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

<2>
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. 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. 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. 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. Copyright ©
2022

<3>
Accession Number
2016000668
Title
Aquatic vs. land-based exercise after arthroscopic partial meniscectomy in
middle-aged active patients with a degenerative meniscal tear: A
randomized, controlled study.
Source
Journal of Orthopaedic Science. 28(2) (pp 391-397), 2023. Date of
Publication: March 2023.
Author
Yesil M.; Ozcan O.; Dundar U.; Toktas H.; Yesil H.
Institution
(Yesil, Ozcan) Department of Orthopaedics and Traumatology, Afyonkarahisar
Health Sciences University, Afyonkarahisar, Turkey
(Dundar, Toktas, Yesil) Department of Physical Medicine and
Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar,
Turkey
Publisher
Elsevier B.V.
Abstract
Background: Awareness of the value of aquatic exercise (AE) in the
postoperative rehabilitation has increased, and several inherent
advantages of AE, such as adjustment of both resistance and muscle
strengthening parameters makes good rationale for its inclusion in
postoperative rehabilitation. This study aimed to determine and compare
the benefits of AE and land-based exercise (LBE) on pain, functionality,
and quality of life after arthroscopic partial meniscectomy (APM).
 Method(s): This randomized controlled study included 30 middle-aged
(35-50), physically active patients who were randomized into LBE (n = 15)
and AE (n = 15) groups after APM for a degenerative meniscal tear. Visual
analogue scale (VAS), Short Form-36 (SF-36), single-leg hop test and
Lysholm questionnaire scores in addition to isokinetic muscle strength
values were evaluated at baseline, at fourth week immediately after
cessation of exercise program and at eighth week follow-up visits. The
exercise sessions were conducted in 1-h sessions per day, three days a
week for a total of four weeks. Result(s): Significant improvement
was observed in the VAS, single-leg hop test, Lysholm questionnaire, and
most of SF-36 subscale scores in both groups at both fourth and eighth
follow-ups. Isokinetic dynamometer revealed significant improvement in the
peak torque values for extension at angular velocities of 60degree and
180degree at both follow-ups in the AE group. LBE group showed significant
improvement in the peak torque value for extension only at an angular
velocity of 60degree only at fourth week follow-up. There was no
significant difference between groups for any of these parameters at any
of the follow-ups. Conclusion(s): Both AE and LBE programs had
significantly improved pain, function, isokinetic muscle strength, and
quality of life in patients after APM. Either type of exercise is
essential as part of the rehabilitation protocol for good clinical
outcomes after APM and should not be neglected (level II). ClinicalTrials
registration number: NCT04925726. Copyright © 2021 The Japanese
Orthopaedic Association

<4>
Accession Number
2021196987
Title
Enoxaparin for outpatients with COVID-19: 90-day results from the
randomised, open-label, parallel-group, multinational, phase III OVID
trial.
Source
Thrombosis Research. 221 (pp 157-163), 2023. Date of Publication: January
2023.
Author
Voci D.; Gotschi A.; Held U.; Bingisser R.; Colucci G.; Duerschmied D.;
Fumagalli R.M.; Gerber B.; Hasse B.; Keller D.I.; Konstantinides S.V.;
Mach F.; Rampini S.K.; Righini M.; Robert-Ebadi H.; Rosemann T.;
Roth-Zetzsche S.; Sebastian T.; Simon N.R.; Spirk D.; Stortecky S.;
Vaisnora L.; Kucher N.; Barco S.
Institution
(Voci, Fumagalli, Roth-Zetzsche, Sebastian, Kucher, Barco) Department of
Angiology, University Hospital Zurich, Zurich, Switzerland
(Gotschi, Held) Department of Biostatistics at Epidemiology, Biostatistics
and Prevention Institute, University of Zurich, Zurich, Switzerland
(Bingisser, Simon) Emergency Department, University Hospital Basel, Basel,
Switzerland
(Colucci) Service of Hematology, Clinica Luganese Moncucco, Lugano,
Switzerland
(Colucci) University of Basel, Basel, Switzerland
(Colucci) Clinica Sant'Anna, Sorengo, Switzerland
(Duerschmied) Department of Cardiology, Angiology, Haemostaseology and
Medical Intensive Care, University Medical Centre Mannheim, Medical
Faculty Mannheim, Heidelberg University, Germany
(Duerschmied) European Center for AngioScience (ECAS) and German Center
for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim,
Mannheim, Germany
(Duerschmied) Department of Cardiology and Angiology I, Heart Center
Freiburg University, Faculty of Medicine, University of Freiburg,
Freiburg, Germany
(Gerber) Clinic of Hematology, Oncology Institute of Southern Switzerland,
Ente Ospedaliero Cantonale, Bellinzona, Switzerland
(Gerber, Hasse, Keller, Kucher) University of Zurich, Zurich, Switzerland
(Hasse) Department of Infectious Diseases and Hospital Epidemiology,
University Hospital Zurich, Switzerland
(Keller) Emergency Department, University Hospital Zurich, Zurich,
Switzerland
(Konstantinides, Barco) Center for Thrombosis and Hemostasis, University
Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
(Konstantinides) Department of Cardiology, Democritus University of
Thrace, Komotini, Greece
(Mach) Cardiology Division, Geneva University Hospital, Geneva,
Switzerland
(Rampini) Division of Internal Medicine, University Hospital Zurich,
Zurich, Switzerland
(Righini, Robert-Ebadi) Division of Angiology and Hemostasis, Department
of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva,
Switzerland
(Rosemann) Institute of Primary Care, University of Zurich, Zurich,
Switzerland
(Spirk) Institute of Pharmacology, University of Bern, Bern, Switzerland
(Stortecky, Vaisnora) Department of Cardiology, Inselspital Bern,
University of Bern, Bern, Switzerland
Publisher
Elsevier Ltd
Abstract
Introduction: The benefits of early thromboprophylaxis in symptomatic
COVID-19 outpatients remain unclear. We present the 90-day results from
the randomised, open-label, parallel-group, investigator-initiated,
multinational OVID phase III trial. Method(s): Outpatients aged 50
years or older with acute symptomatic COVID-19 were randomised to receive
enoxaparin 40 mg for 14 days once daily vs. standard of care (no
thromboprophylaxis). The primary outcome was the composite of untoward
hospitalisation and all-cause death within 30 days from randomisation.
Secondary outcomes included arterial and venous major cardiovascular
events, as well as the primary outcome within 90 days from randomisation.
The study was prematurely terminated based on statistical criteria after
the predefined interim analysis of 30-day data, which has been previously
published. In the present analysis, we present the final, 90-day data from
OVID and we additionally investigate the impact of thromboprophylaxis on
the resolution of symptoms. Result(s): Of the 472 patients included
in the intention-to-treat population, 234 were randomised to receive
enoxaparin and 238 no thromboprophylaxis. The median age was 57 (Q1-Q3:
53-62) years and 217 (46 %) were women. The 90-day primary outcome
occurred in 11 (4.7 %) patients of the enoxaparin arm and in 11 (4.6 %)
controls (adjusted relative risk 1.00; 95 % CI: 0.44-2.25): 3 events per
group occurred after day 30. The 90-day incidence of cardiovascular events
was 0.9 % in the enoxaparin arm vs. 1.7 % in controls (relative risk 0.51;
95 % CI: 0.09-2.75). Individual symptoms improved progressively within 90
days with no difference between groups. At 90 days, 42 (17.9 %) patients
in the enoxaparin arm and 40 (16.8 %) controls had persistent respiratory
symptoms. Conclusion(s): In adult community patients with COVID-19,
early thromboprophylaxis with enoxaparin did not improve the course of
COVID-19 neither in terms of hospitalisation and death nor considering
COVID-19-related symptoms. Copyright © 2022 The Authors

<5>
Accession Number
2021665351
Title
Combination Therapy With Nicardipine and Isosorbide Dinitrate to Prevent
Spasm in Transradial Percutaneous Coronary Intervention (from the NISTRA
Multicenter Double-Blind Randomized Controlled Trial).
Source
American Journal of Cardiology. 188 (pp 89-94), 2023. Date of Publication:
01 Feb 2023.
Author
Bouchahda N.; Ben Abdessalem M.A.; Ben Hlima N.; Ben Messaoud M.; Denguir
H.; Boussaada M.M.; Saoudi W.; Jamel A.; Hassine M.; Bouraoui H.; Mahjoub
M.; Mahdhaoui A.; Jeridi G.; Betbout F.; Gamra H.
Institution
(Bouchahda, Ben Messaoud, Boussaada, Hassine, Mahjoub, Betbout, Gamra)
Cardiology A Department, University of Monastir, Research Laboratory LR12
SP 16 Fattouma Bourguiba University Hospital, Rue du 1er juin, Monastir,
Tunisia
(Ben Abdessalem, Saoudi, Bouraoui, Mahdhaoui, Jeridi) Cardiology
Department, universite de Sousse, Laboratoire de Recherche: interactions
cardiopulmonaires LR14ES05, Farhat Hached University Hospital, Tunisia
(Ben Hlima, Jamel) Cardiology Department, Kairouen Ibn el Jazzar
University Hospital, Universite de Sousse, Tunisia
(Denguir) Cardiology Department, Gabes University Hospital, University of
Monastir, Tunisia
Publisher
Elsevier Inc.
Abstract
Verapamil and nitroglycerin are widely used to prevent radial artery spasm
(RAS) during percutaneous cardiovascular procedures. However, these agents
are not typically available in most African countries and consequently,
isosorbide dinitrate is often the only spasmolytic treatment. Our aim was
to compare the efficacy of isosorbide dinitrate alone versus isosorbide
dinitrate used together with nicardipine to prevent RAS during transradial
coronary procedures. This was a randomized controlled double-blind
multicenter trial. Patients (n = 1,523) were randomized to receive either
a sole therapy of isosorbide dinitrate (n = 760) or the combination of
isosorbide dinitrate and nicardipine (n = 763). Our primary end point was
the occurrence of RAS; defined as considerable perceived hindrance of
catheter advancement. Our secondary end points were severe RAS; defined as
(1) severe arm pain, (2) the need for either morphine or midazolam
treatment, and (3) necessity for crossover to the contralateral radial or
femoral artery. RAS incidence was reduced with the combination therapy
versus isosorbide dinitrate alone (15% vs 25%, p <0.001), with a number
needed to treat of 10 patients. There was also a significant reduction in
the incidence of the secondary end points with combination therapy (3.6%
vs 8.2%, p <0.001), with a number needed to treat of 22 patients. This
result was driven by reductions in both femoral crossover (0.5% vs 2.4%, p
= 0.003) and the use of morphine or midazolam injections (1.6% vs 3.5%, p
= 0.02) with combination therapy. In conclusion, we demonstrated the
superiority of the combination therapy of isosorbide dinitrate and
nicardipine over isosorbide dinitrate alone in reducing the incidence of
RAS. Copyright © 2022 Elsevier Inc.

<6>
Accession Number
2015500472
Title
The effect of peripheral regional analgesia in thoracic surgery: a
systematic review and a meta-analysis of randomized-controlled trials.
Source
Tumori. 109(1) (pp 6-18), 2023. Date of Publication: February 2023.
Author
Balzani E.; Rosboch G.L.; Ceraolo E.; Lyberis P.; Filippini C.; Piccioni
F.; Guerrera F.; Ruffini E.; Pedoto A.; Brazzi L.
Institution
(Balzani, Guerrera, Ruffini, Brazzi) Department of Surgical Science,
University of Turin, Torino, Italy
(Rosboch, Ceraolo, Brazzi) Department of Anesthesia, Intensive Care and
Emergency, 'Citta della Salute e della Scienza di Torino' Hospital,
Torino, Italy
(Lyberis, Guerrera, Ruffini) Department of Cardiovascular and Thoracic
Surgery, 'Citta della Salute e della Scienza di Torino' Hospital, Torino,
Italy
(Filippini) Clinical Statistics, Department of Surgical Sciences,
University of Torino, Corso Bramante 88, Turin, Italy
(Piccioni) General and Specialistic Surgical Department, Anesthesia and
Intensive Care Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
(Pedoto) Clinical Attending Department of Anesthesia and CCM, Memorial
Sloan Kettering Cancer Center, NY, United States
Publisher
SAGE Publications Ltd
Abstract
Background: Several peripheral regional anaesthesia (RA) techniques are
commonly used in thoracic surgery even in the absence of precise
indications regarding their effectiveness on postoperative pain
management. Objective(s): This systematic review and meta-analysis
aims to describe and evaluate the relative effectiveness of different
peripheral regional blocks and systemic analgesia in the context of
video-assisted thoracoscopic surgery (VATS) or thoracotomy.
 Design(s): Systematic review of randomized controlled clinical trials
(RCTs) with meta-analyses. Data sources: We searched PubMed and Embase for
all RCTs comparing the 24 hour morphine equivalents (MMEs) consumption
following peripheral regional blocks and systemic analgesia (SA).
Eligibility criteria: We selected only RCTs including adult participants
undergoing thoracic surgery, including esophagectomy and reporting on
postoperative pain outcomes including 24 hour MMEs consumption.
 Result(s): Among the 28 randomized studies including adult
participants undergoing thoracic surgery and reporting on 24 hour opioid
consumption, 11 reporting a comparison of individual blocks with systemic
analgesia were meta-analyzed. RA was effective for almost all peripheral
blocks. Regarding intercostal block, its antalgic effect was not well
evaluated SMD -1.57 (CI -3.88, 0.73). RA in VATS was more effective in
reducing MMEs than thoracotomy SMD -1.10 (CI -1.78, -0.41).
 Conclusion(s): RA is a useful choice in thoracic surgery. However, it
is still not possible to determine the most appropriate block in the
individual surgical settings to be performed due to RCTs
paucity. Copyright © Fondazione IRCCS Istituto Nazionale dei
Tumori 2022.

<7>
Accession Number
2022026311
Title
The Role of Preservation Solutions upon Saphenous Vein Endothelial
Integrity and Function: Systematic Review and UK Practice Survey.
Source
Cells. 12(5) (no pagination), 2023. Article Number: 815. Date of
Publication: March 2023.
Author
Layton G.R.; Ladak S.S.; Abbasciano R.; McQueen L.W.; George S.J.; Murphy
G.J.; Zakkar M.
Institution
(Layton, Ladak, McQueen, Murphy, Zakkar) Department of Cardiovascular
Sciences, University of Leicester, Leicester LE1 7RH, United Kingdom
(Abbasciano) Department of Cardiac Surgery, Imperial College London,
London SW7 2BX, United Kingdom
(George) Department of Translational Health Sciences, Bristol Medical
School, University of Bristol, Bristol BS2 1UDD, United Kingdom
Publisher
MDPI
Abstract
The long saphenous vein is the most used conduit in cardiac surgery, but
its long-term patency is limited by vein graft disease (VGD). Endothelial
dysfunction is a key driver of VGD; its aetiology is multi-factorial.
However emerging evidence identifies vein conduit harvest technique and
preservation fluids as causal in their onset and propagation. This study
aims to comprehensively review published data on the relationship between
preservation solutions, endothelial cell integrity and function, and VGD
in human saphenous veins harvested for CABG. The review was registered
with PROSPERO (CRD42022358828). Electronic searches of Cochrane Central
Register of Controlled Trials, MEDLINE, and EMBASE databases were
undertaken from inception until August 2022. Papers were evaluated in line
with registered inclusion and exclusion criteria. Searches identified 13
prospective, controlled studies for inclusion in the analysis. All studies
used saline as a control solution. Intervention solutions included
heparinised whole blood and saline, DuraGraft, TiProtec, EuroCollins,
University of Wisconsin (UoW), buffered, cardioplegic and Pyruvate
solutions. Most studies demonstrated that normal saline appears to have
negative effects on venous endothelium and the most effective preservation
solutions identified in this review were TiProtec and DuraGraft. The most
used preservation solutions in the UK are heparinised saline or autologous
whole blood. There is substantial heterogeneity both in practice and
reporting of trials evaluating vein graft preservation solutions, and the
quality of existing evidence is low. There is an unmet need for high
quality trials evaluating the potential for these interventions to improve
long-term patency in venous bypass grafts. Copyright © 2023 by
the authors.

<8>
[Use Link to view the full text]
Accession Number
2022956832
Title
Perioperative Tracking of Intravenous Iron in Patients Undergoing On-Pump
Cardiac Surgery: A Prospective, Single-Center Pilot Trial.
Source
Anesthesia and Analgesia. 136(3) (pp 578-587), 2023. Date of Publication:
01 Mar 2023.
Author
Olivier R.M.R.; Macke M.; Muller J.C.; Schrader L.; Eveslage M.; Rauer M.;
Wempe C.; Martens S.; Zarbock A.; Wagner N.-M.; Karst U.; Dogan D.Y.;
Steinbicker A.U.
Institution
(Olivier, Schrader, Rauer, Wempe, Zarbock, Wagner, Dogan, Steinbicker)
Department of Anaesthesiology, Intensive Care and Pain Medicine,
University Hospital Muenster, University of Muenster, Muenster, Germany
(Macke, Muller, Karst) Institute of Inorganic and Analytical Chemistry,
University of Muenster, Muenster, Germany
(Eveslage) Institute of Biostatistics and Clinical Research, University of
Muenster, Muenster, Germany
(Martens) Department of Thoracic, Heart and Vascular Surgery, University
Hospital Muenster, University of Muenster, Muenster, Germany
(Dogan, Steinbicker) Department of Anaesthesiology, Intensive Care
Medicine and Pain Therapy, University Hospital Frankfurt, Goethe
University, Frankfurt, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Preoperative intravenous iron administration is a frequently
used patient blood management procedure. If the timeframe of intravenous
iron administration before surgery is short, (1) the concentration of the
intravenous iron compound might still be high in patients' plasma when
undergoing surgery and (2) this iron in patients' plasma is at risk to be
lost due to blood loss. The aim of the current study was, therefore, to
track the iron compound ferric carboxymaltose (FCM) before, during, and
after cardiac surgery requiring cardiopulmonary bypass, with an emphasis
on intraoperative iron losses in shed blood and potential recovery through
autologous cell salvage. METHOD(S): Concentrations of FCM were
analyzed in patients' blood using a hyphenation of liquid chromatography
and inductively coupled plasma-mass spectrometry to distinguish between
pharmaceutical compound FCM and serum iron. In this prospective,
single-center pilot trial, 13 anemic and 10 control patients were
included. Anemic patients with hemoglobin levels <=12/13 g/dL in women and
men were treated with 500 milligrams (mg) intravenous FCM 12 to 96 hours
before elective on-pump cardiac surgery. Patients' blood samples were
collected before surgery and at days 0, 1, 3, and 7 after surgery. One
sample each was taken of the cardiopulmonary bypass, the autologous red
blood cell concentrate generated by cell salvage, and the cell salvage
disposal bag. RESULT(S): Patients who had received FCM <48 hours
before surgery had higher FCM serum levels (median [Q1-Q3], 52.9
[13.0-91.6]) compared to >=48 hours (2.1 [0.7-5.1] microg/mL, P =.008). Of
500-mg FCM administered <48 hours, 327.37 (257.96-402.48) mg were
incorporated compared to administration >=48 hours with 493.60
(487.78-496.70) mg. After surgery, patients' plasma FCM concentration in
the FCM <48 hours group was decreased (-27.1 [-30 to -5.9] microg/mL).
Little FCM was found in the cell salvage disposal bag (<48 hours, 4.2
[3.0-25.8] microg/mL, equivalent to 29.0 [19.0-40.7] mg total; equivalent
to 5.8% or 1/17th of the 500 mg FCM initially administered), almost none
in the autologous red blood cell concentrate (<48 hours, 0.1 [0.0-0.43]
microg/mL). CONCLUSION(S): The data generate the hypotheses that
nearly all FCM is incorporated into iron stores with administration >=48
hours before surgery. When FCM is given <48 hours of surgery, the majority
is incorporated into iron stores by the time of surgery, although a small
amount may be lost during surgical bleeding with limited recovery by cell
salvage. Copyright © 2023 Authors. All rights reserved.

<9>
Accession Number
2023105569
Title
Efficacy and safety of transcutaneous electrical acupoints stimulation for
preoperative anxiety in thoracoscopic surgery: study protocol for a
randomised controlled trial.
Source
BMJ Open. 13(2) (no pagination), 2023. Article Number: e067082. Date of
Publication: 16 Feb 2023.
Author
Wu X.; Chen T.; Wang K.; Wei X.; Feng J.; Zhou J.
Institution
(Wu) Yueyang Hospital of Integrated Traditional Chinese and Western
Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai,
China
(Wu, Chen, Feng, Zhou) Cardiothoracic Surgery Department, Yueyang Hospital
of Integrated Traditional Chinese, Western Medicine Affiliated to Shanghai
University of Traditional Chinese Medicine, Shanghai, China
(Wang, Wei) Clinical Research Institute of Acupuncture and Anaesthetic,
Yueyang Hospital of Integrated Traditional Chinese, Western Medicine
Affiliated to Shanghai University of Traditional Chinese Medicine,
Shanghai, China
Publisher
BMJ Publishing Group
Abstract
Introduction Preoperative anxiety occurs at a very high rate in patients
undergoing video-assisted thoracoscopic surgery (VATS). Moreover, it will
result in poor mental state, more analgesic consumptions, rehabilitation
delay and extra hospitalisation costs. Transcutaneous electrical acupoints
stimulation (TEAS) is a convenient intervention for pain control and
anxiety reduction. Nevertheless, TEAS efficacy of preoperative anxiety in
VATS is unknown. Methods and analysis This single-centre randomised
sham-controlled trial will be conducted in cardiothoracic surgery
department of the Yueyang Hospital of Integrated Traditional Chinese and
Western Medicine in China. A total of 92 eligible participants with
pulmonary nodules (size >=8 mm) who are arranged for VATS will be randomly
assigned to a TEAS group and a sham TEAS (STEAS) group in a 1:1 ratio.
Daily TEAS/STEAS intervention will be administered starting on 3 days
before the VATS and continued once per day for three consecutive days. The
primary outcome will be the generalised anxiety disorder scale score
change between the day before surgery with the baseline. The secondary
outcomes will include serum concentrations of 5-hydroxytryptamine,
norepinephrine and gamma-aminobutyric acid, intraoperative anaesthetic
consumption, time to postoperative chest tube removal, postoperative pain,
and length of postoperative hospital stay. The adverse events will be
recorded for safety evaluation. All data in this trial will be analysed by
the SPSS V.21.0 statistical software package. Ethics and dissemination
Ethics approval was obtained from the Ethics Committee of the Yueyang
Hospital of Integrated Traditional Chinese and Western Medicine affiliated
to Shanghai University of Traditional Chinese Medicine (approval number:
2021-023). The results of this study will be distributed through
peer-reviewed journals. Trial registration number
NCT04895852. Copyright © 2023 BMJ Publishing Group. All rights
reserved.

<10>
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.
 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. 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.
 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. Copyright © 2023 Elsevier Inc.

<11>
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.
 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.
 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 Copyright © 2023 Elsevier Inc.

<12>
Accession Number
2020808315
Title
Cardiac Autonomic Neuropathy in Type 1 and 2 Diabetes: Epidemiology,
Pathophysiology, and Management.
Source
Clinical Therapeutics. 44(10) (pp 1394-1416), 2022. Date of Publication:
October 2022.
Author
Williams S.; Raheim S.A.; Khan M.I.; Rubab U.; Kanagala P.; Zhao S.S.;
Marshall A.; Brown E.; Alam U.
Institution
(Williams, Raheim, Khan, Rubab, Kanagala, Brown, Alam) Department of
Medicine, Aintree University Hospital, Liverpool University Hospitals NHS
Foundation Trust, Liverpool, United Kingdom
(Kanagala, Zhao, Marshall, Brown, Alam) Department of Eye & Vision
Sciences, Institute of Life Course and Medical Sciences, University of
Liverpool, Liverpool, United Kingdom
(Zhao) Centre for Epidemiology Versus Arthritis, Division of
Musculoskeletal and Dermatological Sciences, School of Biological
Sciences, Faculty of Biology Medicine and Health, Manchester Academic
Health Science Centre, University of Manchester, Manchester, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Purpose: Cardiac autonomic neuropathy (CAN) is a serious complication of
type 1 and type 2 diabetes and is independently associated with major
cardiovascular events, morbidity, and mortality. This narrative review
examines the epidemiology, pathophysiology, and management and identifies
areas of future research to address the challenge posed by CAN.
 Method(s): We conducted a comprehensive literature search using a
range of sources, including the electronic databases PubMed Central,
Google Scholar, OVID, and Open Athens, to search for studies on CAN,
diabetes mellitus, lifestyle intervention, and cardiovascular risk. We set
inclusion criteria to consider review articles or original research
published in peer-reviewed journals that examined CAN in diabetes.
 Finding(s): Epidemiologic data indicate a varied prevalence of CAN in
type 1 and 2 diabetes, with prevalences of 17% to 73%) depending on
clinical and demographic factors. Indeed, duration of diabetes and
hyperglycemia are the strongest risk factors for CAN development in type 1
diabetes. However, in type 2 diabetes, multifactorial risk factors,
including obesity, hypertension, and hyperlipidemia, are associated with
the development of CAN. Insulin resistance, which underpins type 2
diabetes and metabolic syndrome, has a direct role in the pathogenesis of
CAN. Lifestyle interventions, including dietary measures and tailored
exercise programs, have been beneficial in improving cardiac autonomic
function primarily measured through heart rate variability. In addition,
weight loss through bariatric surgery also improves heart rate variability
and may prevent or reduce CAN progression in people living with obesity
and concomitant type 2 diabetes. For optimization in type 2 diabetes, both
lifestyle and targeted pharmacologic interventions are required to achieve
glycemic/metabolic targets, and weight loss is required to prevent or
reverse early CAN or prevent the progression to definite and severe CAN.
Implications: The focused use of diagnostic testing for CAN, including
cardiac autonomic reflex testing in those at high risk of CAN, will enable
earlier diagnosis. This testing will allow timely interventions at a
reversible stage. Future research should examine targeted early diagnostic
testing with subsequent intervention with a combination of lifestyle
measures and newer pharmacotherapeutics (eg, sodium-glucose cotransporter
2 inhibitors and glucagon-like peptide 1 receptor agonists), which have
produced significant cardiovascular benefit in diabetes. Copyright
© 2022

<13>
Accession Number
639192438
Title
Complete Revascularization vs Culprit Lesion-Only Percutaneous Coronary
Intervention for Angina-Related Quality of Life in Patients with
ST-Segment Elevation Myocardial Infarction: Results from the COMPLETE
Randomized Clinical Trial.
Source
JAMA Cardiology. 7(11) (pp 1091-1099), 2022. Date of Publication: 09 Nov
2022.
Author
Mehta S.R.; Wang J.; Wood D.A.; Spertus J.A.; Cohen D.J.; Mehran R.;
Storey R.F.; Steg P.G.; Pinilla-Echeverri N.; Sheth T.; Bainey K.R.;
Bangalore S.; Cantor W.J.; Faxon D.P.; Feldman L.J.; Jolly S.S.; Kunadian
V.; Lavi S.; Lopez-Sendon J.; Madan M.; Moreno R.; Rao S.V.; Rodes-Cabau
J.; Stankovic G.; Bangdiwala S.I.; Cairns J.A.
Institution
(Mehta, Wang, Pinilla-Echeverri, Sheth, Jolly, Bangdiwala) Population
Health Research Institute, McMaster University, Hamilton Health Sciences,
Hamilton, ON, Canada
(Wood, Cairns) University of British Columbia, Vancouver, BC, Canada
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri-Kansas City, Kansas City, United States
(Cohen) Cardiovascular Research Foundation, New York, NY, United States
(Cohen) St Francis Hospital, Roslyn, NY, United States
(Mehran) The Zena A. Wiener Cardiovascular Institute, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Storey) Department of Infection, Immunity and Cardiovascular Disease,
University of Sheffield, Sheffield, United Kingdom
(Steg, Feldman) Universite Paris Cite, INSERM U-1148, Hopital Bichat,
Assistance Publique-Hopitaux de Paris, Paris, France
(Bainey) University of Alberta, Mazankowski Alberta Heart Institute,
Edmonton, AB, Canada
(Bangalore) New York University Grossman School of Medicine, New York,
United States
(Cantor) Southlake Regional Health Centre, University of Toronto, Toronto,
ON, Canada
(Faxon) Brigham and Women's Hospital, Harvard Medical School, Boston, MA,
United States
(Kunadian) Translational and Clinical Research Institute, Faculty of
Medical Sciences, Newcastle University, Cardiothoracic Centre, Freeman
Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle
upon Tyne, United Kingdom
(Lavi) Western University, London Health Sciences Centre, London, ON,
Canada
(Lopez-Sendon, Moreno) Hospital Universitario la Paz, UAM, IdiPaz Research
Institute, Madrid, Spain
(Madan) Sunnybrook Health Sciences Centre, University of Toronto, Toronto,
ON, Canada
(Rao) NYU Langone Health System, New York, United States
(Rodes-Cabau) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Quebec City, QC, Canada
(Stankovic) Serbia to Faculty of Medicine, University of Belgrade,
Belgrade, Serbia
(Steg, Feldman) FACT (French Alliance for Cardiovascular Trials), Paris,
France
Publisher
American Medical Association
Abstract
Importance: In patients with multivessel coronary artery disease (CAD)
presenting with ST-segment elevation myocardial infarction (STEMI),
complete revascularization reduces major cardiovascular events compared
with culprit lesion-only percutaneous coronary intervention (PCI). Whether
complete revascularization also improves angina-related health status is
unknown. Objective(s): To determine whether complete
revascularization improves angina status in patients with STEMI and
multivessel CAD. Design, Setting, and Participant(s): This secondary
analysis of a randomized, multinational, open label trial of
patient-reported outcomes took place in 140 primary PCI centers in 31
countries. Patients presenting with STEMI and multivessel CAD were
randomized between February 1, 2013, and March 6, 2017. Analysis took
place between July 2021 and December 2021. Intervention(s): Following
PCI of the culprit lesion, patients with STEMI and multivessel CAD were
randomized to receive either complete revascularization with additional
PCI of angiographically significant nonculprit lesions or to no further
revascularization. Main Outcomes and Measures: Seattle Angina
Questionnaire Angina Frequency (SAQ-AF) score (range, 0 [daily angina] to
100 [no angina]) and the proportion of angina-free individuals by study
end. Result(s): Of 4041 patients, 2016 were randomized to complete
revascularization and 2025 to culprit lesion-only PCI. The mean (SD) age
of patients was 62 (10.7) years, and 3225 (80%) were male. The mean (SD)
SAQ-AF score increased from 87.1 (17.8) points at baseline to 97.1 (9.7)
points at a median follow-up of 3 years in the complete revascularization
group (score change, 9.9 [95% CI, 9.0-10.8]; P <.001) compared with an
increase of 87.2 (18.4) to 96.3 (10.9) points (score change, 8.9 [95% CI,
8.0-9.8]; P <.001) in the culprit lesion-only group (between-group
difference, 0.97 points [95% CI, 0.27-1.67]; P =.006). Overall, 1457
patients (87.5%) were free of angina (SAQ-AF score, 100) in the complete
revascularization group compared with 1376 patients (84.3%) in the culprit
lesion-only group (absolute difference, 3.2% [95% CI, 0.7%-5.7%]; P =.01).
This benefit was observed mainly in patients with nonculprit lesion
stenosis severity of 80% or more (absolute difference, 4.7%; interaction P
=.02). Conclusions and Relevance: In patients with STEMI and
multivessel CAD, complete revascularization resulted in a slightly greater
proportion of patients being angina-free compared with a culprit
lesion-only strategy. This modest incremental improvement in health status
is in addition to the established benefit of complete revascularization in
reducing cardiovascular events. Copyright © 2022 American Medical
Association. All rights reserved.

<14>
[Use Link to view the full text]
Accession Number
2021323009
Title
Benefits of Icosapent Ethyl Across the Range of Kidney Function in
Patients With Established Cardiovascular Disease or Diabetes: REDUCE-IT
RENAL.
Source
Circulation. 144(22) (pp 1750-1759), 2021. Date of Publication: 30 Nov
2021.
Author
Majithia A.; Bhatt D.L.; Friedman A.N.; Miller M.; Steg G.; Brinton E.A.;
Jacobson T.A.; Ketchum S.B.; Juliano R.A.; Jiao L.; Doyle R.T.; Granowitz
C.; Budoff M.; Mason R.P.; Tardif J.-C.; Boden W.E.; Ballantyne C.M.
Institution
(Majithia) Division of Cardiovascular Medicine, Lahey Hospital and Medical
Center, Burlington, MA, United States
(Bhatt, Mason) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
(Friedman) Department of Medicine, Indiana University School of Medicine,
Indianapolis, United States
(Miller) Department of Medicine, University of Maryland School of
Medicine, Baltimore, United States
(Steg) Universite de Paris, FACT (French Alliance for Cardiovascular
Trials), Assistance Publique-Hopitaux de Paris, Hopital Bichat, INSERM
Unite 1148, France
(Brinton) Utah Lipid Center, Salt Lake City, United States
(Jacobson) Office of Health Promotion and Disease Prevention, Department
of Medicine, Emory University School of Medicine, Atlanta, GA, United
States
(Ketchum, Juliano, Jiao, Doyle, Granowitz) Amarin Pharma, Inc.,
Bridgewater, NJ, United States
(Budoff) Division of Cardiology, Harbor UCLA Medical Center, Torrance, CA,
United States
(Tardif) Montreal Heart Institute, Universite de Montreal, Canada
(Boden) Division of Cardiovascular Medicine, Boston Medical Center, MA,
United States
(Ballantyne) Department of Medicine, Baylor College of Medicine, Center
for Cardiovascular Disease Prevention, Methodist DeBakey Heart and
Vascular Center, Houston, TX, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Chronic kidney disease is associated with adverse outcomes
among patients with established cardiovascular disease (CVD) or diabetes.
Commonly used medications to treat CVD are less effective among patients
with reduced kidney function. METHOD(S): REDUCE-IT (Reduction of
Cardiovascular Events with Icosapent Ethyl-Intervention Trial) was a
multicenter, double-blind, placebo-controlled trial that randomly assigned
statin-treated patients with elevated triglycerides (135-499 mg/dL) who
had CVD or diabetes and 1 additional risk factor to treatment with
icosapent ethyl (4 g daily) or placebo. Patients from REDUCE-IT were
categorized by prespecified estimated glomerular filtration rate (eGFR)
categories to analyze the effect of icosapent ethyl on the primary end
point (composite of cardiovascular death, nonfatal myocardial infarction,
nonfatal stroke, coronary revascularization, or unstable angina) and key
secondary end point (a composite of cardiovascular death, nonfatal
myocardial infarction, or nonfatal stroke). RESULT(S): Among the 8179
REDUCE-IT patients, median baseline eGFR was 75 mL.min-1.1.73
m-2 (range, 17-123 mL.min-1.1.73 m-2).
There were no meaningful changes in median eGFR for icosapent ethyl versus
placebo across study visits. Treatment with icosapent ethyl led to
consistent reduction in both the primary and key secondary composite end
points across baseline eGFR categories. Patients with eGFR <60
mL.min-1.1.73 m-2 treated with icosapent ethyl had
the largest absolute and similar relative risk reduction for the primary
composite end point (icosapent ethyl versus placebo, 21.8% versus 28.9%;
hazard ratio [HR], 0.71 [95% CI, 0.59-0.85]; P=0.0002) and key secondary
composite end point (16.8% versus 22.5%; HR 0.71 [95% CI, 0.57-0.88];
P=0.001). The numeric reduction in cardiovascular death was greatest in
the eGFR <60 mL.min-1.1.73 m-2 group (icosapent
ethyl: 7.6%; placebo: 10.6%; HR, 0.70 [95% CI, 0.51-0.95]; P=0.02).
Although patients with eGFR <60 mL.min-1.1.73 m-2
treated with icosapent ethyl had the highest numeric rates of atrial
fibrillation/ flutter (icosapent ethyl: 4.2%; placebo 3.0%; HR 1.42 [95%
CI, 0.86-2.32]; P=0.17) and serious bleeding (icosapent ethyl: 5.4%;
placebo 3.6%; HR, 1.40 [95% CI, 0.90-2.18]; P=0.13), HRs for atrial
fibrillation/flutter and serious bleeding were similar across eGFR
categories (P-interaction for atrial fibrillation/flutter=0.92;
P-interaction for serious bleeding=0.76). CONCLUSION(S): In
REDUCE-IT, icosapent ethyl reduced fatal and nonfatal ischemic events
across the broad range of baseline eGFR categories. Copyright ©
2021 The Authors.

<15>
Accession Number
640014319
Title
Effect of High-Dose Selenium on Postoperative Organ Dysfunction and
Mortality in Cardiac Surgery Patients: The SUSTAIN CSX Randomized Clinical
Trial.
Source
JAMA surgery. 158(3) (pp 235-244), 2023. Date of Publication: 01 Mar 2023.
Author
Stoppe C.; McDonald B.; Meybohm P.; Christopher K.B.; Fremes S.; Whitlock
R.; Mohammadi S.; Kalavrouziotis D.; Elke G.; Rossaint R.; Helmer P.;
Zacharowski K.; Gunther U.; Parotto M.; Niemann B.; Boning A.; Mazer C.D.;
Jones P.M.; Ferner M.; Lamarche Y.; Lamontagne F.; Liakopoulos O.J.;
Cameron M.; Muller M.; Zarbock A.; Wittmann M.; Goetzenich A.; Kilger E.;
Schomburg L.; Day A.G.; Heyland D.K.
Institution
(Stoppe, McDonald) University of Ottawa Heart Institute, Ottawa, ON,
Canada
(Meybohm, Helmer) Department of Anaesthesiology, Intensive Care,
Emergency, Pain Medicine, University Hospital Wuerzburg, Wuerzburg,
Germany
(Christopher) Division of Renal Medicine, Brigham and Women's Hospital,
Boston, MA, United States
(Fremes) Sunnybrook Research Institute, Toronto, ON, Canada
(Whitlock) Hamilton Health Sciences, Hamilton, Ontario, Canada
(Mohammadi, Kalavrouziotis) Quebec Heart and Lung Institute, Laval
University, Quebec City, QC, Canada
(Elke) University Hospital Schleswig-Holstein, Kiel, Germany
(Rossaint, Goetzenich) University Hospital Aachen, Aachen, Germany
(Zacharowski) University Hospital Frankfurt, Frankfurt, Germany
(Gunther) Oldenburg Clinic, University of Oldenburg, Oldenburg, Germany
(Parotto) Department of Anesthesiology and Pain Medicine, Toronto General
Hospital, Toronto, ON, Canada
(Parotto) Division of Critical Care Medicine, Department of Anesthesia and
Interdepartmental University of Toronto, Toronto, ON, Canada
(Niemann, Boning) University Hospital of Giessen, Giessen, Germany
(Mazer) Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto,
ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, Department of
Physiology, University of Toronto, Toronto, ON, Canada
(Jones) London Health Sciences Centre, London, ON, Canada
(Ferner) University Medical Center of the Johannes Gutenberg-University
Mainz, Mainz, Germany
(Lamarche) Hopital du Sacre-Coeur de Montreal, Montreal, QC, Canada
(Lamarche) Montreal Heart Institute, Montreal, QC, Canada
(Lamontagne) Hopital Fleurimont (CHUS), Sherbrooke, QC, Canada
(Liakopoulos) Department of Cardiothoracic Surgery, Heart Center,
University Hospital of Cologne, Cologne, Germany
(Cameron) Jewish General Hospital, Montreal, QC, Canada
(Muller) University Heart Center Freiburg Bad Krozingen, Bad Krozingen,
Germany
(Zarbock) University Hospital Munster, Munster, Germany
(Wittmann) University Hospital Bonn, Bonn, Germany
(Goetzenich) now with Abiomed Europe GmbH, Aachen, Germany
(Kilger) Ludwig Maximilian University of Munich, Munich, Germany
(Schomburg) Institute for Experimental Endocrinology,
Charite-Universitatsmedizin Berlin, Berlin, Germany
(Day, Heyland) Clinical Evaluation Research Unit, Queen's University,
Kingston, Ontario, Canada
(Heyland) Department of Critical Care Medicine, Queen's University,
Kingston, Ontario, Canada
Publisher
NLM (Medline)
Abstract
Importance: Selenium contributes to antioxidative, anti-inflammatory, and
immunomodulatory pathways, which may improve outcomes in patients at high
risk of organ dysfunctions after cardiac surgery. Objective(s): To
assess the ability of high-dose intravenous sodium selenite treatment to
reduce postoperative organ dysfunction and mortality in cardiac surgery
patients. Design, Setting, and Participant(s): This multicenter,
randomized, double-blind, placebo-controlled trial took place at 23 sites
in Germany and Canada from January 2015 to January 2021. Adult cardiac
surgery patients with a European System for Cardiac Operative Risk
Evaluation II score-predicted mortality of 5% or more or planned combined
surgical procedures were randomized. Intervention(s): Patients were
randomly assigned (1:1) by a web-based system to receive either
perioperative intravenous high-dose selenium supplementation of 2000 mug/L
of sodium selenite prior to cardiopulmonary bypass, 2000 mug/L immediately
postoperatively, and 1000 mug/L each day in intensive care for a maximum
of 10 days or placebo. Main Outcomes and Measures: The primary end
point was a composite of the numbers of days alive and free from organ
dysfunction during the first 30 days following cardiac surgery.
 Result(s): A total of 1416 adult cardiac surgery patients were
analyzed (mean [SD] age, 68.2 [10.4] years; 1043 [74.8%] male). The median
(IQR) predicted 30-day mortality by European System for Cardiac Operative
Risk Evaluation II score was 8.7% (5.6%-14.9%), and most patients had
combined coronary revascularization and valvular procedures. Selenium did
not increase the number of persistent organ dysfunction-free and alive
days over the first 30 postoperative days (median [IQR], 29 [28-30] vs 29
[28-30]; P=.45). The 30-day mortality rates were 4.2% in the selenium and
5.0% in the placebo group (odds ratio, 0.82; 95% CI, 0.50-1.36; P=.44).
Safety outcomes did not differ between the groups. Conclusions and
Relevance: In high-risk cardiac surgery patients, perioperative
administration of high-dose intravenous sodium selenite did not reduce
morbidity or mortality. The present data do not support the routine
perioperative use of selenium for patients undergoing cardiac surgery.
Trial Registration: ClinicalTrials.gov Identifier: NCT02002247.

