78. In our study post-operative RVEDD and TVPG found
significant with p-value 0.044 and <0.01 respectively. Similarly, the
p-value of follow-up RVSTDI and RVEDD was statistically significant with
p-value 0.03 and 0.007 respectively. <br/>Conclusion(s): Both Dacron band
and segmental annuloplasty techniques are available for TV repair;
however, dacron band placement in TV repair patients is associated with
better RV remodelling, and as a result, a more likely improvement in right
ventricular function and a better repair outcome are predicted. After
tricuspid valve surgery, dacron band implantation is correlated with a
lower incidence of TR recurrence and enhanced long-term event-free
survival. As a result, this method in tricuspid valve surgery should be
used more frequently.<br/>Copyright &#xa9; 2023 Lahore Medical And Dental
College. All rights reserved.

<131>
Accession Number
2022850101
Title
Genome-wide association study reveals novel genetic loci: A new polygenic
risk score for mitral valve prolapse.
Source
European Heart Journal. 43(17) (pp 1668-1680), 2022. Date of Publication:
01 May 2022.
Author
Roselli C.; Yu M.; Nauffal V.; Georges A.; Yang Q.; Love K.; Weng L.C.;
Delling F.N.; Maurya S.R.; Schrolkamp M.; Tfelt-Hansen J.; Hagege A.;
Jeunemaitre X.; Debette S.; Amouyel P.; Guan W.; Muehlschlegel J.D.; Body
S.C.; Shah S.; Samad Z.; Kyryachenko S.; Haynes C.; Rienstra M.; Le
Tourneau T.; Probst V.; Roussel R.; Wijdh-Den Hamer I.J.; Siland J.E.;
Knowlton K.U.; Jacques Schott J.; Levine R.A.; Benjamin E.J.; Vasan R.S.;
Horne B.D.; Muhlestein J.B.; Benfari G.; Enriquez-Sarano M.; Natale A.;
Mohanty S.; Trivedi C.; Shoemaker M.B.; Yoneda Z.T.; Wells Q.S.; Baker
M.T.; Farber-Eger E.; Michelena H.I.; Lundby A.; Norris R.A.; Slaugenhaupt
S.A.; Dina C.; Lubitz S.A.; Bouatia-Naji N.; Ellinor P.T.; Milan D.J.
Institution
(Roselli, Nauffal, Weng, Guan, Lubitz, Ellinor) Cardiovascular Disease
Initiative, The Broad Institute of MIT and Harvard, Cambridge, MA 02142,
United States
(Roselli, Rienstra, Siland) Department of Cardiology, University of
Groningen, University Medical Center Groningen, Groningen, Netherlands
(Yu, Georges, Hagege, Jeunemaitre, Kyryachenko, Bouatia-Naji) Universite
de Paris, PARCC, Inserm, Paris F-75015, France
(Nauffal) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Boston, MA, United States
(Yang, Vasan) School of Public Health, Boston University, Boston, MA,
United States
(Love, Weng, Guan, Lubitz, Ellinor, Milan) Cardiovascular Research Center,
Massachusetts General Hospital, Boston, MA, United States
(Delling) Division of Cardiology, University of California San Francisco,
San Francisco, CA, United States
(Maurya, Schrolkamp, Lundby) Department of Biomedical Sciences, Faculty of
Health and Medical Sciences, University of Copenhagen, Kobenhavn 2200,
Denmark
(Tfelt-Hansen) Department of Cardiology, The Heart Centre, Rigshospitalet,
Copenhagen University Hospital, Copenhagen, Denmark
(Tfelt-Hansen) Department of Forensic Medicine, Faculty of Medical
Sciences, University of Copenhagen, Copenhagen, Denmark
(Hagege, Jeunemaitre) Assistance Publique-Hopitaux de Paris, Departments
of Cardiology and Genetics, Hopital EuropEen Georges Pompidou, Paris
75015, France
(Debette) Bordeaux Population Health Research Center, Inserm Center U1219,
University of Bordeaux, Bordeaux, France
(Debette) Department of Neurology, Bordeaux University Hospital, Inserm
U1219, Bordeaux, France
(Amouyel) Univ. Lille, Inserm, Centre Hosp. Univ Lille, Institut Pasteur
de Lille, UMR1167-RID-AGE-Risk Factors and Molecular Determinants of
Aging-related Diseases, Lille F-59000, France
(Guan, Lubitz, Ellinor) Center for Cardiac Arrhythmias, Massachusetts
General Hospital, Boston, MA, United States
(Muehlschlegel) Department of Anesthesiology, Perioperative and Pain
Medicine, Brigham and Women's Hospital, Boston, MA, United States
(Body) Department of Anesthesiology, Boston University School of Medicine,
Boston, MA, United States
(Shah, Haynes) Duke Molecular Physiology Institute, Duke University,
Durham, NC, United States
(Shah, Samad) Division of Cardiology, Department of Medicine, Duke
University School of Medicine, Durham, NC, United States
(Samad) Department of Medicine, Aga Khan University, Karachi, Pakistan
(Le Tourneau, Probst, Jacques Schott, Dina) L'Institut du Thorax, INSERM,
CNRS, Univ Nantes, CHU Nantes, Nantes, France
(Le Tourneau) L institut du Thorax, CHU Nantes, Nantes, France
(Roussel) Cordeliers Research Centre, ImMeDiab Team, INSERM, UniversitE de
Paris, Paris, France
(Roussel) Hopital Bichat-Claude-Bernard, APHP, Department of Diabetology,
Paris, France
(Wijdh-Den Hamer) Department of Cardiothoracic Surgery, University of
Groningen, University Medical Center Groningen, Groningen, Netherlands
(Knowlton, Horne, Muhlestein) Intermountain Medical Center Heart
Institute, Salt Lake City, UT, United States
(Knowlton) Division of Cardiovascular Medicine, Department of Medicine,
University of California San Diego, San Diego, CA, United States
(Levine) Cardiac Ultrasound Laboratory, Harvard Medical School,
Massachusetts General Hospital, Boston, MA, United States
(Benjamin, Vasan) National Heart, Lung, and Blood Institute's and Boston
University's, The Framingham Heart Study, Framingham, MA, United States
(Benjamin) Section of Cardiovascular Medicine, Boston University School of
Medicine, Boston, MA, United States
(Benjamin) Department of Epidemiology, Boston University School of Public
Health, Boston, MA, United States
(Vasan) School of Medicine, Boston University, Boston, MA, United States
(Horne) Division of Cardiovascular Medicine, Department of Medicine,
Stanford University, Stanford, CA, United States
(Muhlestein) Cardiology Division, Department of Internal Medicine,
University of Utah, Salt Lake City, UT, United States
(Benfari, Enriquez-Sarano, Michelena) Department of Cardiovascular
Medicine, Mayo Clinic, Rochester, MN, United States
(Natale, Mohanty, Trivedi) Texas Cardiac Arrhythmia Institute, St David's
Medical Center, Austin, TX, United States
(Shoemaker, Yoneda, Wells, Baker, Farber-Eger) Department of Medicine,
Division of Cardiovascular Diseases, Vanderbilt University Medical Center,
Nashville, TN, United States
(Wells) Department of Pharmacology, Vanderbilt University Medical Center,
Nashville, TN, United States
(Wells) Department of Biomedical Informatics, Vanderbilt University
Medical Center, Nashville, TN, United States
(Lundby) The Novo Nordisk Foundation Center for Protein Research, Faculty
of Health and Medical Sciences, University of Copenhagen, Kobenhavn 2200,
Denmark
(Norris) Cardiovascular Developmental Biology Center, Department of
Regenerative Medicine and Cell Biology, Medical University of South
Carolina, Charleston, SC, United States
(Slaugenhaupt) Center for Genomic Medicine, Department of Neurology,
Massachusetts General Hospital Research Institute, Harvard Medical School,
Boston, MA, United States
(Milan) Leducq Foundation, Boston, MA 02110, United States
Publisher
Oxford University Press
Abstract
Aims: Mitral valve prolapse (MVP) is a common valvular heart disease with
a prevalence of >2% in the general adult population. Despite this high
incidence, there is a limited understanding of the molecular mechanism of
this disease, and no medical therapy is available for this disease. We
aimed to elucidate the genetic basis of MVP in order to better understand
this complex disorder. <br/>Methods and Results: We performed a
meta-Analysis of six genome-wide association studies that included 4884
cases and 434 649 controls. We identified 14 loci associated with MVP in