<16>
Accession Number
639946637
Title
Cost-effectiveness of Fibrinogen Concentrate vs Cryoprecipitate for
Treating Acquired Hypofibrinogenemia in Bleeding Adult Cardiac Surgical
Patients.
Source
JAMA surgery. 158(3) (pp 245-253), 2023. Date of Publication: 01 Mar 2023.
Author
Abrahamyan L.; Tomlinson G.; Callum J.; Carcone S.; Grewal D.; Bartoszko
J.; Krahn M.; Karkouti K.
Institution
(Abrahamyan, Tomlinson, Carcone, Krahn, Karkouti) Toronto General Hospital
Research Institute, University Health Network, Toronto, ON, Canada
(Abrahamyan, Carcone, Krahn) Toronto Health Economics and Technology
Assessment (THETA) Collaborative, University Health Network, Toronto, ON,
Canada
(Abrahamyan, Tomlinson, Bartoszko, Krahn, Karkouti) Institute of Health
Policy, Management and Evaluation, University of Toronto, Toronto, ON,
Canada
(Tomlinson) Biostatistics Research Unit, University Health Network,
Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre and Queen's University, Kingston, Ontario, Canada
(Grewal, Bartoszko, Karkouti) Department of Anesthesia and Pain
Management, Sinai Health System, Women's College Hospital, University
Health Network, Toronto, ON, Canada
(Bartoszko, Karkouti) Department of Anesthesiology and Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Bartoszko, Karkouti) Peter Munk Cardiac Centre, University Health
Network, Toronto, ON, Canada
Publisher
NLM (Medline)
Abstract
Importance: Excessive bleeding requiring fibrinogen replacement is a
serious complication of cardiac surgery. However, the relative
cost-effectiveness of the 2 available therapies-fibrinogen concentrate and
cryoprecipitate-is unknown. Objective(s): To determine
cost-effectiveness of fibrinogen concentrate vs cryoprecipitate for
managing active bleeding in adult patients who underwent cardiac surgery.
 Design, Setting, and Participant(s): A within-trial economic
evaluation of the Fibrinogen Replenishment in Surgery (FIBERS) randomized
clinical trial (February 2017 to November 2018) that took place at 4
hospitals based in Ontario, Canada, hospitals examined all in-hospital
resource utilization costs and allogeneic blood product (ABP) transfusion
costs incurred within 28 days of surgery. Participants included a subset
of 495 adult patients from the FIBERS trial who underwent cardiac surgery
and developed active bleeding and acquired hypofibrinogenemia requiring
fibrinogen replacement. Intervention(s): Fibrinogen concentrate (4 g
per dose) or cryoprecipitate (10 units per dose) randomized (1:1) up to 24
hours postcardiopulmonary bypass. Main Outcomes and Measures:
Effectiveness outcomes included number of ABPs administered within 24
hours and 7 days of cardiopulmonary bypass. ABP transfusion (7-day) and
in-hospital resource utilization (28-day) costs were evaluated and a
multivariable net benefit regression model built for the full sample and
predefined subgroups. Result(s): Patient level costs for 495 patients
were evaluated (mean [SD] age 59.2 [15.4] years and 69.3% male.)
Consistent with FIBERS, ABP transfusions and adverse events were similar
in both treatment groups. Median (IQR) total 7-day ABP cost was CAD $2280
(US dollars [USD] $1697) (CAD $930 [USD $692]-CAD $4970 [USD $3701]) in
the fibrinogen concentrate group and CAD $2770 (USD $1690) (IQR, CAD $1140
[USD $849]-CAD $5000 [USD $3723]) in the cryoprecipitate group. Median
(interquartile range) total 28-day cost was CAD $38180 (USD $28431) $(IQR,
CAD $26350 [USD $19622]-CAD $65080 [USD $48463]) in the fibrinogen
concentrate group and CAD $38790 (USD $28886) (IQR, CAD $26180 [USD
$19495]-CAD $70380 [USD $52409]) in the cryoprecipitate group. After
exclusion of patients who were critically ill before surgery (11%) due to
substantial variability in costs, the incremental net benefit of
fibrinogen concentrate vs cryoprecipitate was positive (probability of
being cost-effective 86% and 97% at $0 and CAD $2000 (USD $1489)
willingness-to-pay, respectively). Net benefit was highly uncertain for
nonelective and patients with critical illness. Conclusions and
Relevance: Fibrinogen concentrate is cost-effective when compared with
cryoprecipitate in most bleeding adult patients who underwent cardiac
surgery with acquired hypofibrinogenemia requiring fibrinogen replacement.
The generalizability of these findings outside the Canadian health system
needs to be verified.

<17>
Accession Number
640536202
Title
Prognostic Value of Preprocedural LV Global Longitudinal Strain for
Post-TAVR-Related Morbidity and Mortality: A Meta-Analysis.
Source
JACC. Cardiovascular imaging. 16(3) (pp 332-341), 2023. Date of
Publication: 01 Mar 2023.
Author
Stens N.A.; van Iersel O.; Rooijakkers M.J.P.; van Wely M.H.; Nijveldt R.;
Bakker E.A.; Rodwell L.; Pedersen A.L.D.; Poulsen S.H.; Kjonas D.; Stassen
J.; Bax J.J.; Tanner F.C.; Lerakis S.; Shimoni S.; Poulin F.; Ferreira V.;
Reskovic Luksic V.; van Royen N.; Thijssen D.H.J.
Institution
(Stens) Department of Cardiology, Radboud Institute for Health Sciences,
Radboud University Medical Center, Nijmegen, the Netherlands; Department
of Physiology, Radboud Institute for Health Sciences, Radboud University
Medical Center, Nijmegen, the Netherlands
(van Iersel, Bakker) Department of Physiology, Radboud Institute for
Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
(Rooijakkers, van Wely, Nijveldt, van Royen) Department of Cardiology,
Radboud Institute for Health Sciences, Radboud University Medical Center,
Nijmegen, Netherlands
(Rodwell) Department of Health Evidence, section of Biostatistics, Radboud
Institute for Health Sciences, Radboud University Medical Center,
Nijmegen, Netherlands
(Pedersen, Poulsen) Department of Cardiology, Aarhus University Hospital,
Aarhus N, Denmark
(Kjonas) Department of General and Gastrointestinal Surgery, University
Hospital of North Norway, Tromso, Norway
(Stassen) Department of Cardiology, Leiden University Medical Center,
Leiden, Netherlands
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
the Netherlands; Turku Heart Center, University of Turku and Turku
University Hospital, Turku, Finland
(Tanner) Department of Cardiology, University Heart Center Zurich, Zurich,
Switzerland
(Lerakis) Department of Cardiology, Mount Sinai Heart, Icahn School of
Medicine at Mount Sinai, NY, United States
(Shimoni) Heart Center, Kaplan Medical Center, Rehovot, Israel
(Poulin) Division of Cardiology, Hopital du Sacre-Coeur de Montreal,
Montreal, Canada
(Ferreira) Department of Cardiology, Hospital de Santa Marta, Centro
Hospitalar Universitario de Lisboa Central Lisbon, Lisbon, Portugal
(Reskovic Luksic) Department of Cardiovascular Diseases, University of
Zagreb School of Medicine and University Hospital Centre Zagreb, Zagreb,
Croatia
(Thijssen) Department of Physiology, Radboud Institute for Health
Sciences, Radboud University Medical Center, Nijmegen, the Netherlands;
Research Institute for Sport and Exercise Sciences, Liverpool John Moores
University, Liverpool, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Left ventricular ejection fraction (LVEF) demonstrates limited
prognostic value for post-transcatheter aortic valve replacement (TAVR)
outcomes. Evidence regarding the potential role of left ventricular global
longitudinal strain (LV-GLS) in this setting is inconsistent.
 OBJECTIVE(S): The aim of this systematic review and meta-analysis of
aggregated data was to evaluate the prognostic value of preprocedural
LV-GLS for post-TAVR-related morbidity and mortality. METHOD(S): The
authors searched PubMed, Embase, and Web of Science for studies
investigating the association between preprocedural 2-dimensional
speckle-tracking-derived LV-GLS and post-TAVR clinical outcomes. An
inversely weighted random effects meta-analysis was adopted to investigate
the association between LV-GLS vs primary (ie, all-cause mortality) and
secondary (ie, major cardiovascular events [MACE]) post-TAVR outcomes.
 RESULT(S): Of the 1,130 identified records, 12 were eligible, all of
which had a low-to-moderate risk of bias (Newcastle-Ottawa scale). On
average, 2,049 patients demonstrated preserved LVEF (52.6% +/- 1.7%), but
impaired LV-GLS (-13.6% +/- 0.6%). Patients with a lower LV-GLS had a
higher all-cause mortality (pooled HR: 2.01; 95% CI: 1.59-2.55) and MACE
(pooled odds ratio [OR]: 1.26; 95% CI: 1.08-1.47) risk compared with
patients with higher LV-GLS. In addition, each percentage point decrease
of LV-GLS (ie, toward 0%) was associated with an increased mortality (HR:
1.06; 95% CI: 1.04-1.08) and MACE risk (OR: 1.08; 95% CI: 1.01-1.15).
 CONCLUSION(S): Preprocedural LV-GLS was significantly associated with
post-TAVR morbidity and mortality. This suggests a potential clinically
important role of pre-TAVR evaluation of LV-GLS for risk stratification of
patients with severe aortic stenosis. (Prognostic value of left
ventricular global longitudinal strain in patients with aortic stenosis
undergoing Transcatheter Aortic Valve Implantation: a meta-analysis;
CRD42021289626). Copyright © 2023 American College of Cardiology
Foundation. Published by Elsevier Inc. All rights reserved.

<18>
Accession Number
2022678435
Title
Cardiac Surgery Training in Brazil - What Are We Discussing in Our
Journal?.
Source
Brazilian Journal of Cardiovascular Surgery. 38(1) (pp 157-161), 2023.
Date of Publication: 2023.
Author
da Silveira Maia A.
Institution
(da Silveira Maia) Department of Cardiovascular Surgery, Instituto Dante
Pazzanese de Cardiologia (IDPC), Sao Paulo, Sao Paulo, Brazil
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Cardiovascular surgery has undergone numerous changes over
the last decades. Transcatheter technologies, endovascular procedures,
hybrids, and minimally invasive surgery have undoubtedly advanced as a
therapy for patients. Thus, the discussion about the training of residents
in the face of new technologies in the specialty is in check. In this
article, it is proposed a review to discuss the challenges in this
scenario as well as the current training in cardiovascular surgery in
Brazil. Method(s): A comprehensive review was performed in the
Brazilian Journal of Cardiovascular Surgery. All editions from 1986 to
2022 were included. The research was carried out using the search engine
on the journal's website (https://www.bjcvs.org) and an individual
analysis of the titles and abstracts of each article published.
 Result(s): All the studies are summarized in the appropriate table
with a discussion along this review. Conclusion(s): Most articles
that discuss training in cardiovascular surgery in the national context
are editorials and expert points of view with no observational studies
evaluating the residency programs. Keywords: Cardiovascular Surgery.
Internship and Residency. Mentoring. Minimally Invasive Surgical
Procedures. Patients. Research. Review. Copyright © 2023,
Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

<19>
Accession Number
2022613657
Title
Joint 2022 European Society of Thoracic Surgeons and The American
Association for Thoracic Surgery guidelines for the prevention of
cancer-associated venous thromboembolism in thoracic surgery.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(3) (pp 794-824.e6),
2023. Date of Publication: March 2023.
Author
Shargall Y.; Wiercioch W.; Brunelli A.; Murthy S.; Hofstetter W.; Lin J.;
Li H.; Linkins L.-A.; Crowther M.; Davis R.; Rocco G.; Morgano G.P.;
Schunemann F.; Muti-Schunemann G.; Douketis J.; Schunemann H.J.; Litle
V.R.
Institution
(Shargall) Department of Surgery, McMaster University, Hamilton, ON,
Canada
(Wiercioch, Morgano, Muti-Schunemann, Schunemann) Department of Health
Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON,
Canada
(Brunelli) Department of Thoracic Surgery, St. James's University
Hospital, Leeds, United Kingdom
(Murthy) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(Hofstetter) Department of Thoracic and Cardiovascular Surgery, The
University of Texas MD Anderson Cancer Center, Houston, Tex
(Lin) Section of Thoracic Surgery, University of Michigan, Ann Arbor,
Mich, United States
(Li) Department of Thoracic Surgery, Capital Medical University, Beijing,
China
(Linkins, Crowther, Douketis, Schunemann) Department of Medicine, McMaster
University, Hamilton, ON, Canada
(Davis) Patient Representative, Burlington, ON, Canada
(Rocco) Memorial Sloan Kettering Cancer Center, New York, NY, United
States
(Schunemann) Medizinische Fakultat, Albert-Ludwigs-Universitat Freiburg,
Freiburg, Germany
(Litle) Department of Surgery, Boston University School of Medicine,
Boston, Mass
Publisher
Elsevier Inc.
Abstract
Background: Venous thromboembolism (VTE), which includes deep vein
thrombosis and pulmonary embolism, is a potentially fatal but preventable
postoperative complication. Thoracic oncology patients undergoing surgical
resection, often after multimodality induction therapy, represent among
the highest risk groups for postoperative VTE. Currently there are no VTE
prophylaxis guidelines specific to these thoracic surgery patients.
Evidenced-based recommendations will help clinicians manage and mitigate
risk of VTE in the postoperative period and inform best practice.
 Objective(s): These joint evidence-based guidelines from The American
Association for Thoracic Surgery and the European Society of Thoracic
Surgeons aim to inform clinicians and patients in decisions about
prophylaxis to prevent VTE in patients undergoing surgical resection for
lung or esophageal cancer. Method(s): The American Association for
Thoracic Surgery and the European Society of Thoracic Surgeons formed a
multidisciplinary guideline panel that included broad membership to
minimize potential bias when formulating recommendations. The McMaster
University GRADE Centre supported the guideline development process,
including updating or performing systematic evidence reviews. The panel
prioritized clinical questions and outcomes according to their importance
for clinicians and patients. The Grading of Recommendations Assessment,
Development and Evaluation (GRADE) approach was used, including GRADE
Evidence-to-Decision frameworks, which were subject to public comment.
 Result(s): The panel agreed on 24 recommendations focused on
pharmacological and mechanical methods for prophylaxis in patients
undergoing lobectomy and segmentectomy, pneumonectomy, and esophagectomy,
as well as extended resections for lung cancer. Conclusion(s): The
certainty of the supporting evidence for the majority of recommendations
was judged as low or very low, largely due to a lack of direct evidence
for thoracic surgery. The panel made conditional recommendations for use
of parenteral anticoagulation for VTE prevention, in combination with
mechanical methods, over no prophylaxis for cancer patients undergoing
anatomic lung resection or esophagectomy. Other key recommendations
include: conditional recommendations for using parenteral anticoagulants
over direct oral anticoagulants, with use of direct oral anticoagulants
suggested only in the context of clinical trials; conditional
recommendation for using extended prophylaxis for 28 to 35 days over
in-hospital prophylaxis only for patients at moderate or high risk of
thrombosis; and conditional recommendations for VTE screening in patients
undergoing pneumonectomy and esophagectomy. Future research priorities
include the role of preoperative thromboprophylaxis and the role of risk
stratification to guide use of extended prophylaxis. Copyright ©
2022

<20>
Accession Number
2013264659
Title
Comparison of SYNTAX score strata effects of percutaneous and surgical
revascularization trials: A meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(4) (pp 1405-1413.e13),
2023. Date of Publication: April 2023.
Author
Gaudino M.; Hameed I.; Di Franco A.; Naik A.; Demetres M.; Biondi-Zoccai
G.; Bangalore S.
Institution
(Gaudino, Hameed, Di Franco, Naik) Department of Cardiothoracic Surgery,
Weill Cornell Medicine, New York, NY, United States
(Hameed) Section of Cardiac Surgery, Yale University School of Medicine,
New Haven, Conn, United States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Biondi-Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Rome, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Napoli, Italy
(Bangalore) New York University Grossman School of Medicine, New York, New
York, NY, United States
Publisher
Elsevier Inc.
Abstract
Objectives: The evidence supporting the use of the Synergy Between
Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX)
score for risk stratification is controversial. We performed a systematic
review and meta-analysis of all the randomized controlled trials comparing
percutaneous coronary intervention versus coronary artery bypass grafting
that reported their outcomes stratified by SYNTAX score, focusing on
between-strata comparisons. Method(s): A systematic review of
MEDLINE, EMBASE, Cochrane Library databases was performed. Incidence rate
ratios were pooled with a random effect model. Between-group statistical
heterogeneity according to accepted SYNTAX score tertiles was computed in
the main analysis. Ratios of incidence rate ratios were computed to
appraise between-strata effect, as sensitivity analysis. Primary and
secondary outcomes were major adverse cardiac and cerebrovascular events
and all-cause mortality, respectively. Separate sub-analyses were
performed for left main and multivessel disease. Result(s): From 425
citations, 6 trials were eventually included (8269 patients [4134
percutaneous coronary interventions, 4135 coronary artery bypass
graftings]; mean follow-up: 6.2 years [range: 3.8-10]). Overall,
percutaneous coronary intervention was associated with a significant
increase in major adverse cardiac and cerebrovascular events (incidence
rate ratio, 1.39, 95% confidence interval, 1.27-1.51) and nonsignificant
increase in all-cause mortality (incidence rate ratio, 1.17, 95%
confidence interval, 0.98-1.40). There was no significant statistical
heterogeneity of treatment effect by SYNTAX score for major adverse
cardiac and cerebrovascular events or mortality (P = .40 and P = .34,
respectively). Results were consistent also for patients with left main
and multivessel disease (major adverse cardiac and cerebrovascular events:
P = .85 in left main, P = .78 in multivessel disease 0.78; mortality: P =
.12 in left main; P = .34 in multivessel disease). Results of analysis
based on ratios of incidence rate ratios were consistent with the main
analysis. Conclusion(s): No significant association was found between
SYNTAX score and the comparative effectiveness of percutaneous coronary
intervention and coronary artery bypass grafting. These findings have
implications for clinical practice, future guidelines, and the design of
percutaneous coronary intervention versus coronary artery bypass grafting
trials. Copyright © 2021 The American Association for Thoracic
Surgery

<21>
Accession Number
2023145747
Title
The level of adherence to best-practice guidelines by interprofessional
teams with and without acute care nurse practitioners in cardiac surgery:
A study protocol.
Source
PLoS ONE. 18(3 March) (no pagination), 2023. Article Number: e0282467.
Date of Publication: March 2023.
Author
Audet L.-A.; Lavoie-Tremblay M.; Tchouaket E.; Kilpatrick K.
Institution
(Audet, Kilpatrick) Ingram School of Nursing, Faculty of Medicine and
Health Sciences, McGill University, Montreal, QC, Canada
(Lavoie-Tremblay) Faculte des Sciences Infirmieres, Universite de
Montreal, Pavillon Marguerite-d'Youville, Montreal, QC, Canada
(Tchouaket) Departement des Sciences Infirmieres, Universite du Quebec en
Outaouais, Saint-Jerome, QC, Canada
(Kilpatrick) Centre Integre Universitaire de Sante et de Services Sociaux
de l'Est-de-l'Ile-deMontreal-Hopital Maisonneuve-Rosemont
(CIUSSS-EMTL-HMR), Montreal, QC, Canada
(Kilpatrick) Nursing Research and Innovative Practice, Ingram School of
Nursing, Faculty of Medicine and Health Sciences, McGill University,
Montreal, QC, Canada
Publisher
Public Library of Science
Abstract
Background Acute care nurse practitioners (ACNPs) in postoperative cardiac
surgery settings provide significant benefits to patients and
organizations. Recent studies have suggested that ACNPs increase the level
of adherence to best-practice guidelines by interprofessional teams. It is
however, unknown whether interprofessional teams with ACNP are associated
with higher levels of adherence to best-practice guidelines compared to
interprofessional teams without ACNPs. Furthermore, no extraction tool is
available to measure the level of adherence to best-practice guidelines by
interprofessional teams in postoperative cardiac surgery settings. This
project aims to measure and examine the level of adherence to
best-practice guidelines of interprofessional teams with and without ACNPs
in a postoperative cardiac surgery setting in Quebec, Canada. Methods A
retrospective observational study will be conducted of 300 patients
hospitalized between January 1, 2019 and January 31, 2020 in a
postoperative cardiac surgery unit in Quebec, Canada. Data will be
collected from patient health records and electronic databases. An
extraction tool will be developed based on systematic review of the
literature, and will include best-practice guidelines and confounding
variables related to patient and interprofessional teams' characteristics.
Content and criterion validation, and a pilot-test will be conducted for
the development of the tool. A multivariate linear regression model will
be developed and adjusted for confounding variables to examine the
association between interprofessional teams with and without ACNPs, and
level of adherence to best-practice guidelines by those teams. Discussion
This project represents the first study to measure and examine the level
of adherence to best-practice guidelines by interprofessional teams with
and without ACNPs in a postoperative cardiac surgery setting. The findings
of this project will generate empirical data focusing on the contribution
of ACNPs within interprofessional teams, and ultimately enhance the
delivery of high quality and evidence-based care for patients and
families. Copyright © 2023 Audet 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.

<22>
Accession Number
640542968
Title
In a secondary analysis from a randomised, double-blind placebo-controlled
trial Dexmedetomidine blocks cholinergic dysregulation in delirium
pathogenesis in patients with major surgery.
Source
Scientific reports. 13(1) (pp 3971), 2023. Date of Publication: 09 Mar
2023.
Author
Jacob Y.; Schneider B.; Spies C.; Heinrich M.; von Haefen C.; Kho W.;
Pohrt A.; Muller A.
Institution
(Jacob, Schneider, Spies, Heinrich, von Haefen, Kho, Muller) Department of
Anesthesiology and Operative Intensive Care Medicine (CCM, Charite -
Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin,
Berlin Institute of Health, Humboldt-Universitat Zu BerlinCharite Platz 1,
Berlin 10117, Germany
(Heinrich) Berlin Institute of Health (BIH), Berlin 10178, Germany
(Pohrt) Institute of Biometry and Clinical Epidemiology, Charite -
Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin,
Humboldt-Universitat Zu Berlin, Berlin, Germany
Publisher
NLM (Medline)
Abstract
Dexmedetomidine is an alpha-2 adrenoreceptor agonist with
anti-inflammatory and anti-delirogenic properties. Pathogenesis of
postoperative delirium (POD) includes cholinergic dysfunction and
deregulated inflammatory response to surgical trauma. Acetylcholinesterase
(AChE) and butyrylcholinesterase (BChE) are discussed as biomarkers for
both POD and severity in acute inflammation. To show whether there is a
link between blood cholinesterase activities and dexmedetomidine, we
performed a secondary analysis of a randomised, double-blind,
placebo-controlled trial that recently showed a lower incidence of POD in
the dexmedetomidine group. Abdominal or cardiac surgical patients aged>=60
years were randomised to receive dexmedetomidine or placebo intra- and
postoperatively in addition to standard general anaesthesia. We analysed
the course of perioperative cholinesterase activities of 56 patients,
measured preoperatively and twice postoperatively. Dexmedetomidine
resulted in no change in AChE activity and caused a rapid recovery of BChE
activity after an initial decrease, while placebo showed a significant
decrease in both cholinesterase activities. There were no significant
between-group differences at any point in time. From these data it can be
assumed that dexmedetomidine could alleviate POD via altering the
cholinergic anti-inflammatory pathway (CAIP). We advocate for further
investigations to show the direct connection between dexmedetomidine and
cholinesterase activity. Copyright © 2023. The Author(s).

<23>
Accession Number
2022332615
Title
Rationale and design for the myocardial ischemia and transfusion (MINT)
randomized clinical trial.
Source
American Heart Journal. 257 (pp 120-129), 2023. Date of Publication: March
2023.
Author
Carson J.L.; Brooks M.M.; Chaitman B.R.; Alexander J.H.; Goodman S.G.;
Bertolet M.; Abbott J.D.; Cooper H.A.; Rao S.V.; Triulzi D.J.; Fergusson
D.A.; Kostis W.J.; Noveck H.; Simon T.; Steg P.G.; DeFilippis A.P.;
Goldsweig A.M.; Lopes R.D.; White H.; Alsweiler C.; Morton E.; Hebert
P.C.; Ghafghazi S.; Wood F.; Menegus M.; Uretsky B.; Vallurupalli S.;
Maniatis G.; Gruberg L.; Roswell R.; Rossi J.; Abtahian F.; Tessalee M.;
Barsness G.; Aronow H.; Ramanathan K.; Schmidhofer M.; Keating F.; Carson
M.; Kontos M.; Qureshi M.; Clegg S.; Laskey W.; Polonsky T.; Gupta R.;
Sheikh M.A.; Uhl L.; Mullen P.; Bracey A.; Matthai W.; Stowell C.;
Dudzinski D.; Marhefka G.; Weinstock P.; Lawson W.; Keller N.; Yuriditsky
E.; Thomas M.; Jacobs A.; Hochberg C.; Siddiqi O.; Schulman-Marcus J.;
Torosoff M.; Gitter M.; Dai X.; Traverse J.; McCamant E.; Scott J.;
Swaminathan R.; Rao S.; Salisbury A.; Landers D.; Raveendran G.; Ebrahimi
R.; Bach R.; Delehanty J.; Shah R.C.; Brener S.; Doroshow J.; Caixeta A.;
Precoma D.; Dall'Orto F.T.C.; De Andrade P.B.; Dracoulakis M.; Maia L.N.;
Ritt L.E.F.; Quadros A.; Filho D.C.S.; De Martino F.; Huynh T.; Schnell
G.; Senaratne M.; Tandon V.; Neary J.; Laflamme D.; Dery J.-P.; Bainey K.;
Haichin R.; Dehghani P.; Quraishi A.U.R.; Potter B.J.; Carrier F.M.;
Goldfarb M.; Fordyce C.; Sia Y.T.; Daneault B.; Madan M.; McPherson T.;
Ducas J.; Minhas K.; Brass N.; Bagai A.; Robinson S.; Dzavik V.; Khan R.;
Michaud N.; Steg G.; Ducrocq G.; Puymirat E.; Lemesle G.; Ferrari E.;
Lattuca B.; Silvain J.; Vanzetto G.; Cetran L.; Lhermusier T.; Cottin Y.;
Rosamel Y.; Angoulvant D.; Dillinger J.G.; Thuaire C.; Popovic B.; Durand
E.; Bouleti C.; Roubille F.; Delorme L.; Crozier I.; Benatar J.; Nandra
S.; Ternouth I.; Fisher N.; Brieger D.; Hillis G.
Institution
(Carson, Kostis, Noveck) Rutgers Robert Wood Johnson Medical School, New
Brunswick, NJ
(Brooks, Bertolet) University of Pittsburgh School of Public Health,
Pittsburgh, Panama
(Chaitman) St Louis University School of Medicine, St Louis, Macao
(Alexander, Lopes) Duke Clinical Research Institute, Durham, New Caledonia
(Goodman) St. Michael's Hospital, University of Toronto, Toronto, Canada
(Goodman) Canadian VIGOUR Centre, University of Alberta, Edmonton, AB,
Canada
(Abbott) Warren Alpert Medical School. Brown University, Providence, RI
(Cooper) Westchester Medical Center, Valhalla, NY
(Rao) Durham VA Medical Center, Durham, New Caledonia
(Rao) NYU Langone Health, New York, NY
(Triulzi) University of Pittsburgh School of Medicine, Pittsburgh, Panama
(Fergusson) Ottawa Hospital Research Institute Ottawa, ON, Canada
(Simon) Hopital Saint Antoine, Paris, France
(Steg) Universite Paris-Cite, Paris, France
(DeFilippis) Vanderbilt University, Nashville, Tunisia
(Goldsweig) University of Nebraska Medical Center, Omaha, Niger
(Lopes) Brazilian Clinical Research Institute, Sao Paulo, Brazil
(White, Alsweiler) Green Lane Clinical Coordinating Centre Ltd, Auckland,
New Zealand
(Morton) Finders University, Adelaide, Australia
(Hebert) Centre de Recherche du Centre Hosp. Universitaire de Montreal,
Montreal, Quebec, Canada
(Carson) Rutgers Robert Wood Johnson Medical School (A01), United States
(Ghafghazi) Louisville - University of Louisville (A02), Jewish Hospital
(A14), Norton Hospital (A65), United States
(Cooper) Westchester Medical Center (A03), United States
(Wood) WakeMed Health & Hospitals (A04), United States
(Menegus) Montefiore - Weiler Hospital (A06), Moses Hospital (A23), United
States
(Uretsky) University of Arkansas Medical Sciences - Central Arkansas
Veterans (A07), United States
(Vallurupalli) University of Arkansas Medical Sciences -University of
Arkansas Medical (A49), United States
(Maniatis) Northwell Hospital System - Staten Island University (A09),
United States
(Gruberg) Northwell Hospital System - Southside Hospital (A53), United
States
(Roswell) Northwell Hospital System - Lenox Hill Hospital (A62), United
States
(Rossi) UNC Hospitals (A10), United States
(Abtahian) Rochester General Hospital (A11), United States
(Tessalee) AdventHealth - Adventist Hinsdale Hospital (A12), Adventist La
Grange Hospital (A21), Adventist Bolingbrook (A22), United States
(Barsness) Mayo Clinic (A13), United States
(Abbott) Lifespan - Rhode Island Hospital (A15), United States
(Aronow) Lifespan - The Miriam Hospital (A16), United States
(Ramanathan) Memphis VA Medical Center (A18), United States
(Schmidhofer) UPMC Presbyterian (A20), United States
(Keating) University of Vermont Medical (A27), United States
(Carson) Jersey Shore University Medical (A29), United States
(Kontos) Virginia Commonwealth (A31), United States
(Qureshi) St. Joseph Mercy Hospital (A32), United States
(Clegg, Laskey) University of New Mexico (A33), United States
(Polonsky) University of Chicago (A34), United States
(Gupta, Sheikh) University of Toledo (A36), United States
(Uhl) Beth Israel Deaconess (A37), United States
(Mullen) Memorial Hospital at Gulfport (A38), United States
(Bracey) Baylor St Luke's (A39), United States
(Matthai) PENN Presbyterian (A40), United States
(Stowell, Dudzinski) Massachusetts General Hospital (A44), United States
(Marhefka) Thomas Jefferson University (A45), United States
(Weinstock) Cooper University Hospital (A47), United States
(Lawson) Stony Brook University (A48), United States
(Keller, Yuriditsky) NYU Langone Medical Center (A51), United States
(Thomas) University of Michigan (A54), United States
(Jacobs, Hochberg, Siddiqi) Boston Medical Center (A56), United States
(Schulman-Marcus, Torosoff) Albany Medical College (A57), United States
(Gitter) Medical College of Wisconsin (A59), United States
(Dai) NYP Queens (A60), United States
(Traverse) Minneapolis Heart Institute (Foundation) (A61), United States
(McCamant, Scott) Lancaster General (A63), United States
(Swaminathan, Rao) Durham VA Medical Center (A64), United States
(Goldsweig) University of Nebraska Medical Center (A67), United States
(DeFilippis) Vanderbilt (A69), United States
(Salisbury) Saint Luke's Mid America Heart (A05), United States Sites -
Inactive
(Landers) Hackensack University Medical (A17), United States Sites -
Inactive
(Raveendran) University of Minnesota (A25), United States Sites - Inactive
(Ebrahimi) UCLA / Veterans Affairs Greater LA (A30), United States Sites -
Inactive
(Bach) Washington University St Louis (A35), United States Sites -
Inactive
(Delehanty) University of Rochester (A43), United States Sites - Inactive
(Shah) Rush University Medical Center (A46), United States Sites -
Inactive
(Brener) NYP Brooklyn Methodist (A50), United States Sites - Inactive
(Doroshow) Lankenau Medical Center (A66), United States Sites - Inactive
(Caixeta) Hospital Sao Paulo (B01), Brazilian Sites
(Precoma) Sociedade Hospitalar Angelina Caron (B02), Brazilian Sites
(Dall'Orto) Hospital Maternidade e Pronto Socorro Santa Lucia (B04),
Brazilian Sites
(De Andrade) Santa Casa de Marilia (B05), Brazilian Sites
(Dracoulakis) Hospital da Bahia (B06), Brazilian Sites
(Maia) Hospital de Base de Rio Preto (B07), Brazilian Sites
(Ritt) Hospital Cardio Pulmonar (B10), Brazilian Sites
(Quadros) Instituto de Cardiologia do RS (B13), Brazilian Sites
(Filho) Pronto Socorro Cardiologico de Prof. Luiz Tavares (B14), Brazilian
Sites
(De Martino) Hospital de Clinicas UFTM (B16), Brazilian Sites
(Huynh) Montreal General Hospital (C01), Canadian Sites
(Schnell) Foothills Medical Centre (C02), Canadian Sites
(Senaratne) Grey Nuns Community Hospital (C03), Canadian Sites
(Tandon) Hamilton Health Sciences/St. Joseph's Healthcare Hamilton -
Hamilton General Hospital (C04), Canadian Sites
(Tandon) Hamilton Health Sciences/St. Joseph's Healthcare Hamilton -
Juravinski Hospital (C29), Canadian Sites
(Neary) Hamilton Health Sciences/St. Joseph's Healthcare Hamilton - St.
Joseph's Healthcare Hamilton (C30), Canadian Sites
(Laflamme) Hopital Charles Lemoyne (C05), Canadian Sites
(Dery) Quebec Heart and Lung Institute (C06), Canadian Sites
(Bainey) University Of Alberta Hospital (C07), Canadian Sites
(Haichin) Royal Victoria Hospital (C08), Canadian Sites
(Dehghani) Regina General Hospital (C09), Canadian Sites
(Quraishi) QE II Health Sciences Center (C10), Canadian Sites
(Potter, Carrier) Centre Hosp. Universitaire de Montreal (C12), Canadian
Sites
(Goldfarb) Jewish General Hospital (C14), Canadian Sites
(Fordyce) Vancouver General Hospital (C15), Canadian Sites
(Sia) Centre integre universitaire de sante et de services sociaux de la
Mauricie-et-du-Centre-du-Quebec (C17), Canadian Sites
(Daneault) Centre Hospitalier Sherbrooke (C21), Canadian Sites
(Madan) Sunnybrook Health Sciences Centre (C22), Canadian Sites
(McPherson) London Health Sciences Centre - Victoria Hospital - LHSC
(C11), University Hospital (C23), Canadian Sites
(Ducas) St. Boniface General Hospital (C24), Canadian Sites
(Minhas) St. Boniface General Hospital (C24), Canadian Sites
(Brass) Royal Alexandra Hospital (C25), Canadian Sites
(Bagai) St. Michael's Hospital (C27), Canadian Sites
(Robinson) Victoria Heart Institute (C28), Canadian Sites
(Dzavik) UHN (C31), Canadian Sites
(Khan) Royal Columbian Hospital (C13), Canadian Sites - Inactive
(Michaud) Hotel Dieu de Levis (C19), Canadian Sites - Inactive
(Steg, Ducrocq) Hopital BICHAT - APHP (E01), European Union Sites
(Puymirat) HEGP - APHP (E02), European Union Sites
(Lemesle) CHRU Lille (E03), European Union Sites
(Ferrari) CHU Nice - Hopital Pasteur (E04), European Union Sites
(Lattuca) CHU Caremeau - Nimes (E05), European Union Sites
(Silvain) Hopital Pitie Salpetriere - APHP (E06), European Union Sites
(Vanzetto) Hopital Michalon - Grenoble (E07), European Union Sites
(Cetran) Hopital Haut Leveque - Pessac (E08), European Union Sites
(Lhermusier) CHU Rangueil - Toulouse (E09), European Union Sites
(Cottin) CHU le Bocage - Dijon (E10), European Union Sites
(Rosamel) Centre Hospitalier sud francilien (E11), European Union Sites
(Angoulvant) CHRU Tours - Hopital Trousseau (E12), European Union Sites
(Dillinger) Hopital Lariboisiere - APHP (E13), European Union Sites
(Thuaire) CH Louis Pasteur, Chartres (E14), European Union Sites
(Popovic) CHU Nancy (E15), European Union Sites
(Durand) CHU de Rouen (E16), European Union Sites
(Bouleti) CHU Poitiers (E18), European Union Sites
(Roubille) CHU Arnaud de Villeneuve - Montpellier (E19), European Union
Sites
(Delorme) Clinique du pont de chaume - Montauban (E20), European Union
Sites
(Crozier) Christchurch Hospital (N01), New Zealand Sites
(Benatar) Auckland Hospital (N02), New Zealand Sites
(Nandra) Whangarei Hospital (N04), New Zealand Sites
(Ternouth) Taranaki Hospital (N05), New Zealand Sites
(Fisher) Nelson Hospital (N06), New Zealand Sites
(Brieger) Concord Repatriation General Hospital (V03), Australian Sites
(Hillis) Royal Perth Hospital (V04), Australian Sites
Publisher
Elsevier Inc.
Abstract
Background: Accumulating evidence from clinical trials suggests that a
lower (restrictive) hemoglobin threshold (<8% g/dL) for red blood cell
(RBC) transfusion, compared with a higher (liberal) threshold (>=10 g/dL)
is safe. However, in anemic patients with acute myocardial infarction
(MI), maintaining a higher hemoglobin level may increase oxygen delivery
to vulnerable myocardium resulting in improved clinical outcomes.
Conversely, RBC transfusion may result in increased blood viscosity,
vascular inflammation, and reduction in available nitric oxide resulting
in worse clinical outcomes. We hypothesize that a liberal transfusion
strategy would improve clinical outcomes as compared to a more restrictive
strategy. Method(s): We will enroll 3500 patients with acute MI (type
1, 2, 4b or 4c) as defined by the Third Universal Definition of MI and a
hemoglobin <10 g/dL at 144 centers in the United States, Canada, France,
Brazil, New Zealand, and Australia. We randomly assign trial participants
to a liberal or restrictive transfusion strategy. Participants assigned to
the liberal strategy receive transfusion of RBCs sufficient to raise their
hemoglobin to at least 10 g/dL. Participants assigned to the restrictive
strategy are permitted to receive transfusion of RBCs if the hemoglobin
falls below 8 g/dL or for persistent angina despite medical therapy. We
will contact each participant at 30 days to assess clinical outcomes and
at 180 days to ascertain vital status. The primary end point is a
composite of all-cause death or recurrent MI through 30 days following
randomization. Secondary end points include all-cause mortality at 30
days, recurrent adjudicated MI, and the composite outcome of all-cause
mortality, nonfatal recurrent MI, ischemia driven unscheduled coronary
revascularization (percutaneous coronary intervention or coronary artery
bypass grafting), or readmission to the hospital for ischemic cardiac
diagnosis within 30 days. The trial will assess multiple tertiary end
points. Conclusion(s): The MINT trial will inform RBC transfusion
practice in patients with acute MI. Copyright © 2022 Elsevier
Inc.