our primary analysis and 2 additional loci associated with a subset of the
samples that additionally underwent mitral valve surgery. Integration of
epigenetic, transcriptional, and proteomic data identified candidate MVP
genes including LMCD1, SPTBN1, LTBP2, TGFB2, NMB, and ALPK3. We created a
polygenic risk score (PRS) for MVP and showed an improved MVP risk
prediction beyond age, sex, and clinical risk factors. <br/>Conclusion(s):
We identified 14 genetic loci that are associated with MVP. Multiple
analyses identified candidate genes including two transforming growth
factor-beta signalling molecules and spectrin beta. We present the first
PRS for MVP that could eventually aid risk stratification of patients for
MVP screening in a clinical setting. These findings advance our
understanding of this common valvular heart disease and may reveal novel
therapeutic targets for intervention.<br/>Copyright &#xa9; 2022 The
Author(s).

<132>
Accession Number
640428203
Title
Application of topical pharyngeal anesthesia to reduce adverse reactions
during painless gastroscopy: A prospective randomized study.
Source
Technology and health care : official journal of the European Society for
Engineering and Medicine. (no pagination), 2023. Date of Publication: 16
Feb 2023.
Author
Sun H.; Lin X.; Liu Y.; Hu S.; Song C.; Yu Y.
Publisher
NLM (Medline)
Abstract
BACKGROUND: Studies have reported that certain adverse reactions can occur
during painless gastroscopy examination. Knowing how to decrease the risks
and incidence of adverse reactions is of great importance.
<br/>OBJECTIVE(S): To investigate whether topical pharyngeal anesthesia
combined with intravenous anesthesia is superior to intravenous anesthesia
alone in patients undergoing painless gastroscopy and to determine whether
this combined approach had any additional benefits. <br/>METHOD(S): Three
hundred patients undergoing painless gastroscopy were randomly assigned to
either the control group or the experimental group. In the control group,
patients were anesthetized with propofol, while patients in the
experimental group received propofol combined with 2% lidocaine spray for
topical pharyngeal anesthesia. Hemodynamic parameters before and after the
procedure, including the heart rate (HR), mean arterial pressure (MAP),
and pulse oxygen saturation (SPO2) were recorded. Any adverse reactions
experienced by the patient, including choking and respiratory depression,
and the total dosage of propofol required during each procedure were also
documented. <br/>RESULT(S): Compared with pre-anesthetic data, the HR,
MAP, and SPO2 were reduced after the completion of the painless
gastroscopy procedure in both groups. However, the HR, MAP, and SPO2
measurements taken after the gastroscopy were significantly lower in the
control group than those of the experimental group (P< 0.05); thus, the
hemodynamic parameters of the experimental group were more stable.
Compared with the control group, there was significant reduction in the
total amount of propofol administered in the experimental group (P< 0.05).
The incidence of adverse reactions, including choking and respiratory
depression, was significantly lower in the experimental group (P< 0.05).
<br/>CONCLUSION(S): The results demonstrated that the application of
topical pharyngeal anesthesia in painless gastroscopy can significantly
reduce the incidence of adverse reactions. Thus, the combination of
topical pharyngeal and intravenous anesthesia is worthy of clinical
application and promotion.

<133>
Accession Number
640426168
Title
Impact of storage time prior to cryopreservation on mechanical properties
of aortic homografts.
Source
Cell and tissue banking. (no pagination), 2023. Date of Publication: 27
Feb 2023.
Author
Axelsson I.; Gustafsson A.; Isaksson H.; Nilsson J.; Malm T.
Institution
(Axelsson, Malm) Tissue Bank Lund, Lund 22242, Sweden
(Axelsson, Nilsson) Department of Cardiothoracic Surgery, Skane University
Hospital, Lund, Sweden
(Axelsson, Nilsson, Malm) Department of Clinical Science, Cardiothoracic
Surgery, Lund University, Lund, Sweden
(Gustafsson, Isaksson) Department of Biomedical Engineering, Lund
University, Lund, Sweden
(Nilsson) Department of Translational Medicine, Artificial Intelligence
and Bioinformatics in Cardiothoracic Sciences, Lund University, Lund,
Sweden
(Malm) Pediatric Cardiac Surgery Unit, Children's Hospital, Skane
University Hospital, Lund, Sweden
Publisher
NLM (Medline)
Abstract
Optimal time spans in homograft procurement are still debatable among
tissue banks and needs to be further investigated. Cell viability
decreases at longer preparation intervals, but the effect on collagen and
elastic fibers has not been investigated to the same extent. These fibers
are of importance to the homograft elasticity and strength. The objective
of this study was to analyze the mechanical properties of homograft tissue
at different time spans in the procurement process. Ten aortic homografts
were collected at the Tissue Bank in Lund. Twelve samples were obtained
from each homograft, cryopreserved in groups of three after 2-4 days, 7-9
days, 28-30 days, and 60-62 days in antibiotic decontamination. Mechanical
testing was performed with uniaxial tensile tests, calculating elastic
modulus, yield stress and energy at yield stress. Two randomly selected
samples were assessed with light microscopy. Procurement generated a total
of 120 samples, with 30 samples in each time group. Elastic modulus and
yield stress was significantly higher in samples cryopreserved after 2-4
days (2.7 MPa (2.5-5.0) and 0.78 MPa (0.68-1.0)) compared to 7-9 days (2.2
MPa (2.0-2.6) and 0.53 MPa (0.46-0.69)), p=0.008 and 0.011 respectively.
Light microscopy did not show any difference in collagen and elastin at
different time spans. There was a significant decrease in elastic modulus
and yield stress after 7 days of decontamination at 4 degreeC compared to
2-4 days. This could indicate some deterioration of elastin and collagen
at longer decontamination intervals. Clinical significance of these
findings remains to be clarified.<br/>Copyright &#xa9; 2023. The
Author(s).

<134>
Accession Number
640435956
Title
The Rise and Fall of Antithrombin Supplementation in Cardiac Surgery.
Source
Anesthesia and analgesia. (no pagination), 2022. Date of Publication: 06
Dec 2022.
Author
Ranucci M.; Baryshnikova E.; Pistuddi V.; Di Dedda U.
Institution
(Ranucci) From the Department of Cardiothoracic and Vascular Anesthesia
and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
Publisher
NLM (Medline)
Abstract
Various cohort studies, both retrospective and prospective, showed that
low antithrombin levels after cardiac surgery (at the arrival in the
intensive care unit and during the next days) were associated with a
number of adverse outcomes, including surgical reexploration and
thromboembolic events, eventually leading to prolonged stay in the
intensive care. Values lower than 58% to 64% of antithrombin activity were
indicative of this higher morbidity with good sensitivity and specificity.
The scenario generated the hypothesis that low antithrombin levels needed
to be corrected by supplementation to improve postoperative outcome.
However, randomized controlled studies run to test this idea failed to
demonstrate any benefit of antithrombin supplementation, showing no
effects on outcome, neither as preemptive preoperative strategy nor for
treating postoperative low antithrombin values. In addition, randomized
trials highlighted that those patients who received antithrombin
experienced significantly higher incidence of acute kidney injury with a
pooled odds ratio of 4.41 (95% CI, 1.90-10.23; P = .001). A strongly
decreased thrombin activity after antithrombin correction may eventually
affect the efficiency of the glomerular filtration and cause the
deterioration of kidney function, but underlying biological mechanisms
remain unclear. In conclusion, low levels of antithrombin activity after
cardiac surgery should be considered as a marker of greater severity of
the patient's conditions and/or of the complexity of the surgical
procedure. There are no indications for antithrombin supplementation in
cardiac surgery unless for correcting heparin resistance.<br/>Copyright
&#xa9; 2022 International Anesthesia Research Society.