<24>
Accession Number
2022017839
Title
Artificial intelligence guidance of advanced heart failure therapies: A
systematic scoping review.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1127716. Date of Publication: 2023.
Author
Al-Ani M.A.; Bai C.; Hashky A.; Parker A.M.; Vilaro J.R.; Aranda Jr J.M.;
Shickel B.; Rashidi P.; Bihorac A.; Ahmed M.M.; Mardini M.T.
Institution
(Al-Ani, Parker, Vilaro, Aranda Jr, Ahmed) Division of Cardiovascular
Medicine, University of Florida, Gainesville, FL, United States
(Bai, Mardini) Department of Health Outcomes and Biomedical Informatics,
University of Florida, Gainesville, FL, United States
(Hashky) Department of Computer and Information Science and Engineering,
University of Florida, Gainesville, FL, United States
(Shickel, Bihorac) Department of Medicine, University of Florida,
Gainesville, FL, United States
(Shickel, Rashidi, Bihorac) Intelligent Critical Care Center (IC3),
University of Florida, Gainesville, FL, United States
(Rashidi) Department of Biomedical Engineering, University of Florida,
Gainesville, FL, United States
Publisher
Frontiers Media S.A.
Abstract
Introduction: Artificial intelligence can recognize complex patterns in
large datasets. It is a promising technology to advance heart failure
practice, as many decisions rely on expert opinions in the absence of
high-quality data-driven evidence. Method(s): We searched Embase, Web
of Science, and PubMed databases for articles containing "artificial
intelligence," "machine learning," or "deep learning" and any of the
phrases "heart transplantation," "ventricular assist device," or
"cardiogenic shock" from inception until August 2022. We only included
original research addressing post heart transplantation (HTx) or
mechanical circulatory support (MCS) clinical care. Review and data
extraction were performed in accordance with PRISMA-Scr guidelines.
 Result(s): Of 584 unique publications detected, 31 met the inclusion
criteria. The majority focused on outcome prediction post HTx (n = 13) and
post durable MCS (n = 7), as well as post HTx and MCS management (n = 7, n
= 3, respectively). One study addressed temporary mechanical circulatory
support. Most studies advocated for rapid integration of AI into clinical
practice, acknowledging potential improvements in management guidance and
reliability of outcomes prediction. There was a notable paucity of
external data validation and integration of multiple data modalities.
 Conclusion(s): Our review showed mounting innovation in AI
application in management of MCS and HTx, with the largest evidence
showing improved mortality outcome prediction. Copyright © 2023
Al-Ani, Bai, Hashky, Parker, Vilaro, Aranda, Shickel, Rashidi, Bihorac,
Ahmed and Mardini.

<25>
Accession Number
2021995165
Title
Nomogram prediction model of postoperative pneumonia in patients with lung
cancer: A retrospective cohort study.
Source
Frontiers in Oncology. 13 (no pagination), 2023. Article Number: 1114302.
Date of Publication: 2023.
Author
Jin F.; Liu W.; Qiao X.; Shi J.; Xin R.; Jia H.-Q.
Institution
(Jin, Liu, Qiao, Shi, Xin, Jia) Department of Anesthesiology, The Fourth
hospital of Hebei Medical University, Hebei, Shijiazhuang, China
(Jin) Department of Anesthesiology, Zhuji People's Hospital, Zhejiang,
Shaoxing, China
Publisher
Frontiers Media S.A.
Abstract
Background: The prediction model of postoperative pneumonia (POP) after
lung cancer surgery is still scarce. Method(s): Retrospective
analysis of patients with lung cancer who underwent surgery at The Fourth
Hospital of Hebei Medical University from September 2019 to March 2020 was
performed. All patients were randomly divided into two groups, training
cohort and validation cohort at the ratio of 7:3. The nomogram was
formulated based on the results of multivariable logistic regression
analysis and clinically important factors associated with POP. Concordance
index (C-index), receiver operating characteristic (ROC) curve,
calibration curve, Hosmer-Lemeshow goodness-of-fit test and decision curve
analysis (DCA) were used to evaluate the predictive performance of the
nomogram. Result(s): A total of 1252 patients with lung cancer was
enrolled, including 877 cases in the training cohort and 375 cases in the
validation cohort. POP was found in 201 of 877 patients (22.9%) and 89 of
375 patients (23.7%) in the training and validation cohorts, respectively.
The model consisted of six variables, including smoking, diabetes
mellitus, history of preoperative chemotherapy, thoracotomy, ASA grade and
surgery time. The C-index from AUC was 0.717 (95%CI:0.677-0.758) in the
training cohort and 0.726 (95%CI:0.661-0.790) in the validation cohort.
The calibration curves showed the model had good agreement. The result of
DCA showed that the model had good clinical benefits. Conclusion(s):
This proposed nomogram could predict the risk of POP in patients with lung
cancer surgery in advance, which can help clinician make reasonable
preventive and treatment measures. Copyright © 2023 Jin, Liu,
Qiao, Shi, Xin and Jia.

<26>
Accession Number
2023110367
Title
Meta-Analysis of Cerebral Embolic Protection During Transcatheter Aortic
Valve Replacement.
Source
American Journal of Cardiology. 192 (pp 255-257), 2023. Date of
Publication: 01 Apr 2023.
Author
Al-Abdouh A.; Mhanna M.; Jabri A.; Ahmed T.; Altibi A.M.; Ghanem F.;
Alhuneafat L.; Albadawi A.; Barbarawi M.; Dewaswala N.; Bhopalwala H.;
Kundu A.; Elgendy I.Y.
Institution
(Al-Abdouh, Ahmed, Bhopalwala) Department of Medicine, University of
Kentucky, Lexington, Kentucky
(Mhanna) Department of Cardiovascular Medicine, University of Iowa, Iowa
City, IA, United States
(Jabri) Department of Cardiology, Case Western University (Metrohealth),
Cleveland, Ohio, United States
(Altibi) Division of Cardiology, Oregon Health and Science University,
Portland, Oregon, United States
(Ghanem) Department of Internal Medicine, East Tennessee State University,
Johnson City, TN, United States
(Alhuneafat) Department of Internal Medicine, Allegheny Health Network,
Pittsburgh, PA, United States
(Albadawi) Division of Cardiology UT Southwestern Dallas, TX, United
States
(Barbarawi, Kundu) Department of Cardiology, University of Connecticut,
Framingham, CT, United States
(Dewaswala, Elgendy) Division of Cardiovascular Medicine, Gill Heart
Institute, University of Kentucky, Lexington, Kentucky
Publisher
Elsevier Inc.

<27>
Accession Number
2021341503
Title
2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease:
A Report of the American Heart Association/American College of Cardiology
Joint Committee on Clinical Practice Guidelines.
Source
Journal of the American College of Cardiology. 80(24) (pp e223-e393),
2022. Date of Publication: 13 Dec 2022.
Author
Isselbacher E.M.; Preventza O.; Hamilton Black III J.; Augoustides J.G.;
Beck A.W.; Bolen M.A.; Braverman A.C.; Bray B.E.; Brown-Zimmerman M.M.;
Chen E.P.; Collins T.J.; DeAnda A.; Fanola C.L.; Girardi L.N.; Hicks C.W.;
Hui D.S.; Jones W.S.; Kalahasti V.; Kim K.M.; Milewicz D.M.; Oderich G.S.;
Ogbechie L.; Promes S.B.; Ross E.G.; Schermerhorn M.L.; Times S.S.; Tseng
E.E.; Wang G.J.; Woo Y.J.
Publisher
Elsevier Inc.
Abstract
Aim: The "2022 ACC/AHA Guideline for the Diagnosis and Management of
Aortic Disease" provides recommendations to guide clinicians in the
diagnosis, genetic evaluation and family screening, medical therapy,
endovascular and surgical treatment, and long-term surveillance of
patients with aortic disease across its multiple clinical presentation
subsets (ie, asymptomatic, stable symptomatic, and acute aortic
syndromes). Method(s): A comprehensive literature search was
conducted from January 2021 to April 2021, encompassing studies, reviews,
and other evidence conducted on human subjects that were published in
English from PubMed, EMBASE, the Cochrane Library, CINHL Complete, and
other selected databases relevant to this guideline. Additional relevant
studies, published through June 2022 during the guideline writing process,
were also considered by the writing committee, where appropriate.
Structure: Recommendations from previously published AHA/ACC guidelines on
thoracic aortic disease, peripheral artery disease, and bicuspid aortic
valve disease have been updated with new evidence to guide clinicians. In
addition, new recommendations addressing comprehensive care for patients
with aortic disease have been developed. There is added emphasis on the
role of shared decision making, especially in the management of patients
with aortic disease both before and during pregnancy. The is also an
increased emphasis on the importance of institutional interventional
volume and multidisciplinary aortic team expertise in the care of patients
with aortic disease. Copyright © 2022 American College of
Cardiology Foundation and the American Heart Association, Inc.

<28>
Accession Number
2023110168
Title
Recombinant Alpha-1-Microglobulin (RMC-035) to Prevent Acute Kidney Injury
in Cardiac Surgery Patients: Phase 1b Evaluation of Safety and
Pharmacokinetics.
Source
Kidney International Reports. (no pagination), 2023. Date of Publication:
2023.
Author
Weiss R.; Meersch M.; Wempe C.; von Groote T.; Agervald T.; Zarbock A.
Institution
(Weiss, Meersch, Wempe, von Groote, Zarbock) Department of Anesthesiology,
Intensive Care and Pain Medicine, University Hospital Munster, Munster,
Germany
(Agervald) Guard Therapeutics International AB, Stockholm, Sweden
(Agervald) Renal Division, Department of Clinical Science, Intervention
and Technology, Karolinska Institutet, Stockholm, Sweden
Publisher
Elsevier Inc.
Abstract
Introduction: Acute kidney injury (AKI) is a common complication in
cardiac surgery patients and prevention is needed to improve clinical
outcomes. Alpha-1-microglobulin (A1M) is a physiological antioxidant with
strong tissue-protective and cell-protective properties that has
demonstrated renoprotective effects. RMC-035, a recombinant variant of
endogenous human A1M, is being developed for the prevention of AKI in
cardiac surgery patients. Method(s): In this phase 1b, randomized,
double-blind, and parallel group clinical study, 12 cardiac surgery
patients undergoing elective, open-chest, on-pump coronary artery bypass
graft and/or valve surgery with additional predisposing AKI risk factors
were enrolled to receive in total 5 intravenous doses of either RMC-035 or
placebo. The primary objective was to evaluate the safety and tolerability
of RMC-035. The secondary objective was to evaluate its pharmacokinetic
properties. Result(s): RMC-035 was well tolerated. The nature and
frequency of adverse events (AEs) were consistent with the expected
background rates in the underlying patient population with no AEs reported
as related to study drug. No clinically relevant changes were observed for
vital signs or laboratory parameters except for renal biomarkers. Several
established AKI urine biomarkers were reduced at 4 hours after first dose
administration in the treatment group, indicating a reduced perioperative
tubular cell injury following RMC-035 treatment. Conclusion(s):
Multiple intravenous doses of RMC-035 were well tolerated in patients
undergoing cardiac surgery. Observed RMC-035 plasma exposures were safe
and in the range of expected pharmacological activity. Furthermore, urine
biomarkers suggest reduced perioperative kidney cell injury, warranting
further investigation of RMC-035 as a potential renoprotective
treatment. Copyright © 2023 International Society of Nephrology

<29>
Accession Number
2023108228
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: 2023.
Author
Townsley M.M.
Institution
(Townsley) Division of Congenital Cardiac Anesthesiology, University of
Alabama at Birmingham School of Medicine, Birmingham, AL
(Townsley) Bruno Pediatric Heart Center, Children's of Alabama,
Birmingham, AL
Publisher
W.B. Saunders

<30>
Accession Number
2023101193
Title
A Randomized Trial of an Exclusive Human Milk Diet in Neonates with Single
Ventricle Physiology.
Source
Journal of Pediatrics. (no pagination), 2023. Date of Publication: 2023.
Author
Blanco C.L.; Hair A.; Justice L.B.; Roddy D.; Bonagurio K.; Williams P.K.;
Machado D.; Marino B.S.; Chi A.; Takao C.; Gordon E.E.; Ashrafi A.; Cacho
N.; Pruetz J.D.; Costello J.M.; Cooper D.S.
Institution
(Blanco, Bonagurio) Division of Neonatology, Department of Pediatrics,
University of Texas Health Science Center and University Health, San
Antonio, TX
(Hair) Division of Neonatology, Department of Pediatrics, Texas Children's
Hospital, Baylor College of Medicine, Houston, TX
(Justice) Department of Cardiology, The Heart Institute, Cincinnati
Children's Hospital Medical Center, Cincinnati, OH
(Roddy) Division of Pediatric Critical Care, Department of Pediatrics,
Texas Children's Hospital, Baylor College of Medicine, Houston, TX
(Williams) Division of Neonatal Perinatal Medicine, Department of
Pediatrics, Oklahoma Children's Hospital, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, United States
(Machado) Pediatric Cardiac ICU, Congenital Heart Center, Shands Hospital
University of Florida, Gainesville, FL, United States
(Marino, Costello) Department of Pediatrics, Ann & Robert H. Lurie
Children's Hospital of Chicago, Chicago, IL
(Marino) Department of Pediatric Cardiology, Cleveland Clinic Children's,
Cleveland, OH
(Chi) Division of Neonatology, Cook Children's Medical Center, Fort Worth,
TX, United States
(Takao, Pruetz) Division of Cardiology, Department of Pediatrics,
Children's Hospital of Los Angeles, University of Southern California, Los
Angeles, CA
(Gordon) Division of Critical Care, Department of Pediatrics, University
of Texas Southwestern., Dallas, TX
(Ashrafi) Department of Pediatrics, Children's Hospital of Orange County,
Orange, CA
(Cacho) Division of Neonatology, Congenital Heart Center, Department of
Pediatrics, Shands Hospital University of Florida, Gainesville, FL, United
States
(Costello) Pediatric Cardiology, Department of Pediatrics, Shawn Jenkins
Children's Hospital, Medical University of South Carolina, Charleston, SC
(Cooper) The Heart Institute, Cincinnati Children's Hospital Medical
Center, Department of Pediatrics, University of Cincinnati College of
Medicine, Cincinnati, OH
Publisher
Elsevier Inc.
Abstract
Objective: To determine whether weight gain velocity (g/kg/day) 30 days
after the initiation of feeds after cardiac surgery and other clinical
outcomes improve in infants with single ventricle physiology fed an
exclusive human milk diet compared with a mixed human and bovine diet.
Study design: In this multicenter, randomized, single blinded, controlled
trial, term neonates 7 days of age or younger with single ventricle
physiology and anticipated cardiac surgical palliation within 30 days of
birth were enrolled at 10 US centers. Both groups received human milk if
fed preoperatively. During the 30 days after feeds were started
postoperatively, infants in the intervention group received human milk
fortified once enteral intake reached 60 mL/kg/day with a human milk-based
fortifier designed for term neonates. The control group received standard
fortification with formula once enteral intake reached 100 mL/kg/day.
Perioperative feeding and parenteral nutrition study algorithms were
followed. Result(s): We enrolled 107 neonates (exclusive human milk =
55, control = 52). Baseline demographics and characteristics were similar
between the groups. The median weight gain velocity at study completion
was higher in exclusive human milk vs control group (12 g/day [IQR, 5-18
g/day] vs 8 g/day [IQR, 0.4-14 g/day], respectively; P =.03). Other growth
measures were similar between groups. Necrotizing enterocolitis of all
Bell stages was higher in the control group (15.4 % vs 3.6%, respectively;
P =.04). The incidence of other major morbidities, surgical complications,
length of hospital stay, and hospital mortality were similar between the
groups. Conclusion(s): Neonates with single ventricle physiology have
improved short-term growth and decreased risk of NEC when receiving an
exclusive human milk diet after stage 1 surgical palliation. Trial
Registration: This trial is registered with ClinicalTrials.gov
(www.clinicaltrials.gov, Trial ID: NCT02860702). Copyright © 2022
Elsevier Inc.

<31>
Accession Number
625556086
Title
Effects of patient-controlled analgesia with hydromorphone or sufentanil
on postoperative pulmonary complications in patients undergoing thoracic
surgery: A quasi-experimental study.
Source
BMC Anesthesiology. 18(1) (no pagination), 2018. Article Number: 192. Date
of Publication: 19 Dec 2018.
Author
Yan G.; Chen J.; Yang G.; Duan G.; Du Z.; Yu Z.; Peng J.; Liao W.; Li H.
Institution
(Yan, Chen, Yang, Duan, Du, Peng, Liao, Li) Department of Anesthesiology,
Anesthesiology of Xinqiao Hospital of Third Military Medical University,
Shapingba District, Chongqing 400037, China
(Yu) Department of Anesthesiology, Xinqiao Hospital, Thoracic Surgery of
Xinqiao Hospital of Third Military Medical University, Shapingba District,
Chongqing 400037, China
Publisher
BioMed Central Ltd
Abstract
Objective: To compare the analgesic effects of patient-controlled
intravenous analgesia (PCA) with hydromorphone and sufentanil after
thoracic surgery on postoperative pulmonary complications (PPCs).
 Method(s): A total of 142 patients who were scheduled for thoracic
surgery were randomly allocated to receive PCA with hydromorphone (group
A: experimental group): hydromorphone 0.2 mg/kg + dezocine 0.5 mg/kg +
ramosetron 0.6 mg diluted with normal saline to 200 mL; or with sufentanil
(group B: control group): sufentanil 3.0mug/kg + dezocine 0.5 mg/kg +
ramosetron 0.6 mg diluted with normal saline to 200 mL. The parameters of
intravenous analgesia pump were set as background dose 4 ml/h, PCA dose 1
mL, locking time 15 min. Pain NRS (numerical rating scale), Ramsay
sedation score, nausea or vomiting score were evaluated at 0 h, 6 h, 12 h,
24 h, 48 h after operation. The cases of PPCs (atelectasis, pulmonary
infection, respiratory failure), CRP (C-reaction protein) and inflammatory
cells (white cell count and percentage of neutrophils) and blood gas
analysis at 12 h after operation, length of ICU and postoperative stay
were recorded for each patient. Result(s): Data of 136 patients were
analyzed. Compared with group B (4[IQR:2,2]), the pain NRS in group A
(2[IQR:4,4]) was significantly lower at 6 h after operation (P = 0.000).
The CRP in group A (69.79 +/- 32.13 mg/L) were lower than group B (76.76
+/- 43.42 mg/L) after operation, but the difference was not significant (P
= 0.427). No difference of nausea or vomiting was found between group A
(7.3%) and group B (5.8%) postoperatively (P = 0.999). The PPCs were
happened in 11 patients in group A (16.2%) and 22 patients in group B
(32.4%) and the difference between two groups was significant (P = 0.027).
Seven patients in group A (10.3%) and eighteen patients in group B (26.5%)
had clinical evidence of pneumonia and the difference between two groups
was significant (P = 0.014). The length of ICU and postoperative stay in
group A were 2.73 h and 1.82 days less than group B respectively but the
differences were not significant (P = 0.234, P = 0.186 respectively).
 Conclusion(s): Compared with sufentanil, hydromorphone may provide
better postoperative analgesic effect with less pulmonary complications
for patients undergoing thoracic surgery, and it may accelerate patients'
rehabilitation. Trial registration: Randomized Controlled Trials
ChiCTR1800014282c. Registered 3 January 2018. Copyright © 2018
The Author(s).

<32>
Accession Number
625534090
Title
Bioactive scaffolds in stem-cell-based therapies for cardiac repair:
Protocol for a meta-analysis of randomized controlled preclinical trials
in animal myocardial infarction models.
Source
Systematic Reviews. 7(1) (no pagination), 2018. Article Number: 225. Date
of Publication: 05 Dec 2018.
Author
Khan K.; Gasbarrino K.; Mahmoud I.; Makhoul G.; Yu B.; Dufresne L.;
Daskalopoulou S.S.; Schwertani A.; Cecere R.
Institution
(Khan, Makhoul, Yu, Dufresne, Schwertani, Cecere) Division of Cardiology
and Cardiac Surgery, McGill University Health Centre, Montreal, QC, Canada
(Gasbarrino, Daskalopoulou) Division of Experimental Medicine, Department
of Medicine, Faculty of Medicine, McGill University Health Centre,
Montreal, QC, Canada
(Mahmoud) McConnell Resource Centre, McGill University Health Centre,
Montreal, QC, Canada
(Cecere) Glen Campus-The Royal Victoria Hospital, 1001 Decarie Blvd,
Montreal, QC H4A 3J1, Canada
Publisher
BioMed Central Ltd
Abstract
Background: Acute myocardial infarction (MI) remains one of the leading
causes of death worldwide with no curative therapy available. Stem cell
therapies have been gaining interest as a means to repair the cardiac
tissue after MI and prevent the onset of heart failure. Many in vivo
reports suggest that the use of stem cells is promising, yet clinical
trials suggest that the cells fail to integrate into the native tissue,
resulting in limited improvements in cardiac function and repair. To
battle this limitation, the combination of using stem cells embedded in a
bioactive scaffold that promotes cell retention is growing in interest.
Yet, a systematic review of the literature on the use of stem cells
embedded in bioactive scaffolds for cardiac repair has not yet been
performed. In this protocol, we outline a systematic review and
meta-analysis of preclinical trials in animal MI models that utilize stem
cell-embedded scaffolds for cardiac repair and compare their effects to
stem cell-treated animals without the use of a scaffold. Methods/design:
We will search the following electronic databases: Cochrane Library,
MEDLINE, Embase, PubMed, Scopus and Web of Science, and gray literature:
Canadian Agency for Drugs and Technologies in Health and Google Scholar.
We will only include randomly controlled preclinical trials that have
directly investigated the effects of stem cells embedded in a scaffold for
cardiac repair in an animal MI model. Two investigators will independently
review each article included in the final analysis. The primary endpoint
that will be investigated is left ventricular ejection fraction. Secondary
endpoints will include infarct size, end systolic volume, end diastolic
volume, fractional shortening and left ventricular wall thickness. Pooled
analyses will be conducted using the DerSimonian-Laird random effects and
Mantel-Haenszel fixed-effect models. Between-studies heterogeneity will be
quantified and determined using the Tau2 and I 2
statistics. Publication bias will be assessed using visual inspection of
funnel plots and complemented by Begg's and Egger's statistical tests.
Possible sources of heterogeneity will be assessed using subgroup-meta
analysis and meta-regression. Discussion(s): To date, the use of
scaffolds in myocardial repair has not yet been systematically reviewed.
The results of this meta-analysis will aid in determining the efficacy of
stem cell-embedded scaffolds for cardiac repair and help bring this
therapy to the clinic. Copyright © 2018 The Author(s).

<33>
Accession Number
625468090
Title
Prevention of post-operative complications by using a HMG-CoA reductase
inhibitor in patients undergoing one-lung ventilation for non-cardiac
surgery: Study protocol for a randomised controlled trial.
Source
Trials. 19(1) (no pagination), 2018. Article Number: 690. Date of
Publication: 18 Dec 2018.
Author
Shyamsundar M.; O'Kane C.; Perkins G.D.; Kennedy G.; Campbell C.; Agus A.;
Phair G.; McAuley D.
Institution
(Shyamsundar, O'Kane, McAuley) Centre for Experimental Medicine, Queen's
University Belfast, Belfast BT9 7BL, United Kingdom
(Perkins) Warwick Trials Unit, University of Warwick, Coventry CV4 7AL,
United Kingdom
(Kennedy, Campbell, Agus, Phair) Northern Ireland Clinical Trials Unit,
Royal Hospitals, 1st Floor Elliott Dynes Building, Belfast BT12 6BA,
United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative pulmonary complications (PPC) and peri-operative
myocardial infarction (MI) have a significant impact on the long-term
mortality of surgical patients. Patients undergoing one-lung ventilation
(OLV) for surgery are at a high risk of developing these complications.
These complications could be associated with intensive care unit (ICU)
admissions and longer hospital stay with associated resource and economic
burden. Simvastatin, a HMG-CoA reductase enzyme inhibitor has been shown
to have pleiotropic anti-inflammatory effects as well as being endothelial
protective. The benefits of statins have been shown in various
observational studies and in small proof-of-concept studies. There is an
urgent need for a well-designed, large clinical trial powered to detect
clinical outcomes. The Prevention HARP 2 trial will test the hypothesis
'simvastatin 80 mg when compared to placebo will reduce cardiac and
pulmonary complications in patients undergoing elective oesophagectomy,
lobectomy or pneumonectomy'. Methods/design: The Prevention HARP 2 trial
is a UK multi-centre, randomised, double-blind, placebo-controlled trial.
Adult patients undergoing elective oesophagectomy, lobectomy or
pneumonectomy will be eligible. Patients who are already on statins will
be excluded from this trial. Patients will be randomised to receive
simvastatin 80 mg or matched placebo for 4 days pre surgery and for up to
7 days post surgery. The primary outcome is a composite outcome of PPC and
MI within 7 days post surgery. Various secondary outcome measures
including clinical outcomes, safety outcomes and health economic outcomes
will be collected. The study aims to recruit 452 patients in total across
12 UK sites. Discussion(s): The results of the Prevention HARP 2
trial should add to our understanding of the benefits of peri-operative
statins and influence clinical decision-making. Analysis of blood and
urine samples from the patients will provide insight into the mechanism of
simvastatin action. Trial registration: International Standard Randomised
Controlled Trials registry, ID: ISRCTN48095567. Registered on 11 November
2016. Copyright © 2018 The Author(s).

<34>
Accession Number
624971429
Title
A perioperative surgeon-controlled open-lung approach versus conventional
protective ventilation with low positive end-expiratory pressure in
cardiac surgery with cardiopulmonary bypass (PROVECS): Study protocol for
a randomized controlled trial.
Source
Trials. 19(1) (no pagination), 2018. Article Number: 624. Date of
Publication: 13 Nov 2018.
Author
Lagier D.; Fischer F.; Fornier W.; Fellahi J.-L.; Colson P.; Cholley B.;
Jaber S.; Baumstarck K.; Guidon C.; Quintana G.; Gaillat F.; Nedir P.;
Duponq R.; Gomert R.; Guinard B.; Heraud F.; Villacorta J.; Degirmenci S.;
Pernoud N.; Samarani G.; Lalande M.; Huynh T.M.; Gros C.; Elmiloudi F.;
Tacquard C.; Bilger A.; Levy F.; Cinca E.; Bongarzone C.; Heger B.; Balvay
V.; Berns M.; Oulehri W.; Ouattara A.
Institution
(Lagier, Guidon) Department of Cardiovascular Anesthesiology and Critical
Care Medicine, La Timone University Hospital, AP-HM, Aix-Marseille
University, 264 rue saint Pierre, Marseille, cedex 5 13005, France
(Fischer) Department of Cardiovascular and Thoracic Anesthesiology, Nouvel
Hopital Civil, Strasbourg, France
(Fornier, Fellahi) Department of Anesthesiology and Critical Care
Medicine, Louis Pradel University Hospital, University Claude Bernard, 28
Avenue du Doyen Lepine, Bron 69677, France
(Colson) Department of Anesthesiology and Critical Care Medicine, Arnaud
de Villeneuve University Hospital, 371 Avenue du Doyen Gaston Giraud,
Montpellier 34295, France
(Cholley) Department of Anesthesiology and Critical Care Medicine, Hopital
Europeen Georges Pompidou, AP-HP, University Paris Descartes-Sorbonne
Paris Cite, 20 Rue Leblanc, Paris 75015, France
(Jaber) Department of Anesthesiology and Critical Care Medicine, Saint
Eloi University Hospital, 80 Avenue Augustin Fliche, Montpellier 34295,
France
(Baumstarck) Unite de Recherche EA3279, Aix-Marseille University, 27 bd
Jean Moulin, Marseille, Marseille, cedex 5 13385, France
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative pulmonary complications (PPCs) are frequent
after on-pump cardiac surgery. Cardiac surgery results in a complex
pulmonary insult leading to high susceptibility to perioperative pulmonary
atelectasis. For technical reasons, ventilator settings interact with the
surgical procedure and traditionally, low levels of positive
end-expiratory pressure (PEEP) have been used. The objective is to compare
a perioperative, multimodal and surgeon-controlled open-lung approach with
conventional protective ventilation with low PEEP to prevent PPCs in
patients undergoing cardiac surgery. Methods/design: The perioperative
open-lung protective ventilation in cardiac surgery (PROVECS) trial is a
multicenter, two-arm, randomized controlled trial. In total, 494 patients
scheduled for elective cardiac surgery with cardiopulmonary bypass (CPB)
and aortic cross-clamp will be randomized into one of the two treatment
arms. In the experimental group, systematic recruitment maneuvers and
perioperative high PEEP (8 cmH2O) are associated with ultra-protective
ventilation during CPB. In this group, the settings of the ventilator are
controlled by surgeons in relation to standardized protocol deviations. In
the control group, no recruitment maneuvers, low levels of PEEP (2 cmH2O)
and continuous positive airway pressure during CPB (2 cmH2O) are used. Low
tidal volumes (6-8 mL/kg of predicted body weight) are used before and
after CPB in each group. The primary endpoint is a composite of the single
PPCs evaluated during the first 7 postoperative days. Discussion(s):
The PROVECS trial will be the first multicenter randomized controlled
trial to evaluate the impact of a perioperative and multimodal open-lung
ventilatory strategy on the occurrence of PPCs after on-pump cardiac
surgery. The trial design includes standardized surgeon-controlled
protocol deviations that guarantee a pragmatic approach. The results will
help anesthesiologists and surgeons aiming to optimize ventilatory
settings during cardiac surgery. Trial registration: Clinical Trials.gov,
NCT 02866578. Registered on 15 August 2016. Last updated 11 July
2017. Copyright © 2018 The Author(s).

<35>
Accession Number
624073315
Title
Effects of methylprednisolone on blood-brain barrier and cerebral
inflammation in cardiac surgery - A randomized trial.
Source
Journal of Neuroinflammation. 15(1) (no pagination), 2018. Article Number:
283. Date of Publication: 27 Sep 2018.
Author
Danielson M.; Reinsfelt B.; Westerlind A.; Zetterberg H.; Blennow K.;
Ricksten S.-E.
Institution
(Danielson, Reinsfelt, Westerlind, Ricksten) Department of Anesthesiology
and Intensive Care Medicine, Sahlgrenska University Hospital, University
of Gothenburg, Gothenburg SE-413 45, Sweden
(Zetterberg, Blennow) Deparment of Anesthesiology and Intensive Care
Medicine, Sahlgrenska University Hospital, Sahlgrenska Academy, University
of Gothenburg, Gothenburg SE-41345, Sweden
Publisher
BioMed Central Ltd
Abstract
Background: Cognitive dysfunction is a frequent complication to open-heart
surgery. Cerebral inflammation caused by blood-brain barrier (BBB)
dysfunction due to a systemic inflammatory response is considered a
possible etiology. The effects of the glucocorticoid, methylprednisolone,
on cerebrospinal fluid (CSF) markers of BBB function, neuroinflammation,
and brain injury in patients undergoing cardiac surgery with
cardiopulmonary bypass were studied. Method(s): In this prospective,
randomized, blinded study, 30 patients scheduled for elective surgical
aortic valve replacement were randomized to methylprednisolone 15 mg/kg (n
= 15) or placebo (n = 15) as a bolus dose administered after induction of
anesthesia. CSF and blood samples were obtained the day before and 24 h
after surgery for assessment of systemic and brain inflammation
(interleukin-6, interleukin-8, tumor necrosis factor-alpha), axonal injury
(total-tau, neurofilament light chain protein), neuronal injury
(neuron-specific enolase), astroglial injury (S-100B, glial fibrillary
acidic protein), and the BBB integrity (CSF/serum albumin ratio).
 Result(s): In the control group, there was a 54-fold and 17-fold
increase in serum interleukin-6 and interleukin-8, respectively. This
systemic activation of the inflammatory cytokines was clearly attenuated
by methylprednisolone (p < 0.001). The increase of the CSF levels of the
astroglial markers was not affected. A postoperative BBB dysfunction was
seen in both groups as the CSF/serum albumin ratio increased from 6.4 +/-
8.0 to 8.0 in the placebo group (p < 0.01) and from 5.6 +/- 2.3 to 7.2 in
the methylprednisolone group (p < 0.01) with no difference between groups
(p = 0.98). In the CSF, methylprednisolone attenuated the interleukin-6
release (p < 0.001), which could be explained by the fall in systemic
interleukin-6, and the serum to CSF gradient of IL-6 seen both at baseline
and after surgery. In the CSF, methylprednisolone enhanced the
interleukin-8 release (p < 0.001) but did not affect postoperative changes
in CSF levels of tumor necrosis factor alpha. Serum levels of S-100B and
neuron-specific enolase increased in both groups with no difference
between groups. CSF levels of total tau, neurofilament light chain
protein, and neuron-specific enolase were not affected in any of the
groups. Conclusion(s): Preventive treatment with high-dose
methylprednisolone attenuated the systemic inflammatory response to
open-heart surgery with cardiopulmonary bypass, but did not prevent or
attenuate the increase in BBB permeability or the neuroinflammatory
response. Trial registration: Clinical Trials, Identifier: NCT01755338,
registered 24 December 2012 Copyright © 2018 The Author(s).

<36>
[Use Link to view the full text]
Accession Number
2022956869
Title
Clear cell "sugar" tumor of the lung: Diagnostic characteristics of a rare
pulmonary tumor: A case report and review of literature.
Source
Medicine (United States). 102(7) (pp E33035), 2023. Date of Publication:
17 Feb 2023.
Author
Wang B.; Xu X.; Zhao Z.
Institution
(Wang, Xu, Zhao) Department of Pathology, Xingtai People's Hospital
Affiliated to Hebei Medical University, Hebei, Xingtai, China
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Clear cell tumors of the lung (CCTLs), also known as "sugar
tumors" for an abundant cellular glycogen concentration, are an extremely
rare type pulmonary neoplasm. Often, they are incidentally found on chest
roentgenogram or computed tomography scan during routine examination.
CCTLs usually present with nonspecific symptoms that pose a diagnostic
challenge to clinicians. Accordingly, histopathology remains the gold
standard for diagnosing. Moreover, some of them can present with either
appearances or histopathological features similar to other pulmonary
neoplasms under the light microscope, including pulmonary malignancy,
thereby causing misdiagnosis prior to or after surgery. Accordingly,
herein, we describe a rare case of CCTL, review the literature has been
published, and then discuss the benign versus malignant nature of this
rare tumor. Patient concerns: A 59-year-old man presented due to a
high-density chest nodule in the left diaphragm. The patient's medical
history was unremarkable and he also denied smoking in the past.
Diagnosis: Physical examination, there were no noted signs. A new chest
contrast-enhanced computed tomography revealed a 3.2 x 2.5 cm, solitary,
circular nodule with a smooth edge located in the beside of the left
thoracic aorta. Postoperative pathological and immunohistochemical
examinations of the surgical specimens revealed a final diagnosis of
CCTLs. Intervention(s): The patient underwent video-assisted
thoracoscopic surgery. A wedge resection of left lower lung lobe was
carried out and the tumor node was successfully removed alongside normal
surrounding parenchyma. Outcome(s): The operation was successful.
Then the patient recovered completely and continued to do well on
postsurgical thoracic surgical clinic visits. The tumor was a benign
tumor, and the patient did not require any additional treatment. The
patient had been followed-up regularly for 4 years after surgery; she did
not experience any complications and remained disease-free.
 Conclusion(s): CCTLs should be considered in the differential
diagnosis if a patient shows a solitary, circular chest nodule with a
smooth edge. They are extremely rare lung tumors that must be
differentiated from other lung tumors, especially the malignant tumors.
Although pathological and immunohistochemical findings are important for
making the diagnosis, the varying histopathological features on microscope
make diagnosis difficult. The current case highlights the importance of
physicians being aware of and suspecting CCTLs in similar cases, along
with knowing the characteristics of CCTLs for the diagnosis and
differential diagnosis. Copyright © 2023 Authors. All rights
reserved.

<37>
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). Design(s):
A single-center, double-blind, prospective, randomized, placebo-controlled
trial. Setting(s): Postoperative period; operating room,
post-anesthesia care unit (PACU) and hospital ward in a university
hospital. Patient(s): Sixty-four patients undergoing RAMIDCAB surgery
via left-sided mini-thoracotomy and enrolled in the institutional enhanced
recovery after cardiac surgery program. 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. 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. Conclusion(s): Following RAMIDCAB surgery, adding
an ESP block to a standard multimodal analgesia regimen did not reduce
opioid consumption and pain scores. Copyright © 2023 Elsevier
Inc.

<38>
Accession Number
2023165456
Title
Metacognitive therapy home-based self-help for anxiety and depression in
cardiovascular disease patients in the UK: A single-blind randomised
controlled trial.
Source
PLoS Medicine. 20(1) (no pagination), 2023. Article Number: e1004161. Date
of Publication: January 2023.
Author
Wells A.; Reeves D.; Heal C.; Fisher P.; Doherty P.; Davies L.; Heagerty
A.; Capobianco L.
Institution
(Wells) Faculty of Biology, Medicine and Health, School of Psychological
Sciences, The University of Manchester, Manchester, United Kingdom
(Wells, Capobianco) Research and Innovation, Greater Manchester Mental
Health NHS Foundation Trust, Manchester, United Kingdom
(Reeves, Heal) NIHR School for Primary Care Research, Manchester Academic
Health Science Centre, The University of Manchester, Manchester, United
Kingdom
(Fisher) Institute of Psychology, Health and Society, University of
Liverpool, Liverpool, United Kingdom
(Fisher) Liverpool Clinical Health, The Royal Liverpool and Broadgreen
University Hospital NHS Trust, Liverpool, United Kingdom
(Doherty) Department of Health Sciences, University of York, York, United
Kingdom
(Davies) Centre for Health Economics, Division of Population Health,
Health Services Research and Primary Care, Faculty of Biology Medicine and
Health, School of Health Sciences, The University of Manchester,
Manchester, United Kingdom
(Heagerty) Core Technology Facility, The University of Manchester School
of Medical Sciences, Manchester, United Kingdom
(Heagerty) Manchester University NHS Foundation Trust, Manchester Royal
Infirmary, Manchester, United Kingdom
Publisher
Public Library of Science
Abstract
Background Anxiety and depression in cardiac rehabilitation (CR) are
associated with greater morbidity, mortality, and increased healthcare
costs. Current psychological interventions within CR have small effects
based on low-quality studies of clinic-based interventions with limited
access to home-based psychological support. We tested the effectiveness of
adding self-help metacognitive therapy (Home-MCT) to CR in reducing
anxiety and depression in a randomised controlled trial (RCT). Methods and
findings We ran a single-blind, multi-centre, two-arm RCT. A total of 240
CR patients were recruited from 5 NHS-Trusts across North West England
between April 20, 2017 and April 6, 2020. Patients were randomly allocated
to Home-MCT+CR (n = 118, 49.2%) or usual CR alone (n = 122, 50.8%).
Randomisation was 1:1 via randomised blocks within hospital site,
balancing arms on sex and baseline Hospital Anxiety and Depression Scale
(HADS) scores. The primary outcome was the HADS total score at
posttreatment (4-month follow-up). Follow-up data collection occurred
between August 7, 2017 and July 20, 2020. Analysis was by intention to
treat. The 4-month outcome favoured the MCT intervention group
demonstrating significantly lower end of treatment scores (HADS total:
adjusted mean difference = -2.64 [-4.49 to -0.78], p = 0.005, standardised
mean difference (SMD) = 0.38). Sensitivity analysis using multiple
imputation (MI) of missing values supported these findings. Most secondary
outcomes also favoured Home-MCT+CR, especially in reduction of
post-traumatic stress symptoms (SMD = 0.51). There were 23 participants
(19%) lost to follow-up in Home-MCT+CR and 4 participants (3%) lost to
follow-up in CR alone. No serious adverse events were reported. The main
limitation is the absence of longer term (e.g., 12-month) follow-up data.
Conclusion Self-help home-based MCT was effective in reducing total
anxiety/depression in patients undergoing CR. Improvement occurred across
most psychological measures. Home-MCT was a promising addition to cardiac
rehabilitation and may offer improved access to effective psychological
treatment in cardiovascular disease (CVD) patients. Copyright: ©
2023 Wells et al. This is an open access article distributed under the
terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original author and source are credited.

<39>
Accession Number
2021195535
Title
Cerebral Embolic Protection in Transcatheter Aortic Valve Replacement: A
Meta-Analysis of Randomized Clinical Trials.
Source
American Journal of Cardiology. 187 (pp 179-180), 2023. Date of
Publication: 15 Jan 2023.
Author
Al-Abcha A.; Saleh Y.; Abbasi M.; El-Am E.; Alkhouli M.
Institution
(Al-Abcha, Abbasi, El-Am, Alkhouli) Department of Cardiovascular Medicine,
Mayo Clinic, Rochester, Minnesota, United States
(Saleh) Department of Cardiovascular Medicine, Houston Methodist DeBakey
Heart and Vascular Center, Houston, Texas, United States
Publisher
Elsevier Inc.

<40>
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. 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). 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). 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. Copyright © 2023
Wiley Periodicals LLC.

<41>
Accession Number
640073453
Title
Transcatheter versus surgical aortic valve replacement in lower-risk and
higher-risk patients: a meta-analysis of randomized trials.
Source
European heart journal. 44(10) (pp 836-852), 2023. Date of Publication: 07
Mar 2023.
Author
Ahmad Y.; Howard J.P.; Arnold A.D.; Madhavan M.V.; Cook C.M.; Alu M.; Mack
M.J.; Reardon M.J.; Thourani V.H.; Kapadia S.; Thyregod H.G.H.;
Sondergaard L.; Jorgensen T.H.; Toff W.D.; Van Mieghem N.M.; Makkar R.R.;
Forrest J.K.; Leon M.B.
Institution
(Ahmad, Forrest) Yale School of Medicine, Yale University, CT 06510, 135
College Street, New Haven, United States
(Howard, Arnold) National Heart and Lung Institute, Imperial College
London, Du Cane Road, London W120HS, United Kingdom
(Madhavan, Leon) Division of Cardiology, Department of Medicine, Columbia
University Medical Center/New York-Presbyterian Hospital, W. 168th St. New
York, NY 10032, United States
(Madhavan, Alu, Leon) Clinical Trials Center, The Cardiovascular Research
Foundation, 1700 Broadway, New York, NY 10019, USA
(Cook) Essex Cardiothoracic Center, Nether Mayne, Basildon SS16 5NL,
United Kingdom
(Mack) Department of Cardiovascular Disease, Baylor Scott and White
Health, 4700 Alliance Blvd, Plano, United States
(Reardon) Houston Methodist DeBakey Heart & Vascular Center, 6565 Fannin
St Suite 1901, Houston TX 77030, United States
(Thourani) Department of Cardiovascular Surgery, Marcus Valve Center,
Piedmont Heart and Vascular Institute, 95 Collier Rd NW Suite 5015,
Atlanta, United States
(Kapadia) Cleveland Clinic OH 44195, United States
(Thyregod, Sondergaard, Jorgensen) Heart Centre, Rigshospitalet,
Copenhagen University Hospital, Blegdamsvej 9 ,2100 Copenhagen O, Section
2151, Denmark
(Toff) Department of Cardiovascular Sciences, University of Leicester and
NIHR Leicester Biomedical Research Centre, Glenfield Hospital ,University
Rd, Leicester LE1 7RH, United Kingdom
(Van Mieghem) Department of Interventional Cardiology, Thoraxcenter,
Erasmus University Medical Center, Dr. Molewaterplein 40, Rotterdam 3015
GD, Netherlands
(Makkar) Cedars-Sinai Medical Center, Smidt Heart Institute, S San Vicente
Blvd, Los Angeles, CA 90048, USA
Publisher
NLM (Medline)
Abstract
AIMS: Additional randomized clinical trial (RCT) data comparing
transcatheter aortic valve implantation (TAVI) with surgical aortic valve
replacement (SAVR) is available, including longer term follow-up. A
meta-analysis comparing TAVI to SAVR was performed. A pragmatic risk
classification was applied, partitioning lower-risk and higher-risk
patients. METHODS AND RESULTS: The main endpoints were death, strokes, and
the composite of death or disabling stroke, occurring at 1 year (early) or
after 1 year (later). A random-effects meta-analysis was performed. Eight
RCTs with 8698 patients were included. In lower-risk patients, at 1 year,
the risk of death was lower after TAVI compared with SAVR [relative risk
(RR) 0.67; 95% confidence interval (CI) 0.47 to 0.96, P = 0.031], as was
death or disabling stroke (RR 0.68; 95% CI 0.50 to 0.92, P = 0.014). There
were no differences in strokes. After 1 year, in lower-risk patients,
there were no significant differences in all main outcomes. In higher-risk
patients, there were no significant differences in main outcomes.
New-onset atrial fibrillation, major bleeding, and acute kidney injury
occurred less after TAVI; new pacemakers, vascular complications, and
paravalvular leak occurred more after TAVI. CONCLUSION(S): In
lower-risk patients, there was an early mortality reduction with TAVI, but
no differences after later follow-up. There was also an early reduction in
the composite of death or disabling stroke, with no difference at later
follow-up. There were no significant differences for higher-risk patients.
Informed therapy decisions may be more dependent on the temporality of
events or secondary endpoints than the long-term occurrence of main
clinical outcomes. Copyright © The Author(s) 2023. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<42>
Accession Number
2015744277
Title
Clinical features of Danon disease and insights gained from LAMP-2
deficiency models.
Source
Trends in Cardiovascular Medicine. 33(2) (pp 81-89), 2023. Date of
Publication: February 2023.
Author
Zhai Y.; Miao J.; Peng Y.; Wang Y.; Dong J.; Zhao X.
Institution
(Zhai, Peng, Dong, Zhao) Centre for Cardiovascular Diseases, Henan Key
Laboratory of Hereditary Cardiovascular Diseases, The First Affiliated
Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
(Miao) Academy of Medical Sciences, Zhengzhou University, Zhengzhou, P.R.
China;Department of Science and Technology, Henan University of Chinese
Medicine, Henan, Zhengzhou, China
(Miao, Wang) Sino-British Research Center for Molecular Oncology, National
Center for the International Research in Cell and Gene Therapy, School of
Basic Sciences, Academy of Medical Sciences, Zhengzhou University,
Zhengzhou, Henan, China
(Wang) Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary
University of London, London, United Kingdom
(Dong) Beijing Anzhen Hospital, Capital Medical University, Beijing, China
Publisher
Elsevier Inc.
Abstract
Danon disease (DD) is an X-linked multisystem disorder with clinical
features characterized by the triad of hypertrophic cardiomyopathy,
skeletal muscle weakness, and mental retardation. Cardiac involvement can
be fatal in the absence of an effective treatment option such as heart
transplantation. Molecular studies have proved that LAMP-2 protein
deficiency, mainly LAMP-2B isoform, resulting from LAMP2 gene mutation, is
the culprit for DD. Autophagy impairment due to LAMP-2 deficiency mediated
the accumulation of abnormal autophagic vacuoles in cells. While it is not
ideal for mimicking DD phenotypes in humans, the emergence of
LAMP-2-deficient animal models and induced pluripotent stem cells from DD
patients provided powerful tools for exploring DD mechanism. In both in
vitro and in vivo studies, much evidence has demonstrated that
mitochondria dysfunction and fragmentation can result in DD pathology.
Fundamental research contributes to the therapeutic transformation. By
targeting the molecular core, several potential therapies have
demonstrated promising results in partial phenotypes improvement. Among
them, gene therapies anticipate inaugurate a class of symptom control and
prevention drugs as their in vivo effects are promising, and one clinical
trial is currently underway. Copyright © 2021

<43>
Accession Number
2023258187
Title
A Systematic Review of Periprocedural Risk Prediction Scores in Chronic
Total Occlusion Percutaneous Coronary Intervention.
Source
American Journal of Cardiology. 193 (pp 118-125), 2023. Date of
Publication: 15 Apr 2023.
Author
Simsek B.; Rempakos A.; Kostantinis S.; Karacsonyi J.; Rangan B.V.;
Mastrodemos O.C.; Patel U.A.; Allana S.; Azzalini L.; Kearney K.E.; Hirai
T.; Sandoval Y.; Burke M.N.; Brilakis E.S.
Institution
(Simsek, Rempakos, Kostantinis, Karacsonyi, Rangan, Mastrodemos, Allana,
Sandoval, Burke, Brilakis) Center for Coronary Artery Disease, Minneapolis
Heart Institute and Minneapolis Heart Institute Foundation, Minneapolis,
MN, United States
(Patel) School of Medicine, Pramukhswami Medical College, Gujarat,
Karamsad, India
(Azzalini, Kearney) Division of Cardiology, Department of Medicine,
University of Washington, Seattle, WA, United States
(Hirai) Division of Cardiovascular Medicine, University of Missouri,
Columbia, Missouri, United States
Publisher
Elsevier Inc.
Abstract
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is
associated with high incidence of complications. We queried PubMed and the
Cochrane Library (last search: October 26, 2022) for CTO PCI-specific
periprocedural complication risk scores. We identified 8 CTO PCI-specific
risk scores: (1) Angiographic coronary artery perforation (OPEN-CLEAN
[Outcomes, Patient Health Status, and Efficiency iN (OPEN) Chronic Total
Occlusion (CTO) Hybrid Procedures - CABG, Length (occlusion), EF <50%,
Age, CalcificatioN] perforation, c-statistic 0.75): previous coronary
artery bypass graft surgery, occlusion length 20 to 60 mm or >=60 mm, left
ventricular ejection fraction (LVEF) <50%, age 50 to 70 years or >=70
years, heavy calcification. (2) Major adverse cardiovascular events (MACE)
(PROGRESS-CTO complication, c-statistic 0.76): age >65 years, lesion
length >=23 mm, retrograde strategy, and (3) MACE (PROGRESS-CTO MACE,
c-statistic 0.74): age >=65 years, female gender, moderate/severe
calcification, blunt/no stump, anterograde dissection and re-entry (ADR)
or retrograde strategy. (4) All-cause mortality (PROGRESS-CTO mortality,
c-statistic 0.80): age >=65, moderate/severe calcification, LVEF <=45%,
ADR or retrograde strategy. (5) Perforation requiring pericardiocentesis
(PROGRESS-CTO pericardiocentesis, c-statistic 0.78): age >=65 years,
moderate/severe calcification, female gender, ADR or retrograde strategy.
(6) Acute myocardial infarction (PROGRESS-CTO acute myocardial infarction,
c-statistic 0.72): previous coronary artery bypass graft surgery, atrial
fibrillation, blunt/no stump. (7) Perforation requiring any treatment
(PROGRESS-CTO perforation, c-statistic 0.74): age >=65 years,
moderate/severe calcification, blunt/no stump, ADR, or retrograde
strategy. (8) Contrast-induced acute kidney injury (c-statistic 0.84): age
>=75, LVEF <40%, serum creatinine >1.5 mg/100 ml, serum albumin <=30,
30<albumin<=40 or >40 g/L. There are 8 CTO PCI periprocedural risk scores
that may facilitate risk assessment and procedural planning in patients
who underwent CTO PCI. Copyright © 2023 Elsevier Inc.

<44>
Accession Number
2023104993
Title
The impact of chronic obstructive pulmonary disease on the prognosis
outcomes of patients with percutaneous coronary intervention or coronary
artery bypass grafting: A meta-analysis.
Source
Heart and Lung. 60 (pp 8-14), 2023. Date of Publication: 01 Jul 2023.
Author
Li Y.; Zheng H.; Yan W.; Cao N.; Yan T.; Zhu H.; Bao H.
Institution
(Li, Zheng, Yan, Cao, Yan, Zhu, Bao) School of Public Health, Inner
Mongolia Medical University, Hohhot, China
Publisher
Elsevier Inc.
Abstract
Background: Coronary artery disease (CAD) is one of the main types of
cardiovascular disease and is characterized by myocardial ischemia as a
result of narrowing of the coronary arteries. Objective(s): To
evaluate the impact of chronic obstructive pulmonary disease (COPD) on
outcomes in patients with CAD treated by percutaneous coronary
intervention (PCI) or coronary artery bypass grafting (CABG).
 Method(s): We searched PubMed, Embase, Web of Science, and Cochrane
Library for observational studies and post-hoc analyses of randomized
controlled trials published before Jan 20, 2022, in English. Adjusted odds
ratios (ORs), risk ratios (RRs), and hazard ratios (HRs) for short-term
outcomes (in-hospital and 30-day all-cause mortality) and long-term
outcomes (all-cause mortality, cardiac death, major adverse cardiac
events) were extracted or transformed. Result(s): Nineteen studies
were included. The risk of short-term all-cause mortality was
significantly higher in patients with COPD than in those without COPD (RR
1.42, 95% CI 1.05-1.93), as were the risks of long-term all-cause
mortality (RR 1.68, 95% CI 1.50-1.88) and long-term cardiac mortality (HR
1.84, 95% CI 1.41-2.41). There was no significant between-group difference
in the long-term revascularization rate (HR 1.01, 95% CI 0.99-1.04) or in
short-term and long-term stroke rates (OR 0.89, 95% CI 0.58-1.37 and HR
1.38, 95% CI 0.97-1.95). Operation significantly affected heterogeneity
and combined results for long-term mortality (CABG, HR 1.32, 95% CI
1.04-1.66; PCI, HR 1.84, 95% CI 1.58-2.13). Conclusion(s): COPD was
independently associated with poor outcomes after PCI or CABG after
adjustment for confounders. Copyright © 2023 Elsevier Inc.

<45>
Accession Number
2023167520
Title
Minimum Core Data Elements for Evaluation of TAVR: A Scientific Statement
by PASSION CV, HVC, and TVT Registry.
Source
JACC: Cardiovascular Interventions. 15(7) (pp 685-697), 2022. Date of
Publication: 11 Apr 2022.
Author
Simonato M.; Vemulapalli S.; Ben-Yehuda O.; Wu C.; Wood L.; Popma J.;
Feldman T.; Krohn C.; Hardy K.M.; Guibone K.; Christensen B.; Alu M.C.;
Chen S.; Ng V.G.; Chau K.H.; Shahim B.; Vincent F.; MacMahon J.; James S.;
Mack M.; Leon M.B.; Thourani V.H.; Carroll J.; Krucoff M.
Institution
(Simonato) Yale School of Medicine, New Haven, CT, United States
(Vemulapalli, Krucoff) Duke Clinical Research Institute, Durham, NC,
United States
(Ben-Yehuda) University of California-San Diego, San Diego, CA, United
States
(Ben-Yehuda, Alu, Shahim, Vincent) Cardiovascular Research Foundation, New
York, New York, United States
(Wu) U.S. Food and Drug Administration, Silver Spring, MD, United States
(Wood, Feldman) Edwards Lifesciences, Irvine, CA, United States
(Popma) Medtronic, Minneapolis, MN, United States
(Krohn) The Society of Thoracic Surgeons, Chicago, IL, United States
(Hardy) Common Spirit Health, Chicago, IL, United States
(Guibone) Beth Israel Deaconess Medical Center, Boston, MA, United States
(Christensen) American College of Cardiology, Washington, DC, United
States
(Chen, Ng, Chau, Leon) Columbia University Irving School of Medicine, New
York, NY, United States
(MacMahon) Mitre Medical Corporation, Morgan Hill, CA, United States
(James) Department of Medical Sciences and Uppsala Clinical Research
Center, Uppsala, Sweden
(Mack) Baylor Scott and White Health, Dallas, TX, United States
(Thourani) Piedmont Heart and Vascular Institute, Atlanta, GA, United
States
(Carroll) University of Colorado School of Medicine, Denver, CO, United
States
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve replacement (TAVR) is the standard of care for
severe, symptomatic aortic stenosis. Real-world TAVR data collection
contributes to benefit/risk assessment and safety evidence for the U.S.
Food and Drug Administration, quality evaluation for the Centers for
Medicare and Medicaid Services and hospitals, as well as clinical research
and real-world implementation through appropriate use criteria. The
essential minimum core dataset for these purposes has not previously been
defined but is necessary to promote efficient, reusable real-world data
collection supporting quality, regulatory, and clinical applications. The
authors performed a systematic review of the published research for
high-impact TAVR studies and U.S. multicenter, multidevice registries. Two
expert task forces, one from the Predictable and Sustainable
Implementation of National Cardiovascular Registries/Heart Valve
Collaboratory and another from The Society of Thoracic Surgeons/American
College of Cardiology TVT (Transcatheter Valve Therapy) Registry convened
separately and then met to reconcile a final list of essential data
elements. From 276 unique data elements considered, unanimous consensus
agreement was achieved on 132 "core" data elements, with the most common
reasons for exclusion from the minimum core dataset being burden or
difficulty in accurate assessment (36.9%), duplicative information
(33.3%), and low likelihood of affecting outcomes (10.7%). After a
systematic review and extensive discussions, a multilateral group of
academicians, industry representatives, and regulators established 132
interoperable, reusable essential core data elements essential to
supporting more efficient, consistent, and informative TAVR device
evidence for regulatory submissions, safety surveillance, best practice,
and hospital quality assessments. Copyright © 2022 The Authors

<46>
Accession Number
2023167337
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: 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
(Zhang) Department of Biomedical and Molecular Sciences, Queen's
University, Kingston, ON, Canada
Publisher
Elsevier Inc.
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. Copyright © 2023 Elsevier Inc.

<47>
Accession Number
2022040851
Title
Surgical versus interventional coronary revascularization in kidney
transplant recipients: a systematic review and meta-analysis.
Source
International Urology and Nephrology. (no pagination), 2023. Date of
Publication: 2023.
Author
El-Qushayri A.E.; Reda A.
Institution
(El-Qushayri) Faculty of Medicine, Minia University, Minia, Egypt
(Reda) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Publisher
Springer Science and Business Media B.V.
Abstract
Aim: To study the most beneficial coronary revascularization strategy in
kidney transplant recipients (KTR). Method(s): In 16th June 2022 and
updated on 26th February 2023, we searched in five databases including
PubMed for relevant articles. The odds ratio (OR) together with the 95%
confidence interval (95%CI) were used to report the results.
 Result(s): Percutaneous coronary intervention (PCI) was significantly
associated with significant lower in-hospital mortality (OR 0.62; 95%CI
0.51-0.75) and 1-year mortality (OR 0.81; 95%CI 0.68-0.97), but not
overall mortality (mortality at the last follow-up point) (OR 1.05; 95%CI
0.93-1.18) rather than coronary artery bypass graft (CABG). Moreover, PCI
was significantly associated with lower acute kidney injury prevalence (OR
0.33; 95%CI 0.13-0.84) compared to CABG. One study indicated that
non-fatal graft failure prevalence did not differ between the PCI and the
CABG group until 3 years of follow up. Moreover, one study demonstrated a
short hospital length of stay in the PCI group rather than the CABG group.
 Conclusion(s): Current evidence indicated the superiority of PCI than
CABG as a coronary revascularization procedure in short- but not long-term
outcomes in KTR. We recommend further randomized clinical trials for
demonstrating the best therapeutic modality for coronary revascularization
in KTR. Copyright © 2023, The Author(s).

<48>
Accession Number
640536933
Title
Myocardial Revascularization in Patients With Ischemic Cardiomyopathy: For
Whom and How.
Source
Journal of the American Heart Association. (pp e026943), 2023. Date of
Publication: 09 Mar 2023.
Author
Liga R.; Colli A.; Taggart D.P.; Boden W.E.; De Caterina R.
Institution
(Liga, Colli, De Caterina) Cardiology Division, Pisa University Hospital
and Chair of Cardiology University of Pisa Italy, Italy
(Taggart) Nuffield Department of Surgical Sciences Oxford University John
Radcliffe Hospital Oxford United Kingdom, United Kingdom
(Boden) VA Boston Healthcare System Boston University School of Medicine
Boston MA
(De Caterina) Fondazione VillaSerena per la Ricerca, Italy
Publisher
NLM (Medline)
Abstract
Background Myocardial revascularization has been advocated to improve
myocardial function and prognosis in ischemic cardiomyopathy (ICM). We
discuss the evidence for revascularization in patients with ICM and the
role of ischemia and viability detection in guiding treatment. Methods and
Results We searched for randomized controlled trials evaluating the
prognostic impact of revascularization in ICM and the value of viability
imaging for patient management. Out of 1397 publications, 4 randomized
controlled trials were included, enrolling 2480 patients. Three trials
(HEART [Heart Failure Revascularisation Trial], STICH [Surgical Treatment
for Ischemic Heart Failure], and REVIVED [REVascularization for Ischemic
VEntricular Dysfunction]-BCIS2) randomized patients to revascularization
or optimal medical therapy. HEART was stopped prematurely without showing
any significant difference between treatment strategies. STICH showed a
16% lower mortality with bypass surgery compared with optimal medical
therapy at a median follow-up of 9.8years. However, neither the
presence/extent of left ventricle viability nor ischemia interacted with
treatment outcomes. REVIVED-BCIS2 showed no difference in the primary end
point between percutaneous revascularization or optimal medical therapy.
PARR-2 (Positron Emission Tomography and Recovery Following
Revascularization) randomized patients to imaging-guided revascularization
versus standard care, with neutral results overall. Information regarding
the consistency of patient management with viability testing results was
available in =65% of patients (n=1623). No difference in survival was
revealed according to adherence or no adherence to viability imaging.
Conclusions In ICM, the largest randomized controlled trial, STICH,
suggests that surgical revascularization improves patients' prognosis at
long-term follow-up, whereas evidence supports no benefit of percutaneous
coronary intervention. Data from randomized controlled trials do not
support myocardial ischemia or viability testing for treatment guidance.
We propose an algorithm for the workup of patients with ICM considering
clinical presentation, imaging results, and surgical risk.

<49>
Accession Number
640535273
Title
Left Atrial Appendage Occlusion in the Elderly: Insights From PROTECT-AF,
PREVAIL, and Continuous Access Registries.
Source
JACC. Clinical electrophysiology. (no pagination), 2023. Date of
Publication: 27 Feb 2023.
Author
Sulaiman S.; Roy K.; Wang H.; de Backer O.; Alloco D.; Reddy V.Y.; Holmes
D.R.; Alkhouli M.
Institution
(Sulaiman, Holmes, Alkhouli) Department of Cardiovascular Disease, Mayo
Clinic, Rochester, MN, United States
(Roy, Wang, Alloco) Boston Scientific Corporation, Marlborough,
Massachusetts, USA
(de Backer) Department of Cardiology, Heart Center, Copenhagen University
Hospital, Rigshospitalet, Copenhagen, Denmark
(Reddy) Helmsley Electrophysiology Center, Department of Cardiology, Icahn
School of Medicine at Mount Sinai, NY, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Data on the safety and efficacy of left atrial appendage
occlusion (LAAO) in elderly patients are limited. OBJECTIVE(S): We
aimed to compare the outcomes of LAAO between patients >=80 and <80 years
of age. METHOD(S): We included patients enrolled in randomized trials
and nonrandomized registries of the Watchman 2.5 device. The primary
efficacy endpoint was a composite of cardiovascular/unknown death, stroke,
or systemic embolism at 5 years. Secondary endpoints included
cardiovascular/unknown death, stroke, systemic embolism, and major and
nonprocedural bleeding. Survival analyses were performed using the
Kaplan-Meier, Cox proportional hazards, and competing risk analysis
methods. Interaction terms were used to compare the 2 age groups. We also
estimated the average treatment effect of the device with the use of
inverse probability weighting. RESULT(S): We studied 2,258 patients,
of whom 570 (25.2%) were >=80 years old, and 1,688 (74.8%) were <80 years
old. Procedural complications at 7 days were similar in both age groups.
The primary endpoint occurred in 12.0% in the device group vs 13.8% in the
control group (HR: 0.9; 95% CI: 0.6-1.4) among patients <80 years of age
and in 25.3% vs 21.7%, respectively (HR: 1.2; 95% CI: 0.7-2.0) among
patients >=80 (interaction P value = 0.48). There was no interaction
between age and treatment effect for any of the secondary outcomes. The
average treatment effects of LAAO (compared with warfarin) were similar in
the elderly population (compared with younger patients).
 CONCLUSION(S): Despite the higher event rates, octogenarians derive
similar benefits from LAAO as their younger counterparts. Age alone should
not preclude LAAO in otherwise suitable candidates. Copyright ©
2023 American College of Cardiology Foundation. Published by Elsevier Inc.
All rights reserved.

<50>
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). Design(s): A
single-center, prospective, randomized, controlled study. Setting(s):
At a tertiary children's medical center. Participant(s): A total of
180 children undergoing cardiac surgery, aged 1 month to 3 years.
 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). 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. 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. Copyright © 2022

<51>
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). 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. 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). 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. Copyright © 2023 The Authors

<52>
Accession Number
2020843675
Title
Comparative Outcomes of TAVR in Mixed Aortic Valve Disease and Aortic
Stenosis: A Meta-analysis.
Source
Cardiology and Therapy. 12(1) (pp 143-157), 2023. Date of Publication:
March 2023.
Author
Ugwu J.K.; Kandah D.R.; Ndulue J.K.; Ebiem O.P.; Ugwu-Erugo J.N.; Hamilton
R.; Osei K.; Taskesen T.; Shivapour D.M.; Chawla A.; Marcus R.H.
Institution
(Ugwu, Hamilton, Osei, Taskesen, Shivapour, Chawla, Marcus) Department of
Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave,
Des Moines, IA 50314, United States
(Kandah) Internal Medicine Residency, MercyOne Des Moines Medical Center,
Des Moines, IA, United States
(Ndulue) Providence Medical Group, Chehalis Family Medicine, Chehalis, WA,
United States
(Ebiem) Department of Hospital Medicine, Miami Valley Hospital, Dayton,
OH, United States
(Ugwu-Erugo) Ebonyi State University Teaching Hospital, Abakaliki, Nigeria
Publisher
Adis
Abstract
Introduction: Transcatheter aortic valve replacement (TAVR) has become a
suitable alternative to surgical aortic valve replacement (SAVR) for the
treatment of symptomatic severe aortic stenosis (AS). A high proportion of
patients with AS have mixed aortic valve disease (MAVD) with mild or more
concurrent aortic regurgitation (AR). Differential outcomes of TAVR among
patients with AS and MAVD have not been well characterized. We compared
1-year mortalities following TAVR among patients with MAVD and AS.
 Method(s): We conducted a meta-analysis of studies published in
PubMed/Medline. The primary outcome was 1-year all-cause mortality
following TAVR among patients with MAVD vs. AS. Secondary endpoints were:
(1) incidence of AR within 30 days following TAVR (post TAVR AR); and (2)
1-year all-cause mortality within each group stratified according to
severity of post TAVR AR. Result(s): Nine studies involving 9505
participants were included in the analysis. At 1 year following TAVR,
mortality was lower in MAVD than in AS; HR 0.89, 95% CI 0.81-0.98. The
mortality advantage increased when pre-TAVR AR was moderate or more; HR
0.84, 95% CI 0.72-0.99. The mortality advantage was attenuated after
correction for publication bias. There was a higher risk of post TAVR AR
in the MAVD group; OR 1.51, 95% CI 1.20-1.90 but the impact on mortality
of moderate vs. mild post TAVR AR was greater among patients with AS than
in patients with MAVD HR 1.67 95% CI 0.89-3.14 vs. 0.93 95% CI 0.47-1.85.
 Conclusion(s): Patients with MAVD have similar or improved survival 1
year after TAVR compared to those with AS. Copyright © 2022, The
Author(s).

<53>
Accession Number
2021048561
Title
Sex Differences in Periprocedural and Long-Term Outcomes Following
Transcatheter Left Atrial Appendage Occlusion: A Systematic Review and
Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 48 (pp 23-31), 2023. Date of
Publication: March 2023.
Author
Mathai S.V.; Sohal S.; Flatow E.; Nagaraj S.; Hajra A.; Chugh Y.;
Palaiodimos L.; Lee H.J.; Ansari J.; Cohen M.; Volgman A.S.; Faillace R.
Institution
(Mathai, Flatow, Nagaraj, Hajra, Palaiodimos, Faillace) Department of
Medicine, NYC Health +Hospitals/Jacobi Medical Center, 1400 Pelham Pkwy S,
Bronx, NY 10461, United States
(Sohal, Lee, Ansari, Cohen) Division of Cardiology, Department of
Medicine, RWJ-BH Newark Beth Israel Medical Center, 201 Lyons Ave, Newark,
NJ 07112, United States
(Chugh) Division of Interventional and Structural Cardiology, Department
of Medicine, Minneapolis Heart Institute, Minneapolis, MN, United States
(Volgman) Division of Cardiology, Department of Medicine, Rush University
Medical Center, 1620 W Harrison St, Chicago, IL 60612, United States
Publisher
Elsevier Inc.
Abstract
Background: Atrial fibrillation (AF) is among the most common arrhythmias
associated with an increased risk of cardioembolic phenomena, including
stroke. Percutaneous left atrial appendage occlusion (LAAO) has proven
beneficial in reducing stroke and mortality in patients with atrial
fibrillation who have contraindications to anticoagulation. However, the
sex differences in outcomes following LAAO have not been studied
systematically. Method(s): Electronic databases PUBMED, Embase, and
Web of Science were systematically searched until March 2022 for studies
evaluating patient outcomes following LAAO for AF. The primary outcomes of
interest were the risks of periprocedural stroke, major bleeding,
pericardial complications, and all-cause mortality. Secondary outcomes
included stroke risks, major bleeding, device-related thrombus,
cardiovascular and all-cause mortality on long-term follow-up. A
random-effects model meta-analysis was conducted, and heterogeneity was
assessed using the I-squared test. Result(s): Sixteen studies were
included in the final analysis encompassing 111,775 patients, out of which
45,441 (40.7 %) were women. Women had a significantly higher risk of
peri-procedural complications including all-cause mortality [relative risk
(RR), 95 % confidence intervals (CI); RR 1.94, 95 % CI 1.40-2.69], stroke
[RR 1.85, 95 % CI 1.29-2.67], major bleeding [RR 1.63, 95 % CI 1.08-2.44],
and pericardial events [RR 1.80, 95 % CI 1.58-2.05]. However, there were
no statistically significant differences between sexes in terms of risk of
stroke, major bleeding, device-related thrombus, cardiovascular and
all-cause mortality on long-term follow-up. Conclusion(s): Among
patients undergoing LAAO implantation, women were at higher risk of
periprocedural complications than men. This risk was not significant on
long-term follow-up. Copyright © 2022 Elsevier Inc.

<54>
Accession Number
2020016012
Title
Effects of Melatonin on Cardiac Injury and Inflammatory Biomarkers in
Patients Undergoing Coronary Artery Bypass Graft Surgery: a Meta-analysis.
Source
Cardiology and Therapy. 12(1) (pp 11-20), 2023. Date of Publication: March
2023.
Author
Farshidianfar M.; Ardekani A.; Tabrizi R.; Lankarani K.B.; Taherifard E.;
Abdollahi A.; Azizi A.; Akbari M.
Institution
(Farshidianfar, Ardekani, Lankarani, Azizi, Akbari) Health Policy Research
Center, Institute of Health, Shiraz University of Medical Sciences,
Shiraz, Iran, Islamic Republic of
(Farshidianfar) Department of Medical Sciences, Islamic Azad University,
Mashhad, Iran, Islamic Republic of
(Tabrizi) Noncommunicable Diseases Research Center, Fasa University of
Medical Sciences, Fasa, Iran, Islamic Republic of
(Tabrizi) Clinical Research Development Unit, Valiasr Hospital, Fasa
University of Medical Sciences, Fasa, Iran, Islamic Republic of
(Ardekani, Taherifard) School of Medicine, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Abdollahi) Student Research Committee, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Azizi) School of Pharmacy, Kerman University of Medical Sciences, Kerman,
Iran, Islamic Republic of
(Tabrizi) USERN Office, Fasa University of Medical Sciences, Fasa, Iran,
Islamic Republic of
Publisher
Adis
Abstract
Introduction: The antiinflammatory and antioxidative effects of melatonin
have been established in recent years. Several studies indicate that
oxidative stress and inflammation are key drivers of post-coronary artery
bypass graft (CABG) surgery complications. In the present study, we aimed
to investigate the effects of melatonin on cardiac injury and inflammatory
biomarkers in CABG candidates. Method(s): Embase, Medline/PubMed, Web
of Science, Scopus, and the Cochrane library were searched up to 5 June
2022. All randomized controlled trials examining cardiac injury and
inflammatory biomarkers of CABG patients who received melatonin were
included. The random-effects model was utilized to perform the analysis.
 Result(s): A total of 947 citations were retrieved through database
searches. Finally, five articles (six trials with 342 patients) were
included after the screening. Melatonin supplementation led to a
significant reduction in cardiac troponin I (CTnI) [weighted mean
difference(WMD): -2.28 ng/ml; 95% CI -2.87, -1.69; P < 0.01;
I2: 91.25%] and high sensitivity-C reactive protein (hs-CRP)
levels (WMD: -0.62 mg/L; 95% CI -0.73, -0.5; P < 0.01; I2:
99.98%) in patients undergoing CABG surgery. We found a nonsignificant
decrease in creatine kinase isoenzyme muscle/brain (CK-MB) levels (WMD:
-2.87 ng/ml; 95% CI -5.97, 0.23; P = 0.07; I2: 99.98%) after
melatonin supplementation. No publication bias was found according to
Egger's test. Conclusion(s): Melatonin supplementation may be useful
in reducing cardiac injury and inflammatory biomarkers in CABG candidates.
Future studies should investigate the clinical significance of these
findings. Copyright © 2022, The Author(s).

<55>
Accession Number
2021076931
Title
Left Ventricular Assist Devices and Pregnancy: Systematic Review of
Existing Literature and Case Report.
Source
Current Problems in Cardiology. 48(2) (no pagination), 2023. Article
Number: 101469. Date of Publication: February 2023.
Author
Yadalam A.K.; Yoo B.W.; Horton J.P.; Krishna I.; Vega J.D.; Bhatt K.N.;
Gupta D.; Abdou M.H.
Institution
(Yadalam) Department of Medicine, Emory University School of Medicine,
Atlanta, GA, United States
(Yoo, Bhatt, Gupta, Abdou) Department of Medicine, Division of Cardiology,
Emory University School of Medicine, Atlanta, GA, United States
(Horton) Department of Obstetrics and Gynecology, Emory University School
of Medicine, Atlanta, GA, United States
(Krishna) Department of Obstetrics and Gynecology, Division of Maternal
Fetal Medicine, Emory University School of Medicine, Atlanta, GA, United
States
(Vega) Department of Surgery, Division of Cardiothoracic Surgery, Emory
University School of Medicine, Atlanta, GA, United States
Publisher
Elsevier Inc.
Abstract
Although pregnancy is generally contraindicated in advanced heart failure
(AHF), successful pregnancies have been observed in patients with left
ventricular assist devices (LVADs). The number of pregnancies in patients
with LVADs is increasing, yet optimal management strategies remain
undefined. Additionally, no successful pregnancies have been reported with
the HeartMate 3 (HM3) (Abbott) LVAD. A systematic review of pregnancy in
patients with LVADs was prepared utilizing 3 major scientific databases.
We also present the first reported case of successful pregnancy and
delivery in a patient supported by an HM3 LVAD. The systematic search
yielded 95 results. After filtering to include only relevant citations,
eight unique cases were identified. Cases were compared on the basis of
several clinical factors. Although pregnancies supported by LVADs are
medically complex, several cases of successful deliveries have been
observed. Clinical management between cases, however, did vary
significantly. Several areas requiring further study were
identified. Copyright © 2022 Elsevier Inc.

<56>
Accession Number
2022932451
Title
Outpatient 6-Hour Levosimendan Treatment as a Bridge to Heart Transplant.
Source
Arquivos Brasileiros de Cardiologia. 120(2) (no pagination), 2023. Article
Number: e20220205. Date of Publication: 2023.
Author
Goncalves A.V.; Reis J.P.; Timoteo A.T.; Soares R.; Pereira-Da-silva T.;
Gomes V.; Moreira R.I.; Pombo D.; Carvalho T.; Correia C.; Santos C.;
Ferreira R.C.
Institution
(Goncalves, Reis, Timoteo, Soares, Pereira-Da-silva, Gomes, Moreira,
Pombo, Carvalho, Correia, Santos, Ferreira) Departamento de Cardiologia,
Hospital de Santa Marta, Centro Hospitalar Universitario de Lisboa
Central, Lisboa, Portugal
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Heart transplantation is the treatment of choice for selected patients
with advanced heart failure (HF), improving quality of life and conferring
a survival benefit compared to conventional management.1
However, heart transplantation depends on a donor's presence,
necessitating bridge strategies. Infusion of inotropes was suggested as
one of these treatments, but a meta-analysis of randomized trials found
increased mortality with long-term inotropic support,2 and HF
guidelines do not now endorse this strategy. The inodilator Levosimendan
has arisen as a treatment option: its inotropic action can continue for up
to 2 weeks while being less pro-arrhythmic than traditional
inotropes.3 It was traditionally administered as a 24-hour
infusion. Nonetheless, a 24-hour infusion necessitates at least a two-day
stay in the hospital. Recently, two randomized placebo-controlled,
double-blind clinical trials evaluated 6-hour cycles of Levosimendan
therapy in ambulatory patients with advanced HF and demonstrated that it
reduces NT-proBNP levels and admissions for acute decompensated
HF.4,5 To the best of our knowledge, this is the first report
of an outpatient 6-hour Levosimendan infusion being used to bridge to
heart transplant in patients classified as INTERMACS class 3 or 4. This
single-center observational registry includes 8 consecutive patients
waiting for a heart transplant and required permanent or regular inotropic
therapy (INTERMACS class 3 or 4) between 2018 and 2021. The investigation
conforms to the principles outlined in the Declaration of Helsinki. All
patients provided written informed consent. Levosimendan was given as a
6-hour intravenous infusion (0.2 mug/kg/min, without bolus) every two
weeks in an ambulatory setting with non-invasive monitoring of vital
signs. HF therapy was maintained during the day of the procedure. In the
first treatment cycle, a dose of 0.05 mug/kg/min was started, titrated to
0.1 mug/kg/min if well tolerated in the first two hours, and to 0.2
mug/kg/min after another two hours of treatment. Copyright ©
2023, Sociedade Brasileira de Cardiologia. All rights reserved.

<57>
Accession Number
2019005297
Title
Heart Rate Variability-Guided Training for Improving Mortality Predictors
in Patients with Coronary Artery Disease.
Source
International Journal of Environmental Research and Public Health. 19(17)
(no pagination), 2022. Article Number: 10463. Date of Publication:
September 2022.
Author
Manresa-Rocamora A.; Sarabia J.M.; Guillen-Garcia S.; Perez-Berbel P.;
Miralles-Vicedo B.; Roche E.; Vicente-Salar N.; Moya-Ramon M.
Institution
(Manresa-Rocamora, Sarabia, Moya-Ramon) Department of Sport Sciences,
Sports Research Centre, Miguel Hernandez University of Elche, Elche 03202,
Spain
(Manresa-Rocamora, Sarabia, Roche, Vicente-Salar, Moya-Ramon) Institute
for Health and Biomedical Research of Alicante (ISABIAL), Alicante 03010,
Spain
(Guillen-Garcia) Department of Cardiology, Hospital General de Elda, Elda
03600, Spain
(Perez-Berbel) Department of Cardiology, Hospital Clinico Universitario
San Juan, San Juan de Alicante 03550, Spain
(Perez-Berbel, Miralles-Vicedo) Department of Cardiology, Hospital
Universitario del Vinalopo, Elche 03293, Spain
(Roche, Vicente-Salar) Department of Applied Biology-Nutrition, Institute
of Bioengineering, Miguel Hernandez University of Elche, Elche 03202,
Spain
(Roche) CIBER Fisiopatologia de la Obesidad y Nutricion (CIBEROBN),
Instituto de Salud Carlos III (ISCIII), Madrid 28029, Spain
Publisher
MDPI
Abstract
The objective of this research was to investigate whether heart rate
variability (HRV)-guided training improves mortality predictors to a
greater extent than predefined training in coronary artery disease
patients. Twenty-one patients were randomly allocated to the HRV-guided
training group (HRV-G) or the predefined training group (PRED-G). They
measured their HRV at home daily and trained three times a week for six
weeks. Resting heart rate, isolated vagal-related HRV indices (i.e.,
RMSSD, HF, and SD<inf>1</inf>), weekly averaged RMSSD, heart rate
recovery, and maximum oxygen uptake were assessed before and after the
training period. There was a statistically significant difference (p =
0.034) in the change in weekly averaged RMSSD in favor of the HRV-G, while
no differences were found in the remaining analyzed variables (p > 0.050).
Regardless of the training prescription method, exercise training
decreased resting heart rate (p = 0.001; -4.10 [95% CI = -6.37--1.82]
beats per minute (bpm)), and increased heart rate recovery at 2 min (p =
0.010; 4.33 [95% CI = 1.15-7.52] bpm) and maximum oxygen uptake (p <
0.001; 3.04 [95% CI = 1.70-4.37] mL.kg-1.min-1).
HRV-guided training is superior to predefined training in improving
vagal-related HRV when methodological factors are accounted
for. Copyright © 2022 by the authors.

<58>
Accession Number
2018232483
Title
Does Pacemaker Implantation After Surgical Aortic Valve Replacement Impact
Long-Term Morbidity and Mortality? A Focused Review.
Source
Texas Heart Institute Journal. 49(5) (no pagination), 2022. Article
Number: e207518. Date of Publication: September 2022.
Author
El Diasty M.; Davies M.; Fernandez A.L.; Ribeiro I.; Payne D.; Petsikas D.
Institution
(El Diasty, Ribeiro, Payne, Petsikas) Cardiac Surgery Department, Kingston
Health Science Centre, Kingston, ON, Canada
(Davies) Cardiology Department, Oxford University Hospital, Oxford, United
Kingdom
(Fernandez) Cardiovascular Surgery Department, University Hospital,
Santiago de Compostela, Spain
Publisher
Texas Heart Institute
Abstract
Permanent pacing remains a serious complication that can occur in the
postoperative period of surgical aortic valve replacement. The reported
incidence is variable, and there are many perioperative factors that have
been linked with a greater need for permanent pacing. Permanent pacing can
also be associated with late lead-related and cardiac complications that
can affect late outcome. However, the degree of late dependence on
pacemakers is varied, and some studies have shown that a substantial
proportion of patients do not need long-term pacing. Some groups have
found that permanent pacing was associated with a negative impact on
long-term survival in these patients. A common finding among these studies
is that the groups of patients with pacemakers had higher preoperative
surgical risk and comorbidity status. This makes it difficult to establish
whether permanent pacing on its own represents a risk factor for late
mortality or whether it is simply a marker that re-flects the higher
complexity and comorbidities in this group of patients. Copyright
© 2022 by the Texas Heart Institute, Houston.

<59>
Accession Number
2019840043
Title
Ross Procedure in Neonate and Infant Populations: A Meta-Analysis Review.
Source
World Journal for Pediatric and Congenital Heart Surgery. 13(6) (pp
759-769), 2022. Date of Publication: November 2022.
Author
Tohme S.; Jiang S.; Farooqi K.; Crystal M.A.; Blitzer D.; Ferrari G.;
Bacha E.; Kalfa D.
Institution
(Tohme, Bacha, Kalfa) Section of Congenital and Pediatric Cardiac Surgery,
Division of Cardiac, Thoracic and Vascular Surgery, Morgan Stanley
Children's Hospital, NewYork -Presbyterian Hospital, Columbia University
Irving Medical Center, New York, NY, United States
(Jiang) Department of Epidemiology, Columbia University Mailman School of
Public Health, New York, NY, United States
(Farooqi, Crystal) Division of Pediatric Cardiology, Morgan Stanley
Children's Hospital, NewYork -Presbyterian Hospital, Columbia University
Irving Medical Center, New York, NY, United States
(Blitzer, Ferrari) Division of Cardiothoracic and Vascular Surgery,
Department of Surgery, Columbia University Irving Medical Center, New
York, NY, United States
Publisher
SAGE Publications Inc.
Abstract
Objective: This study aims to perform a meta-analysis of early and late
outcomes of the Ross/Ross-Konno procedures in neonates/infants.
 Method(s): A meta-analysis was performed in accordance with PRISMA
guidelines. We used Ovid versions of MEDLINE/PubMed for relevant studies
and included those that reported Ross/Ross-Konno operations in
neonates/infants and at least one of the predetermined clinical outcomes.
I2 and double arcsine methods assessed the heterogeneity
between pooled estimates. We used a random-effect model to account for
heterogeneity with MetaXL. We calculated point estimates of a pooled
estimates along with its 95% CI. Result(s): 587 neonate/infant
patients were included with median age of 87.5 days old. The follow-up
range was five days to 23 years. Early mortality reported in 25 studies
with pooled estimates of 18.3% (95% CI: 13.6%-23.5%). Estimates ranged
from 0% to 50% with relatively substantial heterogeneity (P =.01,
I2 = 48.6%). Late mortality reported in 22 studies with pooled
incidence of 9.7% (95% CI: 5.9%-14.3%). Estimates ranged from 0% to 53%
with relatively substantial heterogeneity (P =.01, I2 = 46.1%).
Autograft reintervention reported in 18 studies with pooled estimate of
19.2% (95% CI: 7.3%-34.5%). Estimates ranged from 0% to 81.8% with high
heterogeneity (P <.001, I2 = 90.5%). Right
ventricle-to-pulmonary artery conduit reintervention reported in 16
studies with pooled estimates of 32.0% (95% CI: 20.9%-44.12%). Estimates
ranged from 0% to 92.3% with high heterogeneity (P <.001, I2 =
75.9%). Conclusion(s): The data suggest that the Ross/Ross-Konno
procedure in neonates/infants still carries significant risk of early/late
mortality and autograft/conduit reintervention. The high variability of
results among centers confirms the need for surgical expertise and good
patient selection. Prospective multicenter studies are warranted to
investigate the rate of autograft reintervention and the impact on
long-term survival in this specific population. Copyright © The
Author(s) 2022.

<60>
Accession Number
2020686885
Title
Provisional Versus Dual Stenting of Left Main Coronary Artery Bifurcation
Lesions (from a Comprehensive Meta-Analysis).
Source
American Journal of Cardiology. 185 (pp 10-17), 2022. Date of Publication:
15 Dec 2022.
Author
Bhogal S.; Zhang C.; Aladin A.I.; Mintz G.S.; Waksman R.
Institution
(Bhogal, Zhang, Aladin, Mintz, Waksman) Section of Interventional
Cardiology, MedStar Washington Hospital Center, Washington, DC
Publisher
Elsevier Inc.
Abstract
The optimal technique for bifurcation of left main coronary artery (LMCA)
stenting has been a subject of controversy since the inception of
drug-eluting stents. We searched PubMed, Clinical Trials Registry, and the
Cochrane Central Register of Controlled Trials from January 2002 through
October 2021. A total of 13 studies comparing the use of provisional
versus dual stenting in patients with LMCA bifurcation lesions were
included. Any major adverse cardiac event (MACE) was considered the
primary composite end point. The secondary end points included individual
components of MACE, including death, myocardial infarction, and target
lesion revascularization. The treatment effect was defined as the log odds
ratio (OR) of provisional over dual stenting for cumulative event rate at
3 years. In 12 studies with 8,377 patients included for MACE, the use of a
provisional-stenting strategy was associated with a significant reduction
of 3-year MACE (OR 0.64, 95% confidence interval [CI] 0.46 to 0.88)
compared with a dual-stenting strategy, primarily driven by target lesion
revascularization (OR 0.51, 95% CI 0.36 to 0.73). No significant
difference was found regarding death (OR 0.88; 95% CI 0.65 to 1.21) or
myocardial infarction (OR 0.97, 95% Cl 0.61 to 1.54). In conclusion, our
meta-analysis suggests that provisional stenting should be the preferred
technique over dual stenting when treating LMCA bifurcation lesions with
drug-eluting stents. Further randomized controlled studies compounded with
intracoronary imaging comparing the 2 strategies are
warranted. Copyright © 2022 Elsevier Inc.

<61>
Accession Number
2020641533
Title
Pathophysiology of High Output Arteriovenous Fistula with Heart Failure: A
Systematic Review and Meta-analysis.
Source
Journal of Clinical and Diagnostic Research. 16(9) (pp OE07-OE12), 2022.
Date of Publication: September 2022.
Author
Bhaskaran A.P.; Bhaskaran I.P.; Bhaskaran P.
Institution
(Bhaskaran, Bhaskaran) Department of Cardiovascular Surgery, Imperial
College, London, United Kingdom
(Bhaskaran) Department of Cardiothoracic Surgery, Imperial College,
London, United Kingdom
Publisher
Journal of Clinical and Diagnostic Research
Abstract
Introduction: Arteriovenous Fistula (AVF) is extensively used as vascular
access for haemodialysis patients. It induces a high output state, which
is associated with cardiac remodeling. With High Output Heart Failure
(HOHF), the AVF occupies a low pressure; reduced vascular resistance and
increased venous return. The High Output Arteriovenous Fistula with Heart
Failure (HOHF-AVF) patients often undergo a comprehensive assessment of
type of underlying diseases, the degree of vasodilatation along with
laboratory investigations and cardiac imaging. Hence identification of the
pathophysiological determinants of HOHF-AVF is intriguing. Aim(s): To
identify the pathophysiological determinants of HOHF-AVF. Material(s)
and Method(s): This systematic review was conducted from May 2021 to
December 2021 at the Department of Cardiovascular Surgery, Imperial
College, United Kingdom. Randomised Controlled Trials (RCTs), cohort,
case-control, cross-sectional and descriptive studies, conducted on adult
patients who underwent AVF creation or ligation and addressed the
pathophysiological determinants of HOHF-AVF were included. Studies
conducted among Paediatric cases, case reports, and case series were
excluded. Medline (PubMed), EMBASE, ProQuest, and the Cochrane database
were searched, by utilising the key words {[("HOHF" OR "High output heart
failure") AND ("AVF" OR "Arteriovenous fistula")] AND ("LV parameters" OR
"Structural Characteristics" OR "Echocardiographic indices)}. The searches
were restricted from January 2000 to October 2021 with studies published
in the English language. All the included studies were subjected to
critical appraisal using the "Cochrane risk of bias assessment tool" for
RCTs, and the "Joanna Briggs Institute (JBI) checklist" for cohort,
case-control, cross-sectional and descriptive studies. For meta-analysis
Mantel-Haenszel Odds Ratio (M.H. O.R.) with its 95% Confidence Interval
(C.I), Mean Difference (M.D) with its 95 % C.I were computed. The Review
Manager Software (Rev Man 5, Cochrane collabouration, Oxford, England) was
used for data analytics. Result(s): Overall, 115 citations were
identified from the initial search, of which 29 studies were retrieved.
Later, 14 studies were excluded. Of the remaining 15 studies, 12 were
subjected to meta-analysis. There was a change in Left Ventricular (LV)
end diastolic diameter (M.D=2.0; p<0.001; 95% C.I=1.13 to 2.86), and
cardiac index (M.D=0.63; p<0.001, 95% C.I=0.46 to 0.79) from baseline to
atleast three months of postsurgery among HOHF-AVF patients. According to
the AVF flow, there was a change in LV systolic diameter (M.D=-18.90;
p<0.01; 95% C.I=-22.84 to-14.96), cardiac index (M.D=0.50; p=0.007; 95%
C.I=0.14 to 0.86) and tricuspid annular plane systolic excursion
(M.D=3.90; p=0.03; 95% C.I=0.30 to 7.50). Conclusion(s): Left
ventricular end diastolic diameter and cardiac index were found to be the
major determinants for a HOHF-AVF. The left ventricular mass index,
ejection fraction, posterior wall thickness, interventricular septum were
not associated with HOHF-AVF. Left ventricular systolic diameter, cardiac
index and tricuspid annular plane systolic excursion were the determinants
of AVF flow. Copyright © 2022 Journal of Clinical and Diagnostic
Research. All rights reserved.

<62>
Accession Number
2013245614
Title
Impact of preoperative glycometabolic status on outcomes in cardiac
surgery: Systematic review and meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 164(6) (pp 1950-1960.e10),
2022. Date of Publication: December 2022.
Author
Corazzari C.; Matteucci M.; Kolodziejczak M.; Kowalewski M.; Formenti
A.M.; Giustina A.; Beghi C.; Barili F.; Lorusso R.
Institution
(Corazzari, Matteucci, Kowalewski, Lorusso) Department of Cardiothoracic
Surgery, Heart and Vascular Centre, Maastricht University Medical Centre,
Maastricht, Netherlands
(Corazzari, Matteucci, Beghi) Department of Surgical and Morphological
Sciences, Circolo Hospital, University of Insubria, Varese, Italy
(Kolodziejczak) Department of Anaesthesiology and Intensive Care,
Collegium Medicum Nicolaus Copernicus University, Antoni Jurasz University
Hospital No. 1, Bydgoszcz, Poland
(Kolodziejczak) Yale Cardiovascular Research Group, Yale School of
Medicine, New Haven, Conn
(Kowalewski) Department of Cardiac Surgery, Central Clinical Hospital of
the Ministry of Interior, Centre of Postgraduate Medical Education,
Warsaw, Poland
(Kowalewski) Thoracic Research Centre, Collegium Medicum Nicolaus
Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
(Formenti, Giustina) Institute of Endocrine and Metabolic Sciences, San
Raffaele Vita-Salute University, IRCCS San Raffaele Hospital, Milan, Italy
(Barili) Cardiac Surgery Unit, S. Croce Hospital, Cuneo, Italy
(Lorusso) Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Historically, impaired glucose metabolism has been associated
with early and late complicated clinical outcomes after cardiac surgery;
however, such a condition is not specific to subjects with diabetes
mellitus and involves a larger patient population. Method(s):
Databases were screened (January 2000 to December 2020) to identify
eligible articles; studies that evaluated the association between
preoperative metabolic status, as assessed by glycosylated hemoglobin
levels and clinical outcomes, were considered. The studies were stratified
in thresholds by baseline glycosylated hemoglobin level (lower vs higher).
 Result(s): Thirty studies, involving 34,650 patients, were included
in the review. In a meta-analysis stratified by glycosylated hemoglobin
levels, early mortality was numerically reduced in each threshold
comparison and yielded the highest reductions when less than 5.5% versus
greater than 5.5% glycosylated hemoglobin levels were compared (risk
ratio, 0.39; 95% confidence interval, 0.18-0.84; P =. 02). Comparing
higher glycosylated hemoglobin threshold values yielded comparable
results. Late mortality was reduced with lower levels of glycosylated
hemoglobin. Low preoperative glycosylated hemoglobin was associated with
the lowest risk of sternal wound infections (risk ratio, 0.50; 95%
confidence interval, 0.32-0.80; P =. 003 and risk ratio, 0.53; 95%
confidence interval, 0.39-0.70; P <. 0001) for comparisons of less than
7.5% versus greater than 7.5% and less than 7.0% versus greater than 7.0%
glycosylated hemoglobin thresholds, respectively. Additionally, levels of
glycosylated hemoglobin lower than 7% were associated with reduced
hospital stay, lower risk of stroke/transient ischemic attack (risk ratio
0.53; 95% confidence interval, 0.39-0.70; P <. 0001), and acute kidney
injury (risk ratio, 0.65; 95% confidence interval, 0.54-0.79; P <. 0001).
 Conclusion(s): Lower levels of glycosylated hemoglobin in patients
undergoing cardiac surgery are associated with a lower risk of early and
late mortality, as well as in the incidence of postoperative acute kidney
injury, neurologic complications, and wound infection, compared with
higher levels. Copyright © 2021 The Authors

<63>
Accession Number
640525531
Title
Effects of regional cerebral oxygen saturation monitoring on postoperative
cognitive dysfunction in older patients: a systematic review and
meta-analysis.
Source
BMC geriatrics. 23(1) (pp 123), 2023. Date of Publication: 06 Mar 2023.
Author
Ding X.; Zha T.; Abudurousuli G.; Zhao C.; Chen Z.; Zhang Y.; Gui B.
Institution
(Ding, Zha, Abudurousuli, Zhao, Chen, Zhang, Gui) Department of
Anesthesiology and Perioperative Medicine, 1st Affiliated Hospital with
Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, Jiangsu
210029, China
(Zhao) Department of Anesthesiology, Nanjing Qixia District Hospital,
Nanjing 210046, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative cognitive dysfunction (POCD) is common after
surgery and anesthesia, particularly in older patients. It has been
reported that regional cerebral oxygen saturation (rSO2) monitoring
potentially influences the occurrence of POCD. However, its role in the
prevention of POCD remains controversial in older patients. Additionally,
the quality of evidence on this topic is still relatively poor.
 METHOD(S): The electronic databases PubMed, EMBASE, Web of Science,
and Cochrane Library were systematically searched using the indicated
keywords from their inception to June 10, 2022. We limited our
meta-analysis to randomized controlled trials (RCTs) that assessed the
effects of rSO2 monitoring on POCD in older patients. Methodological
quality and risk of bias were assessed. The primary outcome was the
incidence of POCD during hospitalization. The secondary outcomes were
postoperative complications and the length of hospital stay (LOS). Odds
ratios (OR) and 95% confidence intervals (CI) were calculated to determine
the incidence of POCD and postoperative complications. The standardized
mean difference (SMD) instead of the raw mean difference and 95% CI were
calculated for LOS. RESULT(S): Six RCTs, involving 377 older
patients, were included in this meta-analysis. The incidence of POCD
ranges from 17 to 89%, with an overall prevalence of 47% in our pooled
analysis. Our results demonstrated that rSO2-guided intervention could
reduce the incidence of POCD in older patients undergoing non-cardiac
surgery (OR, 0.44; 95% CI, 0.25 to 0.79; P=0.006) rather than cardiac
surgery (OR, 0.69; 95% CI, 0.32 to 1.52; P=0.36). Intraoperative rSO2
monitoring was also associated with a significantly shorter LOS in older
patients undergoing non-cardiac surgery (SMD, -0.93; 95% CI, -1.75 to
-0.11; P=0.03). Neither the incidence of postoperative cardiovascular (OR,
1.12; 95% CI, 0.40 to 3.17; P=0.83) nor surgical (OR, 0.78; 95% CI, 0.35
to 1.75; P=0.54) complications were affected by the use of rSO2
monitoring. CONCLUSION(S): The use of rSO2 monitoring is associated
with a lower risk of POCD and a shorter LOS in older patients undergoing
non-cardiac surgery. This may have the potential to prevent POCD in
high-risk populations. Further large RCTs are still warranted to support
these preliminary findings. Copyright © 2023. The Author(s).

<64>
Accession Number
2022952577
Title
Correlation Between Cardiac Index, Plasma Troponin I, Myocardial
Histopathology, CPB and AoX Duration in Glutamine versus No Glutamine
Administered Patients with Low Ejection Fraction Undergoing Elective
On-Pump CABG Surgery: Secondary Analysis of an RCT.
Source
Vascular Health and Risk Management. 19 (pp 93-101), 2023. Date of
Publication: 2023.
Author
Parmana I.M.A.; Boom C.E.; Rachmadi L.; Hanafy D.A.; Widyastuti Y.;
Mansyur M.; Siswanto B.B.
Institution
(Parmana, Boom) Department of Anesthesiology and Intensive Care, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Rachmadi) Department of Anatomical Pathology, Faculty of Medicine,
Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
(Hanafy) Department of Cardiothoracic and Vascular Surgery, Faculty of
Medicine, Universitas Indonesia/National Cardiovascular Center Harapan
Kita, Jakarta, Indonesia
(Widyastuti) Department of Anesthesiology and Intensive Care, Universitas
Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
(Mansyur) Department of Community Medicine, Faculty of Medicine,
Universitas Indonesia, Jakarta, Indonesia
(Siswanto) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Universitas Indonesia/National Cardiovascular Center Harapan
Kita, Jakarta, Indonesia
Publisher
Dove Medical Press Ltd
Abstract
Purpose: On-pump coronary artery bypass graft (CABG) causes myocardial
ischemia, through the cardiopulmonary bypass (CPB) and aortic
cross-clamping (AoX). Glutamine supplementation protects cardiac cells
during cardiac ischemia. This study analysed the correlation between
cardiac index (CI), plasma troponin I, myocardial histopathology, CPB and
AoX duration in low ejection fraction patients receiving glutamine and no
glutamine undergoing elective on-pump CABG. Material(s) and
Method(s): This was a secondary analysis of a double-blind, randomised
controlled trial of 60 patients, split into control and intervention
(glutamine) groups. Glutamine was administered at a dose of 0.5 g/kg/24
hours. There were 29 patients in each respective groups after a total of
two patients dropped out. Result(s): A negative correlation (p =
0.037) was observed between CPB duration and CI at 6 hours after CPB in
the glutamine group. A positive correlation (p = 0.002) was also observed
between AoX duration and plasma troponin I at 6 hours after CPB in the
control group. However, no correlation was observed between myocardial
histopathology and plasma troponin I level at 5 minutes after CPB.
 Conclusion(s): Significant negative correlation between CPB duration
and CI at 6 hours after CPB in the glutamine group, along with significant
positive correlation between AoX duration and plasma troponin I level at 6
hours after CPB in the control group demonstrated the myocardial
protection qualities of intravenous glutamine administration in patients
with low ejection fraction undergoing elective on-pump CABG
surgeries. Copyright © 2023 Parmana et al.

<65>
Accession Number
2022551314
Title
The Role of Insulin-Like Growth Factor 1 in Delirium: A Systematic Review
and Meta-Analysis.
Source
Dementia and Geriatric Cognitive Disorders. 51(6) (pp 449-459), 2023. Date
of Publication: 01 Feb 2023.
Author
Adamis D.; Eikelenboom P.
Institution
(Adamis) Sligo Mental Health Services, Sligo, Ireland
(Eikelenboom) GGZinGeest, Amsterdam, Netherlands
(Eikelenboom) Department of Neurology, Academic Medical Center, Amsterdam,
Netherlands
Publisher
S. Karger AG
Abstract
Background: The relationship between delirium and low levels of
insulin-like growth factor 1 (IGF-1) is contradictory and uncertain. We
hypothesised that low levels of IGF-1 are a predisposing factor for
delirium in medical and abdominal surgical cohorts, in contrast to other
surgical cohorts. Aim(s): Systematic review and meta-analysis
investigating the association between peripheral levels of IGF-1 and
delirium in medical and surgical patients to explore if there are distinct
patterns of associations by using subgroup meta-analysis. Method(s):
PubMed, Scopus, CINAHL, Cochrane, and Embase databases were searched.
Inclusion criteria were prospective studies in medical and surgical
populations and available data. The following were collected: the setting
(surgical/medical), the type (orthopaedic surgery, abdominal,
cardiovascular, or medical), the number of participants, mean age, the
number of delirious patients, scale/criteria for delirium, IGF-1 levels,
and MMSE. Result(s): Thirteen studies were included and analysed. Low
levels of IGF-1 are significantly associated with delirium in abdominal
surgical samples and medical samples but not in the other surgical
samples. Age, cognition, and the setting (medical vs. surgical) do not
have any significant effect on the differences in IGF-1 levels between
those with and without delirium. Discussion(s): Delirium in acute
medical and abdominal surgery is triggered by low IGF-1 which may reflect
chronic conditions like frailty/cachexia/sarcopenia, while in other
surgeries perhaps from an inflammatory process. Conclusion(s): Low
peripheral levels of IGF-1 are a predisposing factor for delirium only in
acute medical and abdominal surgery. More studies are needed to confirm
and to explore further this finding. Copyright © 2023 S. Karger
AG. All rights reserved.

<66>
Accession Number
2021994328
Title
Perioperative transfusion and long-term mortality after cardiac surgery: a
meta-analysis.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2023. Date
of Publication: 2023.
Author
Woldendorp K.; Manuel L.; Srivastava A.; Doane M.; Bassin L.; Marshman D.
Institution
(Woldendorp, Manuel, Bassin, Marshman) Department of Cardiothoracic
Surgery, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
(Srivastava, Doane) Department of Anaesthetics, Royal North Shore
Hospital, Sydney, Australia
(Doane) The University of Sydney, Sydney, Australia
(Doane, Marshman) The Kolling Institute, Royal North Shore Hospital,
Sydney, Australia
(Doane) The Northern Sydney Anaesthesia Research Institute, Royal North
Shore Hospital, Sydney, Australia
Publisher
Springer
Abstract
Objectives: Cardiac surgical procedures are associated with a high
incidence of periprocedural blood loss and blood transfusion. Although
both may be associated with a range of postoperative complications there
is disagreement on the impact of blood transfusion on long-term mortality.
This study aims to provide a comprehensive review of the published
outcomes of perioperative blood transfusion, examined as a whole and by
index procedure. Method(s): A systematic review of perioperative
blood transfusion cardiac surgical patients was conducted. Outcomes
related to blood transfusion were analysed in a meta-analysis and
aggregate survival data were derived to examine long-term survival.
 Result(s): Thirty-nine studies with 180,074 patients were identified,
the majority (61.2%) undergoing coronary artery bypass surgery.
Perioperative blood transfusions were noted in 42.2% of patients and was
associated with significantly higher early mortality (OR 3.87, p < 0.001).
After a median of 6.4 years (range 1-15), mortality remained significantly
higher for those who received a perioperative transfusion (OR 2.01, p <
0.001). Pooled hazard ratio for long-term mortality similar for patients
who underwent coronary surgery compared to isolated valve surgery.
Differences in long-term mortality for all comers remained true when
corrected for early mortality and when only including propensity matched
studies. Conclusion(s): Perioperative red blood transfusion appears
to be associated with a significant reduction in long-term survival for
patients after cardiac surgery. Strategies such as preoperative
optimisation, intraoperative blood conservation, judicious use of
postoperative transfusions, and professional development into minimally
invasive techniques should be utilised where appropriate to minimise the
need for perioperative transfusions. Copyright © 2023, The
Author(s), under exclusive licence to The Japanese Association for
Thoracic Surgery.

<67>
Accession Number
2021977033
Title
Medical Therapy After CABG: the Known Knowns, the Known Unknowns, and the
Unknown Unknowns.
Source
Cardiovascular Drugs and Therapy. (no pagination), 2023. Date of
Publication: 2023.
Author
Barron L.K.; Moon M.R.
Institution
(Barron, Moon) Division of Cardiothoracic Surgery, Michael E. DeBakey
Department of Surgery, Baylor College of Medicine and Texas Heart
Institute, Houston, TX, United States
Publisher
Springer
Abstract
Purpose: Medical therapies play a central role in secondary prevention
after surgical revascularization. While coronary artery bypass grafting is
the most definitive treatment for ischemic heart disease, progression of
atherosclerotic disease in native coronary arteries and bypass grafts
result in recurrent adverse ischemic events. The aim of this review is to
summarize the recent evidence regarding current therapies in secondary
prevention of adverse cardiovascular outcomes after CABG and review the
existing recommendations as they pertain to the CABG subpopulations.
Recent Findings: There are many pharmacologic interventions recommended
for secondary prevention in patients after coronary artery bypass
grafting. Most of these recommendations are based on secondary outcomes
from trials which include but did not focus on surgical patients as a
cohort. Even those designed with CABG in mind lack the technical and
demographic scope to provide universal recommendations for all CABG
patients. Conclusion(s): Recommendations for medical therapy after
surgical revascularization are chiefly based on large-scale randomized
controlled trials and meta-analyses. Much of what is known about medical
management after surgical revascularization results from trials comparing
surgical to non-surgical approaches and important characteristics of the
operative patients are omitted. These omissions create a group of patients
who are relatively heterogenous making solid recommendations elusive.
While advances in pharmacologic therapies are clearly adding to the
armamentarium of options for secondary prevention, knowing what patients
benefit most from each therapeutic option remains challenging and a
personalized approach is still required. Copyright © 2023, The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<68>
Accession Number
2020989628
Title
Complications after early versus late mobilization after an incidental
durotomy: a systematic review and meta-analysis.
Source
European Spine Journal. 32(3) (pp 778-786), 2023. Date of Publication:
March 2023.
Author
Najjar E.; Hassanin M.A.; Komaitis S.; Karouni F.; Quraishi N.
Institution
(Najjar, Hassanin, Komaitis, Karouni, Quraishi) Centre for Spinal Studies
and Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS
Trust, Nottingham NG7 2UH, United Kingdom
(Hassanin) Department of Orthopedic Surgery, Assiut University, Asyut,
Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: An incidental durotomy (IDT) is a frequent complication of
spinal surgery. The conventional management involving a period of flat bed
rest is highly debatable. Indeed, there are scanty data and no consensus
regarding the need or ideal duration of post-operative bed rest following
IDT. Objective(s): To systematically evaluate the literature
regarding the outcomes of mobilization within 24 h and after 24 h
following IDT in open lumbar or thoracic surgery with respect to the
length of hospital stay, minor and major complications. Method(s): A
systematic review of the literature using PubMed, Embase and Cochrane and
dating up until September 2022 was undertaken following Preferred
Reporting Items for Systematic Review and Meta-Analysis guidelines.
Quality of evidence was assessed using a modified version of Sackett's
Criteria of Evidence Support. Result(s): Out of 532 articles, 6
studies met the inclusion criteria (1 Level-I, 4 level-III and 1 Level-IV
evidence) and were analyzed. Overall, 398 patients of mean age 59.9 years
were mobilized within 24 h. The average length of stay (LOS) for this
group was 5.7 days. Thirty-four patients (8.5%) required reoperation while
the rate of minor complications was 25.4%. Additionally, 265 patients of
mean age 63 years with IDT were mobilized after 24 h. The average LOS was
7.8 days. Twenty patients (7.54%) required reoperation while the rate of
minor complications was 55%. Meta-analysis comparing early to late
mobilization, showed a significant reduction in the risk of minor
complications and shorter overall LOS due to early mobilization, but no
significant difference in major complications and reoperation rates.
 Conclusion(s): Although early mobilization after repaired incidental
dural tears in open lumbar and thoracic spinal surgery has a similar major
complication/ reoperation rates compared to late mobilization, it
significantly decreases the risk of minor complications and length of
hospitalization. Copyright © 2023, The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature.

<69>
Accession Number
2023227328
Title
Suggested robotic-assisted thoracic surgery training curriculum.
Source
Journal of Thoracic Disease. 15(2) (pp 791-798), 2023. Date of
Publication: February 2023.
Author
Zaidi M.A.; Wright G.M.; Yasufuku K.
Institution
(Zaidi, Yasufuku) Division of Thoracic Surgery, University Health Network,
Toronto General Hospital, Toronto, ON, Canada
(Zaidi) Division of Thoracic Surgery, King Abdullah Medical City, Makkah,
Saudi Arabia
(Wright) St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia
(Wright) Department of Surgery, University of Melbourne, Melbourne, VIC,
Australia
(Wright) Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia
(Yasufuku) Division of Thoracic Surgery, University of Toronto, Toronto,
ON, Canada
Publisher
AME Publishing Company
Abstract
Robotic-assisted surgery, a technological advancement in the field of
surgery, has become increasingly popular among surgeons of many
specialties over time. Robotic-assisted thoracic surgery (RATS) is
comparable to video-assisted thoracic surgery (VATS) in terms of patient
care outcomes; however, the perception of increased operative time and a
lack of cost-effectiveness have led to controversy regarding its alleged
benefits. Nevertheless, robotic surgery is one of the preferred options
for minimally invasive surgery by some thoracic surgeon over VATS, due to
its ability to provide 3-D vision, precise wrist movements, enhanced
magnification, and instrument stability and articulation. Notably,
trainees in the field of thoracic surgery experience difficulty gaining
knowledge and learning skills associated with RATS due to its complexity,
limited access to robotic instruments, the lack of a standardized
curriculum for trainees, and lack of mentorship or proctorship, thus
leading to a steeper learning curve compared to laparoscopic or VATS
procedures that are cost-friendly, easy to learn, and feasible to
practice. Nevertheless, focusing on RATS training for thoracic surgeons
will keep them familiar with robotic techniques, including the
pre-operative setup and intra-operative process, which will ultimately
decrease operative times. In this paper, we will review the literature,
express and discuss the most viable training curriculum from authors'
point of view to help achieve this goal. Copyright © Journal of
Thoracic Disease. All rights reserved.

<70>
Accession Number
2023227369
Title
Prolonged air leak after robotic lung resection: a narrative review.
Source
Journal of Thoracic Disease. 15(2) (pp 909-917), 2023. Date of
Publication: February 2023.
Author
Muriana P.; Rossetti F.; Viscardi S.; Novellis P.; Veronesi G.
Institution
(Muriana, Rossetti, Viscardi, Novellis, Veronesi) Department of Thoracic
Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Veronesi) School of Medicine and Surgery, Vita-Salute San Raffaele
University, Milan, Italy
Publisher
AME Publishing Company
Abstract
Background and Objective: Prolonged air leak (PAL) following lung
resection is related to an increase in morbidity and both direct and
indirect costs. In recent years, robotic-assisted thoracic surgery (RATS)
has proved to be a safe technique with comparable perioperative outcomes
of video-assisted thoracic surgery (VATS), optimal oncological results,
and potential advantages in case of sublobar resection. We here focus on
the incidence and clinical impact of PAL in the field of robotic surgery
and discuss the therapeutic strategies currently available.
 Method(s): We conducted a search on PubMed/MEDLINE and Scopus
database from inception until May 27th 2022 to select the
relevant literature published in English exploring the occurrence of PAL
following RATS. Key Content and Findings: The implementation of robotic
surgery led to a significant reduction in PAL occurrence after pulmonary
resection compared to open thoracotomy, while there is still no clear
advantage with respect to VATS. However, the enhanced dexterity and
improved visualization of the robot seem to particularly valuable in case
of sublobar lung resection, especially complex ones. Accurate selection of
patients based on the presence of risk factors allows the implementation
of intraoperative measures in order to reduce the occurrence of PAL.
 Conclusion(s): Robotic lung resection is a safe technique,
advantageous compared to traditional open thoracotomy in terms of PAL
occurrence reduction and it is a valid alternative to manual VATS.
Moreover, with the extension of indications for sublobar resection in the
treatment of early stage lung cancer, RATS may prove to be the technique
of choice thanks to its intrinsic advantages. Copyright © Journal
of Thoracic Disease. All rights reserved.

<71>
Accession Number
2023227352
Title
Intrathoracic vacuum therapy for the therapy of pleural empyema-a
systematic review and analysis of the literature.
Source
Journal of Thoracic Disease. 15(2) (pp 780-790), 2023. Date of
Publication: February 2023.
Author
Stuben B.-O.; Plitzko G.A.; Reeh M.; Melling N.; Izbicki J.R.; Bachmann
K.; Tachezy M.
Institution
(Stuben, Plitzko, Reeh, Melling, Izbicki, Bachmann, Tachezy) Department of
General, Visceral and Thoracic Surgery, University Medical Centre
Hamburg-Eppendorf, Hamburg, Germany
Publisher
AME Publishing Company
Abstract
Background: Pleural empyema is a serious and potentially deadly disease
leading to a significant burden on health care systems. Conservative and
surgical treatment results remain poor, with high morbidity and mortality
rates. Patients with pleural empyema are often multimorbid and poor
candidates for surgery. Therefore, it appears sensible to explore
alternative, less invasive treatment options. Recently, the
well-established vacuum sponge therapy has been adopted in the treatment
of pleural infections. The goal of this systematic review was to identify
the existing literature and reported results of vacuum therapy for pleural
empyema. Method(s): A systematic search of MEDLINE and the Cochrane
Database was performed independently by two reviewers using predefined
criteria according to the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA) 2020 guidelines. In addition, abstracts from
selected conference proceedings were screened and reference scanning of
the search results was performed. Single case reports were excluded.
 Result(s): Fourteen studies met the selection criteria and were
reviewed. A total of 165 patients were treated with vacuum therapy in the
studies reviewed. 61.2% of the patients had pleural empyema secondary to
thoracic surgery. In 71.5% of the patients, vacuum therapy was applied
following open window thoracostomy (OWT). Mortality rates of 0-33% were
reported for vacuum therapy after OWT and 0-9.3% for vacuum therapy
without OWT. Length of hospital stay (LOHS) ranged from 44-217 days for
patients after OWT and could not be analysed for vacuum therapy without
OWT due to lacking data. Median treatment time was 7-14 days. Treatment
related complications were rare overall. Success rates defined as
infection resolution were high irrespective of previous treatment and
cause of empyema. Conclusion(s): The current literature shows that
pleural vacuum therapy is a promising, safe, and feasible treatment
alternative to existing treatment modalities for pleural empyema. However,
the evidence for vacuum therapy without OWT is poor, and further data,
optimally prospective or randomised control trials comparing the
conventional surgical approach of video-assisted thoracoscopic surgery
(VATS) decortication and minimally invasive vacuum therapy, are
needed. Copyright © Journal of Thoracic Disease. All rights
reserved.

<72>
Accession Number
2023178241
Title
A prospective double-blind randomised controlled trial to evaluate the
clinical profile and outcome of patients receiving spinal anaesthesia with
intrathecal bupivacaine with clonidine and intrathecal bupivacaine with
fentanyl.
Source
European Journal of Molecular and Clinical Medicine. 7(9) (pp 3647-3651),
2020. Date of Publication: September 2020.
Author
Singh S.; Kumar M.; Prasad A.
Institution
(Singh, Kumar, Prasad) Department of Anaesthesia, Jawahar Lal Nehru
Medical College and Hospital, Bihar, Bhagalpur, India
Publisher
EJMCM, International House
Abstract
Aim: to assess the Clinical profile of patients undergoing spinal
Anesthesia with intrathecal bupivacaine with clonidine and intrathecal
bupivacaine with fentanyl. Method(s): For 1 year, 80 adult patients
were enrolled in a prospective double-blind randomised controlled trial at
Jawahar Lal Nehru Medical College and Hospital in Bhagalpur, Bihar, India.
The patients were split into two classes of 40 patients each at random.
Bupivacaine and clonidine (Group "A"). Bupivacaine + fentanyl g (Group
"B") Results: Majority of patients in the both the groups belonged to the
group 25 to 45 years. Samples were age matched. The number of males and
females in each group was same (n=40) and samples in both groups were
matched with respect to sex. Majority of female patients in the both the
groups belonged to the group 160 to 170 cms and males 171 to 175 cms,
Samples were height matched. Most of the patients 43.25 percent from
gynaecology surgery followed by lower limb surgery 31.25 percent and Lower
Abdominal Surgery 25 percent. Conclusion(s): We concluded that the
administration of local anaesthetics in combination with opioids
intrathecally is an established technique for managing postoperative pain
following abdominal, pelvic, thoracic or orthopaedic procedures on lower
extremities. Local anaesthetics with opioids demonstrate significant
synergy. Copyright © 2020 Ubiquity Press. All rights reserved.

<73>
Accession Number
2022285485
Title
Pacemaker implantation associated with tricuspid repair in the setting of
mitral valve surgery: Insights from a Cardiothoracic Surgical Trials
Network randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2023.
Date of Publication: 2023.
Author
Ailawadi G.; Voisine P.; Raymond S.; Gelijns A.C.; Moskowitz A.J.; Falk
V.; Overbey J.R.; Chu M.W.A.; Mack M.J.; Bowdish M.E.; Krane M.; Yerokun
B.; Conradi L.; Bolling S.F.; Miller M.A.; Taddei-Peters W.C.; Fenton
K.N.; Jeffries N.O.; Kramer R.S.; Geirsson A.; Moquete E.G.; O'Sullivan
K.; Hupf J.; Hung J.; Beyersdorf F.; Bagiella E.; Gammie J.S.; O'Gara
P.T.; Iribarne A.; Borger M.A.; Gillinov M.
Institution
(Ailawadi, Bolling) Department of Cardiac Surgery, University of Michigan
Health System, Ann Arbor, Mich, United States
(Voisine) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec (IUCPQ), Quebec, Canada
(Raymond, Gelijns, Moskowitz, Overbey, Moquete, O'Sullivan, Hupf,
Bagiella) Department of Population Health Science and Policy, Icahn School
of Medicine at Mount Sinai, NY, New York
(Falk) Department of Cardiothoracic and Vascular Surgery, Deutsche
Herzzentrum Berlin, Department of Cardiovascular Surgery, Charite
Universitatsmedizin Berlin, and German Centre for Cardiovascular Research,
DZHK, Partner Site Berlin, Berlin, Germany
(Chu) Division of Cardiac Surgery, London Health Sciences Centre, Western
University, London, ON, Canada
(Mack) Cardiac and Thoracic Surgery, Baylor Scott & White Health, Tex,
Plano
(Bowdish) Department of Surgery and Population and Public Health Sciences,
Keck School of Medicine of USC, University of Southern California, Calif,
Los Angeles
(Krane, Geirsson) Division of Cardiac Surgery, Department of Surgery, Yale
School of Medicine, Conn, New Haven
(Yerokun) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University, NC, Durham
(Conradi) University Heart and Vascular Center Hamburg, Hamburg, Germany
(Miller, Taddei-Peters, Fenton) Division of Cardiovascular Sciences,
National Heart, Lung, and Blood Institute, National Institutes of Health,
Md, Bethesda
(Jeffries) National Heart, Lung, and Blood Institute, National Institutes
of Health, Md, Bethesda
(Kramer) Thoracic Surgery (Cardiothoracic Vascular Surgery), Internal
Medicine, Maine Medical Center, Portland, ME, United States
(Hung) Division of Cardiology, Massachusetts General Hospital, Mass,
Boston
(Beyersdorf) Department of Cardiovascular Surgery, University Heart Center
Freiburg, Freiburg, Germany
(Gammie) Cardiac Surgery, Johns Hopkins Heart and Vascular Institute, Md,
Baltimore
(O'Gara) Cardiovascular Medicine, Brigham and Women's Hospital, Mass,
Boston
(Iribarne) Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center,
NH, Lebanon
(Borger) Leipzig Heart Center, University of Leipzig, Leipzig, Germany
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Objectives: In a recent trial, tricuspid annuloplasty (TA) during mitral
valve surgery (MVS) for degenerative mitral regurgitation and moderate or
less tricuspid regurgitation (TR) reduced the composite rate of death,
reoperation for TR, or TR progression at 2 years. However, this benefit
was counterbalanced by an increase in implantation of permanent pacemakers
(PPMs). In this study, we analyzed the timing, indications, and risk
factors for these implantations. Method(s): We randomized 401
patients (MVS alone = 203; MVS + TA = 198). Potential risk factors for
PPMs were assessed using multivariable time-to-event models with death and
PPM implantation for heart failure indications as competing risks.
 Result(s): A PPM was implanted in 36 patients (9.6; 95% CI, 6.8-13.0)
within 2 years of randomization, with 30/187 (16.0%) in the MVS + TA and
6/188 (3.2%) in the MVS groups (rate ratio, 5.08; 95% CI, 2.16-11.94; P
<.001). Most (29/36; 80.6%) implantations occurred within 30 days
postoperatively. Independent risk factors for PPM implantation within 2
years were TA (hazard ratio [HR], 5.94; 95% CI, 2.27-15.53; P <.001),
increasing age (5 years, HR, 1.23; 95% CI, 1.01-1.52; P =.04), and left
ventricular ejection fraction (LVEF; HR, 0.96; 95% CI, 0.92-0.99; P =.02).
In the subset of TA recipients (n = 197), age (5 years, HR, 1.05; 95% CI,
1.00-1.10; P =.04) and LVEF (HR, 0.95; 95% CI, 0.91-0.99; P =.01) were
associated with PPM within 2 years. Conclusion(s): Concomitant TA,
age, and baseline LVEF were risk factors for PPM implantation in patients
who underwent MVS for degenerative mitral regurgitation. Although TA was
effective in preventing progression of TR, innovation is needed to
identify ways to decrease PPM implantation rates. Copyright ©
2022 The American Association for Thoracic Surgery

<74>
Accession Number
2023144100
Title
Pectus Excavatum in Cardiac Surgery Patients.
Source
Annals of Thoracic Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Stephens E.H.; Dearani J.A.; Jaroszewski D.E.
Institution
(Stephens, Dearani) Department of Cardiovascular Surgery, Mayo Clinic,
Rochester, Minnesota, United States
(Jaroszewski) Division of Thoracic Surgery, Department of Cardiovascular
and Thoracic Surgery, Mayo Clinic, Phoenix, Arizona, United States
Publisher
Elsevier Inc.
Abstract
Background: Pectus excavatum frequently accompanies congenital heart
disease and connective tissue diseases requiring cardiac surgery.
Sometimes the indication is cardiac repair, with the pectus being
incidentally noticed; other times, the pectus subsequently develops or
becomes more significant after cardiac surgery. This review arms cardiac
and congenital surgeons with background about the physiologic impact of
pectus, indications for repair and repair strategies, and outcomes for
cardiac surgery patients requiring pectus repair. Method(s): A
comprehensive literature review was performed using keywords related to
pectus excavatum, pectus repair, and cardiac/congenital heart surgery
within the PubMed database. Result(s): The risks of complications
related to pectus repair, including in the setting of cardiac surgery or
after cardiac surgery, are low in experienced hands, and patients
demonstrate cardiopulmonary benefits and symptom relief. Concomitant
pectus and cardiac surgery should be considered if it is performed in
conjunction with those experienced in pectus repair, particularly given
the increased cardiopulmonary impact of pectus after bypass. In the
setting of potential bleeding or hemodynamic instability, delayed sternal
closure is recommended. For those with anticipated pectus repair after
cardiac surgery, the pericardium should be reconstructed for cardiac
protection. For those undergoing pectus repair after cardiac surgery
without a membrane placed, a "hybrid" approach is safe and effective.
 Conclusion(s): Patients undergoing cardiac surgery noted to have
pectus should be considered for possible concomitant or staged pectus
repair. For those who will undergo a staged procedure, a barrier membrane
should be placed before chest closure. Copyright © 2023 The
Society of Thoracic Surgeons

<75>
Accession Number
2023144027
Title
The Rationalisation of Intra-Operative Imaging During Cardiac Surgery: A
Systematic Review.
Source
Heart Lung and Circulation. (no pagination), 2023. Date of Publication:
2023.
Author
Jaffar-Karballai M.; Kayali F.; Botezatu B.; Satti D.I.; Harky A.
Institution
(Jaffar-Karballai) Department of Medicine, St George's University of
London, London, United Kingdom
(Kayali) School of Medicine, University of Central Lancashire, Preston,
United Kingdom
(Botezatu) Queen's University Belfast, School of Medicine, Dentistry and
Biomedical Sciences, Belfast, Northern Ireland, United Kingdom
(Satti) Shifa College of Medicine, Shifa Tameer-e-millat University,
Islamabad, Pakistan
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
Publisher
Elsevier Ltd
Abstract
Introduction: One critical complication of cardiac surgery is
cerebrovascular accidents (CVAs). Ascending aorta atherosclerosis poses a
significant risk of embolisation to distal vessels and to cerebral
arteries. Epi-aortic ultrasonography (EUS) is thought to offer a safe,
high-quality accurate visualisation of the diseased aorta to guide the
surgeon on the best surgical approach to the planned procedure and
potentially improve neurological outcomes post-cardiac surgery.
 Method(s): The authors conducted a comprehensive search of PubMed,
Scopus and Embase. Studies that reported on epi-aortic ultrasound use in
cardiac surgery were included. Major exclusion criteria were: (1)
abstracts, conference presentations, editorials, literature reviews; (2)
case series with <5 participants; (3) epi-aortic ultrasound in trauma or
other surgeries. Result(s): A total of 59 studies and 48,255 patients
were included in this review. Out of the studies that reported patient
co-morbidities prior to cardiac surgery, 31.6% had diabetes, 59.5% had
hyperlipidaemia and 66.1% had a diagnosis of hypertension. Of those that
reported significant ascending aorta atherosclerosis found on EUS, this
ranged from 8.3% of patients to 95.2% with a mean percentage of 37.8%.
Hospital mortality ranged from 7% to 13%; four studies reported zero
deaths. Long-term mortality and stroke rate varied significantly with
hospital duration. Conclusion(s): Current data have shown EUS to have
superiority over manual palpation and transoesophageal echocardiography in
the prevention of CVAs following cardiac surgery. Yet, EUS has not been
implemented as a routine standard of care. Extensive adoption of EUS in
clinical practice is warranted to aid large, randomised trials before
making prospective conclusions on the efficacy of this screening
method. Copyright © 2023 Australian and New Zealand Society of
Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<76>
Accession Number
2023143887
Title
Long term follow-up of the tacrolimus in combination, tacrolimus alone
compared (TICTAC) trial.
Source
Journal of Heart and Lung Transplantation. (no pagination), 2023. Date of
Publication: 2023.
Author
Baran D.A.; Kapoor S.; Grewal J.; Andries G.; Camacho M.
Institution
(Baran) Department of Cardiology, Cleveland Clinic Heart, Vascular and
Thoracic Institute, Cleveland, Ohio, United States
(Kapoor, Grewal, Andries) Division of Cardiology, Newark Beth Israel
Medical Center, Heart Failure Treatment and Transplant Program, Newark,
New Jersey
(Camacho) Division of Cardiothoracic Surgery, Division of Cardiothoracic
Surgery, Newark Beth Israel Medical Center, Newark, New Jersey
Publisher
Elsevier Inc.
Abstract
Background: Tacrolimus (TAC) monotherapy has been compared to TAC and
mycophenolate mofetil (MMF) in the randomized Tacrolimus in Combination,
Tacrolimus Alone Compared (TICTAC) trial. Long term results are now
reported. Method(s): Demographics are presented with descriptive
statistics. Time to event was determined with Kaplan-Meier plots and
Mantel-Cox Logrank statistics used to compare groups. Result(s): One
hundred and forty-seven (98 %) of the initial 150 TICTAC trial patients
had long-term follow-up data available. The median follow-up was 13.4
years (interquartile range 7.2-15.1 years). Post-transplant survival at 5,
10 and 15 years in the TAC monotherapy group was 84.5 %, 66.9 %, and 52.7
%, and 94.4 %, 78.2 % and 56.1 % for patients randomized to TAC / MMF (p =
0.19 logrank). The freedom from cardiac allograft vasculopathy (>=grade 1)
was 100 %, 87.5 %, 69.3 % and 46.5 % at 1, 5, 10 and 15 years in the
monotherapy group and 100 %, 76.9 %, 68.1 % and 54.4 % in the TAC/MMF
group respectively (p = 0.96 logrank). Crossover of treatment assignment
did not alter these findings. The freedom from dialysis or renal
replacement was 92.8 %, 84.2 % and 68.4 % for TAC monotherapy patients
versus 100 %, 93.4 % and 82.3 % for TAC/MMF patients at 5, 10 and 15-years
post-transplant (p = 0.15 logrank). Conclusion(s): Patients
randomized to TAC/ MMF with 8-week steroid weaning had comparable outcomes
to those with similar steroid regimen but discontinuation of MMF at 2 week
post-transplant. The best outcomes were noted for patients initiated on
TAC/ MMF including those where MMF was discontinued for intolerance. Both
strategies are reasonable alternatives for patients post heart transplant.
Condensed Abstract: Tacrolimus monotherapy was compared to TAC and
mycophenolate mofetil without long term steroids in the randomized
Tacrolimus in Combination, Tacrolimus Alone Compared (TICTAC) trial.
Post-transplant survival at 5, 10 and 15 years in the TAC monotherapy
group was 84.5%, 66.9 %, and 52.7 %, and 94.4 %, 78.2 % and 56.1 % for
patients randomized to TAC / MMF (p = 0.19 logrank). Cardiac allograft
vasculopathy and kidney failure were similar between groups.
Immunosuppression should be individualized to avoid over treating some
patients while undertreating others. Copyright © 2023
International Society for Heart and Lung Transplantation

<77>
Accession Number
2023142702
Title
Gender trends in cardiothoracic surgery authorship.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2023.
Date of Publication: 2023.
Author
Bryan D.S.; Debarros M.; Wang S.X.; Xie Y.; Mazzola E.; Bueno R.; Marshall
M.B.
Institution
(Bryan) Section of Thoracic Surgery, University of Chicago, Chicago, Ill
(Debarros) Department of Thoracic Surgery, Madigan Army Medical Center,
Tacoma, Wash
(Wang, Bueno, Marshall) Division of Thoracic and Cardiac Surgery, Brigham
and Women's Hospital, Boston, Mass, United States
(Xie, Mazzola) Department of Biostatistics and Computational Biology,
Dana-Farber Cancer Institute, Boston, Mass, United States
(Bueno, Marshall) Harvard Medical School, Boston, Mass, United States
Publisher
Elsevier Inc.
Abstract
Objective: In recent years, the historically low proportion of women
cardiothoracic surgeons and trainees has been a subject of intense focus.
Publications remain a key metric of academic success and career
advancement. We sought to identify trends in the gender of first and last
author publications in cardiothoracic surgery. Method(s): We searched
for publications between 2011 and 2020 in 2 US cardiothoracic surgery
journals, identifying those with Medical Subject Heading publication types
of clinical trials, observational studies, meta-analyses, commentary,
reviews, and case reports. A commercially available, validated software
(Gender-API) was used to associate gender with author names. Association
of American Medical Colleges Physician Specialty Data Reports were used to
identify concurrent changes in the proportion of active women in
cardiothoracic surgery. Result(s): We identified 6934 (57.1%) pieces
of commentary; 3694 (30.4%) case reports; 1030 (8.5%) reviews, systematic
analyses, meta-analyses, or observational studies; and 484 (4%) clinical
trials. In total, 15,189 total names were included in analysis. Over the
10-year study period, first authorship by women rose from 8.5% to 16%
(0.42% per year, on average), whereas the percentage of active US women
cardiothoracic physicians rose from 4.6% to 8% (0.42% per year). Last
authorship was generally flat over the decade, going from 8.9% in 2011% to
7.8% in 2020 and on average, increased at just 0.06% per year (P = .79).
 Conclusion(s): Over the past decade, authorship by women has steadily
increased, more so at the first author position. Author-volunteered gender
identification at the time of manuscript acceptance may be useful to more
accurately follow trends in publication. Copyright © 2023 The
American Association for Thoracic Surgery

<78>
Accession Number
640530073
Title
Updates on the Global Prevalence and Etiology of Constrictive
Pericarditis: A Systematic Review.
Source
Cardiology in review. (no pagination), 2023. Date of Publication: 08 Mar
2023.
Author
Kosmopoulos M.; Liatsou Epsilon.; Theochari C.; Stavropoulos A.;
Chatzopoulou D.; Mylonas K.S.; Georgiopoulos G.; Schizas D.
Institution
(Kosmopoulos) From the Department of Medicine, University of Minnesota
Medical School, Minneapolis, MN, United States
(Liatsou, Schizas) First Department of Surgery, National and Kapodistrian
University of Athens, Laikon General Hospital, Athens, Greece
(Theochari) Third Department of Internal Medicine, National and
Kapodistrian University of Athens, Thoracic Diseases General Hospital
Sotiria, Athens, Greece
(Stavropoulos) Department of Medicine, Internal Medicine, North Bristol
NHS Trust, Bristol, United Kingdom
(Chatzopoulou) Department of Surgery, General Surgery, Frimley Health NHS
Trust, Frimley, Surrey, United Kingdom
(Mylonas) Department of Cardiac Surgery, Onassis Cardiac Surgery Center,
Athens, Greece
(Georgiopoulos) Department of Therapeutics, National and Kapodistrian
University of Athens - Faculty of Medicine, Alexandra Hospital
Publisher
NLM (Medline)
Abstract
Constrictive pericarditis is a rare disease with poorly understood
epidemiology. A systematic literature search was adopted to assess the
region- and period-specific traits of constrictive pericarditis through
Pubmed, EMBASE, and Scopus. Case reports and studies including less than
20 patients were excluded. The risk of bias was assessed through the Study
Quality Assessment Tools developed by the National Heart Lung Blood
Institute by 4 reviewers. Patient demographics, disease etiology, and
mortality were the primary assessed outcomes. One hundred thirty studies
with 11,325 patients have been included in this systematic review and
meta-analysis. The age at diagnosis of constrictive pericarditis has
markedly increased after 1990. Patients from Africa and Asia are
considerably younger compared with those from Europe and North America.
Moreover, there are differences in etiology, as tuberculosis remains the
dominant cause of constrictive pericarditis in Africa and Asia but has
been surpassed by history of previous chest surgery in North America and
Europe. The human immunodeficiency virus affects 29.1% of patients from
Africa diagnosed with constrictive pericarditis, a feature that is not
observed on any other continent. The early mortality rate after
hospitalization has improved. The variances of age at diagnosis and
etiology of constrictive pericarditis should be considered by the
clinician during the work-up of cardiac and pericardial diseases. An
underlying human immunodeficiency virus infection complicates a
significant portion of constrictive pericarditis cases in Africa. Early
mortality has improved across the world but remains high. Copyright
© 2023 Wolters Kluwer Health, Inc. All rights reserved.

<79>
Accession Number
640528418
Title
High efficacy and low early mortality in high-volume center tricuspid
valve surgery.
Source
The Thoracic and cardiovascular surgeon. (no pagination), 2023. Date of
Publication: 07 Mar 2023.
Author
Gotte J.; Zittermann A.; Schramm R.; Bleiziffer S.; Deutsch M.-A.; Renner
A.; Gummert J.F.
Institution
(Gotte, Renner) Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad
Oeynhausen, Germany
(Zittermann) Department of Cardio-Thoracic Surgery, Herz- und
Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany
(Schramm, Deutsch, Gummert) Clinic for Thoracic and Cardiovascular
Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen,
Germany
(Bleiziffer) Clinic for Cardiovascular Surgery, Herz- und Diabeteszentrum
Nordrhein-Westfalen, Bad Oeynhausen, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: Isolated tricuspid valve surgery has been associated with
early mortality rates of up to 10%. With rapidly emerging interventional
catheter-based options, the question arises of whether current technical
and perioperative protocols in cardiac surgery might translate into lower
than previously expected mortality rates, especially when looking at data
from high-volume centers. METHOD(S): We performed a retrospective
single-center analysis in 369 patients undergoing isolated tricuspid valve
repair (n=256) or replacement (n=113) between 2009 and 2021. Surgical
approaches included full sternotomy, as well as right-sided
mini-thoracotomy. According to a recently introduced clinical risk score
(CRS), patients were divided into scoring groups and observed (O) versus
expected (E) early mortality were compared. Pre- and postoperative
tricuspid valve function was also analyzed. RESULT(S): Overall,
30-day mortality was 4.1%, ranging from 0% (scoring group 0-1 points) to
8.7% (scoring group >=10 points), which was substantially lower than the
expected early mortality (2% in the lowest to 34% in the highest scoring
group). Preoperative tricuspid regurgitation was severe in 71.3% (n=263),
moderate to severe in 14.9% (n=55), and mild or less in 6.5% (n=24). The
corresponding postoperative values were 0% (n=0), 1.4% (n=5), and 81.6%
(n=301). CONCLUSION(S): Our high-volume center data indicate
substantially lower than predicted 30-day mortality in different cardiac
surgical risk scoring groups. The majority of patients had zero to minimal
residual tricuspid valve insufficiency postoperatively. Randomized
controlled trials are needed to compare tricuspid valve functional results
and long-term outcomes of surgical versus interventional procedures in
patients undergoing isolated tricuspid valve procedures. Copyright The
Author(s). This is an open access article published by Thieme under the
terms of the Creative Commons
Attribution-NonDerivative-NonCommercial-License, permitting copying and
reproduction so long as the original work is given appropriate credit.
Contents may not be used for commercial purposes, or adapted, remixed,
transformed or built upon.
(https://creativecommons.org/licenses/by-nc-nd/4.0/

<80>
Accession Number
640527974
Title
Three-Year Outcomes After Transcatheter or Surgical Aortic Valve
Replacement in Low-Risk Patients with Aortic Stenosis.
Source
Journal of the American College of Cardiology. (no pagination), 2023.
Date of Publication: 24 Feb 2023.
Author
Forrest J.K.; Deeb G.M.; Yakubov S.J.; Gada H.; Mumtaz M.A.; Ramlawi B.;
Bajwa T.; Teirstein P.S.; DeFrain M.; Muppala M.; Rutkin B.J.; Chawla A.;
Jenson B.; Chetcuti S.J.; Stoler R.C.; Poulin M.-F.; Khabbaz K.; Levack
M.; Goel K.; Tchetche D.; Lam K.Y.; Tonino P.A.L.; Ito S.; Oh J.K.; Huang
J.; Popma J.J.; Kleiman N.; Reardon M.J.
Institution
(Forrest) Yale University School of Medicine, New Haven, CT, United States
(Deeb, Chetcuti) University of Michigan Health Systems Ok - University
Hospital, Ann Arbor, MI, United States
(Yakubov) OhioHealth Riverside Methodist Hospital, Columbus, OH, United
States
(Gada, Mumtaz) University of Pittsburgh Medical Center, Harrisburg, PA,
United States
(Ramlawi) Lankenau Heart Institute, Philadelphia, PA, United States
(Bajwa) Aurora St Luke's Medical Center, Milwaukee, WI, United States
(Teirstein) Scripps Clinic, La Jolla, CA, United States
(DeFrain, Muppala) HealthPark Medical Center, Fort Myers, FL, Puerto Rico
(Rutkin) North Shore University Hospital, Manhasset, NY, United States
(Chawla, Jenson) Mercy Medical Center, Des Moines, IA, United States
(Stoler) Baylor Heart and Vascular Hospital, Dallas, TX, United States
(Poulin, Khabbaz) Beth Israel Deaconess Medical Center, Boston, MA, United
States
(Levack, Goel) Vanderbilt University Medical Center, Nashville, TN, United
States
(Tchetche) Clinique Pasteur, Toulouse, France
(Lam, Tonino) Catharina Ziekenhuis, Eindhoven, Netherlands
(Ito, Oh) Echocardiography Core Laboratory, Mayo Clinic, Rochester, MN,
United States
(Huang, Popma) Medtronic, Mounds View, MN, United States
(Kleiman, Reardon) Methodist DeBakey Heart and Vascular Center, Houston,
TX, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Randomized data comparing outcomes of transcatheter aortic
valve replacement (TAVR) to surgery in low surgical risk patients at time
points beyond 2 years is limited. This presents an unknown for physicians
striving to educate patients as part of a shared decision-making process.
 OBJECTIVE(S): We evaluated 3-year clinical and echocardiographic
outcomes from the Evolut Low Risk trial. METHOD(S): Low-risk patients
were randomized to TAVR with a self-expanding, supra-annular valve or
surgery. The primary endpoint of all-cause mortality or disabling stroke
and several secondary endpoints were assessed at 3 years. RESULT(S):
There were 1414 attempted implants (730 TAVR; 684 surgery). Patients had a
mean age of 74 years and 35% were women. At 3 years, the primary endpoint
occurred in 7.4% of TAVR patients and 10.4% of surgery patients (HR, 0.70;
95% CI, 0.49-1.00; p=0.051). The difference between treatment arms for
all-cause mortality or disabling stroke remained broadly consistent over
time: -1.8% at year 1; -2.0% at year 2; -2.9% at year 3. The incidence of
mild paravalvular regurgitation (20.3% TAVR vs. 2.5% surgery) and
pacemaker placement (23.2% TAVR vs. 9.1% surgery; p<0.001) were lower in
the surgery group. Rates of moderate or greater paravalvular regurgitation
for both groups were <1% and not significantly different. Patients who
underwent TAVR had significantly improved valve hemodynamics (mean
gradient 9.1mmHg TAVR vs. 12.1mmHg surgery; p<0.001) at 3 years.
 CONCLUSION(S): Within the Evolut Low Risk study, TAVR at 3 years
showed durable benefits compared to surgery with respect to all-cause
mortality or disabling stroke. Copyright © 2023. Published by
Elsevier Inc.

<81>
Accession Number
640527872
Title
Three-year clinical outcomes of the novel sirolimus-eluting bioresorbable
scaffold for the treatment of de novo coronary artery disease: A
prospective patient-level pooled analysis of NeoVas trials.
Source
Catheterization and cardiovascular interventions : official journal of the
Society for Cardiac Angiography & Interventions. (no pagination), 2023.
Date of Publication: 07 Mar 2023.
Author
Wang X.; Li Y.; Fu G.; Xu B.; Zhou Y.; Su X.; Liu H.; Zhang Z.; Yu B.; Tao
L.; Zheng Q.; Li L.; Xu K.; Han Y.
Institution
(Wang, Li, Xu, Han) General Hospital of Northern Theater Command,
Shenyang, Liaoning, China
(Fu) Department of Cardiology, Sir Run Run Shaw Hospital, College of
Medicine, Zhejiang University, Hangzhou, Zhejiang, China
(Xu) State Key Laboratory of Cardiovascular Disease, Department of
Cardiology, Centre for Coronary Heart Disease, Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing, China
(Zhou) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
(Su) Department of Cardiology, Wuhan Asia Heart Hospital, Affiliated to
Wuhan University of Science and Technology, Wuhan, Hubei, China
(Liu) Beijing CAPF General Hospital, Beijing, China
(Zhang) Department of Cardiology, First Hospital of Lanzhou University,
Lanzhou, Gansu, China
(Yu) Key Laboratory of Myocardial Ischemia, Department of Cardiology, 2nd
Affiliated Hospital of Harbin Medical University, Chinese Ministry of
Education, Harbin, China
(Tao) Department of Cardiology, Xijing Hospital, Air Force Medical
University, Xi'an, Shaanxi, China
(Zheng) Department of Cardiology, Halison International Peace Hospital,
Hengshui, Shijiazhuang, China
(Li) Department of Cardiology, First Affiliated Hospital of Guangxi
Medical University, Nanning, Guangxi, China
Publisher
NLM (Medline)
Abstract
OBJECTIVES: We aimed to evaluate the long-term outcomes of the novel
NeoVas sirolimus-eluting bioresorbable scaffold (BRS) for the treatment of
de novo coronary artery disease. BACKGROUND: The long-term safety and
efficacy of the novel NeoVas BRS are still needed to be elucidated.
 METHOD(S): A total of 1103 patients with de novo native coronary
lesions for coronary stenting were enrolled. The primary endpoint of
target lesion failure (TLF) was defined as a composite of cardiac death
(CD), target vessel myocardial infarction (TV-MI), or
ischemia-driven-target lesion revascularization (ID-TLR). RESULT(S):
A three-year clinical follow-up period was available for 1,091 (98.9%)
patients. The cumulative TLF rate was 7.2% with 0.8% for CD, 2.6% for
TV-MI, and 5.1% for ID-TLR. Additionally, 128 (11.8%) patient-oriented
composite endpoint and 11 definite/probable stent thromboses (1.0%) were
recorded. CONCLUSION(S): The extended outcomes of the NeoVas
objective performance criterion trial demonstrated a promising 3-year
efficacy and safety of the NeoVas BRS in low-risk patients with low
complexity in terms of lesions and comorbidities. Copyright ©
2022 Wiley Periodicals LLC.

<82>
Accession Number
640526169
Title
Managing Patients With Moderate Aortic Stenosis.
Source
JACC. Cardiovascular imaging. (no pagination), 2023. Date of Publication:
14 Jan 2023.
Author
Stassen J.; Ewe S.H.; Pio S.M.; Pibarot P.; Redfors B.; Leipsic J.;
Genereux P.; Van Mieghem N.M.; Kuneman J.H.; Makkar R.; Hahn R.T.;
Playford D.; Marsan N.A.; Delgado V.; Ben-Yehuda O.; Leon M.B.; Bax J.J.
Institution
(Stassen) Department of Cardiology, Leiden University Medical Center,
Leiden, the Netherlands; Department of Cardiology, Jessa Hospital,
Hasselt, Belgium
(Ewe) Department of Cardiology, National Heart Centre Singapore, Singapore
(Pio, Kuneman, Marsan, Delgado) Department of Cardiology, Leiden
University Medical Center, Leiden, Netherlands
(Pibarot) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec/Quebec Heart and Lung Institute, Universite Laval, Quebec City,
Quebec, Canada
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Leipsic) Departments of Medicine and Radiology, University of British
Columbia, Vancouver, BC, Canada
(Genereux) Department of Cardiology, Gagnon Cardiovascular Institute,
Morristown Medical Center, Morristown, NJ, United States
(Van Mieghem) Department of Cardiology, Thoraxcenter, Erasmus University
Medical Center, Rotterdam, Netherlands
(Makkar) Department of Cardiology, Cedars-Sinai Heart Institute, Los
Angeles, CA, United States
(Hahn, Ben-Yehuda, Leon) Presbyterian Hospital/Columbia University Irving
Medical Center, NY, United States
(Playford) Department of Cardiology, University of Notre Dame, Fremantle,
WA, Australia
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
the Netherlands; Turku Heart Center, University of Turku and Turku
University Hospital, Turku, Finland
Publisher
NLM (Medline)
Abstract
Current guidelines recommend that clinical surveillance for patients with
moderate aortic stenosis (AS) and aortic valve replacement (AVR) may be
considered if there is an indication for coronary revascularization.
Recent observational studies, however, have shown that moderate AS is
associated with an increased risk of cardiovascular events and mortality.
Whether the increased risk of adverse events is caused by associated
comorbidities, or to the underlying moderate AS itself, is incompletely
understood. Similarly, which patients with moderate AS need close
follow-up or could potentially benefit from early AVR is also unknown. In
this review, the authors provide a comprehensive overview of the current
literature on moderate AS. They first provide an algorithm that helps to
diagnose moderate AS correctly, especially when discordant grading is
observed. Although the traditional focus of AS assessment has been on the
valve, it is increasingly acknowledged that AS is not only a disease of
the aortic valve but also of the ventricle. The authors therefore discuss
how multimodality imaging can help to evaluate the left ventricular
remodeling response and improve risk stratification in patients with
moderate AS. Finally, they summarize current evidence on the management of
moderate AS and highlight ongoing trials on AVR in moderate
AS. Copyright © 2023 American College of Cardiology Foundation.
Published by Elsevier Inc. All rights reserved.

<83>
Accession Number
640525252
Title
Advantages and feasibility of intercostal nerve block in uniportal
video-assisted thoracoscopic surgery (VATS).
Source
Postgraduate medicine. (pp 1-8), 2023. Date of Publication: 06 Mar 2023.
Author
Wang L.; Ge L.; Ren Y.
Institution
(Wang, Ren) Department of Thoracic Surgery, Shenyang Chest Hospital &
Tenth People's Hospital, Shenyang, China
(Ge) Department of Health Management, Shengjing Hospital of China Medical
University, Shenyang, China
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Uniportal video-assisted thoracic surgery (VATS) has been
successfully used worldwide as a minimally invasive method of
thoracoscopic surgery. Although pain was significantly reduced after VATS,
acute postoperative pain was still significant. This study aimed to assess
the advantages and feasibility of intercostal nerve block in uniportal
VATS. METHOD(S): We conducted a retrospective analysis of
perioperative data from 280 consecutive patients who underwent uniportal
VATS at our institution between May 2021 and February 2022. The patients
were assigned to either Group A (142 patients with 3 intercostal nerves
blocked) or Group B (138 patients with 5 intercostal nerves blocked). We
analyzed the perioperative data of both groups and utilized repeated
measures ANOVA to determine the difference in postoperative pain between
the two groups across time. RESULT(S): A total of 280 patients
underwent successful uniportal VATS during the study period. There were no
significant differences between Group A and Group B in terms of age,
gender, pulmonary function, arterial blood gas analysis, laterality,
incision location, nodule size, nodule location, operative time, blood
loss, drainage time, length of hospital stays, tumor stage, or
postoperative complications. Furthermore, no surgical or 30-day
postoperative mortalities occurred. Using repeated measures ANOVA, we
found that the intercostal nerve block had significant effects on the
group, time, and interaction terms group x time (P < 0.05).
 CONCLUSION(S): Intercostal nerve block is safe and effective, and is
associated with simple, accurate, and high patient satisfaction as opposed
to other postoperative analgesics in uniportal VATS. Blocking five
intercostal nerves may be more beneficial for effective postoperative pain
management. Nevertheless, further confirmation through prospective
randomized controlled trials is required.

<84>
Accession Number
640514333
Title
Treat-to-Target or High-Intensity Statin in Patients With Coronary Artery
Disease: A Randomized Clinical Trial.
Source
JAMA. (no pagination), 2023. Date of Publication: 06 Mar 2023.
Author
Hong S.-J.; Lee Y.-J.; Lee S.-J.; Hong B.-K.; Kang W.C.; Lee J.-Y.; Lee
J.-B.; Yang T.-H.; Yoon J.; Ahn C.-M.; Kim J.-S.; Kim B.-K.; Ko Y.-G.;
Choi D.; Jang Y.; Hong M.-K.
Institution
(Hong, Lee, Lee, Ahn, Kim, Kim, Ko, Choi, Hong) Severance Hospital, Yonsei
University College of Medicine, Seoul, South Korea
(Hong) Gangnam Severance Hospital, Seoul, South Korea
(Kang) Gachon University College of Medicine, Incheon, South Korea
(Lee) Kangbuk Samsung Hospital, Sungkyunkwan University School of
Medicine, Seoul, South Korea
(Lee) Daegu Catholic University Medical Center, Daegu, South Korea
(Yang) Inje University Busan Paik Hospital, Busan, South Korea
(Yoon) Wonju Severance Christian Hospital, Wonju, South Korea
(Jang) CHA University College of Medicine, Seongnam, South Korea
Publisher
NLM (Medline)
Abstract
Importance: In patients with coronary artery disease, some guidelines
recommend initial statin treatment with high-intensity statins to achieve
at least a 50% reduction in low-density lipoprotein cholesterol (LDL-C).
An alternative approach is to begin with moderate-intensity statins and
titrate to a specific LDL-C goal. These alternatives have not been
compared head-to-head in a clinical trial involving patients with known
coronary artery disease. Objective(s): To assess whether a
treat-to-target strategy is noninferior to a strategy of high-intensity
statins for long-term clinical outcomes in patients with coronary artery
disease. Design, Setting, and Participant(s): A randomized,
multicenter, noninferiority trial in patients with a coronary disease
diagnosis treated at 12 centers in South Korea (enrollment: September 9,
2016, through November 27, 2019; final follow-up: October 26, 2022).
 Intervention(s): Patients were randomly assigned to receive either
the LDL-C target strategy, with an LDL-C level between 50 and 70 mg/dL as
the target, or high-intensity statin treatment, which consisted of
rosuvastatin, 20 mg, or atorvastatin, 40 mg. Main Outcomes and
Measures: Primary end point was a 3-year composite of death, myocardial
infarction, stroke, or coronary revascularization with a noninferiority
margin of 3.0 percentage points. Result(s): Among 4400 patients, 4341
patients (98.7%) completed the trial (mean [SD] age, 65.1 [9.9] years;
1228 females [27.9%]). In the treat-to-target group (n=2200), which had
6449 person-years of follow-up, moderate-intensity and high-intensity
dosing were used in 43% and 54%, respectively. The mean (SD) LDL-C level
for 3 years was 69.1 (17.8) mg/dL in the treat-to-target group and 68.4
(20.1) mg/dL in the high-intensity statin group (n=2200) (P=.21, compared
with the treat-to-target group). The primary end point occurred in 177
patients (8.1%) in the treat-to-target group and 190 patients (8.7%) in
the high-intensity statin group (absolute difference, -0.6 percentage
points [upper boundary of the 1-sided 97.5% CI, 1.1 percentage points];
P<.001 for noninferiority). Conclusions and Relevance: Among patients
with coronary artery disease, a treat-to-target LDL-C strategy of 50 to 70
mg/dL as the goal was noninferior to a high-intensity statin therapy for
the 3-year composite of death, myocardial infarction, stroke, or coronary
revascularization. These findings provide additional evidence supporting
the suitability of a treat-to-target strategy that may allow a tailored
approach with consideration for individual variability in drug response to
statin therapy. Trial Registration: ClinicalTrials.gov Identifier:
NCT02579499.

<85>
Accession Number
2021804971
Title
Can COVID-19 Vaccines Induce Premature Non-Communicable Diseases: Where
Are We Heading to?.
Source
Vaccines. 11(2) (no pagination), 2023. Article Number: 208. Date of
Publication: February 2023.
Author
Hromic-Jahjefendic A.; Barh D.; Uversky V.; Aljabali A.A.; Tambuwala M.M.;
Alzahrani K.J.; Alzahrani F.M.; Alshammeri S.; Lundstrom K.
Institution
(Hromic-Jahjefendic) Department of Genetics and Bioengineering, Faculty of
Engineering and Natural Sciences, International University of Sarajevo,
Hrasnicka Cesta 15, Sarajevo 71000, Bosnia and Herzegovina
(Barh) Department of Genetics, Ecology and Evolution, Institute of
Biological Sciences, Federal University of Minas Gerais, Belo Horizonte
31270-901, Brazil
(Barh) Institute of Integrative Omics and Applied Biotechnology (IIOAB),
Nonakuri, Purba Medinipur 721172, India
(Uversky) Department of Molecular Medicine and USF Health Byrd Alzheimer's
Institute, Morsani College of Medicine, University of South Florida,
Tampa, FL 33612, United States
(Aljabali) Department of Pharmaceutics and Pharmaceutical Technology,
Faculty of Pharmacy, Yarmouk University, P.O. Box 566, Irbid 21163, Jordan
(Tambuwala) Lincoln Medical School, University of Lincoln, Brayford Pool
Campus, Lincoln LN6 7TS, United Kingdom
(Alzahrani, Alzahrani) Department of Clinical Laboratories Sciences,
College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif
21944, Saudi Arabia
(Alshammeri) Department of Optometry, College of Applied Medical Sciences,
Qassim University, Buraydah 51452, Saudi Arabia
(Lundstrom) PanTherapeutics, Route de Lavaux 49, Lutry CH1095, Switzerland
Publisher
MDPI
Abstract
According to the WHO, as of January 2023, more than 850 million cases and
over 6.6 million deaths from COVID-19 have been reported worldwide.
Currently, the death rate has been reduced due to the decreased
pathogenicity of new SARS-CoV-2 variants, but the major factor in the
reduced death rates is the administration of more than 12.8 billion
vaccine doses globally. While the COVID-19 vaccines are saving lives,
serious side effects have been reported after vaccinations for several
premature non-communicable diseases (NCDs). However, the reported adverse
events are low in number. The scientific community must investigate the
entire spectrum of COVID-19-vaccine-induced complications so that
necessary safety measures can be taken, and current vaccines can be
re-engineered to avoid or minimize their side effects. We describe in
depth severe adverse events for premature metabolic, mental, and
neurological disorders; cardiovascular, renal, and autoimmune diseases,
and reproductive health issues detected after COVID-19 vaccinations and
whether these are causal or incidental. In any case, it has become clear
that the benefits of vaccinations outweigh the risks by a large margin.
However, pre-existing conditions in vaccinated individuals need to be
taken into account in the prevention and treatment of adverse
events. Copyright © 2023 by the authors.

<86>
Accession Number
2021764657
Title
Effect of Prolonged and Substantial Weight Loss on Incident Atrial
Fibrillation: A Systematic Review and Meta-Analysis.
Source
Nutrients. 15(4) (no pagination), 2023. Article Number: 940. Date of
Publication: February 2023.
Author
Pontiroli A.E.; Centofanti L.; Le Roux C.W.; Magnani S.; Tagliabue E.;
Folli F.
Institution
(Pontiroli, Centofanti, Folli) Dipartimento di Scienze della Salute,
Universita degli Studi di Milano, Milan 20133, Italy
(Le Roux) Diabetes Complications Research Centre, University College
Dublin, Dublin D04 V1W8, Ireland
(Magnani) Ospedale San Paolo, Milan 20142, Italy
(Tagliabue) IRCCS MultiMedica, Value-Based Healthcare Unit, Milan 20099,
Italy
Publisher
MDPI
Abstract
Background. Overweight and obesity are associated with atrial fibrillation
(AF), and bariatric surgery (BS), able to induce sustained and prolonged
weight loss, might represent the ideal treatment in the prevention of AF.
Previous studies could not definitely establish a role for weight loss and
BS in preventing incident AF so far. During the last few years, several
studies on the effect of bariatric surgery on cardiovascular diseases have
been published, and we performed a systematic review and meta-analysis to
evaluate the role of weight loss through BS in the prevention of incident
AF in obesity. Methods. This meta-analysis followed the PRISMA guideline.
Eligible studies were controlled trials evaluating the appearance of
atrial fibrillation in patients undergoing weight loss through BS as
compared with patients receiving medical treatment. Quality of studies was
assessed according to the Newcastle-Ottawa Quality Assessment Scale, and
risk-of-bias was evaluated employing the Egger's test. All analyses were
run by a random-effects model according to Hartung and Knapp and
sensitivity analyses were performed. Heterogeneity was assessed through Q
and I2 statistics for each comparison, and potential
publication bias was formally investigated. Results. Ten studies were
included in the meta-analysis, and the overall result was statistically
significant [OR = 0.665 (0.475-0.929), p = 0.017], with significant
heterogeneity (Q = 48.98, p < 0.001; I2 = 81.6%), but with no
publication bias. In sensitivity analyses, the amount of weight loss,
percentage of patients with diabetes and value of the Newcastle-Ottawa
Quality Assessment Scale, were all associated with significance of effect.
Since age was different in one study, a sensitivity analysis was performed
by excluding this study; OR was similar [OR = 0.608 (0.454-0.814), p <
0.001]; heterogeneity was reduced but still significant (Q = 35.74, p <
0.001, I2 = 77.6%) and again no publication bias was detected.
Conclusions. Bariatric surgery as compared to medical treatment is
associated with reduced appearance of incident AF. Copyright ©
2023 by the authors.

<87>
Accession Number
2021752042
Title
Mechanical versus Bioprosthetic Aortic Valve Replacement in Middle-Aged
Adults: A Systematic Review and Meta-Analysis.
Source
Journal of Cardiovascular Development and Disease. 10(2) (no pagination),
2023. Article Number: 90. Date of Publication: February 2023.
Author
Jiang Y.; Wang S.; Bian J.; Chen S.; Shao Y.
Institution
(Jiang, Wang, Bian, Shao) Department of Cardiovascular Surgery, The First
Affiliated Hospital of Nanjing Medical University, Guangzhou Road, No.
300, Nanjing 210000, China
(Chen) Department of Cardiovascular Surgery, Union Hospital, Tongji
Medical College, Huazhong University of Science and Technology, Jiefang
Road, No. 1277, Wuhan 430022, China
Publisher
MDPI
Abstract
Background: Mechanical prostheses and bioprosthetic prostheses have their
own advantages and disadvantages. Mechanical ones are recommended for
younger patients (<50 years old), and bioprosthetic ones are recommended
for older patients (>70 years old). There is still debate regarding which
kind of prosthesis is better for middle-aged patients (50 to 70 years old)
receiving aortic valve replacement (AVR). To solve this problem, we
conducted this meta-analysis. Given that only one randomized controlled
trial (RCT) study was included, we conducted a subgroup analysis of RCT
and propensity score matching (PSM) retrospective studies to reduce the
bias. Method(s): We systematically searched articles related to
clinical outcomes of mechanical and bioprosthetic prostheses in
middle-aged patients receiving AVR in the PubMed, Cochrane Library, and
China National Knowledge Infrastructure (CNKI) databases. The published
date was up to 1 October 2022. Studies were excluded if not only
middle-aged patients were included, or if they lacked direct comparisons
between mechanical and bioprosthetic prostheses. Result(s): In total,
22 studies with 32,298 patients were included in the final analysis. The
results show that patients aged between 50 and 70 receiving AVR with
mechanical prostheses achieved better long-term survival and fewer
reoperations and valve-related events but suffered more with bleeding
events. No significant difference could be found in terms of early
mortality and long-term cardiac death. The same results could be observed
in the subgroup analysis of RCT and PSM retrospective studies.
 Conclusion(s): Both mechanical and bioprosthetic prostheses are
beneficial to middle-aged patients undertaking AVR procedures. However,
mechanical prostheses show better clinical outcomes in long-term survival
and comorbidities. Individual recommendation is still
necessary. Copyright © 2023 by the authors.

<88>
Accession Number
2021648489
Title
Clinical Outcomes by Consolidation of Bone Marrow Stem Cell Therapy and
Coronary Artery Bypass Graft in Patients With Heart Failure With Reduced
Ejection Fraction: A Meta-analysis.
Source
Cell Transplantation. 32 (no pagination), 2023. Date of Publication:
January-December 2023.
Author
Jiang Y.; Yang Z.; Shao L.; Shen H.; Teng X.; Chen Y.; Ding Y.; Fan J.; Yu
Y.; Shen Z.
Institution
(Jiang, Yang, Shao, Shen, Teng, Chen, Ding, Fan, Yu, Shen) Department of
Cardiovascular Surgery of the First Affiliated Hospital & Institute for
Cardiovascular Science, Soochow University, Suzhou, China
Publisher
SAGE Publications Ltd
Abstract
Bone marrow stem cell (BMSC) transplantation during coronary artery bypass
graft (CABG) is an innovative treatment for ischemic heart disease (IHD).
We conduct a meta-analysis to examine whether patients with IHD presenting
heart failure with reduced ejection fraction (HFrEF) can be beneficent
from CABG with additional BMSC transplantation. Electronic searches were
performed on PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov from
their inception to July 2021. The efficacy was based on left ventricular
ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD),
left ventricular end-diastolic volume (LVEDV), left ventricular
end-diastolic volume index (LVEDVi), left ventricular end-systolic volume
index (LVESVi), and 6-min walk test (6MWT) change after treatment. Eight
randomized-controlled trials (RCTs) were included in this meta-analysis,
with a total of 350 patients. Results showed BMSC transplantation
significantly improved the LVEF [mean difference (MD) = 6.23%, 95%
confidence interval (CI): 3.22%-9.24%, P < 0.0001], LVEDVi (MD = -20.15
ml/m2, 95% CI: -30.49 to -9.82 ml/m2, P < 0.00001),
and LVESVi (MD = -17.69 ml/m2, 95% CI: -25.24 to -10.14
ml/m2, P < 0.00001). There was no statistically significant
difference in the improvement of LVEDD, LVEDV, and 6MWT between the cell
transplantation group and control groups. Subgroup analysis revealed that
the intervention for control group could affect the efficacy of BMSC
transplantation. Sensitivity analysis found the conclusion of LVEDD,
LVEDV, and 6MWT changes was not stable. Therefore, among patients with IHD
presenting HFrEF, BMSC transplantation during CABG is promising to be
beneficial for postoperative left ventricular (LV) function improvement.
However, according to the unstable results of the sensitivity analysis, it
cannot be concluded whether the extra step has a positive effect on left
ventricular remodeling and exercise capacity. RCTs with larger cohorts and
more strict protocols are needed to validate these
conclusions. Copyright © The Author(s) 2023.

<89>
Accession Number
2023019881
Title
Apolipoprotein E4 allele is genetically associated with risk of the short-
and medium-term postoperative cognitive dysfunction: A meta-analysis and
trial sequential analysis.
Source
PLoS ONE. 18(2 February) (no pagination), 2023. Article Number: e0282214.
Date of Publication: February 2023.
Author
Hsiao W.-J.; Chen C.-Y.; Kang Y.-N.; Hu C.-J.; Chen C.H.; Lin P.-L.; Lin
Y.-C.
Institution
(Hsiao, Hu) School of Medicine, College of Medicine, Taipei Medical
University, Taipei, Taiwan (Republic of China)
(Chen, Lin) Department of Anesthesia, Taipei Medical University Hospital,
Taipei, Taiwan (Republic of China)
(Chen) Department of Anesthesia, School of Medicine, College of Medicine,
Taipei Medical University, Taipei, Taiwan (Republic of China)
(Chen) Graduate Institute of Humanities in Medicine, College of Humanities
and Social Sciences, Taipei Medical University, Taipei, Taiwan (Republic
of China)
(Kang) Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical
University, Taipei City, Taiwan (Republic of China)
(Kang) Cochrane Taiwan, Taipei Medical University, Taipei City, Taiwan
(Republic of China)
(Kang) Institute of Health Policy and Management, College of Public
Health, National Taiwan University, Taipei City, Taiwan (Republic of
China)
(Hu) Department of Neurology, Shuang Ho Hospital, Taipei Medical
University, New Taipei City, Taiwan (Republic of China)
(Chen) Department of Chemical and Systems Biology, School of Medicine,
Stanford University, Stanford, CA, United States
(Lin) Department of Anesthesia, National Taiwan University Hospital,
Taipei, Taiwan (Republic of China)
(Lin) School of Nursing, College of Nursing, Taipei Medical University,
Taipei, Taiwan (Republic of China)
(Lin) Post-Baccalaureate Program in Nursing, College of Nursing, Taipei
Medical University, Taipei City, Taiwan (Republic of China)
Publisher
Public Library of Science
Abstract
The aim of systematic review and meta-analysis was to investigate whether
APOE4 was associated with postoperative neurologic dysfunction occurrence
in short- or medium-term among surgical patients and to study the
potential genetic association among these two entities. We searched
electronic databases for reserch studies to evaluate the association of
APOE4 with postoperative delirium (POD) or short- and medium term
postoperative cognitive dysfunction (POCD). Twenty-two trials (16
prospective and six retrospective) with 6734 patients were included. APOE4
alleles was shown significantly associated with POCD within 1 week (odds
ratio, OR, 1.89, 95% confidence interval, CI, 1.36 to 2.6278, p < 0.01) in
the random-effects model. A significant association was also noted between
APOE4 and POCD in medium-term, 1-3 months, after surgery (OR: 1.67, 95%
CI: 1.003-2.839, p = 0.049). However, APOE4 was not significantly
associated with POCD 1 year after surgery (OR: 0.98, 95% CI: 0.57-1.70, p
= 0.9449) and POD (OR: 1.28, 95% CI: 0.85-1.91, p = 0.23). In conclusion,
APOE4 alleles was genetically associated with short- and mediumterm
postoperative neurological dysfunction and future screening or preventive
strategies derived is highly potential to improve outcomes. Copyright
© 2023 Hsiao et al.

<90>
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. Copyright © The Author(s) 2022.

<91>
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. 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. 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. 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. Copyright © 2023 Lahore Medical And Dental
College. All rights reserved.

<92>
Accession Number
2015142338
Title
Maintained P2Y<inf>12</inf> inhibitor monotherapy after shorter-duration
of dual antiplatelet therapy in patients undergoing coronary drug-eluting
stents implantation: An updated meta-analysis of randomized trials.
Source
Journal of Clinical Pharmacy and Therapeutics. 47(7) (pp 860-869), 2022.
Date of Publication: July 2022.
Author
Fan Z.-G.; Tian N.-L.; He S.-H.; Ma G.-S.
Institution
(Fan, Ma) Department of Cardiology, Zhongda Hospital Affiliated to
Southeast University, Nanjing, China
(Tian) Department of Cardiology, Nanjing First Hospital, Nanjing Heart
Center, Nanjing Medical University, Nanjing, China
(He) Department of Cardiology, Northern Jiangsu People's Hospital,
Yangzhou University, Yangzhou, China
Publisher
John Wiley and Sons Inc
Abstract
What is known and Objective: It is well known that high in-stent
thrombotic risk due to the superimposition of a platelet-rich thrombus was
considered as the main origin of major adverse cardiac events after stent
implantation. The clinical management of antiplatelet therapy strategy
after percutaneous coronary intervention (PCI) remains controversial. This
study is sought to explore the efficacy and safety of a maintained
P2Y<inf>12</inf> inhibitor monotherapy after shorter-duration of dual
antiplatelet therapy (DAPT) in these patients. Method(s): Medline,
Google Scholar, Web of Science, and the Cochrane Controlled Trials
Registry were searched online for retrieving eligible citations. A
composite of all-cause death, myocardial infarction (MI) and stroke was
defined as major adverse cardio- and cerebro-vascular events (MACCE),
which is analysed as the primary efficacy endpoint. The risk of bleeding
events was chosen as safety endpoint. Result(s): Five randomized
clinical trials (RCT) with 32,143 patients were finally analysed. A
maintained P2Y<inf>12</inf> inhibitor monotherapy after shorter-duration
of DAPT cloud not only reduce the incidence of MACCE [odds ratios (OR):
0.89, 95% confidence intervals (CI): 0.79-0.99, p = 0.037], but also the
bleeding risk (OR 0.61, 95% CI: 0.44-0.85, p = 0.003). No higher incidence
of any ischaemic events, including MI, stroke or definite stent thrombosis
(ST) was observed with respect to this new antiplatelet therapy option.
 Conclusion(s): A maintained P2Y<inf>12</inf> inhibitor monotherapy
after shorter-duration of DAPT was suggested as a more preferable
antiplatelet therapy option in patients undergoing coronary drug-eluting
stents (DES) placement. Larger and more powerful randomized trials with
precise sub-analyses are still necessary for further confirming these
relevant benefits. Copyright © 2022 John Wiley & Sons Ltd.

<93>
Accession Number
2019065582
Title
Solid organ transplantation from donors with recent or current SARS-CoV-2
infection: A systematic review.
Source
Anaesthesia Critical Care and Pain Medicine. 41(4) (no pagination), 2022.
Article Number: 101098. Date of Publication: August 2022.
Author
Martinez-Reviejo R.; Tejada S.; Cipriano A.; Karakoc H.N.; Manuel O.;
Rello J.
Institution
(Martinez-Reviejo, Tejada, Rello) Clinical Research/Epidemiology in
Pneumonia & Sepsis (CRIPS), Vall d'Hebron Institute of Research (VHIR),
Barcelona, Spain
(Martinez-Reviejo, Tejada, Rello) Centro de Investigacion Biomedica En Red
de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III,
Madrid, Spain
(Cipriano, Manuel) Infectious Diseases Service, Lausanne University
Hospital and University of Lausanne, Lausanne, Switzerland
(Karakoc) Karadeniz Technical University School of Medicine, Trabzon,
Turkey
(Manuel) Transplantation Centre, Lausanne University Hospital and
University of Lausanne, Lausanne, Switzerland
(Rello) Department of Medicine, Universitat Internacional de Catalunya,
Barcelona, Spain
(Rello) Clinical Research, CHRU Nimes, Nimes, France
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Solid-organ transplantation (SOT) from SARS-CoV-2 positive
donors could be a life-saving opportunity worth grasping. We perform a
systematic review to evaluate the recipient outcomes of SOT from donors
with recent or current SARS-CoV-2 infection. Method(s): Search
strategy was performed in PubMed, Cochrane COVID-19 Study Register, and
Web of Science databases from the 1st of January 2019 to the
31st of December 2021. SOT adult recipients from a donor with
past or current SARS-CoV-2 infection were elegible for inclusion. Outcomes
were viral transmission, COVID-19 symptoms, mortality, hospital stay, and
complications. PROSPERO Register Number: CRD42022303242 Findings:
Sixty-nine recipients received 48 kidneys, 18 livers and 3 hearts from 57
donors. Six additional transplants from positive lungs were identified.
IgG+ anti-SARS-CoV-2 titers were detected among 10/16 recipients; only 4%
(3/69) recipients were vaccinated. Non-lung transplant recipients received
organs from 10/57 (17.5%) donors with persistent COVID-19. In 18/57
donors, SARS-CoV-2 RNA was detected (median 32 Cycle threshold [Ct]) at
procurement. Among non-lung transplant recipients, SARS-CoV-2 viral
transmission was not documented. Four patients presented delayed graft
dysfunction, two patients acute rejection, and two patients died of septic
shock. The median (IQR) hospital stay was 18 (11-28) days in recipients
from symptomatic donors. Viral transmission occurred from three lung
donors to their recipients, who developed COVID-19 symptoms. One of the
recipients subsequently died. Conclusion(s): Use of non-lung (kidney,
liver and heart) organs from SARS-CoV-2 positive donors seem to be a safe
practice, with a low risk of transmission irrespective of the presence of
symptoms at the time of procurement. Low viral replication (Ct > 30) was
safe among non-lung donors, even if persistently symptomatic at
procurement. Copyright © 2022 Societe francaise d'anesthesie et
de reanimation (Sfar)

<94>
Accession Number
638557345
Title
Effect of 4% Albumin Solution vs Ringer Acetate on Major Adverse Events in
Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass: A
Randomized Clinical Trial.
Source
JAMA. 328(3) (pp 251-258), 2022. Date of Publication: 19 Jul 2022.
Author
Pesonen E.; Vlasov H.; Suojaranta R.; Hiippala S.; Schramko A.; Wilkman
E.; Eranen T.; Arvonen K.; Mazanikov M.; Salminen U.-S.; Meinberg M.;
Vahasilta T.; Petaja L.; Raivio P.; Juvonen T.; Pettila V.
Institution
(Pesonen, Vlasov, Suojaranta, Hiippala, Schramko, Wilkman, Arvonen,
Mazanikov, Meinberg, Petaja, Pettila) Department of Anesthesiology,
Intensive Care and Pain Medicine, University of Helsinki, Helsinki
University Hospital, Helsinki, Finland
(Eranen) HUS Pharmacy, University of Helsinki, Helsinki University
Hospital, Helsinki, Finland
(Salminen, Vahasilta, Raivio, Juvonen) Department of Cardiac Surgery,
Heart and Lung Center, University of Helsinki, Helsinki University
Hospital, Helsinki, Finland
Publisher
American Medical Association
Abstract
Importance: In cardiac surgery, albumin solution may maintain hemodynamics
better than crystalloids and reduce the decrease in platelet count and
excessive fluid balance, but randomized trials are needed to compare the
effectiveness of these approaches in reducing surgical complications.
 Objective(s): To assess whether 4% albumin solution compared with
Ringer acetate as cardiopulmonary bypass prime and perioperative
intravenous volume replacement solution reduces the incidence of major
perioperative and postoperative complications in patients undergoing
cardiac surgery. Design, Setting, and Participant(s): A randomized,
double-blind, single-center clinical trial in a tertiary university
hospital during 2017-2020 with 90-day follow-up postoperatively involving
patients undergoing on-pump coronary artery bypass grafting; aortic,
mitral, or tricuspid valve surgery; ascending aorta surgery without
hypothermic circulatory arrest; and/or the maze procedure were randomly
assigned to 2 study groups (last follow-up was April 13, 2020).
 Intervention(s): The patients received in a 1:1 ratio either 4%
albumin solution (n = 693) or Ringer acetate solution (n = 693) as
cardiopulmonary bypass priming and intravenous volume replacement
intraoperatively and up to 24 hours postoperatively. Main Outcomes
and Measures: The primary outcome was the number of patients with at least
1 major adverse event: death, myocardial injury, acute heart failure,
resternotomy, stroke, arrhythmia, bleeding, infection, or acute kidney
injury. Result(s): Among 1407 patients randomized, 1386 (99%; mean
age, 65.4 [SD, 9.9] years; 1091 men [79%]; 295 women [21%]) completed the
trial. Patients received a median of 2150 mL (IQR, 1598-2700 mL) of study
fluid in the albumin group and 3298 mL (IQR, 2669-3500 mL) in the Ringer
group. The number of patients with at least 1 major adverse event was 257
of 693 patients (37.1%) in the albumin group and 234 of 693 patients
(33.8%) in the Ringer group (relative risk albumin/Ringer, 1.10; 95% CI,
0.95-1.27; P =.20), an absolute difference of 3.3 percentage points (95%
CI, -1.7 to 8.4). The most common serious adverse events were pulmonary
embolus (11 [1.6%] in the albumin group vs 8 [1.2%] in the Ringer group),
postpericardiotomy syndrome (9 [1.3%] in both groups), and pleural
effusion with intensive care unit or hospital readmission (7 [1.0%] in the
albumin group vs 9 [1.3%] in the Ringer group). Conclusions and
Relevance: Among patients undergoing cardiac surgery with cardiopulmonary
bypass, treatment with 4% albumin solution for priming and perioperative
intravenous volume replacement solution compared with Ringer acetate did
not significantly reduce the risk of major adverse events over the
following 90 days. These findings do not support the use of 4% albumin
solution in this setting. Trial Registration: ClinicalTrials.gov
Identifier: NCT02560519. Copyright © 2022 American Medical
Association. All rights reserved.

<95>
Accession Number
640507414
Title
UPDATE ON GLYCEMIC TARGETS IN THE ICU.
Source
Diabetes Technology and Therapeutics. Conference: International Conference
on Advanced Technologies and Treatments for Diabetes, ATTD 2023. Berlin
Germany. 25(Supplement 2) (pp A17-A18), 2023. Date of Publication:
February 2023.
Author
Hirsch I.
Institution
(Hirsch) University of Washington, Diabetes Institute, Seattle, United
States
Publisher
Mary Ann Liebert Inc.
Abstract
We don't have evidenced-based glycemic targets in the ICU for as the data
to date has been unclear (except for cardiac surgery). Society
recommendations suggest all patients, with or without diabetes, maintain
glucose in the 140-180 mg/dL range. These pragmatic targets consider
glycemic safety (hypoglycemia) and concerns for hyperglycemia resulting in
worse infection, wound healing, and inflammation. It has been noted
repeatedly since 2002 (including with COVID patients) that those without
diabetes have higher ICU mortality rates with hyperglycemia than those
with diabetes. The reason for this is unclear. In 2020, Krinsley et al
published a retrospective study where HbA1c levels were measured on each
ICU patient starting in 2011. With over 5500 patients, it was shown those
with HbA1c levels benefited from glucose levels 80-140 mg/dL and had a
3.5X higher mortality with glucose levels above 180 mg/dL. However, for
those with admission HbA1c levels >8%, those with glucose levels 80-140
mg/dL had a 3X greater mortality than those with glucose levels above 180
mg/dL. A future study reported the exception to these observations were
those with HbA1c levels less than 6.5% receiving insulin. For this
population, mortality was almost twice as high with the well-controlled
glucose levels of 80-140 mg/dL. While the etiology of these findings is
not known, there are several speculatory hypotheses, including brain
adaptation to pre-admission glycemia. This also explains why those with,
compared to without diabetes appear to be protected in the hospital from
hyperglycemia. While the impact of these findings could result in
''precision glycemia'' for those admitted to the ICU, it is time to
consider an appropriate randomized controlled trial to test these
findings.

<96>
Accession Number
2020990207
Title
Risk factors of early complications after thoracic and lumbar spinal
deformity surgery: a systematic review and meta-analysis.
Source
European Spine Journal. 32(3) (pp 899-913), 2023. Date of Publication:
March 2023.
Author
Kuo C.C.; Soliman M.A.R.; Aguirre A.O.; Youngs D.; Kruk M.; Hess R.M.;
Nyabuto E.M.; Khan A.; Jowdy P.K.; Pollina J.; Mullin J.P.
Institution
(Kuo, Aguirre, Kruk) Jacobs School of Medicine and Biomedical Sciences at
University at Buffalo, Buffalo, NY, United States
(Soliman, Hess, Nyabuto, Khan, Jowdy, Pollina, Mullin) Department of
Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at
University at Buffalo, 100 High Street, Suite B4, Buffalo, NY 14203,
United States
(Soliman, Hess, Nyabuto, Khan, Jowdy, Pollina, Mullin) Department of
Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, NY,
United States
(Soliman) Department of Neurosurgery, Faculty of Medicine, Cairo
University, Cairo, Egypt
(Youngs) SUNY Upstate Medical University, Syracuse, NY, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: To determine risk factors increasing susceptibility to early
complications (intraoperative and postoperative within 6 weeks) associated
with surgery to correct thoracic and lumbar spinal deformity.
 Method(s): We systematically searched the PubMed and EMBASE databases
for studies published between January 1990 and September 2021.
Observational studies evaluating predictors of early complications of
thoracic and lumbar spinal deformity surgery were included. Pooled odds
ratio (OR) or standardized mean difference (SMD) with 95% confidence
intervals (CI) was calculated via the random effects model.
 Result(s): Fifty-two studies representing 102,432 patients met the
inclusion criteria. Statistically significant patient-related risk factors
for early complications included neurological comorbidity (OR = 3.45, 95%
CI 1.83-6.50), non-ambulatory status (OR = 3.37, 95% CI 1.96-5.77), kidney
disease (OR = 2.80, 95% CI 1.80-4.36), American Society of
Anesthesiologists score > 2 (OR = 2.23, 95% CI 1.76-2.84), previous spine
surgery (OR = 1.98, 95% CI 1.41-2.77), pulmonary comorbidity (OR = 1.94,
95% CI 1.21-3.09), osteoporosis (OR = 1.60, 95% CI 1.17-2.20),
cardiovascular diseases (OR = 1.46, 95% CI 1.20-1.78), hypertension (OR =
1.37, 95% CI 1.23-1.52), diabetes mellitus (OR = 1.84, 95% CI 1.30-2.60),
preoperative Cobb angle (SMD = 0.43, 95% CI 0.29, 0.57), number of
comorbidities (SMD = 0.41, 95% CI 0.12, 0.70), and preoperative lumbar
lordotic angle (SMD = - 0.20, 95% CI - 0.35, - 0.06). Statistically
significant procedure-related factors were fusion extending to the sacrum
or pelvis (OR = 2.53, 95% CI 1.53-4.16), use of osteotomy (OR = 1.60, 95%
CI 1.12-2.29), longer operation duration (SMD = 0.72, 95% CI 0.05, 1.40),
estimated blood loss (SMD = 0.46, 95% CI 0.07, 0.85), and number of levels
fused (SMD = 0.37, 95% CI 0.03, 0.70). Conclusion(s): These data may
contribute to development of a systematic approach aimed at improving
quality-of-life and reducing complications in high-risk
patients. Copyright © 2023, The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature.

<97>
Accession Number
2017967478
Title
Addressing unmeasured confounding bias with a prior knowledge guided
approach: coronary artery bypass grafting (CABG) versus percutaneous
coronary intervention (PCI) in patients with stable ischemic heart
disease.
Source
Health Services and Outcomes Research Methodology. 23(1) (pp 59-79), 2023.
Date of Publication: March 2023.
Author
Duan L.; Lee M.-S.; Doctor J.N.; Adams J.L.
Institution
(Duan) Department of Research and Evaluation, Kaiser Permanente Southern
California, 100 S Los Robles Ave, 5th Floor, Pasadena, CA 91101, United
States
(Lee) Department of Cardiology, Kaiser Permanente Los Angeles Medical
Center, Los Angeles, CA, United States
(Doctor) Price School of Public Policy, University of Southern California,
Los Angeles, CA, United States
(Adams) Kaiser Permanente Center for Effectiveness and Safety Research and
the Bernard J. Tyson School of Medicine, Pasadena, CA, United States
Publisher
Springer
Abstract
Unmeasured confounding undermines the validity of observational studies.
Although randomized clinical trials (RCTs) are considered the "gold
standard" of study types, we often observe divergent findings between RCTs
and empirical settings. We present the "L-table", a simulation-based,
prior knowledge (e.g., RCTs) guided approach that estimates the true
effect adjusting for the potential influence of unmeasured confounders
when using observational data. Using electronic health record data from
Kaiser Permanente Southern California, we compare the effectiveness of
coronary artery bypass grafting (CABG) and percutaneous coronary
intervention (PCI) on endpoints at 1, 3, 5, and 10 years for patients with
stable ischemic heart disease. We applied the L-table approach to the
propensity score adjusted cohort to derive the omitted-confounder-adjusted
estimated effects. After the L-table adjustment, CABG patients are 57.6%
less likely to encounter major adverse cardiac and cerebrovascular event
(MACCE) at 1 year (OR [95% CI] 0.424 [0.396, 0.517]), 56.4% less likely at
3 years (OR [95% CI] 0.436 [0.369, 0.527]), and 48.9% less likely at 5
years (OR [95% CI] 0.511 [0.451, 0.538]). CABG patients are also 49.5%
less likely to die by the end of 10 years than PCI patients (OR [95% CI]
0.505 [0.446, 0.582]). We found the estimated true effects all shifted
towards CABG as a more effective procedure that led to better health
outcomes compared to PCI. Unlike existing sensitivity tools, the L-table
approach explicitly lays out probable values and can therefore better
support clinical decision-making. We recommend using L-table as a
supplement to available techniques of sensitivity analysis. Copyright
© 2022, The Author(s), under exclusive licence to Springer
Science+Business Media, LLC, part of Springer Nature.

<98>
Accession Number
2023176109
Title
A Systematic Review and Meta-Analysis of Influences of Chronic Kidney
Disease on Patients after Percutaneous Coronary Intervention for Chronic
Total Occlusions.
Source
Computational and Mathematical Methods in Medicine. 2023 (no pagination),
2023. Article Number: 9450752. Date of Publication: 2023.
Author
Wu W.; Gao M.; Wu X.
Institution
(Wu, Gao, Wu) Department of Nephrology, Huzhou Central Hospital,
Affiliated Central Hospital Huzhou University, No. 1558, Sanhuan North
Road, Wuxing District, Zhejiang, Huzhou 313000, China
Publisher
Hindawi Limited
Abstract
Objective. Chronic kidney disease (CKD) is a clinical collective term for
kidney disease with glomerular filtration rate GFR<60 mL/min for more than
three months due to various factors and is usually associated with
coronary heart disease and is also an independent risk factor for coronary
heart disease. This study is aimed at systematically reviewing the
influence of CKD on the outcomes of patients after percutaneous coronary
intervention (PCI) for chronic total occlusions (CTOs). Methods. The
Cochrane Library, PubMed, Embase, China biomedical literature database
(SinoMed), China National Knowledge Infrastructure, and Wanfang database
were searched for case-control studies on the influence of CKD on outcomes
after PCI for CTOs. After screening the literature, extracting data, and
evaluating the quality of literature, RevMan 5.3 software was used for
meta-analysis. Results. There were 11 articles with a total of 558,440
patients included. Meta-analysis results indicated that left ventricular
ejection fraction (LVEF) level, diabetes, smoking, hypertension, coronary
artery bypass grafting, angiotensin converting enzyme inhibitor
(ACEI)/angiotensin receptor blocker (ARB), beta-blockers, age, and renal
insufficiency were the factors affecting outcomes after PCI for CTOs [risk
ratio and 95% confidence interval were: 0.88 (0.86, 0.90), 0.96 (0.95,
0.96), 0.76 (0.59, 0.98), 1.39 (0.89, 2.16), 0.73 (0.38, 1.40), 0.24
(0.02, 3.9), 0.78 (0.77, 0.79), 0.81 (0.80, 0.82), and 1.50 (0.47, 4.79)].
Conclusion. LVEF level, diabetes, smoking, hypertension, coronary artery
bypass grafting, ACEI/ARB, beta-blockers, age, renal insufficiency, etc.
are important risk factors for outcomes after PCI for CTOs. Controlling
these risk factors is of great significance for the prevention, treatment,
and prognosis of CKD. Copyright © 2023 Weifei Wu et al.

<99>
Accession Number
2022952781
Title
Clinical application of evidence for reduced physical restraint with ICU
adult catheterized patients: a stepped-wedge randomized controlled trial.
Source
International Journal of Clinical and Experimental Medicine. 16(2) (pp
15-30), 2023. Article Number: IJCEM0145852. Date of Publication: 2023.
Author
Yang Y.; Wu J.; Qian H.; Xu H.; Chen X.; Lu L.; Xu Y.; Wang C.; Gao Y.; Li
J.
Institution
(Yang, Wu, Qian, Xu, Chen, Lu, Xu, Wang, Gao, Li) Affiliated Hospital of
Nantong University, Jiangsu, Nantong 226001, China
Publisher
E-Century Publishing Corporation
Abstract
Background: In recent years, there have been many disputes about the
validity and rationality of physical restraint. More and more nurses are
beginning to pay attention to the pros and cons of restraint use, and
rebal-ance the priority of restraint use. Aim(s): This study was
performed to guide and standardize the practice of physical restraint by
nurses and evaluate the effects of application. Method(s): The trial
was a stepped-wedge, cluster, randomized controlled trial. Four ICUs in
the Affiliated Hospital of Nantong University were recruited, including
the general ICU, Neurosurgery ICU, Neurology ICU and Cardiac Surgery ICU.
Catheterized patients aged 18 years or older who were admitted to ICU and
were willing to participate in the study were included. During the control
phase, each ICU implemented nursing procedures and the management model as
usual, and during the intervention phase implemented practical reform.
 Result(s): Compared with pre-implementation and post-implementation,
the patient restraint time was shortened (682.16+/-370.81 vs
467.41+/-406.37; P=0.000) and the restraint rate was decreased (91.2% vs
73.7%; P=0.000). In the general ICU, the restraint time gradually
decreased (P > 0.05). The restraint rate gradually decreased, but slightly
increased in the fourth stage (P < 0.05). In the Neurosurgery ICU,
restraint time was shortened in the fourth stage (P=0.000), and the
restraint rate of the fourth stage was also decreased (P=0.000). In the
Neurology ICU, the restraint time was extended during post-implementation
(P=0.000) and the restraint rate increased during post-implementation (P <
0.05). In the Cardiac Surgery ICU, there was no significant difference of
restraint time and rate in different implementation stages (P > 0.05).
Linking evidence to action: The best evidence of reasonable physical
restraint with ICU adult catheterized patients was transformed and applied
to clinical practice. We believe that this study has evidence-based
potential to help healthcare providers reduce the restraint rate and
shorten the restraint time of ICU patients. Copyright © 2023,
E-Century Publishing Corporation. All rights reserved.

<100>
Accession Number
2021896573
Title
Prognostic relevance of mitral and tricuspid regurgitation after
transcatheter aortic valve implantation: Impact of follow-up time point
for decision-making.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 990373. Date of Publication: 2023.
Author
Baz L.; Mobius-Winkler S.; Diab M.; Kraplin T.; Westphal J.G.; Ibrahim K.;
Schulze P.C.; Franz M.
Institution
(Baz, Mobius-Winkler, Westphal, Schulze, Franz) Department of Internal
Medicine I, University Hospital Jena, Jena, Germany
(Baz) Research Program "Else Kroner-Forschungskolleg AntiAge", Jena
University Hospital, Jena, Germany
(Diab) Department of Cardiothoracic Surgery, University Hospital Jena,
Jena, Germany
(Kraplin) University Hospital Jena, Jena, Germany
(Ibrahim) Department of Internal Medicine I, Klinikum Chemnitz, Chemnitz,
Germany
Publisher
Frontiers Media S.A.
Abstract
Background: In patients with aortic stenosis treated by transcatheter
aortic valve implantation (TAVI), mitral and tricuspid regurgitation (MR
and TR) at baseline and after TAVI are likely to be of prognostic
relevance, and questions such as whether and when treatment further
improves prognosis in these patients arise. Aim(s): Against that
background, the purpose of this study was to analyze a variety of clinical
characteristics including MR and TR with respect to their potential value
as predictors of 2-year mortality after TAVI. Method(s): A cohort of
445 typical TAVI patients was available for the study and clinical
characteristics were evaluated baseline, 6 to 8 weeks as well as 6 months
after TAVI. Result(s): In 39% of the patients relevant (moderate or
severe) MR and in 32% of the patients relevant (moderate or severe) TR
could be detected at baseline. The rates were 27% for MR (p = 0.001,
compared to baseline) and 35% for TR (p = n.s., compared to baseline) at
the 6- to 8-week follow-up. After 6 months, relevant MR was observable in
28% (p = 0.036, compared to baseline) and relevant TR in 34% (p = n.s.,
compared to baseline) of the patients. As predictors of 2-year mortality,
a multivariate analysis identified the following parameters for the
different time points: sex, age, AS entity, atrial fibrillation, renal
function, relevant TR, systolic pulmonary artery pressure (PAPsys), and
6-min walk distance at baseline; clinical frailty scale and PAPsys 6-8
weeks after TAVI and BNP and relevant MR 6 months after TAVI. There was a
significantly worse 2-year survival in patients with relevant TR at
baseline (68.4% vs. 82.6%, p < 0.001; whole population, n = 445) and in
patients with relevant MR at 6 months (87.9% vs. 95.2%, p = 0.042;
landmark analysis: n = 235). Conclusion(s): This real-life study
demonstrated the prognostic relevance of repeated evaluation of MR and TR
before and after TAVI. Choosing the right time point for treatment is a
remaining clinical challenge, which should be further addressed in
randomized trials. Copyright © 2023 Baz, Mobius-Winkler, Diab,
Kraplin, Westphal, Ibrahim, Schulze and Franz.

<101>
Accession Number
2023167440
Title
Naltrexone-bupropion combinations do not affect cocaine
self-administration in humans.
Source
Pharmacology Biochemistry and Behavior. 224 (no pagination), 2023. Article
Number: 173526. Date of Publication: March 2023.
Author
Regnier S.D.; Stoops W.W.; Lile J.A.; Alcorn J.L.; Bolin B.L.; Reynolds
A.R.; Hays L.R.; Rayapati A.O.; Rush C.R.
Institution
(Regnier, Stoops, Lile, Alcorn, Bolin, Reynolds, Rush) Department of
Behavioral Science, University of Kentucky College of Medicine, 1100
Veterans Drive, Medical Behavioral Science Building, Lexington, KY
40536-0086, United States
(Stoops, Lile, Hays, Rayapati, Rush) Department of Psychiatry, University
of Kentucky College of Medicine, 245 Fountain Court, Lexington, KY
40509-1810, United States
(Stoops, Lile, Rush) Department of Psychology, University of Kentucky
College of Arts and Sciences, 171. Funkhouser Drive, Lexington, KY
40506-0044, United States
(Stoops) Center on Drug and Alcohol Research, University of Kentucky
College of Medicine, 845 Angliana Ave, Lexington, KY 40508, United States
Publisher
Elsevier Inc.
Abstract
The FDA has not yet approved a pharmacotherapy for cocaine use disorder
despite nearly four decades of research. This study determined the initial
efficacy, safety, and tolerability of naltrexone-bupropion combinations as
a putative pharmacotherapy for cocaine use disorder. Thirty-one (31)
non-treatment seeking participants with cocaine use disorder completed a
mixed-design human laboratory study. Participants were randomly assigned
to the naltrexone conditions (i.e., 0, 50 mg/day; between-subject factor)
and maintained on escalating doses of bupropion (i.e., 0, 100, 200, 400
mg/day; within-subject factor) for at least four days prior to the conduct
of experimental sessions. Cocaine self-administration (IN, 0, 40, 80 mg)
was then determined using a modified progressive ratio and relapse
procedure. Subjective and cardiovascular effects were also measured.
Cocaine produced prototypical dose-related increases in
self-administration, subjective outcomes (e.g., "Like Drug"), and
cardiovascular indices (e.g., heart rate, blood pressure) during placebo
maintenance. Naltrexone and bupropion alone, or in combination, did not
significantly decrease self-administration on either procedure. Low doses
of bupropion (i.e., 100 mg) blunted the effects of the cocaine on
subjective measures of "Like Drug" and "Stimulated". No unexpected adverse
effects were observed with naltrexone and bupropion, alone and combined,
in conjunction with cocaine. Together, these results do not support the
use of these bupropion-naltrexone combinations for the treatment of
cocaine use disorder. Future research should determine if novel drug
combinations may decrease cocaine self-administration. Copyright
© 2023

<102>
Accession Number
640510536
Title
Transcatheter Repair for Patients with Tricuspid Regurgitation.
Source
The New England journal of medicine. (no pagination), 2023. Date of
Publication: 04 Mar 2023.
Author
Sorajja P.; Whisenant B.; Hamid N.; Naik H.; Makkar R.; Tadros P.; Price
M.J.; Singh G.; Fam N.; Kar S.; Schwartz J.G.; Mehta S.; Bae R.; Sekaran
N.; Warner T.; Makar M.; Zorn G.; Spinner E.M.; Trusty P.M.; Benza R.;
Jorde U.; McCarthy P.; Thourani V.; Tang G.H.L.; Hahn R.T.; Adams D.H.
Institution
(Sorajja, Whisenant, Hamid, Naik, Makkar, Tadros, Price, Singh, Fam, Kar,
Schwartz, Mehta, Bae, Sekaran, Warner, Makar, Zorn, Spinner, Trusty,
Benza, Jorde, McCarthy, Thourani, Tang, Hahn, Adams) From Allina Health
Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis
(P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W.,
N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ
(H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.),
Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center,
Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks
(S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in
California; Kansas University Medical Center, Kansas City (P.T., G.Z.);
St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton,
ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC
(J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical
Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and
New York-Presbyterian Columbia University Medical Center (R.T.H.), New
York - all in New York; Northwestern University, Chicago (P.M.); and
Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
Publisher
NLM (Medline)
Abstract
BACKGROUND: Severe tricuspid regurgitation is a debilitating condition
that is associated with substantial morbidity and often with poor quality
of life. Decreasing tricuspid regurgitation may reduce symptoms and
improve clinical outcomes in patients with this disease. METHOD(S):
We conducted a prospective randomized trial of percutaneous tricuspid
transcatheter edge-to-edge repair (TEER) for severe tricuspid
regurgitation. Patients with symptomatic severe tricuspid regurgitation
were enrolled at 65 centers in the United States, Canada, and Europe and
were randomly assigned in a 1:1 ratio to receive either TEER or medical
therapy (control). The primary end point was a hierarchical composite that
included death from any cause or tricuspid-valve surgery; hospitalization
for heart failure; and an improvement in quality of life as measured with
the Kansas City Cardiomyopathy Questionnaire (KCCQ), with an improvement
defined as an increase of at least 15 points in the KCCQ score (range, 0
to 100, with higher scores indicating better quality of life) at the
1-year follow-up. The severity of tricuspid regurgitation and safety were
also assessed. RESULT(S): A total of 350 patients were enrolled; 175
were assigned to each group. The mean age of the patients was 78 years,
and 54.9% were women. The results for the primary end point favored the
TEER group (win ratio, 1.48; 95% confidence interval, 1.06 to 2.13;
P=0.02). The incidence of death or tricuspid-valve surgery and the rate of
hospitalization for heart failure did not appear to differ between the
groups. The KCCQ quality-of-life score changed by a mean (+/-SD) of
12.3+/-1.8 points in the TEER group, as compared with 0.6+/-1.8 points in
the control group (P<0.001). At 30 days, 87.0% of the patients in the TEER
group and 4.8% of those in the control group had tricuspid regurgitation
of no greater than moderate severity (P<0.001). TEER was found to be safe;
98.3% of the patients who underwent the procedure were free from major
adverse events at 30 days. CONCLUSION(S): Tricuspid TEER was safe for
patients with severe tricuspid regurgitation, reduced the severity of
tricuspid regurgitation, and was associated with an improvement in quality
of life. (Funded by Abbott; TRILUMINATE Pivotal ClinicalTrials.gov number,
NCT03904147.). Copyright © 2023 Massachusetts Medical Society.

<103>
Accession Number
640510265
Title
Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients.
Source
The New England journal of medicine. (no pagination), 2023. Date of
Publication: 04 Mar 2023.
Author
Nissen S.E.; Lincoff A.M.; Brennan D.; Ray K.K.; Mason D.; Kastelein
J.J.P.; Thompson P.D.; Libby P.; Cho L.; Plutzky J.; Bays H.E.; Moriarty
P.M.; Menon V.; Grobbee D.E.; Louie M.J.; Chen C.-F.; Li N.; Bloedon L.;
Robinson P.; Horner M.; Sasiela W.J.; McCluskey J.; Davey D.;
Fajardo-Campos P.; Petrovic P.; Fedacko J.; Zmuda W.; Lukyanov Y.;
Nicholls S.J.
Institution
(Nissen, Lincoff, Brennan, Ray, Mason, Kastelein, Thompson, Libby, Cho,
Plutzky, Bays, Moriarty, Menon, Grobbee, Louie, Chen, Li, Bloedon,
Robinson, Horner, Sasiela, McCluskey, Davey, Fajardo-Campos, Petrovic,
Fedacko, Zmuda, Lukyanov, Nicholls) From the Cleveland Clinic, Cleveland
(S.E.N., A.M.L., D.B., D.M., L.C., V.M., J.M., D.D.); Imperial College
London, London (K.K.R.); University of Amsterdam Academic Medical Center,
Amsterdam (J.J.P.K.), and University Medical Center Utrecht, Utrecht
(D.E.G.) - both in the Netherlands; Hartford Hospital, Hartford, CT
(P.D.T.); Brigham and Women's Hospital, Harvard Medical School, Boston
(P.L., J.P.); Louisville Metabolic and Atherosclerosis Research Center,
Louisville, KY (H.E.B.); University of Kansas Medical Center, Kansas City
(P.M.M.); Esperion Therapeutics, Ann Arbor, MI (M.J.L., C.-F.C., N.L.,
L.B., P.R., M.H., W.J.S.); Centro de Investigacion Cardiovascular y
Metabolica, Tijuana, Mexico (P.F.-C.); General Hospital Sveti Luka,
Smederevo, Serbia (P.P.); Center of Clinical and Preclinical Research
Medipark, Pavol Jozef Safarik University, Kosice, Slovakia (J.F.);
Medicome, Oswiecim, Poland (W.Z.); Pavlov First St. Petersburg State
Medical University, St. Petersburg, Russia (Y.L.); and Victorian Heart
Institute, Monash University, Melbourne, VIC, Australia (S.J.N.)
Publisher
NLM (Medline)
Abstract
BACKGROUND: Bempedoic acid, an ATP citrate lyase inhibitor, reduces
low-density lipoprotein (LDL) cholesterol levels and is associated with a
low incidence of muscle-related adverse events; its effects on
cardiovascular outcomes remain uncertain. METHOD(S): We conducted a
double-blind, randomized, placebo-controlled trial involving patients who
were unable or unwilling to take statins owing to unacceptable adverse
effects ("statin-intolerant" patients) and had, or were at high risk for,
cardiovascular disease. The patients were assigned to receive oral
bempedoic acid, 180 mg daily, or placebo. The primary end point was a
four-component composite of major adverse cardiovascular events, defined
as death from cardiovascular causes, nonfatal myocardial infarction,
nonfatal stroke, or coronary revascularization. RESULT(S): A total of
13,970 patients underwent randomization; 6992 were assigned to the
bempedoic acid group and 6978 to the placebo group. The median duration of
follow-up was 40.6 months. The mean LDL cholesterol level at baseline was
139.0 mg per deciliter in both groups, and after 6 months, the reduction
in the level was greater with bempedoic acid than with placebo by 29.2 mg
per deciliter; the observed difference in the percent reductions was 21.1
percentage points in favor of bempedoic acid. The incidence of a primary
end-point event was significantly lower with bempedoic acid than with
placebo (819 patients [11.7%] vs. 927 [13.3%]; hazard ratio, 0.87; 95%
confidence interval [CI], 0.79 to 0.96; P=0.004), as were the incidences
of a composite of death from cardiovascular causes, nonfatal stroke, or
nonfatal myocardial infarction (575 [8.2%] vs. 663 [9.5%]; hazard ratio,
0.85; 95% CI, 0.76 to 0.96; P=0.006); fatal or nonfatal myocardial
infarction (261 [3.7%] vs. 334 [4.8%]; hazard ratio, 0.77; 95% CI, 0.66 to
0.91; P=0.002); and coronary revascularization (435 [6.2%] vs. 529 [7.6%];
hazard ratio, 0.81; 95% CI, 0.72 to 0.92; P=0.001). Bempedoic acid had no
significant effects on fatal or nonfatal stroke, death from cardiovascular
causes, and death from any cause. The incidences of gout and
cholelithiasis were higher with bempedoic acid than with placebo (3.1% vs.
2.1% and 2.2% vs. 1.2%, respectively), as were the incidences of small
increases in serum creatinine, uric acid, and hepatic-enzyme levels.
 CONCLUSION(S): Among statin-intolerant patients, treatment with
bempedoic acid was associated with a lower risk of major adverse
cardiovascular events (death from cardiovascular causes, nonfatal
myocardial infarction, nonfatal stroke, or coronary revascularization).
(Funded by Esperion Therapeutics; CLEAR Outcomes ClinicalTrials.gov
number, NCT02993406.). Copyright © 2023 Massachusetts Medical
Society.

<104>
Accession Number
2022732976
Title
Parkinson's disease and cardiovascular involvement: Edifying insights
(review).
Source
Biomedical Reports. 18(3) (no pagination), 2023. Article Number: 25. Date
of Publication: March 2023.
Author
Grosu L.; Grosu A.I.; Crisan D.; Zlibut A.; Perju-Dumbrava L.
Institution
(Grosu, Perju-Dumbrava) Department of Neurology, Iuliu Hatieganu
University of Medicine and Pharmacy, Cluj-Napoca 400012, Romania
(Grosu) Department of Neurology, Municipal Clinical Hospital, Cluj-Napoca
400139, Romania
(Grosu, Crisan, Zlibut) Department of Internal Medicine, 5th Medical
Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca
400139, Romania
(Grosu) Departments of Cardiology, Cluj-Napoca 400139, Romania
(Crisan) Internal Medicine, Municipal Clinical Hospital, Cluj-Napoca
400139, Romania
(Zlibut) Department of Cardiology, Emergency Clinical Hospital of
Bucharest, Bucharest 014461, Romania
Publisher
Spandidos Publications
Abstract
Parkinson's disease (PD) is one of the most common neurodegenerative
illnesses, and is a major healthcare burden with prodigious consequences
on life-quality, morbidity, and survival. Cardiovascular diseases are the
leading cause of mortality worldwide and growing evidence frequently
reports their co-existence with PD. Cardiac dysautonomia due to autonomic
nervous system malfunction is the most prevalent type of cardiovascular
manifestation in these patients, comprising orthostatic and postprandial
hypotension, along with supine and postural hypertension. Moreover, many
studies have endorsed the risk of patients with PD to develop ischemic
heart disease, heart failure and even arrhythmias, but the underlying
mechanisms are not entirely clear. As importantly, the medication used in
treating PD, such as levodopa, dopamine agonists or anticholinergic
agents, is also responsible for cardiovascular adverse reactions, but
further studies are required to elucidate the underlying mechanisms. The
purpose of this review was to provide a comprehensive overview of current
available data regarding the overlapping cardiovascular disease in
patients with PD. Copyright © 2023, Spandidos Publications. All
rights reserved.

<105>
Accession Number
2019399671
Title
Tipping the balance: A systematic review and meta-ethnography to unfold
the complexity of surgical antimicrobial prescribing behavior in hospital
settings.
Source
PLoS ONE. 17(7 July) (no pagination), 2022. Article Number: e0271454. Date
of Publication: July 2022.
Author
Parker H.; Frost J.; Day J.; Bethune R.; Kajamaa A.; Hand K.; Robinson S.;
Mattick K.
Institution
(Parker) Pharmacy Department, Royal Devon University Healthcare NHS
Foundation Trust, Exeter, United Kingdom
(Frost, Day, Robinson, Mattick) College of Medicine and Health, University
of Exeter, Exeter, United Kingdom
(Bethune) Royal Devon University Healthcare NHS Foundation Trust, Exeter,
United Kingdom
(Kajamaa) Faculty of Education, University of Oulu, Oulu, Finland
(Hand) Medical Directorate, NHS England & NHS Improvement, London, United
Kingdom
Publisher
Public Library of Science
Abstract
Surgical specialties account for a high proportion of antimicrobial use in
hospitals, and misuse has been widely reported resulting in unnecessary
patient harm and antimicrobial resistance. We aimed to synthesize
qualitative studies on surgical antimicrobial prescribing behavior, in
hospital settings, to explain how and why contextual factors act and
interact to influence practice. Stakeholder engagement was integrated
throughout to ensure consideration of varying interpretive repertoires and
that the findings were clinically meaningful. The meta-ethnography
followed the seven phases outlined by Noblit and Hare. Eight databases
were systematically searched without date restrictions. Supplementary
searches were performed including forwards and backwards citation chasing
and contacting first authors of included papers to highlight further work.
Following screening, 14 papers were included in the meta-ethnography.
Repeated reading of this work enabled identification of 48 concepts and
subsequently eight overarching concepts: hierarchy; fear drives action;
deprioritized; convention trumps evidence; complex judgments;
discontinuity of care; team dynamics; and practice environment. The
overarching concepts interacted to varying degrees but there was no
consensus among stakeholders regarding an order of importance. Further
abstraction of the overarching concepts led to the development of a
conceptual model and a line-of-argument synthesis, which posits that
social and structural mediators influence individual complex antimicrobial
judgements and currently skew practice towards increased and unnecessary
antimicrobial use. Crucially, our model provides insights into how we
might 'tip the balance' towards more evidence-based antimicrobial use.
Currently, healthcare workers deploy antimicrobials across the surgical
pathway as a safety net to allay fears, reduce uncertainty and risk, and
to mitigate against personal blame. Our synthesis indicates that
prescribing is unlikely to change until the social and structural
mediators driving practice are addressed. Furthermore, it suggests that
research specifically exploring the context for effective and sustainable
quality improvement stewardship initiatives in surgery is now
urgent. Copyright © 2022 Parker 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.

<106>
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. 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. 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. Copyright © 2022 The
Author(s).

<107>
Accession Number
2021647102
Title
COP27 Climate Change Conference Editorial, TAVI, SGLT2 inhibitors.
Source
Anatolian Journal of Cardiology. 26(11) (pp 798), 2022. Date of
Publication: 18 Dec 2022.
Author
Erol C.
Institution
(Erol) AnkaraTurkey
Publisher
Turkish Society of Cardiology

<108>
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. 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. 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. 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. Copyright ©
2023, The Author(s), under exclusive licence to The Japanese Association
for Thoracic Surgery.

<109>
[Use Link to view the full text]
Accession Number
633337562
Title
Long-Axis In-Plane Approach Versus Short-Axis Out-of-Plane Approach for
Ultrasound-Guided Central Venous Catheterization in Pediatric Patients: A
Randomized Controlled Trial*.
Source
Pediatric Critical Care Medicine. 21(11) (pp E996-E1001), 2020. Date of
Publication: 01 Nov 2020.
Author
Takeshita J.; Tachibana K.; Nakajima Y.; Nagai G.; Fujiwara A.; Hamaba H.;
Matsuura H.; Yamashita T.; Shime N.
Institution
(Takeshita, Tachibana, Nagai, Fujiwara, Hamaba, Matsuura, Yamashita)
Department of Anesthesiology, Osaka Prefectural Hospital Organization,
Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
(Takeshita, Nakajima) Department of Anesthesiology, Kansai Medical
University Hospital, Hirakata, Osaka, Japan
(Shime) Department of Emergency and Critical Care Medicine, Institute of
Biomedical & Health Sciences, Hiroshima University, Minami-ku, Hiroshima,
Japan
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: The aim of this study was to compare the occurrence of
posterior wall puncture between the long-axis in-plane and the short-axis
out-of-plane approaches in a randomized controlled trial of pediatric
patients who underwent cardiovascular surgery under general anesthesia.
 Design(s): Prospective randomized controlled trial. Setting(s):
Operating room of Osaka Women's and Children's Hospital. Patient(s):
Pediatric patients less than 5 years old who underwent cardiovascular
surgery. Intervention(s): Ultrasound-guided central venous
catheterization using the long-axis in-plane approach and short-axis
out-of-plane approach. Measurements and Main Results: The occurrence
of posterior wall puncture was compared between the long-axis in-plane and
short-axis out-of-plane approaches for ultrasound-guided central venous
catheterization. Patients were randomly allocated to a long-axis group or
a short-axis group and underwent ultrasound-guided central venous
catheterization in the internal jugular vein using either the long-axis
in-plane approach (long-axis group) or the short-axis out-of-plane
approach (short-axis group). After exclusion, 97 patients were allocated
to the long-axis (n = 49) or short-axis (n = 48) groups. Posterior wall
puncture rates were 8.2% (4/49) and 39.6% (19/48) in the long-axis and
short-axis groups, respectively (relative risk, 0.21; 95% CI, 0.076-0.56;
p = 0.0003). First attempt success rates were 67.3% (33/49) and 64.6%
(31/48) in the long-axis and short-axis groups, respectively (relative
risk, 1.04; 95% CI, 0.78-1.39; p = 0.77). Overall success rates within 20
minutes were 93.9% (46/49) and 93.8% (45/48) in the long-axis and
short-axis groups, respectively (relative risk, 0.99; 95% CI, 0.90-1.11; p
= 0.98). Conclusion(s): The long-axis in-plane approach for
ultrasound-guided central venous catheterization is a useful technique for
avoiding posterior wall puncture in pediatric patients, compared with the
short-axis out-of-plane approach. Copyright © 2020 Lippincott
Williams and Wilkins. All rights reserved.

<110>
Accession Number
2023161452
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 (United States). 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
Lippincott Williams and Wilkins
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.
 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. Result(s): The results of
this meta-analysis will be submitted to a peer-reviewed journal for
publication. Conclusion(s): This meta-analysis will evaluate the
efficacy and safety of dexmedetomidine in patients undergoing cardiac
surgery with cardiopulmonary bypass. Copyright © 2023 Lippincott
Williams and Wilkins. All rights reserved.

<111>
[Use Link to view the full text]
Accession Number
2023123837
Title
Hematic Antegrade Repriming Reduces Emboli on Cardiopulmonary Bypass: A
Randomized Controlled Trial.
Source
ASAIO Journal. 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) 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, Spain
(Morillo-Cuadrado) Network-Based Biomedical Research Consortium, Area of
Mental Health (CiberSAM), Carlos III Health Institute, 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, UZ Gasthuisberg, KU
Leuven, Belgium
(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
(Salmeron Martinez) CIBER Epidemiology and Public Health, CIBERESP,
Madrid, Spain
Publisher
Lippincott Williams and Wilkins
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 300 ml. 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] = 0.28 ml vs. HAR = 0.08 ml; p = 0.004) and
high embolic volume exposure (>1 ml) 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. Copyright © 2023 Lippincott
Williams and Wilkins. All rights reserved.

<112>
Accession Number
2023169227
Title
A Protocol to help the Prevent Postoperative Delirium in Cardiac Surgery.
Source
Trauma Monthly. 27(6) (pp 643-660), 2022. Date of Publication: November
2022.
Author
Moradi A.; Azimi A.V.; Moradian S.T.; Motamedi M.H.K.; Zavareh S.M.A.;
Mahmoudi H.
Institution
(Moradi) Students Research Center, Nursing Faulty, Baqiyatallah University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Azimi, Mahmoudi) Trauma research center, Nursing Faulty Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Moradian, Motamedi, Zavareh) Atherosclerosis Research Center,
Baqiyatallah University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Official Publication of the National Center for Trauma Research
Abstract
Introduction: Postoperative delirium (POD), a highly prevalent syndrome
after cardiac surgery, is characterized by a rapid decline in brain
function with inattention, disorganized thinking, and an altered level of
consciousness. It is clinically important because it is associated with
severe negative consequences. This study aimed to develop a protocol to
help the prevent postoperative delirium in cardiac surgery.
 Method(s): This multiphase design study consisted of two phases. The
first phase was a scoping review to identify risk factors associated with
POD in cardiac surgery. The second phase included three consecutive rounds
of expert panels based on a Delphi method to obtain consensus from experts
to determine and use these risk factors to develop a protocol. A scoping
review was performed using the Arksey and O'Malley framework. Literature
searches using PubMed/MEDLINE, Scopus, Web of Science, and ProQuest
databases were conducted. Two independent investigators performed the
selection of studies and data extraction via checklists. In the second
phase, based on two Delphi rounds, risk factors with a significant effect
on postoperative delirium in cardiac surgery were identified according to
the consensus of experts (>=75% agreement). In the third round of the
expert panel, only modifiable factors that could improve based on existing
conditions and context were used to develop a protocol. Result(s):
The final protocol was developed based on 20 pharmacological and
non-pharmacological interventions to prevent POD in three stages pre-,
intra-, and post-cardiac surgery. Conclusion(s): Interventions such
as prescribing melatonin instead of benzodiazepines, dexmedetomidine
treatment, preoperative education patients that were candidated for
cardiac surgery, training nurses, use of arterial filters and pre-bypass
filters in the perfusion circuit, prevention of intraoperative
hyperglycemia, cerebral oximetry and temperature management during CPB and
some interventions in ICU-OH can reduce POD in cardiac
surgery. Copyright © 2021 The Author(s).

<113>
Accession Number
2021904273
Title
A survey of solid organ transplant recipient attitudes and concerns
regarding contraception and pregnancy.
Source
Clinical Transplantation. (no pagination), 2023. Date of Publication:
2023.
Author
McIntosh T.; Puerzer P.; Li M.T.; Malat G.; Sammons C.; Norris M.; Fallah
T.; Trofe-Clark J.; DuBois J.M.; Iltis A.; Mohan S.; Sawinski D.
Institution
(McIntosh, DuBois) Bioethics Research Center, Department of Medicine,
Washington University School of Medicine, St. Louis, MO, United States
(Puerzer) School of Arts and Sciences, University of Pennsylvania,
Philadelphia, PA, United States
(Li, Mohan) Department of Medicine, Division of Nephrology, Columbia
University Vagelos College of Physicians and Surgeons, NY, United States
(Malat, Sammons, Norris, Fallah, Trofe-Clark) Department of Pharmacy,
Hospital of the University of Pennsylvania, Philadelphia, PA, United
States
(Trofe-Clark) Renal, Electrolyte, and Hypertension Division, Perelman
School of Medicine, University of Pennsylvania, Philadelphia, PA, United
States
(Trofe-Clark) Department of Surgery, Division of Transplantation, Perelman
School of Medicine, University of Pennsylvania, PA, United States
(Iltis) Center for Bioethics, Health and Society, Wake Forest University,
Winston-Salem, NC, United States
(Sawinski) Weill Cornell Medical College, Department of Medicine, Division
of Nephrology and Transplantation, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Many women who are solid organ transplant (SOT) recipients
wish to have children after transplantation. Contraception is an important
component of post-transplant planning and care, given the increased risk
associated with post-transplant pregnancies. We sought to understand
patient attitudes and concerns about post-transplant contraception and
pregnancy. Method(s): Following a comprehensive literature review,
our team developed a survey that was administered to female SOT recipients
of childbearing age. We used descriptive and inferential statistics to
characterize participant views. Result(s): A total of 243 transplant
recipients completed the survey (80.7% response rate). The mean age of
respondents was 37.5 years (+/-8.1 years), 66.7% were kidney recipients,
and 40.7% were within the first year after transplant. The most common
concerns among respondents included fetal and maternal health
complications. Participants generally did not agree that transplant
recipients should be advised to avoid pregnancy. There was strong support
for shared decision-making about pregnancy after transplantation.
 Conclusion(s): Understanding patient perspectives can help transplant
providers make better care recommendations and support patient autonomy in
reproductive decisions post-transplant. Given that there are some
differences in views by transplant type, individualized conversations
between patients and providers are needed. Copyright © 2023 John
Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

<114>
Accession Number
640496782
Title
Eliminating Medication Copayments for Low-income Older Adults at High
Cardiovascular Risk: A Randomized Controlled Trial.
Source
Circulation. (no pagination), 2023. Date of Publication: 05 Mar 2023.
Author
Campbell D.J.T.; Mitchell C.; Hemmelgarn B.R.; Tonelli M.; Faris P.; Zhang
J.; Tsuyuki R.T.; Fletcher J.; Au F.; Klarenbach S.; Exner D.V.; Manns
B.J.
Institution
(Campbell) Department of Community Health Sciences, Cumming School of
Medicine, University of Calgary, Calgary, Alberta, Canada; Department of
Medicine, Cumming School of Medicine, University of Calgary, Calgary,
Alberta, Canada; Department of Cardiac Sciences, Cumming School of
Medicine, University of Calgary, Calgary, Alberta, Canada; ; Libin
Cardiovascular Institute, University of Calgary, Calgary, Canada; O'Brien
Institute for Public Health, University of Calgary, Calgary, Canada
(Mitchell) Pharmaceutical Branch, Alberta Health, Government of Alberta,
Edmonton, AB, Canada
(Hemmelgarn, Tsuyuki, Klarenbach) Department of Medicine, Faculty of
Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
(Tonelli) Department of Community Health Sciences, Cumming School of
Medicine, University of Calgary, Calgary, Alberta, Canada; Department of
Medicine, Cumming School of Medicine, University of Calgary, Calgary,
Alberta, Canada; Libin Cardiovascular Institute, Cumming School of
Medicine, University of Calgary, Calgary, Alberta, Canada; O'Brien
Institute of Public Health, Cumming School of Medicine, University of
Calgary, Calgary, Alberta, Canada
(Faris) Department of Community Health Sciences, Cumming School of
Medicine, University of Calgary, Calgary, Alberta, Canada; Data
Integration, Management, and Reporting, Analytics, Alberta Health
Services, Edmonton, Alberta, Canada
(Zhang, Fletcher, Exner) Department of Community Health Sciences, Cumming
School of Medicine, University of Calgary, Calgary, AB, Canada
(Au) Department of Medicine, Cumming School of Medicine, University of
Calgary, Calgary, AB, Canada
(Manns) Department of Cardiac Sciences, Cumming School of Medicine,
University of Calgary, Calgary, Alberta, Canada; Libin Cardiovascular
Institute, Cumming School of Medicine, University of Calgary, Calgary,
Alberta, Canada
Publisher
NLM (Medline)
Abstract
Background: One in eight people with heart disease has poor medication
adherence that, in part, is related to copayment costs. This study tested
whether eliminating copayments for high-value medications among low-income
older adults at high cardiovascular risk would improve clinical outcomes.
 Method(s): This randomized 2x2 factorial trial studied 2 distinct
interventions in Alberta, Canada: eliminating copayments for high value
preventive medications and a self-management education and support program
(reported separately). The findings for the first intervention, which
waived the usual 30% copayment on 15 medication classes commonly used to
reduce cardiovascular events, compared to usual copayment, is reported
herein. The primary outcome was the composite of death, myocardial
infarction, stroke, coronary revascularization, and cardiovascular-related
hospitalizations over a three-year followup. Rates of the primary outcome
and its components were compared using negative binomial regression.
Secondary outcomes included quality of life(EQ-5D index score), medication
adherence, and overall healthcare costs. Result(s): 4,761 individuals
were randomized and followed for a median of 36 months. There was no
evidence of statistical interaction(p=0.99) or of a synergistic effect
between the two interventions in the factorial trial with respect to the
primary outcome, which allowed us to evaluate the effect of each
intervention separately. The rate of the primary outcome was not reduced
by copayment elimination, (521 vs 533 events, incidence rate ratio(IRR)
0.84, 95%CI 0.66 to 1.07, p=0.162). The IRR for non-fatal MI, non-fatal
stroke, and cardiovascular death (0.97; 95% CI 0.67 to 1.39), death (0.94
(95%CI 0.80 to 1.11) and for cardiovascular-related hospitalizations (0.78
(95%CI 0.57 to 1.06) did not differ between groups. No significant
between-group changes in quality of life over time were observed(mean
difference 0.012, 95%CI -0.006 to 0.030, p=0.19). The proportion of
participants who were adherent to statins was 0.72 vs 0.69 for the
copayment elimination vs usual copayment groups, respectively(mean
difference 0.03, 95% CI 0.006-0.06, p=0.016). Overall adjusted health care
costs did not differ ($3,575, 95%CI -605 to 7,168, p=0.098).
 Conclusion(s): In low-income adults at high cardiovascular risk,
eliminating copayments (average $35 a month) did not improve clinical
outcomes or reduce healthcare costs, despite a modest improvement in
adherence to medications.

<115>
Accession Number
640496493
Title
Self-management Support Using Advertising Principles for Older Low Income
Adults at High Cardiovascular Risk: a Randomized Controlled Trial.
Source
Circulation. (no pagination), 2023. Date of Publication: 05 Mar 2023.
Author
Campbell D.J.T.; Tonelli M.; Hemmelgarn B.R.; Faris P.; Zhang J.; Au F.;
Tsuyuki R.T.; Mitchell C.; Pannu R.; Campbell T.; Ivers N.; Fletcher J.;
Exner D.V.; Manns B.J.
Institution
(Campbell) Department of Community Health Sciences, Cumming School of
Medicine, University of Calgary, Calgary, Alberta, Canada; Department of
Medicine, Cumming School of Medicine, University of Calgary, Calgary,
Alberta, Canada; Department of Cardiac Sciences, Cumming School of
Medicine, University of Calgary, Calgary, Alberta, Canada; O'Brien
Institute for Public Health, University of Calgary, Calgary, Canada; Libin
Cardiovascular Institute, University of Calgary, Calgary, Canada
(Tonelli, Manns) Department of Community Health Sciences, Cumming School
of Medicine, University of Calgary, Calgary, Alberta, Canada; Department
of Medicine, Cumming School of Medicine, University of Calgary, Calgary,
Alberta, Canada; O'Brien Institute for Public Health, University of
Calgary, Calgary, Canada; Libin Cardiovascular Institute, University of
Calgary, Calgary, Canada
(Hemmelgarn) Department of Medicine, Faculty of Medicine and Dentistry,
University of Alberta, Edmonton, AB, Canada
(Faris) Department of Community Health Sciences, Cumming School of
Medicine, University of Calgary, Calgary, Alberta, Canada; Data
Integration, Management, and Reporting, Analytics, Alberta Health
Services, Edmonton, Alberta, Canada
(Zhang, Au, Fletcher) Department of Community Health Sciences, Cumming
School of Medicine, University of Calgary, Calgary, AB, Canada
(Tsuyuki) Department of Medicine, Faculty of Medicine and Dentistry,
University of Alberta, Edmonton, Alberta, Canada; Department of
Pharmacology, Faculty of Medicine and Dentistry, University of Alberta.
Edmonton, Alberta. Canada
(Mitchell) Pharmaceutical and Supplementary Benefits Division, Alberta
Health, Government of Alberta, Edmonton, AB, Canada
(Pannu) Emergence Creative, New York, NY
(Campbell) Department of Psychology, Cumming School of Medicine,
University of Calgary, Calgary, AB, Canada
(Ivers) Department of Family and Community Medicine, Temerty School of
Medicine, University of Toronto, Toronto, Ontario, Canada; Women's College
Research Institute, Toronto, Ontario, Canada
(Exner) Department of Community Health Sciences, Cumming School of
Medicine, University of Calgary, Calgary, Alberta, Canada; Department of
Cardiac Sciences, Cumming School of Medicine, University of Calgary,
Calgary, Alberta, Canada; O'Brien Institute for Public Health, University
of Calgary, Calgary, Canada; Libin Cardiovascular Institute, University of
Calgary, Calgary, Canada
Publisher
NLM (Medline)
Abstract
Background: Self-management education and support (SMES) interventions
have modest effects on intermediate outcomes for those at risk of
cardiovascular disease, but few studies have measured or demonstrated an
impact on clinical endpoints. Advertising for commercial products is known
to influence behavior, but advertising principles are not typically
incorporated into SMES design. Method(s): This randomized trial
studied the impact of a novel tailored SMES program designed by an
advertising firm among a population of low-income older adults at high
cardiovascular risk in Alberta, Canada. The intervention included health
promotion messaging from a fictitious "peer" and facilitated relay of
clinical information to patients' primary care provider and pharmacist.
The primary outcome was the composite of death, myocardial infarction,
stroke, coronary revascularization, and hospitalizations for
cardiovascular-related ambulatory care-sensitive conditions. Rates of the
primary outcome and its components were compared using negative binomial
regression. Secondary outcomes included quality of life (EQ-5D index
score), medication adherence, and overall healthcare costs.
 Result(s): We randomized 4,761 individuals, with a mean age of 74.4
years, of whom 46.8% were female. There was no evidence of statistical
interaction (p=0.99) or of a synergistic effect between the two
interventions in the factorial trial with respect to the primary outcome,
which allowed us to evaluate the effect of each intervention separately.
Over a median follow-up time of 36 months, the rate of the primary outcome
was lower in the group that received SMES compared with the control group
(incidence rate ratio (IRR): 0.78, 95% confidence interval (CI):
0.61-1.00, p=0.047). No significant between-group changes in quality of
life over time were observed (mean difference 0.0001, 95%CI -0.018 to
0.018, p=0.99). The proportion of participants who were adherent to
medications was not different between the two groups (p = 0.199 for
statins, and p=0.754 for ACEi/ARBs). Overall adjusted health care costs
did not differ between those receiving SMES and the control group ($2,015,
95%CI -1,953 to 5,985, p=0.320). Conclusion(s): In low-income older
adults, a tailored SMES program using advertising principles reduced the
rate of clinical outcomes compared with usual care, though the mechanisms
of improvement are unclear and further studies are required.

<116>
Accession Number
640495867
Title
Utility of Cerebral Embolic Protection Devices in Transcatheter
Procedures: A Systematic Review and Meta-Analysis.
Source
Current problems in cardiology. (pp 101675), 2023. Date of Publication:
02 Mar 2023.
Author
Baloch Z.Q.; Haider S.J.; Siddiqui H.F.; Shaikh F.N.; Shah B.U.D.; Ansari
M.M.; Qintar M.
Institution
(Baloch) Michigan State University/Sparrow Hospital Lansing, MI, United
States
(Haider) University of Alabama, Birmingham, AL, United States
(Siddiqui, Shaikh) Department of Medicine, Dow University of Health
Sciences
(Shah) Pakistan Institute of Medical Sciences - Islamabad, Pakistan
(Ansari) Texas Tech University Health Sciences Center
(Qintar) Michigan State University/Sparrow Hospital Lansing, MI, United
States
Publisher
NLM (Medline)
Abstract
BACKGROUND: With the emergence of the largest randomized control trial to
date - the Stroke Protection With Sentinel During Transcatheter Aortic
Valve Replacement (PROTECTED TAVR) study- we sought to conduct an updated
meta-analyses to evaluate the utility of CEP devices on both clinical
outcomes and neuroimaging parameters. METHOD(S): Electronic databases
were queried through November 2022 for clinical trials comparing the
utility of Cerebral Embolic Protection (CEP) devices in Transcatheter
Aortic Valve Replacement (TAVR) with non-CEP TAVR procedures.
Meta-analyses were performed using the generic inverse variance technique,
and a random-effects model, and results are presented as weighted mean
differences (WMD) for continuous outcomes, and hazard ratios (HR) for
dichotomous outcomes. Outcomes of interest included stroke, disabling
stroke, non-disabling stroke, bleeding, mortality, vascular complications,
new ischemic lesions, acute kidney injury (AKI) and total lesion volume.
 RESULT(S): 13 studies (8 RCTs, 5 observational studies) consisting of
128,471 patients were included in the analysis. Results from our
meta-analyses showed a significant reduction in stroke (OR: 0.84 [0.74 -
0.95]; P < 0.01; I2=0%), disabling stroke (OR: 0.37 [0.21 - 0.67]; P <
0.01; I2=0%) and bleeding events (OR: 0.91 [0.83 - 0.99]; P = 0.04; I2=0%)
through CEP device use in TAVR. The use of CEP devices had no significant
impact on non-disabling stroke (OR: 0.94 [0.65 - 1.37]; P < 0.01; I2=0%),
mortality (OR: 0.78 [0.53 - 1.14]; P < 0.01; I2=17%), vascular
complications (OR: 0.99 [0.63 - 1.57]; P < 0.01; I2=28%), AKI (OR: 0.78
[0.46 - 1.32]; P < 0.01; I2=0%), new ischemic lesions (MD: -1.72 [-4.01,
0.57]; p < 0.001; I2=95%) and total lesion volume (MD: -46.11 [-97.38,
5.16]; p < 0.001; I2=81%). CONCLUSION(S): The results suggest that
CEP device use was associated with a lower risk of disabling stroke and
bleeding events in patients undergoing TAVR. Copyright © 2023
Elsevier Ltd. All rights reserved.

<117>
Accession Number
640494798
Title
Within and beyond 12-month efficacy and safety of antithrombotic
strategies in patients with established coronary artery disease. Two
companion network meta-analyses of the 2022 joint clinical consensus
statement of the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), European Association for Acute CardioVascular Care
(ACVC) and European Association of Preventive Cardiology (EAPC).
Source
European heart journal. Cardiovascular pharmacotherapy. (no pagination),
2023. Date of Publication: 03 Mar 2023.
Author
Navarese E.P.; Landi A.; Oliva A.; Piccolo R.; Aboyans V.; Angiolillo D.;
Atar D.; Capodanno D.; Fox K.A.A.; Halvorsen S.; James S.; Juni P.;
Kunadian V.; Leonardi S.; Mehran R.; Montalescot G.; Niebauer J.; Price
S.; Storey R.F.; Voller H.; Vranckx P.; Windecker S.; Valgimigli M.
Institution
(Navarese) Department of Cardiology and Internal Medicine, Nicolaus
Copernicus University, Poland and SIRIO MEDICINE research network,
Bydgoszcz, Poland
(Landi, Valgimigli) Division of Cardiology, Cardiocentro Ticino Institute,
Ente Ospedaliero Cantonale, Via Tesserete 48, Lugano 6900, Switzerland
(Oliva) Department of Biomedical Sciences, Humanitas University, Italy
(Piccolo) Department of Advanced Biomedical Sciences, Division of
Cardiology, University of Naples Federico II, Naples, Italy
(Aboyans) Department of Cardiology, Dupuytren University Hospital,
University of Limoges, Martin Luther King ave, Limoges 87042, France
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine-Jacksonville, FL 32209, 655 West 8th Street, Jacksonville, United
States
(Atar) Oslo University Hospital Ulleval, Department of Cardiology,
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
(Capodanno) Division of Cardiology, Azienda Ospedaliero Universitaria
Policlinico "G. Rodolico-San Marco", University of Catania, Via Santa
Sofia, Catania 95123, Italy
(Fox) Centre for Cardiovascular Science, University of Edinburgh Division
of Clinical and Surgical Sciences, Edinburgh, United Kingdom
(Halvorsen) Institute of Clinical Medicine, University of Oslo, Norway and
Department of Cardiology, Oslo University Hospital Ulleval, Blindern ,P.O.
Box 1078, Oslo N-0316, Norway
(James) Department of Medical Sciences, Uppsala Clinical Research Center,
Uppsala University, Uppsala 751 85, Sweden
(Juni) Applied Health Research Centre, Li Ka Shing Knowledge Institute of
St Michael's Hospital, Department of Medicine and Institute of Health
Policy, Management and Evaluation, University of Toronto, Canada
(Kunadian) Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne
Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
(Leonardi) University of Pavia and Coronary Care Unit, Fondazione IRCCS
Policlinico San Matteo, Pavia, Italy
(Mehran) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, NY, United States
(Montalescot) ACTION Group, INSERM UMRS 1166, Institut de Cardiologie,
Hopital Pitie-Salpetriere, Sorbonne Universite, Assistance
Publique-Hopitaux de Paris, Paris, France
(Niebauer) Institute of Sports Medicine, Prevention and Rehabilitation,
Paracelsus Medical University Salzburg, Salzburg 5020, Austria
(Price) Royal Brompton Hospital, National Heart and Lung Institute,
Imperial College, London, United Kingdom
(Storey) Cardiovascular Research Unit, Department of Infection, Immunity &
Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
(Voller) Department of Rehabilitation Medicine, Faculty of Health Science
Brandenburg, University of Potsdam, Potsdam, Germany
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Hasselt, Belgium; Faculty of Medicine and Life
Sciences, Hasselt University, Hasselt, Belgium
(Windecker) Department of Cardiology, Inselspital, University of Bern,
Bern, Switzerland
Publisher
NLM (Medline)
Abstract
AIMS: To appraise all available antithrombotic treatments within or after
12 months following coronary revascularization and/or acute coronary
syndrome in two network meta-analyses (NMA). METHODS AND RESULTS:
Forty-three (N = 189 261) trials within 12 months and 19 (N = 139 086
patients) trials beyond 12 months were included for efficacy/safety
endpoints appraisal.Within 12 months, ticagrelor 90 mg bis in die (b.i.d.)
(hazard ratio [HR] 0.66; 95% confidence interval [CI]: 0.49-0.88), aspirin
and ticagrelor 90 mg (HR 0.85; 95%CI: 0.76-0.95), or aspirin, clopidogrel
and rivaroxaban 2.5 mg b.i.d. (HR 0.66; 95%CI: 0.51-0.86) were the only
treatments associated with lower cardiovascular mortality, compared with
aspirin and clopidogrel, without or with greater bleeding risk for the
first and the other treatment options, respectively.Beyond 12 months, no
strategy lowered mortality; compared with aspirin; the greatest reductions
of myocardial infarction (MI) were found with aspirin and clopidogrel (HR
0.68; 95%CI, 0.55-0.85) or P2Y12 inhibitor monotherapy (HR 0.76; 95%CI,
0.61-0.95), especially ticagrelor 90 mg (HR 0.54; 95%CI, 0.32-0.92), and
of stroke with VKA (HR, 0.56; 95%CI, 0.44-0.76) or aspirin and rivaroxaban
2.5 mg (HR, 0.58; 95%CI, 0.44-0.76). All treatments increased bleeding
except P2Y12 monotherapy, compared with aspirin. CONCLUSION(S):
Within 12 months, ticagrelor 90 mg monotherapy was the only treatment
associated with lower mortality, without bleeding risk trade-off compared
with aspirin and clopidogrel. Beyond 12 months, P2Y12 monotherapy,
especially ticagrelor 90 mg, was associated with lower MI without bleeding
trade-off; aspirin and rivaroxaban 2.5 mg most effectively reduced stroke,
with a more acceptable bleeding risk than VKA, compared with aspirin.
Registration URL: https://www.crd.york.ac.uk/PROSPERO/; Unique
identifiers: CRD42021243985 and CRD42021252398. Copyright © The
Author(s) 2023. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<118>
Accession Number
640481005
Title
Restrictive or liberal red blood cell transfusion in patients with
diabetes undergoing cardiac surgery: results from the TRICS III randomised
multinational trial.
Source
Diabetologia. Conference: 55th Annual Meeting of the European Association
for the Study of Diabetes, EASD 2019. Barcelona Spain. 62(Supplement 1)
(pp S509-S510), 2019. Date of Publication: September 2019.
Author
Mazer C.; Shehata N.; Carmona P.; Bolliger D.; Hu R.; Thorpe K.; Mistry
N.; Hare G.; Juni P.; Verma S.
Institution
(Mazer, Shehata, Thorpe, Mistry, Hare, Juni, Verma) University of Toronto,
Toronto, Canada
(Carmona) University Hospital La Fe, Valencia, Spain
(Bolliger) Universitatsspital Basel, Basel, Switzerland
(Hu) Austin Health, Heidelberg, Australia
Publisher
Springer Verlag
Abstract
Background and aims: In patients with diabetes and multi-vessel coronary
artery disease, clinical practice guidelines prioritize cardiac surgery as
the preferred revascularization strategy. Cardiac surgery also represents
one of the highest utilizers of red blood cell transfusion overall, with
recent data supporting a restrictive (versus liberal) transfusion trigger.
However, accumulating evidence suggests that the diabetic milieu is
associated with changes in red blood cell structure and function, in
addition to abnormalities in thrombo-homeostasis. This has raised concerns
about whether restrictive transfusion thresholds should also apply to
patients with diabetes undergoing cardiac surgery, and whether such an
approach leads to increased risk of adverse clinical events. Herein, we
report the analyses of the effect of diabetes in the global TRICS III
study. Material(s) and Method(s): TRICS III was a randomized
controlled noninferiority trial of restrictive transfusion (haemoglobin
[Hb] trigger <75 g/L) versus liberal (Hb trigger <95 g/L during operation
or intensive care unit stay; <85 g/L on ward) in patients undergoing
cardiac surgery with cardiopulmonary bypass and at least moderate risk of
mortality as defined by a EuroSCORE I of >=6. The primary outcome was a
composite of allcause mortality, non-fatal myocardial infarction, stroke
or renal failure with dialysis. Other outcomes included transfusion,
coronary revascularization and healthcare utilization (hospital
re-admission and emergency room visits). Result(s): From a total of
5243 patients randomized in 74 sites from 19 countries, 4860 patients were
included in the per protocol analysis population. Of the 1332 patients
with diabetes, 646 were in the restrictive group and 686 were in the
liberal group; and of the 3528 patients without diabetes, 1784 were in the
restrictive group and 1744 were in the liberal group. The presence of
diabetes did not increase red blood cell transfusion requirements. There
were no clinically significant between group differences evident for the
primary outcome (odds ratio [OR] for patients with diabetes 1.10, 95%
confidence interval [CI] 0.83, 1.45; OR for patients without diabetes
0.98, 95% CI 0.81, 1.18; p=0.556 for interaction) or for other outcomes.
The odds ratios for individual outcomes are shown in figure 1.
 Conclusion(s): In patients undergoing cardiac surgery, the presence
of diabetes did not exhibit additional meaningful risk for either red
blood cell transfusion or the composite outcome of death from any cause,
myocardial infarction, stroke or new-onset renal failure with dialysis at
6 months after surgery. We conclude that restrictive red blood cell
transfusion triggers are safe in people with diabetes undergoing cardiac
surgery.

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Sunday, March 19, 2023

EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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